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Discuss with Dr. Shirin your personal medical problems
or any other issue that would help you understand your body better.
This is your forum.
Q :My wife is 24 years old. We are having 3 kids their ages 8years,7years
and 1 and half year old. My wife has a big belly, she is not fat,she
dosent have stretch marks on her stomach. She thinks it might be because
of the copper-T. We are married since 12years. She is too much worried
about her stomach, its like a balloon with little air. Its not hard. Will
it go if she does regular excersices?. Please help her as she is worried
too much.
A :Many women develop a laxity of the abdominal muscles
after delivery and that leads to a protruding belly. Tell her to try
abdominal exercises for atleast 6mths regularly with a diet. To be on the
safe side it is better to go to General Practitioner and let him examine her
tummy for any lump or any other abnormality.
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Q :I am 18 and have a symmetry problem with my breats. The left one is
obviously larger than the right one. The difference shows ever since
puberty, I thought they may balance out as I get older, but they have
not. I am, very concerned about it, and would like them to be equal in
size, maybe its a hormonal imbalance? If you could please suggest
medications, maybe even surgery perhaps?
A :
I can understand your concern but I would like to
assure you that many women have unequal breasts the question is how unequal?
if you are so concerned please see a Plastic surgeon as only he can rectify the
problem, also you could try some estrogen cream on the under developed breast.
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Q :Thank you for this resource, I am terribly concerned. I have just arrived in
the UAE from America less than a week ago. I will be here for at least twelve months.
I am alone here and I have difficulty with the language. Thank you for this
opportunity to discuss a delicate matter with you.
I have regular periods. I am currently a week late. I practice a natural
birth control method with my partner and I would be terribly surprised if I were to
be pregnant. I am hoping that the delay in period may be contributed to travel,
stress, etc. For the last three afternoons, I have suffered from a nasuea,
highly unusual for me. I take Paxil, the antidepressent, and my dosage was
just upped from 20 mg to 30 mg. I am wondering if that might be a factor as
well.
Can you please advise me on any available alternatives to terminate a
pregnancy? Is the practice legal in the UAE? Is it a surgical procedure or is another
method available, like RU486, a pill that is used in Europe but unavailable
in the U.S.?
I will pursue the pregnancy test at my earliest convenience. Even if
the results are negative, I would like to visit your office regarding the
delayed period.
A :
Yes the period could be delayed due to all the factors you have mentioned, and yes abortion
is illegal in the UAE whether by tablet ( none of these drugs are available
here) or curettage therefore no sensible doctor would do one.
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Q :I am 24 yrs old. I have been taking the pill called "nordette" for about 17months now,its has helped a lot with my period pains,but theres one problem I was also taking it for the few pimples and blemishes that I have on my face,it doesnt seem to be helping my skin,i have spent a lot of money to treat it with no success. Is the nordette going to eventually help me with my skin after 17months? And do you have any home made remedies/herbal(ayuvedic) treatment for blemishes,which I can make from home to get rid of them.
A :It is quite alright for you to continue the pill for your
period problem, rarely the pill may increase acne. As regards to the skin it is the
most important thing the use of make up will block pores and makes
pimples more .You could use a face pack of tomatoes crushed in yogurt
that is the only home remedy I know hope it works. Take a lot of fruits in
your diet and avoid oily foods such as cheese and chocolates. since I am not
an expert on skin problems I would like you to consult a dermatologist.
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Q :Me and my wife are expecting our first child in feb 2000 and already thinking about contraception I refer to your described methods of contraception in godubai.com
Natural Methods :Abstinence during the fertile period. The fertile period of a woman
depends on being able to accurately predict the day the egg is formed so
that avoiding intercourse 48hrs prior and 48hrs later could ensure that fertilization does not take place. The method relies on a woman being
trained to determine changes in her own cervical mucus secretion. The secretion is increased clear and slippery just prior to egg release. The WHO has tried to develop a dipstick to determine the change in urinary hormones during the fertile period. Use effectiveness is 25 hundred-woman years (HWY).
Can you please describe in more detail how to recognise the fertile period in a woman. Does it happen inbetween 2 periods or during the period?
A :If the cycle is a regular one of 28 days the
fertile period is in between ie. day 14 of the cycle the days are counted from
the first day of the period-ie. the day the blood starts. There are also kits
available in the market which will pinpoint the day of the ovulation in any
cycle. However as I have said the best method for a woman who has delivered
one child would be to use the loop or IUCD so that she does not have to
remember anything. Proper check up is all that is required.
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Q :I am a 40 year old female, married for over 8 years but
have not been able to concieve.I have been to a gynec and she confirmed
that nothing is wrong with both of us. My husbands sperm count is
excellent and I did the tube test and all was confirmed to be well. I
have also taken fertility pills but nothing seems to work ... PLS PLS
help! My periods are regular i.e. 26 day cycle also when is the best
dates to have sex (we are not very regular any more due to
frustration).
A : Yes it can be very frustrating when one does not
concieve. Especially if nothing is wrong with both partners. This is called
unexplained infertility and now that you are 40yrs old,I dont think you should
waste anymore time in ordinary methods. My advice would be to go to centre
for infertility where IVF ET are done for example the Fertility Unit at
Rashid Hospital. In answer to your second question the best time for conception is
midcycle or you could buy a kit available in the pharmacy which pinpoints the
day of ovulation and try to have sex then.
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Q : I am completely breastfeeding my 5-month-old baby and
I am yet to have my monthly period.
My husband and I are using only the
natural method since we are practicing Catholics and artificial methods
of birth control are still unacceptable.
Please advise me as to when it is safe to have sex with my husband?
A :
When you have not started your period, it is impossible to
specify the safe period and the only natural method I can suggest is
WITHDRAWAL ie; everytime you sleep with your husband he has to withdraw
prior to ejaculation he has to ejaculate outside the vagina so that
no fluid enters the womb. This must be practised everytime you sleep together.
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Q :I have ovarian cysts measuring 3.3cm and 4.8 cm since five years
and with endromisis. I entered menopause 2 years ago.
What is the solution for it? I am also an insulin dependent diabetic.
A :First of all I must tell you that cysts of the ovary at
this age are not to be taken lightly. You must have a check up,a scan and a
blood test which can confirm whether these are of the adverse kind. Endometriosis
usually resolves after menopause .Please visit a well qualified gyneacologist.
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Q :
I have had a loop for 2 years, without any problems at all.
This summer,I removed the loop, had a pause for 2 months, and have recently been inserted
with a new loop by my doctor. I was fine for the first two weeks.
Then I started bleeding like I had never before experienced in my life.
The bleeding is continuous and accompanied with pain all over my abdomen.
I have consulted my doctor, who made an internal scan-check, which
showed that the loop was located in the right position.
I am now on medication (Zinnat, Fergyl and Ponstan) since 3 days but
neither the bleeding nor the pain has stopped.
Is it possible that there is another cause for the bleeding?
I opted for the loop because I can't take the pill. Do you think
the 3-month injection is a good solution?
A :One of the main causes for pain after inserting the
loop is misplacement and the second is infection. Since your doctor seems to have
ensured that the loop is in place and is treating you for possible infection
there really is nothing else one can do except remove this loop and reinsert
it in another cycle. Please however be sure of the diagnosis.
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Q :I am 35 years old,with two children.
I had not been using any contraceptive untill 2 months ago (pills).
Is it safe to use it and for how long will I
have to use it? Will there be any reaction?
And if I discontinue for 2-3 months, then how should I start again?
A :There is no harm in taking the "pill" even at this age
as long as the contraindications have been ruled out and you go for your annual
checkups to the gynaecologist. However for you the ideal contraceptive would be
the loop. Regarding your second question if you did discontinue it for 2-3 months, you
just have to start again from day 5 of the period but keep in mind that the
first cycle is not totally safe and some other precaution such as the condom
or withdrawal should be used for the first month along with the pill.
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Q :I am married and a mother of a 1 year old daughter.
During menses, I have severe pain since my first
period at the age of 14.I am very frustrated.
I can't go anywhere during my periods. The pain lasts for about 2-3hours. Please tell me what to do?
A: Did you have a normal delivery or ceasarian? It seems to me
that you must have had a Ceasarian because once the cervix has been
dilated you should not have pain, unless there is something wrong with you.
In which case, please have a check up. You might need an ultrasound and later a
dilatation and curettage.
Q: My husband has
a problem of premature ejaculation.
He does not last more than a minute;
more often before he enters me he
ejaculates, leaving me totally unsatisfied. I have to resort to masturbation
to have any satisfaction. Althought I have not told him directly, he
also understands that he has got a problem. He used to beleive
that all men come so fast, and never thought much about it. Very recently
we happened to see the couple staying in the flat opposite ours, making love and we
were both surprised to see the man going on for more than 15 minutes. I am
very frustrated and don't know what to do, I really envied my neighbour, who
could enjoy sex for so long. I love my husband very much and want him to
get over the problem. Will the new drug viagara help? Can you
recommend any good doctor for him in Dubai?
Another thing my husband insists on anal sex, I don't enjoy it. We tried
it once and it was very painful. Is it normal? Do most couples indulge in it?
A: Premature ejaculation is treatable so do not panic
you need to see a urologist / psychiatrist (I can recommend some doctors).
Anal sex is not normal as it can lead to infections of several
kinds. Remember that AIDS first began in homosexuals.
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Q :I wanted to ask u a question for 1 of my friends,
she wants to change to the opposite sex but in her karotype she is xx
although she has some problems
can doctors do the sex change operations on her?
if it is possible , where shall she go to do that?
just tell me if it is possible to do the operation or not.
A :
It is possible to change the sex of an individual. However it is
very important to know that it is very easy to convert from male to female
but the reverse is very difficult. Also first of all a Psychiatrists opinion
will be required before any surgery can be undertaken any where usually a
gynecologist and a urologist need to operate and it is done over 2 phases
first of all the female internal organs will need to be removed then the patient
is given hormones to develop male distribution of hair etc. Then the other
surgery such as closure of vagina and penile implant is undertaken. If the
patient can be dissuaded from undergoing all this torture and some
counselling done it would be far better in the long run. However the best help
would be available with the Psychiatrist only.
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Q : My daughter has cerebal palsey she is 4 years old she has periods one year ago she
started to have breast and pubic hair growth. Can she be going through
menstrual cycle without bleeding and have the cramps of p.m.s. My daughter
crys for three days a month the rest of the month she is the happiest kid you
would want to see. Her crying is about the same time each month. Thank you in advance for your
help.
A :If she has started puberty at this age, it is indeed very precocious. We could put it off with
some injections and also I would like to examine the child to see if there
is any gynec defect also. So if you could bring her along I will be happy to
be of help.
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Q :I am a married woman aged 42 with 4 childern. The problem is that I
weigh 80kgs
and my height is 5'7".
Some time when I have a bad throat & I cough suddenly i urinate a
little,cause of the hard cough, or when ever I excercise or try to do
skipping same thing happens.
So because of this I only walk regularly but my weight remains the same,
some times its 81 kgs.
Please do help & tell me when do i suddenly urinate? Am i over weight?
A :I can well understand your problem it is necessary
that you do some specific exercises for the perineal muscles first to help
improve the stress incontinence also you should have a GyneC check up for
excluding any prolapse. Incase it is possible for you to come over I would be
happy to see you and advise. Sometimes only surgery will help this problem.
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Q :I have just delivered a baby girl 5 months ago, i.e. on 22/05/99. I am
breast-feeding her at the moment. My concern is that I have still not
got my periods after delivery. I conducted two home pregnancy tests on
my first (early morning) urine and both times the results were
negative. But as I said earlier I am concerned on the delay of my
periods. Could I be pregnant even though the results show negative ?
Are the periods getting delayed because I am breast-feeding ?
A :The answer is simple. YES breast feeding does alter
the cycle. But it is no guarantee that you will not become pregant while
feeding the baby. What you need is some hormone to bring on the period and
then a definitive method of contraception such as loop.
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Q :I am writing this e mail on behalf of my wife. She has recently conceived.
she is in her 4th month now. She has noticed that just after having fore
play and intercourse ( whenever she is sexually excited ) she gets a
brownish discharge from her vagina. she is 5'7" and weighs 50 kgs she is
under weight and 32 years old. Kindly advice if this is normal and any medical prescription is adviced.
A : It is not normal to have brown discharge and if it is
related to sexual intercourse it may be due to some slight injury to the
mouth of the womb ie. cervix or the vagina.It is wise to get a check up and
you are welcome to the clinic if you live here.
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Q :I am 31 yrs old. I got married last Aug. 99, My husband and I want to have a baby right away. I came to know that I got pregnant last Nov. 15, 1999, after 2 days I started to have a spotting, I consulted a doctor and she said its normal. I undergo, blood test to check my hormones and it was fine. I was pregnant for 6 weeks but the spotting continues until it became like a menstural period, unfortunately I lost the baby. I was totally depressed and scared at the same time. I went to the doctor and they advised me not to make a D&C because the whole conception was gone (after checking thru ultra sound) they have given me medicine only .
Now, we are planning to try again, Dr.please advise me, what shall I do in preparation. What vitamins I must take? (I am taking folic acids now, is it safe?) I am eating healthy food like vegetable, fish and drink a lot of milk. I am afraid maybe I will not make it again, please advise me. Some said maybe because my uterus is very low and I am really stressed out with my work. Please,tell me what shall I do to make my pregnancy a successful one this time.
A :Please do not be anxious. 1 miscarriage is quite common I am
sure you will have a normal pregnancy next time. Carry on with the folic acid and
report early when you miss your period you could come to me if you are nearby. Also
in case you have a family history of Diabetes get your blood sugar checked.
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Q :I'm married for the past 1 yr & 5 mths. I got my periods last on
6th of August & so far have still not menstruated . I got my pregnancy test
done but negative so far . Before marriage too I had a delay in periods
but definitely not this long . Maybe just delay of about 1 - 2 weeks .
I'm really worried . I hope u can help me out in this . I was having
this homeopathy medicine "gynovit ". It did help for sometime that is 3
months before Sept. I had my periods regularly from 4th -6th of these
Months . I am 21 yrs of age.
A : Some women naturally do not menstruate regularly. However ,it is important that you menstruate atleast once every 40
days. Now what I suggest is that if you are overweight please bring down your
weight. Then depending on whether you are planning a baby or not the treatment
is totally different so I would advice you to come over if possible for
further management or go to your gynecologist.
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Q :I have a doubt.What is this lowering of placenta
(near to the mouth of womb) Any thing because
of our fault. I daily go up to 4th floor through
staircase , this may cause any problem? kindly give
necessary advise what all things i must do and not to.
A : It is no fault of yours that the placenta is low lying with regard to what
you may or may not do everyday. I would refer you back to the doctor who
diagnosed your case in the first place
it is really quite impossible to suggest a daily timetable for you.
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Q :I have just been through a c section,it has been exactly a month. I was
unable to breast feed and was wondering if it was okay to take diet pills
which I had taken earlier and lost weight. Don't get me wrong and think I am
the type to do it the easier way as I am already on a protien diet but just
need a little help. Will these diet pills harm my stitches from inside or
cause any complications as such?
A :Diet pills will not harm your stitches and since you are not
breast feeding it is OK. But give yourself atleast 6 months to get back to
shape exercise after another 2 wks.
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Q :I am 39 yrs. I am getting my periods in 3 weeks. Is it because of
menopause or should I consult a gynaecologist?
A : It is a little early for menopause, the most likely
cause is some hormonal imbalance it is wise to go to a Gynecologist for a
check up in the meanwhile take iron tablets and drink plenty of milk or
take calcium too.
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Q :We have been married now for 2 whole years and have been TTC for over an
year now. My ultrasound has revealed a cyst on my left ovary which was
diagnosed by an ayurvedic doctor as harmless and untreatable. My periods
used to be regular, every 32 days but nowadays sometimes goes to 36 and
sometimes 40. Otherwise I have no female problems and more or less note
all the cycle signs such as fertile and infertile CM , and symptoms of
oncoming AF. What are the chances of my being "normal"?.
A : Your chances of being Normal are very good. But this is
not the way we investigate infertility. It is important that your husband's
semen count be done first and then we could investigate you regarding ovulation
and the patency of the tubes etc. It has to be done systematically so either
come over or go to a good gynecologist. Most important DONT WORRY.
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DISCLAIMER :
Dr. Shirin will not be responsible for any consequences of her
advice in cases where she has not conducted a physical examination of
the person. We would advise you to physically
consult your doctor before beginnning a course of treatment.
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Dr. Shirin Venkatramani, MD (Bom), FRCOG (Lon),
Consultant Obstetrician and Gynaecologist, based in Dubai,
is an authority on women's medical problems and is well-known for her work
in the areas of High Risk Pregnancy, Menstrual disorders
and ovarian cancer.
