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Q&A Topics

Contraception


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 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 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 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 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 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 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 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

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

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


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 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 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 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

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 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

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

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.

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

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 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

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

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

Angela Lombard Nursing Practitioner View profile

Dear W

Many thanks for your question.

Most definitely the chemical components of your Depo-Provera contraceptive injection will still be in all the systems of the body. After prolonged usage of this injection there will be a collection of chemicals from the contraceptive in the linings of all the soft organs of the body. I suggest that you allow for up to a year to allow for full detoxification, with you having been on Depo-Provera for 6 years. It will eventually be released from the body.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear A

Many thanks for your question. Taking Flax seed and Vitamin A will not lower the effectiveness of Petogen, or any other contraceptive for that matter. These two products will work parallel with these nutritional topups.

Alcohol when consumed in a large quantity could challenge the efficasy of a contraceptive due to the fact that the body will be thrown out of balance. Alcohol taken in, in a small to moderate quantity should not impair the effectiveness of Petogen at all. A contraceptive tablet should not be taken at the same time as alcohol.

Pharmateutical antibiotics and cough mixtures on the other hand, are a different story all together - and yes will definitely affect the effectiveness of all contraceptives, and even more so if the contraceptive has not been taken for more than a few months. All pharmaceutical cough mixtures contain some alcohol, and certain hoemeopathic cough mixtures contain a very small quantity of alcohol, merely as a preservative - as likewise do tinctures.

I have double checked the above information with our Natural Medicine and Homeopathic Dispensary, and they have confirmed the same.

With warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Z

Many thanks for your question.

As you have used Nur-Isterate for longer than the 2 year recommended time span, you will take a minimum of 6 months to detoxify. However, I suggest that you allow for up to a year to detoxify from this contraceptive.

Should you have a slow metabolic rate, it may take you a little long than a year to fall pregnant.

I wish you all the very best with your baby making plans.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear M

I am very glad that you have asked this question!

There are a number of age-old natural contraceptive methods which have been practised for centuries.

I suggest that you check the website for the 'pearly', which is a feminine, small hand-held, handhandbag-friendly contraceptive computer, which is ideal for active women on the go. This small computer recording device will take your body temperature morning and evening, and record it up to 2500 times, and then you can start again with a fresh set of recordings. It is the safest contraceptive approach I have seen for a long time! The website is www.ecobabe.co.za

The pearly has been clinically trialed in Germany for over 25 years. You can also contact Meg or Peter at info@ecobabe.co.za The contact telephone number is 0790960977.

This device will help you to take control of your hormonal cycle without all the side effects of pharmaceutical contraceptives, by simply taking your temperature morning and evening with this recording device.

There are many women who have health problems due to contraceptives, so I have sourced this little computer so as to empower you to take charge of your health without all the nasty side effects of pharmaceutical contraceptives.

All the very best of luck!

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear M

Many thanks for your question.

I most definitely do recommend that you consider discontinuing these contraceptive injections, and for at least six months. Please remember to always use an effective barrier method like condoms, so as to avoid an unplanned pregnancy.

Unfortunately Nur-Isterate is listed to cause weight gain or massive weight gain. Suggesting that Nur-Isterate will assist you in losing weight is completely incorrect! The best thing would be to allow your body to detoxify from this contraceptive, and the 'build up' from the Petogen prior to having Nur-Isterate administered. These injectable contraceptives are pharmaceutical and are 100% synthetic. Over a period of time they accumulate in the membrane linings of all the systems of the body, thereby contributing to weight gain, and especially when used for more than two years.

Your age bracket of 41 - 45 years indicates that you might be either perimenopausal or menopausal, so this may be a time in your life when you might be prone to weight gain anyway. I can assist you with all future queries, but please always refer back to your previous question and the reply ( I answer at least 70 - 80 questions for the website alone, every 6 - 7 days).

You should be able to win with this problem, but it may take a bit of time, so patience needs to be called upon!

You may also experience a hormonal flux when discontinuing your contraceptive.

I wish you well, and should you wish for advice about losing body mass, you are welcome to contact me further.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear D

Thank you for your question.

There is a remote possibility that there could be a pregnancy, however this would all depend on how long you were taking the Nur-Isterate contraceptive injection for. As there is too little history to go on here, I suggest that for peace of mind you have a pregnancy test done please.

Should you decide to use a home pregnancy kit, only do this in the morning, and preferably before 10 a.m. as the HCG hormone, which is what is checked for in determining a pregnancy, is only raised in the morning.

Kind regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear EH

Many thanks for your question.

It is crucial that you take your pill on time, every 24 hours. Your hormonal cycle will be affected by the emergency contraceptive pill, and yes you may find that you won't have your period on time or for awhile. And yes, it is preferable to to recommence your pill on the first day of your menstrual bleed, as this will assist in regulating your hormonal cycle correctly from the beginning. In the interim, I recommend that you do use condoms as a good barrier method.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear T

Many thanks for your question and appreciation.

Contraception can be a bit of a 'hit and miss' process, as each woman is a unique individual and needs to feel for herself as to which one she responds to best.

Trigestrel is a cheap generic sourced by our South African government from Malaysia and Hong Kong. To date I have not seen clinical trials for Trigestrel, so I prefer to recommend Triphasil which is what was originally dispensed in the government and municipal clinics, prior to the cheaper generics being sourced.

Your symptoms may persist while on Trigestrel, but would improve should you change to Triphasil. However, I am trained to look at the individual, assess and determine which contraceptive would suit you according to your physiological makeup. If you can, I would prefer for you to come in and see me (with an appointment please!) and let me assess you fully. My primary concern is your health, and the response you would give to the relevant contraceptive recommended. Of course the contraceptive function is important, but you still need to be well while on it! And don't worry, 90% of the questions subitted are all to do with reproductive health!

With warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear P

Many thanks for your question.

Your implant may still have some affect in preventing pregnancy. I do however recommend that you have it removed, and as this is a surgical procedure, you need to contact your gynaecologist, or alternatively a plastic surgeon or general surgeon.

I wish you well and good luck with the baby making plans!

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Rose

Many thanks for your question. The Petogen contraceptive intramuscular injection is of schedule 4 status. It is administered every 12 weeks in the buttock area. Petogen is the generic for Depo-Provera, and is the identical replacement. It is a slow release contraceptive in a milky solution and was originally formulated for the older woman of 28 years and more.

One of the side effects listed is that there can be amennorrhoea (temporary inhibition of menses); or menstruation can disappear altogether while on Petogen. It does depend on each individual woman, as each one is unique. So therefore, some women do have menses but it is invariably light, or not at all. I hope this answers your question.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear A

Many thanks for your question.

I suggest that you give yourself a little longer in waiting for your menses to return. It is not unusual for a period to take longer than a month to return, so yes it is normal. Should you be concerned about an unplanned pregnancy, for peace of mind I suggest that you have a pregnancy test done.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Emma

Many thanks for your question.

Unfortunately I do need to assess you in more detail, as the information given is not sufficient to determine a cause.

You should not be bleeding every day, even though it is quite light. You are welcome to make an appointment to see me, or alternatively your general practitioner.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear R

Many thanks for your question.

Please confirm whether you are in perimenopause or have polycystic ovaries. Both conditions are different. Your doctor should have done this for you at the time.

Has your doctor done tests for the thyroid? This is where I would start with you first due to your clinical profile given. Also with you having had a tubal ligation 8 years ago, and being in the age category of 41 - 45 years, this alone would begin to indicate a hormonal change.

You are welcome to make an appointment to see me at the Kloof Clinic in Cape Town. It is important to be seen and assessed and examined if necessary, as I suspect a hormone imbalance. There are nine different hormones which need to be considered, when treating a patient for an imbalance like this.

I do hope that you can make a time to see me, and if possible bring your test results with you. I do liase with pathology services on a daily basis, so at least know which pathology company your test results came from when you see me.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Tums

Many thanks for your question. It is quite normal for you to go through a hormonal flux when discontinuing the contraceptive pill. Bear in mind that you have been on it for two years, so detoxification should take a minimum of 2 - 3 months. However, this can vary from one person to the next.

You could consider taking CHASTEBERRY PLUS by Metagenics, as x1 capsule twice a day, after breakfast and supper. This product will assist in regulating your menstrual cycle, and also assist in correcting a hormonal imbalance. Do this for at least a month.

To determine further answers to your questions I request that you make an appointment to see me, so as to do a proper assessment, and examination if necessary, of you in person.

You do need to allow for up to a six month time span so as to fully detoxify from the two years of using Oralcon. Were you on a contraceptive previously before having Oralcon prescribed? This also needs to be taken into account as well when detoxifying.

I also suggest that you consider have a gynaecological checkup with your medical specialist on an annual basis, so as to determine your ovulation health.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear T

Many thanks for your question. Unfortunately the government clinics are providing Trigestrel in place of Triphasil, which is a cheaper generic alternative sourced from Malaysia and Hong Kong.

You are welcome to contact me for an appointment for the contraceptive service. I am able to write the prescription for Triphasil, as Wellness Warehouse sources Triphasil from a private supplier. Contact me on telephone number 021-4875435, or 4875420 between the hours of 09h00 - 16h00, Monday to Friday, at our Kloof Well Clinic.

I wish you well.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Vasti

Many thanks for your question. I apologise for the delay as some of us have been on sabatical.

I certainly recommend that you discontinue with Oralcon due to the skin sensitivity. This contraceptive does not suit you!

It would be best if you could make an appointment to see me so that I can physiologically assess you to see which contraceptive would suit you.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question. The 2 month injection is called Nur-Isterate and is given every 8 weeks. It is better to work with a 'week' quota than a 'month', as weeks vary from month to month. So then, better accuracy is maintained for contraception and monitoring of your hormonal cycle.

Changing from one contraception to another will illicit a hormonal change, and this can vary from one woman to the next. Do be sure of why you want to change your contraceptive, so that there is as little upset as possible, and that it is really necessary for you to change.

Yes, you might well have a period when changing over, due to the different formulations of Nur-Isterate and Depo Provera ( the generic alternative is Petogen), but this should only be temporary.

If you were on Nur-Isterate for longer than one year, you will have a measure of this contraception in your systems, so a pregnancy is less likely. However, I always recommend the use of an affective barrier method like condoms for up to six weeks from the time of change over. You should have enough contraceptive in your systems to protect you from pregnancy after two weeks of the new contraceptive, but it is better to avoid an unplanned pregnancy where possible.

Do take care now, and all the best of luck!

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear M

Many thanks for your question, and no your question is definitely not dumb, as each woman is unique and different, and not all women respond to a contraceptive the same way. Treating and counselling from a website is very different to seeing a client in person, so the detail you have given is much appreciated.

You are well tuned into your body, and your sense of awareness is correct. The 21 yellow pills in Nordette are the active pills. The 7 red pills are the inactive pills in the pack. From your clinical profile your hormonal cycle is well regulated and suitable for using Nordette. The fact that your menses commences on the third red (inactive) pill means that your required response for hormonal regulation is good.

Ovulation calenders can be a little confusing - count the first day of your menstruation as day 1. Your particular hormonal cycle is a 28 day cycle. So day 14 would be your ovulation date, or day of ovulation. This is your most riskiest day for intercourse. However, should you be very concerned about having an unplanned pregnancy before you are ready to start your family, take extra precautionary measures for 3 days before your ovulation date and for 3 days after the day of ovulation. As you have been on Nordette for 8 years you will however be protected.

I hope my reply has helped to answer your question.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question. I fully understand your concern.

As you were only on Nur-Isterate for ten months, and the last injection was given in September 2010, your body has had enough time now to detoxify from this particular contraceptive.

Of course, you do need to eat correctly, drink sufficient water, have sufficient exercise and destress effectively for a pregnancy to occur. You sound as if you are a healthy individual, and with your age bracket I see no reason for you not falling pregnant.

However, as I have not seen you in person, it would be a good idea if you could book an appointment with me to do our Wellness Assessment. This is a non-invasive medical checkup to evaluate your blood pressure, weight, height, girth measurement, body mass index, haemogobin (to check for anaemia), and glucose and total cholesterol screenings.

You can contact me on telephone number 021-4875435, between the hours of 09h00 - 16h00, Monday to Friday at the Kloof Clinic in Cape Town.

Good luck with your forthcoming nuptials and have a wonderful wedding day in December!

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear L

Many thanks for your question, and I am just in time to answer your query!

You have worked all your dates out correctly, so the 27th May 2011 is correct.

Always think in terms of 'weeks', rather than 'months', as months vary from month to month.

Petogen can cause you to not have your period for longer than a few days, or not at all. Your abdominal/period pains are how you as an individual are when reacting to your hormonal cycle. The pains are normal, although not pleasant. You can overcome this by taking EVENING PRIMROSE OIL by Vital, as x1 capsule every evening about one hour or more after supper. This will help to aleviate the unpleasant side effects of menstruation, assist you in feeling more on an even keel, and will help you to pleasantly experience your menstrual cycle. You do need to take this product for at least a month before you experience the full benefit of it. Just continue with it, as it is completely safe, non-addictive and fully beneficial for this purpose.

With warmes regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question. I fully understand your concern, and thank you for the little detail given.

The pattern that has occurred with you thus far is normal. Should you have undue pain, excessive bleeding, mood swings - to name a few side effects, then my answer would be different.

You may or may not have your next period in June - there are other factors which can also decide this, like your general health and well being, nutritional status and stress levels.

I suggest that you give yourself until your next Petogen injection in June, and then reassess the situation once again. In all probability, your hormonal system should have settled down by then.

You are welcome to contact me again, should you still have a problem.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear L

Many thanks for your question.

Should you be healthy overall, the best approach would be for you to let your body adjust of its own accord. This would mean detoxifying for a minimum of six months by just coming off Nur-Isterate. It is preferable to treat yourself naturally with a supplement like CHASTEBERRY by Metagenics, as x1 capsule, twice a day after food, should you wish to trigger your menstrual cycle back to regularity. Taking a quality effective multivitamin is essential as well, like VITA LIFE by Amipro, as x2 capsules, 2 - 3 times a day after food, as this product will assist in restoring the depletion of mineral salts and nutrients, caused by using Nur-Isterate as a pharmaceutical contraceptive, which is 100% synthetic.

The Nur-Isterate contraceptive injection is formulated not to be used for longer than two years at a time. After two years, the chemical components settle into the membrane linings of the soft organs of the body, and depending on an individual, this is what can can prolong detoxification. Three years is not too drastic, and I suggest that you take the above approach first. I have to say that patience is a necessary quality, when planning to have a baby. Chasteberry may work within a month, or a little longer, as Nur-Isterate does cause the menstrual cycle not to release an ovum and therefore there is no period.

Once your menstrual cycle has returned, please e-mail me again and then we can look at recommendations for supplements for you in preparation for pregnancy etc. Please refer back to this original e-mail at the time.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question.

There is always a possibility of having an unplanned pregnancy when not taking a contraceptive. It is essential to use a good effective barrier method like condoms when stopping a contraceptive, or changing over to a different contraceptive.

As you have been off Petogen for eight months now, the possibility is there for an unplanned pregnancy happening if you do not take precautionary measures.

Please take care and look after yourself.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear A

Many thanks for your question.

Unfortunately you have not said which contraceptive pill you are using - this is really important in order for me to give you a correct answer. However, you have approached your problem well by doing what you have done. From hereon, continue with your pack and please do not forget to take your pill, in the applicable section, and follow your pack through to the end.

Should you still be concerned about the possibility of an unplanned pregnancy, then I do suggest that for peace of mind, you do a pregnancy test.

Many thanks once again for your question.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear K

Thank you for your questions.

It is crucial to commence with Triphasil on the FIRST DAY of your menstrual bleed, and then this is counted as day one of your menstrual cycle. Should you have a 28 day cycle, then day 14 would be your day of ovulation - this all happens when you are healthy and well and your body is in balance. Some women do have a 30 or 31 day cycle, and this is again an indication of how each woman is unique within herself.

Please don't get yourself tied up in knots! It is a lot simpler than it seems, and you will become accustomed to working out your cycle. I do however suggest that you keep a daily diary of your menstrual cycle.

Should you wish to AVOID your ovulation date when considering intercourse, then day 14, as explained above is the day to do this. However, the first 3 days before day 14, and the 3 days after day 14, also have a measure of risk, but not as much as day 14, when considering a 28 day cycle. Day 14 is noted due to it being a crucial day for ovulation. The next day after day 14, is referred to as day 15 and so on. Does this answer your question? It is not referred to as 14 days, and then another 14 days - it is a 28 day cycle for most healthy women.

You are welcome to 'phone me (have your diary handy) and I will 'talk' you through your daily cycle. I wish you all the best.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear M

Many thanks for your questions, and for giving the detail you have.

You switched over from Yasmin to Nordette correctly, according to which pills to take. However, it is strongly recommeded that you are always to commence Nordette (just like Jasmine!) on the FIRST DAY of your menstrual bleed. Should you have done this, then you did change over correctly. Your clinic sister should also have advised you to use condoms for at least 2 - 3 weeks when changing your contraceptive pill, so as to avoid an unplanned pregnancy.

It is really important that you fully understand how to take, and or to change over to your new contraceptive pill, before you leave the clinic. It is the family planning sister's responsibility to explain how to do this and to ensure that you do understand, as this can save you unnecessary hearache and frustration.

For peace of mind, it may help you to consider having a pregnancy test done. Depending on your ovulation date; the length of your hormonal cycle; and changing over to a new contraceptive pill - my answer is yes, there could be a chance for a pregnancy.

Your approach to continue taking Nordette from hereon is correct. You seem to have read your packet inserts correctly for Yasmine and Nordette - I am impressed,as not everyone does!

Should you still be uncertain, you are more than welcome to give me a ring on 021-4875435, between the hours of 09h00 - 16h00, Monday to Friday (excluding public holidays). My goal for you is that your problem be resolved, and that you will feel confident to cope with taking Nordette correctly.

Many thanks again for your queries.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear K

Many thanks for your question. Please can you indicate which contraceptive pill you are referring to. I suspect that you are referring to the Triphasil contraceptive pill, but request that you confirm this please as there are other types of pills that also have red pills in their packs.

Many thanks again for your question. I hope to hear from you soon, and please copy this original query with your reply.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear A

The correct approach to commencing a contraceptive pill is to start on the FIRST DAY of your menstrual bleed. You must start with the correct pill for the relevant day. Should you not have done this, then you need to recommence taking the pill correctly, applying the above approach. Starting the first pill on the first day of your menstrual bleed will assist in regulating your hormonal cycle, and from thereon a regular menstrual cycle should occur.

There are other factors which could contribute to you not having menstruated already, should you have commenced taking your pill correctly. For example, iron deficiency anaemia, being overly stressed, incorrect eating habits, and certain medical conditions like recovering from a bad dose of influenza - to name a few examples.

I suggest that you make an appointment to see the nursing sister who dispensed the Triphasil pack to you, and ask her to explain it to you again, so that this can assist you in eliminating any doubt as to how to take your pill correctly. She is there to help you, and will be aware that you are adjusting to taking the Trigestrel pill.

I hope that my reply assists you. Alternatively, you are welcome to make an appointment to see me, and then bring your Trigestrel pack with you.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear A

Thank you for your question. I apologise for the delay due to illness.

Primolut N is a schedule 4 pharmaceutical drug and has to be prescribed by a medical doctor. It is prescribed for certain specific medical conditions like endometriosis and dysfunctional uterine bleeding. To take medication like this, you should have consulted your doctor please, as I have no record of your previous history. It is not what I would have recommended for you, due to the possible side effects, and also a complete medical history should be taken and a physical and gynaecological examination should be performed prior to the initiation or reinstitution of the use of Primolut N. Apart from me not recommending it, and you fly tomorrow, it would be too late for you to commence medication like this now. I suggest that you speak to your doctor directly about Primolut N, should you still wish to use it.

You have not mentioned if you are not definitely on a contraceptive pill already. However, the usual and best approach would be to avoid taking the placebo pills in a contraceptive pack, so as not to have a period. Any contraceptive pill should be commenced on the first day of bleeding of menses, in order for the hormonal cycle to be regulated from the beginning.

Please liase directly with your medical doctor about your situation as it is now. As the situation currently stands, you might still have a period for April, and then avoid it for May, all depending on when your last period was.

Thank you once again for your question.

Kind regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear R



Thank you for your question. All forms of oral contraception carry a failure rate of around 8%. SO there is always an 8% chance that you will fall pregnant even when you use it perfectly, at the same time every day.



If you want to reduce your risk of falling pregnant I would recommend always using a barrier method (condoms, diaphragm) in conjunction with the pill.



Many thanks and warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear C

Many thanks for your question.

It is vital that the packet insert for the relevant contraceptive pill is read carefully before commencing the contraceptive. You should have started in the red section with the relevant pill labelled 'Monday'.

What you should do now, is to wait until the following menstrual cycle, and recommence taking the relevant pill in the RED section for the correct day as of the FIRST day of bleeding of your menstrual cycle. In the interim, it is vital that you make use of condoms as an affective barrier method so as to avoid an unplanned pregnancy.

Starting your contraceptive pill correctly will assist you greatly in regulating your hormonal cycle. Restarting etc. can be very frustrating and annoying, however this is the correct approach for your hormonal health.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear T

Many thanks for your question. I apologise for the delay, as I have not been available due to illness.

I would say that you are adjusting hormonally to the Trigestrel contraceptive. Should you not be experiencing unpleasant side effects from Trigestrel, and feel fine apart from not starting your menstruation yet, I then suggest that you carry on with Trigestrel for a while longer, as in a month, so as to allow your body to adapt further. Unless you were iron deficient or overly stressed, then yes this could also delay menstruation.

Otherwise you are welcome to make an appointment to see me for a one on one consultation so that I can fully assess you further.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear S

Many thanks for your queries. I fully understand your predicament.

To be honest with you, it would be best for you to make an appointment with me so that I can fully assess you as to which oral contraceptive would suit your physiological profile.

Oralcon is a cheaper generic sourced from Malaysia and Hong Kong and has a number of potential side effects - our Well Clinic service does not stock this contraceptive.

Sometimes it is necessary to try a couple of contraceptives in order to find out which one suits you best. You could commence Oralcon and take it for a month, and see how you go.

Please try and see me if you can, otherwise you are welcome to e-mail me again, or telephone me on 021-4875435, Monday to Friday between 09h00 - 16h00.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Vanessa

Many thanks for your e-mail. Unfortunately your e-mail must have been missed when I was ill earlier in the year. I do sincerely apologise for the inconvenience.

At the time I would have suggested that you not alter the pill dosage for the different days, and to menstruate normally, as my primary concern would have been to avoid potential blood clots from forming, which could have happened with altering the days and your pattern for taking the pill. Hopefully you were fine and your surgery went well.

Once again, I apologise for the delay.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear J

Many thanks for your query. Triphasil obviously suited you well. Trigestrel is the generic alternative to Triphasil as provided currently by the government and municipal clinics. Trigestrel has been sourced as a cheaper alternative from Malaysia and Hong Kong, by our government for the government and municipal clinics.

I suggest that you return to the family planning sister and explain to her how you feel, and ask for an alternative form of contraception.

You are welcome to contact me for an appointment, and then I can advise you further once I have done a physiological assessment to see what other contraceptives would suit you.

Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear I

Thank you for your question. Unfortunately there are no definite answers when it comes to the game of contraception. Even if you had followed the instructions to the T you still have a risk of falling pregnant.

My advice would be to use condoms until the onset of your next period and if necessary have a pregnancy test done two to three weeks after the unprotected intercourse occurred,

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear J

Thank you for your question. Ideally the dentist should have advised your girlfriend to continue with the condoms until the onset of her next period. But in my experience the chances of falling pregnant during this period is quite slim.

To be safe I would recommend continuing with the condoms and waiting for her next period to pass before considering alternative forms of birth control.

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear B

Thank you for your question. I understand your concern. It can be quite disconcerting when you do not understand what is going on with your body. All I can add is that if you understand how synthetic hormones affect your body you will see it is not unusual for you to experience the symptoms you currently are. Synthetic hormones attempt to overwhelm your natural cycle, dictating when and how long your menstruation should be. This is achieved by giving you enough synthetic hormones to silence the effect of your own hormonal cycle and the body starts listening to the synthetic hormones instead. But your body also needs the monthly menstruation as a tool to release, cleanse and ovulate. When you attempted to skip your period you confused you body and it probably began to change the amount of natural hormones it produced itself in an attempt to "fix" the situation and so you have an increase in the production of natural hormones in the middle of your cycle which gives you the spotting you experience.

Your gynae is trying an alternate form of contraceptive in the hope that your body will once again be tricked into believing that the synthetic is what it should listen to and not the natural. Sometimes this works. Often not. I would recommend completing the trial seeing as you've already started. If it does not work after three months then I would recommend stopping the contraception entirely for at least 3-6 months, allowing your body an opportunity to reboot. thereafter if you decide to go back onto the pill you can.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear Z

Thank you for your question.

Due to your approach of using the Yaz contraceptive pill your hormonal cycle will most definitely be upset. It is a requirement of the pill that it be taken every day at the same time. Yaz also has to be commenced on the FIRST DAY of a menstrual cycle. It is alright to miss the placebo pills in the pack as a once off situation, due to for example, a camping holiday, a honeymoon, or sometimes for very long plane flights - but preferably not to be done on a regular basis.

I recommend that you have a pregnancy test done, even if just for peace of mind.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear S

Thank you for your question.

It is very important that you keep the fertility clinic informed of your progress. Please always liase with your medical specialist and the nursing sister at the fertility clinic, as each doctor has his or her approach to fertility and the problems posed.

Always follow the instructions given carefully. Should you take Clomid differently to the instructions given by your doctor, you will be counter productive to assisting yourself to becoming fertile. As this process is expensive, you would also be wasting your money if you take your Clomid tablets against guidelines given.

I wish you well with your baby plans!

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Isabel

Many thanks for your question. Yes indeed, it is very important that you start your new contraceptive on the FIRST DAY of bleeding of your menstrual cycle. It is unfortunate that you did not read your packet leaflet carefully before commencing your new contraceptive.

The ideal situation now would be for you to wait until the first day of your next period and restart again, otherwise your hormonal cycle will be thrown into flux, and could become really topsy-turvy - and then this can cause a host of problems you really won't want e.g. like mood changes as in being weepy, depressed, irritable etc. A fluid imbalance would also be created if you don't recommence your pill correctly.

I suggest that you use a good barrier method like condoms in the interim, and for at least 4 weeks with your change to Oralcon from Triphasil, so as to avoid an unplanned pregnancy.

I wish you luck and good health. Please do as I suggest, and you should be fine.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear KK

Many thanks for your question. You commenced taking Femodene correctly. Having missed one of your pills around your ovulation time could most certainly have caused you to fall pregnant. Femodene is a low dosage progesterone based contraceptive pill and it is absolutely vital that it is taken every single day, at the same time. With you being 15 days late, I suggest that you have a pregnancy test done. If you had been 1 - 2 hours maximum late in taking your pill, then this would not have made much difference, as a once off situation.

Should you decide to use a home pregnancy test kit, then this must only be done in the morning, and preferably before 10 a.m., as the HCG hormone is only raised in the morning, and this is the hormone that is tested for a pregnancy. A blood test for pregnancy can be done at any time of the day, and then would be sent off to a laboratory for analysis.

You are welcome to book an appointment with me should you be apprehensive about doing the test. Or when you can, I would like to know how you are, and how your result went.

Take care now, and thanks once again for your question.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear B

Many thanks for your question.

Unfortunately, you have given me no personal medical history, hence my answer as follows. The efficasy of Nur-Isterate will not be affected with you bleeding, however you should not be bleeding all the time. The two most likely reasons for you bleeding could be either that you have been on Nur-Isterate for two years or longer, or it may be that it just does not suit you as an individual.

I suggest that you visit your family planning clinic and explain the situation to the family planning sister who sees you. Alternatively, you can make an appointment to see me, and we will both look at things in detail for you, as your bleeding does need to be resolved. The other solution is to see your gynaecologist.

I do hope that your problem is resolved soon and that you will feel better shortly.

Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear S

Thank you for your question. You are correct in your assumption that your mood swings are due to the change in oral contraception. Although they all contain synthetic oestrogens and progesterones the quantities and ratios of each differ between products, and if your body is sensitive enough you will have a reaction to the change. The good news is that in most cases the body learns to adapt after a couple of months to the new drug and you return once again to some form of equilibrium. There are cases of women not adjusting and those are the cases where an alternate will need to be sought.

I think an important question to ask is why are you on the oral contraceptive pill? The reason being the high side effect profile of long-term use of synthetic hormones n the human body. Search for oral contraceptive on Wikipedia.com and read through the long list of conditions associated with the pill, which include both mood swings and decreased libido/sex drive.

If your use of oral contraception is to prevent pregnancy I would recommend investigating an alternative such as a cervical cap, temperature monitoring or a diaphragm as less harmful options.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear L

Thank you for your interest and questions. I believe in starting off with keeping things simple, and then with time broadening out to being more detailed where necessary.

I suggest that you keep a diary of your daily menstrual cycle.

Most women have either a 28 day cycle, or a 30 day cycle, and then some have a 31 day cycle. Then there are also women who only have one menstrual cycle every 3 months, or once every 6 months.

Start counting your cycle on the FIRST day of bleeding of your menstrual cycle. Should you have a 28 day cycle, then day 28 would be the first day again of your next menstrual bleed - don't become confused now! With a 28 day cycle, day 14 would be your most high risk day for ovulating. However, I always say the 3 days before ovulation, and then the 3 days after your day 14 are also high risk days. Just remember, that every woman is unique and different, and no-one knows you better than yourself. You need to understand your own body and the responses you have to what is happening in your life. For example, if you have a major upset, or are writing exams - you could trigger off an extra period in the space of a month. Should you not be eating correctly for example, with enough iron rich foods, you could either delay a period or even miss a period.

Having been on the pill for 2 months will give you sufficient contraceptive coverage. The pill (although you haven't indicated which one it is) should take about 4 weeks to settle into the systems of the body in order to prevent conception. It is absolutely crucial that you are 100% compliant in taking your pill at the same time every single day. Most contraceptive pills are listed to preferably be taken in the evening - should this not suite you, then you must stay with the same time every day. Certain medications like allopathic/pharmaceutical antibiotics and cough mixtures can cause the contraceptive pill to lose its efficasy, i.e. effectiveness. It is always advisable to commence taking the pill on the first day of your menstrual bleed - this will assist your menstrual cycle in being regulated correctly from the beginning. There would definitely have been a reason, once looked at closely, as to why your respective friends fell pregnant.

Having said all of the above, I always find it safest to advise and councel women commencing the pill, to give the pill 6 weeks to be fully effective, and at the same time to make use of a good barrier method like condoms, during this 6 week time span.

Should you be unsure, you are most welcome to telephone me, and I will talk you through any further queries. My direct clinic line is 021-4875435, between the hours of 09h00 - 16h00, Monday to Friday. Or alternatively, you can e-mail me again, always referring back to your original question, please.

All the best of luck, and enjoy your two week break!

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear K

Thank you for your question, and I apologise for the unfortunate delay.

To put it simply, all you need to have done was to to avoid the inactive or placebo pills in your contraceptive pack. For Yaz this would mean the 4 white pills.

So in future, avoid the four white pills all together and just carry on with the next day's pill after the fourth placebo pill. Should you have done as you have suggested from thereon, your approach would have been correct for your purpose at the time.

I do hope that you were able to come right before your holiday.

Kind regards

Angela


Yesheen (dr.) Singh Medical Doctor View profile

Dear B

Thank you for your question. I would recommend stopping oral contraceptives altogether for two to three months and seeing whether the leaking around the time of your menstruation stops as well. If it does stop then you can consider restarting on a different one from Femodene. If it does not stop I would consider visiting your gynaecologist for a couple of hormonal tests.

Usually this type of symptom is related to an imbalance in the hormone pathway that leads up to the release of oestrogen and progesterone from your ovaries, and another hormone called prolactin that is related to the production of breast milk. In you case from the history you provide I would suspect that imbalance is caused by the pill. But there are other causes of an imbalance and these need to be investigated if the symptom does not stop when the contraceptives are removed.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question. I apologise for the delay as we have had on-going problems with our systems and internet access.

The Nur-Isterate contraceptive injection is indeed the problem causing your signs and symptoms of "extreme sweats, and becoming hot at regular intervals throughout the day and night". Your symptoms are similar to that of menopause, but don't worry, you will not be in the phase of menopause yet! Your age of 25 years is way too young for this phase. The youngest age I have treated for menopause was 34 years of age.

I suggest that you consider giving your body a rest or break from Nur-Isterate. This should be done every 2 years anyway, otherwise the symptoms you have described will occur. With you having been on Nur-Isterate for 5 years, you will take at least 3 to 6 months to detoxify your body from the chemical components of this contraceptive, which will have accumulated in the different organs of the body. After 2 years of usage, it can take this length of time, and for some women, a little longer to detoxify. It is vitally important that you make use of a good barrier method like condoms in the interim, so as to avoid an unplanned pregnancy.

You should find that once your hormonal cycle has settled, your signs and symptoms will have abated. Once you have detoxified sufficiently from Nur-Isterate, then you could consider taking the Ovral pill as your doctor has suggested.

You are welcome to make an appointment to see me, so that I can assess you carefully, as to what other contraceptives would suit your physiological profile, other than Ovral.

My direct clinic land line is 021-4875435, between the hours of 09h00 - 16h00, Monday to Friday. Should I not be able to speak to you at the time, please leave your name and contact telephone number so that I can return your call.

Your problem can be resolved - it just needs time and patience! And thank you once again for your query.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear C

Many thanks for your query. I apologise for the unfortunate delay.

In all honesty, these symptoms are not good and healthy for you, and I suggest that you discontinue Trigestrel. Having "headaches and bad pains" are a definite indication that Trigestrel is not for you.

It would be better for you to contact me directly for an appointment please, so that I can physiologically assess you for an alternative form of contraception. My direct clinic landline is 021 - 4875435, between the hours of 09h00 - 16h00, Monday to Friday.

I do hope that you are able to schedule an appointment to see me.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear T

Thank you for your question again. Have just answered a previous question posed by yourself.

Please make an appointment to see me should your problem not have been resolved. Hopefully you have visited the family planning sister at your clinic in the interim. The clinic sister must reassess you and determine if your contraceptive is not suitable for you, especially with your given signs and symptoms of breast tenderness and headaches.

You are also welcome to contact me directly on telephone number 021-4875435, between the hours of 09h00 - 16h00, Monday to Friday.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear T

Thank you for your question and I apologise for the delay.

I suggest that you visit your family planning clinic and request that the nursing sister on duty check your bloodpressure. Alternatively you are welcome to make an appointment to see me.

A headache can be due to a number of reasons, and as you have not given any other signs and symptoms, the first approach would be to go back to your family planning clinic for a reassessment and blood pressure check.

To avoid headaches do steer clear of foods like chocolate, coffee, cheese, citrus, and alcohol, either singly or in combination, as they can trigger headaches. Ask the sister to assess you for anaemia, as this condition can also cause headaches. Drink at least 2 - 3 litres of water daily and manage stress affectively for yourself as an individual.

Kind regards

Angela

D

Angela Lombard Nursing Practitioner View profile

Dear G

Thank you for your question. I understand your dilemma and confusion.

To be frank with you, I have not seen an Oralcon pack or Trigestrel contraceptive pack. Oralcon and Trigestrel are generic contraceptives sourced by the government from Malaysia, Hong Kong and other countries in the East. These contraceptives are only supplied by government family planning clinics.

I have to say that these questions should have been covered by the family planning sister who dispensed the Trigestrel to you, when you changed over from Oralcon. Not having seen these packs visually, I do not want to advise you incorrectly, so I suggest that you return to the family planning sister and put these questions to her.

I really would like to help you as much as possible - otherwise 'phone me on my direct clinic line of 021-4875435 and ask to speak to me directly, and do make sure that you have your Trigestrel pack in front of you. Also be aware of the first day of your last menstrual bleed. Please understand that there are clinic bookings right throughout the day, so I will speak to you when I can. Try getting hold of your family planning sister first at the clinic which dispensed your new contraceptive. I wish you much luck!

Kind regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear L

Any use of synthetic hormones or oral contraceptives will disrupt your normal menstrual cycle. This can result in either longer heavier periods, shorter lighter periods, more frequent or less frequent periods. There is no real predictive formula that will accurately determine how you will react because every woman's physiology is unique. As such I cannot say whether it is healthy or unhealthy until we see if this pattern stays around for a while, and compare it to how you have or have not been using the pill.

All I can say is be observant, do not stop-and-start your pill too many times as this confuses the body, and determine why it is that you are using the pill and whether there are any alternates available that will accomplish the same outcome but without the side-effect profile of oral contraception.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear A

Many thanks for your questions.

No, Escapelle should not adversely affect your condition of hypothyroidism at all. I have double checked this with out senior pharmacist on duty.

There will always be a bit of a hormonal flux when taking emergency contraception, so yes, your menstruation may be upset with an eratic pattern initially, but will settle down.

It is advisable not to take an emergency contraceptive pill unless it is absolutely necessary. Should it be taken too often and with prolonged usage of routine contraception, then there is the possibility of infertility setting in.

I hope this answers your questions.

Warmest regards

Angela


Yesheen (dr.) Singh Medical Doctor View profile

Dear M

Thank you for your question. What is your primary intention behind the use of the pill? To control your acne or to prevent pregnancy? If it is the acne you are most concerned about I would recommend stopping the pill because it has such a wide variety of side effects and beginning something like Saw Palmetto to help balance out the ratio between oestrogen and testosterone in your body which underlies the development of acne in most females.

If your primary intention is to prevent pregnancy I would recommend researching alternate methods such as condoms, diaphragms and femidoms, which as almost as effective but without the side effects. As to how effective oral contraceptives are in preventing pregnancy? Nothing besides abstinence is 100% pregnancy proof. Oral contraceptives about an 8% failure rate with typical use, the cervical cap 7.6% and fertility monitoring with a thermometer 0.7%.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear M

Many thanks for your query.

The red and inert tablets are simply your placebo tablets in the Trigestrel contraceptive pack. So long as you do not forget to take your pill every day at the same time, you will not fall pregnant. The placebo tablets are in every contraceptive pack, regardless of the type of contraceptive pill. A placebo means a non hormonal based pill. You will not fall pregnant while taking a placebo tablet, unless for example you were also taking an allopathic/pharmaceutical antibiotic, as this can cause a contraceptive not to be fully effective at the time of taking medication.

So don't worry, you should be completely fine. On commencing a new contraceptive pill, I always recommend that a woman uses condoms for the first 6 weeks, although it is listed that after the first 4 weeks she would have enough contraceptive in her body not to fall pregnant.

I hope this helps to reassure you.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear J

Thank you for your question. I apologise for the delay due to illness.

I fully comprehend your problem. As there is a fluid imbalance with your periods being so erratic, I suggest that you take the following :

NAT MUR TISSUE SALT NO. 9, as x1 celloid, 4 times a day, under the tongue 10 - 15 minutes before meals. Do this for 3 days. Then reduce the dose to 3 times a day. Nat Mur is a fluid regulator, and will assist in regulating your menstrual cycle.

EVENING PRIMROSE OIL CAPSULES by Vital, to be taken as x1 capsule daily after food. This needs to be done for a month before you experience the full benefit of the product. Continue even when your periods are more regulated.

It is better not to interfere with your cycle, if possible. If you were on a contraceptive pill, then you would avoid taking the placebo or inert tablets in the contraceptive pack and then just carry on with the other pills in the pack.

I hope your anniversary went alright.

Kind regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear S

All oral contraceptives have the side effect of unhealthy unwanted weight gain. Simply switching oral contraceptives will not prevent this from occurring. Why did you begin the contraceptive in the first place? If it was to prevent pregnancy there are alternative available that do so without the side effects. If it was for other reasons speak to your practitioner about healthier alternatives.

With regards to the weight gain, fat tissue, once present, almost takes on a life of its own, changing your metabolism around so that it can grow bigger, even without the presence of a stimulant such as an oral contraceptive. Once your body is in a cycle of fat storage you have to use the tools of healthy caloric restriction and increased activity to try and switch your metabolism from fat storage to fat burning. One of the way to begin is to have a high protein breakfast such as a rice protein smoothie, within 30 minutes of waking in the morning.

Please stay away from metabolism enhancers and other fad diets because none of them have ever shown sustainable healthy results. For a more tailored plan please feel free to contact us at 076-229-4662.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question. I apologise for the unfortunate delay, due to illness.

You will most certainly detoxify when stopping the Petogen contraceptive injection. There is also no harm in having a pregnancy test done, even just for peace of mind. It can take a minimum of 3 - 6 months for the body to release the chemical components from the different systems of the body. With you having been on Petogen for 4 years, you may well find that it will take a little longer for your body to detoxify. All your signs and symptoms are an indication of detoxification taking place.

I do hope that your problem has been resolved, but if not you are welcome to e-mail me again.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear m

Many thanks for your query. I do apologise for the delay due to illness.

Your body would have undergone some adjustment hormonally while changing over from Triphasil to Trigestrel.

The brown discharge you experienced along with pain, should be assessed by having a Pap smear (cervical smear) done so as to rule out the possibility of a vaginal infection. A possible examination may also need to be done by your medical doctor, should your signs and symptoms not have been resolved. Should your pain persist, and all other causes are looked at, it might be that your new contraceptive does not agree with you.

I do hope that you are feeling better already at the time of this being sent to you.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your return e-mail, and I apologise for the delay due to illness. You may have seen your doctor by the time you read this. Do try and relax, and ask all relevant questions of him, which concern you - doctors are there to provide a service which include answering queries.

You have achieved such a lot by having had three children - I only have the one daughter, and although I have encouraged her to be confident, I feel as if I have ten!!

When you can, please let me know how your appointment went, as I am interested.

Warm regards

Angela

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question, and for giving me the detail of your contraceptive profile.

Well, once Premarin has regulated your menstrual cycle and on condition that there is no underlying medical condition, I see no reason for you not falling pregnant! You could fall pregnant at any time.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear T

Many thanks for your question, and I do apologise for the unfortunate delay due to illness. You may have had this problem resolved in the interim.

Tri-gestril is the cheaper generic alternative to Triphasil, as sourced at government clinics. All the signs and symptoms mentioned are an indication of a possible pregnancy, except for the dark urine. Her dark urine is an indication of a possible kidney infection. Should you not have taken her to a general practitioner already, and the dark urine and back pain is still present, then I suggest that you do so please.

The antibiotics your daughter had prescribed for her, can cause the efficasy of her contraceptive to be disrupted, so it was correct for her to have a pregnancy test done. All pregnancy tests are now designed to check for the presence of pregnancy from ten days post conception. All pregnancy urine tests should be done before 10 a.m. in the morning, and a blood test for pregnancy can be taken at any time.

I do hope that your daughter's problem has been resolved, and once again I apologise for the unfortunate delay.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear M

Thank you for your questions, and I apologise for the unfortunate and unavoidable delay. Oralcon is a generic alternative, and is not the same as Nordette. Yes, from your signs and symptoms Oralcon is very likely to be the cause of your weight gain and mood swings. Nordette is not available in all the government family planning clinics. We do source and stock it at Wellness Warehouse, and then I currently do the private scripts for Nordette at the moment while we can get it.

I have never heard of Altvera, or Levora, or Portia - but would say that they are also sourced as generic alternatives, like Oralcon, from Malaysia, Hong Kong and other Eastern countries.

I recommend that you try and make an appointment to see me so that I can physiologically assess you as to what would be suitable for you as an individual, with the available contraceptives currently on the market.

Many thanks once again for your questions.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Thank you for your questions. Yes indeed, being on the Nur-Isterate contraceptive injection and then the Triphasil contraceptive pill thereafter (and my understanding is that this was done without giving your body a break or rest from these contraceptives during this time span) will cause your body to take longer to detoxify from these contraceptives.

Nur-Isterate is a slow release hormonal contraceptive and should not be taken for longer than 2 years at a time. A minimum period of 6 months rest away from this contraceptive is then required so as to allow the body to release the chemical components from all the systems of the body.

On average the pill takes 1 - 2 months to detoxify from. Another factor to consider is your metabolic rate. If you have a slow metabolic rate you would be looking at, at least 9 months or a little longer for a proper hormonal cycle to return as a slow metabolic rate can slow the process of detoxification down.

Your own nutritional state, stress levels, and leading a healthy lifestyle can all influence conception - so do look after yourself properly.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Ms. T

Many thanks for your question. My heart goes out to you, as I fully comprehend your dilemma.

I can definitely help you, but the best thing is for you to make a family planning appointment to see me please. I can then fully assess you physiologically as to whether Trigestrel or any other contraceptive would suit you. It is unfortunate that you cannot continue with Yasmin, as it is always best to stay with the contraceptive that suits you personally. Each woman is unique and different to the next, and this is so important to bear in mind when treating a client.

All the pharmaceutical contraceptives are 100% synthetic/artificial. Every single one of these contraceptives has a list of side effects! Not knowing you or having seen you yet, it would be wrong of me to say if Trigestrel would suit you or not - it would be great if you could see me first, prior to commencing Trigestrel or any other contraceptive. I will tell you that there have been a number of concerning side effects reported to our Well Clinic by patients who have started taking Trigestrel. Trigestrel is the generic for Triphasil, and is what is dispensed predominantly by the municipal clinics. I do not dispense Trigestrel, out of choice, due to these reports.

I wish you well with your decision, and hope to see you soon. Should you be out of the Cape Town area, you are welcome to contact me telephonically on 021-4875435 or 4875420 between 09H00 - 16H00, Monday to Friday.

Warmest regards, and thank you once again for your question.

Angela


Please Note:

The Wellness Q & A is for informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your health, you should always consult directly with your healthcare professional. Wellness Warehouse will not be liable for any errors in the Wellness Q & A, or for any actions taken in reliance thereon. The advice on the Wellness Q & A is not comprehensive and does not replace the assessment and advice of your own healthcare professional. Consultation with your healthcare professional is extremely important if you are experiencing persistent or severe symptoms.

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Consult your doctor, healthcare professional, and/or pharmacist before using any supplements or before making any changes in prescribed medications. If you have a chronic illness or routinely take prescribed or over-the-counter (OTC) medication, or you are pregnant or breastfeeding, it is extremely important to consult your doctor, healthcare professional, and/or pharmacist before taking any new medication. Do not stop taking any prescription medication without consultation and guidance from your doctor.

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