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Obstetrics, Gynecology & Reproductive Sciences Archive Questions

Below are Dr. Omicioli’s answers to Obstetrics, Gynecology & Reproductive Sciences questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Now displaying records 16 to 25 of 25.

Q : 16 01/13/2011	I am post menopausal and have had a vaginal odor for several years. What could be causing this? The pH in the vagina changes after menopause and becomes more alkaline. This can result in a change in the normal bacteria that live in the vagina. Some women find that a vaginal gel such as RepHresh helps to keep the pH in better balance and decreases their symptoms.
Q : 17 01/12/2011	I am in perimenopause and experience non-stop irregular skips in my heart. Do you think bioidenticals estradiol or progesterone could help? Some women experience palpitations as part of perimenopause/menopause. Hormone therapy may help some women with intermittent palpitations. There are a variety of hormones that are bioequivalent/bioidentical that are available. Many women erroneously think that they are not associated with any health risks. Transdermal estrogen and micronized progesterone may have lower risks of blood clots and stroke and are often recommended. Unfortunately, in perimenopausal women, the doses of hormones aren't high enough to suppress the body's production of hormones, so the fluctuating levels of hormones often persist. A good resource for an experienced menopause practitioner in your area can be found by going to the website www.menopause.org and looking for a NAMS (North American Menopause Society) certified menopause practitioner.
Q : 18 10/13/2010	Can hormone replacement therapy make you bleed after sex? Hormone therapy is not associated with bleeding after intercourse. Bleeding after sex should be evaluated by a gynecologist to determine whether the bleeding is coming from the vagina, cervix or uterus.
Q : 19 08/13/2010	I am 49 years old and have had my period for 6 months, non-stop. What should I do? Prolonged vaginal bleeding lasting more than 10 days needs to be evaluated by a gynecologist. Treatment for abnormal bleeding will depend upon the cause of the bleeding.
Q : 20 07/07/2010	I have been dealing with bacterial vaginosis (BV) for 4 or 5 years. I was first treated with a seven-day treatment of Flagyl it went away, but returned awhile later. The second time the nurse prescribed metro gel vaginally and it never went away. I have had no relief with Flagyl or home remedies and i always have this thick creamy discharge. Even during ovulation I don't get the clear egg white discharge, which I would get every once in awhile while having BV. Are there any other treatments? Some women are prone to recurrent bacterial vaginosis. Changing medication to Tindamax orally for seven days may be helpful. Suppressive therapy using Metrogel vaginal twice weekly for six months has also been shown to be beneficial. Finally not all creamy white discharge is BV. If there is any uncertainty as to the cause of the discharge, a BV culture can be performed. This is different from the over the counter test. Women who douche are much more prone to vaginal infections, especially BV. There is never a reason to douche.
Q : 21 06/04/2010	I have had a yeast infection for three months. Every time I go to my doctor she treats me with two doses of Diflucan and sometimes a cream. It helps for a few days but comes right back. She says it's a recurring yeast infection. She also said that I might have to go see a dietitian. I'm a little over weight, but have no symptoms of diabetes. Are there any other options to clear the infection? Recurrent yeast infections can be very troublesome. Women who suffer from recurrent yeast should have a blood test to exclude diabetes and an HIV test, since both of these can cause persistent/recurrent yeast. A culture to identify the species of yeast is also important. Most yeast infections are caused by Candida Albicans; however, sometimes a different strain of yeast, Candida Glabrata, can be the culprit. Candida Glabrata frequently does not respond to oral fluconazole or the vaginal creams and may respond to boric acid suppositories.
Q : 22 05/26/2010	Is there any other way to get trichomonas besides an unfaithful partner? The medical evidence to date all supports trichomonas as being a sexually transmitted infection. Women can become infected from both male and female sexual partners. The protozoan organism that causes the infection does not live or survive on inanimate objects such as towels or toilet seats. Pap smears are not reliable in diagnosing an infection. A gyn exam with either a microscopic evaluation of vaginal secretions showing motile trichomonas or a positive culture are the best ways to confirm the diagnosis.
Q : 23 04/12/2010	Can you get pregnant after menopause? Menopause is diagnosed ONLY after 12 consecutive months without a period and normally occurs between age 45-55. In naturally occurring menopause, a women can no longer get pregnant (unless someone else donates the egg). If she is in perimenopause, with irregular periods, she may still be able to get pregnant. Women who become menopausal due to treatment for cancer, such as chemotherapy, may resume getting their periods, depending on the type of medication. Women who don't want to get pregnant, should continue using contraception until 12 months without a period has passed.
Q : 24 03/10/2010	I am 40 now but I had a hysterectomy at 33. One ovary was left and the cervix removed. I don't take HRT anymore but I do take a low dose of DHEA which helps me. It's hard for me to get sexually aroused and I have no feelings either but I can arouse myself when I'm alone. Can you help me? It's embarrassing for me and also frustrating because I was quite young when this began. Women frequently notice a decrease in desire after menopause (either natural or surgical menopause). Hormone therapy has been shown to improve sexual function in women with menopause. It is often easier to get aroused when a woman self-stimulates, because she knows exactly where to touch and how much pressure to use. Communicating to their sexual partner about what is pleasurable and not being embarassed is very important. An experienced menopause practitioner can provide guidance and help determine if the causes of sexual problems are hormonal, problems with a patient's personal relationship with their partner, or a combination of these factors.
Q : 25 12/28/2009	I am 51 years old and have had irregular periods for 4 or 5 years. They range from heavy and long to spotty for only a day or two. For the last two months I have had trouble sleeping because of a pounding heartbeat? Is there anything I can do for this? Palpitations or pounding heartbeat can be related to fluctuating hormone levels in perimenopause. However, they can also be caused by other conditions such as an overactive thyroid gland. You should see your primary care provider as a first step. If other causes for the palpitations have been excluded, then some women benefit from taking very low dose birth control pills for a year or two during the menopause transition, which helps to even out hormone levels.

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