Dr. Mahantesh Karoshi - Gynaecologist

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

07/08/2026

Why some fibroids are hard to visualise during hysteroscopy…

Why some fibroids are hard to visualise during HYsteroscopy…
06/08/2026

Why some fibroids are hard to visualise during HYsteroscopy…

My idea and I used AI to make slides…enjoy….• Benign in the overwhelming majority — palpitations without associated syn...
30/07/2026

My idea and I used AI to make slides…enjoy….

• Benign in the overwhelming majority — palpitations without associated syncope, chest pain, or sustained tachyarrhythmia rarely reflect structural or electrical cardiac disease in this context.
• Red flags warranting cardiology referral/ECG: sustained episodes, associated syncope/pre-syncope, chest pain, exertional onset, or a background of cardiac risk factors — worth a baseline ECG and TFTs to exclude arrhythmia and thyrotoxicosis before attributing symptoms to the menopause transition.
• HRT evidence: a systematic review looked specifically at menopausal symptom treatment options and their effect on palpitations — HRT is generally reported to improve palpitation frequency/severity in perimenopausal women, consistent with the oestrogen-stabilisation hypothesis, though robust RCT data specifically powered for palpitations as a primary endpoint remains limited.
• Postmenopausal shift in risk profile: worth noting for patient counselling that sustained lower oestrogen postmenopause is associated with increased longer-term cardiovascular risk (via lipid and endothelial effects), which is a distinct issue from the acute palpitation symptom itself.

Understanding Progestogens in HRTIf you are taking combined HRT, the progestogen component is there to protect your womb...
28/07/2026

Understanding Progestogens in HRT

If you are taking combined HRT, the progestogen component is there to protect your womb lining (endometrium) from the effects of oestrogen. Not all progestogens are equivalent in strength, and the right choice depends on your individual clinical picture.

Very strong / highly potent:

Levonorgestrel (via the LNG-IUS) and medroxyprogesterone acetate provide the most robust endometrial protection. These are often recommended if you have heavy bleeding, a higher BMI, adenomyosis, or require a higher oestrogen dose.

“There isn’t a day that goes by where I don’t reflect on having had a misdiagnosis and a near-hysterectomy.”These are a ...
11/07/2026

“There isn’t a day that goes by where I don’t reflect on having had a misdiagnosis and a near-hysterectomy.”

These are a patient’s own words, shared with her full consent, nearly a year on from her surgery.

She had been told she needed her womb removed. She didn’t. When someone finally stopped to listen, the true diagnosis came into focus — and her uterus, and a part of her life, were given back to her.

I share this not for praise, but because her message matters. Too many women are still offered hysterectomy as a first answer rather than a last resort. Uterus-sparing options exist. Second opinions exist. Being properly listened to should never be a privilege.

With heartfelt thanks to my patient for allowing me to share her words. 💛

Helping my patients with passion is the best…..
09/07/2026

Helping my patients with passion is the best…..

In loving memory of Professor Christopher Balogun-Lynch, who passed peacefully at home on 15th June 2026.To the world, h...
17/06/2026

In loving memory of Professor Christopher Balogun-Lynch, who passed peacefully at home on 15th June 2026.

To the world, he was a giant of obstetrics — the mind behind a surgical technique that has saved the lives of countless mothers facing catastrophic bleeding after childbirth.

Across continents, in operating theatres he would never visit, doctors reach for what he taught us, day in and day out.

Few people can say their work changed the course of childbirth for the entire world. He could.

To me, he was my Guru.

What I will remember most is not only his brilliance, but his extraordinary kindness.

He gave his time, his wisdom and his encouragement freely, lifting up the younger generation without ever expecting anything in return.

That generosity of spirit is rarer than any technical gift, and it shaped the doctor — and the person — I have tried to become.

Thank you, Prof. Lynch, for your guidance, your patience and your boundless generosity. The mothers whose lives continue because of you will never know your name. We who were lucky enough to learn from you will never forget it.

Rest in peace. 🕊️

With deepest respect and gratitude🙏🏽.

14/06/2026

🌱 I spotted this fallen tree with new green shoots emerging whilst hiking in Slovenia — and it reminded me of something I see in clinical practice that is far more stark: where ongoing pregnancy is at danger….

Abruptio placentae — premature separation of the placenta — and what it means for the baby.

🚨 Not all placental abruptions are equal. The degree of separation can mean the difference between foetal life or foetal death.

Here is what the evidence tells us 👇

< 30% separation
Generally survivable — but foetal distress remains possible, particularly when the bleed is retroplacental rather than marginal.

30–40% separation ⚠️
This is where we enter “severe” territory. At this level — especially with more than 60 ml of concealed bleeding— foetal death rate reaches 50%.

> 50% separation 🔴
Foetal mortality exceeds 50%. Location matters enormously: a retroplacental bleed at this level carries far greater risk than a marginal one of equivalent volume.

Near-complete or complete separation
Foetal death is almost inevitable without immediate delivery by emergency caesarean section.

💡 The key takeaways:

✔️ It is not only how much placenta has separated — it is where
✔️ Concealed haemorrhage ( hidden bleed) exceeding 60 ml is a critical danger signal
✔️ Survival is not the only concern — 10–15% of surviving babies sustain neurological injury

📌 Placental abruption is rare, affecting approximately 1% of pregnancies — but it remains one of obstetrics’ true emergencies. Knowing these thresholds can save a life.

10/06/2026

What keeps me going….

Patients who inspire me….
21/05/2026

Patients who inspire me….

Address

108 Harley Street
London
W1G7ET

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

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