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Q&A Topics


Yesheen (dr.) Singh Medical Doctor View profile

Dear C



Thank you for your question. The loop has a greater ability to prevent pregnancy (failure rate of 0.05%) than Petogen (failure rate of 3%) so in this regard it is a more effective contraceptive. You will not run the risk of it falling out while you are joggin provided it is inserted properly by an appropriately trained practitioner. With regards to the risk profile of using the loop please refer to the following website:



1. IUD with progestogen

2. IUD with copper



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile



Dear R



Thank you for your question. PCOS is a challenging disease to manage in the western medicine model of health care, where most doctors rely on synthetic hormones to regulate periods and fertility drugs like Fermotid or insulin receptor modifier drugs like Metformin. These all attempt to treat the symptoms of PCOS but don't do anything to heal the underlying imbalance. Sometimes the work and a woman with PCOS will fall pregnant but the underlying inflammatory disease process continues and simply chooses another avenue to display itself. The rate of successful pregnancy on the combination of Provera and Fermotid is unpredictable but the general consensus is a success rate of around 20% depending on the complexity of the underlying pathology.



I would recommend completing your course of medication since you have already begun it. I would not advocate using any other form of therapy in conjunction as they may adversly affect the medication. But if you come to the end of your course and are still not pregnant then contact me via www.healthnation.co.za if you would like to try an alternate approach to rebalancing your underlying oestrogen:progesterone imbalance and thus improving your chances of falling pregnant.



Many thanks and warm regards

Yesheen Singh


Yesheen (dr.) Singh Medical Doctor View profile

Dear Q



Thank you for your question. All forms of synthetic hormone contraceptive will have some form of side-effect profile on your body. What particular side-effects will depend on how your body is composed. If you experienced depression and weight-gain on deop-provera, a progesterone-only contraceptive then it is easy to assume that most other forms of progesterone-only contraceptives, irrespective of form, will have a similar effect.



Yaz though is a progestin (fake progesterone) and oestrogen combination pill so may have different effects on your body. But please note that in the USA Yaz and Yasmin have been the cause of a law suite against the pharmaceutical company that manufactures them by groups of past users and advocacy groups. These groups argue that the drugs put women at higher risk for strokes, blood clots and other health problems than some other oral contraceptives. I would therefore suggest you reconsider your choice of combined oral contraceptive. Alternatively use one of the barrier forms of contraceptive available in South Africa.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear R



Thank you for your question. If you are not using any form of contraception, be it condoms, the pill or the injection, then your chances of falling pregnant are between 85-100%. This is unrelated to whether you are having regular cycles or not. If you choose to have sex but don't want to fall pregnant then choose a form of contraception and use it diligently. Wishing yourself pregnancy-free will not make it happen. The only way to make sure that you are not pregnant is to have a pregnancy test.



Please remember that unprotected sex does not only increase your risk of falling pregnant but also picking up many sexually-transmitted diseases like HIV, gonorrhoea, chlamydia and syphillis. Educate yourself, make informed decisions and stand your ground if you feel pressured into having unprotected sex.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear K



Thank you for your question. Implantation devices have a failure rate of about 0.05%. What this means s that there is still a chance of falling pregnant despite haveing the device in-utero. Urine based tests are usually good enough as a screening tool but I would recommend having a blood-based test done asap. If this is positive you need to have the Implanon removed asap if you want to keep the baby as it's presence will cause serious malformation and deformity problems, and possible lead to a spontaneous abortion.



If you do decide to keep the baby don't forget to use a pregnancy-specific multivitamin supplement with appropriate levels of Folate and Iron.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile





Thank you for your question. I appreciate how challenging this issue probably is for you. It''s great to read that you have made some effort towards nutritional modification and activity but these do take time to work. If you have been diligent and have as yet to see results then perhaps the changes you made were either not entirely appropriate or enough. There is also the fact that the excess weight itself will encourage more fat to be stored.



I do not think that there is a one-pill-for-all solution for your weight issue, i.e. stay away from products that promise a cure for all ills in one simple tablet. My advice would be to find a FLT practitioner in your area who understands the complexity of your health issues and ask them to assist you to appropriately modifiy your mealplan, appropriately modify your activity plan and to consider the impact of your imbalanced endocrine system and excess weight on your weight loss goals. Contact www.amipro.co.za to find one near you. FLT practitioners work with sustainable lifestyle modification, not fad dieting. This makes it much healthier for your body and the results are longer lasting.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear I



Thank you for your question. I do not advise an aggressive form of "colon cleanse" that your refer to in your question. It is too harsh on the body, and prevents your body from learning how to naturally balance out your bowel movement itself. When I recommend psyllium husk to my clients I usually recommend a heaped teaspoon of the loose psyllium husk with a glass of water before bed followed by another glass of water. This regime should continue for at least three to six months but often goes on for longer. This slow-and-steady approach does not shock or stress your digestive system and provides a gentle healing stimulus instead of the heavy handed approach you refer to.



So to answer you I would recommend using 1-2 capsules or 1 teaspoon of psyllium husk before bed over a longer period of time than only for a short cleanse program.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear K



Thank you for your question. It is quite difficult for me to provide you with an accurate response with the little information you provide. There are many causes of adult acne and usualy it requires an in-depth history taking and clinical exam to ellicit the possible causes. Usually it has something to do with the balance of various forms of oestrogens within the body. I can recommend something like Saw Palmetto for example which is know to be of assistance in some cases but if it works, or does not, we will not know why without proper investigation.



You are welcome to try the Saw Palmetto - Solgar make a great product - but if you would like to discuss this further please contact me via www.healthnation.co.za to make an appointment.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear T



Thank you for your question. The rate of abdominal distension during pregnancy varies greatly across the general population. There are no predictive factors or normal growth curves to follow. But usually there is a faster pace of growth earlier in pregnancy that plateaus as the fetus reaches full dimensions in-utero. Sometime a good gage is to ask your mom or the mother of the baby's father how her rate of abdominal expansion was during her pregnancy - sometimes this can be predictive. If there are concerns though that your abdomen is expanding faster than you expected or that the rate of growth is uncomfortable then the next step would be to have an utrasound, which you are due to have in a couple of days.



My advice would be to ensure that you are eating healthily, using a good pregnancy multivitamin, exercising appropriately and maintainng healthy lifestyle choices while you wait for you appointment.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear V



Thank you for your question. From what you write I think you have a great chance of being anaemic due to all the blood you are loosing. This is probably contributing to the symptoms of depression, fatigue and weight loss. Iron deficiency is also know to contribute to dusfunctional uterine bleeding. I would immediately test your iron levels, begin you on a form of iron supplementation and make sure that the foods you were eating contain high levels of natural iron - think leafy green vegetables.



As for the dysfunctional uterine bleeding my first advice would be to take a complete time-out from all forms of synthetic contraception. These havetotally confused your body's own ability to balance estrogen and pregesterone, resulting in the abnormal bleed. Unfrtunately your body will have to detox itself of the medication contained within it, especially the injection, before it can begin to return to some form of normal menstrual cycle. I am afraid that without a proper consult with a detailed history and examination I cannot offer you any advice regarding medication or alternate therapies you can try. You are welcome to contact me for an appointment via www.healthnation.co.za



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear M



Thank you for your question though I am not entirely sure of what it is you are asking. I am going to assume that you are worried that you may be pregnant. If so my advice would be to have a pregnancy test done as this is the only way to be certain of your condition. If, on the other hand, you are worried about the spooting you are experiencing my advice would be to visit a gynaecologict for an examination. Perhaps during intercourse you damaged a part of the vaginal canal resulting in bleeding. Perhaps there is an endocrine issue and your oestrogen:progesterone ratios are out of sync resulting in dysfunctional uterine bleeding. Only a proper consult wil ellicit this cause.



Many thanks and warm regards

Yesheen Singh


Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for your question. The answer will depend on the reason for your water retention, if it is indeed water retention that you are experiencing. I would recommend having a professional consultation to determine the underlying cause before you decide upon a course of treatment. I would much rather treat the underlying cause of any problem instead of just the superficial symptom. Once the cause is understood then you can decide on what products will be most beneficial, whether they are from Solal or another company.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear I



Thank you for your question. Diane 35 is indeed a form of oral contraceptive. So this will provide you with as much cover as other types of synthetic hormone oral contraceptives.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear M



Thank you for your question. There are a number of possible causes of your symptom, ranging from simply trace mineral deficiencies like magnesium to more complicated inflammatory issues like a blood clot or a cyst behind the knee. I would recommend taking a break from strenuous exercise, increasing your mineral intake (either through the use of himalayan crystal salt or something like happy water or concentrace) and if there is no resolution in 24-48 hours to seek the opinion of your local GP so s/he can exclude the more nefarious causes. If it is a simple muscle tension then rest and massage will be of greatest benefit. If the minerals do work then great, but ask youself why you are mineral deficient in the first place.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear T



Thank you for your question. I empathise with what you are going through. It is often quite traumatic to have one's trust broken. That said it is impossible for me to advise you on an appropriate course of treatment, be it pharmaceutical or alternative, without doing a proper history clinical examination first. This is especially important given your previous history of depression. I can advise that you ensure that you take in high quantities of good quality omega 3 fatty acids as these have been found to be beneficial to most people with mood disorders but anything more will have to follow a consultation.



You are welcome to contact me via www.healthnation.co.za to make an appointment.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear C



Thank you for your question. It is not abnormal to have periods while on the injectable form of contraception. But no contraception is 100% effective apart from abstinence. Petogen has a failure rate of around 3% and this means that there is always a 3% possibility of falling pregnant. If you suspect you may be pregant go have a urine- or blood-based pregnancy test to confirm or exclude it.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y



Thank you for your question. It is really difficult to make out what you are trying to communicate but I will try to answer appropriately.



It sounds like you have had two termination-of-pregnancy's done this year, the first in March and the second in July. Thereafter you were put onto some form of contraceptive. Where it get confusing is when you write about some form of abnormal uterine bleeding which your doctor managed with medication different from your usual contraceptive. Subsequently you have found out that you are indeed pregnant for a third time this year and you want to know if either the contraceptive or the second drug your doctor gave you will adversly affect your baby.



To answer you question I cannot say whether or not the medication will be harmful because I do not know what either of the two medications were. You will have to provide me with the names of both, the doses you were using and the duration of use. Alternatively you can consult with the doctor who prescribed the second drug to find out if that medication will harm your baby.



Many thanks and warm regards

Yesheen Singh


Yesheen (dr.) Singh Medical Doctor View profile

Dear R



I think that you have been extremely irresponsible. Using medication like this simply because you missed your period is unethical and should be illegal. The use of a drug like Postinor, which is intended to abort a pregnancy will definitely have an impact on the health of your baby, varying from fetal malformations and irreversible damage to ectopic pregnancies. It should never be used without excluding the possibility of pregnancy with a urine- or blood-based pregnancy test. In addition to your poor behaviour, the doctor who prescribed the "medicine to ensure the period come" is also at fault for not checking your history and not doing a pregnancy test.



I am afraid that your baby is already a living being. Although the heart beat is audible to a doctor from week 9-10 the organs may begin to function two to three weeks earlier. I strongly advise that you visit a gynaecologist to have a professional fetal ultrasound done to determine if there are any fetal malformations present because of you irresponsible use of Postinor. IF there are then you will have to decide what the way forward is for you.



Many thanks and warm regards

Yesheen Singh


Yesheen (dr.) Singh Medical Doctor View profile

Dear J



Thank you for your questions. To answer them simply:



1. No it is not normal to have blood-stained semen. This is often a sign of infection or some form of prostate or urethral disease.

2. Yes semen that is blood-stained may still be fertile, but please consider the risk of also catching other forms of sexually transmitted diseases in the process that will endanger your life and the life of you baby should you fall pregnant such as HIV/AIDS, syphilis, etc.

3. I cannot answer this question.

4. Yes there are indeed cases of meningitis infections that are not associated with HIV, but these are usually found in children. In adults the immune system has to be pretty compromised or the infecting bug has to be pretty powerful to get into the brain fluid.



My recomendation is to have a honest open conversation with your partner before you engage in unprotected sex.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear V



Thank you for your question. There are many reasons why you are experiencing difficulty falling pregnant, too many to discuss in this forum. I would recommend firstly trying to have intercourse with an approved lubricant because hair cream often contains many harmful substances that negatively affect the vagina and cervix making them less receptive to sperm. If this does not work after two to three months I would recommend seeking help, either from your local GP, your gynaecologist or from myself, via www.healthnation.co.za. Secondary infertility is a complex issue and needs a proper history and clinical exam to ellicit the cause. It is only once the cause is known that a solution can be suggested.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear J



Thank you for your question. There is no quick answer to your question because the reason for you inability to ovulate can be due to so many factors. It could be related to obesity, ovarian cysts, prescription medication, high levels of stress, etc, and the reason will need to be ellicited during an in-depth consultation. It is only once the reason is know that we can suggest a treatment option. If you would like to discuss this further please contact me at www.healthnation.co.za



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear M



Thank you for your question. Yes the oral contraception will most definitely have confused your body. But if you have decided to go the route of oral contraception then you will have to wait it out - i.e. continue with the contraception at the recommended dose and the recommended regime for at least three months in order to give your body an opportunity to accomodate the medication.



In the interim you should be using a secondary barrier form of contraception. Like condoms. Oral contraceptives already have an 8% failure rate with perfect usage and this increases when you first begin with a new one. If there are any doubts about the possibility of you being pregnant I would recommend a blood-based pregnancy test to confirm or deny this.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear A



Thank you for your concise statement. I an assuming you would like to know why you have not had a period for five years? If so you will need to provide more information, preferably in a personal consultation because the many possible causes of secondary amenorrhoea (which is the technical term for what I assume your condition to be). Please contact me through www.healthnation.co.za if you would like help on this matter.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear H



Thank you for your question. While I don't quite understand what you are asking I will try to answer what I think you would like to know.



Any form of oral birth control pill will have a typical failure rate of arouond 8%. And this is when a woman uses it at the same time every day without skipping a dose for at least two to three months. If there are any variations in this pattern then the risk of failure goes up. So if you only used Yasmin after sex then your risk increases, if you missed three weeks of it then you risk goes up, etc.



If there are any doubts about whether you may be pregnant then have a blood-based pregnancy test done to make certain.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear R



Thank you for your question. I am afraid that without a proper consultation with an examination of your respiratory system I cannot offer you an opinion regarding the probable causes of your symptoms. You are welcome to contact me through www.healthnation.co.za if you wish to make an appointment.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear S



Thank you for your question. The medication you are using, Fertomid or Clomiphene, is usually prescribed to force ovulation of an egg from an ovary that is not healthy. It does so by increasing the levels of progesterone. The symptoms you describe are all associated with elevated levels of progesterone. Usually a pregnant woman will have higher progesterone levels because the egg itself produces these, and so she will develop pregnancy symptoms like morning sickness and breast tenderness. But because you are falsly increasing your progesterone levle syou may be experiencing the effects of higher progesterone without the presence of a fertilized egg.



I hope this explains the symptoms you are experiencing. If you would like to consider an alternate approach you are welcome to contact us at www.healthnation.co.za for a non-pharmaceutucal option to managing ovarian cysts and infertility.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear K



If you continued to have full periods, i.e. normal duration, normal volume, normal consistency, for 4 months after you last had intercourse I doubt you are pregnant. If however your periods have not been consistent then go have yourself a blood pregnancy test.



I, however, think that you are experiencing some other form of secondary amenorrhoea and think you need to visit your GP to find out what it is. Make sure though that you have not been using contraception.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear R



Thank you for your question. BioOil uses a base of petroleum-derived oil so I would not recommend it for anyone, let alone people with sensitive skin.



With regards to helping reduce scarring from acne there are no products that will completely rid your skin of the scars. For that you will have to experiment with dermabrasion of laser therapy with a registered therapist. IF you are looking to minimise them though then I would recommend a combination of rosehip, lavender and geranium oil in a mixture applied twice daily to the affected areas. Gentle exfoliation twice a week also helps to stimulate scar reduction. Make your own exfoliator with oatmeal, avocado and some of the oils I mentioned above. Also include a high-dose omega 3 supplement and consider ading in some MSM to help build collagen.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear C



Thank you for your question. If there is any doubt about the possibilities of you being pregnant when on a contraceptive I recomend having a blood test for pregnancy. No contraceptive, even when used perfectly, assures you of 100% prevention and when there are any irregularities the rate for failure increases. The symptoms you are experiencing may be pregnancy related or they may simply be due to your endocrine system struggling to get used to the synthetic hormones you are introducing through the injection.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear S



Thank you for your question. I am sorry to read of your experience. To answer your questions there are no real predictors in terms of how soon after a miscarriage you will be able to fall pregnant. Some women do so almost immediately whereas other take months. It all depends on how quickly your body takes to get over the physiological stress of the miscarriage. It is a good idea to continue with the folic acid but I would add an omega 3 and a probiotic supplement as well. I would also recommend that you stop the condom use if you feel like you are ready to begin trying again.



When it comes to the onset of the period it is similar to what I said above with regards to falling pregnant. Some women have a period three to four weeks post-miscarriage whereas other take longer. If your received a contraceptive injection then you cycle may be imbalanced for months to come - ask the hospital where you had the D&C done if they gave you a contraceptive injection. If no injection was given then sometimes the woman is able to fall pregnant before the first period is experienced.



Basically there are no predictions when it comes to fertility. You simply have to keep your body clean and prepared and keep trying. Good luck.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear A



Thank you for your question. The main concern I would have about adding in the new supplement is that your Vitamin E intake would be quite high. Additionally I would question the need for so many supplements.



With regards to a recommendation I am afraid I cannot legally make one without a personal consult as that would fall in the realm of a therapeutic guide. Usually if you do not have any health concerns and have not been trying for long I would recomend a good multivitamin, a probiotic and an omega 3 supplement combined with adequate intercourse for at least 12 months. If there are any other factors that influence your fertility, such as use of contraception, previous or other diseases, family history, we would begin to look at additional supplements. If you would like to make an appointment please contact www.healthnation.co.za



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear Lauren



Thank you for your question. The reality is that scars are notoriously challenging to "influence" - they will usually take their own course and all you can do is try to perform damage control. Fortunately though your son is young, so his scar will more easily allow itself to be helped along.



To this regard there are a couple of pointers you should keep in mind that decrease his systemic levels of inflammatory markers, be they from the scar process itself or from something completely different like a blocked nose - they all share similar inflammatory signalling and so one can influence the other. Ensure he is cutting out as many inflammatory foods as possible - sugar, dairy, gluten, preservatives, artificial colourants and sweeteners. Secondly add in a good probiotic, usually an adult one from the fridge section of your local health shop. Probiotics not only help bowel health but keep the skin microenvironment in good running order. Thirdly introduce him to a paediatric omega 3 supplement - there are some available in liquid format and a teaspoon of this once a day will increase the availability of omega 3 in his body which can then be used as the preferred building blocks of new cell membranes instead of other "second-grade" materials that lead to anunsightly scar. Fourthly massage into the scar a good organic natural essential oil. Bio Oil is petrochemical based (horror!) and I would not advise anyone to continue applying refined petrol to their faces. Start off with a base of rosehip (3 drops in the palm of your hand) and add to it some lavender (1 drop), some marigold (1 drop) or some geranium (1 drop). Mix together and massage into his skin twice daily for as lon as it takes for the scar to whiten or to contract. Usually this can take a couple of months.



The fact that the incident occured in January will make it more challenging to alter the scar now but if you combine the systemic tips and the topical oil application then you will be hitting it in both directions with the best nature has to offer.



Best of luck, many thanks and warm regards

Yesheen Singh

HealthNation


Yesheen (dr.) Singh Medical Doctor View profile

Dear L



Please see my response to you other post regarding your son's facial scar.



Warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for your question. I would not advise that you mix the two. Both make use of a particular enzyme group in the liver to deactivate used molecules of the drug and if you use both together then a bottle-neck occurs and both drugs float around for much longer in your system than intended. This can be dangerous as it can lead to overdosing of both the Wellbutrin (Bupropion) and Solal's Burnout Fatigue product.



I would advise a proper consult with a practitioner to why you feel the need for Solal's Burnout product and then the practitioner can find something that helps alleviate the symptoms you are experiencing that will either work wth the Wellbutrin or even take away the need for the pharmaceutical.



You are welcome to contact me at www.healthnation.co.za if you would like to discuss your options further.



Many thanks and warm regards

Yesheen Singh

HealthNation

Angela Lombard Nursing Practitioner View profile

Dear K



Many thanks for your question.



I fully understand your concern. Let me just reassure you first of all with the detail you have given, which I do appreciate, is that with the change of contraceptives you will have a hormonal flux. In other words, your menstrual cycle will be a bit erratic. It may settle down soon, or a bit later.



However, your primary concern is the possibility of an unplanned pregnancy - with all the information given and not having taken your contraceptive pill for two weeks and having intercourse without the use of a condom, I do recommend that you be tested for a BHCG blood test for pregnancy. This test can be done at any time of the day at your local Path Care clinic, or you could book an appointment to see me and I will do the same - pathology services are provided for with our Well Clinic in Cape Town. The BHCG blood test would also determine how far a pregnancy is as in weeks, and is sensitive enough to determine a pregnancy ten days post intercourse.



Good luck, and for peace of mind, make this appointment please.



Warm regards

Angela


Yesheen (dr.) Singh Medical Doctor View profile

Dear A



Thank you for your question. Your history is quite confusing. And it makes sanse that it is because of the fact that you used a hormone contraceptive which can totally mess up your body's hormone cycles. I cannot answer your question on whether you are pregnant or not with what you have provided.



In your case the urine pregnancy tests are worthless. I advise you to pop into your local lab and ask them to perform a blood-based pregnancy test to 100% confirm whether you are or are not pregnant.



Many thanks and warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear A



Many thanks for your question.



I strongly recommend that you visit your nearest clinic or make an appointment to see your medical doctor and request that a BHCG pregnancy blood test be done. This test will be sent away to a pathology laboratory to determine pregnancy and also how far a pregnancy would be as in weeks. It is really important that you are tested correctly so as to determine if there is a pregnancy or not as you must NOT have the Nur-Isterate contraceptive injection if this is so.



You are also welcome to make an appointment to see me for the same. My direct clinic landline is 021-4875435 between the hours of 09h00 - 16h00, Monday to Friday.



Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear L



Many thanks for your query.



You may well only be having a heavy menstrual bleed which has been triggered even further from having recent intercourse - however, I do recommend that you see your general practitioner should your bleeding increase even further. I practise from a preventative, promotive and curative aspect so I would like you to be assessed and examined in person by your medical doctor please. Please make this responsible appointment today.



Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear R



Thank you for your question.



Yes, Yasmin is a lower dose pill in comparison to Ginette.



Depending on your physiological profile, and the fact that you are experiencing a bloating sensation in the stomach and enlargement of breast tissue, I recommend that you make an appointment to see your gynaecologist so as to be fully assessed as to whether Yasmin would be suitable for you or not.



Alternatively, you can make an appointment to see me so that I can do the same.



Every woman is unique and and will respond to certain contraceptives differently as apposed to the next person. Yasmine was formulated with a two fold function - firstly, as an androgen based pill for acne healing and control of acne, and then as a contraceptive. In this sense, it is very similar to Ginette.



Depending on your clinical picture at this point in time, it may or may not assist with fluid retention.



Kind regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear P



Thank you for your question. Firstly I do not think the use of Mumomega or Chela-Preg would influence your pregnancy tests. They do not directly impact on the markers the urine-based pregnancy tests look for.



With your history of contraceptive use I am not surprised that your cycles are so confusing - they are infamous for messing up regular time cycles. With this in mind I think that using dates alone would be a most unwise decision to determine the gestation of your pregnancy, if indeed you are pregnant.



As a first step I would recommend having a blood tests for Beta-HCG - the hormone that turns up positive only if you have pregancy-related tissue growing within your body. If the blood test comes back elevated/positive I would repeat the uterine ultrrasound to find out if there is any embrionic sac in the uterus. If there is then great! Continue with your supplements and ask the ultrasound technician to help you estimate your delivery dates. If however the uterus is empty then you need to visit a gynaecologist to find out where in your body the pregnancy-related tissue is growing. The gynaecologist may advise further scanning or they may advise sequential blood tests to test if the Beta-HCG levels continue to rise. Either way this needs to be managed by a doctor.



You are more than welcome to contact me on www.healthnation.co.za if you would like me to walk you through the above tests.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear E



Thank you for your question. Diotroxin is a synthetic formulation containing both T3 and T4 synthetic hormones. Eltroxin on the other hand contains only synthetic T4. Most people begin to experience some change in symptoms within three to four weeks of beginning therapy.



My question to you though is whether your practioner has looked at whether your thyroid imbalance is related to other endocrine imbalances such as in the ovaries or the adrenals. In my experience hypothyroidism is rarely a disease in isolation and often the use of thyroid-directed therapy alone is basicly looking after the superficial sypmptoms but not the underlying imbalance. Do some online research to inform yourself and then begin asking questions…



You are welcome to consult me individually if you would like more personal assistance at www.healthnation.co.za



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear C



Thank you for your question. Danazol is an androgen-derivative, i.e. a brother of testosterone, and it's use has been discouraged because of the powerful side-effects it can have in the femal body. I would not advise beginning this medication.



Polycystic ovarian syndrome is quite a complex disease to manage because of the many different pathways that contribute to the underlying imbalance that results in disruption of the balance between oestrogen and testosterone in the female body. I usually take a detailed history before making recommendations on how one can begin to heal and correct the imbalance without relying on synthetic contraceptive or other pharmaceuticals. I would recomend making an appointment directly at www.healthnation.co.za



For now I would suggest asking her to begin by beginning a Saw Palmetto supplement (Solgar make a good one) and introducing some Psyllium Husk (1 teaspoon before bed in a glass of water every night). These two will begin to rebalance the oestrogen:testosterone ratios and streamline the excretion of oestrogen metabolites out of the body. Additionally I would recommend cutting out all sugar and gluten-containing foods and limiting carbohydrate intake to 2-3 servings of low GI carbohydrates per day (e.g. brown rice, buckwheat or quinoa).



If managed correctly there is no reason why PCOS should preclude you from beginning a family.



Many thanks and warm regards

Yesheen Singh

HealthNation

Angela Lombard Nursing Practitioner View profile

Dear Anonymous



Many thanks for your question.



The instructions for taking Yasmin are very specific. You must only commence taking your first Yasmin pill on the FIRST day of your menstrual bleed. Should you start taking this pill incorrectly, you will only have to start all over again, and this will obviously cause unneccessary frustration. To regulate your hormonal cycle from the outset, please do as I have recommended.



However, with your listed symptoms, it would be a good idea for you to have a pregnancy test first, before starting with Yasmin.

Should the pregnancy test be negative, then you can commence with Yasmin.



Please read some of my other website replies about the importance of detoxifying from contraceptives.



Kind regards

Angela


Yesheen (dr.) Singh Medical Doctor View profile

Dear J



Thank you for your question. I would not advise changing the dose of any pharmaceutical without the consent of a consulting doctor. So no, I would not advise you to even slightly increase your dose without consulting him. Changes in thyroid medication doses should always be measured against blood tests of thyroid hormones to make sure that you do not run into an over stimulation scenario.



If you found some positive change and then plateauing of symptoms then my guess would be that while the thyroid may be a part of the underlying disease process it is not the main reason for your symptoms. In my experience it rarely is. I would advise either asking your doctor to think outside the box and look at other endocrine glands like your ovaries or adrenals for further imbalances, or that you consult someone who understands the complexity of the problem. You are welcome to contact me individually at www.healthnation.co.za



If you are post-menopausal then changes in thyroid levels can be part of the change process and need to be managed in the context of the post-menopausal hormone state and not in isolation.



Many thanks and warm regards

Yesheen Singh

HealthNation


Yesheen (dr.) Singh Medical Doctor View profile

Dear C



Thank you for your question. I have to say that without having a look at the reports of your special investigations it will be difficult for me to offer an opinion. There are indeed cases where, due to previous infections or trauma, genetic defects or anatomical aberations, the womb is found to be less than hospitable to hosting a gestating fetus. But these are few and far between. If you would like to consult me in person and bring the reports along you are welcome to contact me through www.healthnation.co.za



Womb transplants are not commonly performed because of the highly vascular nature of the uterus. In true cases where the womb is indeed found to be inhospitable then your options would be surrogacy or adoption. Some researchers have tried extra-uterine pregnancies but this is VERY dangerous and not advisable.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear P



Thank you for your question. It can take up to 12 months from the last time you used the injection before you will find a return to a normal menstrual cycle. So in this regard I would not worry as yet.



But if you have been indulging in unprotected sex I would highly recommend having a blood test for pregnancy, not a urine test. If the blood test is negative then simply wait until January next year before contacting a doctor for further investigation.



Please remember that the twelve month period includes the abscence of any form of oral contraceptive as well, so if you have tried the pill since January then you need to begin counting twelve months from the date of the last pill you took.



Many thanks and warm regards

Yesheen Singh

HealthNation

Angela Lombard Nursing Practitioner View profile

Dear Angel



Many thanks for your question.



The fact that you have a "milky discharge coming out of your breast" is a sign and symptom that should be checked by a medical doctor please. I would say that this is due to an overload of oestrogen from the contraceptive pill, however there are certain medical conditions which need to be ruled out, which are indicative of this symptom.



You will not harm your body by coming off the contraceptive pill, although the signs and symptoms when detoxifying from the chemical components in pharmaceutical contraception are not always pleasant - you might experience slight mood swings, periods will return, you might have abdominal cramps etc. Each individual is different, so you might have one or a combination of side effects when coming off the pill.



It is vital that you use a good barrier method like condoms so as to prevent an unplanned pregnancy.



I suggest that you make an appointment to see me so that I can assist you further. You can contact me on my direct clinic landline, 021-4875435 Monday - Friday, between the hours of 09h00 - 16h00.



Kind regards

Angela














Angela Lombard Nursing Practitioner View profile

Dear Rosebud



Many thanks for your question.



I am concerned that you have had such increasingly frequent, heavier and painful periods for the last few weeks. It is very important please, that you are treated preferably by a gynaecologist for this condition - medically termed menorrhagia. There is a schedule 4 pharmaceutical medication which corrects this condition, however you would need to see a medical doctor.



I am reluctant to treat you from a website with these signs and symptoms until you have been fully assessed and examined by your doctor. There are a number of reasons why menorrhagia happens and this is why you must be fully checked out in order to determine and treat the cause. I also do not want you to become anaemic and also tired and lethargic, which will result in a lowered immune system, allowing you then to be open to a variety of infections.



Please make this responsible appointment, as you can be easily treated once your cause has been determined.



I hope you will feel better soon, and I wish you luck.



Warm regards

Angela











Angela Lombard Nursing Practitioner View profile

Dear S



Many thanks for your question.



There are other pharmaceutical contraceptives other than the two contraceptive pills you have mentioned. I suggest that you make an appointment to see me so that I can physiologically assess you so as to determine which would be the best contraceptive for you as an individual. Oralcon is obviously not suitable for you!



Alternatively, go back to your family planning clinic and discuss changing your contraceptive with the nursing sister who saw you. But it would be great if you could see me, as I would then look at everything in detail with you, in order to determine what the best approach would be for you.



You could also consider using the PEARLY contraceptive computer, which is a small hand held device. No medication or hormones are ingested and this device just monitors and records your body temperature twice a day, and indicates very clearly your hormonal cycle and your high risk days to avoid for sexual intercourse. The big plus is that there are no side effects, and this device has been clinically trialed in Germany for over 25 years!

The website is www.ecobabe.co.za

The e-mail address is info@ecobabe.co.za

Cell no. 0790960977, and you can ask for Meg or Peter, who are the agents in South Africa for this little handheld device.



Please look at all your other options as apposed to taking Oralcon, as growing extra hair on the face for a woman is not something you would want!



Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear P



Thank you for your question. The only person who will be able to tell you more on your cycle is yourself. My recommendation is to begin a menstrual cycle where you make a daily note of any activity and detail what occurs. Over time you will begin to see a pattern emerge which will help you know more about how your own body works. Each woman's cycle is unique so don't compare your's to anyone elses.



With regards to trying to fall pregnant the first thing I would advise is to put yourself onto a good pregnant-mom multivitamin with high doses of Omega 3 fatty acids, Folate, Iron and Vitamin B12. Other than that I would say that until you have been trying regularly (i.e. unprotected intercouse at least three-four times per week) for a minimum of twelve months there is not much else we can recommend. Any special investigations into fertility issues should only be begun if ample opportunity has been given to nature to work her magic.



There is very little association between the time of your cycle and the ability to fall pregnant so please don't worry about picking the "ideal time" to have intercourse. Sperm and ovums can still dance the conception dance days, even weeks, after ovulation. So remember - 3-4 times every week of unprotected intercouse when both you and your partner are in a suitable frame of mind for a year. Forcing one another to desperately have sex is only going to increase your levels of stress hormones in your body and make it more difficult to fall pregnant.



Many thanks and warm regards

Yesheen SIngh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear T



Thank you for your question. As long as the ultrasound showed an empty uterus then I would not worry about any anatomical or infective factors contributing to your curent problem.

Do you remember if you were given an intramuscular contraceptive injection at the time of your D&C? It is often standard protocol but the patient should also be informed before administration - this would be a possible reason for your secondary amenorrhoea.



Additionally the stress from the D&C procedure is often enough to cause a disruption to your normal cycle so I would recommend giving your self some more time before you begin to worry about any ovarian imbalances.



Any further advice would depend on the reason for the D&C in the first place. If you would like to discuss this in person please contact me through www.healthnation.co.za



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for your question. The use of Acnetane is usually accompanied by a big red warning sign that you should be on tight contraceptive control because of the large possibilities of having fetal deformities if you fall pregnant while on the meds. This hasn't changed.



With regards to your future risk though, I usually advise at least a further year of stringent contraceptive use after the acnetane is stopped before your begin trying to start a family. Usually this is enough time for the body to clear out the last remaining particles of the drug from your system and for your liver to return to a normal level of functioning. If you give your body this time then there should be no increase in your risk of fetal abnormalities when compared to other women of your age.



I have not heard of a change in your ability to fall pregnant after using a course of acnetane.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear R



Thank you for your question. No contraceptive is 100% pregnancy-proof. The 3-monthly injection can have a failure rate of 3%! If you are suspicious I would advise having a blood test done to test for the pregnancy-related hormone Beta-HCG. This is the definitive test.



Many thanks and warm regards

Yesheen Singh

HealthNation

Felicia Rubin Pharmacist View profile

Dear Wendy,

Thank you for your question regarding Oratane 20mg & your interest in your health.

I am sure your dermatologist has explained the use over a period of 4-8 months as well as the effect should you have any existing medical problems.

However, your dosage is not high & am sure you are taking same according to your prescription.



Oratane does have side effects as do all medicines, of which dryness causes the most discomfort.

As far as long term use, the liver needs to be taken into consideration, & perhaps a liver detox, on a homeopathic level, would be most useful. (Heel Detox Kit)

Thus alcohol would not be recommended.

Further, check your cholesterol by means of a fasting Lipogramme, as the good cholesterol (HDL) maybe reduced.

,& Triglycerides increased.

Most of all, avoid prolonged exposure to UV rays or sunlight.



Best wishes

Yours in Health, Felicia Rubin (Senior Pharmacist & Integrated Health Practitioner)













Yesheen (dr.) Singh Medical Doctor View profile

Dear R



Thank you for your question. Please note that pulling out is not a safe form of preventing pregnancy as the penis is known to "leak" sperm even before ejaculation takes place. Please either use a condom or consider alternate forms of contraception if you would like to continue having intercourse but not fall pregnant.



With regards to the possibility of you being pregnant from what you write I think it may be quite unlikely. If you have had two periods of the usual duration and volume between the unprotected intercourse and today than your body is not holding a baby in it. If however the vaginal bleeds have changed in any way, be it duration, volume of flow or consistency of bleed, I would advise seeking a professional opinion. You may then be pregnant but more likely you may have contracted some form of vaginal infection from your boyfriend which woul dtie in with the new symptom of pain you are experiencing. Also consider having a pap smear asap.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for the questions. The question of the most appropriate management of an ovarian cyst is quite a complex one to answer because of the many factors that contribute to a win-win solution for all. What I can say is that the anatomy of your uterus has very little to do with the development of cysts on your ovaries. Cyst development is more of an inflammatory or hormonal problem. That is why symptoms usually associated with cysts often overlap with other hormone-related issues such as dysfunctional uterine bleeding, PCOS and PMS.



I think that surgery is not the only way to manage cysts, in fact it should be reserved as a last resort because of the after effects of abdonimal scar formation and general anaesthesia. Western medicine relies on synthetic contraceptives to try and reduce the imbalance in the ratio of oestrogen:progesterone that results in the inflammation and subsequent cyst formation. This often works to reduce symptoms but rarely addresses the underlying imbalance that causes changes in the hormone ratios in the first place. Typically surgery and synthetic contraceptives have rapid but temporary results while alternate measures that aim to rebalance the hormone ratio and reduce the inflammation take slightly longer to kick in but usually last much longer.



You are the only person who will be able to say which route you wish to follow. If you decide to continue with the synthetic hormone route (i.e. Primolut) you will have to give it enough time to work. Please note that there are several long term side effects caused by chronic use of synthetic hormones and be sure to research these fully before you decide to follow this path.



If you would like to discuss alternate options that work towards healing the underlying imbalance you are welcome to contact me through www.healthnation.co.za for a consultation.



Many thanks and warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear C



Many thanks for your question.



I fully understand how you feel, so I suggest that you have a BHCG pathology blood test done so as to determine whether you are pregnant or not. This test is sensitive enough to be done from 10 days post ovulation, so it will determine correctly if you are pregnant or not. You are most welcome to book an appointment with me to have this done - this test can be done at any time of the day, unlike a urine test for pregnancy. Contact me directly on 021-4875435 for an allocated time.



Sometimes if a woman really wants a pregnancy so much, she can 'think' herself into a pregnancy mode. The best way is to have a blood test done.



Hopefully I will meet you soon, and assist you further in person!



Warmest regards

Angela



Yesheen (dr.) Singh Medical Doctor View profile

Dear K



Thank you for your question. Often we find the act of breast feeding will change the menstrual cycle, acting as a form of natural contraceptive. But in your case more than 9 months has passed between the cessation of breast feeding and the onset of your current symptoms so I don't think there is any relationship.



What you describe sounds most likely like a vaginal infection, most likely candidiasis. I would advise seeking professional help to confirm diagnosis and formulate both pharmaceutical and natural otions for treatment. You are welcome to contact me individually at www.healthnation.co.za for an appointment.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear M



Thank you for the question. The symptoms you describe is simply your body tryig to rebalance itself without the presence of the synthetic hormones of the injection in your system. These symptoms can continue for some time before you return to a normal cycle.



With regards to unprotected sex there is no 100% guarantee that any contraceptive will prevent pregnancy. If you are concerned go have a blood test to confirm or deny it.



Many thanks and warm regards

Yesheen Singh

HealthNation

Angela Lombard Nursing Practitioner View profile

Dear A



Many thanks for your question.



With the information you have given, I would say that yes there is a possibility that a pregnancy could be considered. However, the best way to check this is to have a pregnancy test done, and I suggest that you do this for peace of mind anyway. I suggest that you have a BHCG pathology blood test done at your local Path Care clinic or make an appointment to see me for the same. Once you have seen me the blood sample is couriered to the relevant laboratory and I would then have a result within two hours, as I grade this as a socially sensitive test.



With your clinical profile given, it should not take longer than 2 - 3 months to detoxify, but then if there is a previous history of prolonged contraceptive usage, which you have not mentioned here, it would then take longer for you to detoxify. But overall, it should not take you too long to detoxify. You do not mention what pregnancy symptoms you are experiencing, as mild stomach cramps, tender breasts, mood swings can also occur with detoxifying from a pharmaceutical contraceptive.



I wish you lots of happiness and success with having your third baby!



Warmest regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear M



Thank you for your question. Any hormonal contraceptive, whether it is in pill or injection form, will continue to disrupt your normal hormone cycle for up to 12 months after your last dose. I your case this twelve month period began on the last day you took a triphasil pill, not from the injection.



Some women fall pregnant earlier but we usually advise to keep trying for up to 12 months before becoming concerned.



Dont forget to begin your pregnancy vitamins, omega 3's and probiotics now.



Many thanks and warm regards

Yesheen SIngh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear L



Thank you for your question. There is no contraceptive, injection or pill, that provides you with 100% effectiveness in terms of preventing pregnancy. If you are worried about being pregnant go have a blood pregnancy test.



If you are not pregnant then the lack of periods is probably due to the effect of the Petogen, which is know to stop menstruation in some individuals. The offensive vaginal discharge is probably a sign of a vaginal infection and I would recommend visiting your local clinic or GP for treatment.



Many thanks and warm regards

Yesheen SIngh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear K



Thank you for your question. As no contraceptive, injection or pill, is 100% effective in terms of preventing pregnancy the only way to confirm pregnancy or a lack thereof is to have a blood tests done at your nearest lab or GP.



Many thanks and warm regards

Yesheen SIngh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear L



Thank you for your question. No ultrasound is 100% definitive in terms of assessing the age of your baby. That is why good gynaes usually qualify their predictions by saying that you can add or subtract 2 weeks from the estimate they provide. Don't stress over this minor issue. As long as they find a healthy growing baby in the uterus on ultrasound and they find on follow-up ultrasounds an appropriate rate of growth and development I would not worry about the date. Try to stay with one gynae because technique differs so much between them that outcomes can be quite disparate.



Don't forget to take your pregnancy vitamins, omega 3's and probiotics!



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear A



Thank you for your question. Does the discharge itch or have an offensive scent? If so you may have a concommitant infection you should have checked out with a pap smear. If not I would pay attention to the duration of the change - i.e. does the period change for a couple of cycles or did it change for just the one? If it continues to remain darker and of a different consistency I recommend having a pap smear once the period is over. The characteristics of menstrual flow change depending on your diet, stress levels, physiological balance and are also influenced by things like infection or other diseases. We usually look for a pattern before decding on the necessity for follow up testing but if you are in any doubt have a pap smear.



Many thanks and warm regards

Yesheen Singh

HealthNation

Hi Doc,

Thanks for your previous reply. I ended up in hospital last Friday with severe abdominal pain. I My bloods showed that my white and red blood count was high as well as the CRP markers. They also did xrays and a scan. The trauma doctor said that it looked like a cyst thats bleeding.At the time i was having my periods so he could have been mistaken. I have to admit it was a weird period (dark brown and clotty)The trauma doctor refered my case to my gynae since i had the laparoscopy a week prior to the emergency. The gynae administered pain meds and no other treatment. He said that it could have something to do with my bowel. But never refered me whilst in hospital. He ordered another blood test the following morning and it came back pretty much the same. At that stage i wasnt experiencing any more pain but when pressing at my lower abdomen and aroung my tummy i could feel tenderness inside. He did another blood test on the sunday and the CRP levels had come down to 23, where it was previously 60. He sent me home, no medication. This has left me feeling so depressed because i know something is not right. The pain may have subsided and is intermittend at this stage, but i still am naseous and still have cramping in my thigh as well as lower back ache. He said he’d refer me to a gastroenterologist as he thought it may be a case of diverticulitis, but he’d post me the letter.Meanwhile i feel unwell (but not so bad that warrants another casualty visit). There is definately an improvement but it seems that i have the pain when i am menstruating. I had it last month and this month it was worst. When i was discharged i took an enema hoping that it would give some relief to the pressure inside my abdomen when sitting and all the gas. It did help, but when i have a bm, i have pain in my ovaries. What should be my next step. My medical aid has been exhausted and im paying all the shortfalls of the claims not paid by my pathetic medical aid. Where do i go from here that isnt going to cripple me financially?

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y



Thank you for the feedback. At this stage I have to recuse myself from providing you with further advice. This is because we are bordering on clinical recomendations and I cannot provide you with appropriate guidelines without a personal consultation. I can say that there are other considerations to be taken into account when trying to find out the underlying imbalance of your issues and that there are options available to heal the imbalance in your endocrine and/or GIT system. So don't despaire.



You are welcome to contact us at www.healthnation.co.za to make an appointment.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear L



Thank you for your question. Both Oralcon and Nordette contain 0.15mg Levonorgestrel and 0.03mg Ethinylestradiol so in terms of active ingredients they are the same. The carrier substance may differ though. The best way to find out if you can alternate is to try a course of Nordette and find out. Please remember to use the full course and not to swop half-way.



Many thanks and warm regards

Yesheen Singh

HealthNation

Angela Lombard Nursing Practitioner View profile

Dear B

Many thanks for your question.

You need to be on the pill for a minimum of three weeks in order to provide sufficient contraceptive protection when preventing an unplanned pregnancy.

Always use an affective barrier method like condoms in a situation like this so as to prevent this from happening, and then you will save yourself a lot of unnecessary heartache!

The morning after pill is graded as EMERGENCY CONTRACEPTION and must be taken sooner than later, and definitely before 72 hours, post intercourse.

It is crucial that an emergency contraceptive pill is not taken more than twice in a lifetime please. This pill is not a smartie and when taken too often, it can introduce and cause cancer.

Kind regards
Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear L



Thank you for your question. There are many factors that contribute towards the development of an hypertropic scar. They range from genetic predispositions, the impact of nutritional and lifestyle factors on immune and inflammatory responses and stress. I would recommend beginning with a good quality Omega 3 supplement at high doses, a fridge-stored probiotic, a diet targetted at reducing the inflammation and increasing your activity levels. Topical application of Rose Hip oil or any other oil rich in anti-oxidants may also help. There are more specialised supplements such as collagen powders but these are not necessarily the best first line therapy.



Laser therapy can be beneficial on scar reduction depending the tone of your skin and the type of laser your local practitioner has available. I would recommend seeing a reputable dermatologist as they would be more likely not to take advantage of you desperation and identify the more appropriate forms of laser therapy useful in your condition.



Unfortunately I do not know any dermatologists who offer free consultations. Payment plans depend on your discussion with the individual dermatologist.



As I practice in Cape Town my knowledge of KZN-based dermatologists is limited. You could try Dr Dylan Naidoo at (031) 206 1060 to start with. He is based in Durban but perhaps they can refer you to a practitioner in Pietermaritzburg.



Many thanks and warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear T



Many thanks for your question.



Both you and your fiance need to be followed up again. I need to see you for an appointment so as to visually assess and determine that it definitely is genital herpes that your partner has been diagnosed with.



There are many different skin conditions that itch and are uncomfortable, so guiding you over a website is inadequate. A visual assessment does need to be done, inclusive of a medical and social history.



Your first doctor should have recommended that you return to be reassessed and followed up.



It is vital that the full course of medication is taken exactly as it was prescibed - if not, then the possible infection can break out again and a whole new cyclic reaction will reoccur, and you will both just keep infecting each other. There are a number of blood tests which can be done for sexually transmitted diseases - unfortunately, you do not say which one it was, and again I would need to see the final pathology report for this.



Please make an appointment to see your doctor again for a follow up appointment, or alternatively, you are welcome to contact me for the same on 021-4875435, Monday - Friday, from 09h00 - 16h00, at the Kloof Well Clinic in Cape Town.



Please make this responsible appointment.



Kind regards



Angela











Yesheen (dr.) Singh Medical Doctor View profile

Dear L



It is not surprising that you are not experiencing any periods - you switched from an injectable contraception to an oral contraception! If you were using both at the same time then I would be worried about major oestrogen metabolism disruptions. There is most definitely a link between the chronic use of synthetic contraceptives and changes in hair patterns because of how the contraception effects the oestrogen:testosterone ratio.



My recommendations to you would be to take a complete break from all forms of oral or injectable contraception and allow your body an opportunity to "reboot" and remember how to function without the confusing presence of synthetic hormones. In place you could use condoms for pregnancy prevention and Saw Palmetto supplements for hormonal symptoms.



It can take up to 12 months after stopping contraceptives like the injection or the pill before your periods return to normal so be patient with your body. If you are worried in the interim have a pregnancy test at your local clinic to rule out that possibility.



Many thanks and warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear N



Many thanks for your question.



You would be a perfect candidate for using the PEARLY. This is a feminine, 'handbag-friendly' contraceptive computer, ideal for active women on the go. There are no side effects and no hormones involved in using this nifty gadget.



It is also 99.3% reliable. The pearly has been clinically trialed in Germany for more than 25 years. All that it entails is taking your temperature every morning and evening, and it will detect your most fertile days, and indicate clearly when intercourse should be avoided.



The website is www.ecobabe.co.za

The contact telephone number is 0790960977. The agents in South Africa are Meg and Peter.

The e-mail address is info@ecobabe.co.za



Side effects from discontinuing your pill will involve a bit of a hormonal influx, and detoxification will start to take place. Your menstruation could be erratic, but should this happen, you are welcome to e-mail me again, desribe your symptoms and I will treat you effectively and safely.



All the very best of health to you -



Warmest regards



Angela

Angela Lombard Nursing Practitioner View profile

Dear Cindy



I am really thrilled to hear your wonderful news! You and your husband must be so excited! This has happened just the way it is supposed to - Thank you for letting me know and for sharing your happy news. All the best of luck, and we are here when you next need us!



Warmest regards to the three of you!



Angela


Angela Lombard Nursing Practitioner View profile

Dear R



Many thanks for your question.



As we have spoken on the telephone yesterday, I would like to confirm that the minipill is the only pharmaceutical contraceptive that should be taken when breastfeeding, and again a very big NO to Oralcon while breastfeeding.

Do consider using the 'pearly' as a very safe alternative.



All the very best to you and your family,



Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for your question. Pregnancy-induced hypertension is sometimes included under the umbrella diagnosis of secondary hypertension, but unlike most of of theother causes of secondary hypertension should not be taken to mean that it will be with you for life. In a lot of the cases it disappears post-partum, only to sometimes return with following pregnancies.



There are certainly alternates to pharmaceuticals which you can use for now to manage it, and there are comprehensive lifestyle plans available, incorporating nutritional, supplement, activity and stress modifying therapies, that assist you to heal your body so that in the long run you don't have to medicate any more. But these are to complex to discuss via email. I would suggest contacting me for an appointment via our website www.healthnation.co.za or alternatively look for your local alternate health care practitioner who works with functional medicine.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y



Thank you for question. I am happy to read that your lap-scope was clear. As much as I have been following your case via your messages through this website I have to say that without a proper history and consultation I cannot offer any further advice. The steps I suggested in previous emails were to exclude the more common obvious forms of pathology related to the pain your experience. To go beyond these common diagnoses will require a more detailed history.



I do not hink that pain is ever something you should have to learn to live with. It is your body's way of indicating to you that there is something off balance, with the hope that you will find out what it is and correct it. Scopes and ultrasounds are limited to looking for physical abnormalities visible to the human eye. They do not exclude abnormalities occuring on a hormonal or metabolic level.



If you would like to make an appointment, both physical or telephonic, please contact us through www.healthnation.co.za. Alternatively contact your local functional medicine practitioner.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for your question. There is a lot of new information coming out about what causes the development of endometriosis and the use of chronic synthetic contraceptives is no longer my first choice of therapy, especially because of the side effects associated with synthetic hormones. I appreciate though how effective something like Mirena can be in controlling the symptoms of endometriosis and allowing you to get on with life. But contraceptives work by putting a band-aid on the symptoms of the disease and affect no change on the underlying cuases that gives rise to the imbalance in the first place. This is when we find life-long use of contraceptions being prescribed because if you stop the contraceptive the problem simply reappears from uder the band-aid.



By going into the different pathways oestrogen follows through your body we are able to ellicit where the imbalance is that causes the inflammation that gives rise to endometriosis. This requires a careful history and a couple of special investigations. This allows us an opportunity to heal or reduce the severity of the cause of the endometriosis.



So to answer your question if you would like to continue with the contraceptive route then repeat the Mirena contraceptive because of all those available on the market it is the easiet to use and has a lower side effect profile. If you would like to try something alternate contact us through www.healthnation.co.za for more information. My approach uses a combination of nutritional, supplement, activity and stress modification tools to effect physiological change and because it is tailored to the individuals metabolism it is difficult to answer with the little information available in a forum like this.



Many thanks and warm regards

Yesheen Singh


Yesheen (dr.) Singh Medical Doctor View profile

Dear L



I am sorry to read that you are distracted from the joys of motherhood by the imbalance in your health. Unfortunately the information you provide is rather murky. Eltroxin is usually prescribed for thyroid imbalances and from the symptoms you describe it is not surprising that your doctor thought to look there first. I cannot coment on the blood results because I do not know what was tested but if the doctor started you on eltroxin then perhaps there may have been something wrong with the thyroid levels.



Eltroxin would not be my first line of therapy for someone who has such a significant trigger (pregnancy and lactation) where your sex hormones will most certainly be disrupted, leading to disruption in thyroid hormone levels and the associated symptoms. There are many other pathways through which your thyroid can be influenced that have little to do with an inherent thyropid imbalance. Managing these diseases with eltroxin is tantamount to sweeping the true cause under the rug and hoping it will resolve itself in the long-run.



You have two options available to you: Firstly revisit your doctor and insist on a full and thorough explanation of why they ordered the tests they did, what the results mean and why they chose to prescribe eltroxin. It is actually unethical and illegal for you to be on a medication without completely understanding the reasoning behind the prescription. Secondly you are welcome to make an appointment with me via www.healthnation.co.za to discuss your clinical picture, your blood results and alternate options to pharmaceuticals like eltroxin as first line therapy to manage your symptom picture.



Many thanks and warm regards

Yesheen Singh




Yesheen (dr.) Singh Medical Doctor View profile

Dear V



Your question has been cut off half way but I'm going to assume that you are referring to trying to fall pregnant for "years now."



Yes you can most definitely experience a period without releasing an egg. Menstruation not only concerns the growth and release of an egg but also the priming of the lining of the uterus to receive said egg if it happened to become fertilised. This "womb-priming" process is dependant on the changing ratios of oestrogen to progesterone as you move through a cycle.



Did you gynae mention whether you had eggs present in the ovary on ultrasound or that they were absent?



If there are eggs present and they simply are not being released then your problems with ovulation are due to an oestrogen metabolism issue. Clomid attempts to act on this cascade of metabolic steps by going upstream and effecting increased levels of hormones known to increase the production of other hormones downstream that encourage ovulation. But if there are already enough of these types of hormones floating around then simply increasing their concentration will not make much of a difference. That is unless the dose of Clomid is enough to hyperstimulate the ovary and release more than one egg which is sometimes the case.



My approach would be to study the passage of oestrogen through your body, from production to transport and disseminaton and activty until deactivation and excretion. Any alterations to any of these steps in the pathway can contribute to abnormal oestrogen:progesterone levels and result in loss of ovulation. There are many compounding factors, too many to list in a forum such as this. I usually begin with a full lifestyle assessment and history and then we conduct testing to look at the various concentrations of hormones at different stages of the pestrogen cascade to find out where the possible imbalance may lie.



My advice is to pick one method, commit to it and then trust that it will work out if appropriate for you. Either choose to continue with the Clomid route and give it enough time to work - if it doesn't after a couple of months then certainly re-evaluate. Alternatively you can contact me through www.healthnation.co.za to arrange a more personal assessment. Remember though that either choice will require time and consistency.



Many thanks and warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear E

Many thanks for your question. For the information given, it could be one of two things. Sometimes when there is stress or additional stress, a woman will have a second period in a month - e.g. it could be a loved one who is sick, writing or preparing for exams, moving home, and so on.

The second reason, would be that your body is saying that it now needs a break or rest from your contraceptive. It is advisable to have a rest from the pill at least every two years for 1 - 2 months so as to detoxify from the different chemicals in Triphasil, as all pharmaceutical contraceptives are 100% synthetic.

You are welcome to make an appointment to see me, so that you can be fully assessed and advised in more detail.

Kind regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear D



Thank you for your question. I am sorry to read of your troubles with your skin. In my opinion it is more worrying why your immune system is allowing your skin to be so sensitive and reactive to the point of developing chronic infections. My advice would be to forget about the creams and antibiotics as they obviously have not helped and porbably only make the situation worse. Focus instead on super-charging your immune system.



Begin with your diet - cut out all foods that suppress immunity - i.e. dairy, sugar, meat, wheat.

Secondly use a strong probiotic from the fridge section of your local health shop.

Thirdly use immune-bosting supplements like Ester C, Spirulina, Chlorophyll and Immucore - choose one only.

Fourthly look at the products you use on your skin - soaps, lotions, washing powder, etc to evaluate for any sensitivities.

Lastly think about consulting a knowledgable practitioner to discuss undergoing a cleanse or detox - you may have picked up levels of environmental toxins that are suppressing your immune system, opening the door to opportunistic infections such as the one's you are experiencing.



You are welcome to contact me through www.healthnation.co.za if you would like to set up an appointment to discuss a cleanse plan for you.



Many thanks and warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear E

Many thanks for your question. It definitely seems that Oralcon does not suit you, as it has greatly contributed to a fluid imbalance, hence you feeling bloated and as if you are pregnant. I suggest that you discontinue Oralcon with immediate effect.

I would like to resolve your fluid imbalance first before you commence a new and different contraceptive, should you visit your doctor. I recommend the following :

NAT MUR TISSUE SALTS NO. 9, as x1 celloid (tablet), every 2 hours for the first day. Please use the Allison Effting range of tissue salts as this is dose C30 (triple strength for homeopathy). Take your celloid sublingually (under the tongue). Thereafter, take x1 celloid 10 - 15 minutes before meals, 4 times a day. Nat Mur is pure sodium chloride in tissue salt form and will centre down your hatha line (the main miridian line of the body) and pull all your different body fluids into the correct ratio quantities for you as an individual. For the first day do make sure that you are not too far from a bathroom!

You might want to consider the 'pearly' which is a feminine handbag-friendly contraceptive computer which has been clinically trialed in Germany for over 25 years. It is safe, natural, simple, fast, without side effects, and reliable. The website is info@ecobabe.co.za and the telephone number is 0790960977. The e-mail address is www.ecobabe.co.za You can ask to speak to Meg or Peter, who will help you.

Do remember to make use of an effective barrier method like condoms, while you decide which contraceptive approach to use.

I wish you health and happiness!

Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear S



Usually we advise the use of condoms for 1-2 weeks after you receive an injectable contraceptive but in some women it can take immediate effect, depending on the rate of your metabolism. There is no definitive predicatability with regards to how easy it is to fall pregnant - injectable contraceptions are only 98% effective even if used in ideal conditions. I think if you are concerned about being pregnant take a pregnancy test, available from your local health shop. It's quick and easy and provides peace of mind.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Please refer to my response in your later post on the same question.

Angela Lombard Nursing Practitioner View profile


Garth (dr.) Roberts Chiropractor View profile

Dear R

Many thanks for your question.

It is really important that you do take your pill every single day, at the same time. One hour either way, i.e. like one hour before your normal time of taking it, or one hour after your normal time of taking your pill as a once off occasion would be acceptable - but not on a regular basis. Your spotting and light bleeding has predominantly occurred due to an upset of your hormonal cycle with the erratic taking of your pill.

It is preferable when commencing a new pill pack, to start on the first day of a menstrual bleed. This really assists the hormonal cycle to get off to a good start, correctly, from the very beginning.

For peace of mind, I recommend that you do a pregnancy test. You are welcome to chat to me again about any results you may be concerned with.

Kind regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for your question. Firstly are you 100% certain that this was his first time having sexual intercourse of any nature with someone else? If he was indeed a virgin the he most probably caught the infection from you. Herpes is a virus. Acyclovir will help to clear up the rash but you cannot ever kill the virus, you simply "put it to sleep". It will reawaken if your immune system is low, which opens to the door to it, and begin a new series of painful genital rashes. It is fairly common in communities who practice unprotected sex. There are many women and men who go on to get married, have children and lead happy lives after contracting herpes because they look after their immune systems and keep the door closed to the virus.



My advice:

1. If you are not exclusive with one another use a condom. Having herpes makes it easier to contract other STD's like syphilis and HIV.

2. Have a pap smear - herpes increases your risk of developing cervical cancer down the line so make sure you have a smear every 1-2 years.

3. Keep your immune system healthy - avoid foods that suppress it like sugar and dairy, Use strong immune boosting supplements like a probiotic and Ester-C or Spirulina.

4. Remember that your thoughts are very powerful. If you are stressed your immune system will be suppressed and when that happens the virus will wake up and become active again. Always remain postive, gorunded and calm.



Many thanks and warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear T

Many thanks for your question.

You are quite correct in taking your oral contraceptive in the evening - it is always preferable to take an oral contraceptive in the evening because of the formulation of a contraceptive tablet. Taking your pill ten minutes earlier is fine, and yes you can still take your pill the following evening at your usual 8 p.m. time. This will not cause any problems health-wise, and will not result in an unplanned pregnancy. Your pill should be taken within an hour of the usual scheduled time. So, should you have taken it at 7 p.m. or even 9 p.m. as a once off situation, this would also have been acceptable.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Thank you for your follow-on question.

It is normal to start a period after stopping the pill, as this is already an indication for you that your body is starting to detoxify etc. It is difficult to say how long it would last, although a maximum length for a period should be no more than 7 days. Do consider taking the supplements I suggested according to the prescription I have given you. Your physical medical state can also determine how long you menstruate for, but in your instance I am not currently concerned that there is a problem.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question. Your "light bleeding/spotting" is as a result of the withdrawal of hormones (in the pill) and the beginning of detoxification thereof, and yes it is normal for this to happen. Your body will now attempt to re-regulate your hormonal cycle. It should take no more than 2 - 3 months maximum for regular menstruation to return. I suggest that you consider doing the following:

Take CHASTEBERRY PLUS by Metagenics as x1 capsule, twice daily, in the morning and evening after meals. This nutritional supplement will assist in re-regulating your hormonal cycle, in supporting menstrual regularity, and in relieving menstrual symptoms. Chasteberry Plus also contains Ashwagandha which helps with the emotional 'topsy-turvy' when detoxifying from the synthetic hormones in the contraceptive. Rather complete detoxifying first and then plan your pregnancy.

When there is an overload of contraceptive hormones in the systems, and detoxification has not been allowed to happen sufficiently, it is listed for Triphasil that on occasion, male babies have been born with female features - so just to be safe, detoxify.

Also, being on the pill for 6 years without a break is a fair length of time, and it is important to be aware that you may take anything up to a year to fall pregnant. Should you not have been on a multivitamin while on the pill, I recommend that you now take a good multivitamin and omega supplement.

You are welcome to e-mail me again, or even telephone with any concerns you may have. I wish you and your husband all the very best of luck with your baby plans.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear K

Many thanks for your e-mail. I suggest that you please give me a call on 021-4875435 between the hours of 09h00 - 16h00, as I have a few suggestions to discuss with you, apart from my reply below.

Your daughter should not be bleeding for 2 months at all. Nur-Isterate definitely does not suit her, and should not be administered again. With her being 17 years, and for the purpose of regulating her menstruation I suggest the following:

AGNUS CASTUSBERRY PLUS by Metagenics , as x1 capsule in the morning after breakfast, and then x1 capsule again after supper. This nutritional product will support menstrual regularity and relieve menstrual symptoms, and also assist with coming off Nur-Isterate. This product contains Ashwagandha which is a 2000 year old Indian remedy, and has been included for settling the emotional upsets from detoxifying from a contraceptive, and for settling hormones within the body. Let her take this for 1 - 2 months, until her menstruation has settled.

EVENING PRIMROSE OIL CAPSULES by Vital, as x1 capsule after supper, or even an hour later. Evening Primrose oil does take a month to kick in, but will assist in maintaining her menstrual cycle and regularity etc. long after her menstruation has returned.

Both of the above two mentioned products can be commenced together, and then to safely continue with Evening Primrose oil. Should she have been prone to painful periods before, you could substitute Evening Primrose oil with x1 Starflower oil capsule daily, instead - which is more concentrated.

All the best of luck - do as I suggest and your daughter should be fine.

Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for your question. It often takes up to a year for your body to get back to a normal regular cycle after the complete cessation of all forms of synthetic contraceptives. As such I think it is too early to draw any conclusions from the changes in the onset/duration of your cycle.



However the discharge you describe is not normal. From what you describe it sounds more like a candida infection more than any other form of vaginal discharge. You can confirm this by testing via a culture of the fluid. Any GP will be able to arrange this.



If it is indeed candida you have two options available:



1. A pharmaceutical approach that is supposed to kill the fungus (although today we are seeing a lot of drug resistance so I would ask the GP doing the culture to ask for a drug sensitivity before you begin the drug).

2. A wholistic approach using plant-based compounds that are as effective as the pharmaceutical but without the side effects. Examples here include products including grapefruit seed extract, berberine and garlic extracts. But as above I would wait to confirm the candida diagnosis before beginning treatment.



With either of these options I would also recommend high doses of a fridge-stored probiotic, at least 10 billion organisms per day.



I would also recommend looking at the rest of your body to look for symptoms of candida presence. Usually the vaginal discharge is the tip of the iceberg. If there are other symptoms then consider a good cleanse or detox program combined with immune-boosting supplements to enhance your immune system. Candida is a normal part of our flora but only becomes problematic when the immune system is compromised and the balance between healthy flora and unhealthy fungi like candida changes.



You are welcome to contact me via www.healthnation.co.za for a more personalised program.



Many thanks and warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear D

Thank you for your question.

I am sorry to hear about your miscarriage, as this can be a very traumatic experience to go through. The dillutage and curitage procedure is an invasive surgical procedure, and both experiences will have upset your hormonal cycle, so it is normal not to have menstruation for a couple of months.

I suggest that you have a haemoglobin check (a simple finger prick test would suffice) at a clinic, or alternatively make an appointment to see me for this simple procedure, so as to determine if there is any iron deficiency anaemia.

There are a number of products which would help to rectify your hormonal levels, however your haemoglobin should be checked first prior to a script being given, so that the correct medication or nutritional supplement can be recommended.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear T

Many thanks for your question.

I am most concerned that your friend went to the family planning clinic and was given a contraceptive which was meant for you, but for which the clinic sister did not even see you for! Please rather make an appointment to see me if you can, or rather change your clinic sister!

There are a number of questions the family planning sister needs to ask you prior to prescribing a contraceptive pill. I do not want you to become a mismanaged case due to unnacceptable negligence! Perhaps your friend went to the family planning clinic for herself under the provisio that it was for you, but told the sister that the checkup was for her instead. No trained professional would give a contraceptive without seeing the person it is for. You need to also, and importantly, have a blood pressure and weight check with your family planning visit. And this happens with each family planning visit every time.

I suggest that you do have a proper clinic visit yourself, or see me please. I can then assess you physiologically as to which contraceptive would suit you best - it would be better to do this before commencing Oralcon. You are one of many young women who feel conscious about first time contraception, so please do not feel alone. Your health is my priority and I only want what's best for you.

With warm regards

Angela

Melissa Usher Dietician View profile

Dear Angelica

Many thanks for your query.

I can most certainly consult with you on an individual basis to discuss your dietary requirements for GERD.

Please contact me on the following email address: melissa@thefoodexpert.co.za to discuss the matter further.

Kind regards,

Melissa

Angela Lombard Nursing Practitioner View profile

Dear S

Thank you for your question. The light spotting you mention is the tail end of your menses. Normal monthly menstruation can go on for a maximum of 7 days. Should your bleeding have been of a different and heavier flow with blood clots, then I would be treating you differently. However, what you describe is quite normal and there is no need for you to be concerned.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear K

Many thanks for your question.

I am so sorry that you have experienced this often very painful condition. You are correct in saying that pelvic inflammatory disease inhibits conception, however there is still a remote chance that there may be a pregnancy with what you have mentioned, and also with you having been on a pharmaceutical antibiotic. Therefore, I do recommend that you have a pregnancy test done please. You may use one of the home pregnancy test kits for this purpose, but do test the urine before 10 a.m. in the morning, as this is the time that the human chorionic gonadotrophin hormone (HCG hormone) is raised when there is a pregnancy. If done at a later time in the day, you may end up with have a false reading either way. I recommend that you do the pregnancy test for peace of mind as well, due to your concern.

I wish you well, and hope that you fully recover soon.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear S

Many thanks for your question.

In this particular instance, and due to your signs and symptoms, I suggest that you make an appointment to see your general practitioner so that he or she can fully assess and examine you properly. There is a lot that I can discuss at length here, but you do need to see your GP please.

I hope you feel better soon.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear S

Many thanks for your question.

The contraceptive pill usually takes 1-2 months to be detoxified from the different systems of the body. It is always advisable to give your body a rest or break from the pill after a year, or at most after 2 - 3 years. I take it that this has not been done, so I suggest that you allow for a minimum of at least 6 months to one year, so as to allow for proper and full detoxification. This will help with the release of the different chemical components in the pill from the body.

I don't think there is cause for concern, should you be generally healthy. Patience is definitely a virtue when planning a baby! You are welcome to read the many questions already answered on this website about assisting with fertility suplementation.

I wish you all the best of luck with your baby plans!

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear C

Many thanks for your question. Oralcon is one of the recently sourced and cheaper generics from Malaysia and Hong Kong. Oralcon is supplied by the government and municipal clinics as a cost effective alternative pill. As I have not seen the clinical trials for this pill, I am reluctant to recommend it - however, I do manage many reported side effects from this particular pill!

I would prefer for you to visit our Natural Medicine Dispensary at either our Kloof store in Cape Town, or Cavendish in Claremont, and let us have a look at you and recommend from there. A good cleansing routine for the face morning and evening will assist greatly with controlling skin problems. In fact there is a lot we can assist you with. Do eat correctly, and you can be given an eating plan as well.

I suggest you consider taking EVENING PRIMROSE OIL CAPSULES by Vital, as x1 capsule at night, so as to assist with hormonal fluctuations.

You are also welcome to see me for an appointment, and I can treat you in total.

Warm regards

Angela


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