chatwithketch

Q: Hello Dr. please post for me and hide my ID. Just wanted to find out when ‘hot flushes’ end.  I am 52 going on 53 years old soon.  I started having hot flushes when I was 39 years old.  I haven’t had my pees (periods) for over a year now but still have the hot flushes. It can be embarrassing at times.  If there is any remedy? Please advise. Thanking you in advance

A: Menopause is a period defined by at least 12 months of cessation of menstrual period. It occurs as a natural process of aging which can start as early as late 30s as the ovaries start making less amounts of hormones (estrogen) but typically around the 40s and 50s. Menopause can also be induced by chemotherapy or radiotherapy (treatment for cancers), surgical removal of the ovaries etc. This is called premature menopause and is likely to run in families.

Symptoms of menopause can start months or even years before the cessation of periods and may last for up to four years (and sometimes even longer) after your last period as appears to be the case here. Common symptoms include:

• Reduced sex drive
• Vaginal dryness
• Night sweats
• Difficulty with sleeping
• Anxiety
• Hot flushes, as you have described

Hot flushes are typically described as a sudden feeling of heat that seemingly appears from nowhere and spreads throughout the face and body. This may happen occasionally but some women have several episodes a day, which they find uncomfortable and embarrassing.

The real culprit here is the deficient hormone, estrogen but this can also be triggered by wearing thick clothing, a high temperature, anxiety, drinking coffee or alcohol, eating spicy foods, some medicines etc

To reduce these symptoms, focus on the related cause. Examples include reducing coffee and alcohol intake, keeping the room temperature cool, sipping on cool drinks, having lukewarm baths/showers as opposed to hot ones, reviewing medicines with doctor if you suspect the medicine you are taking etc. Other helpful tips include spraying your face with some cool water if you feel a flush coming on, wearing more of cotton fabrics and stopping smoking.

Treatment for menopausal symptoms (including hot flushes) include hormone replacement therapy, eating healthy, balanced diets, exercising and cognitive behavioral therapy for people with anxiety. Your doctor will be able to assess what will benefit you most after reviewing any other medical condition you may have.

All the best!

Q: Hi Doc, I am sorry to just barge into your inbox. I have a problem. I am breastfeeding an 11-month old baby, while pregnant for 10 weeks. Is it safe?

A: It’s generally considered safe to continue breastfeeding in pregnancy. In fact some mothers would even breastfeed the new baby and the older one, concurrently. This is called tandem nursing. However, given the requirements of breastfeeding and of pregnancy, this mum must ensure that she is eating healthy and drinking sufficient fluids.

If your already born baby can talk, he may comment on the fact that the taste of your breast milk has changed especially towards the end of pregnancy and a few days after the birth of the new baby as colostrum is produced.

For more posts on colostrum, please click on this link: https://chatwithdrketch.com/2014/05/27/daily-health-tips-what-should-i-do-after-having-my-baby-if-my-breast-milk-doesnt-come-in-immediately/

For the mum, she may notice more breast tenderness…sorry 😀 And also, milk production reduces as pregnancy progresses.

The process of letting down milk involves the release of a hormone called oxytocin. This hormone can also cause uterine contractions, which you absolutely do not want when you’re pregnant until it’s time for delivery. The good news is that the oxytocin released is not enough to cause significant contractions that can lead to a pre-term labour. However, people who already have a history of pre-term or premature contractions need to check with their doctors as nipple stimulation (either during sexual intercourse or breastfeeding may lead to pre-term contractions)

Your 7-month old baby can take water (of course). You can give him freshly squeezed fruit juices (this basically means you’re buying the fruits and squeezing out the juice yourself or blending up a smoothie). Remember that your baby must not have any cow milk until the baby turns 12 months…well, unless it’s in yoghurt (unsweetened, flavor-free yoghurt). You can add some bananas to the yogurt and blend it up.

For more on weaning and preparation of yoghurt, please click on these links: https://chatwithdrketch.com/2014/12/29/daily-health-tips-weaning-foods/

Have a good night y’all 

Q: Please, I want to know what can stop my watery sperm. I am a boy of 16+ years

A: Thanks for writing in.

One of the causes of ‘watery’ sperm is pre-ejaculate (a lubricating fluid) which may contain some sperm cells. It is believed that 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 thought that urinating and cleaning the tip of the penis before sexual intercourse helps to clear the urethra of the sperm left from previous ejaculations. Diets poor in protein, frequent ejaculation as occurs in people who masturbate and exposing the testicles to high temperatures like in saunas could lead to a watery consistency of semen.

Just to be sure you do know what normal semen should look like, below is a guide.

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.

The causes of low sperm count, which is often considered a cause of watery sperm, could be medical, environmental or due to lifestyle issues. Sometimes, the cause(s) can, also not be identified.

Medical causes include infections like gonorrhea and chlamydia, certain drugs used for cancer and fungal infections, hormone imbalance, undescended testes, varicocele (swelling of veins that drain the testicle) and cancer.

Environmental causes include over-exposure to industrial chemicals, heavy metals and X-rays; over-heating the testicles by frequently using the sauna and hot tubs; prolonged bicycling

Lifestyle causes include alcohol use, tobacco smoking, illegal drug use, obesity and emotional stress.

To get a woman pregnant, a man has to have at least 40 million sperm per ejaculate. People with low sperm count usually have less than this.
If you have been diagnosed with low sperm count, then do something about it. Here are some tips that could help to improve your sperm count. Treatment is generally based on the cause:
Stress has been found to contribute to infertility problems such as hormonal issues. So, prevent excessive stress and perform relaxation exercises. Remember that infertility and life in general can be stressful. Learn to relax.

Stop smoking because smoking significantly reduces both sperm count and the movement of sperm cells.

Prevent overheating of the scrotum: When scrotal temperature rises (caused by tight underwear, long stays in a sauna or Jacuzzi, for example) sperm production can be impaired.

Maintain a healthy weight: Not too under or overweight since weight influences estrogen and testosterone levels.

Stop using drugs: Prolonged use of recreational drugs (for example, alcohol, marijuana, cocaine)

If you have infections like gonorrhea and chlamydia, these need to be treated.

Surgeries can be done for varicocele and cancers. Radio and chemotherapy are also treatment options for cancer.

Medications or hormone replacements can be used for hormonal problems.

The major challenge with low sperm count is infertility. Sometimes, the treatments listed above do not work, especially when the cause is not known. But IVF is an option that exists for this group of people.

So, first thing is to confirm from the doctor what exactly the cause of the low sperm count is (if known) and then review your options from there.

All the best.

Have a good night, everyone 😀

‘Avoiding animal products and eating a plant-based diet is a great way to keep type 2 diabetes under control’ Read!

https://www.health.harvard.edu/staying-healthy/meat-free-diet-linked-to-benefits-for-people-with-type-2-diabetes

Having trouble sleeping? Want to deal with this without resorting to sleeping pills? Read!

https://www.health.harvard.edu/healthbeat/better-sleep-naturally

Q: Hallo! I have a 1-month-old implant. I started my periods one week ago and it’s still on. How long can it take? Previously it was going for a maximum of 4 days

A: How long can it take? Well, it varies, but this change in duration of period would typically revert to ‘normal’ between three to six months after you inserted the implant.

For those who do not know, 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 (as appears to be the case here), 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!