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Doctors' Answers to "Frequently Asked Questions" - Menstrual Cycle
These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.
Question: Hello, I'm taking Triphasil-28 and am going on a vacation in late June. As it happens, my period will occur right smack in the middle if I keep on my regular schedule. I've looked at it both ways, if I should skip the placebo pills of this packet and continue onto the next, or if I should take the second week twice in two packets and delay my period by a week. As I see it, I would rather have my period a week early than a week late- is this wise to do? Thanks for you help.
Answer: Either way will work, but you should use an additional method of birth control(condoms, spermicidal jelly, or both) while you are juggling. The taking a 2nd week is more likely to delay your period over the vacation.
Question: My boyfriend and I were having oral sex and his seman was on my hand. I wiped it off and some time later, I used the same hand to wash my vagina. Can I be pregnant through this? Can sperms survived in the open air? Also, recently, I started exercising regularly and has be keeping to it for 1-2 months. I didn't exercise for about 2 years. Then, last month, my mentrual flow decreases and ended 1 day early. For this month, it came 2 days early and stopped. All my periods have been regular until recently. What is the cause of this. I have heard that intensive training can result in this. How true is this?
Answer: Pretty unlikely but not absolutely impossible. Extensive exercise can change a woman's period probably by decreasing the fat which metabolizes estrogen. There also appears to be some type of limit on getting pregnant below a certain body weight-this seems set by your pituitary gland. If you are concerned about sperm in the future use a vaginal spermical suppository(available over the counter in any pharmacy) before you go out with your boyfriend. This creates a little vaginal discharge as the suppository melts but, gives some protection.
PMS and Hormones [posted 1/13/99]
Question: Exactly what happens to your hormones during PMS? What triggers the onset
of PMS as related to hormones? Also, what role does serotonin play in relation?
Answer: Well, we really don't know. You would think that we would have some
idea, but we're pretty clueless as to the cause of PMS, except that it is obviously
hormonal in some way.
Hypertension in Menopause [posted
Question: On Aug 18,1998 I started bleeding heavily I was finally able to see a
doctor. He prescribed medroxyprogesterone to stop the bleeding and then prescribed iron
supplement with B-12 and folic acid. My regular doctor was concerned for my hypertension
(180/110). I have not had a problem with this before until August. He told me that in some
cases with the onset of menopause some women start having hypertension. My main concern is
that in taking the hydrodiuril that my potassium levels will drop and I'll just start
taking one pill after another for subsequent problems. I am not sure I can really trust
Answer: Most women have elevated blood pressure in the presence of estrogen
withdrawal. The restarting of estrogen usually fixes this problem. I'd focus on estrogen
replacement, not bp treatment. If you have decided not to replace the estrogen, clonidine
is an excellent bp medication during the withdrawal months.
Early Menopause [posted 1/11/99]
Question: I have been going through menopause since I was 16. Is this normal?
Answer: No. See your doctor or get a second opinion.
Period Stoppage [posted 1/8/99]
Question: In January of last year, I gained a total of 12 pounds. This, during a
time when I was exercising at least 4 times a week for at least 40 minutes. Also, during
this time my period stopped. I am not pregnant. I stopped eating red meats in February and
eat very little pork. I am taking ziac for hypertension. My doctor prescribed provera for
the cessation of menses, which I take 5 mg a day for the first 12 days of the month. I
have gained an additional 5 pounds in the last two weeks. Is it possible that the
combination of these two drugs is slowing my metabolism? My doctor also said that my body
wasn't producing the progesterone because of my weight. Is this possible? What are other
causes for one's period to stop? I currently weigh 185 pounds and I am 5'4". I have a
Answer: Most common would be menopause. However, if you aren't the correct age,
there is a long list and it needs to be evaluated by an endocrinologist or gyn-endo
specialist. The weight gain can cause period abnormalities, but sounds like its a chicken
Non-stop Menstruation Concerns [posted
Question: I started the pill (Ortho-Tricyclen) last month and I haven't stopped
bleeding. I've now gone through an entire cycle while persistently bleeding. I am getting
married in three weeks and I'm scared that the bleeding will not stop by then. On Sunday I
will have finished my spacer pills and will be starting the whole process over again. Is
this side effect normal? I've talked to one gynecologist here in town about the problem
but she wasn't much help. She just told me to stick it out? If someone could please let me
know what is going on with my body and when this will stop I would really appreciate it!
I'm desperate not to spend my honeymoon or first months of my marriage with this problem.
Thank you for your help!
Answer: Well, I'd try a big dose of progesterone to ensure that the lining of
your uterus is sloughed. Common problem with low dosage birth control pills.
Relieving PMS Symptoms [posted
Question: I have read that to relieve symptoms of PMS, diet and excercise are
important,and it is recommended that you take vitamins B complex and eat heavy
carbohydrates. Can you suggest proper foods that would be helpful and what is the best way
to increase serotonin in the body during the premenstrual period? What is the dosage of B
complex that I should take? I am 40 yrs old and weigh 120 lbs. Thank you.
Answer: Possible, but, unlikely. PMS is one of those problems for which we
really don't have good treatments. But, shouldn't do any harm(except weight gain with the
carbs). Take 2 B complex vitamins from the pharmacist, this would be more than enough.
Lengthy Menstrual Cycle [posted
Question: Hi, I am sixteen years old and a year round swimmer. My menstural cycle
has never been regular because of swimming, but it lasts no more then 7 days. Well, my
period came two Sunday's ago and has gone on all that week and all this week. Could you
please tell me what's wrong (if anything)? Thank you .
Answer: Probably nothing. Occasionally, you may need an extra dosage of
progesterone to slough the lining. This is pretty common in thin, athletic women.
Missed Periods [posted 11/05/98]
Question: I have missed my periods for 2 months now and the last one i did have
only lasted one day. I am currently taking bcp- Dimulen. I have taken 2 preg. tests, which
are neg.One only last week. I have been feeling awful. terrible headaches, vomiting, after
eating I almost always feel nasiated, like my food is stuck in my upper chest. Like a big
wad siting there . I feel as if I should throw up to rid myself, although when I do it not
always helps. My dr. says not having a period is normal while on bcp. Is it? Should I have
some other tests ran? Some advice will be much appreciated. Thanks
Answer: Missing a period here and there can occur on the pill;but, missing two
would be unusual. However, if you have some metabolic problem or are ill that can happen.
Does an Extended Period Mean
Pregnancy or Another Problem [posted 11/04/98]
Question: Ok...I guess I'll start in the beginning... my ex-boyfriend and I one
night had sex, but not technically had sex. See he tried to go inside but could never get
in. He also had no condom. Ok, about 3 weeks after that night I got my period, but it
hasn't stopped. I have had it for about 4 weeks and its still going. My mom called the
doctor and they said I might be pregnant. Could that be? And if not then what is wrong
Answer: Well, you could be - but probably not. We always check this first since
the treatment is so different. Usually, a protracted period will call for progesterone for
a week or two to slough the lining of the uterus. This is pretty common.
Went Off Pill months Ago, But
Menstrual Cycle Has Yet to Start [posted 10/23/98]
Question: I am a healthy active 24 year old woman. About 10 months ago I went off
the birth control pill Nordette. I took Nordette for a year with no problems except I
gained 7 extra pounds. I did lose the 7 lbs but since going off I haven't had a period. I
have been to my OBGYN numerous times. Each time the nurse gives me a pregnancy test and a
progesterone shot. The shots have failed to bring on my period so about 4 months ago I had
blood drawn. All the hormone tests came back normal and the nurse said I could get another
shot of progesterone or do nothing. I am 5'6" and weigh 114 lbs. For exercise I walk
4 miles 4-5 times a week with 7lb weights., I do not eat dairy products (I take a calcium
citrate vitamin) and only rarely do I eat any meat. I try to keep my fat intake extremely
low. My health is excellent otherwise, my husband and I want to have children someday and
I am starting to become worried. My OBGYN annual is in a month. Should I just wait until
Answer: Yeah, you probably need a D&C to remove the hypertrophy of the
uterus, usually responsive to progesterone.
Pain & Irregular Cycle
Question: I am a 32 year old female. I have had 4 children. As long as I have had a
period I have charted it and have been as regular as the sun rising and setting (28 -31
days/cycle). In May, 15 days after the first day of my last period I had some bleeding
accompainied with menstrual cramps, and a more defined pain in my lower right abdominal
area near my right hip. This alarmed me and I visited my OBGYN, who gave me a pelvic exam,
took a pap smear, which came back as no sign of cancer for my cervic or vagina and was
told that the bleeding was "normal", they also gave me a urine pregnancy test
that came back negative. As my pain continued to be constant and I did not have period as
of day 35 when I had another pelvic exam, & blood pregnancy test, both were negative;
and the following day my cycle began. I have also had my blood count tested for white
cells, red cells, hemoglobin, hematocrit, MCV, platelets, granulocytes, lymphocytes,
monocyte, eosinophil, basophil, and beta-HCG.
Every result was within their normal range, my pain persisted I was scheduled for an
ultrasound of my pelvic area. My pain increased sharply, so I was prescripbed
hydrocodone/apap 5/500. I have taken this and while on this medicine I still have the
pain. Since then I had my ultrasound, which was evaluated as "entirely normal".
I was told that they do not know what is causing my pain. I am very bothered by my pain,
it is constant lasting 24 hrs a day, and I have no other noticeable symptoms. Do you have
any ideas what could be going on and any suggestions to what steps I should take next to
get to the bottom of this. Please help me as I am very concerned about why I have the
Answer: I would see a general surgeon for an evaluation if the ultrasound is
normal. However, it sounds like you had a ruptured ovarian cyst. This occurs in the mid
cycle and can be quite painful. Especially so if there is a lot of blood released to the
pelvic area from the rupture. These happen every month with ovulation;but, occasional ones
are large and bloody.
Menstrual Side Effects on Arthrotec [posted
Question: For two consecutive months I have experienced severe mid-cycle pain with
some bleeding. Concurrent with these episodes were nausea and projectile vomiting. I
suspect this may be related to the use of Arthrotec which I have been prescribed for joint
inflammation. Is this a recorded side effect and what effect might the drug have on normal
Answer: Usually nothing on menstruation, except sometimes changing the duration
or severity of the period-stumped on this one, check with your md.
Menstrual Cycle [posted
Question: I had a termination of pregnacy beofre than my periods were Always
regular, about 3 months after the termination my periods were on for about 2 months. My
gyn gave me loestrin(bcp) for 3 months. My per became regular for about 6months. Now I
haven't seen My period for 4 months now. I've been having intercourse without protection,
for about 4 months -nothing Is going on. My periods are delayed- and i don't want (bcp) to
regulate. Please help - i'm stressed. I'm trying now to make plans to see an
Answer: Sounds like you need a pulse of progesterone to completely slough the
lining of your uterus. If this does not work, most would recommend a d&c to ensure
that the lining is completely back to normal. However, stress can also do this.
Painful Menstrual Cycle [posted
Question: My doctor has recently prescribed Megace for me so I will no longer have
such painful periods. I have only seen reference to this drug for cancer patients. Is
there any information available concerning my use of Megace? Any long term side effects?
It has worked well and I feel fine and appreciate not having to go through a hysterectomy.
Any information would be appreciated. Thank you.
Answer: Well, it is a potent steroid, usually used to increase energy, appetite
etc. in cancer and HIV patients. Long term side effects center on its progesterone like
effects. Also, there are reports of adrenal problems, insufficiency, Cushings Disease
,etc. Short term effects are nausea, vomiting etc.
Hormone Replacement Therapy
Question: I have been going to the V.A. outpatient clinic, because I am a veteran,
at which time they started me on HRT because I have been going through menopause since I
was 37. The Hormones caused my blood pressure to shoot up to approximately
146-154/102-112. They decided with that, that they did not want to stop the hormone
therapy, so they put me on hydrochlorothiazide, to decrease my blood pressure. I went back
after app. 1 month, and my blood pressure is still high. They increased the dosage to a
whole tablet of hdrothzd, which is 25 mg. I started waking up with splitting headaches, I
was confused, etc. I stopped taking the hormones yesterday, but today went back to taking
a half of tablet of hydchlotzd. What should I do now, I am at a loss? Do you have any
suggestions for me. Is there other types of hormone replacements that are better for me?
Are there an ┐ü4d side-effects with taking this medicines together?
Answer: Well, what were they giving you? There are several different types of
estrogen replacement regimens and several doses possible. Try a different regimen. Also,
some women tend to elevate their bp on estrogen withdrawal. Clonidine is very effective in
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