⚡ KICK-START 2019 WITH OUR JANUARY DEALS! SHOP NOW

100% SECURE

Online Shopping

FREE DELIVERY

orders over R1000*

Q&A Topics

Menstruation Problems


Yesheen (dr.) Singh Medical Doctor View profile

Dear V



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



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



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear M



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



Many thanks and warm regards

Yesheen Singh


Angela Lombard Nursing Practitioner View profile

Dear L



Many thanks for your query.



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



Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear P



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



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



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



Many thanks and warm regards

Yesheen Singh

HealthNation

Angela Lombard Nursing Practitioner View profile

Dear Rosebud



Many thanks for your question.



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



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



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



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



Warm regards

Angela











Yesheen (dr.) Singh Medical Doctor View profile

Dear T



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

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



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



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



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear R



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



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



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear A



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



Many thanks and warm regards

Yesheen Singh

HealthNation

Angela Lombard Nursing Practitioner View profile

Dear S

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

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear R

Many thanks for entrusting me once again with another query.

What is happening here, is that your hormonal system is out of sync. This is not unusual, but you do need to have your contraceptive injection regularly so as to avoid these little upheavals.

I recommend the following, so as to regulate your menstrual cycle and to assist with the emotional side of the hormonal imbalance :

CHASTEBERRY PLUS by Metagenics, as x1 capsule, 3 times a day, after food. Complete the course. This particular product is amazing and I have had great success with clients who experience your signs and symptoms.

Always eat correctly, get enough sleep, drink sufficient water, etc., etc. and you should be fine.

I wish you well. Please let me know how you do.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Nicks

Many thanks for your question.

It is really important that a home pregnancy kit is used in the morning only, and preferably before 10 a.m.

The reason for this is that the HCG (human chorionic gonadotrophin) hormone is only raised in the morning, and this is what is checked for when doing a pregnancy test. As the day wears on, these levels drop, so a false reading may be indicated. All pregnancy tests are sensitive enough to determine a pregnancy from ten days onwards, although as a practitioner I have often diagnosed a pregnancy from seven days onwards.

I suggest that you have another pregnancy test done, so as to make sure. At the same time ask the nursing sister at your local clinic to do a haemoglobin finger prick test so as to determine if you are iron deficient. As an adult woman, a normal haemoglobin should be between 12 - 14 grammes per cent.

You are welcome to book an appointment to see me for all of this at our Kloof Well Clinic in Cape Town.

Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear N

Thank you for your question. There are many reasons why you have noticed a change in your menstrual cycle. My first bet would be pregnancy, and I would recommend having a blood pregnancy test if your period has not occurred by now to definitively exclude this possibility.

Other possibilities depend on whether you are using any form of contraceptive, whether you are on any medications or supplements, where you mood and stress levels have been over the past 4 weeks, your diet and activity levels and how they influence your body mass index… the list is almost endless. If your period does not return during the upcoming cycle I would recommend making an appointment wit us or your local doctor to find out why.

Warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear Bee

Many thanks for your question.

Nur-Isterate and Petogen contraceptive injections are different in the sense that you did experience a change in menstrual pattern. I am sorry that you were not given the correct contraceptive injection, as this is what has caused your hormonal system to be upset.

I recommend the following so as to correct your menstrual flow and fluid imbalance :

Take CHASTEBERRY PLUS by Metagenics, as x1 capsule, twice a day after food (i.e. after breakfast, and after supper). Do this for at least one month. This product will correct the irregularity of your menstrual cycle and assist with the unpleasantness of stomach cramps etc.

NAT MUR TISSUE SALTS NUMBER 9, as x1 celloid (tablet), 3 time a day, ideally 10 - 15 minutes in a clean mouth, under the tongue, before meals. The primary function of Nat Mur is as a fluid regulator, and it will correct the erratic pattern you are experiencing.

It normally takes a minimum of 3 months to detoxify from the contraceptive injecation. However, do allow up to 6 months or a little longer if need be.

Once the above problems have been corrected, you can e-mail me again with reference to your original query, and we can take it from there.

All the best of luck, and I am sure that you will come right.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Y



Many thanks for your question.



You should definitely not be having menstrual periods of a duration of 3 - 4 weeks! This is much, much too long. A normal average period should be a minimum of 3 days to a maximum of 7 days.



From the information you have given me, neither Nur-Isterate (the 8 week contraceptive injection) or Depo Provera (the 12 week contraceptive injection) seem to suit you. Prolonged bleeding like this can introduce certain medical conditions and other symptoms which must be avoided, e.g. iron deficiency anaemia; a lowered immune system; susceptibility to colds and 'flu and other infections; tiredness; temporary memory loss, to name a few.



I recommend that you make an appointment to see your gynaecologist please for a full assessment and examination. Your doctor will take a detailed medical history of you, including any other medication you have been taking so as to check for interaction of such.



With your given clinical picture you do need to be seen in person by your medical specialist. Please make this responsible

appointment today.



I wish you a speedy recovery!



Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear C

Many thanks for your question.

To what extent do you mean "a really heavy flow" ? You should not be using more than 6 - 8 sanitary pads in a 24 hour time span. The length of time for a period can vary from one woman to the next. The average time span is three days minimum, to seven days maximum.

Should there be dark clots and in excess, this would then need to be assessed and possibly examined by your medical doctor, and expecially if your symptoms increase and if there was abdominal pain.

But as you currently state your query, this should not be of concern right now.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear M

Many thanks for your question.

With the clinical profile given, my answer is yes, your signs and symptoms are as a result of detoxifying from the contraceptive pill. You do not mention which contraceptive, or for how long you have been taking it though.

Please be aware that it is advisable to use a barrier method like condoms in the interim, so as to avoid an unplanned pregnancy.

Do take care of yourself and still eat correctly and drink enough filtered water, do gentle exercise etc, and your body will recreate its hormonal balance.

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear L

Many thanks for your question. I fully empathise with you for the extremely frustrating time you have been having.

However, your doctors and the family planning sister have approached your situation correctly from the begining and advised you accordingly - although I do think that the pattern of your clinical profile could have been more comprehensively explained to you, as it is understandable as to how frustrated and tired you must be with all this!

The following has happened : Due to the change of contraceptives, from the Evra patch to the Oralcon pill, a hormonal imbalance was created. Your doctor correctly stopped the Evra patch because of the concern with a possible blood clot, although you say there was none on investigation, a precautionary measure was taken by administering an infusion of heparin - again this was correct. The compounding side effect of your history is that with heparin being an anticoagulant (i.e. blood thinning) this has in conjunction with the hormonal imbalance upset your body and thrown you out of sync! For you this has been distressing and frustrating, but the reason for the approach taken was to eliminate a potential or fatal blood clot travelling to the heart which would have resulted in a myocardial infarction (heart attack) or a cerebrovascular accident (stroke). So the good news is that this was avoided, and best of all, you are alive to tell the tale!

To correct your hormonal imbalance, along with a fluid imbalance, I now recommend that you consider doing the following :

Take CHASTEBERRY by Metagenics, as x1 capsule after breakfast, and again x1 capsule after supper. Chasteberry will correct your menstrual irregularity and relieve menstrual symptoms. It will also correct your hormonal imbalance. Try and continue with your Oralcon pill for another month and then see how you feel - you should be alright by then. This product also contains Ashwagancha root extract, which is an ancient remedy for mild depression (often due to a fluid imbalance).

FERRUM PHOS TISSUE SALTS NUMBER 4 in the Allison Effting range of tissue salts, as x1 celloid (tablet), 3 times a day, ideally 10 - 15 minutes before your three main meals, breakfast, lunch and dinner. Ferrum Phos is an anti inflammatory, but will also correct your depleted iron levels. Please visit your clinic sister and request that a haemoglobin finger prick test be done so as to check your iron levels. You can e-mail me the result and I can advise you accordingly. This tissue salt will boost your immune system and is listed as a first aid remedy for all conditions.

MAG PHOS TISSUE SALTS NUMBER 8, as x1 celloid, 3 times a day for the stomach cramps. This tissue salt is a muscle relaxant.

NAT MUR TISSUE SALTS NUMBER 9, as x1 celloid, 3 times a day as a fluid regulator. Your menstrual flow will be corrected even further.

All of the above will work for you nicely with gentle vibrationary energy healing. Try and be patient - you will come right.

Please let me know how you do, and always refer back to your previous e-mail, please.

Good luck!

With warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Cindy

Many thanks for letting me know how you are getting on. I am really pleased for you that the Agnus Castus Berry supplement has been effective for you in bringing back, and regulating your menstrual cycle. You can continue with this product for another month if you like, and then discontinue it.

You should be taking a good multivitamin and an omega supplement now, so as to prepare your body for conception. I put all my prospective mums onto a 90 day (3 month) programme prior to pregnancy. I suggest the following, bearing in mind that there are a number of ranges of supplements to choose from. My choice for you is as follows:

PREGNACARE by Arctic, taken as x1 tablet daily after breakfast. This is an excellent multivitamin formulated to be taken for 3 months prior to pregnancy, during pregnancy, and for at least 3 months after delivery.

MUM OMEGA by Equazen, taken as x1 capsule, preferably at night 1 - 2 hours after food. This is a top of the range omega supplement which will assist your baby in having healthy brain tissue, and a healthy nervous system and musculoskeletal system.

These last two products are your essential supplements to take prior to falling pregnant, during pregnancy and for at least three months after your baby is born.

Patience is a much needed quality when trying for a baby! Don't give up, but please do all the usual healthy things like eating correctly, drinking enough water, doing gentle exercise, and remaining as stress-free as possible. Smoking is a very big no-no by the way!

I wish you all the very best of luck, and would love to hear your news when it happens!

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear H

Many thanks for your question.

It is correct that you commenced taking Triphasil as a red pill on the FIRST DAY of your menstrual bleed.

The best and safest way to avoid having a period while on Triphasil is to avoid taking the 5 white inert or placebo tablets in the pack. It is important that you do complete taking all of the other 21 active pills. So, according to my count, on Friday the 22nd April, do not take the white pill or the remaining white pills from thereon. Continue straight with the next and first yellow pill and then follow your pack through.

You may still yet be able to avoid having a period, taking into account when you commenced this new pack.

I wish you well for the wedding and enjoy being a bridesmaid.

Warmest regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear C



Thank you for your question. Synthetic hormones, be they in pill form or injection form, are infamouse for disrupting normal hormonal cycles in sensitive women. These disruptions can last for up to a year after the last dose of the hormone. It sounds like your use of the contraceptive pushed your natural cycle off balance and it hasn't found a way to get back. I would recommend staying away from all forms of synthetic hormones for at least 12 months. You need to give your body a chance to work the last bits of the hormones out of your body and for it to remember how to get back onto a "normal" cycle. If after this time you still experience problems contact either myself or your local gynaecologist for further investigation.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear M



I have replied to your previous question on the forum. I do not keep copies of questions and answers in my personal records.



I do not work in a hospital. I have a private practive in Cape Town - have a look at www.healthnation.co.za for more information.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear M



Thank you for your reply. Regarding the discharge I would strongly recommend having the discharge swabbed and sent away for a microscopy, culture and sensitivity. Today there are many bugs with high levels of resistance to traditional antibiotics which may be the reason why previous courses of medication have not worked. I would also recommend having a pap smear asap.



Re. the possible miscarriage I cannot remember the timeline you mentioned in your previous question but irrespective of when it occured if the uterus is clean it will be quite difficult to confirm the miscarriage at this stage.



Given your colection of gynaecological problems I would not recommend going to an ordinary GP. The ideal person for you to visit would be a gynaecologist, either in state or in prvate practice, who will be able to ultrasound your uterus, perform a pap smear and send some of the vaginal discharge away for the MC&S I mentioned above. If private is too costly I think you should get to the clinic or hospital early in order to prevent having to wait for a long time once the clinic opens - i.e. 6am. Don't postpone seeking care because your current issues may have permanent affects on your gynaecological health and future fertility.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear U

Thank you for your question. Unfortunately without a proper history and clinical examination I cannot offer an opinion on the possible reasons for the change in your menstrual cycle or weight. What I want to say though is that you should not be comparing your cycle to other girls' as everyone is unique in their combination of genetic predisposition and environmental exposure. Comparison with close family members is sometimes a good predictor but in all honesty the only person you should be comparing yourself to is yourself.

I would recommend seeing your GP or gynaecologist for further assistance with this problem.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question.

You are experiencing detoxification from the contraceptives you have been taking. You also have a deficiency of magnesium due to your abdominal discomfort. By all means do a pregnancy test, even if just for peace of mind. However, I do not think that you are currently pregnant.

Obviously I want you to be well, and to start feeling more like your 'old self' again, so I recommend the following for you:

VITA-LIFE MULTIVITAMIN by Amipro, to be taken as x3 capsules every day, after breakfast. This product will replensish you with the mineral salts your body has been depleted from as a result of the oral contraceptives, which drain the skeletal structure of important mineral salts.

CHASTEBERRY PLUS by Metagenics, to be taken as x1 capsule, 3 times a day after food. This product will assist in regulating your menstrual cycle, and in controlling menstrual symptoms. An ingredient in this product is Ashvaganda, which is an ancient remedy which will assist with the emotional side of the hormonal cycle being reregulated.

All these products can be ordered on-line with our website, and delivered directly to you with the charge of a small delivery fee.

Please follow the above, and you will get better!

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Thank you for your question.

A fibroid is a benign tumour. In other words, it is a non-malignant tumour which is located in the uterus.

With your erratic menstruation and regular loss of blood, you need to make an appointment to see either your general practitioner or gynaecologist for a full assessment and examination so as to determine the cause. It would be incorrect of me to treat you from a website when your body is out of balance with regular blood loss.

Please make this responsible appointment soonest.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for e-mailing me a reply, and as to how your appointment went with your doctor. Your doctor has obviously dealt with some emergencies where women have had to have blood transfusions - I did not want this to happen to you as the clinic I run practices the principles of preventative, promotive and curative health. Hence situations are caught before they go too far.

A Tubal Ligation can be reversed (should you change your mind about having another child!), and it also importantly allows you to still have a menstrual cycle. Certain hormones are released during the hormonal cycle which allows your systems to function to their full potential.

I wish you much health and happiness!

Warmest regards

Angela

Megan (dr.) Jones Homeopath View profile

That sounds like a good combination, as your homoeopath is using two modalities to balance the hormones. The Lachesis is a homoeopathic remedy that is commonly used for hormone-related symptoms/conditions. There are many homoeopathic remedies for your symptoms, and the challenge is in finding the correct one for your specific case. The Dioscorea Villosa is a herbal medicine that aids in balancing hormones. It is often difficult to explain to a patient the indication for a particular remedy choice as the choice of remedy is based on a multitude of factors. I trust that your homoeopath chose your remedy after careful consultation and deliberation. Keep in mind that the first remedy you try is not always the correct one, so be patient, as long as you are seeing some improvements. Warm regards, Dr Megan Jones, Registered Homoeopath and BEST Practitioner

Angela Lombard Nursing Practitioner View profile

Dear L

Many thanks for your question.

I suggest that you have a checkup with your gynaecologist at least 6 months after your last appointment which was in August 2010, which will take you to February 2011. My instinct is for you to come off Nur-Isterate as you should not be bleeding for 4 weeks - this is way too long. I appreciate you giving me your history. As a result of the cone biopsy and the history precluding to this procedure being done it is relevant that you have a follow up with your gynae, even though your last appointment went well.

I practise full primary health care working from the preventative, promotive and curative principle approach. As I have not met you and assessed you myself and seen your medical file, the above is my reasoning for referring you back to your specialist. Ask your doctor which family planning method he would prefer you to be on, taking into account your previous history. You may need to give you your body a rest from family planning for about 3 months so as to allow the chemical components of Nur-Isterate to be released from the systems of your body though. Your doctor may recommend a little longer, and not forgetting please, to use a barrier method like condoms in the interim.

I do hope you feel better soon.

Warmest regards and many thanks once again.

Angela

Angela Lombard Nursing Practitioner View profile

Dear M

Thank you for your question and also for the detail given. The low sex drive and weight gain experienced are unfortunately side effects of all pharmaceutical contraceptives, and can vary from one woman to another. Your doctor would have changed you from Nur-Isterate mainly due to your abdominal pains, as this would have been cause for concern at the time.

You should have been advised by your medical practitioner, when changing over from one contraceptive to another, to make use of an affective barrier method like condoms for 3-4 weeks from commencement of the pill.

I recommend the following : Please have a pregnancy test done. Due to you not having had your menses for 8 weeks it would be advisable to do this anyway and for peace of mind. Your hormonal pattern is likely to be out of sync due to the change in contraceptive and yes due to the fact that there will be a residue of the Nur-Isterate in your systems for at least 3 months, but do a pregnancy test first. Once you have a negative result, you could wait for the remaining chemical components to work out of your body naturally, or alternatively you could commence taking VITEX AGNUS CASTUS BERRY by Viridian as x1-2 capsules daily after food, like breakfast - this product will assist your body in re-establishing a hormonal cycle. In your instance, this may take another month or a little longer.

All best wishes to you.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear M

Thank you for your question and for updating me on your history. I appreciate your honesty.

Eating spasmodically and with fast food is a big no-no!! Our first line approach at Wellness Warehouse is always to encourage a correct nutritional intake. What you eat you literally become in cell structure. The old adage ' you are what you eat' is exactly this.

Your haemoglobin as an adult female needs to be not less than 12 gm% (grammes per cent) to 14 gm%. I suggest that you do have your Hb checked at your local clinic, or make an appointment to see me. Your given eating pattern will greatly add to you having an erratic menstrual cycle.

Here are some simple guideline principles to assist you :

Eat a wholesome breakfast within 1 hour of getting up in the morning. Try to eat smaller portions every 3-4 hours. Ensure that most meals and snacks incorporate complex carbohydrates. Choose low GI/GL foods most of the time. Eat at least 5-7 fruit and vegetable portions per day. Incorporate at least 3 low-fat dairy portions per day. Increase fish and some chicken, and reduce red meat consumption. Opt for low-fat and fat free products. Try to eat fatty fish 2-3 times per week. Drink 6-8 glasses of water daily (tea and coffee don't count). Drink no more than 2 units of alcohol daily (if any) as a woman. Exercise regularly (4-5 times a week for 30 minutes+). Use healthy cooking methods, e.g. steam, bake, poach, grill. Spend time taking care of yourself giving yourself me time occasionally. Manage stress. Should you smoke, this is fully discouraged!

Skipping meals will : lower your Hb, could cause erratic periods, make you less able to manage stress, make you tired and lethargic, affect your metabolic rate, make you irritable, and of course lower your immune system.

Breakfast is the most important meal of the day - do try not to skip it please! A bowl of jungle oats in the morning with a few raisins and honey or treacle with milk is very nutritious and loaded with vitamin B and will feed the nervous system, give you energy and maintain clear thinking etc.

See how you go - this should get you started!

Take care and keep safe this Christmas season.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear M

Thank you for your question. I do understand your concern. Let me reassure you first of all that there is no cause for you to worry with the pattern you have given. However, there is a reason as to why your menstruation is slightly out of sync (pattern). There are a number of possible reasons as to why could be. The main one could be stress - I note that you are under the age of 19 years - Have you completed a hectic and jam-packed exam schedule now that the year has ended? Have you experienced any additional emotional distress lately? Have you not been eating correctly?

Teenage girls produce a large quantity of iron rich cells, and sometimes where there is an imbalance of too much iron in the body, and an extra cycle of menstruation can be triggered. Should you have taken medication recently like disprin or medicine containing aspirin (an anticoagulant), this can cause a period to flow more strongly or for longer, all depending on the individual.

Should you have a distinct odour, or discharge or clots, then this would need to be assessed. But what you have described is normal with the pubescent years. It is all part of growing up!

If there was a history of anaemia or other blood disorders, then my approach would be different. But then you have not mentioned history of this nature in your question.

You are welcome to contact me for further advice should you remain worried. My direct clinic telephone number is 021-4875435 or 4875420, from 09h00 - 16h00, Monday to Friday at the Kloof Clinic in Cape Town.

Warm regards

Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Dear O B

Thank you for your question. Amenorrhoea is the medical term for menses becoming less or disappearing for awhile. This could be due to a number of reasons, notably a low Haemoglobin (i.e. low iron levels), or even stress. Due to an incomplete clinical profile to determine the cause, you would need to make an appointment to see me please.

Please contact the Kloof Clinic between 09h00 - 16h00, Monday to Friday, on telephone no. 021-4875435 or 4875420.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear G

Thank you for your question. I understand that you do not want an unplanned pregnancy.

There are many reasons as to why your period may be late. As I have no clinical picture other than you experiencing cramps and your period being late by 12 days, I suggest that you have another pregnancy test done at your local clinic. At the same time request of the nursing sister on duty to do a Haemoglobin test, which will check your iron levels. Not eating correctly, not drinking sufficient water, having low iron levels, and being stressed can all contribute to a late period.

You are welcome to make an appointment to see me so as to do all of the above.

Warm regards

Angela

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

This happens quite often so you don’t need to worry. Sometimes the sex hormone levels fluctuate and one doesn’t have a period even though the cycle is still normal. This is often stress related!

If you look back over the last month, something will have been different. Have a look at your stress levels, your weight, exercise, work load, sleep and anything else that might have changed. If your period doesn’t return back to normal after a couple cycles then go to your Dr or Gynae to see why.

Warms regards

Gabriell

Angela Lombard Nursing Practitioner View profile

Dear A

Thank you for your question - I am not sure if your question has already been answered by our website. If not, I apologise for any delay caused to you.

It does seem that the Agnus Castus Berry did start to work for you with your abdominal cramps being present. There would have been some inevitable hormonal upset as a result of stopping the contraceptive, as there would be when changing over to a different contraceptive.

The Kloof Well Clinic does provide a pathology service. This service is provided under a consultation fee of R60,00c for an appointment of 30 minutes at the 2010 price. The blood tests are sent off to a pathology laboratory and results are received directly by me. I am qualified and licenced to receive all results done for pathology sent away. You would receive a separate bill in the post from the pathology company for the blood tests and requested within 2 weeks of the bloods having been taken.

You are welcome to contact me for further information needed.

Many thanks and warm regards

Angela

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

This is caused by a change in your hormone levels. There are many different things that could cause this, often as simple as stress or dieting. I would need to know more information to be able to tell you exactly what the problem is.

If you don’t have any other symptoms then don’t worry about it. If you continue having irregular periods then go to your Gynae or GP for a check up. If you continue bleeding now and/or have severe abdominal pain then go immediately to the Dr.

Warm regards

Gabriell

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

If your urine has been checked for infections then it is highly unlikely that you have an UTI. Urine smells if it is too concentrated as well as if you are eating certain foods or taking some medications. Has anything else been different since you started having bad smelling urine? The other option is that you have a vaginal infection – do you have a discharge?

The brown blood occurs when the flow is slow and there is time for the blood to oxidise. There are many different things that could cause the dizziness, loss of appetite and tiredness. Are your periods heavy? Are you stressed or anxious during the periods.

For now, continue to drink enough water so that your urine is clear like water. If your symptoms continue then I suggest that you go back to your Dr for a follow up and any tests that are necessary to make work out why you are having these symptoms.

Warm regards

Gabriell

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

Yes, if you are having a withdrawal bleed while on the pill or any regular period, then you are not pregnant. It is most likely that your periods are lighter as your body adjusts to being on the pill.

The body functions naturally on about a 4 week cycle so it is important to keep your cycle while on the pill as close to this as possible. Extending the active period by a week is very confusing for the body so this could have accounted for your unusual period.

Warm regards

Gabriell

Yesheen (dr.) Singh Medical Doctor View profile

Dear T

Thank you for your questions. Regarding the first I think you should visit your GP to find out why your menstruation has continued unabated for three weeks, which according to your message is an unusual duration for you. There may be a variety of reasons, ranging from hormonal imbalances to physical abnormalities within your endocrine or reproductive organs. To ascertain the exact cause s/he needs to perform a couple of tests, such as a pregnancy test or a pelvic ultrasound. Management of a simple extended menstruation, or metrorrhagia, is a short course of oestrogen-only pills. You could try something like Maca root powder is you want to try the alternate route and don't have any symptoms of anaemia.

The second is probably linked to the first, as irregular menstruation is a symptom of infertility. Regular menstruation is regulated by a balanced hormone cycle, and ovulation is a result of a normal menstrual cycle. The tests mentioned above, as well as a hormonal profile, would help inform us as to the reason for your difficulty in conceiving. I think you and your partner should both visit your GP to test the status of both your ovarian and his testicular health.

Many thanks and warm regards

Yesheen

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

I apologise for the delayed response.

It sounds like the problem is most likely a hormonal imbalance. It can take up to a year for your body to return to a regular rhythm with a regular period. Hormonal imbalance can also result in cramping and back pain.

I would need more information to be able to know exactly what the problem is. I suggest that you go to your gynae for a check up. S/he can ask all of the relevant questions, do a full examination and any tests that are required to make a diagnosis.

Warm regards

Gabriell

Angela Lombard Nursing Practitioner View profile

Dear A

Your hormonal cycle is a little out of rhythm. Unfortunately, you have not given any medical history, other than to indicate your hormonal pattern. The change in your hormonal pattern could be due to a number of reasons :

Stress can cause the body to react in a number of ways, and in women it is common for the hormonal pattern to be affected. And when I say stress, I mean stress as it is applicable to you as an individual, and how you manage it for yourself. Some women experience a double period or two periods within a month.

Certain medications can cause bleeding to occur. An anticoagulant (blood thinning medication), or where there is a side effect of frequently used medicines. Disprin; aspirin; ecotrin; and warfarin all have blood thinning properties. Even panado where 8 or more tablets have been taken in a 24 hour time span can result in slow internal bleeding, and even more so when there is a deficiency of one of the clotting factors in the blood.

Stopping a contraceptive, and or changing from one contraceptive to another can commonly cause a hormonal flux resulting in an erratic menstrual pattern.

You are welcome to contact me for an appointment for a consultation at the Kloof Clinic in Cape Town on telephone number 021-4875420 from 09h00 - 16h00, Monday to Friday. Alternatively you could see your general practitioner for an assessment and possible examination.

I am sure your problem is a simple one. Your pattern is not serious, however I suggest that you have a checkup to ensure that you are ok.

Kind regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear P

Thank you for your question. Your particular kind of query often comes up.

For Triphasil, you need only skip all of the 7 white tablets in the pack. This will then cause you not to have your menses.

You still need to take your pill at the same time every day, in order to avoid an unplanned pregnancy.

Enjoy your vacation!

Warm regards

Angela


Angela Lombard Nursing Practitioner View profile

Dear J

Thank you for your query.

Please do not be confused, you have been taking both respective pills correctly so far. All you need to do is just continue with the Femodene pack straight away on the corresponding day, as you have said. Both Femodene and Melodene are a 21 day placebo pill. The 7 pills in each pack are a different colour.

And yes, you continue to adere to the '7 Day Rule' for Femodene, just as you did for Melodene.

Warm regards

Angela

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

You are correct; a UTI won’t cause your period to be late. Sex around the time of your period will also not cause you to be late. While there are many reasons for not having a period, it is possible that you are pregnant, so it would be a good idea to check. To become pregnant one needs to have unprotected sex at the time of ovulation. This occurs on about day 14 of the menstrual cycle (which starts on the first day of your period).

The symptoms that you have sound more like they are related to an infection at this stage. If you haven’t gone to the GP yet, I suggest that you make an appointment to have a urine test to confirm the UTI and get appropriate antibiotics if needed. You could also have a pregnancy test done there. Otherwise you can get a pregnancy test from a chemist. They are easy to use, and then you will know for sure and can make decisions accordingly.

Warm regards

Gabriell

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y

Thank you for your question. I don't think you're being paranoid at all. If this is something out of the ordinary, a new painful sensation not usually associated with your regular menstrual cycle, then I would be suspicious as well. I would try to take note of the pattern of pain - is it constant or does it come and go? Is it getting worse or getting better? Is it staying in the same area or spreading to other areas as well? All of these help us decide whether it is something that warrants further investigation.

I think that if the pain is still present, is increasing in intensity and is either localised to your right side or spreading to the rest of your abdomen or to your lower back you should go have a pelvic ultrasound done. A common diagnosis in someone who presents with your symptoms, prolonged increasing iliac fossa pain after a menstruation, is one of an ovarian cyst, which is relatively harmless if caught early. These days one can manage cysts either laparoscopically or via laser ablation with minimal invasion. Other reasons could include endometriosis, pelvic inflammatory disease of even a STI. But before we go looking for pink canaries I think you should speak to your GP or gynaecologist about having an ultrasound done.

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y

Thank you for your question. From my experience there is absolutely nothing predictable about falling pregnant. Most oral contraceptives state a 93-95% efficacy, i.e. they prevent pregnancy 93-95% of the time. This figure is greatly reduced when you do not use the pill as prescribed, at the same time every day. Missing a day or two while remaining sexually active is the same as not using the pill at all in my book. So firstly I would like you to consider whether a daily oral contraceptive is the best choice for you if you're prone to forgetting to comply with the medication.

With regards to the possibility of you being pregnant, I would have to say that there is a definite possibility that you are, but that the only way to confirm or deny this would be to have a pregnancy test done. A home test kit using your urine is a good place to start, or you could visit your local clinic and get it done for free. If the result is inconclusive, or if it is negative and you still experience the symptoms you describe above I would then recommend a serum pregnancy test and a pelvic ultrasound as these are certain to pick up any changes in your gynaecological system. There are also other possibilities that would explain your symptoms, such as an infection or a cyst. Please contact your GP or gynaecologist to investigate further.

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear N

Thank you for getting in contact again. There is a possibility that what you experienced was indeed a period but one with an irregular volume, given that the discharge and abdominal pain stopped at the same time. An option for you would be to delay the visit to your GP while observing for any return of either the discharge or pain before your next period is due, in which case I would suggest biting the bullet and going in.

If you don't experience any symptoms and the time comes for your next period please pay attention for any return of pain or discharge, as well as the duration and volume of the menstrual flow. If anything is abnormal please consult your GP.

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear N

Thank you for your question. I'm sorry to read about your experience last year. With regards to your current problem, which would technically be named Secondary Amenorrhea, I would highly recommend visiting your gynaecologist for two tests:

1. Serum quantitative Beta HCG, which is a blood-based test to confirm or exclude the presence of a pregnancy. Often home pregnancy tests are not equipped to pick up more subtle levels of the hormones that allude to pregnancy. This will tell us whether there is any tissue present in your body that is producing the HCG hormone usually associated with a growing fetus. This could be due to pregnancy, either intra-uterine or extra-uterine, or to a variety of other causes such as a blighted ovum, which is where the placenta of a fetus continues to grow and produce HCG after the fetus aborts. If this test comes back negative we then know that this problem is not associated with pregnancy and is instead a hormonal or cyclical problem and we can begin down the pathway of trying to regulate your menses back into a regular cycle. If it is positive then test two will further inform our diagnosis.

2. Pelvic Ultrasound, which allows us to have a look at what is going on within the pelvis, especially within the uterus and the ovaries and fallopian tubes to a lesser degree. If test one is positive then the ultrasound will help us see where the fetus has implanted, and whether there are any complications associated with the implantation. If test one is negative this will help us evaluate the state of your uterine lining as an indication of hormonal functioning, and look for any possible blockages that are preventing you from passing the byproducts of the menstruation process.

After these two diagnostic procedures your gynaecologist can then formulate a plan of action to help you move forward. Please ask if you require any further assistance.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Thank you for your query - I understand the depth of your concern.

Your problem could be one of a number of things. As there is no clinical picture given, you will need an assessment done by your general practitioner so as to diagnostically determine what the problem is. At this point, it could be very simply iron deficiency anaemia, which is easily treatable, but does need to be determined with a diagnostic blood test, please.

The other possibility, and this is with so little information given - a possible pregnancy.

Incorrect eating, stress, not obtaining enough sleep, starting a new contraceptive - are a few of the causes which can introduce iron deficiency anaemia. Make this responsible appointment so as to resolve your symptom.

Good luck and take care now.

Kind regards

Angela

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

There are many different reasons for heavy painful flow. Different women have different experiences during menstruation with some naturally having heavy painful periods. If this has been happening for most of your life then it is most likely just a normal variation and nothing to be worried about.

Treatment options depend on the cause of the bleeding and pain. When bleeding is heavy, the blood clots in the uterus and then comes out as thick pieces. If there are no underlying problems one would generally start by giving something to prevent excessive bleeding rather than thin the blood. This is probably what the Gynae has done. Other options of treatment include pain management, hormonal therapy and other specific treatment depending on the cause of the bleeding.

The blood clots are nothing to worry about; they just mean that you are bleeding heavily which can be completely normal. However heavy bleeding can result in anaemia, and obviously the pain can have a negative impact on your life. I would suggest that you go back to see your Gynae again. S/he will have done an examination to confirm why you are experiencing this and can also test to see if you are anaemic. Often one needs to try one form of medication first and if that doesn’t work go on to the next line of treatment.

I hope you have quick success in finding an effective treatment.

Warm regards

Gabriell

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

There are many different things that could account for this, and it is difficult to know without asking a lot of questions. I think that you should make an appointment to visit your GP in the next couple weeks. S/he will then be able to ask all the necessary questions, do an examination and any relevant tests to make a proper diagnosis.

Warm regards

Gabriell

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

It does take time for the hormonal cycle to re-establish its natural balance after stopping hormonal contraceptives. As a result irregular bleeding often occurs. If the bleeding is just light spotting wait a few more weeks for your hormonal cycle to find its natural balance. However if you are still bleeding heavily or if the spotting doesn’t stop in a few weeks, I would recommend that you visit your GP for a full assessment and further advice.

Warm regards

Gabriell

Angela Lombard Nursing Practitioner View profile

Thank you for your query. Your general practitioner advised you correctly about taking your antibiotic treatment. With you having had a cold, and it must have been a bad one for your doctor to prescibe an antibiotic, and the clinical picture you have given, it may well be that your immune system is still recovering. A conventional antibiotic has a number of side effects, one of which is the lowering of the immune system, although prescibed for an infection. What often happens is that the body witholds a menstrual flow because it needs the oxygen which is carried by the red blood cells, hence a missed period or delayed period, in order to recover. However, due to the formulation of Nordette and being a low dosage pill, I suggest that you have a pregnancy test done - also for peace of mind. A simple urine test as done for pregnancy should suffice at this stage - but do this only in the morning, no later than 10 a.m. as the HCG (human chorionic gonadotrphin) hormone is only raised in the morning, and this is what indicates whether a test is negative or positive. I hope this helps you! Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Hi Chantelle,

You can contact me on the company website, which is www.wellnesswarehouse.com and your query will come directly through to me as referred by Doctor Sean Gomes and the Wellness Panel. Sean also sends me all queries to my own personal e-mail address when not in the clinic - so it may be preferable to use this e-mail address. The direct clinic e-mail address is clinickloof@wellnesswarehouse.com The telephone number at the Kloof store in Cape Town is 021-4875420 from monday to friday, 09H00 - 16H00. I do check my e-mails regulary, so please feel free to use this service.

Warmest regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Hi S

Thank you for your question. You have what is termed metrorrhagia, abnormal uterine bleeding. What this basically means is that your period does not follow your usual pattern in terms of either frequency, duration or volume of flow. Most often the cause is a problem with the interaction between the two hormones responsible for menstruation and ovulation, viz. Oestrogen and Progesterone, and these are in turn affected by a wide variety of factors, ranging from the use of oral contraception or other medications like antibiotics and corticosteroids, to stress, diet and exercise.

The pills your gynaecologist gave you were probably high doses of oestrogen which often results in a cessation of the bleeding. In cases where it doesn't it is imperative that you return to your gynaecologist for a follow-up that includes at least an ultrasound of your uterus and a hormonal blood profile.

As this is a chronic problem I would also highly recommend aiding your body in it's efforts to maintain normal blood levels, which it does by producing new blood cells. You can do this by using Iron, Vitamin B12 and Folic Acid supplements, and eating plenty of dark green vegetables such as Spinach and Broccoli.

Please do not wait another three months before seeking help as this sort of chronic low volume uterine bleeding leads to quite serious complications such as anaemia and intra-uterine infections which negatively impact on future fertility.

Warm regards and many thanks

Yesheen

Angela Lombard Nursing Practitioner View profile

Many thanks for your query Lizanne. Your description of your period while on the pill is perfectly normal, and your profile given is an indication that it is working for you, which is great! The signs and symptoms for spotting and implantation bleeding are similar, but there is a difference.

A normal menstrual cycle generally starts off light and then becomes heavier. Spotting can sometimes be the sign of an early period. If this is the case, the spotting will pick up to heavier bleeding. If you have spotting right around the time of your period when it would normally start, it can become confusing - and this is where your question stems from.

Signs of implantation or possible pregnancy are :

1. Implantation cramps : small cramps inside the uterus.

2. Implantation spotting or bleeding : short brief spotting (a couple of drops of light, brown or dark blood).

3. A second temperature shift on the temperature curve.

4. A temperature dip at about 7 - 10 days after ovulation.

A pregnancy test can be done as early as 10 days after ovulation to determine the gestation of a foetus. Only about 20 - 30 per cent of pregnant women experience implantation bleeding.

I suggest that you keep a diary record of when the first day of bleeding of your menstrual cycle commences every month - this is important as most obstetrical questions stem from here when determining expected dates of delivery and in resolving bleeding problems.

Bleeding similar to a menstrual period is unlikely implantation bleeding. Always consult your practitioner if you are not sure. You are very welcome to contact me on telephone number 021-4875020 at the Kloof Clinic in Cape Town between the hours of 09h00 - 16h00 for further clarrification and advice. I hope that this has ironed out some of the confusion for you! Kind regards, Angela, Nursing Practitioner.

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

This is unusual but nothing to be concerned about. There are many factors that can affect our hormonal levels. Make sure that you are taking your pills at about the same time each day. If you have missed a few or have had diarrhoea your hormonal levels might be too low in which case it is advisable to use a barrier form of contraception until you’ve taken the pills regularly for 7 days.

If this happens frequently I would suggest that you visit your GP or gynae to see why and possibly change to a different pill. However one episode is nothing to worry about!

Warms regards

Gabriell

Angela Lombard Nursing Practitioner View profile

Thank you for your query. It is very important that you commenced taking Yaz on the first day of your menstrual bleed. This is due to the formulation of this contraceptive pill. Should you have done this, then your hormonal system may still be settling down. However, as you are anxious about the possibility of another unplanned pregnancy, I do suggest that you have a pregnancy test done so as to ease this concern. Our Kloof Clinic in Cape Town does pregnancy tests. Should you decide to use a home pregnancy test, this is done with your urine, and should always be done by 10 a.m. in the morning as there is a certain hormone which is only raised in the morning, when checking for a pregnancy. You are welcome to telephone me for further advice on 021-4875420 from 09h00 - 16h00, monday to friday. Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Many thanks for your query. Spotting can occur for a number of reasons, a few examples are: a change of contraceptive, or having missed taking a contraceptive pill. Taking new medication in addition to a contraceptive pill, could in certain instances cause extra bleeding, as in taking aspirin. The fact that there is sometimes a brown colour and occasionally a smell leads me to recommend that you consider having a cervical smear (Pap smear) so as to determine the possibility of an infection - this is a diagnostic procedure that can help to determine treatment.

A urinalysis could also be done so as to rule out a urinary tract infection as well.

Our Kloof Clinic at our Cape Town store practices primary health care, and both these procedures can be done for you. Just ensure that you make an appointment please, as an hour will be allocated for this booking.

The clinic works on an appointment basis for this kind of request. The contact telephone number for the clinic is 021-4875420.

Kind regards, Angela, Nursing Practitioner.

Gabriell (dr.) Prinsloo Medical Doctor View profile

It is unlikely that you are pregnant especially if you have been taking your pill every day. The brown discharge is generally a blood stained discharge (blood turns brown as it is exposed to air). Sometimes something will cause hormones to go out of balance and there might be a change in your period, which can range from a change in the duration of your period, to a change in the heaviness of the flow (a brown discharge is the lightest flow). These hormonal changes could be caused by stress, general illness or weight change amongst others.

If you are ever concerned that you might be pregnant, you can do a pregnancy test on urine. These are available at any pharmacy and easy to use.

If your period doesn’t return to normal in the next couple months, if you are generally stressed or there are any other reasons that you think might be contributing to the change in period, then I would suggest going to visit your GP or gynae for a check up.

Kind regards

Dr Gabriell Prinsloo

Gabriell (dr.) Prinsloo Medical Doctor View profile

There are many causes for abnormal bleeding ranging from hormonal changes and stress which you do not need to be concerned about to infections or polyps which would require further treatment. Age can result in hormonal changes and abnormal periods are very common around menopause, but it is important to have a proper diagnosis before attributing the changes to age.

I do not think that you need to be concerned, however if the bleeding continues I would suggest visiting your GP or Gynae so that they can take a full history and do any examination or investigations that are needed to work out why you are bleeding.

Kind regards

Dr Gabriell Prinsloo

Gabriell (dr.) Prinsloo Medical Doctor View profile

The most likely cause for all of your symptoms is that you have stopped the pill. When one stops the pill it takes time for the body’s hormones to balance. The sudden change in hormones could result in bleeding, nausea and cramps, and it can take up to 6 months to have a normal regular cycle. If your last period was a normal period, it is highly unlikely that you are pregnant.

However, if the bleeding, cramps or nausea worsen or have not improved by now, I would suggest going to see your Gynae or GP.

Kind regards
Dr Gabriell Prinsloo

Gabriell (dr.) Prinsloo Medical Doctor View profile

Yes this is normal. It usually takes 2 to 4 weeks for the period to return after stopping the pill; however it can take up to 6 months. In those first 6 months the periods will often be irregular. The length of time it takes to return to normal depends on each individual and what their normal cycle is like. Low weight, excessive exercise and stress, and poor general health may result in a delayed return of your period.

If you feel that any of these apply to you, I would suggest consulting a Dr. If after 6 months your period has still not returned to normal; consult a Gynaecologist to exclude any physical disorder. Until then it is important to eat well, exercise, relax and to continue using contraception to prevent the possibility of pregnancy.

Kind regards

Dr Gabriell Prinsloo

Angela Lombard Nursing Practitioner View profile

It is not normal to bleed each time after intercourse, or when there is an orgasm. I would greatly appreciate it if you could contact me please, as I would like to take a look at your results. I liaise with the pathology laboratories on a regular basis, and am also directly linked to their website. Your query remains anonymous until you make contact with me, so it would be so much better to have an overview of the actual results for concluding your primary cause. Did your general practitioner do a full blood count blood test (FBC), an erythrocyte sedimentation rate (ESR), and even a possible CD4 count blood test? Do you have a history of any type of anaemia or blood disorder, either as an adult or as a child? What medication are you taking? Do you take any medication with asprin in it, or any other medication with an anticoagulant built into it? Do you have a history of endometriosis at all? Bleeding the way you do, does indicate a fluid imbalance, but I would appreciate a more detailed history and blood results and pap analysis please. You should also consider seeing a gynaecologist for a more in detailed examination.You are welcome to continue to communicate with me by emailing me directly at clinickloof@wellneswarehouse.com, or to contact me directly through the Well Clinics. Take care now, Kind regards, Angela, Nursing Practitioner.

Sean (dr.) Gomes Medical Doctor View profile

Thanks for your question and detailed history. There are a number of factors that could be the cause of your heavy and erratic periods. 1) After stopping the depo injection, it can take up to 6 months for your periods to return to normal. 2) Premarin is made of oestrogens. You do not say why you are taking Premarin specifically. One of the potential side effects of Premarin is irregular, painful and heavy periods. In women who have not had a hysterectomy, Premarin is normally taken in conjunction with Progesterone medication. There are also other potential causes for which you would need further investigation which would include cervical and uterine abnormalities. I would recommend you see a gynaecologist to do a full examination including a smear and ultrasound. They may advise you to stop the Premarin. Generally in cases of irregular periods, the first line of therapy is the oral contraceptive pill which helps regulate the menstrual cycle. Following further investigation by a gynaecologist, they will be able to decide on the best way forward. Kind regards Dr Sean Gomes

Sean (dr.) Gomes Medical Doctor View profile

After taking the morning after pill, one’s cycle can take a month or two to settle down. Obviously, menstruating for 18 days is concerning, but given the history of having taken the morning after pill, this is not completely unexpected. Given that the flow is light is reassuring. Make sure you take an adequate iron supplement and eat a healthy diet so as to restore you iron levels after this prolonged bleeding. I would continue on your pill as per normal. You will most likely find that when you reach the placebo pills towards the end of the packet, you will have a normal menstruation after which, things should all settle down. If you have any further concerns please visit Angela our nurse at the WellClinic or your usual medical practitioner. Wishing you a full recovery. Regards Dr Sean Gomes

Angela Lombard Nursing Practitioner View profile

Thank you for your query, which is a very relevant one for your age of 39 years. Yes, it is possible to take a contraceptive pill to help regulate your menstrual bleeding. However, the correct approach would be, to be properly assessed as to the cause of the excessive bleeding. Also, prior to commencing a contraceptive pill, a patient should always be assessed and examined as to her suitability and physiological profile, so that the correct pill is prescribed. Family medical history and her own medical history and lifestyle must always be taken into account and recorded - this can be done with your general practitioner or gynaecologist. I do suggest that you consider the following before going the contraceptive route, should you only be looking at a pill for regulating your heavy bleeding: A blood test can be done for a menopausal screen - this blood test would be sent to a laboratory for analysis to determine your hormonal levels for oestrogen, progesterone and testosterone. At the same time a full blood count should be done to determine your haemoglobin levels and that each of the different blood cell groups are within normal range. Depending on the results, you could then be treated by our natural medicine dispensary in conjunction with the Well Clinics.

Kind regards, Angela, Nursing Practitioner.

Sean (dr.) Gomes Medical Doctor View profile

It depends on at which stage of your monthly cycle you had the D&C. The D&C would have removed some of the endometrial lining of the uterus. You do not say what the procedure was for, so if it was just for sampling, then you should have your normal period, if the D&C removed most of the lining, then you may have a very light period when your next period is due. As the D&C does not effect your hormone levels, you normal cycle should still take place. The amount of menstruation may be effected.
Regards Dr Sean Gomes

Angela Lombard Nursing Practitioner View profile

As this has been so since the start of your menses and I presume you are otherwise in good health, there is no need for major concern. It does however mean that you are ovulating quite infrequently, which could make conception in the future more difficult. There can be a number of reasons for you only having a menstrual cycle every 3 months, and as there is no medical history given here, my reply is as follows: Your hormonal meridian pathways are possibly stagnant and need to be cleared, healed and regulated. The Chinese Pure Herbal Preparations will assist you with this, namely: the Expel Uterus Stagnation supplement and the Expel Stasis supplement. Both products are highly affective and cost effective. They can be used separately or together and are safe to use. I suggest that you use both products for a month and then be reassessed by either myself or our natural medicine dispensary practitioner team. In the long term, if your periods do not become more regular it would be worth being investigated by a gynaecologist. Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Unfortunately you do not mention a date as to when the first day of your last menstrual period was. Work out when this day was on a calendar and mark off each day until you reach the 31/32 day mark - this is when your next menses should be. Include your current extra bleeding days in this total count. But importantly, your age category and the signs and symptoms mentioned along with the colour and inconsistency of your erratic menses poses a query as to your exact age. Should you be nearer to the age of 40 years, from what you have described so far, you could be in a peri-menopausal or in early menopause. You also need to take into account any medication you may be on, which could have triggered off an imbalance in the hormonal cycle and erratic bleeding. When did you last have a pap smear? And if so , were the results all normal? An annual pap smear is encouraged. I suggest the following: Pop into one of our Well Clinics and make a consultation appointment to see me to have a Full Blood Count and Menopausal screen done. You are welcome to phone me for a quote for these pathology tests which would be sent away for laboratory analysis. Should these be normal, I would start you on a 3 month course of 2-3 supplements to prepare your body for conception. Alternatively, you could see your general practitioner or gynaecologist. Kind regards, Angela, Nursing Practitioner

Angela Lombard Nursing Practitioner View profile

14 years of being on the Nur-Isterate contraceptive injection without a break is a long time. There should be a break of 3 months from this contraceptive every 2-3 years. Mass weight gain is a listed potential side effect when taking Nur-Isterate. You have most certainly had a build up of the chemical components in your system from this contraceptive, as a result of not having a regular break from Nur-Isterate. I do suggest that you now discontinue this contraceptive and schedule an earlier appointment with your gynaecologist - your problems should be graded as being of priority on a doctor’s appointment list. The Nur-Isterate contraceptive will take 3-6 months to work out of your system with your given history. You are welcome to contact me to discuss further alternative solutions prior to finalizing your decision to having a mini hysterectomy. My contact clinic details to make an appointment are 021-6737210 on Monday, Tuesday and Wednesday; and 021-4875420 on a Tuesday and a Thursday. Considering you have not had children, there may be the possibility that you will change your mind at some time in the future. If you still decide to have a ‘mini’ (partial) hysterectomy, your hormonal cycle should rectify itself post surgery, after 3 months. You should not have a flabby tummy when correct post surgical care is rendered. Take care, Angela, Nursing Practitioner.

Sean (dr.) Gomes Medical Doctor View profile

You are correct in saying that the spotting can be related to your hormonal cycles adjusting to starting the pill again. This is the most likely cause. You are also correct in saying that it can be an early sign of cancer, but as you have just started the pill this is unlikely. Spotting can be a sign of cervical cancer. As any women concerned about her wellness, you should have regular cervical smears to detect any changes. Should your smears not be up to date, please visit you doctor or nurse for a pap smear. It could also be that your particular oral contraceptive is not suited to you. Feel free to visit our resident nurse at our WellClinic at either our Kloof or Cavendish stores to discuss this further. Alternatively visit your GP should your cycles not regulate over the next month or two. Regards Dr Sean Gomes MD

Sean (dr.) Gomes Medical Doctor View profile

There are a number of factors that can be the cause of your delayed period. Obviously the first one to rule out is pregnancy. If you have had unprotected sex and are not on any form of contraception, then there is a chance you could be pregnant. You may need to repeat the test or even have a blood pregnancy test to be sure. Other causes of a missed or delayed period are illness, stress, being overweight or underweight and poor diet. If this is the first time and you are in good health, then it is likely nothing to worry about. Should this reoccur, I would recommend you visit you GP for investigative tests. Regards Dr Gomes

Reena Sukdev Homeopath View profile

Sincere apologies for delayed reply. Using Agnus Castus is a good idea. You have to however allow yourself at least 6-12 months to establish regularity. Agnus Castus is available from Wellness Warehouse either as a tincture extract or as capsules. We do have a online shop from which you can order. This particular product has not been added to the shop as of yet, but you can email onlineshop@wellnesswarehouse.com and they can arrange a special delivery. Kind regards. Reena (Cavendish Store Homeopath)

Sean (dr.) Gomes Medical Doctor View profile

Clomid is used to stimulate ovulation and is one of the most common female fertility treatments. I presume from the medications that you took after your delayed period, that it is your intention to become pregnant. The heavier period could just be part of you irregular cycles or it could be as a result of you having ovulated. There is also the chance that you could have had a pregnancy and then had a very early miscarriage. I am not aware of the supplements you have taken causing heavier menstruation or being associated with miscarriage. For further advice please consult the specialist that is looking after you. Regards Dr Sean Gomes

Sean (dr.) Gomes Medical Doctor View profile

I would not think it is anything to be too concerned about. Often when you do not take a break between pills, you can have some light bleeding. This is not uncommon. There is also the chance that the bleeding may be due to some minor trauma during intercourse which could have resulted in a small tear and therefore the light bleeding. Things should settle by your next period. Take the normal break and should things continue then I recommend you see your doctor for a gynaecological examination to ensure everything is in order. Regards Dr Sean Gomes MD

Angela Lombard Nursing Practitioner View profile

First of all, menstruating for 2 – 3 weeks at a time, on a monthly basis, is not normal nor how your menses pattern should be. This does need to be assessed and investigated further by your general practitioner or gynaecologist. This needs to be attended to first, so that the possibility of an underlying medical condition is eliminated. Once your menstrual cycle is back in sync, you can then start planning your pregnancy. With you having been on the Nur Isterate contraceptive injection for five years, taking into account if you did not have a break from it in this time span, you may need to allow yourself between 1 – 2 years to fall pregnant. You are welcome to see me for an appointment at either the Kloof Clinic or the Cavendish Clinic for a consultation, and then be referred directly. Kind regards, Angela, Nursing Practitioner.

Sean (dr.) Gomes Medical Doctor View profile

I would continue taking the active pills as recommended by your doctor. The spotting is most likely due to your body adjusting to the new hormonal medication. This should settle as your body becomes accustomed to the pill. It could also be a result of you having missed one of your pills and hence you are having some breakthrough bleeding. This should not be of concern and you should continue taking the active pills. Regards Dr Sean Gomes MD

Sean (dr.) Gomes Medical Doctor View profile

From your description, it sounds like you may have developed mennorhagia (excessive bleeding during menstruation). This can develop as you get older and your hormone levels change. As per your gynae, it could also be a result of fibroids or polyps. This would need to be diagnosed with an ultrasound. Hormonal treatment with oral contraceptives may help regulate your cycle and reduce the heavy bleeding. Other options would include an intra uterine device such as the Mirena coil, which delivers localised hormones. As for the stingy discharge, this could be a result of an underlying infection. I would recommend that you visit your doctor for a gynaecological examination including some swabs which will help rule out any infections that may need treating. For complementary options, please view our healtnotes section at http://www.wellnesswarehouse.com/healthnotes.php?org=wellware&ContentID=1042002 There is a range of vitamins (such as Vitamin A), minerals (such as Iron) and herbs such as (agnus castus and cinnamon) that can assist your symptoms. Also feel free to visit our health professional or nursing sister at our Natural Medicine Dispensary for further advice. Regards Sean

Angela Lombard Nursing Practitioner View profile

The home pregnancy test kit must be used in the morning before 10h00. A sample of urine is taken. The Human Chorionic Gonadotrophin Hormone is what is tested for in the early morning urine specimen, as this hormone is predominantly present in urine in the morning. The raised level would indicate a pregnancy. Should this test be done later in the day, and if a pregnancy is still early, the result might not be reflected correctly. I advise you to have the B-HCG quantitative blood test for pregnancy done, as it is three months since you last menstruated. This would allow you to rule out a pregnancy. This test is done by our nursing sister at the Well Clinic at Cavendish Square (021 673 7210) in Claremont, or at the Kloof Well Clinic (021 487 5420) in Gardens, Cape Town. It is advisable to phone for an appointment, and can be done between the hours of 09h00 and 16h00. The sister can assess you as well to see if you are iron deficient by doing a Haemoglobin test (the finger prick method) to check your iron levels. There need not be an imbalance, but I do urge you to do the above two tests soon. Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Menstruation can occur more than once in a month and need not be for concern should you have a healthy and regular menstrual pattern. A second period in the space of a month could be triggered off as a result of stress, not eating correctly, taking certain medications which could cause a bleed, not having enough sleep - to mention a few causes. Please read similar questions previously answered on the website so as to gain further insight and information about your query. You do need to take care of yourself correctly and gently, and then your body will fall back into sync. Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Your hormonal system is still trying to settle down. With you having been on a contraceptive for at least 5 years (you do not mention which contraceptive), you do need to give your body a time goal of at least 1-2 years in order to recover from the effects of the contraceptive on the different systems of the body. This time span is a realistic goal so as to allow your body an opportunity to re-establish a hormonal cycle naturally. Having said this, you do have erratic, short and frequent bleeds. You should not allow yourself to carry on like this indefinitely, so I suggest the following: Make an appointment with one of our Well Clinics for a consultation and a wellness assessment, whereby you can be visually assessed and advised as to how you can pull your body back into sync and implement a regular hormonal cycle so that you can achieve your goal of having a baby. Have a routine pap smear at the same time so as to eliminate any medical conditions. If you google the website by Beth Kiley, this will greatly assist you overall in helping you to fall pregnant. Alternatively, you can contact your gynaecologist for an appointment for a full gynaecological check up, requesting a routine annual pap smear at the same time. Good luck! Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

I do not think that you have cause for concern about the regularity of your hormonal cycle with the information given by yourself. I do suggest though that you consider having a wellness assessment done at either of our WellClinics at Cavendish Square, or Kloof in the Gardens, Cape Town. From an optimal health care approach, and so as to look at you holistically, you can then be advised accordingly as to whether you have a healthy physiological profile, and that menstruating every 5 weeks plus, is in fact normal for you as an individual. This is a non invasive medical checkup of blood pressure, measuring height and weight and body mass index (BMI), glucose and total cholesterol screening. A Haemoglobin finger prick test could also be done to determine a possible iron deficiency. Should your body be out of sync this can be easily rectified. Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

I really do not think that there is anything for you to be unduly worried about here. Your menstruation is a minimum of 4 days early, according to your given cycle, at present. An early period like this for you may be as a result of any current stress in your life; or an increase in iron rich foods eg. spinach, broccoli, green beans, tomatoes, egg yolks, and of course red meat. Certain allopathic medications can cause a tendency to bleed more easily - but you have not mentioned anything like this here, only that you are not on a contraceptive. Overloading of an iron supplement can sometimes trigger off an early period. Trauma could be listed as another cause, but perhaps not in your instance. Be kind to yourself, nurture and take care of your body, eat sensibly and correctly, hydrate sufficiently, and have enough sleep. For further advice please do not hesitate to arrange to see at the WellClinic. Kind regards, Angela, Nursing Practitioner.

Sean (dr.) Gomes Medical Doctor View profile

Sterilization should not effect your hormones as the procedure blocks the Fallopian tubes and thereby the meeting of the egg and sperm. It has no effect on your ovaries and your normal menstrual cycle should continue to take place. I would recommend that you re-visit the doctor that performed the sterilization. Depending on when the surgery was performed you could still have some discomfort from the procedure. You should also be re-examined and potentially have a scan to look at your ovaries. It could be that you have developed some other pathology that is causing our symptoms. Regards Dr Sean Gomes MD

Chase (dr.) Webber Naturopath View profile

Menstrual irregularity can be assisted with natural medicine, particularly certain herbal formula that can stimulate particular hormones during your cycle. I would recommend that you consult a Naturopath in your area, have a full hormonal profile to see what is imbalanced and then start a program of natural medicine. I would encourage that your gynaecologist work with the naturopath together to assist you in the best way. The herbals Vitex Agnus Castus, Black Cohosh, Licorice and Dong Quai are most often used, but they work in different ways so it is best to test your hormone levels to see which is more appropriate to use to stimulate a regular cycle. best regards Dr Chase Webber ND

Chase (dr.) Webber Naturopath View profile

Menstrual problems and imbalanced hormonal levels can be assisted with natural medicine, particularly certain herbal formula that can stimulate particular hormones or encourage regularity. The particular type of imbalance is important though so I would recommend that you consult a Naturopath in your area, have a full hormonal profile to see what is imbalanced and then start a program of natural medicine. I would encourage that your gynaecologist work with the naturopath together to assist you in the best way. The herbals Vitex Agnus Castus and Dong Quai are most often used, but as mentioned they work in different ways so get the tests done first. best regards Dr Chase Webber ND


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.

Caution:

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.

Oops! Unfortunately there seems to be an error with your payment.

Please try again, otherwise contact us for help.


Error Message:

×

SnapScan is a cashless and cardless payment method that lets you pay securely with your smartphone. You can use the app on iPhone, Android and most BlackBerry phones.

If you don't have Snapscan installed, you can download it here

To use SnapScan, choose it from our list of payment options. Open the app and scan the QR code on your screen. Follow the instructions on your phone. Once payment has been made successfully, click the "I have made payment. Place order" button.

If you have any questions, don’t hesitate to contact us.

×
Item has been added to your cart.
Continue shopping
×
Item has been removed from your cart.
Continue shopping
×

Unfortunately we don't have enough stock. *
Continue to add to cart.

* Please note that we do not guarantee that items will be in stock. This is merely an indicative quantity

Should you wish to purchase more, please contact us at support@wellnesswarehouse.com
and we will do our best to organise more stock for you.

×

Unfortunately we are out of stock online.

Should you wish to purchase more, please contact us at support@wellnesswarehouse.com
and we will do our best to organise more stock for you.

×
×

or

Don't have an account? Click below to register.

×

Create new wishlist


×

Add to wishlist


Select wishlist

×

Send via Email


×

Are you sure you want to delete "{wishlist_name}" wishlist?

×