Question: HI, IM A 41 YEAR OLD,WHEN I HAVE MY MONTHLY CYCLE.AT THE END OF MY CYCLE I HAVE LIKE BROWN BLOOD AND IT REALLY SMELLS BAD AND IT LAST A COUPLE DAYS.WHAT COULD THAT BE.
THANKS

Answer: At the end of a period, the amount of bleeding is reduced, so the blood maybe brown instead of red. Change your pads often, and the smell maybe less. If not, see a gynec. who can examine you and decide whether there is any infection in the vagina or cervix causing this.

Question: Dear Doctor, I am residing in Kuwait. I was in India in October 2006 and had a checkup done by a Gynaecologist . Everything was fine. She never told me I had any fibroids or cysts. And I guess I had conceived at that time. On Jan 7th 2007 I underwent a D&C for a missed abortion in Kuwait.At this time I was diagnosed for a fibroid in the uterus. It was my first pregnancy.I would like to try for a child again. Just recently on 14 march 2007 I had been to my Gynaecologist here for a routine checkup. She said that I had fluid retention when she performed an Ultrasound and said that it could be an infection due to the D&C and asked me to take Floxacin 500mg during my periods for five days 2 tablets day.However, I went back to the doctor who performed my D&C and told her about the fluid. She said hat it could be that the fluid was in the pouch of douglas due to follicle rupture (since it was my 16th day after periods when i did the checkup). However, she asked me to do a Pelvic Sono. And I was not prpared for what had to come. The results were:

1) Fibroid Uterus (Two Intramural fibroids 19x18mm and 13x11 mm and another anterior walled submucosal mass 9x5mm seen). Endometrial line clear and thin 6 mm. Uterus 65x42x36 mm

(2) Small cyst at the right ovary showing low level of internal echoes (Haemorraghic cyst versus endometioma). Right ovary 40x43mm Left ovary normal =22x16mm

(3) Mild amount of fluid at the cul de sac.

I do not know what this report means. I don't know if I am having a grave condition and if I will have problems conceiving. The doctor advised to use Duphaston for 3 menstrual cycles(from the fifth day till the twentieth day 2 tablet a day).

My question:
1. Can I still try to concieve and will I concieve with all these problems? I am taking folic acid and aspirin protect as advised. Is endometrioma a very serious condition? Will I develop cancer or any other such thing?

2. Just in case I conceive while taking Duphaston 10mg , will it effect my baby adversely? Do I try to conceive while taking this drug?Is it safe to take duphaston?

3. I was diagnosed for a fibroid during my pregnancy. Can fibroids develop during pregnancy? I was diagnosed for one fibroid in Jan. But now the report says two fibroids and another small anterior walled submucosal mass. I am confused. What's happening to me? Will this cyst disappear? Will I ever conceive again? I am scared, tensed and worried which I know will not help me in any way. What do I do? Do I need a surgery for those fibroids and cyst?

Would be greatly obliged if i could receive your advise I have no children and this is my 2nd year of married life.I am already 29 years and age is not on my side.Pls advise since i do not know whom to consult in this country.

Answer: Stop worrying ! Ovarian cysts are quite common and usually do not interfere with conception and regress with treatment. Do a scan on day 5 of the period and let me know the size of the cyst. ( you have not mentioned the size of the cyst now, so let me know both the sizes for comparison). This will determine whether the cyst has regressed and whether that is really an endometrioma or a corpus luteum in the previous cycle. A corpus luteum is formed when one ovulates and has the same appearance as an endometrioma. An endometrioma does NOT lead to cancer. Duphaston is safe for the baby, so you can conceive while taking it.You do not have to worry about the fibroids and do not need surgery for them. They do increase during pregnancy, so that is the reason they were seen during pregnancy and maybe not later when their size was reduced. All the best !

Question: I took fertomid for three months and did not have success. I stopped taking it. I have been 2 months with no period and a negative urine pregnancy test. Could this be a result of fertomid and will things go back to normal on their own?
 

Answer: You were probably ovulating while on the fertomid and therefore had regular periods. Now that you have stopped it, you may not be ovulating. Had you done ultrasound monitoring while on the fertomid to determine the most fertile period and also to ensure that your ovaries were not getting enlarged? Are your tubes and your husband's semen count normal ?

Question: I am 48 old and my period stop for about one year, and came back for almost 3 weeks now with out interrupcion. a doctor gave me a provera 10mg i am a little better and he said to continuo until my period stop other wise to consult an specialist.Is it ok? i am a little worried.thank you erika
 

Answer: Since you have had a period after one year, it is considered post- menopausal bleeding, which is not usual. You must have an ultrasound and a Pap smear done. Let me know the results, so I can advice you further. 

Question: I am 43 years old. I had my first and only child when I was 40. My husband is of the same age. We have been trying to get another baby for the last 6 month but with no success. All tests I have done demonstrated that I am ovulating and my condition to have and bear another baby seems fine. I have been taking folic acid for the last 6 month. I was able to get pregnant last September but had to terminate the pregnancy, as the fetus was not developing normally. The termination took place last October. I know I am not twenty years old anymore but both my husband and I would love to have a second chance. We do not know what to do to help our chances of getting another child before it is fat too late.

Please Doctor if you think there is something that we could do, do let us know. Thank you for your time and kind regards
 

Answer: Sorry to hear about your problems. Your periods are very irregular and you should investigate further. Have an ultrasound done and check your thyroid and prolactin hormones . Also, are you ovulating ? This can be detected by ultrasound or by an ovulation( LH surge) kit .Let me know the results, so I can advice you accordingly.

Question: I have painful period. Doctor suggested me take Duphaston from day 5-25 of my cicle..After 2-3 days after last tablet I should start menstruating, but it is 10 days after my last pill ...still no menses and I feel dizzy...What wrong with me?...
 

Answer:  Sorry to hear about your missed abortion. How are your tubes and your husband's semen result? Have you tried IUI( intra- uterine insemination)? Which city are you in ? Let me know, so I can advice you further.

Question: Dear doctor, My Velocit test during 7th week of pregnancy showed a faint band. My gyn suggested that I take maintane. Now my ultrasound shows I have twins. Do I still continue with maintane.
Thank You,
Madhuri
 

Answer: If you have not yet got a period, check the urine for pregnancy.

Question: Respected doctor iam 30 newley maried we are planning to have child after one year gap and my wife helth is soso so i sugest her not to take pills and iam bit uncomfortable to use condoms i request doctor what is the safeperiod to have intercource to avoid pregenancy thankig you yours faithfully makrand
 

Answer: It depends on the growth of the fetuses. You will have to discuss that with your obstetrician.

Question: Dear doctor, I message you before regarding my problem. on feb 13 i was supposed to get my period and all i got was hardly nothing not even one day of brown spotting and only when i wiped. I went to the doctor after 2 weeks on the feb 24 i took a hpt was negative she did a sonogram saw nothing so she said i can wait for the next period or she can induce it to get my blood work. she wanted a prolaction test because i had some discharge. after taking primoult on the 25 on march 1 i got my period thursday night and on saturday i went to the lab fasting because i had to do a fsh lh and prolaction incase it required fasting better safe than sorry.my result were fsh 3.0 lh was like 9.2 or 9.8 im going by memory my prolaction was 14 she said all was normal. Im living in jordan and im american so i am a little stressed not being in my home land. I got my period but after 13 days of bleeind not so heavy at first lasted 8 days i figured normal then i spotted when i went to the bathroom on toliet paper brown then on the 15 day it and i can take it to day 25 and hopefull bleed by april 9 and be back on my regualr schedule. i hope my lab work is accurate i mean she induced it 2 weeks after it should of been but never stopped and i believe it ran into the next cycle which id be due. i have a small fiborid but its not inside and only 3.3 cm and she said it doesnt need to have concern with. please help me. i was finally at rest that all was ok and i wasnt in early menapuse because im 35 and this happened can u advise me please

Answer: The safe period is not a foolproof method and she can get pregnant with that and the condoms. The pills are the safest method. You should consult a gynec. who can examine her and decide which is the best pill for her.

Question: I got my last period on 10/2/07, this march i did not get my period till 12th so i did pregnancy test on 12th which is negative. my dr. said to take meprate tablest for 5days or wait for more 15 days. this is the first time delay in my periods otherwise i usually get on the same date for else two-three days early. please help me out what should i do and what is the reason. one more thing last month only after my periods got over i removed my copper-t insulated.
 

Answer: First of all - RELAX ! Stress can also cause the irregular periods that you have had. The fibroid could also be another cause. The hormones are fine. However, also check your thyroid levels and let me know the result. Do you have any cervical erosion or polyp? These can also cause the irregularity.

Question: Hi doctor, I had a vaginal swab done last week,the vigical culture showes "heavy growth of mixed bacterial flora" and "no yeasts isolated".What does this mean? Thank you.
 

Answer: Occasionally, periods are irregular, so you do not have to worry about it. However, have a scan done on day 6 of your period to determine whether you have an ovarian cyst . Also, if the problem recurs, have your thyroid levels checked.

Question: Hello, I have just found out that I am pregnant, with a home teast. The two dates of intercourse where 12 days ago and 28 days ago with my husband. I was sure I was not pregnant two weeks ago and had rather alot to drink over one weekend and am concerned if the conception had occurred 14 days prior to this. i am unsure of my period cycle as it has been all over the place lately. Can you reassure me that infrequent over indulgence in alcohol (9 units) in two nights in the first 16 days of conception will cause any harm, as i was unaware that I may be pregnant.

Very worried, M.
 

Answer: This means that there is a bacterial infection. The culture sensitivity report would also show which antibiotics would work best against the bacteria you have. There are no yeast( fungus )infection, so you do not need anti- fungal medication.

Question: I had a very difficult delivery of my first child. 33 hour labor, 4.5 hour pushing phase, baby was not coming down canal on his own, doctor said I could continue towards a natural birth if I was able to push him down enough myself. After four hours, I did it, however the baby was faced the wrong way, he was 10 lbs, and the doctor had to use forceps to pull the baby out the rest of the way. I also had a vaginal side wall tear during this whole process. Since this delivery (three years ago) I have pelvic pain, extreme pelvic pain during periods, if I step too quickly off a curb, shut the car door with my hip, go down stairs, or anything that would cause a "bump" to my body, I feel movement in my pelvic area - a sort of jiggling sensation. I have a hard time putting in tampons. The tampon will veer off in different directions, and sometimes it feels like I have to push really hard. If I'm in a pool or tub, it feels like the water is freely flowing in and out of my vagina, while I'm just going
 

Answer: Alcohol at any stage of pregnancy can cause some damage to the fetus. It would not be possible for me to reassure you regarding this and can only hope that your fetus is not affected. The following are some of the details:

Alcohol Consumption Among Women Who Are Pregnant or Who Might Become Pregnant --- United States, 2002
Alcohol use during pregnancy is associated with health problems that adversely affect the mother and fetus (1,2); no level of alcohol consumption during pregnancy has been determined safe (3). Fetal alcohol syndrome (FAS) is recognized as the foremost preventable condition involving neurobehavioral and developmental abnormalities (1). Women who drink during pregnancy place themselves at risk for having a child with FAS or fetal alcohol spectrum disorders (FASD) (4).

The findings indicated that more than half of women who might become pregnant reported drinking alcohol, including 12.4% who reported binge drinking and, therefore, were at particular risk for an alcohol-exposed pregnancy (8). A dose-response relation has been observed between prenatal alcohol consumption and dysmorphic brain development in the fetus as early as 3--6 weeks' gestation (2), a period during which the majority of women might not know they are pregnant. Further studies have determined that alcohol consumption can be associated with prenatal growth delays and neurodevelopmental insults throughout the entire pregnancy (8).

Question: Thank you dr. smita for your interest to reply my question regarding cervical erosion for three times,i am from iraq basrah & I did not do a pap smear,can you tell me whats the next step,espacielly I want to have a 2nd baby.thanks a lot dr.God bless you.

Answer: Sorry to hear about your problems. Have an x-ray of the pelvic bone done. This may determine if there is separation of the pubic bones which can cause this pain. Taking calcium with vitamin D tablets for 2-3 months might help. Also, you seem to have a lax vaginal wall. Check with your gynec. who can advice you regarding some perineal exercises for this.

Question: Dear Doctor, Regards to you. I hope you remember my case. My last montly period was started on 8th of February '07. From 5th day till 10th day I took a tablet Siphene for 5 days. (Last month (Jan) I took tablet CLOFERT 50 but had a reaction). After taking CLOFERT 50 my periods were regular. Now my problem is I did not get my periods till today (11th March). Am I pregnant?? What should I do to get pregnancy?? Please advice.
 

Answer: Have a pap smear done. this can be done around the 12th day of the period. Regarding pregnancy, start taking folic acid tablets. Check in the pharmacy whether you get ovulation detection kits. If these are not available, have an ultrasound done on day 12 to determine whether you are ovulating or not. If not, you might require medication like clomid. All the best !

Question: Hi Doctor I am 24years old. My periods have been irregular for years.. since i was 21. I am married in 2005 April.I done my blood test last month prolactin hormone is very high(210). i take 1) Cabergolin 0.5 mg(once in a week ),Glycomet 500 daily 3 times ,Tablet Novelon also So it's my personal request to help me. Is my treatment is going properly. And why she has prescribed me Glycomet tablet. Can Polysystic ovaries are curable This all will not create a huge problem for me in pregnancy?
 

Answer: First of all, your questions go to the omanaccess website and are then sent to me without your name, for privacy purposes. So , everytime you send a mail, it would be better if you mention the previous history in brief, as I do not know who has sent which question when. What reaction did you get with clofert? Siphene and clofert are the same drugs, so there should not have been any difference. If you are not pregnant, take siphene again in the next cycle and have a scan done to determine whether you are ovulating or not. Let me know the result of that, so I can advice you further.

Question: Hi. I am 17 years of age and on the pill. I recently asked my doctor if I could skip m period, (this was on a Tuesday) and he gave a prescription for primolut. And said take it Wednesday to Friday 3 times a day, which I did then leave it and go back to the normal pill. Because the red section the next active pill through that week was on Saturday. This was last week, it has since been a week, and an I have been bleeding all the way through. Is this normal? What do I do? Or what can I do to stop this?
 

Answer: Polycystic ovary stays forever- so in that sense it is not " curable". However, as long as you are ovulating , you can conceive.It is associated with insulin resistance, which prevents the eggs from forming and glycomet helps to correct that. Novelon is a contraceptive pill , so I do not understand why it has been given to you now if you wish to conceive. Is it only for 1-2 cycles? Please check with your gynec. regarding that. Cabergolin is fine. Repeat the prolactin level after 3 weeks to determine whether you need to continue the cabergolin in the same dose or not.

Question: Hi doc, my question is doc had given me letroz 2.5 mg for 5 days from day 3 after that on day on 9 day he called me for ovulation study that time the follices were tooo small so he had given me injection named MENOVUL 75 ml the injection was given me for 2days hence the growth of the follice was poor so on the 11 day he gave me MENOVUL 750 Ml and called me on 12 day but the result was neagtaive soo i want to know why it is happening??? why the follices are not growing I have thyroid but it is now 1.8 (normal range), I have prolactin 13.5 (normal range), my hsg report is also normal, so plss tell me why it is happening
 

Answer: I think the irregular bleeding is because of taking primolut and the pill. You can take dicynone tablets- one tablet three times a day for 3 days.

Question: I have been diagnosed with endometriosis and the doctor suggested contraceptive pill as treatment option (I have to skip the placebo's). I've been on it for two months now. Recently I experienced pressure near the anus and examined the inside of my vigina. It seems the cervix is swollen, or at least it feels like it. I'm not sure exactly what it should feel like. I was sexually active about 5 months ago. Could you give me some advice pls?
 

Answer: Were you ovulating with clomid prior to taking the letroz? If yes, you can switch back to that. Alternately, you can take letroz and start the injections early- one everyday from day 5 of the period , till day 9 . Do a scan on day 10 and then take more injections if required. Careful ultrasound monitoring is a must. All the best!

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