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Dr. Mahantesh Karoshi - Gynaecologist

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Dr. Mahantesh Karoshi - Gynaecologist

Consultant Gynaecologist, with special interest in Fibroids,heavy periods, subfertility, HRT, PCOS, Provider of excellent service.

Individual attention, evidence based practice.Strive hard to get the best out of everything I offer and providing care with value for money

07/09/2025

My Mentor Who Shaped My Career – Prof. Louis Keith, Northwestern University Medical School, Chicago

Some encounters change the course of your life forever. For me, that moment came in 1997 — a chance meeting that turned into a lifelong mentorship and friendship.

I still remember the day vividly. I had been asked to pick up Prof. Louis Keith, a renowned figure in obstetrics from Northwestern University Medical School, Chicago, from Goa airport and drive him to my hometown, Belgaum, in India. It was a three-hour journey, and by then, I had already studied his extraordinary work and admired his contributions deeply.

During that car ride, our conversation flowed effortlessly. I told him about my dream — to one day publish a textbook, just like he had. Prof. Keith listened, encouraged me, and planted a seed of belief that day: that this dream was not only possible, but achievable. That drive marked the beginning of a wonderful friendship, one that would profoundly shape my career.

Years passed, and with Prof. Keith’s inspiration and guidance always in my heart, I pursued that dream relentlessly. In 2005, it became a reality — I published the first standalone textbook on Postpartum Haemorrhage, a project made possible through the generosity of David Bloomer, the publisher who believed in making knowledge freely available to everyone.

From there, the journey took on a life of its own. Today, over 30,000 free copies of the book have been shared worldwide, and it continues to be freely available for download and reading. The contents have formed the backbone of numerous international workshops on preventing and managing postpartum haemorrhage, helping specialists across the globe improve care and save lives.

Even today, the book remains a gold-standard reference in the field. But beyond the statistics and global impact, it represents something deeply personal — a dream fulfilled, a promise kept, and above all, the power of mentorship.

I owe an enduring debt of gratitude to Prof. Louis Keith, whose guidance, generosity, and belief in me lit the path I continue to walk. His influence is woven into every chapter of my career and every life touched through this work.

01/09/2025

What keeps me going…..

20/08/2025

Just saw my face on Channel 5 news! Catch me discussing fibroids and modern management of them

17/08/2025

💊🌙🧬 Why Fear of Hormones Matters

Across social media and in daily practice, I see more women expressing concern—or outright fear—about hormonal treatments. This trend, often called “hormonophobia,” reflects growing mistrust of therapies such as contraception, hormone replacement therapy (HRT), and fertility medications.

⸻

🗨️ So where does this fear come from?
• Side effects: Many women share real experiences of weight gain, mood changes, or irregular bleeding.
• Misinformation: Negative stories spread widely online, often without scientific evidence.
• Historical distrust: Women’s health concerns have too often been minimised in medicine, fuelling skepticism.
• The “natural” preference: The idea that hormones are “unnatural” persists, despite their essential role in the body.

⸻

🌙 Balancing Risks and Benefits

While it is true that hormonal treatments carry risks, the benefits are significant:
💊 Reliable contraception
🌙 Relief of menopausal symptoms
🧬 Support for bone, heart, and brain health
🧬 New options for fertility treatment

For many women, these benefits far outweigh the potential drawbacks.

⸻

🤝 How do we address hormonophobia?
• Listen to women’s concerns and validate their experiences.
• Provide clear explanations of risks and benefits in everyday language.
• Practice shared decision-making so choices feel collaborative, not imposed.
• Take responsibility as health professionals to counter misinformation online.

⸻

🌸 The Bigger Picture

“Hormonophobia” is not just about hormones—it highlights the importance of trust, empathy, and partnership in women’s healthcare. By engaging openly and respectfully, we can help women feel confident in making the decisions that are right for them.

⸻

👉 Have you noticed hormonophobia among your patients, colleagues, or peers?
I’d love to hear your perspective…..

15/08/2025

“Three decades,– just a few more laugh lines along the way!

📍 30’s – Ambition in full swing, fuelled by big dreams and plenty of coffee.

📍 40’s – A a little greyer, but still chasing goals with the same energy.

📍 50’s – Grateful, grounded, and smiling wider than ever – proof that life just keeps getting better.

Age changes the hair… but never the sparkle. ✨

05/08/2025

What keeps me going….

24/07/2025

Are We Going Back to Square One on Menopausal Hormone Therapy?

🔗 Original Article: American Family Physician, July 2025

For over two decades, menopausal hormone therapy (MHT) has been the subject of intense debate. First heralded as a near-panacea for aging women, then sharply criticized after the landmark Women’s Health Initiative (WHI) study, it now seems we’re facing another turning point—one that risks repeating past mistakes.

In the latest issue of American Family Physician, Dr. Adriane Fugh-Berman and Dr. Barbara Mintzes revisit the risks of MHT with a powerful editorial: “Menopausal Hormone Therapy: Limited Benefits, Significant Harms.” Their message is crystal clear: the harms of long-term MHT—such as stroke, pulmonary embolism, gallbladder disease, and increased risk of breast and ovarian cancer—are still very real and should not be ignored or downplayed.

Key takeaways:

The WHI trial, involving over 27,000 women, found increased risks of invasive breast cancer, dementia, and cardiovascular events with combined hormone therapy.

Estrogen-only therapy was linked to increased stroke and ovarian cancer risks, but not breast cancer.

Despite these findings, narratives around MHT have softened—prompting concern that risks are being trivialized.

The editorial reminds clinicians that MHT is not recommended for long-term use or for prevention of chronic disease.

Yet, the piece doesn’t deny MHT’s role in treating vasomotor symptoms and vaginal dryness. These are valid, quality-of-life issues. But the therapy should be used only at the lowest effective dose and for the shortest time necessary.

👩‍⚕️ As clinicians, we must strike a careful balance between symptom relief and long-term safety. Patients deserve full, nuanced information—not oversimplified reassurance.

Let’s not forget: the drop in MHT use after WHI findings was followed by a dramatic decline in breast cancer rates worldwide. That was no coincidence.

So, are we going back to square one?

We shouldn’t be.

23/07/2025

The Vanishing Hysterectomy?

This recent article touches on an increasingly relevant issue in gynaecological practice — the declining surgical case load.

Gone are the days when our consultants performed hysterectomies for heavy periods on patients with relatively straightforward anatomy — thin-built women with no prior surgery. It was often a “routine” operation.

Fast forward to today:
⚖️ Obesity is more common.
🔪 Caesarean deliveries and other abdominal surgeries are increasing.
🧩 And every surgical case seems more complex.

For many gynaecologists, the decision to proceed with a hysterectomy is no longer straightforward. It’s not just the surgeon — anaesthetists and theatre teams alike brace for challenges: transferring a patient with high BMI, handling distorted pelvic anatomy, and managing post-operative risks.

What’s more, the average surgical exposure for consultants is declining. It’s not just about being technically trained — it’s about regular hands-on experience. The combination of reduced case volumes and increased complexity can leave even senior consultants questioning their readiness.

And rightly so — because non-surgical options have come a long way. Women today are more informed, more empowered, and often prefer uterine-preserving choices.

This trend should push us to reflect:
👩‍⚕️ Are we doing enough to maintain surgical skills in a rapidly changing landscape?
📉 What happens when experience doesn’t keep up with case complexity?

It’s time for open conversations, structured training updates, and realistic surgical expectations in the modern gynaecology era.

Would love to hear your thoughts.

20/07/2025

An interesting insight from Sweden…

30/06/2025

New Concept for Couples Trying to Conceive Naturally

If a couple is aiming to achieve pregnancy through natural means, it’s important to focus on timing and s***m quality. For the male partner, regular ej*******on plays a key role. Ideally, this means:
• Having sexual in*******se every other day, or
• Ej*******ng every alternate day (even outside of in*******se)

Why does this matter? Regular ej*******on helps maintain healthy, good-quality s***m, which increases the chances of fertilising the egg during the fertile window.

29/06/2025

Why Do RFA Devices Need TWO Diathermy Pads, Not One?

🧐I’ve asked this question so many times.

Why does radiofrequency ablation (RFA) require two grounding pads, when standard diathermy works perfectly fine with just one?

🤔 Most couldn’t give a clear answer.

So I went digging—through vascular surgery, neurology, and liver ablation literature—and here’s what I found:

🔍 Let’s break it down simply:

🔹 Standard Diathermy (1 pad):
Think of a caesarean section. The RF energy is highly focused, with tip temperatures up to 1000°C. The heat travels in a linear path—ideal for cutting or cauterising. Quick, sharp, controlled.

🔹 RFA for Fibroids (2 pads):
Completely different goal.
Here, we’re not cutting—we’re ablating a whole fibroid (like the size of a lime or clementine).
We need a 3D, spherical zone of heat—not a line. That means even, slow, balanced energy all around the needle tip.

👥 Using two pads helps distribute the energy evenly, prevents hotspots, and ensures a proper spherical burn zone for complete fibroid necrosis.

⚡ Here’s the energy logic:

▪️ 1 pad = Linear energy = cutting/coagulating
▪️ 2 pads = Spherical energy = ablating/diffusing

Big difference in purpose = Big difference in technique.

🔥 Science Bite:

The RF probe doesn’t “burn” tissue directly.
It creates an electromagnetic field, which makes water molecules vibrate → this vibration generates heat.

☠️ At:
• 60–99°C → proteins coagulate, cells die
• 100°C → tissue chars = BAD! (Charred tissue blocks further heat), a slow rise to 100°C is fine

✅ That’s why we aim for controlled heating ( slow cooking in a 3 dimensional way)not an instant burn.

📚 So next time someone asks, you’ll know:

2 pads for RFA = precise, spherical, safe ablation.
A whole different philosophy of energy delivery.

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108 Harley Street
London
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Opening Hours

Monday	9am - 7:30pm
Tuesday	8am - 7:30pm
Wednesday	2pm - 7:30pm
Thursday	9am - 7:30pm
Friday	2pm - 7:30pm
Saturday	9am - 12:30pm

Website

https://mahanteshkaroshi.co.uk/

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A Consultant Obstetrician & Gynaecologist who brings wide and specialist skillset to the patients. I believe in educating my patients as best as I can, to contribute in achieving the best possible clinical and holistic outcomes. With the help of high level of training, holistic approach and extensive research I ensure that I am able to provide the highest standards of care and treatment to all my patients.