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“My period used to last five days. Now it barely lasts two. I am 43. Is menopause starting?”

Maybe.

Changing periods can be one of the first signs of perimenopause, the transition leading up to menopause. Your periods may become shorter or longer, lighter or heavier, or less predictable.

But one shorter period does not confirm perimenopause. A two-day period can still be normal.

You may also notice hot flushes, night sweats, poor sleep, vaginal dryness or changes in your mood.

Menopause has not begun simply because your periods have changed. It is confirmed after 12 consecutive months without a period.

Until then, ovulation may still happen. This means pregnancy is still possible.

Keep a record of when your periods come, how long they last and whether the bleeding has changed. Speak with your doctor if the changes continue or other symptoms begin. If the symptoms are affecting your life, treatment options are available.

Please arrange an assessment if the bleeding becomes very heavy, lasts longer than seven days, occurs between periods or after sex, or returns after you have gone 12 months without a period.

Did your periods change before you noticed any other signs of perimenopause?

#WomensHealth

#HealthyLivingWithDrKetch

“But you already have one child.”

People may say this to comfort you. After months of negative pregnancy tests, it can make you feel as though you have no right to be worried.

You do.

Difficulty becoming pregnant after a previous pregnancy is called secondary infertility. That previous pregnancy does not have to have ended in the birth of a child.

If you are under 35, arrange an evaluation after 12 months of regular unprotected sex without pregnancy. From age 35, seek help after six months. Seek help sooner if your periods are absent or very irregular, you have significant pelvic pain, or you already know of a condition that may affect fertility.

Both partners should be assessed. The woman may need checks to see whether she is releasing eggs and whether her womb and fallopian tubes are healthy. Her partner may need a semen test.

Do not assume fibroids are responsible simply because they appeared on a scan. Many women with fibroids become pregnant. Whether a fibroid affects fertility depends on its size and where it is growing.

An uncomplicated abortion does not usually cause infertility. Infection or scarring after a complication can sometimes affect fertility, but this needs proper investigation.

A persistent swelling in the lower abdomen also needs an examination and scan.

If you have moved from one hospital to another, gather your previous results and take them to one gynaecologist or fertility clinic for a coordinated review.

You deserve a proper assessment, even if you have been pregnant before.

The doctor said, “You have PCOS.”

By the time you got home, the sentence in your head was, “I may never have a baby.”

But that is not what the diagnosis means.

Pregnancy requires an egg to be released. With polycystic ovary syndrome, commonly called PCOS, the ovaries may release eggs irregularly or may not release one during some cycles.

That can mean fewer opportunities to become pregnant. It does not mean there is no possibility.

Many women with PCOS conceive without fertility treatment. When help is needed, medication can encourage the ovaries to release an egg. Other fertility treatments are available if the first approach does not work.

If your periods are very irregular or absent, speak with your clinician when you are ready to start trying. You do not need to spend months guessing whether you are releasing eggs.

The fertility assessment should not end with “You have PCOS.” Other factors affecting you or your partner may also need to be checked.

If you currently take birth-control pills to manage your periods or other PCOS symptoms, tell your clinician when you want to become pregnant. The treatment plan will need to change because those pills prevent pregnancy while you are taking them.

Once pregnant, register for antenatal care early. PCOS can increase the likelihood of diabetes or high blood pressure during pregnancy, but it does not mean that miscarriage is inevitable.

If you have PCOS and hope to become a mother, ask for a preconception review so you understand your own situation and the help available.

You know exactly where the tweezers are.

Every few days, the same coarse hairs appear on your chin. Meanwhile, your period comes late, disappears for months or arrives without warning.

These two changes may be connected.

A few facial hairs can be normal. But when thick, dark facial hair is increasing and your periods are irregular, it is worth arranging an assessment.

Hormones called androgens can affect hair growth and the release of eggs from the ovaries. Polycystic ovary syndrome, commonly called PCOS, is one possible cause. It is not the only one, and facial hair alone cannot diagnose PCOS.

Your clinician may ask when the hair growth began, how your periods have changed and which medicines you take. Blood tests may be needed to check your hormone levels.

Treatment depends on the cause and usually takes time. You can still remove existing hair by shaving, threading, waxing or other suitable methods. Shaving does not make the hair grow back thicker.

Please seek prompt medical attention if thick facial or body hair appears suddenly, grows rapidly or is accompanied by a noticeably deeper voice.

Do not let anyone dismiss the menstrual changes with “just remove the hair.” The hair can be managed, but the reason it is growing may also deserve attention.

“My period only comes when I take the pills. Has my body become dependent on them?”

No. Let’s look at why this can happen.

PCOS means polycystic ovary syndrome. It is a hormonal condition that can make the ovaries release eggs irregularly. When that happens, periods may be months apart.

Depending on the medicine your doctor prescribed, it may bring on bleeding or make it more predictable. But bleeding while taking the medicine does not necessarily mean your ovaries have started releasing eggs regularly.

So if your periods disappear again after you stop, it does not mean the pills made you dependent. It means the reason your periods were irregular may still be there.

If you have gone about three months without a period, arrange a review. Tell your doctor if you hope to become pregnant so your treatment plan can reflect that. PCOS may make pregnancy harder for some women, but it does not mean you cannot have a baby.

“My friend took this medicine and her fibroids shrank. She said I should try it.”

Please don’t!

Two women can both have fibroids and need completely different care. One may only need monitoring. Another may need treatment for heavy bleeding. A woman who is pregnant requires a different approach altogether.

In pregnancy, fibroids are usually monitored rather than removed. Even pain medicines that seem familiar may be unsuitable. From 20 weeks, medicines such as ibuprofen or diclofenac should only be used when your maternity clinician specifically prescribes them.

The same caution applies to herbal mixtures. “Natural” does not tell you whether something is safe for you or your baby.

Take your scan report to your maternity team. Ask what the finding means for this pregnancy and which symptoms should bring you back to the hospital.

Your friend’s experience can encourage you to seek care. It should not become your prescription.

Have you ever been offered someone else’s fibroid medicine or herbal mixture?

“My friend took this medicine and her fibroids shrank. She said I should try it.”

Please don’t!

Two women can both have fibroids and need completely different care. One may only need monitoring. Another may need treatment for heavy bleeding. A woman who is pregnant requires a different approach altogether.

In pregnancy, fibroids are usually monitored rather than removed. Even pain medicines that seem familiar may be unsuitable. From 20 weeks, medicines such as ibuprofen or diclofenac should only be used when your maternity clinician specifically prescribes them.

The same caution applies to herbal mixtures. “Natural” does not tell you whether something is safe for you or your baby.

Take your scan report to your maternity team. Ask what the finding means for this pregnancy and which symptoms should bring you back to the hospital.

Your friend’s experience can encourage you to seek care. It should not become your prescription.

Have you ever been offered someone else’s fibroid medicine or herbal mixture?

The doctor says, “You have fibroids,” and your mind jumps straight to one fear:

Will they remove my womb?

A fibroid diagnosis does not automatically mean surgery. It certainly does not automatically mean a hysterectomy.

The first question should be, “What problem are we treating?”

If the fibroids are not causing problems, monitoring may be all that is needed.

Medicines can reduce heavy bleeding or pain. Some hormone treatments may shrink fibroids for a time. They do not permanently remove them.

Procedures that shrink or destroy fibroid tissue are also available in some locations. If you hope to become pregnant, ask how the proposed treatment could affect that plan.

If surgery is recommended, find out exactly which operation is being discussed. A myomectomy removes the fibroids and leaves the womb in place. A hysterectomy removes the womb, which means pregnancy will no longer be possible.

You deserve to understand why treatment is being recommended and what it will mean for your womb before you consent.

#WomensHealth#Fibroids

#HealthyLivingWithDrKetch

The scan report says “fibroids.”

Before the doctor finishes explaining, your mind has already gone to one question: Will I ever have a baby?

Fibroids can affect fertility, but finding them does not prove that they are the reason pregnancy has not happened. Read!

Q: Dear Dr, I’ve been married for some years without a child. It’s been revealed that I have tiny fibroids. What kinds of foods and drinks should I avoid so the fibroids would not get enlarged? Thanks

A: You didn’t tell me how long you’ve been married for or better still, how long you’ve been trying for a baby. Usually, if it’s not up to one year of frequent, unprotected sex, then we would not be quick to say there is a problem. By the way, frequent unprotected intercourse means that sexual intercourse is not less than 3 times a week and it is done without any means of contraception.

Fibroids may or may not cause inability to have a pregnancy. It depends on size and position. Big fibroids in the area of the womb where a baby is meant to implant may cause a miscarriage or indeed, failure of the fertilized embryo to implant. Your doctor will take a decision on what to do with the fibroids based on size, symptoms etc

What foods to avoid? Once fibroids have been developed, shrinking their size can be conveniently done using medication. There’s no evidence to support the role of food in shrinking fibroids.

Ask your doctor to show you where the fibroids are on the scan. Find out whether they are affecting the part of the womb where a pregnancy would develop.

Not every fibroid needs to be removed. Surgery may help in some situations, but the decision should be based on what the fibroid is actually doing.

A fertility assessment should also look beyond the fibroids and include both partners.

If you are under 35, seek help after 12 months of trying. If you are 35 or older, seek help after 6 months. You may need an earlier assessment if you already have a known reproductive health concern.

#womenshealth
#HealthyLivingWithDrKetch

You feel perfectly well, so cervical screening is easy to postpone.

But screening is not something you wait to need. Its purpose is to find HPV or early changes in the cervix before you feel anything.

The cervix is the mouth of the womb. HPV is a common virus that can cause changes in its cells. Most HPV infections clear without causing problems, but some persist and may eventually lead to cervical cancer.

WHO recommends screening from age 30 for most women. Women living with HIV should generally begin from age 25. Your clinic can tell you which screening test is available and when you should repeat it.

An abnormal result does not automatically mean cancer. Your doctor will explain what was found and what should happen next.

Do not wait for routine screening if you notice a new symptom. Unexpected vaginal bleeding should be assessed, even if it stops. Any other change that persists should also be checked.

And yes, screening is still important, even if you have received the HPV vaccine.😊

#WomensHealth
#HealthyLivingWithDrKetch