Thursday, March 31, 2005

Unexpressed fears

I recently saw a very smart educated woman who was worried that her periods had become very scanty. I spent a long time reassuring her that this was not a cause for concern; that a scanty period simply means that the uterine lining was thin, which is why there was not much bleeding when it shed; and that it didn't t have any sinister significance. I thought she was happy with this logical explantation, but she kept on calling repeatedly. I finally had to ask her what her anxiety was, and she told me that she was scared that the fact her periods had become scanty meant that her uterus was decaying as she was getting older , and that she wouldn't be able to conceive. I finally had to do an ultrasound scan in order to show her uterus was perfectly normal, but the moral of the story is simple: your doctor cannot read your mind, so it's much easier to tell him openly what's worrying you, so he can reassure you in terms you understand. And don't worry that the doctor may think you are "crazy" - it's highly likely that he's heard wackier worries before !


  1. savvymummy6:27 AM

    Hi DR Aniruddha, I have very short periods (1.5days) which just happened these 3 months. I can see from your blog entries that you are a very honest ivf doctor. Sometimes I feel that the questions I asked the gps and doctors here made them feel that I am asking too much or that I was asking stupid questions. I love the idea of being an informed patient. It is quite saddening that as a patient, I should be able to get answers to my questions but in the end, I had to resort to self-researching myself. That's how I stumbled upon your website.

    I hope you can shed some light to my issue. I know you probably have seen all sort of infertility patients. My hubby and I have done one cycle of ivf but did not get any pregnancy with 3 grade 2&3 embryos. Then I had a natural pregnacy but miscarriaged at 5.5weeks. Thereafter, my usual 3days period became 1.5 days. I am not sure why this happened. I am very concerned if this will cause me to be infertile cos I corelate light & short periods to thin lining and therefore low% of implantation. Could you tell me what to do? I am thinking of doing U/S and blood tests for my hormones but is there a day in my cycle (28-31days) that I should get them done? Thanks!

  2. You are a very thoughtful patient. Many infertile women do worry about the amount of their menstrual bleeding. They are worried that scanty periods could be a cause of their infertility, because of a thin uterine lining.

    However, this is usually not true. The amount of menstrual blood loss varies considerably even in fertile women. It's just that fertile women do not may much attention to their periods !

    Yes, you can do a scan to reassure yourself that all is well. The vaginal ultrasound scan on Day 10 or 11 should check for the following.

    a. ovarian volume
    b. antral follicle count
    c. uterus morphology
    d. endometrial thickness and texture

    Please send me the detailed test results and medical reports . You can scan them in as a single Word file and email them to me.

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Bombay 400 005. India
    Tel: 91-22-22151065, 22151066, 2218 3270
    FAX ( India) 91-22-22150223.

    Helping you to build your family !

    PS Watch our infertility cartoon film at

    Read our book, How to Have a Baby - A Guide for the Infertile Couple,
    online at !

    Read my blog about improving the doctor-patient
    relationship at

  3. savvymummy11:04 AM

    Hi Dr Aniruddha Malpani, thanks for replying to my query!

    I am past the 10 and 1lth day for this month. Can the scan be done between 20-22nd day? I hope to get a blood test done and I believe that has to be on day 21. If possible I would like to do the scan and blood test on the same day at the same clinic. As it is a GP clinic, I am not sure if they will write a report according to what you stated. I will try to request..the radiotherapist doesnt even communicate with me when I asked questions! And my GP just wrote 'irregular periods, period pain' on the request form, which is not what I have having at all. It's appalling how the doctors here generalise things.

    Thank you so much for your efforts as a doctor with such amazing integrity!

  4. I'd suggest you do the scan next month. It's best to do things properly to maximise chances of success.

    You might want to request the sonographer to show you the screen when they are doing the scan, so you can understand what's happening. Most doctors are quite happy to explain stuff when asked nicely !


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