Q: Good morning ma’am. Thanks for your daily health update. Ma’am, I did the family planning that is being inserted in the arm. Ever since June, I’ve not seen my menstruation till now. What could be the cause ma’am? Thanks ma’am

A: The contraceptive implant, as the name suggests, is implanted under the skin….under the skin of the upper arm and protects against pregnancy for about 3 years.

This birth control method contains the hormone progestin which prevents the egg from being released from the ovary (if there’s no egg, then there’s nothing to fertilize, right? :D) and also makes the mucous in the uterus so thick that the sperm cannot sperm cannot swim through to get to the egg, even if it were released!

This method of birth control is good for breastfeeding mothers (because it does not contain estrogen which affects mother’s breast milk production) and is long lasting such that the woman does not need to take pills every day. However, this implant can cause unwanted side effects. While some women would have heavier, prolonged periods, some others experience fewer and lighter periods. Indeed, some may stop seeing their periods after one year of use. Other side effects include headaches, nausea, mood change, nausea, acne, infection at the site of insertion etc. These symptoms would usually stop within the first few months (3 to 6 months). If, however, these continue or your experience severe headaches or excessive bleeding, please see your doctor.

Please note that, this method is not suitable for women with breast cancer.

If you experience a new lump in your breast, yellowing of the eyes, you have concerns about the location of the implants or just have questions to ask, please see your doctor.

I hope this helps.

All the best!

Q: Hello Dr Ketch, what is the causes of mouth odour and how do I prevent it?

A: This is a very frequent question and so I have decided to revisit it today.

Bad breath/mouth odour, also called halitosis, may be as a result of poor hygiene habits, eating strong smelling foods or could be a sign of other medical conditions.

If adequate dental hygiene is not maintained, food particles can remain in our mouths, encouraging bacterial growth bacteria in our mouths can break down food particles and raise a serious stink. Proper dental hygiene habits includes:

Brushing your teeth twice a day (this sounds like a ‘no-brainer’ but the right technique is important. Mentally divide your mouth into four quadrants and spend at least 30 seconds on each quadrant. This way, you spend a minimum of 2 minutes brushing)

Brushing your tongue (if you finish brushing and you can still see all that whitish residue on your tongue, you haven’t done a good job. Some of the smell comes from there. Some tooth brushes come with a tongue scraper at the back of the brush…use that. If not, buy one or just use your brush)

Flossing your teeth everyday. Ask for this in your local super markets. This gets rid of the food particles between your teeth where your tooth brush can’t reach.

Using a mouth wash can also help the prevention of mouth odour.

Eating strong smelling foods like onions and garlic could also cause mouth odour which may not be taken care of by brushing. This is because these ‘foods’ are absorbed into the blood stream and excreted through the lungs. So, the smell will persist until excretion is complete. The small can be masked with mouth wash etc

Disease conditions that can lead to bad breath include mouth infections, Diabetes Mellitus, sinus infection etc.

Other conditions like use of tobacco (chewing or smoking), some drugs and dry mouth (which is the reason for morning breath :D) are also culprits.

Prevention is focused on the tips given above and ensuring that you visit your dentist at least twice a year, brushing at least twice a day (if not after every meal) with a fluoride tooth paste (remember that fluoride is not recommended for children less than 2-3 years and even then, only a pea size is recommended), change your tooth brush once every three months and drink lots of water.

Let’s keep the pearls shining and the breath smelling really fresh.

By the way, would you tell a friend, if he/she had bad breath?

I asked that question during one of my shows and most people didn’t want to be the one that causes offence by telling someone that they have bad breath. However, most people also wanted to be told if they had bad breath. So, who will bell the cat? :d

Catch my show on this subject and watch me have fun putting OC Ukeje on the hot spot. https://chatwithdrketch.com/2015/05/03/watch-the-dr-ketch-show-episode-on-bad-breath-here/

Have a good evening, y’all 😀

‘ Pain makes us human. It is a bell, fine-tuned by evolution, that often rings in moments necessary for our survival. Because of pain, we can receive warnings that trigger the reflexes to escape potential danger. ‘

Want to know more? Click the link: https://www.health.harvard.edu/blog/im-in-pain-so-why-is-my-doctor-suggesting-a-psychologist-2019081417450

Q: Hello, Dr Ketch. Please I need help. My teeth are paining me and I tried different kinds of toothpaste. They are not working

A: Tooth aches are mainly due to tooth decay which may give rise to a hole (cavity) in the tooth as is being experienced by the person who asked the question above.

How does a tooth get to the point of a cavity? There are bacteria that live naturally in the mouth. When we eat foods rich in sugar and starch, the bacteria act on these foods and produce acids. These acids can eat away at the enamel covering of teeth. If these foods are eaten often, serious damage can be done to the teeth leading to the formation of cavities and subsequent decay as the acid eats its way through the enamel and may even get to the nerve ending! Imagine the quantum of pain, this person will experience!

What to do? You need to see your dentist asap. In the meantime, gargle with warm water and take some analgesics. Remember not to go over the recommended dosage. Use dental floss to remove food debris in between teeth.

To prevent this, be sure to remember and follow the rule of twos: brush your teeth twice a day, brush your teeth for at least 2 minutes (brushing up and down in circular motions) and see your dentist at least twice a year. Use fluoride-containing toothpaste. How do you find this? Walk into any shop or supermarket and read the ingredients on the pack. If it states that it has fluoride in it, you’re on the right path Limit your intake of sugary substances…make them occasional treats and if you do take them, please rinse out your mouth or better still, brush your teeth. Be sure to brush your teeth last thing before you go to bed. If you eat afterwards and take in sugary stuff, the acid produced really has time to eat away at your teeth while you’re sleeping as a result of the fact that less saliva is produced.

I hope y’all had a great day

Q: Hi Dr Ketch, I have a question. How soon after giving birth can I have sex again? My partner seems very impatient to me. Our baby is only a month old now,

A: Good question 😀 The honest answer is, as soon as you and your spouse feel up to it. Usually, 6 weeks is advocated at which time the woman would have had a post-natal check.  However, there is really no scientific basis for this and the time a woman feels like intimacy could differ from woman to woman. Some women feel ready earlier and some much later. Bear in mind that there are new issues contending for attention here…namely the new baby who requires a lot of attention, the overwhelming emotion of being in charge of a new life especially for new mothers, the sheer exhaustion after looking after the baby’s needs and sleep deprivation, the pain of vaginal suturing, if the woman had a tear, the dryness of the vagina at this time etc. We could go on and on! So, with all these, it may be difficult to feel really sexy…trust me, I know 😀

So, what’s the way forward? New mums, get as much help as you can so that you don’t feel exhausted every night. Also, rest whenever the baby is taking a nap. Perhaps, timing for intimacy can also be re-scheduled to other times…maybe mornings while the baby is still sleeping etc. Then again, you don’t have to wait for full sexual intercourse to be intimate. You can start off with cuddling and then move on to more adventurous things. Lubrication may also be a great idea to help with vaginal dryness. To help restore muscular tone to the vagina, pelvic floor exercise (Kegel exercises) should be started as soon as possible. The exercise mimics the movements we make when we want to stop the flow of urine. Try holding this for about 10 seconds and then doing about 10 repetitions per set. Try about 4 to 6 sets per day and increase this as you feel ready.

Remember birth control even if you’re breastfeeding exclusively. You don’t want to get pregnant while nursing a baby, right? 😀

I hope this helps 😀

Q: How long is the liquefaction of the sperm on seminalysis?

A: Hello there! Thanks for writing in.

Using WHO reference values, a normal semen sample should fulfill the following:

• Volume amount of sperm produced in one ejaculation): Greater than or equal to 1.5 ml
• pH (whether acidic or alkaline. If less than 7, it’s acidic and greater than 7 is alkaline): Greater than equal to 7.2
• Viscosity (being semi-fluid):  viscous
• Transparency: opaque
• Motility (percentage of sperm that move forward normally):  This should be more than 40%
• Morphology (percentage of sperm that have normal shape): This should be greater than or equal to 15% normal, oval sperm heads
• Liquefaction (time taken for the semen to become ‘liquid’): This should be complete within one hour
• Pus cells should be less than 1 million/ml or less than 5/hpf
• Total sperm count: This should be greater than or equal to 15 million.

Have a good evening, y’all 😀

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.