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The 10 Most Frequently Asked Questions by Patients:
Q: I missed taking one of my birth control pills. What can I do now
that I am spotting?
A: A missed birth control pill can lead to spotting. If you only missed
one, double up the next day and expect to spot. If you missed two pills,
you may double up for two days and expect to spot. If you missed more
than this, it would be wise to stop your pack of pills, use condoms, and
restart a new pack on the next Sunday. Use condoms for the entire next
month as backup to be sure that you don't get pregnant. When you stop or
miss pills, you may spot. It is best to take them the same time each
day.
Q: I am having hot flashes, very moody, and cry easily. Is this the
"change of life"?
A: Hot flashes, moodiness and crying easily can be symptomatic of
premenstrual, perimenopausal, or menopausal conditions. It is best to
make an appointment to determine what each individual's situation could
be.
Q: I am pregnant and my 3-year-old was just diagnosed with having
Fifth's Disease. Should I be concerned?
A: Fifth's disease is very common and anyone who has children or has a
job working with children is at high risk for exposure. Pregnant women
are especially at risk as Fifth's disease can cause problems for their
unborn child.
Pregnancy Information Site
Unless you isolate yourself from society and the job, it is almost
impossible to avoid it completely. We can draw blood titres to see if
you have been exposed. If you have, we will schedule an appointment for
you with Maternal Fetal Medicine to evaluate your fetus.
Q: My 14-year-old daughter has had her period for 2 years and has had
painful cramps and low back pain with it every month. Is there anything
that can be done for this?
A: A young teenager with menstrual cramps can have several options. She
can use over the counter ibuprofen with the onset of her menses or she
can consider oral contraceptive pills which will improve the discomfort
with her menses and give her birth control in the event she needs it.
This is a perfectly acceptable approach for a young female and can also
decrease her bleeding and help her with anemia.
Q: I have osteopenia. Should I be taking medication for this or is
calcium supplement enought?
A: Osteopenia is common as women age. The rate of bone loss is fastest
in the first menopausal year and then continues at a rate of about 1% a
year. The Vitamin D and Calcium levels should be measured and
supplements tried. Exercise is very important. If risk factors are
present and suggest that medication is indicated this will be discussed
with your doctor.
Q: I get migraine headaches right before my menses. Is there anything I
can take to help this?
A: Menstrual migraines are a difficult problem and very painful. There
are numerous options that can be tried: pain medicine, hormonal therapy,
massage or chiropractic treatments, dietary changes, etc. Talk to you
doctor about your symptoms and together you can come up with an approach
that both appeals and works well for you.
Q: I have polycystic ovarian disease and have been told I have insulin
resistance. What is this?
A: Women with Polycystic Ovaries do not ovulate regularly and often miss
periods. Some of these women are insulin resistant and thus at risk for
diabetes. This means that you may respond to diabetic medicines to lower
your risk for diabetes and sometimes regulate your menses. This is a
complicated evaluation that will be run by your doctor and the results
reviewed and a plan developed.
Q: I cannot use oral contraceptives. What other form of birth control is
available?
A: When oral contraceptives are not indicated, there are several options.
The Intrauterine Device is a great alternative if you have had a baby.
If you've never had a baby, this can be a rather painful method. An
implanon is a stick of hormone that is placed in the upper arm and lasts
three years but does not have estrogen and may be acceptable. This is
also true of Depot Provera shots that last three months and have no
estrogen. Condoms and spermicide are always an option. A diaphragm is
also available. Female condoms are also an option. If you can take
hormones but have trouble remembering to take your pills, the Nuva Ring
will give you monthly hormones in an intravaginal ring. The patch can be
changed once weekly. Come in to discuss these options with your
care-giver and decide what might work best for you.
Q: Are generic birth control pills and hormone replacement therapy okay
to use?
A: Generic birth control and hormone replacement therapy are available and costs less than brand names if
well tolerated.
Q: What are "natural hormones" and how do I know if they are okay for
me?
A: The discussion on natural hormones is rather complicated. In a
nutshell, natural or bioidentical hormones are those that resemble the
same ones your body produces. They are now available in brand and
generic name drugs. They can be compounded by a pharmacist, but they are
available and FDA approved in several forms. Some of our doctors are
certified by the North American Menopause Society and all of our doctors
are familiar with bioidentical hormones. Refer to The North American Menopause Society's site for a statement on this.
www.menopause.org
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