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OBGYN.net Young Woman Ask The Expert - June, 2000 |
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 Marta Mendez MD,
OBGYN.net Co-Chair Young Woman Editorial Advisory
Board, is a Pediatric and Adolescent Gynecologist at the Children's Hospital
in Panama City, Panama. She is fluent in both English and Spanish. Please post your questions to her and check
back here each month for a selection of Young Woman focused questions and answers. |
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| In addition to Dr. Mendez, our resident expert, many of this month's questions have been answered by several other professionals at OBGYN.net. Assisting Dr. Mendez are: | |||
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| Q:
Starting period following pregnancy I had a baby 5 months ago, and breastfed him for 4 months. I took Micronor while I was breastfeeding, and switched to Ortho-Tricyclen after I quit breastfeeding. I took the combo pill for a month, and I still have not gotten my period. Is it because of my prolactin levels still being elevated, or could I be pregnant again? |
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| A: Was there any gap in switching fro the Micronor to the Tricyclen? Although the progestin-only pills are less effective than the combination pills, they are a highly effective method of birth control. Nothing is perfect, though! Lack of withdrawal bleeding does occur on combination pills, but I think that checking a pregnancy test would be wise. Betsy Hyde, CNM, MSN, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Why haven't I started my period yet? I am 14 years old and have not started my period yet. I have been having signs, but no period. What's wrong with me? |
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| A: Have your breasts started developing? Do you have pubic hair, and hair under your arms? How is your weight? Sometimes if young women don't have enough body fat, or exercise strenuously, the onset of menstruation could be delayed. Young women develop at many different rates. Some young women get their periods when they are 10, but some don't get their periods until they are 15, 16 or even later. Most of the time, this is perfectly normal. Betsy Hyde, CNM, MSN, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
I haven't started my period and I'm worried... I am worried because I have not started my period yet. The doctors say you should start around the time your mother and grandmothers started, but they all started a lot younger than I am now. The reason this bothers me is that I was sexually abused when I was little and I think that might have something to do with why I have not started my period. |
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| A: The average age of menarche (onset of menses) in the U.S. today is 13. There is a normal range around this (10-16). Usually, breast development begins about 1 year prior to menarche. If breast development has been occurring for more than a year and no periods, then one should see a Gynecologist right away. Sexual abuse should not lead to lack of menses, unless there was serious physical damage. R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
No period for several years I haven't had my period in a very long time. When I was 15 years old I started skipping months. When I was 19 I started taking birth control pills to regulate it, but then I went off them to try to have a baby. Now I'm 20, I'm still not having my period, I've gained weight, and just recently I've been having pain in my stomach, nausea and headaches. I want to have a baby. Do you think I can still have children? |
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| A: Only after taking a complete history and doing a physical exam and then probably some lab tests, would I or anyone else be able to answer that question. R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
Bleeding continuously for 22+ days I had been having normal periods following the birth of my second child (January 2000), but in April I starting having it every other week. On May 28th, I started again and I'm still bleeding! I went to the hospital and told the doctor that I had been bleeding for 22 days, with blood clots and lower abdominal cramping. All the doctor said was that I had anemia and I was given iron pills. I feel there is something very wrong... |
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| A: There are a number of explanations for bleeding of this type. The most likely reason is that you are not ovulating regularly yet. Sometimes it takes a while to begin ovulating regularly following the birth of a baby. When women don't ovulate, the periods can be too frequent, or last too long. Medication such as birth control pills or one of the many progestins can help you. Whether or not you are breast feeding would be important in prescribing hormones to regulate your cycle. Is there any possibility of pregnancy? Even though you just had a baby in January, if you have not consistently used birth control, a pregnancy test might be indicated. Contact your health care provider; tell him or her how worried you are, and that you would like further treatment for this prolonged bleeding. Betsy Hyde, CNM, MSN, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Two-week cycles every month I am currently on the 28-day of Ortho Cyclen birth control pills. I normally have about a two week period each month. I have been on birth control pills for 14 years, my doctor has switched me to various pills many times through the years. It is very hard to have to fight a period for two full weeks each month! My ob/gyn knows about this problem and his solution is switching me to another brand of birth control pills. Do you have any suggestions? |
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| A: I think another option you should consider is to go off the birth control pills and try some other methods of birth control, and let your body get back into its normal cycling. The bleeding is related to the birth control pills, most probably as the pill creates an artificial period. The pill is a combination of synthetic estrogen and progesterone. You didn't mention your age, and whether or not this has been a problem the whole time you have been on the pill, or just in the past few years. I think as women get 'older' their hormonal needs change and they need different things. If you totally don't want pregnancy, and IUD is a very good method that doesn't interfere with your cycles. The other methods, diaphragms for example also do not interfere with your cycles, but must be used to be reliable. The Depo Provera shot is reliable and easy to use, but might confuse the issue more, as it too suppresses your normal ovulation. In any event, switching from pill to pill doesn't seem to be effective for you. Here are some good web sites that review in detail the various birth control methods: http://www.fpnotebook.com/GYN.htm http://www.mjbovo.com/Contracept/ http://www.managingcontraception.com/choice.html Also, look at these Questions and Answers: http://www.managingcontraception.com/qa.html Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Cramping following period I recently finished my period and although it is over, I am experiencing cramping and very, very light bleeding. Is this something serious? Do you have any idea what could be causing this? |
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| A: Not knowing your age, or the other things involved, I cannot explain your situation. Other factors to consider are: vaginal infections such as Chlamydia, which can cause cramps and bleeding. If these symptoms persist, call your health care provider for an evaluation. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
More on irregular periods I am 18 years old and I'm sexually active. I usually get my periods around 30 days but this month I didn't start until the 34th day. A few days after it started, I had some brown discharge for a few days. Now it seems like I have my period again, but with very dark brown blood. I don't know if this could mean that I didn't ovulate or if I am bleeding from pregnancy. |
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| A: Keep close track of your periods. 26-35 days can be a normal range for periods. Did you try a pregnancy test? It is doubtful you are pregnant but a test would show if you have the hormones in your system. The book Taking Charge of Your Fertilty by Toni Weschler has lots of information about the symptoms of ovulation. Once you learn the fertilty symptoms, then you can determine when you are ovulating. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Extremely light period I went off birth control 6 months ago and, according to a home pregnancy test, I am not pregnant. Last month I started my period on the day I expected, but had none of my usual cramping and backaches. The period was only very, very spotty and EXTREMELY light. It was never more than a rust or brownish color. Up until now I have had predictable cycles and normal-colored menstration. Could this mean that I did not ovulate or should I be concerned about any other possible problems? |
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| A: It would appear your body is getting back into your normal cycle. Keep tracking your periods, and monitoring your cycles and fertilty signs. A great book you might find useful is Taking Charge of Your Fertilty by Toni Weschler. One month of something different isn't too concerning. The light period just means that for this month, the uterine lining was not very built up, so perhaps you are low on progesterone. Also, your ovaries alternate, so next month may seem normal. Again, a careful menstrual calendar is very helpful. Having a good discussion and examination by your health care provider might be in order if the light periods persists. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Over-productive "normal" discharge I am concerned about an over-productive normal discharge. It is white, sometimes thick, sometimes more fluidy. I have had a chlamydia test which came back normal. I have also had a vaginal swab that came back as normal vaginal bacteria, just over-productive. It is something that I am very concious of, especially during oral sex. It started when I was about 12, my mother took me to a Gynaecologist, who was very rough. My Mum told me recently when I was discussing this situation with her, and my low libido, how worried she had been after I saw the Gynaecologist because he was extremely rough and seemed to have little consideration of my age, size, and the natural trauma at a young age being prodded. He said it was normal. Apparently I went into a foetal position, and remained very closed and distant for a few weeks. I have never seen another Gynaecologist. I have regular periods, I am not on any contraceptive. (As this does not seem to agree with my body, I would throw up or have diahrrea every day). The only thing my GP has suggested is a vaginal douche. Do you have any suggestions? |
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| A: A normal discharge does not cause itching, burning or other discomfort. It is usually white and odorless, but I really think you should consult a gynecologist. Marta Mendez, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
Clear discharge with black spots I am 26 years old and have been off the the pill (Alyese) for 2 months. I have had one normal period since the discontinuation. I was only on the bcp for two months. Now I have noticed that I am having a clear discharge with black spots in it. I notice it when I urinate. I am assuming this is blood, however I don't know. Does this sound like anything normal or am I panicking for a reason? I do not have insurance and/or a regular doctor. What do you suggest? |
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| A: It could be a vaginal infection (yeast). I suggest you consult a gynecologist. Marta Mendez, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
Only 5 or 6 periods in the last 3 years I am a 15-year-old girl. I am overweight (not fat, just chubby) but I am comfortable with that and have grown to accept my body. I don't exercise very much. I am a vegetarian of three years, and I admit, I don't eat as well as I could. I drink about once a week and smoke pot about once a month. I've only had sex once. I'm a regular smoker. I don't know if this may effect my question, but I masturbate everyday, on average. I first started my period three years ago. Since I started it has been very unpredictable. I would say I have had it about 5 or 6 times. I am afraid something might be wrong. I would appreciate your information before I go to the doctor so I might know what to expect. |
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| A: Nice to hear from you. I am glad you are taking an interest in your health. Continue to keep a calendar of your menstrual cycles and how often you bleed. You might be developing a condition known as Polycystic Ovary Syndrome. Classic to this is a tendency to be on the heavy side and having irregular periods, or months when you skip a period. Usually after the first two years of having periods, the norm is to have a period every month. If you were on the birth control pill, you would have a regular period, but then maybe go back to skipping when you go off the pill. Usually when you don't have a period it means you aren't ovulating, and this is common with PCOS. I highly recommend you try to cut down on cigarette smoking, as it doesn't do much for your health. Marijuana once in awhile might be okay, and of course you are too young to be drinking, but it sounds like that is only occasional. There is nothing wrong with masturbation, and preferable to unprotected or unwanted sex. Especially walking is a very good exercise, and even 30 minutes a day can do wonders for your health. Is there a Planned Parenthood or teen clinic in your area? That might be a nice place to start getting familiar with how you can better care for your health. The nurse practitioners are very helpful, and if you then need to see a physician, they can help you find one who will be sensitive to your needs. Nurse practitioners try to make your experience comfortable, and do lots of explaining. Here are some excellent web links for you. Don't hesitate to ask more questions. I do think you need to have your cycles evaluated and some laboratory tests done. It would be good to get your periods into a more regular pattern. Here are some web sites that might be of use to you: http://www.mjbovo.com/Contracept/ Amenorrhea==no period: http://www.obgyn.net/women/conditions/conditionsa-f.htm#Amenorrhea http://www.fpnotebook.com/GYN46.htm Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Painful cramps I'm 16 years old and I have very painful cramps. I have pain from my belly button down to my toes. The strongest pain is in the central area of my lower abdomen. This lasts for the first day of my period. The pain comes in waves. Every 3 minutes I get intense pain, then a 2 minute break, then it starts again. What could this possibly be? If I were to go to a doctor, what would they do to figure out what is wrong? |
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| A: Many girls have painful menstrual cramps, and there is a physiologic reason for painful cramps. This condition is called Dysmenorrhea (difficult menstruation) and there is nothing 'wrong' with you, just because you have cramps. You body makes higher levels of a hormone called prostiglandins. Many girls notice they have painful cramps about two years after their menstrual cycle begins. There are some excellent medications to help you thought the days of your severe cramps. Ibuprofen 200mg is something you can buy. You can take 2-4 on a regular basis when you have severe cramps. 4 pills would equal 800 mg, which is another prescription medication called Motrin. This is a good one to start with, and start with two pills (400mg) and see how you feel. Take them on a regular basis. If you visit a health care provider, they might offer you one of a variety of medications like this, that help decrease the prostiglandin levels. Some providers offer a birth control pill, which can help with the cramps too. If you are not sexually active, I'd opt for the pain medication first. I've written an article about Dysmenorrhea that should help you to understand what I am saying. Also, here is a website that can help: http://www.obgyn.net/women/conditions/conditionsa-f.htm#Dysmenorrhea Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Extreme bleeding Yesterday, I was bleeding at a rate of 1 super tampon per hour every hour from 8am until 2am (18 hours), then began bleeding at a rate of 1 super tampon every twenty minutes until 4am. I am also experiencing extremely heavy clotting or tissue (doesn't seem to break up like a clot). I went to sleep at 4am and elevated my pelvis to try and slow the bleeding down. I woke up bleeding three times by 10am. I am 28 years old, married to a man who has had a vasectomy (so I quit taking birth control approximately 3.5 years ago), my periods generally last 4-5 days and flow at a rate of 1 tampon every 4-8 hours. I am not on any medications. I am now very weak, faint and tired. Does this sound familiar of any diagnosis? Is there anything I can do before I can get to a doctor for help? I took a couple of multi-vitamins w/iron to try to restore some iron to my system. |
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| A: Hopefully you are able to connect with a provider who can help you determine the cause of your bleeding. There are many possible causes, from miscarriage to fibroids to hormonal imbalances. It is unusual to bleed so much. Some women find taking non-steroidal anti-inflammatory medications help to slow their bleeding down. An example would be Motrin (Ibuprofen 400 mg) and taking up to 800mg at a time can be effective. Of course you feel weak and tired due to all of the bleeding and blood loss. Here are some web sites with information about possible causes: http://www.obgyn.net/women/conditions/conditionsa-f.htm#AUB http://www.mjbovo.com/AbnlBleed.htm http://www.womens-health.com/gyn_health/gyn_md_dub.html http://www.fpnotebook.com/GYN50.htm Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
I just finished my period and it's back! I am 28 years old and have read a lot of the questions that people have written to you, but I am not finding the answer. I have always had a normal period, every 3 weeks to be exact. My period just ended a week and a half ago and 3 days ago I started spotting "light-brown to dark-brown", then I started my period all over again. This is NOT normal for me. I have had one child 5 1/2 years ago by a C-section. I have an appointment for the 21st of this month. Should I call and get in sooner or just wait? There is cervical cancer on both sides of my family, first cousins having had it. What should I do? Could you explain in detail what is this "light-brown to dark-brownish discharge? Is it dried up blood? I also started lifting 5lb weights and doing stomach exercises about a month ago. I am 5 feet tall and 110 (or less) pounds. |
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| A: Occasionally women will have breakthrough bleeding, and there will be no significance to it. It is thought to be a hormonal alteration. Occasionally it signifies other problems, so it is good you have a gyn appointment set for next week. I don't feel there is any reason to more your appointment sooner, but keep a good calendar of when the bleeding occurred. Brownish discharge is in fact dried blood, or the 'tail end' of your bleeding, so nothing to be concerned about. It's possible the exercise has triggered something, or perhaps you have a polyp or fibroid that is contributing to the bleeding. Be sure your provider does a pelvic exam and pap smear, if it is time. Also, sometimes a thyroid condition (either low or high) can cause irregular bleeding. You didn't mention a method of birth control. Some methods might have irregular bleeding as an occasional (or frequent) side effect. Of course, uterine cancer is a faint possibility, and one test your provider might do is an endometrial biopsy. This can be done within the office, and will provide information about the lining of the uterus. Uterine cancer is unlikely, but explain your concerns to your provider. Here are some web sites that might be informative for you, while you wait for your appointment on the 21st: http://www.obgyn.net/women/conditions/conditionsa-f.htm#AUB http://www.mjbovo.com/AbnlBleed.htm http://www.fpnotebook.com/GYNCh10.htm http://www.womens-health.com/gyn_health/gyn_md_dub.html Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
No period since being in car accident When I was 18 years old I was in a car accident and have not had a period since. I had massive head injuries and my pituitary gland was damaged. I did get pregnant two months after my wreck and delivered my son with no complications. He is one year old now and I still have not had a period or even spotting. I also have no sexual interest whatsoever. Is there any thing I can do? |
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| A: Wow, what an interesting story. Obviously you ovulated, as you got pregnant. It is odd you aren't having periods. I think this is something that needs to be discussed with a gynecologist. Have you had a pap smear since the birth of your child? It's about time you did, and this would be something to discuss with your provider. You didn't mention whether or not you were breastfeeding. That of course would stop a period, as would the depo provera injection. If your pituitary gland was damaged, this might have some correlation. I suspect your hormones are out of balance a bit. You might also request some lab work, such as a thyroid test. Your provider might also check you for a condition called PolyCystic Ovary syndrome, which is a hormonal condition some women have. Your health care provider will check things out and perhaps give you something called provera to stimulate a menstrual period. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Provera to correct "dysfunctional bleeding" I am presently on the eleventh day of menstrual bleeding. On the ninth day (it is very unusual for me to continue my cycle for more than 7 days) I went to my family doctor and she sent me to the emergency room to have blood tests done to rule out the possibility of an intrauterine pregnancy. The doctor at the emergency ward also performed an internal gynecological exam and asked me to have an ultrasound done to confirm the blood tests, which yielded a negative result for pregnancy. After the ultrasound, the doctor told me he found an ovarian cyst on my left ovary, and to visit a gynecologist for a full check. The gynecologist checked me, told me he couldn't find an ovarian cyst, and said that my left ovary was simply larger than my right one. He said that the problem was "dysfunctional bleeding" which could be caused by emotional stress. He prescribed provera to help me resume regular menstrual cycles. I haven't yet begun the medication, but my cycles haven't been regular since an abortion which I underwent two years ago. Also, I have been feeling pain recently in my left ovary and the lymph nodes in my left breast and both armpits. I am suspicious of the doctor's quick diagnosis. My questions are: (1)is there anything else that my symptoms could be pointing to, (2)could taking the provera -for 2 weeks, as prescribed- be harmful to me in any way, and (3)are there any other tests that could be done to confirm/refute the present diagnosis? |
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| A: Your question is a bit complicated, and I want to be careful to venture a guess about appropriate management. There is a condition called Dysfunctional Uterine bleeding, and provera is an appropriate management, but usually only for a few days. The ovarian cysts and the breast cysts are probably fine, but of course concerning. You didn't mention your age, so that is significant. If you are over 30, fibroids can be a common cause of bleeding. If you are under 30, common causes are hormonal imbalance. If your cycles are irregular, perhaps you have a condition called PolyCystic Ovarian syndrome. In this condition women skip periods (and don't ovulate), and then have a very heavy period, which might last for a long time. It sounds like you have had a reasonable set of tests. Did anyone check your thyroid? Occasionally there can be irregular bleeding associated with hypo or hyperthyroidism. Another test that could have been done would be an endometrial biopsy. This looks at the uterine lining and rules out problems. My suggestion would be to try the Provera for the prescribed time, and see what happens. Another option, of course is to seek a second opinion. Check out these links for further information: Ovarian Cysts: http://www.obgyn.net/women/conditions/conditionsn-z.htm#ovariancysts Dysfunctional Uterine Bleeding: http://www.fpnotebook.com/GYN50.htm http://www.netreach.net/~hysterectomyedu/dysfunctional.htm and http://www.womens-health.com/gyn_health/gyn_md_dub.html Here's two other links to help put things into perspective: http://www.mjbovo.com/AbnlBleed.htm http://www.obgyn.net/women/conditions/conditionsa-f.htm#AUB Keep a careful calendar of the amount of bleeding, and frequency. If this was just one period, it does happen sometimes, and sometimes it is related to stress. If you continue to have long periods, then you do need specific management. Sometimes this is the birth control pill or provera. Sorry I couldn't be more helpful. Do an Internet search and you should be able to find information about your concerns. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Yellowish heavy discharge I've been having a yellowish heavy discharge since the birth of my child (8 months ago). I consulted my 0b/gyn and he thought it may be yeast and treated me with medication for that. I still have the heavy discharge, especially around the time of my period when it tends to be extremely heavy. It doesn't smell or itch, but I am having some discomfort just below my clitoris. Could these be related problems? This will be the 4th time I've gone back to my ob/gyn for this. My husband of 8 years (to whom I am faithful) suggests I am getting older and maybe this is normal for women my age (31). My ob/gyn is baffled by my problem and I'm getting very upset and embarrassed at going in to see him for the same problem. I have not had a pap smear since my 8 week postpartum checkup. Should he redo it? |
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| A: Well, this is a very difficult situation to evaluate over the web. You need a pap smear annually. If your previous pap smear was normal, and you've never had an abnormal, there wouldn't be much value to repeating the pap smear. In addition to yeast, there are various other infections such as bacterial vaginosis, trichamonas, and of course Chlamydia and gonorrhea. Some women have GBS infections, but these do not usually have a heavy yellow discharge as a component. It sounds as if the discharge does cause some burning just when it is most intense. It might be a normal phenomenon for you, as hormonal levels do change, with age and pregnancy. For evaluation in a situation such as yours, I would do a wet prep and look at the discharge under a microscope, and also a vaginal swab, and Chlamydia and gc culture which is sent for cultures. A pap smear if indicated. If all of these tests are negative, then it appears this is something normal for you right now, and nothing more needs to be done. Check out these links for further information: http://www.obgyn.net/women/conditions/conditionsn-z.htm#Vaginal Virginities: http://www.mjbovo.com/vaginitis.htm Sexually Transmitted Infections: http://www.plannedparenthood.org/sti/ and http://www.afraidtoask.com/std.html Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Pregunta de menstruacion Tengo 25 anios, cuando tuve mi primera menstruacion a los trece, tenia mi menstruacion regularmente osea cada 28 a 30 dias. Desde hace 2 o tres anios tengo mi menstruacion cada 40 - 45 dias. Algunas veces se me tarda hasta 2 meses. Y el primer dia de la menstruacion tengo dolores mas o menos fuertes. La duracion de mi periodo es de 3 a 4 dias. Es todo esto normal? Cuando fui a una gynecologa hace un anio, me hice un eco y me encontro un quiste en cada ovario. Me dijo que no era de importancia, que cuando tuviera un hijo me podian remover el quiste en ese momento. Pero hasta mientras podia seguir normal, si es que los dolores menstruales no empeoraban. Que lo que causaba el retraso de mi menstruacion y el dolor era los quistes? Tambien me dijo que si los dolores menstruales eran insoportables entonces tenia que hacerme remover estos quistes. Digame que opina usted doctora? |
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| A: Con los datos que nos aportas, las dos entidades mas probables son una endometriosis o un ovario poliquistico. Estas dos entidades se pueden diferenciar con una buena ecografia y una analitica hormonal. En ultimo caso una laparoscopia seria definitiva y ademas podria tratarte la endometriosis en el mismo acto. En cualquier caso sin un diagnostico evidente la simple extirpacion de unos quistes ovaricos no suelen evitar la dismenorrea (dolores menstruales). Laureano Folgar Erades, MD, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
No period for six months I have not had my period for about six months (it stopped before I became sexually active). I have been having sex off and on for the past three months. I have a feeling that I could be pregnant, but I'm not sure how I would know... What are the symptoms? And why would my period have stopped even before I ever had sex? By the way, if it is of any help, I am going to be fifteen in a couple of months. |
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| A: How old were you when your periods first started? Perhaps you are still getting established. Of course, pregnancy is always possible, and perhaps you are still skipping periods. If you skipped a month or two of ovulation, and then got pregnant, that might explain your situation. Pregnancy symptoms usually include persistent breast tenderness and nausea. Also, a feeling of being very tired. Not everyone feels these things, however. The first thing you can do is try a home pregnancy test. They are very accurate, and will tell you right away if you are pregnant. If it is negative, then you need to think of what you can use for birth control to prevent yourself from getting pregnant. Look for a local Planned Parenthood or Health Department where they can provide services to you, at a reduced rate. There are many reliable methods available to you. The person you see will help you understand your periods, and if there is something out of the ordinary, they will help you get to the right person for further evaluation. Make out a calendar of your cycles and when you had intercourse. Then the person can see this more visually. If the test shows you are pregnant, then make an appointment with a provider for your care. Please find someone you can talk to about the pregnancy, and who can help you get an appointment with someone. Hopefully you can tell your parents, but I understand that sometimes that is a problem. Here are some web sites that might be useful to you: http://www.cnm.wa.org/reprodhc.htm http://www.mjbovo.com/Contracept/ http://www.plannedparenthood.org/bc/ http://www.managingcontraception.com/choice.html Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Frequent menstruation For the last two months my periods are coming every 12-14 days and lasting about four days. This is exhausting me and I can't understand why suddenly I am having periods twice a month! I am a forty-year-old woman. Two years ago I had a tumor removed from my uterus which had been causing me pain. However since the operation I have not had any problems until now. What are the possible causes? I am a little worried because I don't have health insurance at the moment. If it is something that could be regulated with birth control pills or any kind of hormone therapy that could be a problem for me because I had breast cancer five years ago. |
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| A: I think you should find a way to get a medical exam, to rule out any problems. It might be normal, but now with two months of this much bleeding, and at your age, you need further evaluation. It is possible regulation with the birth control pill might be an option, but only after eliminating any other potential cause. At your age you might have fibroids, which are non-malignant tumors inside of the uterus, very common in women over 30. In any event, keep a careful calendar of your bleeding/periods. Another possibility is perimenopause, in which case you might be ovulating frequently. But, that isn't what you are describing. So, time for an evaluation. Check around for a Planned Parenthood. Perhaps they can guide you in the right direction for future follow-up, and they usually offer a sliding scale for health care. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Brown discharge I am 24 years old and have had normal periods. This past week my boyfriend and I had unprotected sex. I was at the end of my period and now there is this brown discharge. It's not much, but it bothers me. I have never had anything like this before. What could it possibly be? |
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| A: Brownish discharge is just dried blood vs red blood. There might have been some trauma with intercourse. Or you might have been exposed to an infection of some sort. If it is just brownish, it's probably normal, and quite common. If it develops an odor, burning, or persists, then you'll need a gyn exam. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Can I stop menstruating? What can I do so I don't have to menstruate any longer? I am 40 years old, I'm through having children and I just don't want to menstruate any more. In this day and age of modern medicine, can't anything be done? Or are these things just not that important, and I should rejoice in my menstruation? |
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| A: Well, within 10 years or so you will be in menopause, and won't menstruate. Some women (non-smokers only) take the birth control pill without taking the spacer pills...in other words straight through. Then every three or four months they allow themselves to have a period. Depo provera (a shot given every three months or so) can in many cases stop you from having periods, after a period of irregular bleeding. Anything short of a hysterectomy won't totally stop your periods... I would say discuss this with your health care provider and see what they suggest. If you are having problems with your periods, perhaps they can help you with that too. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Initiating a period Is there anything I can do to bring my period on early? I am not pregnant and I am 29 years old. |
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| A: There are several medications that will do this. You need to see your Gynecologist who can select which would be best for you. R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
3-day period I started having my period when I was 10 years old. I am now 23 years old. My periods have always lasted for five days. But, for the past three months my periods have been three days long and they are not heavy. What could be causing this? |
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| A: This is totally normal, and nothing to be concerned about. Perhaps you are just into a nice balance right now. Also you didn't indicate whether or not you started a new birth control method, or had a child. Lengths of periods vary, and this fits into a normal pattern, even though it is a change from something previous. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
No periods with the depo shot Is it normal that I don't get my periods at all with the depo shot? |
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| A: Yes, not having periods on depo is very common. The high levels of progestin suppress ovulation. If you would like to learn more about deproprovera, here are some links: http://www.mjbovo.com/Contracept/ http://www.managingcontraception.com/choice.html Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
No periods since stopping BCPs I stopped the pill (OrthroTriCyclen) in order to get pregnant. Since I have ALWAYS been VERY regular (both off and on the pill), and I DO want to get pregnant, my husband and I used no other form of birth control. The problem is that since I stopped the pill I have had no period. I had a pregnancy test done at the doctor's office, but they said that the first morning urine is more accurate. How likely is it that I am pregnant, even with the negative test, and how can I tell if I do get pregnant when I have had no period since stopping the pill? |
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| A: How long has it been since you've had not period? If it has just been a month or two, wait a bit longer. The pregnancy test is a reflection of how high a hormone level at the time the test was done. if it was very early, it might not be accurate yet. Two weeks after a missed period is a more reasonable time frame. Occasionally it takes several months for periods to kick in, and your provider can give you medication to force a period, if they deem it necessary. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Lupron used for suppressing menstruation I am 15 yrs old and have very painful menstrual cramps. My periods used to be pain-free. I began having my periods at age 11. An endocrinologist stopped my menstrual cycles with the drug Lupron at age 13. I continued the Lupron for about one year. The Lupron was used in conjunction with Growth Hormone. I have since stopped both treatments. It took approximately 16 months for my period to begin again after stopping the Lupron. My very first period was extremely painful and I had to go to the emergency room twice. Since then my periods have been somewhat regular but extremely painful. Why? What can I do about the painful cramps? |
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| A: I suspect the Lupron was used to shut off estrogen production so that bone growth would not be stopped (Estrogen does that). That is also why the Growth Hormone. In general, primary dysmennorrhea (painful periods without a detectable cause) is associated with cramps starting 1-2 days ahead of the period, going away or a at least getting better on 1st or 2nd day of period, frequently nausea, vomiting, and diarrhea. This usually responds to treatment with OCP's. With your past history, I would suggest that you see a "Reproductive Endocrinologist". This is a Gynecologist who has special training in this area. R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
Monthly pain after tubal ligation I tied my tubes when I was 21 and I am now 24. My cramps are very bad every month. Before I had my tubes tied I did not have pain when I was starting my period. The only way I would know I started is when went to the bathroom and see it. The doctor told me the pain would fade in time but it seems to get worse each month. What should I do? |
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| A: Women who are using oral contraceptives and then get their tubes tied have this problem sometimes. They were having cramps before, but the OC's were treating them. Then the tubal and stop OC's, treatment is gone and the cramps return. Also this could be a sign of endometriosis. It could also be a sign of emotional regret at the sterilization. The younger the age at tubal, the more likely this is to occur. R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
50-60 day cycle I am 24 years old, am not taking any pills or medication, exercise regularly, had my first period around 13. My periods come fairly regularly, but not 28-35 days, more like every 50-60 days. Is this normal and if not, what risks or problems should I be aware of? |
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| A: This is not normal. Periods this far apart are frequently a sign of anovulation. This can lead to prolonged unopposed estrogen stimulation of the endometrium which can in turn lead to endometrial hyperplasia and eventually even endometrial cancer. It is rare but it occasionally happens that one has menstrual cycles this long that are associated with ovulation. In either case, infertility can result due to decreased number of eggs available for fertilization or none available. A visit to your Gynecologist to discuss this would seem to be in order. R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
Irregular menstrual cycle Why am I having irregular menstrual cycles at the age of twenty-nine? Is this normal? They have been starting at different times of the month, rather than every 21-28 days like normal. |
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| A: There are many possible explanations. The only way to know is for you to see your Gynecologist for an exam and some tests. R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
Can you facilitate the start of your period? I am going on vacation this weekend and am starting to spot, but sometimes I spot for a few days before my period and I was hoping it would almost be gone by the weekend. Does exercise or anything start your period earlier? |
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| A: Women notice there is some variation in when their periods start, but actually I'm not aware of any easy way to control when your period starts. The birth control pill regulates your cycle so you won't have a period except at a certain time (in most cases), and medications can be given when needed to start a period, but most of the time you just go. Sometimes exercise/weight gain/weight loss can affect cycles, but nothing very dependable. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Missed period while on birth control I have missed my period this month while on birth control. I am not pregnant (both urine & blood came up negative). What could be the problem? I have not had anything strange or unusual to happen in the last month. Should I be concerned? Is this normal? What should I do? |
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| A: As long as pregnancy test is negative, continue taking the pills and if this happens for the second month, go see your gynecologist. R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board P.S. Remember that this is for educational purposes only. |
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| Q:
14-year-old's erratic menstrual cycle I'm 14 years old and I've had my period for almost two years, but something isn't right. My school nurse says that it takes some years for your period to become normal, but mine is just too strange. Sometimes my period comes within twenty-something days and then some months almost fifty days. When it does come, I have terrible cramps, sometimes I can't even walk. I also have headaches a lot. My mom says that she's afraid that I may not be able to have kids. What's wrong with me? |
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| A: Great that you are asking questions about your health. For the first two years of your menstrual periods, many teens do not ovulate, and therefore do not experience cramps. Once they start ovulating, things can change, and they start experiencing cramps (from the increasing levels of prostiglandins). Keep a careful calendar of when you have your period, intensity of cramps, amount of bleeding, and eventually you will tune into signs of ovulation. It is possible you are only ovulating every other month, and thus when you have your period it is more intense, heavy, etc. An excellent book you might find informative is: Taking Charge of Your Fertility by Toni Weschler. Also, I wrote a related article on fertility. If heavy menstrual cramps are a major concern, try Ibuprofen, or discuss this with your health care provider. There are prescription medications (such as Motrin) that can help your cramps. Also, some providers put teens on the birth control pill to 'regulate' periods and help with the cramps. This is okay, but I always like to try the anti-prostiglandin medications first, as they are only taken when you are on your period. If the irregular periods bother you, the birth control pill would regulate them, but when you stop taking the pill, you might revert back to this pattern. If you are overweight and have other problems, you might be developing Polycystic Ovarian syndrome (PCOS), but you might be a bit early for that. In any event, discuss your concerns with a health care provider, and at least get something for the severe cramps and bleeding that happen when you do have a period. Check out these websites for more information on PCOS: http://www.ivf.com/links/pcoslinks.html http://www.mc.vanderbilt.edu/peds/pidl/adolesc/polcysov.htm http://www.mja.com.au/public/issues/nov16/kidson/kidson.html http://www.bmj.org/cgi/content/full/317/7154/329 Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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| Q:
Periodic bleeding and brownish discharge I am a 18-year-old female who became sexually active four months ago. I went on the pill in January, and everything was fine until about a week ago. I forgot to take my pill, but remembered to take two the next day. The following day I started to bleed periodically and had a brownish discharge. I spotted on and off for a week but kept having extremely brown discharge for about 4 days after I stopped spotting. Both my partner and I were virgins so I don't think this is an std. Please help. |
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| A: When you skip a pill or two, spotting can occur almost immediately. Just keep taking your pills, trying to take them at the same time every day. Some women are more sensitive than others, and they spot very easily. Take the pills until the end of the cycle, and then you can expect a period, even if it is a small amount of brownish discharge. Just start your new pack as your normally would. If the spotting continues, or if you have increasing signs of infection, please see your health care provider. Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor P.S. Remember that this is for educational purposes only. |
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