Doctor's Advice: Roller-coaster menses causing concern

Q I am a 19-year-old student. I've been having problems with menstruation, and I'm very worried about it.

In February 2008, I started taking the three-monthly birth-control injections. I stopped taking the injections early this year. It was a couple of months before I had a period, and it was very long and very heavy.

So, I visited the doctor, and he gave me a three-month supply of the oral contraceptive. My periods came normally during that time.

But my last two menses were on August 31 and October 16. So it is now many weeks since I last menstruated.

I need your advice, Doc. I changed my environment over two months ago. Could it have anything to do with that?

Some say it might be hormone problems. What should I do?

A I'm sorry to hear that you have been fretting. However, I am optimistic that everything is going to be OK.

The first thing I must say is that when a sexually active young woman is overdue with her menses, she should usually do a pregnancy test. If you have had sex at all since your last menstruation on October 16, please do that test.

However, let us assume, for a moment, that you are not pregnant. What has been going on here? Well, it is important to realise that the contraceptive jab ('the shot') upsets the menstrual rhythm in a lot of women.

Although the injection is a good and safe method, it does interfere with the periods of around 40 per cent of those who take it. Very frequently, the periods 'disappear' for a while.

But it was quite early this year when you stopped taking the injection, and the effects of it really should have worn off by now.

At some point this year, you visited a doc and he put you on the Pill. That was a smart move, and it regulated your periods. You might need to go back on it again.

But the situation now is that you have not menstruated since mid-October. As I have not examined you, I cannot tell you why. But the main possibilities are:

You could be pregnant;

You could be anaemic;

You could be suffering from a hormonal problem, as your friends have suggested;

Your periods could have been affected by your recent 'change of environment'.

My advice to you is simple: Do that pregnancy test. Then go back and see that doc who advised you earlier this year. He should examine you and probably do some lab tests to find out precisely what is going on in your body. I wish you well.

Q I am a 20-year-old man, and I have been seeing some big bumps on my penis area, where the hairs are.

What is this?

A There shouldn't really be any hairs on the penis itself. So I suspect that what you mean is that the bumps are in your pubic hair, around the base of the penis.

In that area, by far the commonest cause of 'bumps' is a slight infection around the roots of the hairs. That is no big deal, and it is not a form of venereal disease.

I suggest that you talk to a pharmacist about the problem, and buy some gentle antiseptic, as advised by him/her. Apply this to the hair roots three times a day for a week.

But if that has not solved the problem in seven days, you must ask a doc to take a look at you.

Q I am a young woman, and I hope you can help me. I've met a guy who I think is really great, and would make a wonderful husband some day. There is one problem, however. He has really bad breath.

I know he suffers from sinusitis, and I am told that this could be the cause of it. Is that true? And is there anything that can be done to help it?

I would also like to know what the other likely causes of bad breath are, and how they can be remedied.

Finally, how should I approach him when making these suggestions without hurting his feelings? This is a very sensitive subject, and it has put a strain on our relationship,

A I'm sure it has. Bad breath (halitosis) can cause severe relationship problems. I have known quite a few women who terminated their marriages, engagements or other relationships because they could not stand a guy's bad breath.

I have also encountered a number of male patients who ditched their partners for the same reason.

I urge you to get this problem cleared up before you even think of marriage! Imagine how it would be if, in 20 years, you were dreading being kissed or having sex because you knew that you would have to endure the offensive odour of this man's breath!

Next, you ask about sinusitis. That is an inflammation of the sinuses, which are the little air cavities in the bones of the face. Sinusitis can cause smelly breath, but I would not say that this is all that common.

So what are the frequently encountered causes of halitosis? Probably the most common is poor dental hygiene. Again and again, I have been consulted about bad breath among men and women who have turned out to have a rotting tooth - often with bits of food stuck in the crevices.

Other possible causes of halitosis include:

Smoking

Alcohol

Aromatic foods such as garlic and onions

Bacteria growing on the tongue

Gum disease

Infection in the tonsils

Problems in the nose, such as polyps

Belching

Uncommon medical diseases, such as liver failure.

I'm sure you can see that this is quite a complex subject. And as you say, you have to approach it with sensitivity.

My best advice is that you should find some way to persuade your man to have a check-up from a dental surgeon. Dentists are the big experts in dealing with halitosis.

You could even ring the dentist's office beforehand and discreetly ask about the causes of halitosis.

Q My girlfriend has vaginal thrush. Could I get it?

A You could, and you probably have. In guys, thrush often produces no symptoms. But frequently it causes soreness and itching round the tip of the penis.

As a precaution, I would strongly advise you to apply an antifungal cream to your organ three times for the day. Do this for one week.

Q I am a 17-year-old girl, and I am being treated for cystitis, following the loss of my virginity last week.

Is this a venereal disease?

A No. Cystitis is a very common female infection, caused from bowel germs getting into the bladder.

Unfortunately, petting and other forms of sexual activity do increase the chances of those germs entering the female urinary apparatus.

Please continue with your course of treatment. When it is finished, you should take a specimen of urine to the doc for her to check that you are cured.

Email questions for Doc to saturdaylife@gleanerjm.com. Also, read Doctor's Advice in Outlook magazine in The Sunday Gleaner.