chatwithketch

Q: Dear doctor I haven’t seen my period for October and November; then on the 6th of December I broke my virginity using the withdrawal method and on the 8th again I had unprotected sex. Then on the 10th I had a pinkish discharges that turned in to red. I went jogging that day then it stopped on the 11th could I be pregnant??? My periods are always irregular

A: Withdrawal method involves pulling the male organ out of the vagina just before ejaculation. This method may protect against pregnancy if used well but does not protect against STIs. It has been argued in some quarters that the pre-ejaculate (a lubricating fluid) may contain some sperm cells and so even if your partner is able to withdraw before ejaculation, the harm would have been done. However, the sperm in the pre-ejaculate is not there at the time the fluid is produced, but is sperm from previous ejaculations that was probably left in the urethra. It is believed that urinating and cleaning the tip of the penis before sexual intercourse helps to clear the urethra of the sperm left from previous ejaculations.

So, given the recent history of unprotected intercourse, it could very well be that you are pregnant – this is your most usual ‘go to’ question when a period is ‘missing’ and is a key reason for delay of menstrual periods for 9 months J In your case, it’s a little too early to tell.

On the regularity of your period…

A ‘regular’ menstrual cycle is supposedly one in which the cycle (the length of time from the 1st day of a menstrual period to the first day of the next menstrual period) is about 28 days but there is nothing abnormal about cycles that fall outside of this range. It could range from about 24 days to 34 days with ovulation happening at mid cycle. Indeed, in some women each period appears to have a different cycle. For young girls who have just started menstruating, skipped or irregular periods may occur.

What do people refer to as irregular periods? Well, if the time between each period changes, or the length of days of the period changes or indeed when the quantity of blood lost during each period changes, the period is termed irregular. What can cause these changes? They include:

§ Changes in hormone levels, as is common in the puberty period or menopausal period (not an issue here)

§ Stress

§ Excessive weight loss or excessive weight gain

§ Fibroids

§ Problems with the thyroid (hyperthyroidism)

§ Polycystic Ovary Disease (PCOD)

§ Scarring from previous surgery in the uterus

§ Breast feeding mothers may also experience irregular periods as the hormones released may delay return of menstruation. Remember, however, that this is not an effective means of contraception.

So, it’s always a good idea to keep a record of your periods: length of cycles, number of days the period lasts, presence of pain etc. If you keep a chart of this over time, you would be able to know what is normal for you.

Treatment of irregular periods depends on cause: fibroids, PCOD, hyperthyroidism all have to be treated. If irregularity is due to stress, learning coping mechanisms or relaxation techniques may help. Reduce weight or go easy on your exercise routine, if weight issues are a problem.

So, you might want to go and see your doctor to check you out.

All the best.

Q: Good Day Doc, please kindly instruct me on how to improve the quality of egg for a 39 year old woman for conception.
A: Every woman is born with about 1 million eggs. These eggs in the ovary die steadily such that by the time she gets to puberty, she has just about 300,000 left. These eggs are released every month in sync with the menstrual cycle. A woman will release about 300 to 400 eggs in her lifetime. As a woman ages, the quantity and the quality of the eggs reduce. Indeed the ovary’s ability to release eggs reduces until it can no longer release any eggs (menopause). The quality also reduces such that as one ages the eggs are more prone to having problems leading to miscarriage, birth defects etc
How can you improve the quality of your eggs? A study by some scholars at medical school shows that calorie restriction, which has been shown to reduce age-related problems and diseases, is also useful in improving quality of eggs even in old age. Calorie restriction involves limiting one’s normal calorie or food intake with the primary aim of slowing ageing and indeed, improving health. So this is an option. You will be losing weight or keeping trim while improving the quality of your eggs 

Egg freezing is also an option to preserve the quality of the eggs you have now, if conception is not yet on the cards.
Other lifestyle factors that may help give you a better shot at pregnancy include:
Eat healthy.
Keep your weight healthy. Avoid the extremes of weight: underweight or overweight
Exercise. Ensure that you are active at least 30 minutes every day. Goal is at least 150 minutes every week
Stay away from tobacco, alcohol and other drugs of addiction.
You can have more of an in-depth discussion on this with your obstetrician who can also let you know other procedures available to you based on your specific history.
Have a positive attitude too and keep those fingers crossed 

‘A gracefully aging face is a beautiful thing, but there are changes that occur with age that we would like to slow down.’ Read! https://www.health.harvard.edu/healthbeat/why-your-face-ages-and-what-you-can-do?fbclid=IwAR0CExXmravwHX7HZjUcst2XeMf6l_c8Fh_0SZFY8JSFJiiBcAjqvEfQfO0

Q: Good day Doctor !!!! Its been one year I delivered my baby through C-section and it’s still painful and itchy especially if I sit for a long time. Sometimes when it’s cold I have the pain. Also there is this injection which they give when going for c- section – since then I have pain at my back and I cannot bend for a long time I have to struggle or hold something to get up because of the pain. Please help!!!

A: Congratulations on your baby!

Each episode of childbirth is different from the other and same is also true for surgery. Is it normal to feel pain during a C-section? Not really. You shouldn’t feel pain. However, some women who had epidural or spinal anaesthesia (injections given in or around the spine to block pain) would describe the tugging and pressure felt when pulling out the baby as pain.

Again, recovery after surgery differs from person to person and indeed, from one episode to the other in the same person. It could range from a couple of weeks to months. If you do feel that your recovery is abnormally delayed, please be sure to discuss this with your doctor.

So, please go and visit your doctor and let him/her examine you and determine the problem.

All the best!

Q: Good morning, Dr. I need help regarding my health. I suffered depression for the past 3 months but I am getting better now, but for the past 6 weeks I have had difficulty sleeping. Sometimes I don’t sleep for straight 3 days, any time i do, the maximum time would be about 1hr. Therefore, I felt it might be reaction from the depression I had earlier but I don’t know what to do now as I’m not financially strong to visit hospital.

Another reaction is that I have steady headache. Have taken some medications but its not relieving it.

A: Sorry to hear about the health challenges you have faced recently. Depression is never an easy challenge to deal with but glad to hear that you are getting over it. Did you visit a health facility and are you getting medications for the depression? Please ensure that you are getting medical help as you battle this black hole of depression.

Sleep problems may show up as difficulty falling asleep, difficulty staying asleep if one wakes up in the night, waking up too early and being unable to fall back asleep or waking up feeling very tired etc. This is called insomnia. These problems may (secondary insomnia) or may not (primary insomnia) be related to other health/disease conditions. Women over 60 years of age are more prone, people who are stressed and travel long distances across time zones are also more likely to have insomnia.

Causes of insomnia include stress of life (divorce, death of a loved one etc), medications, depression (as in this case), anxiety, pain or discomfort etc. Insomnia without underlying medical conditions can be treated with lifestyle modifications like the under-mentioned ones:

Have a regular sleep routine that allows you (an adult) about 7 to 9 hours of sleep daily. Go for the higher limit, by the way 😀 Cultivate good sleep habits (no TVs in room, no work before bed time, a warm bath before bed etc). Lay off the caffeine and alcohol before bed time too. Regular exercise helps relieve everyday tension but vigorous exercise before bedtime may lead to inability to sleep too. Make your room a haven for sleep and clear out all clutter and be sure that you have invested in a good mattress and pillows. It’s a good idea to ventilate the day’s issues before you actually start getting ready for bed, so you can mentally file every issue away in a ‘to-do’ or ‘done’ box ahead of the next day.

Insomnia due to underlying medical condition needs the medical condition to be addressed. In the case of depression, please ensure that you are taking the medications prescribed by your doctor.

High cholesterol level can be addressed with lifestyle modifications:
Exercise can help increase your level of good cholesterol. Aim for 150 minutes of activity weekly. Be sure to check with your doctor before starting on an exercise regimen, especially if you have been sedentary for a while.
Smoking reduces the level of good cholesterol. So, if you smoke, stop and if you don’t smoke, don’t start
Eat more fiber. Soluble fiber in wheat and oats can help reduce cholesterol levels.
Fatty fish (sardines, salmon, mackerel), walnuts, soya beans etc contain Omega-3 fatty acids which help reduce cholesterol levels.
Use healthier oils to cook. Oils high in mono-unsaturated fatty acids provide health benefits for the body

Your doctor will determine if this is sufficient or you need medication.

The fact that you are not getting enough sleep is enough to give you a tension headache! This is the more common type of headache seen as the everyday sort of headache. It affects both sides of the head as a constant ache. Its causes are not very clear but they can be triggered by stress, hunger, dehydration, etc They can last a couple of minutes to several hours but are not severe enough to stop regular activities. Resting and sleeping well, eating properly and staying hydrated can help prevent this.

Other common causes of primary headaches include:

Migraines: These are felt as severe throbbing pain at the front or side of the head. Some people may experience other symptoms like nausea, vomiting and being sensitive to light. The pain lasts from a couple of hours or can stretch on for days. Thus, it is more severe than the tension headaches and can stop an individual from carrying out their daily tasks. Some find that they need strong medication prescribed by doctors to get relief but others are relieved by using over the counter medications.

Cluster headaches: These cause severe pain around one eye and are associated with red or watery eyes and a blocked nose or runny one. They tend to occur for one or two months at a time at about the same time of the year. Most times medications do not work for these headaches. Your doctor will prescribe specific treatment courses.

Chronic daily headaches may be due to medication overuse. This would occur in people who use pain medications too often and then end up with rebound headaches…the exact condition they were trying to avoid. Moral of the story: Never abuse your medications J Use only as directed by your doctor.

Sex headaches: Yes, this can occur. It’s also known as post-coital headache, orgasmic headache etc. It could occur during sexual intercourse, during orgasm or after sexual intercourse. And it can also occur at any time of the day and during any type of sexual activity. It is felt at the back of the skull just above the neck and is usually described as throbbing. Or it could build up gradually during sexual intercourse and intensifies as the sexual excitement before an orgasm increases. They can last anything from a few minutes to a few hours; may never recur or may happen a couple more times before gradually fading away.

It is thought to be due to the release of adrenaline and rapid rise in blood pressure which occurs as one approaches orgasm. And so in these cases, the headaches may not be a cause for concern. However, it is also a possibility that these headaches are a sign of a more serious condition like bleeding onto the surface of the brain.
People who usually have migraines, who use recreational drugs like marijuana, use birth control pills etc are more likely to have sex headaches.
Should you swear off sex? Yes, if you’re unmarried And no, if you’re married;) If you have just experienced this, try lying quietly for about an hour or two after taking an analgesic (like paracetamol) to handle the pain. However, it is very important to see your doctor as soon as possible to let him/her know what happened. This is important because, while there may very well not be any underlying issue, you want to be sure to rule out any serious medical condition causing these headaches. Your doctor will also prescribe some drugs on a regular or intermittent basis to deal with your symptoms.
Primary headaches may be triggered by stress, skipped meals and dehydration as noted above. However, they may also be associated with alcohol, foods that contain nitrates like spinach and bad posture.

Secondary headaches may be due to dental problems, hangovers ear infections, blood clot in the brain, wearing tight gear on the head like hats or even wigs (yes, I see you ladies :D) or even eating cold stuff like ice creams etc.

So, what should you do? If you find that tight head gear or eating ice cream is the problem, see if stopping helps.

If you find that these headaches are now more frequent than usual, more severe than usual, stops you from going about your daily activities, is no longer responding to the over the counter medications you used to take etc, please see your doctor. If you have been seeing the same doctor, as it appears to be in this case, with no relief, please seek another opinion or request a review by a neurologist.

All the best.

I hope y’all had a great day! 

Big hugs 😀