Marta Mendez, MD

Tubal Ligation has no direct  relation to hysterectomy. The doctor might use general or regional (epidural)  anesthesia. Ask your doctor about what type of anesthesia he/she will use.
            
            

, OBGYN.net Co-Chair Young Woman Editorial Advisory  Board
            

P.S. Remember that this  is for educational purposes only.

Try this: Take only the first  21 pills and on day 22, start a new pack.
            
            

You are probably talking about  IM microspores preparation. Side effects are related to the pattern of bleeding,  spotting, prolonged bleeding or no bleeding at all. Talk with your gynecologist  about ways to handle the side effects.
            
            

 Co-Chair Young Woman Editorial Advisory Board
            

P.S. Remember that this is for  educational purposes only.

It is highly unlikely.
            
            

A woman can only get pregnant  when she ovulates. Ovulation occurs fourteen days before menstruation (about the  middle of the menstrual cycle

 Co-Chair Young Woman Editorial Advisory  Board
            

P.S. Remember that  this is for educational purposes only.

It depends on the type of  pills you have. Some start at the first day and others at the 5th day of your  period. Read the instructions and also, talk to your doctor.
            
            

Nothing is wrong with you.  Usually it takes more than 3 days.
            
            

Light spotting or bleeding  (sometimes heavy) are some common side effects of Depo-Provera.
            
            

Thanks for your question.  There are many benefits of the birth control pill, which is what your moms' health care

  provider was referring to. For some girls it improves (decreases ) their  menstrual cramps. Sometimes it regulates periods, sometimes improves acne. By  suppressing ovulation, it decreases the monthly stimulation of the ovaries and  uterine lining. Taking a pill every day when there is no specific reason does  seem a bit foolish, but if you have extreme cases of any of these problems, the  pill might help you. There are other medications that help with cramps and acne,  but for some the birth control pill might be the lesser of side effects. Despite  what you might think, the birth control pill DOES NOT protect against HIV or  Hepatitis B, or some of the other vaginal infections. This is why condoms are  recommended, even if you are taking the birth control pill. Here are some web  sites that might help you learn more about the benefits (and risks too) of the  birth control pill:
            
            

http://www.obgyn.net/women/conditions/conditions.asp

, OBGYN.net Editorial Advisor
            

This is definitely a  theoretical problem. The theory is that the antibiotic kills off bacteria in the  intestine which help the hormones get absorbed. In practice, it probably doesn't  happen. If you want to be overly cautious, it wouldn't hurt to use condoms as  well during the rest of this cycle.
            
            

The Ask the Expert Forum is an archived feature and no longer visited by the doctors.

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Articles

Questions on Contraception answered by Marta Mendez, MD,

Ask The Expert Archives on Contraception


I am twenty years old. I'm a little confused. I read your past  questions that people write to you. I found one that I can relate to. I  have been having the weirdest periods and discharges lately and I'm not  sure why. Not only the length of time but the brownish color that it is,  just does not seem right to me. I have always had irregular periods. I  was put on birth control pills and the problem was solved. My problem  was that I was not having a period. Now I don't know if I am having a  period or if it's just a weird discharge. What is wrong with me? Now the  differences between the question that I related to my problem was that  the cause could be from using birth control for so long. But my problem  is that I haven't used birth control pills for about two years. If it's  not BCP, what could be causing this brownish discharge?

Some other causes of vaginal  discharge are: recent medication with broad spectrum antibiotics, and  vulvovaginitis ( e.g., bacterial vaginosis, trichomonas, candida  (yeast)). Appearance of the vaginal secretions can give a clue to  diagnosis ( e.g., curly, white, thick discharge is typical of candida,  and a white or yellow, bubbly discharge is typical of trichomonas).

P.S. Remember that this is for educational purposes only

I  am 21 years old and have been on birth control for about 9 months. I am  now on my fourth type of birth control since I have experienced  breakthrough bleeding on all types. My doctor now wants me to undergo an  ultrasound, blood work and some other tests to make sure I am not  suffering from a larger problem. I have been on birth control in the  past (the same type I am on now) without any problems. I also cycled  very regularly when not on birth control. Since I have yet to miss a  pill and am not on any other types of medications, what could be  triggering this? What sort of problems may be discovered by these tests  my doctor is suggesting? Any information you can supply will be greatly  appreciated.

 1. Breakthrough bleeding is one of the negative effects of hormonal contraception.
2. The safety of hormonal contraception for most healthy women is well established.
3. Ultrasound provides information of the pelvic structures.
4. Which are the "some other tests" you mentioned?


I  am 21 years old and for the last 10 months I have not had my period. It  has never been normal. What could be the cause of it being so long  since my last period?

There are many causes of secondary  amenorrhea (skipped menstrual periods). You really need a complete  physical exam (pelvic included) and some important tests. The events of  the menstrual cycle are the results of interactions between the central  nervous system (CNS), ovaries and uterus. Since your periods are always  abnormal, you must go to a gynecologist (thorough history and physical  exam is necessary).


I have never gotten my period regularly and I have had it since I was  13. I am now 19. I have never been to the OB/GYN either. I have am  afraid to go. Are there any diseases I should worry about at my age.  Please give me some advice.

Don't be afraid. It is time to go to a gynecologist.


I was diagnosed with PID in September of 1999. Before that I had  recently, about 3 months earlier stopped using Depo Provera. I have had  heavy discharge for about a week. Last month I never got my period, and  I've been thinking it's soon. I've had cramps, and even a little  spotting, but no real flow....... I'm very worried about this. I don't  think I'm pregnant. I've taken two tests. Should I continue to worry?

Irregular bleeding, headaches, breast tenderness and delayed return to fertility are some of the side affects of Depo-Provera.


I gave birth to a baby girl on October 31, 1998 by C-section after an  18 hour labor. After my delivery, I have been experiencing heavy  bleeding during my periods which extends up to 7-8 days and sometimes  even 10. I even get blood clots in the discharge. Earlier my periods  were only 3 days long and not very heavy. Last month, I found  pinkish/brownish discharge during the days when ovulation occurs. Then  just when my period was supposed to start, I had clots of blood in my  discharge. My period continued for 8 days. I thought it happened because  I have recently taken up exercising (walking & cycling), but I am  worried. Is this something serious or will it get normal after some  time? I do feel that the bleeding is getting lighter gradually.

It could be related to the exercises. Go to your gynecologist in two months.



, OBGYN.net Co-Chair Young Woman Editorial Advisory Board


Q: Do heavy periods and clots mean endometriosis?


I have a question about my cycle. It is sometimes a small flow, then a  big flow. But when I have a big flow, I have a lot of clotting. The  clots are sometimes big, and they come within 10 to 15 minutes at a  time. I was just wondering what might be causing this. I am 22 and I'm  worried something might be wrong, but right know I can't afford to go to  the doctor. Is there anything I can do when it happens to stop it from  happening? In my family there is a history of endometriosis... could  that be what it is? Thank you very much.

It might be a dysfunctional uterine bleeding (DUB). The two major categories of abnormal uterine bleeding are:
-organic (disease)
-Dysfunctional (no disease).
Go to your gynecologist.


I am a 19 year old who is having some period problems. Just recently  they have been very irregular. I have been having them about every 2  weeks and they usually last 4-5 days. But this time it has almost lasted  2 weeks! It seems like it is very heavy when my periods are always  light. Along with this period I got some really bad pains (worse than  cramps). This is also weird because I never get cramps. I have a doctor  appointment scheduled, but all this is causing me to sleep and feel  lazy. My step mom told me to get some iron pills. Do you have any idea  what is going on?

Menstruations are 28 days apart with  normal variations of 7 days. Duration of flow is 4 days with normal  variations of about 2-3 days. The amount of blood is 4o ml with normal  variations of 20 ml. But deviation from these norms can occur,  especially in adolescents and climacteric women.


Por el ultimo ano, no e podido menstruar. En Enero '99 deje de tomar  pastillas anticonceptivas porque mi menstruacin estaba durando 8-10  das, y tambin me venia muy fuerte. La razn principal que empec a  tomar las pastillas fue porque desde que empec a menstruar (al los 11  anos), nunca e podido menstruar regularmente. Ahora tengo un ano si  menstruar y me preocupa que afecte el futuro de poder tener hijos. Que  recomienda que haga? Mi ginecloga me sugiere que empiece de nuevo a  tomar pastillas, pero yo no quiero, tengo miedo que me afecten m  fertilita. Agradezco su ayuda.

¿Cuntos aos tienes ahora? Es  necesario una evaluacin clnica completa (antecedentes, exmen fsico y  plvico) y seguramente pruebas hormonales, de laboratorio e imgenes  para aclarar tu situacin. Tu problema parece caer dentro del terreno  endocrinolgico (hormonal). Debes conversar con tu doctora sobre estos  puntos. Tambin puedes conseguir una segunda opinin de otro coolega de  tu localidad.


I am 26 yrs old experiencing a rather unusual menstruation. I have  hypothyroidism and am taking medication for it. I have been bleeding now  since November 7th. At first it was normal which lasted about 7 days  and then all of a sudden it got really heavy with very large clotting.  Now it's a normal flow. I'm not experiencing any pain and I rarely ever  have menstrual cramping. I know I should go to the doctor but I am  rather embarrassed to go while menstruating. Do you have any idea what  this is? Is there a possibility that I am in need of a hysterectomy like  my mother and grandmother? Please help me with this dilemma.

Hypothyroidism is associated with  menstrual irregularities. I think that you should consult your  endocrinologist and your gynecologist.


I am a 33 year old female with four children. My husband had a  vasectomy two years ago. In January (this month) I spotted a lot (very  light, but I did). Now I am one week late starting my period. All week I  have had some cramping... not a lot, but now I am concerned. This week I  also have had hot flashes

...  mostly at night. Recently I have noticed that I have gained almost five  pounds in two days. I haven't really been on a diet but I am watching  what I eat and cutting back. I also started riding an exercise bike and  doing leg lifts about two weeks ago. My concern is that I still haven't  started. I usually am on time every month. My periods are very light and  only last four to five days. Please give me some advice on what this  might be. I haven't taken a pregnancy test because I have been too  scared. My husband never went back to doctor to have his count checked  after the surgery. That is why I really don't know. Thank you for taking  the time to read my e-mail.

Usual menstrual periods are 28 days  apart, with normal variations of about 7 days. "Vasectomy 2 years  ago"?...Pregnancy is unlikely, but not impossible.


What is the normal cycle length of a period? Do you count the days that it happening or not?

Menstrual periods are (usually) 28 days apart, including the days that it is happening.

Q: Trying to conceive, can I regulate my periods?


My husband and I have been trying to get pregnant

  for almost 2 years now. The problem is that I have very irregular  periods, about every 8 months. The doctors are unsure what is causing  this, and have not diagnosed me with anything in particular. I am 20 and  they have me on Clomid treatment. I was wondering if there is a name  for what I have or what could be causing it. Or if there was anything  that I could do to try to regulate my periods?

The name is anovulation (cessation  of ovulation) or ligoovulation (diminished ovulations). You should  clarify your problem with your gynecologist.


I have recently lost my period (5 months). I am 20 years old and I am obese. Will this effect my chances of getting pregnant

 later in life? What are the other problems I might encounter?

Obesity may alter your menstrual hormonal cycle and your overall health. Consult an endocrinologist.


I  am a 22 yr old, that has been on birth control for almost 2 yrs. I have  had no problems on the pill. The other day after I had intercourse with  my boyfriend, I noticed some reddish-brown discharge. This has been  going on for almost a week. The discharge is not a lot but enough for me  to notice that I am spotting. Also I have noticed a more distinct  smelling odor too. I see my Dr this week to have a yearly pap. I am  wondering if it is OK to have a pap done or what?

Have your pap done, it's OK. Talk to your gynecologist about the discharge.

Q: Can obesity cause irregular menstruation?


My 17 year old daughter is overweight (258lb) and she started her  menstural cycle at age 13. She has not had a consistent cycle since she  started. Recently, she has missed three consecutive months. We went to  the doctor today and he told us it is because of her weight and she may  stop ovulating completely. Needless to say we are stunned. The doctor's  only recommendation is weight loss. We will start on the Sugar Busters  diet as suggested by the doctor.

Our doctor is a family  practitioner. We are in search of any other suggestions, recommedations,  or insight on the subject from an expert in the OB/GYN profession.

Your doctor's recommendation is  correct. Being overweight has a detrimental effect upon the female  reproductive system. You should consult a gynecologist and a nutrition  specialist.

Q: Can I have a gynecological exam during my period?


I am going for my first visit to the gynecologist but due to the dates  available, I ended up with an appointment during the last couple of days  of my period. Can the doctor still due an exam if I am still  menstruating (or almost done menstruating)?

Yes, but it is better to wait a couple of days.


I am a 31-year-old mother of three who has only missed a period when I  was pregnant. My period usually lasts three to five days with moderate  bleeding. I first got my period when I was twelve or thirteen. I had an  emergency surgery for ectopic pregnancy after my second child and a  C-section with the third. The baby is now 11 months and I still have not  had a period. I have had normal pap smears. Two different doctors  prescribed Provera. Two internal sonograms showed nothing except a small  cyst on my right ovary. I have had pain for six months straight as if I  were getting my cycle, but there is still nothing. Hormone blood tests  say everything is normal. The doctor says there is another drug that can  be given.

What I want to know is what might be the problem?  What might be the cause? The doctor doesn't give me a reason. The doctor  explained that after a C-section when the uterus is "wiped clean" your  hormones can go "out of whack". I really wouldn't mind if my period ever  came back, but I know it's not normal. Please respond with some  information of what might be wrong. I know you can't give a definite  answer, I just want to know what might be the reason for this. The  emotional stress is about to send me to the crazy house. I feel as if  I'm in my own private nightmare because the months keep going by and  there are no answers. I don't know if it is some cancer or what!

Maybe your doctor is going to stimulate your uterus inner lining (endometrium) with an oestrogen and progestin (provera) cycle.

Some causes of amenorrhea are: "wiped clean uterus", intrauterine  adhesions, high prolactin level (do you still have a milky nipple  secretion?), psychogenic, stress, or thyroid dysfunction. It is not  cancer!


I am 15 years old and I started menstruating at the age of 14. I got my  period for about 8 months, with the first one being mere spotting and a  60 day interval between the first and second, and then a 40 day  interval between the second and third, and finally the next few periods  had only about 35 days in between. They yielded a more normal amount of  menstrual fluid. All of a sudden I stopped getting one, and I waited and  waited. In January, it will be one full year since I have had a period.  Yes, my mother has taken me to a gynecologist, and he put me on 10 days  of provera pills. We all were certain that would bring on my period,  but it didn't. So a month later he put me on 21 days of 1.25 mg tablets  of premarin and with the last 5 days of the premarin, I also took a  provera pill. I have been on premarin for over 2 weeks now and tomorrow I  will begin incorporating the provera with it, but I was certain I  already would have gotten my period. The doctor told me the reason I  stopped getting my period was because I lost about 25 pounds, but I lost  that weight in July. If that was the problem between July and now,  don't you think I would have gotten a period? It makes me scared and I  know at the age of 15 I should be getting a period, especially because  of the fact that I already have technically started menstruating since  I've had about 6 periods. If the premarin/provera combo doesn't end up  working, what should I do? Does this mean there is something wrong with  me? I am not sexually active and never have been, so it can't be an STD  that has settled in. Please give me a few recommendations.

There's nothing wrong with you.  Menstrual cycles following menarche are irregular for a period of 1 to 3  years and after that they became regular. Sometimes there are other  factors such as stress and heavy exercise.


I have experienced very light discharge between my period for a week  now. It is like I am still on my period but not heavy at all. It has  been about a week since my period. There is also sometimes a gooey,  whitish moisture on my vagina. This happened a few days after having  intercourse, but I have had intercourse before and this didn't happen.  This is the first time this has happened to me. I am 18. In another week  and a half I should start my period again. Can you tell me if I should  start worrying about this or wait and see if it goes away after my next  period? Could it possibly be from not having intercourse during the week  then having it on the weekends? I have not seen an OB/GYN before and I  was wondering if you could give me some possibilities before I do?

It may not be related to intercourse. Vaginal discharge  is a common gynecologic "problem" : Leukorrhea (normal mucoid discharge  due to normal estrogen effect), Trichomonas (malodorous, yellow or  yellow-white), Candida (thick, white, cheesy, pruritic)... Consult your  gynecologist.

  I am 19, and have never been to a gynecologist. Recently, my period has  diminished to almost nothing and lasts for about two weeks. But after  that, a brownish discharge lasts for about 2 weeks. What is this and how  serious is it?

 		Menstrual problems are common among adolescents. Most are minor problems such a variations of the length of the menstrual cycle

, duration and amount of menses. As you put it , it does not sound serious but you should discuss this with your doctor (gyn).

 Is it possible to lose a tampon inside your uterus and how does this happen?

 		I have never heard of a tampon inside the UTERUS. Physically it is not possible.

Tengo 22 aos. Tengo una gran  preocupacion, ya que quiero saber ¿Qu tanto riesgo hay en tener  relciones en periodo de menstruacin? El mircoles tuve relaciones sin  proteccin y fu el primer da de mi menstruacin. Normalmente tengo  mucho flujo y dura aprox. 1 semana. Hoy, a tres das, mi flujo ya es muy  escaso y como cuando faltan dos das para que termine el periodo.  Tambin estoy pasando por una depresin. ¿Esto tambin podra ser un  factor de interrupcin en mi periodo? o ¿Qu podra estar pasando  conmigo? Realmente le agradecera que me contestara lo antes posible a  mi e-mail y ojal y pudiera ser una contestacin directa y no por web.  Le agradezco mucho su atencin y espero oir pronto de usted.

 		El querer tener un hijo y no poder, y el poder y no querer... provocan  depresion. En ambos casos se puede presentar ausencia de la  menstruacin sin embarazo alguno. El riesgo de embarazo por relaciones  durante una menstruacin normal es practicamente cero.

,  OBGYN.net Co-Chair Young Woman Editorial Advisory Board


  I would like to know your opinion on the following: a 13 year old girl  suffers from having a period all the time! We have tried every  medication applicable in this field, but no avail. Further investigation  showed that she has a polycystic uterus (intervention laparoscopic  search took place, normal blood tests; only the estradiol is elevated  (0.72)-she appears to be a normal girl: 162 cm, 65 kg. At this moment  she has no medication because of all the hormones she took already. (she  does not use other medications) Please have some answers, for we are  growing desperate. PS: her mother had an hysterectomy because of a  polycystic uterus at the age of 37.

 		Polycystic uterus? Menorrhagia (heavy menstrual bleeding

)  and anovulation (OVULATION = release of the egg cell from the ovary.  ANOVULATION = absence of ovulation) in teenagers, usually is caused by  "Polycystic Ovary Syndrome (PCOS)". This is a diagnosis of exclusion.  Bleeding may be prolonged and uncontrolled. The prognosis (subsequent  normal fertility) is good. You should discuss this with her doctor  (gyn-endocrinologist).

Questions on Contraception answered by Marta Mendez, MD

Ask The Expert Archives on Menstruation

 You are right. It isn't a good idea to have  intercourse the night before your annual exam.



, OBGYN.net Co-Chair Young Woman  Editorial Advisory Board


P.S.  Remember that this is for educational purposes only.

 You should wait 3 months. Your doctor is right.



, OBGYN.net Co-Chair Young Woman Editorial Advisory  Board


Ask for explanation of the exam  every step of the way. Ask about the tests you will be getting.



 "Lletz", "Leep" or "Loop Excision": The use of a  wire loop with electrical energy flowing through it to remove abnormal cervical  tissue and is commonly done under local anesthesia.



 A regular gynecologist is okay, but it would be  better if it is one that specializes in the care of young women.



 According to the American College of Obstetrician  and Gynecologist Guidelines for Women's Healthcare, a teenager's first visit to  an OB/GYN should take place between the ages of 13 and 15.



 According to the American College of Obstetrician  and Gynecologist Guidelines for Women's Healthcare, a teenager's first visit to  an Ob/gyn should take place between the ages of 13 and 15 and at any age if the  patient has any symptoms. The exam takes only a few minutes. It includes a  breast examination and evaluation of genitalia. It can be uncomfortable but not  painful.



Do not be scared. What you should  do is find a Gyn you feel comfortable with and before the exam ask him/her for a  description of the gyn exam.



Confidentiality is related to  ethics, your doctor should be like a priest.



There will not be drastic changes.  Yes you need not only a gyn but also a general exam.



It is generally recommended at  least 3 days.



"Abnormal Pap" is not enough  information to answer your question, please be more specific.



The procedures at the doctor's  office are:
Interview, general exam, breast exam, pelvic exam  and pap smear ( do not be scared, it is uncomfortable but not painful). If you  don't want your mom to know,  she shouldn't be present. Sexual activity is an important matter to be discussed  with your gyn. Those cramps need to be evaluated with your gyn.



To answer you with 100% accuracy I  would need to do a pelvic exam of you. It is too bad you had this bad luck. Try  to find someone with more empathy.



 Thanks for your question. A pap smear is a  screening tool, helping to differentiate normal, healthy cervical cells from  progressive changes that might lead to cancer of the cervix. It is one of the  most inexpensive and valuable screening tools we have.

There is a progression of cervical changes, form 'atypical' to  'low grade lesions' to 'high grade lesions' to cervical cancer. There are also  infections that can cause abnormal cells to show up, and sometimes there aren't  the right type of cells. One of the most common infections is human papilloma  virus, which can cause significant cervical changes. Your provider will explain  this in more detail, as you don't know specifically what was found. It the cells  found are significant, your provider will offer a 

 examination, a technique which uses a high power  binocular to look at your cervix, and the taking of a biopsy if necessary. This  is indicated when the cells have shown significant changes. It might be that you  just showed signs of an infection, and your provider wants to discuss that with  you and treat that. So, until you go in, you won't know for sure. Don't worry  about it, as the pap smear picks things up very early, and the management is  very easy. Here are several links you might find useful:



 

The pain you are experiencing with your periods is called  Dysmenorrhea, and can be alleviated with comfort measures and some specific  medications such as Motrin and Ibuprofen. These cramps are related to high  levels of the hormone prostaglandin, and these medications help decrease these  levels. These are usually prescription items from your provider, and the painful  cramps are totally unrelated to the abnormal pap smear. Sometimes birth control  pills can help these painful periods also. Here's an article you might find  helpful: 

 You should check with your surgeon right away. If  the blood is coming from your bladder there is a problem. If it is coming from  the vagina, that would be OK as long as it isn't heavier than a period.



 If the hysterectomy was done for benign disease  (Non malignant or Non premalignant, then Pap smears are not necessary. (Some say  one should be done once every 5 years looking for vaginal cancer which is quite  rare.) Even so, all insist that you should still have a checkup with pelvic exam  to look for things like ovarian cancer and high blood pressure, etc. If the  hysterectomy was done for dysplasia or carcinoma-in-situ, then annual Pap smears  are a MUST.



 The doctor would not necessarily be able to tell  during a routine  exam.



 You are right... you should go when you turn 18,  at which time you should have a checkup, even if you are not sexually active.



 Sometimes we describe a Pap test (to patients) as  "abnormal"... Abnormal doesn't mean cancerous. Yes... you must tell the new  doctor what the old one said.



 Don't worry. Just go to a gynecologist ASAP (don't  be nervous or afraid!).



 Pap tests can show the occurrence of some  bacteria, trichomonas, monilias, herpes simplex and human papilloma virus.



 You should go before getting married. Regarding  your second question, this is something you should discuss with your  gynecologist. It also depends on the exact date of your wedding.



 It could be because of the test, but you should  consult a gynecologist to make sure.



 It could be a Bartholin duct (Glandular duct  located within the vulvo-vaginal tissue) cyst. Talk to your gynecologist  again.



 The exam is a bit uncomfortable, but not painful.  They will do a breast, pelvic and gynecological exam. As for people sitting in  for moral support, that's up to the doctor.



Questions on Puberty, Gyn Exam Procedures and Pap Smears answered by Marta Mendez, MD

Ask The Expert Archives on Puberty, Gyn Exam Procedures and Pap Smears

P.S. Remember that this is for educational purposes  only.

 Overgrowth and irregularities of the  labia minora are variants of normal anatomy. It can be surgically corrected if  it bothers you. Talk to your gynecologist.



 You should not be spotting. Make an  appointment for pelvic exam ASAP.



Both you and your boyfriend should go  see a doctor ASAP.



P.S. Remember that this is for educational  purposes only.

 A cyst is a saclike growth on the  body in which liquid is contained. There are many types of cysts: ovarian,  bartholin, and breast, to name a few.



 Ask your gynecologist about  Depo-Provera.



 It sounds like a Bartholin's cyst. Go  see your gynecologist for treatment.



 A laparoscopy could help. Get a  personal second opinion.



 Tissue-like matter could be  "endometrium" (inner uterine lining). Go see your gynecologist.



 The mini-pill oral contraceptives are  the best, low-dose oral contraceptives for breastfeeding women. Some side  effects are: irregular bleeding, spotting or missed periods. At this moment  perhaps you should get another pill. Talk with your gynecologist about your  options.



, OBGYN.net Co-Chair Young Woman Editorial  Advisory Board


 What you have is called  "galacthoerrea". It is not anything serious. See your doctor and ask him about  prolactine (hormone test), X-ray and CT scan.



 Some exercises should help to get  your muscles toned up.



 PMS is usually monthly and/or  whenever you get your period. You are lucky to only get symptoms on certain  cycles!



 HPV is a non-curable condition. A pap  smear is an excellent screening test for cervical abnormalities, including  cancer. All you need is to have a pap smear 3 times/year (the first year after a  positive result for mild dysplasia) and twice/year afterwards.



 It doesn't seem to be related to cancer. Irregular  bleeding, spotting or no bleeding at all are side effects of Depo-Provera.



 The effects of having a hysterectomy depend mostly  on age, previous condition and type of hysterectomy. Many women who have had an  hysterectomy (simple) enjoy a normal, active sex life.



 It's perfectly normal to have one breast slightly  larger than the other. And, as far as your second question, depending on the  type of hymen, you do not necessarily bleed when you have sexual intercourse. By  the way, now is the time you should start gynecological care!



 I agree with your doctor, it could be just  tension. But remember that you can get a second opinion (and a second gyn  exam).



 It's probably due to an infection (trichomonas  (TV) or bacterial vaginosis (BV)). See your gynecologist ASAP.



 Vaginal disorders could be due to trichomonas  vaginalis (TV) or bacterial vaginosis (BV). You should also consult an Internist  to rule out other causes.



 It could be due to stress. It could also be a  bacterial infection. You should try to get medical attention.



 Itching and burning are some of the symptoms of  vulvovaginitis (infection). See your gynecologist to determine the cause.



It could be a vulvovaginitis  (trichomonas, or bacterial vaginosis) that will only be resolved with specific  treatment. Regular vaginal douching is never a good idea.



,   OBGYN.net Co-Chair Young Woman Editorial Advisory Board


 There are a variety of benign medical conditions  that can enlarge the uterus (e.g., fibroids, polyps, endometriosis,  adenomyosis). Consult your gynecologist.



,  OBGYN.net Co-Chair Young Woman Editorial Advisory  Board


 El cuadro se denomina "Galactorrea" (secrecin de  leche sin estar embarazada o lactando). En general se debe a causas BENIGNAS.  Precisamente el estmulo de los senos puede producir galactorrea y se considera  normal. Tu mdico solicitar radiografas y exmenes de lab. (ej. "Prolactina"  en sangre) para descartar otros procesos. No olvides consultarlo. Saludos.



 Normal discharge (ovulation) is usually clear  white and does not cause any irritation. On the other hand, abnormal discharge (  e.g., candida, trichomonas, bacterial vaginosis, chlamydia) can cause itching  and/or burning, abnormal odor and other discomfort.



 Tension-free vaginal tape (TVT) is a safe and  effective method for the treatment of genuine stress urinary incontinence  (GSUI). A polypropylene band is applied underneath the urethra (for  bladder/urethral suspension) under local anesthesia. Surgical time is about 30  minutes.




Is a pelvic infection the same as Pelvic Inflammatory Disease?  Prior to being diagnosed with a pelvic infection, I was diagnosed with  cervicitis which is linked to Chlamydia (which my partner had).

 Pelvic infection and Pelvic  Inflammatory Disease (PID) are the same. PID can represent any infectious  process involving the upper female genital tract (uterus, tubes, ovaries).  Chlamydia is a common cause of PID.


I  had a TAH/BSO for severe endometriosis. How long is normal to stay off HRT to  shrink any remaining implants that remain? I also have pain on one part of my  vagina. My gynecologist thinks it is phantom nerve pain and wants to do a nerve  block. I also get cauterized every time I see him as I have lots of skin  granules. Can you explain why I am having these problems? Is it normal to have  skin granules?

 After a hysterectomy, granulation  tissue may form at the vaginal vault. This tissue may cause vaginal discharge,  irritation and bleeding, and may need to be cauterized. Ask your gynecologist  about Hormone Replacement Therapy (HRT).

Marta Mendez, MD

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