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	Question Type: Pregnancy/Birth I am 23 and have one child already. My husband and I have been active in trying to conceive again since Dec. I have always had very normal periods- never skipping. I have all the symptoms of early pregnancy- even missing my period this month (I am at the least, one week late). But I have yet to test postive using a HPT. My doctor says to wait until next month to see if I start. What could be the cause of missing a period and having all the right symptoms- but NOT being pregnant? Question by Crystal from Houston
	Missed periods do sometimes occur for such simple reasons as added stress in your life. Your physician's advice to wait a little longer is appropriate. Since you do feel you have other symptoms of pregnancy, you may also want to repeat your pregnancy test in the near future, as the hormone level may have been too low yet to record as positive when you did it previously. Remember when achieving pregnancy to take prenatal vitamins. Answered by Dr. Richman on 03/27/2003
	Question Type: Pregnancy/Birth I am 48 3/12 years old. Gravida 4- Para 0. The miscarriages occured between the ages of 40-43 and I have not been pregnant since, to my knowledge. We have a DQ Alpha compatability problem for which I received treatment in 1999. Only one tube is patent. I have over the years taken my temperature to chart my cycles and determine when I would ovulate and start my periods. These temperatures have remained reliable including when I was 4 days late last month and my temp was low and dropping. I am now 7 days late and temp is still up (98.3-98.6) each morning before arising. I hesitate to buy and take a pregnancy test for fear that this is just a perimenopausal symtom and I will be sadly disappointed. (We are in the process of finding a baby to adopt, so I am not in danger of depression :-) ) My main question is: Does the temperature stay up during the passage to menopause or should I consider the possibility of pregnancy? I need to know because if I am pregnant, I will need to take Lovenox for anti-phospholipid antibody syndrom, crinone gel (I'm allergic to my own progesterone, as well as the drugstore variety), and prozac for some previously pregnancy induced severe auto-immune reactions. I appreciate your time and consideration of this question, as I feel silly calling my doctor to ask when this is probably just a perimenopause thing. Question by Twyla from Knoxville, Tennessee
	If trying to determine menopause, a blood test called FSH can be ordered to show menopause. Your thyroid levels could also be checked. Please discuss this testing with your physician. We are not aware of any studies showing a temperature relationship with menopause. The feeling of being warm in menopause is hormonal, not temperature related to our knowledge. Answered by Dr. Betts on 03/27/2003
	Question Type: Pregnancy/Birth Hello I have two question I would like to know if you may answer it. Well, me and my man have been having sex all month march 3,10,15,18,20,22. The method that we use is the withdrawal method. what is my possibility of getting pregnant? My last period was February 24, 2003, at 28 days. 2) When my period is coming or here I have no signs. I don't get cramps, or anything to that nature, is there something wrong with me that I don't get any symptoms? Is there anything wrong if I get sharp pains in my vagina from time to time? Question by kimmie from new york
	1) The withdrawal method is 82% effective with typical use and 96% effective with perfect use. However, a small amount of fluid that is released before ejaculation may contain some sperm. 2) Some women do not have premenstrual symptoms and this is okay, as are occasional sharp pains in the vagina. Answered by Dr. Onuigbo on 03/27/2003
	Question Type: Pregnancy/Birth About a month ago I had surgery because I had a tubal pregancy. I'm 19 and the doctor saved my tube. I'm scared because I don't know what reactions my body has taken. How will my body react in the coming months? Question by Laura from Tulsa
	The early diagnosis and prevention of the tube from rupturing were the greatest threat to your health and these are now in the past. At 19 you should anticipate your recovery to be rapid. A common complaint after any surgery is being tired and this should be anticipated. After a tubal pregnancy, scarring in the tube may interfere with future pregnancies. Successful pregnancy rates vary from 60-100% depending on the amount of damage to the tube. Your other tube, however, can easily compensate and allow pregnancy to occur. Answered by Dr. Richman on 03/27/2003
	Question Type: Other What are cervical polyps and are they common? Can they be cancerous? Can they be also in the uterus? Question by mary from Burlington
	Polyps are noncancerous, flushy tumors that grow in the cervix near the opening to the uterus. They usually have no symptoms, but may cause spotting between periods. Large polyps may cause cramping. They can be identified during a pelvic exam and frequently be removed in the doctor's office. Answered by Dr. Richman on 03/27/2003
	Question Type: Pregnancy/Birth I am 3 months pregnant and I have an uncle, and 2 cousins, all on my dad's side that were born slow, they are not completely retarded, but they are slow. What is the change that my baby is born like that? Question by Rita from springfield, MA
	It would be very difficult to offer any advise regarding your chances of having a child which would be "slow" unless you knew the causes for your relatives "slowness". If it is something genetic there are tests available to project some diseases. Most frequently, such testing occurs at "University Hospitals". You may wish to check with the nearest hosiptal to you. Answered by Dr. Stanford on 03/26/2003
	Question Type: Other I have for the first time been expericing hemroids during pregnancy and I would like to know what will take the swelling away and how long does it usually take? Question by Yelanda from Lawton,OK
	Hemorrhoids are not uncommon in pregnancy. One cause can be constipation. Eating fiber and roughage can help soften the stool. Other helpful measures might be 20-30 minutes of walking per day and drinking at least 8 glasses of liquid a day. Use of prune juice or an over-the-counter stool softener would be fine. The swelling is caused by enlarged veins at the opening of the rectum. An over-the-counter hemorrhoid ointment applied to the rectal area would be the first approach. If you find this to not be helpful, you might wish to approach your physician for a possible prescription for special suppositories for this use. As the baby grows, the pressure of the growing uterus on the pelvic floor may actually make the hemorrhoids worse, so this may be a problem throughout your pregnancy. Answered by Dr. Richman on 03/26/2003
	Question Type: Gynecological Oncology I recently went to the doctor and was given medroxyprogesterone acteate pills because my cycle is irregular. I was prescribed 10 tablets to take once a day and was told I could stop taking them once my cycle started. Only it did not start in ten days. I did not start to have my period until one week after I finished the pills. I then started taking Mircette 28 birth control pills on the 23rd of February, because that is when I started bleeding. The problem now is that I'm still bleeding and it's the 18th of March. Before I started to menstruate, I had what felt like severe uterus contractions. Once my cycle started the blood was very heavy and the "uterus contractions" occurred every couple of minutes and lasted for a few seconds. Also before the bleeding started, my breast started to leak clear fluid. I went back to my ob/gyn and she said the the fluid was the kind that came along with the production of breast milk. She said it was probably caused by stress. All of this seem a little weird to me. I am wondering if the medications caused those reactions or was it possible for me to have a false negative urine pregnancy test during my visit because some of the symptoms I have seemed like those of a miscarriage. Can you please help clarify some of this for me. Question by Dionna from St. Louis
	It is possible but not likely you had a false/negative test. This could be further evaluated by a blood pregnancy test. More than likely it was hormone therapy that contributed to your symptoms. You may pursue additional lab tests (i.e. prolactin level, thyroid study) if you want to rule-out additional medical concerns. Answered by Dr. Betts on 03/18/2003
	Question Type: Pregnancy/Birth I have just recently quit taking the birth control pill Alesse 28 (I quit in early February of 2003) I just started trying to conceive in March. I had a normal period that came and went as usual so I began to try asap. I just read that trying to conceive shortly after quitting birth control can increase the risk of miscarriage and fetal malformations. I was told by all of my GYN's that the birth control I am on is an extremely low dosage. I am not sure if I am pregnant since I just finished intercourse during my most fertile period. Is it possible that I could have harmed my possible unborn child by trying to conceive so quickly? Also I am 19 and my husband is 21. I was wondering what our odds of conceiving in any given month are. We are non smokers and non drinkers, we exercise and are in good health. Thanking you in advance Brandy Waldrop Question by Brandy from Austin
	80% of couples will conceive within the first year after discontinuing the use of birth control. Your non-use of alcohol and tobacco, and exercising are excellent pre-conception measures. If you have not already done so you should also start a prenatal vitamin daily. These contain folic acid and decrease the chances of a baby being born with a neural tube defect . If you do find yourself already pregnant, it would also be important you seek early prenatal care. Since you report a normal period before conception, you should not consider yourself at any greater risk for miscarriage (1 in 4 pregnancies) or fetal abnormalities than the overall population of women in the childbearing years. Studies show that the use of hormones such as oral contraceptives do not increase the risk of miscarriage, it just makes it more difficult to get a definite due date if you conceive right after going off the pill, as you may ovulate more right after going off birth control. Answered by Dr. Richman on 03/18/2003
	Question Type: Pregnancy/Birth I am 27 years old and on Levlin 28. My husband and I want to have a baby soon. He on the other hand is 43. Will we have a problem getting pregnant after we get off of the birth control. I am also on an anti-seiure medication called neurotin. Will it cause any known birth defects? Question by kay from indianapolis
	80% of couples will conceive within one year of going off birth control. With your seizure background, however, it is very important that you have pre-conception counseling with your obstetrician of choice before going off birth control or your seizure medicine. Answered by Dr. Glascock on 03/13/2003
	Question Type: Pregnancy/Birth How long does it take to get pregnant if you have been on birth control for 12 years? Question by Kay from indianapolis
	Your fertility varies with what type of birth control. If you were on the pill, fertility can return almost immediately. If you were on something such as Depo-Provera, it may take as much as 18 months. You did not mention your age, which also impacts fertility. Fertility declines about 7% in women at age 30, and 50% by age 40. If you have not had a recent physical, you would also wish to do this when considering pregnancy. Answered by Dr. Sandy on 03/13/2003
	Question Type: Pregnancy/Birth Questions regarding Rh- and RhoGAM sensitivity..... Recently in our office we have had a young lady struggling with miscarriages. She has now had three consecutive miscarriages back-to-back. Her first miscarriage in November 2002, her second the last day or two in December 2002, for which she was diagnosed with Rh- factor and received a RhoGAM shot the first or second day in January, and now another miscarriage the first week in March. Each pregnancy she did get further into the pregnancy. This last pregnancy she was 8-5/7 weeks. My question and concern is Rh sensitivity and the need for RhoGAM shots. Her OB/GYN explained to her that since she had a RhoGAM shot in January that it was not necessary to have another in March. Apparently it "stays in your system for up to 3 to 4 months" ??? In the nursing work that I have done we always give a RhoGAM shot at the 28th week (for additional pregnancies) and within 72-hours after delivery, miscarriages, abortions, etc. etc. I have never heard that it is not necessary with consecutive miscarriages. I did ask for literature stating this was the case, but nothing has been presented. If you have any information regarding this topic or anything related, I would greatly appreciate it. Sincerely, Ms. Janssen Question by Ms. from Rexburg
	In theory, the expectation after giving Rhogam at 28 weeks gestation is that it is effective until approx. 40 weeks gestation (a period of 12 weeks or 3 months). The common presence of the Rh antibody in the patient's blood after administration, if considering re-administration would also, in theory, suggest some degree of immunity, although the amount would be unknown. Rh sensitization is not usually a concern in very early gestation as the fetus does not yet have the ability to exchange blood. Our research, however, also can't find any documentation of any of the before mentioned. In proactive, we would suggest consulting with your blood bank pathologist for his/her guidance and recommendation regarding such cases as the one presented. Answered by Dr. Glascock on 03/13/2003
	Question Type: Pregnancy/Birth I have read that sperm can live for up to 5 days in a woman so here is my question. If a woman only has fertile cervical mucus for a day or two each month how do they survive for that long? I have heard that if the mucus is not fertile it kills the sperm. Please advise. Thanks Question by Morgan from Cedar Falls
	Seven to eight days before predicted ovulation, normally cloudy mucous becomes clear and slippery and will stretch between your fingers. It is at this time that you are most fertile. You remain fertile during the first 36 hours after ovulation. It is the egg availability (not the mucous) that actually impacts conception. An egg lives only about 24 hours after leaving the ovarian follicle. Sperm can survive 5 or more days in the woman's reproductive tract. If just one of these sperm comes in contact with the egg, pregnancy occurs Answered by Dr. Glascock on 03/13/2003
	Question Type: Other what are the chances of getting pregnant after a tubalication? This was done over 5 years ago. Question by Aimee from Jackson
	Less then 1% of women will become pregnant after this procedure. Answered by Dr. Glascock on 03/12/2003
	Question Type: Other what exactly does a gynecologist do, and how does that coincide with an obstetrician? Question by Carletta from Douglasville
	A gynecologist is a specialist who deals with the health of a woman's reproductive system - care that includes routine pap tests, breast exams, prescriptions for contraceptive pills and devices, fertility counseling, hormone replacement therapy, and diseases of women. An obstetrician concentrates on all aspects of pregnancy and childbirth, including prenatal care, fetal testing, and monitoring. Although many specialists practice both obstetrics and gynecology, they may choose to separate the practice areas also. Answered by Dr. Glascock on 03/12/2003
	Question Type: Sex-Related Issues Hello..I hope you do not feel awkward when I ask you this question..Well here goes..I was a virgin when I got married..I love my husband and all but when we try to have sexual intercourse I die of pain...I cannot stand it..I make him get off of me..and this keeps repeating..We never get anywhere because I keep making him stop and get off...I do not know why I fear him entering me so much...I mean we satisfy each other in different ways...but I cannot stay this way forever...I really want to fix my problem soon..I mean is there a way that I cannot feel the pain..any medicine..i mean please HELP!!! Question by L from Brooklyn
	Painful intercourse can be caused by a number of conditions including, but not limited to, feelings of guilt about sex, memories of traumatic events such as rape or incest, and physical disorders of the female reproductive system. If the latter are a possibility you might wish to consult a sex therapist. Physical causes might include a yet intact hymen that does not allow insertion of the penis or a rare condition called vaginismus which is an involuntary tensing of the vaginal muscles that prevents penetration of any sort. Infection could also be a possibility. A physical problem could be assisted by care from a gynecologist. If you have not had an exam for evaluation of these physical possibilities, it would be recommended to do so now. Answered by Dr. Glascock on 03/12/2003
	Question Type: Menopause I am 45 yrs young, and at the begining of my menopause. I have never had children, have had breast cancer at the age of 32 and currently cancer free. I have not used birth control in the past 20 years, (other than condoms) and had pretty normal periods. I am not on hormone replacement. For the past 2months or so, I feel very nauseated, sort of like motion sickeness, or like my equallibrium is off. I just don't feel right. I do not smoke, am not over weight & I exercise. Is this normal? Is my body not producing a chemical/hormone to cause this feeling? I have annual check ups, blood work, pap smears, x ray, etc. Should I get further tested for anything else? Question by Priscilla from Red River
	There can be a number of causes for symptoms such as yours not menopause related. Since you report regular physicals in which possible causes such as low blood pressure or low blood count are evaluated, another possible cause might be an ear problem or infection. If you have not reported these symptoms to your regular doctor, do so. He/she could refer you to an ear specialist if needed or again re-evaluate other possible causes. Answered by Dr. Betts on 03/05/2003
	Question Type: Sex-Related Issues I know someone who had two abnormal PAPs and had to have her cervix frozen and then the doctor said she'll need to have PAPs more often to make sure it will not reoccur. Is the only way you can have an abnormal PAP due to HPV virus or could there be another cause? The doctor labeled her issus LSIL. Question by Chris from St.Helens
	There are a number of terms used to describe abnormal pap smear results. LSIL is a common diagnosis, especially in young women. Although the majority of LSIL paps do return to normal, some can become pre-cancerous and should be treated as your friend's was to prevent that from occurring. Many LSIL pap smear results can represent HPV infection. The recommendation for more frequent pap smears with this history would be therefore very appropriate. The new "Thin Prep" pap smear procedure can better identify HPV and might be a recommendation as well. Answered by Dr. Sandy on 03/05/2003
	Question Type: Gynecological Oncology I am 19 years old and my discharge is white and clumpy and irrating but i tend to discharge more before my period, is this normal and how do i know it is not a yeast infection? Question by Victoria from Ewing
	A healthy vagina naturally cleanses itself and resists infection. Under some conditions, the vagin may become less resistant to infection. Some of the factors that can affect the health of the vagina are: Menstruation Medications including antibiotics Damp underwear or tight fitting jeans/pants Yeast infections are caused by a fungus. Symptoms include increased amounts of thick, white discharge and itching. If you have never had a yeast infection before it is always best to see your health care provider for evaluation as yeast infections can be confused with other forms of vaginitis. Answered by Dr. Betts on 03/04/2003
	Question Type: Osteoporosis I am 22 years old and have Ehlers-Danlos Syndrome. I have a 4 month old baby after 5 miscarriages. I spent 4 months on complete bedrest and took Heparin for 8 months and Prednisone and progesterone for 4 months and now as a result have severe osteoporosis. My spine is a -3.5 and hips -2.4. My doctor had recommended Forteo but i decided against it because of the newness of the drug and possible bone cancer. I feel i'm too young to take that risk so we decided on Actanal. What do you think would be the best choice for me considering my scores and age? Also, my doctors have told me not to have any more children but i can't help thinking that if i reverse the osteoporosis just maybe... I'm also wanting to start pool thearpy but live in a very rural area without many resources. i am currently taking 3 viactives a day and using a treadmill. what do you think about coral calcium,opc-3, and collagen supplements? i have heard good things about them but am not sure. I have an unknown type of EDS. I also have severe Deltoid Tendonitis where my arm is numb in that area along with Arthritis. I'm on Bextra and lots of pain meds. Any information would be great. Thanks. Question by Lesley from Salem, Mo
	It is common for a post delivery woman to have increased calcium levels for approximately 6 months post delivery. It would be prudent for you to follow your physicians recommendations regarding medications at a minimum until then and then possibly have another Dexa scan to determine a long plan. Answered by Dr. Richman on 03/04/2003
	Question Type: Sex-Related Issues I washaving sex with my boyfriend and he hurt me to the point which i felt something deep within my stomach is it possible that he hit my womb? Question by Victoria from Ewing
	Orgasm can cause rapid contractions of many different muscles including the uterus (womb) which may account for the "pain" you experienced. The womb, however, is well protected by the body from direct contact with the penis. You may wish to discuss use of alternate positions for sex with your partner for greater comfort/reduced discomfort in the future. Such change in position could also avoid possible contact with the cervix (opening of the womb) if this were to cause you discomfort or pain also. Answered by Dr. Betts on 03/04/2003
	Question Type: Pregnancy/Birth I am 35 wks pregnant and work as occupational therapist in long term care with residents who have MRSA. As OT I work closely with residents because I address ADL's. I worked with several residents who had MRSA early in pregnancy. I haven't had any recently, although still several in facility. I was wondering if I contracted MRSA (active or colonized) could it have harmed my baby in anyway and do I need tested? Question by Amye from Tyner
	The use of universal precautions does prevent transmission of MRSA for both you and to your baby. A skin culture of yourself followed by a culture and sensitivity would tell if you had the infection and what if any antibiotic could be effective. This close to delivery, you would want to pursue this possibility immediately if desired. Answered by Dr. Richman on 02/28/2003
	Question Type: Hysterectomy/Hysteroscopy I suffer from PMDD and am scheduled for a supracervical hysterectomy (ovaries included-cervix intact) in a couple of weeks. I was wondering if you could discuss the effectiveness of this procedure for PMDD. Thank you. Question by Lynne from Scottsdale
	About 20-50 percent of all women of childbearing age suffer from some degree of PMDD. The precise cause remains unknown. Progesterone metabolism has been thought to be a possible cause. Eating a complex carbohydrate low fat diet, aerobic exercise, reducing caffeine and alcohol intake, and stress reduction have been found beneficial in easing symptoms. Oral contraceptives may also lessen symptoms in some women. Removal of the ovaries (which produce the female hormones) as part of a hysterectomy stops hormone production, if this was in fact increasing your PMDD symptoms. For severe PMDD, which has not responded to other treatment, hysterectomy may be a choice. It is, however, a major surgery and you should be fully informed of any/all other options before you decide. Answered by Dr. Sandy on 02/28/2003
	Question Type: Other my age is 30/male . my sperm islike water.i smoke a lot.can u tell me what to. i'm planning to get married.first my sperm was thick.now sometime it is thick and sometime it is like water.waht is the proble. Question by rami from hyderbad
	The thickness of sperm can vary depending on the frequency of ejaculation. Decreasing your level of smoking would be a healthy behavior change as smoking can have an impact on sperm production. If you have not had a recent physical, you should do so to rule our infection as a cause. Your personal physician might then recommend a sperm count or refer you to a urologist for further evaluation. Answered by Dr. Betts on 02/28/2003
	Question Type: Other I am not sexually active but have been on birth control for about six months because of cramping. I have not remembered well to take the pill and skipped ocasionally, and when I remembered it wasn't usually a consistent time. There was one month I went off for financial reasons and then went back on. Last mont I had my period early and it seemed like it was ending then it started again lasting about 12 days total instead of the normal 5. It ended about two weeks ago and today it started again. The month I skipped was the month before last. Is my abnormal cycle something I should worry about or is it just the birth control? Should I make an appt with my doctor about it? PLease respond. Question by Heather from gainesville,fl
	Although you do not report being sexually active, the question is answered in the same manner as for someone who would be since the pill was originally developed with contraception in mind. You did not mention your age or if you have had a recent physical - if you have not had a physical within the last year you should schedule one now with your physician. Correct and consistent use of the pill is what increases your protection against pregnancy. It is very important not to skip pills even if you have spotting or bleeding between periods. The pill should be taken at the same time every day. If you miss one only, you may take 2 the following day only. Irregular usage as you report can lead to bleeding such as you describe and also to undesired pregnancy. You might also wish to consider another means to solve your problem such as a contraceptive patch or ring. Answered by Dr. Betts on 02/28/2003