Q: Hello Dr Ketch, please help. All my life l have been going through 7 days of menstruation period days. Now recently for 4 months back, l started going for 3 days only; on day 3, l will be done. What could be causing this? I’m very worried

A: There are various shades of ‘normal’ in menstrual cycles with the menstrual flow lasting between 2 to 8 days and the cycle lasting anything from 21 to 35 days. A reduction in flow (scanty period) is called hypomenrrhea (pronounced hai-po-men-oria) and a reduction in the number of days of flow to less than 3 days is called oligomenorrhea (oli-go-men-oria).

Now at the onset of puberty, the flow and cycle can vary from one cycle to the other; the same goes for the other extreme of life (old age).

Other issues that can cause a decrease in flow include pregnancy (the supposed period may be an implantation bleed), crash dieting (when you want to lose all the weight you added in 5 years in one week :D), intense physical activity, Polycystic Ovary Disease (PCOD), imbalance of hormones and use of contraceptives. Previous instrumentation like Dilatation and Curettage (D and C), where the procedure was too ‘vigorously’ done can result in a condition called Asherman’s syndrome which manifests as reduction in menstrual flow. In the same way that stress can delay a menstrual period, it can also cause a reduction in flow.

You must work with your gynaecologist in order to manage this. If the cause is PCOD, focus will be on the treatment; if due to intense exercise, reducing intensity will be helpful; if due to crash dieting, focus on eating a proper balanced diet will help etc. Your gynaecologist will carry out a detailed examination and investigation to arrive at the cause and advice on treatment.

Have a good night y’all 😀

Q: Good day Doc. Ketch. I want know more about ‘Gyna …..’! Is it recommended for the cleansing of vagina? Or does it reduces the smell down there? Please help. Thank you in advance

A: Let’s start with a statement of fact….Some degree of vaginal odour is common with all women. The vagina has a natural musky smell. In the same way, some degree of discharge is also normal as the glands in the vagina and cervix produce fluid which wash away dry, dead cells and flush out bacteria. A strong vaginal odour which appears different from normal especially when associated with other symptoms like a burning sensation, itching, discharge etc may be suggestive of a problem…some more easily solved than others.

For instance:
Poor vaginal hygiene. This can be easily remedied by washing the vagina daily with or without soap (if soap is used, unscented or mildly scented soap should be used) and loads of water, not douching, cleaning from the front to the back etc. Vaginal odour may also be more pronounced during a menstrual period and after sexual intercourse. And so, more frequent baths (as much as practicable) during and/or before these periods may be helpful. Frequent change of sanitary towels and tampons are also helpful measures. Forgotten tampons are actually a cause of vaginal odour.

A fishy smell associated with vaginal discharge is suggestive of overgrowth of the vagina by bacteria (bacterial vaginosis). This may be caused by over use of antibiotics or douching.

The brand you mentioned in your question is a type of vaginal douche. Douche is a French word which means to clean or soak. People who douche usually inject/spray a mixture of water and vinegar into their vagina. Other douches contain antiseptics and fragrance too and They believe that douching serves one or more of the following functions:

• Cleaning the vagina
• Cleaning out menstrual blood after a period
• Prevent pregnancy
• Prevent STIs
• Get rid of odour

Unfortunately, douching serves none of those purposes and indeed, may even be harmful as you may have noticed with your experience. I suggest that you go see a doctor to get checked out, if you think something is wrong.

To clean the vagina during or after a menstrual period, one does not really need anything other than water. Mild, unscented soap may also be used on the outside. Douching disturbs the natural balance between the good and bad bacteria which live in the vagina, causing other organisms like yeasts to over grow the vagina. So avoid this and other scented feminine hygiene products.

Douching does not prevent pregnancy as loads of sperm may have already swum up to the womb before douching is done, after sexual intercourse. In fact, for those that may not have reached the womb (uterus), the force of douching may very well help deposit the sperm firmly in the uterus 😀 Talk about a boomerang!

STIs cannot be prevented by douching. In fact, if anything, if there is a vaginal infection, douching can actually push it all the way up to the fallopian tubes, potentially. These may lead to pregnancy complications in baby, labor and indeed, preterm delivery.

In summary, leave douching well alone! 😀

Yellow or greenish or frothy discharge with a bad smell with pain and itching while urinating is suggestive of trichomoniasis infection (a sexually transmitted infection)

Some cancers like cervical or vaginal cancer may also cause vaginal odour.

What’s the remedy? Well, if it’s due to lack of vaginal hygiene, that’s easily solved as noted above. If there are other associated symptoms which may suggest other problems, than a proper diagnosis needs to be made so that adequate treatment can be given. So, see a doctor asap.

In the meantime, vaginal hygiene is a good place to start and then, incorporate the other tips noted above.

I hope this helps.

Q: Hello doctor, please I do have frequent urination. What can cause it and what’s the solution?

A: Frequent urination may actually be due to the simple fact that you’re drinking way too much fluid. However, where this is not the case, it is likely to be due to a health problem.

Some causes of frequent urination include:

• Sexually Transmitted Infections as you have already noted.
• Some medications
• Drinks that contain caffeine, alcohol etc
• Infections that along the urinary tract or changes to the bladder
• Infection or enlargement of the prostate
• Disease conditions like Diabetes Mellitus etc
• Some cancer treatment eg radiation treatment for the lower abdomen

If this is due to excessive fluid intake, limiting this will help. If this symptom is associated with others like difficulty with urination, pain during urination, passing out bloody urine, incomplete emptying of bladder when urinating etc, please see your doctor ASAP.

So, I suggest that you just go and see your doctor. He will take a good history, examine you and order some investigations. The treatment of course will depend on the cause of the problem.

For related posts, please click on the following:

Daily Health Tips: Urinary Tract Infections In Men

Daily Health Tips: Why Do I Have Pain When Urinating?

Daily Health Tips: Train That Leaking Bladder!

Daily Health Tips: Prostate Enlargement

Daily Health Tips: More on The Prostate Gland

All the best!

Q: Good Day Doc. Ketch!!! I’ve got a Problem here. Please help!! Is is Normal for a Vagina to Fart?? Because this thing almost happens everyday

A: Vaginal farts are much more common than you may think. However, many women would rather not talk about it because, it may be somewhat embarrassing! Vaginal farts occur when the vaginal walls expand, pulling in lots of air, and then collapse back to release this air. They are usually odorless, in contrast to anal farts. It can happen with exercise, sex, and with sudden movements like getting out of a chair.

The treatment for vaginal farts is really the same as for feeling loose ‘down there’ after you just had a baby. This treatment is the usual suspect…pelvic floor exercise called Kegel exercise.

This is done by trying to hold your vagina together, tightening it like trying to hold urine. Hold these contractions for 10 seconds, then release for another 10 seconds. This should be done several times a day .You can do these exercises anywhere; while waiting on a queue, working at your desk or while watching TV. It may take 6-12 weeks of exercise to see results. These exercises can strengthen the pelvic wall muscles and help keep the vaginal walls from expanding. These exercises provide other benefits like facilitating childbirth, enhancing orgasm, and decreasing the chances of having a leaky bladder later in life.

Try keeping your legs together as much as possible, and also avoid using tampons when you are not menstruating.

The best advice is to think of vaginal farting as natural and fun instead of embarrassing 😀 However, please see your doctor if the Kegel exercises do not help and you feel the same way.

I hope this helps 😀

Q: I’m a male, aged 29 years. Why do I experience orgasm when I am fast asleep but I do not release sperms? It happens monthly. Looking forward to your reply.

A: Thanks for writing in. Not releasing sperm could be due to a condition known as anejaculation. There is failure of ejaculation in this situation. 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 (RE) 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.

During the refractory phase of the sexual response cycle, it is also not possible for a man to achieve orgasm. To better understand this, a quick class  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.

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.

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

All the best!

‘ Eating healthy, plant-based proteins such as beans and nuts instead of red meat may lower your odds of heart disease, new research finds. ‘ Want to learn more? Click he link! https://www.health.harvard.edu/heart-health/to-lower-heart-disease-risk-swap-beef-for-beans

Q: Hello Doc, I just want to ask some remedies for baby’s oral thrush

A: Believe it or not, our bodies are filled with different micro-organisms, all of which are searching for relevance and dominance 😀 These good and bad micro-organisms usually maintain a delicate balance until something happens (like when one takes some medications like steroids, uses antibiotics, has a depressed immune system as occurs in extremes of age: very young and very old and also if one is infected with HIV, has cancer or Diabetes Mellitus) to disturb this delicate balance. When this happens, fungal organisms which were minding their own business before, have an opportunity to overgrow in the mouth and cause problems.  This condition can also happen in the vagina causing vaginal thrush or even in infants causing diaper rash.

What does this look like? It looks like creamy white patches on the tongue, on the inside of the cheeks, gums, tonsils, back of throat etc. They look like you can just scrape them off but any attempt to do that would usually lead to bleeding. People with this condition may also experience pain when swallowing or eating. Children with this condition are usually irritable and fussy.

Treatment of this condition is with the use of anti-fungal drugs which would usually have to be taken for about 10 to 14 days. Your baby’s doctor will advise on the right medicine. For nursing mothers, there may be a need for antifungal cream applied on the breasts as the baby and the mother may pass the infection back and forth to each other. Talk about joy in sharing 😀

I don’t know how old your baby is but irrespective of age, to prevent this:

• Practice good oral hygiene: brush your baby’s teeth twice a day being sure to spend time brushing the surface of the tongue
• Rinse out your mouth after every meal, if you can’t brush, especially if you have just taken a lot of sugary foods.
• Limit intake of sugary foods
• For those who use dentures, take them off before you go to bed
• And for those who smoke (definitely not your baby :D), don’t reduce the number of sticks you smoke. Just quit! 😀

Have a great night, people 😀

To conclude World Breastfeeding Week, I revisit another breastfeeding question

Q: How can I store expressed breast milk?

A: Expressed breast milk has to be handled in a very hygienic way. It is important that it does not form the means by which germs find their way into your baby’s body so utmost care must be taken.

What should you do? I reproduce a post I had made on this a while back;

To express milk for your baby, first, you have to be committed to be hygienic because you don’t want to introduce germs into your baby, do you? Always scrub your hands with soap and water whether you are using the breast pump or your hands.

Having expressed the milk, when stored at room temperature, be sure to use up the milk within 6 hours.

When stored in the fridge,
• Ensure that the temperature in the refrigerator is below 5 degrees centigrade.
• Do not store on the door of the fridge. Please store on the shelf towards the back of the refrigerator where it’s cooler
• At this temperature, you can store milk for up to 5 days.

When stored in the ice compartment of the refrigerator, you can store milk up to 2 weeks

When stored in the deep freezer, you can store milk up to 6 months.

To thaw frozen milk, please put it in the fridge. When it’s thawed, you may feed your baby with it but if your baby prefers it warm, you can run some warm water over the bottle until it’s just right. Do not microwave it as this may create some hot spots in the bottle which may cause scalding of your baby.

Once thawed, please don’t re-freeze the milk as this might encourage the growth of micro-organisms.

Make sure that the container used for storing milk is sterilized to prevent any potential introduction of germs into the milk. Use small containers that hold just about the amount that your baby finishes per feed.

If you express a lot of milk, be sure to label the different containers and use the oldest pack first. Please stick with the duration of storage guideline we’ve given.

Now, it goes without saying that you should not store milk close to contaminants like meat, fish or even strong smelling foods like onions 😀

All the best!

Still celebrating Breastfeeding Week 2019….

Q: Good day Dr. Ketch, please my question is…what supplements can a nursing mother take to enable free flow of breast milk? Is coffee good while breast-feeding?

A: How can we help mum to establish or re-establish breastfeeding? To answer that I’ll reproduce part of a post I had made on this subject.

Mum needs loads of support from her medical team (be that the nurses that provide support for lactation or the doctor who does same). This support can range from teaching her how to latch baby on properly to the doctor prescribing medications that encourage milk production. Drugs and foods that encourage milk production are called galactogogues. A number of local foods have been touted to help eg Pap (akamu, ogi), green leafy veggies like spinach, oats, garlic and ginger, nuts like almonds etc Go ahead and try out what works for you.

Effective breastfeeding requires loads of patience. You have to put baby to the breast as often as possible (at least every 3 hours) or failing that, use a breast pump to extract as much milk as possible. It is thought that some of the galactogogues ‘improve’ the taste of breast milk making the baby spend more time on the breast.

Remember that the sucking process/nipple stimulation encourages milk let-down. Being relaxed and thinking about you and your baby in a nice cozy environment, breastfeeding and bonding may also help this process along.

You may want to assume the regular position you used to adopt when baby was breastfeeding and ensure that baby gets skin to skin time with you. It may be easy for baby to immediately go back to breastfeeding, other times, it may take a while. You need to know when the baby is sucking and indeed whether he’s getting enough. Your baby should make at least six (6) wet nappies per day. If baby is not getting enough breast milk at the beginning of this process, you may have to supplement with formula. Use a cup and spoon to avoid nipple confusion.

Be sure that you are getting enough fluids yourself and eating nourishing foods.

On coffee…

Coffee and other foods and drinks that contain caffeine should, definitely be avoided when breastfeeding as much as possible. Caffeine in coffee energy drinks, some soft drinks etc. This makes the baby irritable and by extension, makes sleep difficult for the baby.

Other foods to avoid or limit their consumption while breast-feeding

Alcohol: This should be avoided at all costs.

Cigarette (yeah, yeah, I know it’s not food) should also be avoided as it reduces the production of breast milk.

If baby reacts to what the mother ate, efforts should be made to pinpoint what the mother ate before the incident started and then eliminating that from the diet to see if the diarrhea or allergy stops.

Make sure that you eat well: lots of fruits and vegetables and complex carbohydrates. Cut out the junk that will not help you achieve your weight loss goals and in addition have empty calories. In addition, drink sufficient fluids daily.

Be careful before taking any drug as most find their way into your baby.

For more on breastfeeding, please click on the links:

Daily Health Tips: Can My Breast Milk Get Sour If I Don’t Express It And My Baby Refuses To Feed?

Daily Health Tips: I’m A Breastfeeding Mother Who Just Developed A Painful Lump in My Breast. Could It Be Cancer?

Daily Health Tips: Breastfeeding Challenges

Daily Health Tips: Please Help! My Breasts Still Feel Engorged Though I stopped Breastfeeding Some Days Ago.

Daily Health Tips: What Should I Do After Having My Baby If My Breast Milk Doesn’t Come In Immediately?

All the best!

Want to eat healthier? Want to know what one serving of bread or rice or pasta or indeed any other food is? You should read this! https://www.health.harvard.edu/blog/the-dash-diet-a-great-way-to-eat-foods-that-are-healthy-and-delicious-2019072517326