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Health Desk

Ask your doctor

Dr.Smita Lulla  MBBS, M.D, .D.G.O. (Gold Medallist),
Consultant Obstetrician & gynecologist at Qurum Clinic, Muscat since 20 years. Have had advanced training in U.K. in Obstetric & Gynecological Ultrasonography & Infertility.
Click here to ask your questions

Latest questions and answers

PCO (Polycystic ovaries)

Question


Dear doctor, i need your help.. please! me and husband was trying to have a baby for almost 1yr already.. i have an iregular period and was diagnosed with PCOS. my 1st ob-gyne recommend me to take clomid for only a month but nothing happens. so i try to consult other ob-gyne, so she recommend me to not to take clomid instead take metformin 3x a day, follic acid everyday and duphaston 1x a day on my 16-25 cycle. i take those medicines for 7 months but no baby yet. so i tried not to take duphaston this november, because i think i already have a regular period because of those medicines but unfortunately im already delayed, im expecting my period last dec 1 so i took a pregnancy test on dec 3 but the result was negative... so i take 5 duphaston like wat my doctor said for 2 1/2 days, 2x a day on dec 10.. so i usually have my period 2-3days after taking duphaston.. but unfortunately until now i dont get my period.. but im experiencing headache, cramps, and back pain...is it possible that im pregnant? pls help

Answer: PCO is associated with irregular periods and infrequent ovulation. If you still have not got a period, do a pregnancy test. If you have got a period, do a scan on day 12 of the period to determine whether you are ovulating or not. If you are not, you must take clomid in the next cycle and again do a scan on day 12. You can continue the metformin. Also, have you checked your TSH ( thyroid ) hormone? If not, checkit . Let me know the results of the scan , the thyroid hormone and your husband's semen report and I can advice you further. Don't worry, with the right treatment, you should be pregnant soon !


Question


Hello Dr, I had an miscarriage in my 11th week of pregnancy in 2007. Dr said it might be due to infection or stress. Since then i was given fertilization tablets to get pregnancy. I also have PCOD problem for about 7 to 8 years. I have been given the following medicines for 3 months cycle to get pregnant. Siphene from day2-day6. Ovacare from day1 - day15. Naturogest from day 15 - day 27. I got my periods exactly after 30 days during my first month course of these medicines. We are also planning parallel. After my second month of this medicine course today is my 35th day. I still didn't get my period also i tested for pregnancy.the result is negative. Do I have to wait for some more days to test. Also i did HSG in India before taking all these medicines. Dr has a doubt that my fallopian tube position is upward. Will I get pregnant again. I am really depressed of planning for the past 2 years. Please suggest

Answer: Sorry to hear about your miscarriage. Since you have conceived before, you should conceive again. Which city are you in ? If you are in Oman and wish to see me, you can take an appointment on 24563181. I think you should monitor your ovulation on ultrasound. if you are taking siphene. This will determine your most fertile period and also ensure that your ovaries are not getting unduly enlarged. I did not understand what you meant by "We are also planning parallel. ".Do send me the written report of your HSG also.


Question


Hi I am 28 years old and I have PCOD (Polycistic Ovarian Disorder). I have been taking OCPs (Novelon) for last two years. Recently, there was some milky discharge from my breasts. I showed it to a gynec and she asked for Prolactin test. My level came out to be 15 but that is normal..right? But the Gynec has prescribed Cabglin 0.5 mg weekly. I am a little concerned as the Prolactin level is normal only. My periods before taking OCPs were quite irregular up to the extent of once in four months sometime. Shall I take Cabgolin or not. I am planning for pregnancy and will be stopping pills after this cycle. What are the side effects of Cabgolin?

Answer: Since your prolactin is normal, you may not require cabgolin. However, the value often varies, so it would be advisable to take it for 2 weeks .. There are usually no side effects with cabegolin.Once you stop the pills, have a scan done on day 12 of the period to determine whether you are ovulating or not. If you do not, you can use clomid in the subsequent cycle.


B) INFERTILITY

Question


Hello, Its 8 months for our marriage me & my wife is trying for a baby. We have not consulted any doctors. She is having her periods regularly. Please let me know should we consult doctor or wait for some more time as we are trying desperately fo a child. Please advice.

Answer: You should have your semen examination done. Your wife should start taking folic acid tablets, to prevent certain abnormalities in the baby. Have her ultrasound done on day 11 of the period to determine whether she is ovulating or not. Let me know the results, so I can advice you further.


Question


Hello Doctor,I got married on nov 2008 and i am 23 now.I have the problem of irregular periods,so i consulted a doctor to regularize.I was given rogestrone first.after taking this i got my period.then from the third day i was given fertomid tablet.the next month i got period correctly(28 days).Again i was given fertomid, and from 14th day (14.12.2009) duphaston was given. will this help me to conceive.i am very much worried help me please.

Answer: Fertomid will help you form eggs and help you conceive. However, you should do a scan on day 12 of the period to determine whether you are ovulating or not. Duphaston should be given after you have ovulated. Also, have your husband's semen examined and your fallopian tubes by doing an HSG ( hysterosalpingography ) or Laparoscopy. All the best !


Question


I have had one son that is 8 and i had a miscarage then a d&c one week after the miscaraige now it has been 4 months and i can not get pregant i checked my levels and lf 4.5 and fsh 5.1, when is it good to try to get prenant? it took me almost 2 years to get pregant but then i lost the baby.

Answer: Sorry to hear about your miscarriage. You have not mentioned how many weeks pregnant you were when you miscarried and whether any reason was found for it. Anyway, have an ultrasound done on day 12 of the period to determine whether you are ovulating or not. If you are not, you would require clomid tablets during the next cycle. Also , have your husband's semen examination done.


Question


Hi Doctor. I have been having unprotected sex with my husband for 4 years now, and have not been able to get pregnant. Went for blood tests, pap smears etc and all seemed to be fine, exept for the fact that I am not Ovulating. My doctor put me on Clomihexal now. Is it possible that I will be able to fall pregnant during the 1st month? How long does this usually take?? I had a history of exxesive bleeding with bloodcloths, no visible systs on my ovaries tough. Please advise! thanx!!

Answer: Clomihexal should help you ovulate and conceive. If you did not conceive this month, take it again the next cycle and have an ultrasound done on day 12 to determine whether you are ovulating or not. If you do not, the dose of clomihexal can be increased in the next cycle. Discuss that with your doctor. All the best !


Question


Hi, Before 2 years i am married. After 1 year i contact my doctor because i am not conceived. My husband's semen count is normal. and my folicules's size are normal. So my doctor suggest me for IUI and after five IUI no result is their. my period is regular, my doctor priscribe me to take 'clome 50 for 5 days and Lynoral for 7 days' plz tell me the usage of these tablats. Is these tablats helpful for pragnancy?

Answer: Sorry to hear that things have not worked out yet! I understand from this that you did IUI without using clomid previously.Clome 50 ( clomid ) would help you form one or more eggs. The chances of success in IUI increase when more eggs are present. How many eggs were you forming when you did the IUI ? Also, let me know your husband's semen report in detail and your HSG ( hysterosalpingography ) or Laparoscopy report , so I can assess the condition of your tubes. Lynoral is also fine.


Question


I am done with lapro-hysteroscopy before 2 months. Did ovulate last month, had IUI, but no success :(. This month after IUI, my doctor has adviced me take ecosprin(ASA 75mg). Can you please tell, why I need it?

Answer: Some studies have shown that ecosprin may help prevent a miscarriage. All the best !


Question


Hello Doctor I am hypothyroid, my TSH is below 5. My ednocro. doctor told me that for pregnancy to occur TSH should be below 3, is it true.Because as per my gynec below 5 is ok. I had laparoscopy, no problem was found. My husbands counts are fine. Then what could be other factors for not conciveing. My age is 33.

Answer: Please check the normal range of the thyroid hormone in your lab . This varies depending on the kit used. Depending on that you would know whether below 3 or 5 is ok. Have you done an ultrasound to determine whether you are ovulating ?Have one done on day 12 of the period and let me know the result, so I can advice you further. Also, have your tubes been checked ?


C) PREGNANCY

Question


I had a miscarriage two years back and found it difficult to conceive until now. Now i am pregnant(four weeks). My doctor has precribed duphaston, jusprin and gupisone for a month. Are they safe?

Answer: All the drugs given are safe . Did you do any other investigations to determine the cause of the miscarriage ? In case you are in Oman , and wish to see me , you can take an appointment on 24563181. I could then advcie you further after seeing you.


Question


HI, I am 27 year old, I had 2 miscarriage within 2 months of pregnancy. Now I am pregnant with 5 months completed (22 week pregnant). From the day one of my pregnancy to till now I am using ECOSPRIN 75 tablets. I want to know is really required for me to take this tablet now also?. And how long I should be taking this tablets? Is there any side effect for this tablet?. Is this tablet affects by baby? please let me know. Thanks in advance –Shruti

Answer: Ecosprin is safe in pregnancy and taken once a day , does not have any side effects. Your doctor would be able to advice you regarding till when you require it, depending on the growth of the fetus and other factors. All the best !


Question


I am 22 weeks pregnant.Yesterday I had TIFFA scanning. Doctor told me about following abnormalities: 1.Right diastolic notch notes. 2.Low placenta 3.Prominent kidney 4.B.P is more She said when scannning at 32 weeks is done, all the identified disorders may not be present. Also she prescribed Loprin 75mg. I have seen some negaive feedback on loprin, leading to miscarriage. Is Loprin usafe? Thank you verymuch for your answer. Kind Reagrds

Answer: I presume Loprin is low dose aspirin. If so, it is safe in pregnancy in the dose prescribed to you.


D) OTHERS

Question


Hi doctor, Iam 24yrs old and have undergone a Laproscopy to remove chocolate cysts in my two ovaries(4.8cms and 3.4cms).In the biopsy it was found I have Endometriosis. I was asked to use NOVELON pills for 6months after the surgery since I dont want to get pregnant now. I have searched many sites whether to use oral pills after laproscopy or not since I heard they would reduce my chances of becoming pregnant later.Please reply since its very important to me and Iam recently married.

Answer: Chocolate cysts is the term used for endometriosis. Novelon is fine. It should reduce any residual endometriosis which maybe present and act as a contraceptive, too. Short term use of pills do not reduce your chances of conception.


Question


Hello doctor...i am 23yr old..i get too wet while intersourse it becomes very difficult for my partner to feel it because of less friction..i went to a doc she suggested me af kit and clingen vaginal tablet. white discharge keeps coming out...is their any way to make the wetness less ..and are these tablets for std ..thank you.

Answer: You need to see a gynec who can determine whether your wetness is due to an infection or whether it is your normal vaginal secretion. Please let me know the contents of clingen ,as it is not available in Oman, so I am not sure whether it is an antifungal or not .


Question


I started my period Dec 3rd and it lasted 4 days like normal. Seven days later on the 13th I started bleeding again and now it's the 4th day and I'm still bleeding. Usually my periods only last 4 days. Is it possible to have 2 in one month like this?

Answer: Do a urine test for pregnancy as sometimes you could be pregnant and the bleeding you had was due to a threatened abortion or ectopic pregnancy. If you have got another period by now, have a scan done to rule out the presence of an ovarian cyst or a fibroid which can cause the irregular bleeding.If the scan is normal andthe problem recurs, have your thyroid hormones checked. Let me know all the results, so I can advice you further.


Question


Hi, i have been on the pill for about two years now and about 12 days ago i had food posioning which caused me to vomit and have dirrea for two day- i carried on taking my pill as normal.when i started taking the inactive pills, i didnt really had a period - its was more like brown discharge.i thoughht i could be pregenant because the pill might have not been absorbed properly because i was sick, so i took a pregnancy test today (5 days into what is suppose to be my time of the month) but it came out negitive - i was wondering could the pregnancy test be inaccurate as its only been 10 days since my husband and i slept together?

Answer: If you have not yet got a period, repeat the pregnancy test. It would be positive 15 days after conception, so it would not have been positive when you had done it earlier. Diarrhoea can cause inadequate absorption of the pill and therefore inadequate blood levels. This may , therefore , not prevent ovulation. You must use an alternative method of contraception during that cycle.


Question


I am 38 years old. I have two childs one is 18 years another is 14 years. I observe paint in left lower abdomen 1 and ˝ months back. Dr. advice me to do Ultrasonography and result is as follows :- 1) Bulky Uterus : Endometrim thk. 8.1 mm. Uterus measures 109.9 x 66.7 mm. 2) Follicle in Left Ovary: Left Ovary Measures 32.4 x 27.1 mm 3) Right Ovary : normal Measures 31.0 x 20.4 mm I felt tremendous pain with vomiting 3 weeks before and was hospitalizes. After two weeks treatment the pain has disappear. Doctor discharged me from the Hospital and advice not to go for operation. This will automatically clear with taking medicine. I am taking medicines as per their advice. Now I am feeling week, acidity, and some sometime feeling so light pain, my lower abdomen is slight weight. My menstruation period is normal Please advice me will I be recover from this.

Answer: Sorry to hear about your problem. Do a scan on day 5 or 6 of the next period. The sizes that you have mentioned - are they of the ovary or the cyst ? Anyway, send me the report of the next scan - including both the ovary sizes, cyst sizes ( if present ) and the thickness of the endometrium. I can then advice you further. Hope your pain is better. Ensure that you are not constipated , as that may aggravate your pain.


Question


I am 23 years old. I have been having a white clumpy vaginal discharge that is very watery. Very mild itching and no odor. I have taken diflucan and nothing changed. Now the discharge is very light pink and clumpy, do you know what this could be.

Answer: It seems that you maybe having afungal infection. Use canesten vaginal pessaries for 6 nights. If the problem still persists, have a vaginal culture and sensitivity test done to determine whether you also have a bacterial infection. This would also determine which antibiotic you may require for the bacterial infection, if any.


Question


Hi doc i ask question i missed my period this month but negative result and im taking duphaston last month can i be pregnant?

Answer: You should get a period within 5-10 days of stopping the duphaston. If you have still not got a period, do a urine test for pregnancy.


Question


What mean mesturation?

Answer: Menstruation is "getting your period ". It is the flow of blood that women get every month .


Question


Hello doctor, i am 31 years old ...Doctor treatment After this month i take duphaston tablets. After taking tablets my vaginal very pain i have very tired then abdominal pain what i am doing? i read lot of details in duphaston through net. i want to know about the reason this tablets take person heavey bleeding but i have normal bleeding then some month only irregular period some month regular period. what problem in my body. i like child but how way i am pregnanat?

Answer: Duphaston usually does not give heavy bleeding. Have a scan done on day 5 of the period to determine whether you have fibroid or a cyst in the ovary. If normal, then repeat the scan on day 12 of the period to determine whether your "eggs" are forming well or not. Also have your husband's semen checked. Let me know all these reports, so I can advice you further.


Question


Married for 8yrs,trying for a baby,detected multiple polyps in the utrus and on 23rd undergone hystolaproscopic to remove the polyp.. my tube, overies and utrus are all normal.My Dr gave decapeptyl depot 172mg,on 30thnov.on 13th of dec i got bleeding same as periods, is it normal. pl. advice

Answer: Decapeptyl should reduce the size of any fibroids or polyps that you may have. Usually, there should not be any bleeding after the injection, but , sometimes, it can occur. Do you have to repeat the injection after four weeks ? What are the sizes of any remaining fibroids or polyps ? Let me know, so I can advice you further.


Question


I have a smelly discharge but its white can you tell me what does that mean I know its not a std because me n my boyfriend was cured for that can you help me please?

Answer: It is difficult to tell you which infection it is without seeing you. Use betadine vaginal pessaries for 7 nights. Check with your pharmacist that you are not allergic to any of its contents. If your discharge still persists, have a vaginal culture and sensitivity done. This would determine the type of organism you have and the appropriate antibiotic for that.


Question


Hello there i have been sterilised for 5yrs and i have missed 2 periods. done 4 preg tests and all came out negative. i feel bloated , feel sick in the mornings , eating like theres no tomorrow and need toilet every 1-2hrs. i had them cut and tied. please could you shine some light please. i am 26yrs old kind regards gill

Answer: Have a beta hcg blood test done. This would rule out pregnancy . If that is negative , have an ultrasound of the pelvis and upper abdomen done. Also, check your blood for H pylori infection and thyroid hormones. . Let me know the results , so I can advice you further. In the meantime ensure that you are not constipated. Also, take disflatyl tablets to reduce the bloating.


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