chatwithketch

Q: Good evening ma’am! Please, help me out . I’m 25yrs and “inexperience’ Please, this last month I didn’t see my flow. What might be cause for I’m not under any medication

A: Hello ‘inexperienced’ girl 😀 Thanks for writing in.

Well, I’m glad to know you’re not on medication…but perhaps, the more material question would be, if you have had unprotected sexual intercourse in the intervening period between your last period and now. This is your most usual ‘go to’ question when a period is missing. So, if ‘inexperienced’ means that you have never had sexual intercourse, then we will be looking at other causes of a missing 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.

Good night y’all 😀

Q: Hi doc. Keep up the good work Please, I want to ask about something that is bothering me. Is it possible for ejaculation to not occur? For instance, we mate today around 1am and everything went well but we decide to go again after another five hours but ejaculation did not occur after trying. This is the second time it ‘s happening but he is not taking it serious. I just want to know if it’s not a serious problem or if there is anything he can do about it. Please Doc, I am counting on you for my reply. Thanks for your time.

A: Thanks for writing in.

There are 4 phases of the sexual response cycle: excitement, plateau, orgasm (climax) and resolution (when the body returns to its normal functioning). After resolution, men usually need recovery time. During this period (refractory period), the man cannot achieve another orgasm. This period may last for minutes, hours or even days…the older one gets, the longer the refractory period. So, this may very well be the issue here.

It is also possible that the issue is anejaculation. Anejaculation is a situation in which there is failure of ejaculation. It can be primary (in which case it is present at birth and is a lifelong condition) or it could be secondary, as appears to be the situation here. In secondary anejaculation, the problem is acquired.

The same conditions that cause retrograde ejaculation are also suspect here. Retrograde ejaculation (RE), refers to backward ejaculation. To understand this, a refresher course on how ejaculation happens is needed:

Usually, during ejaculation, the muscle at the neck of the bladder tightens ensuring that semen does not enter the bladder. In people with this problem, this muscle does not tighten enough to prevent backtrack of the semen into the bladder. So, in these people, their ejaculate during intercourse is usually very little (sometimes almost non-existent, even though they certainly know they have had an orgasm) or their urine after sexual intercourse cloudy as a result of the sperm going into the bladder and mixing with urine.

Retrograde ejaculation does not interfere with a person’s ability to enjoy sexual intercourse, have and maintain an erection or even climax. Usually, these people would show up in the clinic because of infertility.

RE and secondary anejaculation can start after a surgery on the bladder or prostate; it can occur as a side effect of some anti-hypertensive drugs (drugs used to treat hypertension), or as a complication of some surgeries or medical conditions like Diabetes Mellitus, multiple sclerosis or spinal cord injury. A few people are actually born with a weakness of this muscle that closes the neck of the bladder during ejaculation.

If RE or secondary anejaculation is caused by medications, your doctor may consider changing them or stopping them for a while. Otherwise, there are some drugs used to ensure the neck of the bladder is closed during ejaculation. Your doctor will weigh their side effects against their potential benefits in deciding whether to prescribe them to you or not. For those who desire babies, your doctor will also discuss options of ‘harvesting’ sperm to be used on your spouse.

For spinal cord injuries, the ejaculatory pathway may be intact or there may be need for penile vibratory stimulation depending on the level of the injury.

His doctor should be able to take a proper history, carry out a detailed examination and make a proper diagnosis.

Have a great evening, people 😀

Q: Doc please which medicine will help me hold sperm a while before release? Thanks

A: Premature ejaculation is the most common type of sexual dysfunction in men younger than 40years. Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration, with minimal sexual stimulation and before the person wishes. In most cases the cause may not be identified.

It may be due to anxiety, guilt, depression, or if it has been a long time since last ejaculation. It may occur with a new partner, or only in certain sexual situations. In these instances, the problem is the pressure to perform. So, first option is to abstain from sexual intercourse for a while to take off this pressure.

Then, when you do resume, if you feel you’re about to ejaculate, get your partner to apply pressure between the glans (tip) and shaft (body) of his manhood. This should stop the urge. Sexual activity can be resumed after a few minutes.

Counseling or behavioral therapy may help also reduce anxiety related to premature ejaculation

In some cases, medical conditions, hormonal problems, injury or certain medications can cause it.

In most cases, it resolves on its own over time without medical treatment. Cutting down on alcohol, tobacco and illegal drugs may improve this.

Antidepressant drugs have also been found to delay ejaculation. Another option is the use of local anaesthetic creams, which reduce the sensations felt, thus reducing the probability of a premature ejaculation. There are creams, gels and sprays, which can be applied before intercourse.

Talk over this with your doctor who will provide the best advice based on your history. He will evaluate you and give you further advice.

Have a great week ahead

When should I resume sexual relations with hubby? Immediately after a baby? After 6 weeks or 6 months? Whenever hubby feels like it? When wifey feels like it? Any method to this matter?

The book, Just For The Health Of It With Dr Ketch, explores these and other issues

You can get a copy in any of the three following ways:

Get a copy of the book, Just For The Health Of It from any of these channels:
1) Laterna Books online shop with nationwide delivery. Just click on this link:https://www.laternabooks.com/laterna_product_details.php?v=15450&c=44

2) Another option for those in Lagos is Laterna Bookshop on 13, Oko-Awo Close, Off Adetokunbo Ademola Street,. Victoria Island.

3) If you’re outside the country, please visit Amazon through this linkhttp://www.amazon.com/Just-Health-Ketch-Pregnancy-Parenting/dp/9789398026/ref=sr_1_1?s=books&ie=UTF8&qid=1426246647&sr=1-1&keywords=just+for+the+health+of+it+with+dr+ketch+olalere+nkechi

For those in Abuja and environs, please call 07030739403 or pick it up at No 5 Bricks Market, Dawaki 11 Market, Dawaki extension.

For those in Awka, please call 08189944090.

Remember that this book is a great gift for anyone who wishes to live and eat healthy, lose weight, get ready for pregnancy and parenting. Buy copies for bridal showers, baby showers, Christmas gifts etc. It’s a gift that keeps on giving

“Taking NSAIDs routinely over a long time period can raise the risk of blood clots, increase blood pressure, and accelerate cardiovascular disease,” says Dr. Antman. While the danger is greatest in people with heart disease, it’s also present in people without any signs of the disease.

To learn more, please click on this link: http://www.health.harvard.edu/heart-health/are-some-painkillers-safer-for-your-heart-than-others

Q: This is lovely DC but I have something that has been bothering me for a while about my son’s palms. I thought I ask if you can help me out please. He’s 6 years old and I just discovered his palms are hard. I keep wondering why because he’s young. Is there any help I could get from you so that he will have a smooth palms again? Thank you

A: Thanks for writing in dear. You didn’t mention how long ago you noticed this. You need to take in your baby to see his doctor. The paediatrician will refer to a skin doctor. It is only after examination that a proper diagnosis can be made.

But, hard skin like you described in your son could be due to a condition called ichthyosis, an inherited skin disorder with hallmark dry and scaly skin which may be either very thick or very thin. In the case of thickened skin, dead skin cells accumulate and form thick scales on the skin surface causing this condition to be referred to as fish scale or fish skin disease. Mild cases usually pass off as very dry skin.

Skin usually appears normal at birth and then gradually become dry, rough and scaly before the children turn one year of age. Symptoms include thickened palms and soles of feet which may also have more lines than normal. The skin may also split and/or crack. Symptoms are worse in cold, dry conditions and improve in humid conditions.

There is no cure for this condition. But judicious moisturizing and exfoliation (using creams with alpha hydroxy acids) are very helpful.  Oral medications which reduce the production of skin cells may also be prescribed.

Other tips to help….

Give your baby a long soak in a bath and then use a rough sponge or pumice stone (the stone you use to smoothen rough skin on soles of feet) to help with scale removal. After a bath, try dabbing your baby’s skin so that it is still slightly moist before applying a moisturizing lotion that locks in the moisture. Drying your body completely aggravates the dryness. Lotions that contain glycerine, lactic acid and panthenol are very good. Body washes with moisturizers are also be a good for those with this problem as they will not dry out your skin when you take a bath. Having a humidifier at home to moisten the air helps too.

So, I end as I started. First step is go see your baby’s doctor who will examine and make a proper diagnosis and then take it from there.

I wish you all the best.

Have a good night, y’all 😀

Q: Good morning, please ma’am during pregnancy, for someone having continuous heart burn for the first month. What can she use?

A: Heart burn really has nothing to do with the heart…I bet all of you knew that, aye? It is usually felt as a burning sensation in the chest which feels worse on bending down or lying down. Okay, why and how does this happen? You know that the stomach produces acid to help with food digestion, right? Have you ever wondered, how come this acid isn’t all up in your mouth all the time? Well, that’s because there’s a ‘lock’ or control at the junction of the esophagus and the stomach which prevents the acid in the stomach from coming back up into the esophagus. This ‘lock’ is called the Lower Esophageal Sphincter. This lock can get strained if the esophagus opens too often or if there is too much food in the stomach…so, if you regularly over-eat, you might want to re-think that 😀 A major no-no is a very heavy meal just before you lie down. It’s almost certain you may have a heart burn 😀

There are also conditions like pregnancy (like in your case) and obesity that make this sphincter stay open for prolonged periods as a result of pressure on the abdomen and there are also foods that encourage this. Examples of these ‘foods’ are fatty foods, alcohol, orange juice, chocolate and coffee, onions, tomatoes, peppermint and spicy foods. In pregnancy, the hormonal changes and the pressure of the growing womb on the stomach contribute to heart burn.

Heart burn in pregnancy is more likely to occur in women who had heart burn before pregnancy, women who have been pregnant before and women in the last stages of their pregnancy.

So, I suggest you keep a food diary over a period of time and try to figure out the trigger foods. Remember that being over-weight could be a problem or even over-eating.

Prevention involves trying to avoid your trigger foods (quite a number are actually healthy 😀 maintaining a healthy weight, avoiding heavy meals just before bedtime, avoiding alcohol or smoking, sitting up straight when eating, try eating smaller meals and avoid tight clothes that may also put pressure on your abdomen.

Treatment is targeted at the acid and healing the esophagus. So, drugs used can stop acid production, reduce acid production and cause healing of the esophagus or neutralize the effect of the acid. Your doctor will prescribe what works best for you.

Have a fabulous evening and remember…no heavy meals before bedtime.

Have a good night y’all 😀

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Q: Doc please am pregnant and in my second trimester, before being pregnant. I was having candida .So i complain to my doc and was given gyno-daktarin pessary to insert for three days. After the insection i don’t discharge like first and the itching has stop too. Want to know if it can affect my babies, because since it’s an infection

A: Hello dear, thanks for writing in.

Candida infections occur when the fungi which live normally in the vagina overgrow and cause an infection. Usually, there is yeast (fungi) in the vagina and they generally mind their own business until something comes along to disturb the peace of the environment. This disturbance can be in the form of abuse of antibiotics (which kills off the good bacteria that hold the fungi at bay causing them to take over and overgrow the environment) or even in pregnancy (where the estrogen hormone produced in pregnancy messes with the normal order of co-existence of fungi and bacteria, again, allowing the fungi to take over). Other conditions associated candidiasis include Diabetes Mellitus, disorders of the immune system, use of oral contraceptives, the hormonal changes associated with menstrual cycle etc
In pregnancy, the decrease in tolerance to glucose which may occur, also means that the vagina has a rich supply of sugar which encourages the fungi to grow and multiply as they love the dark, warm, moist and rich environment 😀
How can this be prevented? Trust me, I’m not going to suggest not getting pregnant LD There are things you can do to reduce your risk of this infection. They include:
• Wear cotton panties instead of tight fitting nylon panties.
• Always wipe from the front to the back, after using the bathroom
• Do not use perfumed personal care products like sanitary towels, tissue etc
• Do not spray perfumes in your genitals and avoid perfumed soaps
• Change out of wet swimming gear as soon as possible
Now, this infection can be treated using oral drugs (tablets to be taken by mouth) but these are not recommended during pregnancy and breastfeeding. Vaginal pessaries and creams are better bets in pregnancy. However, because of the very small possibility of hurting your cervix (the neck of the womb), it is advisable not to use the applicator to administer the pessary. Instead, use your finger to insert the pessary. It may be necessary to continue the drug application for about 6 days as opposed to the shorter 3 day course. Your doctor will advise on duration.

Now that you are done with treatment, you need not fear about infecting your baby. However, even if you do have it when having your baby, yes, there is a possibility of baby being infected while passing through the birth canal, but it is very easily treated. In babies, this usually manifests as white patches on the roof, sides of the mouth and tongue, too. Your baby’s paediatrician will prescribe an anti-fungal medication. Please note that babies can have this condition known as oral thrush, even if their mums did not have vaginal candidiasis/thrush.
For more on candidiasis, please click on the following links:
https://chatwithdrketch.com/2014/06/26/daily-health-tips-why-do-i-have-recurrent-candidiasis/
https://chatwithdrketch.com/2014/03/07/daily-health-tips-toilet-infection-seriously/
https://chatwithdrketch.com/2014/04/27/daily-health-tips-is-vaginal-discharge-normal/

Have a good night, y’all 😀