How long is a normal pregnancy?

Hello,

My daughter was born 'exactly' 42 wks from when her mother was last with me sexually. Is this likely to be? If not it's not, then its not my daughter. I believe its only 38 wks/266 dys from becoming pregnant to delivery?

Regards,
Ciaran

Dear Ciaran,

The average pregnancy lasts 38 weeks from conception, but it is not uncommon for a particular pregnancy to last 40 weeks from conception. In addition, you have to consider the fact that conception takes place when the egg is released, not when you have sex. Sperm can live inside a woman's body for 5 days or more after intercourse and be available to fertilize an egg when it is released.

There is an easy way to settle the issue. Ask for a paternity test. That will give you a definite answer.

Sincerely,
Amy

Supplements in pregnancy

If you search the internet for information re: flaxseed (ground meal) and pregnancy, you get very confusing results. Some sites (medical ones) say the Omega-3 oils and fatty acids are a great supplement to a pregnancy diet and that it can also help with constipation among other things. Yet, one of your responses said NOT to take flax seed when pregnant, and I've read sites (medical ones) that say flax seed taken during pregnancy can increase the chance of miscarriage. How can a mother to be know what to believe? My own OB-GYN said ground flax meal was fine. So if not your own doctor, than who??

Mary

Dear Mary,

There is no reason to take supplements of any kind during pregnancy once you are taking prenatal vitamins. There is absolutely no evidence to suggest that any supplements improve pregnancy outcome. Furthermore, supplements are an unregulated industry and you cannot be sure that what it says on the label is what is actually in the bottle.

Supplements often contain many times the recommended daily dose of vitamins and minerals and no studies are done on their safety in pregnancy. We know from tragic experience that excess vitamin A leads to severe birth defects. There is always a possibility that excesses of other vitamins and minerals can lead to birth defects.

Finally, to the extent that any substance works, it is only because of the chemicals that are in it. Chemicals made by living things are no better than those made in a lab. Natural substances can be very toxic; tobacco, cocaine and heroin are just the best known examples.

Of course, your most important source of information should be your own doctor. However, to the extent that there is any controversy about a substance, I would avoid it during pregnancy. There is no scientifically established benefit, and there could be substantial risk.

Sincerely,
Amy

Second trimester miscarriage

I had a miscarriage at 8wks in Sept.04 (determined to be a blighted ovum) at age 31 and was pregnant again in Feb.05 with an early scare of a subchorionic hemorrhage, which resolved after 3wks. I had no problems or complaints until 19.5wks.

The very same day we'd heard a healthy heartbeat (after I'd complained to the doctor of slight cramping and staining), my water broke that evening and I went into labor. At the hospital, there was no heartbeat and we delivered a deceased baby boy. Tissue and blood samples from me and the baby were taken and various tests performed. There was nothing found to explain why my water broke and I miscarried.

The "best guess" from my OB-GYN is that I had some kind of bacterial infection (with no symptoms) that caused my membranes to rupture. Two suggestions if/when we should become pregnant again is to 1) be tested for bacterial infections and treated right away if necessary, and 2) be seen by a genetic counselor early in the pregnancy. Can you tell me what this kind of testing might reveal, if anything?

The thought is that these 2 miscarriages are not related, but to miscarry as late as 19.5 weeks when things seemed to be going so well, is obviously disconcerting. I have read about Factor 5 and Antiphospolipid Syndrome, but tests have not indicated that either applies to me. Just hoping to hear another medical opinion and to try and do whatever I can with a subsequent pregnancy.

Mary

Dear Mary,

I am very sorry to hear about the loss of your son.

The first miscarriage was probably the common kind of miscarriage which occurs in 1 in 5 pregnancies. This is almost always due to a one time non-repeating genetic defect in the embryo.

A second trimester miscarriage is unusual and should prompt an investigation for possible causes. One cause that has not been considered is incompetent cervix. An incompetent cervix is a cervix that does not stay closed as the uterus enlarges. When the cervix opens, the membranes bulge through and may rupture. Once the membranes rupture, there is no way to save the pregnancy.

You can be monitored for incompetent cervix in a future pregnancy by having routine ultrasounds and exams to be sure that the cervix remains closed. The treatment for incompetent cervix is cerclage, a surgical procedure in which is large suture (a ribbon, really) is placed around the cervix to hold it closed. At the end of pregnancy, the stitch is removed (in the office) and you can have a vaginal delivery.

Factor V and antiphospholipid antibodies are rare causes of recurrent first trimester miscarriages, and are unlikely to be involved in your case, but you can be tested for them anyway, if you'd like.

You may wish to consult a perinatologist (a specialist in high risk pregnancy) for additional suggestions based on your complete medical history.

Sincerely,
Amy

Sperm life

How long does sperm live outside the body? Is it possible to get pregnant if the man ejaculates outside the body?

MO

Dear MO,

It all depends on how the sperm is treated. If the sperm is preserved carefully it can live for hours to be examined in the lab, or it can be frozen to be used for artificial insemination. However, if the sperm is allowed to dry out, it will die within minutes.

Sincerely,
Amy

Cornual ectopic

Dear Dr Amy,

I had an ectopic pregnancy in the horn, not in the tube and was treated with methotroxate for one week until my hcg level dropped to 25.

I have had two periods since that were normal but two days ago I bled for a couple of hours and then it stopped. My period is not due until this week. I am having mild cramping but no bleeding. Is there something wrong?

T

Dear T,

An ectopic pregnancy in the horn of the uterus (the area where the uterus connects to the fallopian tube) is called a cornual ectopic. It is very difficult to operate on that area of the uterus, so it is fortunate that you could be treated with methotrexate.

It is very important to be sure that your HCG level returned to non-pregnant levels. You should call your doctor about the bleeding. He or she may want to check your HCG level.

Sincerely,
Amy

Bleeding after intercourse

While making love to my boyfriend last week I started to bleed very heavily. The blood was very thin and bright red with what I can only explain as "stringy bits". It took a good 2 hours before the bleeding stopped and i am still spotting now. My friend said it sounds like a miscarrage however I have had an iud coil fitted for 2yrs. Could this be the case?

Thank you,
Kathryn

Dear Kathryn,

I'm not sure what caused the bleeding. You should make an appointment with your doctor to get this checked out.

Sincerely,
Amy

X-rays in early pregnancy

Hi Doctor,

3.5 weeks ago, I was involved in a car accident. On the 12th of September I was sent for neck x-rays I did a pregnancy test before I went. It was negative.

My period was due today, and for some reason, even though I felt like my period was coming, I did a pregnancy test and it was POSITIVE. I'm petrified that I could have harmed my baby. This was supposed to be the most exciting time of my life and yet I'm a mess!

EH

Dear EH,

You can stop worrying. The risk of X-rays during pregnancy is purely theoretical. There are no documented cases in which x-rays led to birth defects. Furthermore, pregnancy is not a reason to postpone necessary X-rays, such as those you had after your accident.

Sincerely,

Amy

Acid reflux

I am 9 1/2 weeks pregnant and have had horrible morning sickness since the beginning of my 6th week. At first it was nausea all day and night. Now I'm not continually nauseous but I've been vomiting a few times a day. It seems as if I've now developed acid reflux which is causing me to cough and makes it hard for me to catch my breath at times. My internist said he didn't feel comfortable prescribing anything besides TUMS but they don't seem to be working. Is there anything you know of that's safe to take? Its keeping me up at night so now I'm even more tired.

Thank you,
Allison

Dear Allison,

You might try a liquid antacid like Mylanta. Liquid antacids often work better than tablets for severe heartburn and acid reflux.

You should make an appointment with an obstetrician for prenatal care, instead of relying on an internist. Women who start prenatal care during the first trimester have better pregnancy outcomes.

Sincerely,

Amy

Ultrasound shows different results for each twin

I am just looking for an explanation. I have a 7 week 2 day yoke sac age and two fetuses. One is measuring 6 weeks 5 days and one 6 weeks 2 days. My doctor is saying that can be normal. Right now there are no fetal pulses. My doctor is saying that the fetal poles can lag behind almost a week and it is not considered unusual. I am just looking for an explanation of whether this is possible, and if it is possible for twins to have different fetal pole measurements or is one of them dead?

Thank you,
Sarah

Dear Sarah,

Ultrasound in the first trimester is accurate within 1 week either way. Therefore a baby who measures 6 weeks 2 days is anywhere from 5 weeks 2 days to 7 weeks 2 days. The gestational ages of the yolk sac and of each twin, although different, are all consistent.

The discrepancy is due to limitations of ultrasound (afterall, the babies are less than 1/4 inch long) and individual variation. Just as the babies may have different weights at the time of birth, they can be slightly different sizes now.

The most accurate measure of gestational age is obtained by calculating from the last menstrual period.

The fetal heartbeat is first seen between 6-7 weeks. By next week you should be able to see both heartbeats.

Sincerely,
Amy

Risk of repeat miscarriage

If you have had one miscariage, are you more likelyto have another one?

NC

Dear NC,

No, you are not more likely to have a miscarriage if you have had one before. That's because almost all miscarriages are caused by one time, non-repeating genetic defects in the embryo. The risk of miscarriage in any pregnancy is 20%.

Sincerely,
Amy

Constipation

I’m suffering from constipation so I’m using an over the counter women laxative, but I just found out that I’m pregnant, can I still use it and do you think that the period I have using it can hurt the baby?

Thank you,
Christine

Dear Christine,

It is better to use a stool softener during pregnancy instead of a laxative. Most doctors recommend Colace which you can buy over the counter. The fact that you have used a laxative up until now should not cause a problem.

Sincerely,
Amy

Vaginal delivery after 2 C-sections

Hi,

I've had two children. My sone was quite large and sunnyside up, so I had to have an emergency C-section. My daughter was small enough for me to have a vaginal birth, but she was breech so I had another C-section. We want another baby. What are my chances of having a vaginal delivery?

Anonymous

Dear Anonymous,

You could try for a vaginal delivery but the chances that your doctor will agree are small. That's because there is a slight risk of rupturing the scar on your uterus during labor. That's why there it is recommended that the doctor be there during your entire labor and that the hospital have an anesthesiologist available for an immediate C-section if necessary. Many doctors and hospitals do not want to comply with these recommendations and advise a repeat C-section instead.

Sincerely,
Amy

Spina bifida

I took an afp test and it came back abnormal, then I had a sonogram today and they said the baby has spina bifida. Can the blood test and sonogram be wrong? I was afraid to take the amniocentesis, because I was told that it could cause birth defects.

Anonymous

Dear Anonymous,

The AFP test is a screening test. It identifies babies who might have a problem. The ultrasound test actually shows the baby and can see if the baby really has spina bifida.

Spina bifida is a neural tube defect. Very early in pregnancy the tube that eventually becomes the spine begins to develop. If the tube does not close at the top and at the bottom, the baby will have an opening in the spine. That's called spina bifida. Spina bifida can range from mild to severe depending on how large the opening is and how high up toward the head it is. Often the baby is paralyzed from the point below the opening of the spine.

Your doctor needs to arrange for you to speak to a pediatric neurologist to find out what to expect when your baby is born.

Spina bifida is sometimes associated with other birth defects. That's why your doctor recommended an amniocentesis, to check the baby's chromosomes. An amniocentesis does not cause birth defects, it finds them. There is a small risk of miscarriage after amniocentesis (less that 1%).

Sincerely,
Amy

42 weeks pregnant

My wife is at 42 weeks and I was wondering how long the baby can stay in there before it can hurt the baby?

Thanks,
John

Dear John,

Most doctors feel pretty strongly that 42 weeks is the maximum amount of time that the baby can stay inside before the risks to the baby begin to rise. Almost all doctors would schedule an induction (giving pitocin to start labor) at 42 weeks. Talk to your doctor about scheduling an induction as soon as possible.

Sincerely,
Amy

Predicting a uterine rupture

Dr. Amy,

I have written you a few times in the past concerning pregnancy after a uterine rupture. Since then, I have miscarried and am wondering what your thoughts are regarding an OB GYN who advises me that I am anatomically sound with no troubling scars after doing an ultrasound. Can the OB GYN see enough on a standard ultrasound to say that I am anatomically good to go? I very much want one more child but my mind goes to the possibility that my uterus and uterine artery(which burst during the rupture) are not up to the task. My rupture was back in 2000 and since then we have miscarried twice and I assume both were due to not supplementing the progesterone early enough. Also, will starting progesterone right after ovulation help if the surface of my uterus is uneven from the rupture? We intend to give my body a break before trying again, but I would love your opinion regarding the validity of an opinion after a simple sonogram. Thanks.

Teresa

Dear Teresa,

There is no way to know for sure whether you will have another uterine rupture. An ultrasound can show an obvious uterine malformation, but I would not expect to see an obvious malformation. If there was a significant defect, it would increase the chances of a problem, but the fact that there is no significant defect does not mean that it can't happen again. That's because a rupture is not caused by an anatomic defect; it is usually a problem with tissue strength, or, less likely, a poor repair in an earlier surgery.

There is not enough experience with pregnancy after uterine rupture since many cases of uterine rupture require hysterectomy at the time of C-section. There are small studies that show no recurrence in women who have scheduled C-sections before the onset of labor, but the studies are really too small to draw any conclusions.

Unfortunately, you will have to make a decision about a future pregnancy without reliable statistics to guide you.

It may be that your recent miscarriages were due to lack of progesterone, but it is equally likely that they were due to genetic defects. It is extremely unlikely that they were due to any irregularity on the internal surface of the uterus, since the surface is probably normal, and the odds that the embryo implanted on the scar are small.

Sincerely,
Amy

Getting pregnant at age 41

Hi,

I am 41 and trying for a baby. My partner and I have a little girl of 2 and are trying again but with no luck. We have been trying since February of this year. Do I need help or am I too old to try?

RA

Dear RA,

You may need help. If you are over age 35 and you have been trying for more than 6 months, it is time to see a gynecologist. You may need medication in order to get pregnant.

Sincerely,
Amy

Birth control after 50

Dear Dr. Amy,

I will turn 52 next month. I stopped taking the pill two weeks ago. What are my chances of getting pregnant? Should I be using another form of birth control?

Thank you,
Marie

Dear Marie,

Some women ovulate (and can get pregnant) right up until they start menopause. If you are still having periods, you will need to use some form of birth control. The Pill is usually not recommended for women over age 40.

Sincerely,
Amy

HCG level not rising

Dr. Amy,

I am so confused right now. I tested on 9/18 at home and got a +, repeated the test on 9/20 +, DH and I had intercourse on the 21st then had some spotting. Went to a new Dr. on the 22nd, did sonogram and did not see anything and the blood test showed a level of 75, had blood work again on Saturday and the level was 71. Had some bleeding w/ clots on Sunday when went to the bathroom and have some residual dark spotting. Felt a little crampy like normal period stuff but no major cramps.

Went to my "old" dr yesterday and had more blood work. I am really confused as to what is going on. Am I pregnant or not? If I am, is there a problem? Could there be another explanation? Doc, said she does not think that I have had a miscarriage at this point and ordered another blood test. I am waiting for the results today. I am scared, confused and anxious. We want to be pregnant and we want a healthy baby, but all of this is not looking good.
Thanks for your help!

Magi

Dear Magi,

It sounds like you are pregnant and you are having a very early miscarriage. This is extremely common.

In a normal pregnancy, the HCG level will double approximately every 48 hours. If it does not risk appropriately, it is unlikely to be a normal pregnancy. If it drops, it is almost certainly a miscarriage. The only other possibility is that it is an ectopic (tubal) pregnancy, but that is less common, and usually produces one sided lower abdominal pain.

Early miscarriages are almost always caused by one time non-repeating genetic defects in the embryo. An early miscarriage does not increase the risk of having another miscarriage in the future.

Sincerely,
Amy

High prolactin and infertility

Hi Dr. Amy,

I am 26yrs. old. I'm trying to have a baby-with no luck of course. I know my prolactin levels are high. I've taken Bromocriptine and Parlodel without success.

I do have irregular menstration. I am not even sure if I ovulate or not. I am almost to the point of giving up and accepting that having a child is not meant for me. But something inside of me won't let me. I am my mothers only child and I would loveto make her a grandmother. Right now I am taking Ovulex, but someone from your website said that you said its a waste of time. Is this true? If it is, what should I do? Thank you for your time.

Nikia

Dear Nikia,

It sounds like you have a hormone problem that is preventing ovulation and therefore, you cannot get pregnant. The best thing to do would be to see an infertility specialist for a complete evaluation. Your situation is more complicated than most, and it will take a specialist to figure out the best treatment for you. I would not give up on pregnancy until an infertility specialist tells you that there are no more treatments to try.

Ovulex does not treat infertility problems. There is nothing you can buy over the counter that will treat infertility.

Sincerely,
Amy

How late can you have an abortion?

What is the latest you can abort a baby?

G

Dear G,

The date varies from state to state. In general, it is somewhere from 20-24 weeks.

Sincerely,
Amy

CIN II

Hi,

I received my biopsy results from my colposcopy last week and it showed that I have CIN2. I found out at the weekend that I am pregnant. Does having CIN2 carry any risks for myself or the baby?

Thanks,
C

Dear C,

CIN II stands for cervical intra-epithelial neoplasia or precancerous cells. It is grade 2 on a scale of 1-3. CIN II needs to be treated to prevent it from progressing to cervical cancer, but treatment should be postponed until after delivery if possible.

CIN poses no risk to the pregnancy or to the baby. Talk to your doctor about your treatment options; be sure to tell him or her that you are pregnant.

Sincerely,
Amy

Home birth after C-section

Hi,

I am 12 weeks pregnant with my second child. My first delivery was by emergency ceserean. Can I have a natural birth at home for this pregnancy?

Gina-Lee

Dear Gina-Lee,

I would not recommend it. The odds of something going wrong are low, but they are not zero. In addition to the usual risks of delivery, there is the increased risk of rupture of the uterine scar from the first C-section.

Sincerely,
Amy

Is this premature labor?

Hi,

I am thirty five weeks and have been having lots of cramps and low backache. Could this be a sign of early labour? If so, is it too early?

S

Dear S,

It could be a sign of premature labor, so you should be sure to talk it over with your doctor. If it is labor, it is too early and an attempt should be made to stop labor to give your baby a few more weeks before birth.

Sincerely,
Amy

Risk of recurrent Down's Syndrome

Dr. Amy,

I turned 41 last month and my husband is 32. We want a baby. I had a previous pregnancy earlier this year but decided to terminate due to trisomy 21 & dandy-walker variant. My dr. said there wasn't really any increased odds of having another down's syndrome pregnancy, but I'm not sure that is correct. I realize the chances of chromosmal defects increase with age, expecially over age 40. Also, what are the chances of having another pregnancy with dandy-walker variant? Where can I find some information? Thanks so much.

Annette

Dear Annette,

The risk of Down's Syndrome rises with maternal age, and it is also increased in women who have had a previous child with Down's Syndrome. The risk of Dandy Walker may also be increased in women who have had a previous child with Dandy Walker, but that is not clear. The best thing to do would be to arrange a consultation with a genetic counselor (your doctor can arrange this for you). A genetic counselor can give you the best estimate of recurrence rates in your specific case.

Sincerely,
Amy

Stopping the Pill in mid cycle

Hi,

Is it safe to stop my pill mid cycle to start trying for a baby?

Many thanks,
K

Dear K,

It is not harmful to stop in mid cycle, but it makes more sense to finish out the pack. That's because stopping in mid cycle will often lead to irregular bleeding.

Sincerely,
Amy

Incompetent cervix

My husband and I have lost three pregnancies to incompetent cervix. The first pregnancy was lost at 16 weeks, and my ob suggested that I may have incompetent cervix. With my next pregnancy, I was sent to a perinatologist to monitor my cervical change, and at 15 weeks, I recieved a rescue cerclage, but the pregnancy was still lost at exactly 21 weeks. With my most recent pregnancy, I recieved a cerclage at 12 weeks, and all was going well until my appointment with the perinatologist at 19 weeks. My cerclage was no longer holding, and I needed another rescue cerclage. I remained in the hospital, and again at exactly 21 weeks I delivered my third son who died shortly after.

I have never had a STD, or trama to my cervix, and I am not a DES baby. Could my cervical incompetence be hormonal, and what tests should be done to find this out? My Ob said that I will need a transabdominal cerclage with my next pregnancy. Is there anything that I can do to strengthen my cervix in addition to the surgery? What is the healing time after the transabdominal cerclage is placed, and how long after that should my husband and I wait to try and conceive? How long should I wait to have the surgery?

Anonymous

Dear Anonymous,

I am so sorry to hear about the loss of your babies. I can only begin to imagine how devastating it must be.

My first concern would be that you have a defect inside the uterus or an abnormal uterus. For example, some women have a septum (wall of tissue) inside the uterus. This restricts the space available for the baby and when the baby gets to a certain size, it is expelled. You may have already been tested for this possibility. The test is a hysterosalpingogram; radio-opaque dye is injected into the uterus and X-rays taken to investigate the uterine cavity.

If you were to have a uterine defect, no cerclage could hold the baby in. A uterine defect would be fixed by surgery before another pregnancy.

If all other possibilities have been ruled out, and the only problem is incompetent cervix, there is not much that you can do about it beyond a cerclage. No one knows what causes incompetence in an undamaged cervix.

I'm not sure what you mean when you say that the cerclage was not holding. A cerclage should not come undone. When a cerclage fails, it is usually because the stitch tears through the cervix.

A transabdominal cerclage is an unusual procedure and there is some controversy about whether it is truly beneficial. You may want to seek a second opinion before trying that procedure.

Good luck.

Sincerely,
Amy

Transverse lie

Dear Dr. Amy,

I had my 33 week check today with my midwife and was told that my baby is lying in a transverse position and that she recommends that I see aconsultant at 35 weeks (2 weeks time). I looked back over my notes and noticed that the baby has been in transverse lie since mid-July. This is my third pregnancy and I am a little worried that the baby has not turned and seems to be nicely settled across my tummy for some time now.This alone does cause some discomfort for me as my tummy is very tight and the movements of the baby feel quite un-comfortable. Can you offer any advice on what I can do to help my baby turn? Will this mean I will have to have a C-section if baby doesn't turn soon?

Joanna

Dear Joanna,

There is still plenty of time for the baby to turn to the head down position. Some obstetricians would also be willing to do a version, which is an attempt to turn the baby under ultrasound guidance. If the baby does not turn, you will need to have a C-section. A baby in a transverse lie cannot be delivered vaginally.

Sincerely,
Amy

Pregnancy after tubal ligation

Dear Dr Amy.

I was sterilised 2 years ago now, but I fear I am pregnant. I took a test on Sunday and it was positive but today was negative. Do you think I could be?

Thanks,
Lesley

Dear Lesley,

A positive pregnancy is quite reliable, and having a positive and then a negative test suggests either that you had a very early miscarriage or that the level of HCG is very low.

You should not be able to get pregnant after a tubal ligation, so you should see a doctor about this as soon possible. Women who get pregnant after a tubal ligation have a much higher risk of having an ectopic (tubal) pregnancy.

Sincerely,

Amy

Hand, foot and mouth disease

Hi Dr Amy,

My son is showing symptoms of hand, foot and mouth disease. I am 15 weeks pregnant. Should I be concerned about my health and the baby's health?

Jodie

Dear Jodie,

Hand, foot and mouth disease is caused by coxsackie viruses. Most adults are immune to them, having been exposed in childhood. Thusfar, there is no evidence that hand, foot and mouth disease causes problems in pregnancy, even in women who are not immune.

Sincerely,
Amy

No more periods after baby was born

Can having a baby at 43 stop my periods completely? My baby is 7 months old , and this has happened to me.

Regards,
Karen

Dear Karen,

If you are breastfeeding, your periods may not return until after you wean the baby. If you are not breastfeeding, it is possible that you are going through menopause. You should talk this over with your doctor.

Sincerely,
Amy

Herbal supplements for anxiety

Dr Amy,

I suffer from some anxiety issues, but am reluctant to take prescription medicines. I grew up with a case of selective mutism, and I did get over it, but i still have anxiety about certain things. I know that you cant tell me whether I should or should not take an herbal supplement, but i was just wondering what you think of the ingredients of one that i am considering. The testimonials on the product seems promising. I know it wont give me an instant cure but if it helps even a little bit, that would be a good thing. The following ingredients are: Melissa Officinalis, Lavandula Augustifolia, and Passiflora Incarnata. Do you know anything about these? Are there any side effects? Do they interefere with birth control medicines? Just curious. I just am wondering about general info. I know for specific info i need to talk to my doc but i was just wondering about your thoughts on this.

Thank You,
Nia

Dear Nia,

Herbal supplements do not work. I am not aware of a single supplement that does what it claims to do. You will be wasting your money if you buy this since it definitely won't work and it may even hurt you.

Most people don't realize that supplements are big business: over $40 billion dollars a year. The supplement manufacturers successfully lobbied Congress to have supplements excluded from the category of medication. Therefore, there is no oversight at all.

Manufacturers of prescription drugs are required to provide data that a medication does what they say it does, that the bottle contains what they say it contains, and that it has been demonstrated to be safe for human consumption. There are no requirements for supplements.
That means that you cannot be sure what is in the bottle; you don't know if it has ever worked for anyone, and you don't know if it safe or what side effects it has.

To the extent that medication works, it is because of the chemicals that are in it. Natural chemicals are no better or safer than chemicals made in a lab. If you think about it, you already know that this is true; some of the most dangerous substances around are "natural", like tobacco, heroin and cocaine. All of them come from plants and probably kill more people combined than any other substances.

There are a variety of very effective prescription medications available for anxiety. Unfortunately, there is no way to predict in advance what medication is best for an individual. That's why there's often a certain amount of trial and error in finding a medication that works and does not have unacceptable side effects.

I wish supplements worked for anxiety, but they don't, and they don't work for any other conditions, either.

Sincerely,
Amy

Pap smears after hysterectomy

Dear Dr. Amy,

I am a 56 year lady who had a Hysterectomy (all except one ovary) at the age of 32 due to Endometriosis. At the age of 40 I under went removal of the remaining ovary due to the presence of endometrial tissue again. Since then I have been on HRT patches with regular checks and no problems.

Question: Do I need a PAP Test done? I had one done last year and nothing abnormal was detected. My Doctor seems to think I need one doing every year. If this is so, perhaps your would be kind enough to explain why?
I look forward to your reply.

Kind regards,
Eileen

Dear Eileen,

The current recommendation is that women who have had their cervix removed and have had 3 normal Pap smears in a row, do not need further Pap smears. The exception to this is women who have had cervical cancer or precancerous cells. That's because cervical cancer can recur at the top of the vagina.

Sincerely,
Amy

Prilosec (omeprazole)

If I am taking omeprazole can this stop me from getting pregnant? If not, can it harm the baby?

JS

Dear JS,

Omeprozole (Prilosec) should not affect your fertility. It is a pregnancy Category C drug, which means that there is not a lot of information available about it. It can be used if the medical benefits outweigh any potential risks. You should talk to your doctor about whether it is necessary to continue this medication while trying to get pregnant or if another medication might be better for you.

Sincerely,
Amy

Acrylic nails during pregnancy

I have acrylic nails and just found out I about 5 weeks pregnant. Is it safe to continue getting "fill-ins" or could this pose some kind of hazard to my baby? I go to a reputible nail tech. who is very compulsive about sterilizing everything.

Thanks,
Sissy

Dear Sissy,

The danger of acrylic nails for the baby is not because of bacteria, but it is the threat posed by inhaling the chemicals used to apply and care for the nails.

No one knows what the risks are, but most doctors advise forgoing acrylic nails during pregnancy. Many women find that their nails become stronger during pregnancy, and they don't need the acrylic nails.

Sincerely,
Amy

Does a woman need to have an orgasm in order to conceive?

If a female has an orgasm at the same time a male does that mean that it is the point of conception?

TJ

Dear TJ,

In order to get pregnant, the man has to have an orgasm during intercourse, because that is the way that the sperm gets inside the woman. After sex, you might or might not get pregnant. That depends on whether there is an egg ready to be fertilized which, in turn, depends on where you are in your cycle.

A woman does not have to have an orgasm to get pregnant.

Sincerely,
Amy

Fibroid

Hi,

My doctor called me yesterday and told me about fibroid. I don't know what this means, but she told me this is related to fetus and cervix. Usually black woman have this when they are pregnant. I am Pakistani and this my second child. I am worried about this because my doctor told me some time this can grow to be very large and I might need surgery.

Thanks,
KA

Dear KA,

I'm not sure I understood your question completely, but what I wrote above is what I think you meant.

A fibroid is a benign growth of the uterus. It is not cancer and it does not turn into cancer. Fibroids are not harmful. The can grow to be large and causes heavy menstrual periods. If a non-pregnant woman has large fibroids, her doctor might recommend surgery to remove them.

Fibroids are stimulated by estrogen. Since there is a lot of estrogen during pregnancy, fibroids can grow much bigger. Usually this does not cause a problem. Occasionally, they can become painful. Rarely, they can block the baby's head from coming down and you would need to have a C-section.

Fibroids should not be removed from the uterus during pregnancy. The surgery could cause severe bleeding and lead to the loss of the pregnancy.

Sincerely,
Amy

Dose of folic acid

I have recently had a miscarriage. I want to try as soon as I have my first period. My doctor prescribed 5mg of Folic Acid but I am worried this will be too much and may affect the baby if I get pregnant soon. Is 5mg to much?

Thanks,
Jo

Dear Jo,

The recommended dose of folic acid is 0.4-1 mg per day. The only time more folic acid is recommended is for women who have given birth to a child with a neural tube defect like spina bifida. In that case, the recommend dose is 4 mg per day.

Sincerely,
Amy

Evening primrose oil

Dr. Amy,

I am pregnant with my 5th baby and am 39 weeks,tired and very uncomfortable and want the baby to be born. I have heard that evening primrose oil can help ripen and efface your cervix to help you to go into labor along with walking. Would you say this is a safe way to naturally help get labor underway?

Desperate

Dear Desperate,

As far as I know, there is no scientific evidence that evening primrose oil works to ripen the cervix or induce labor.

It is also important to keep in mind that inducing labor is not "natural", no matter what substance you use to do it. To the extent that any substance works, it is because of the chemicals that are in it. Chemicals that are created by living things are no safer than chemicals created in the lab. Some of the most dangerous chemicals known are created by living things: tobacco, heroin, cocaine, etc.

Sincerely,
Amy

Irregular bleeding

Dr. Amy,

I was so thankful to find your web site and wanted to ask a question. I had laparoscopic surgery in January of this year, in which both my gallbladder and right kidney were removed. I was born with the nonfunctioning right kidney, and after much discussion when it appeared to be aggravating my gallbladder, my doctor decided it was best to take both of them out.

I am 29 years old, and my husband and I are trying to conceive at this time. I was told to wait a few months before trying for a baby after my surgery. The problem is that I never know when I am ovulating, because I have frequent bleeding.

I had what I think was a "true" period on September 3rd through the 5th, the blood was bright red. Then on September 19th, I noticed I was spotting dark brown blood, enough of it that I had to use a pantyliner, this went on for 3 days. Today on the 24th, I am having the dark brown blood mixed with bright red and again wearing a pantyliner. I have been off of birth control for 2 years. Even while on the pill I had breakthrough bleeding between periods. My OB doctor did not seem overly concerned when I mentioned it to him a couple of years ago, saying "Some women just have breakthrough bleeding and that is normal for them."

This type of bleeding between periods has been going on for at least 3 years, but it seems to be worse since I've been off of the pill. I had a routine physical done in August and all my bloodwork was normal. Should I be concerned at all? I am never sure when my husband and I should try! Any advice you might have, I would appreciate! Thank you for your time.

Sincerely,
Angie

Dear Angie,

Women who are not on the Pill do not usually have breakthrough bleeding. The pattern of bleeding that you describe suggests that you might not be ovulating and may have polycystic ovary syndrome (PCOS), a hormonal problem that causes irregular bleeding. You can ask your doctor for blood tests of hormone levels to see if you do have PCOS.

You can also buy ovulation predictor kits to find out if you are ovulating. There is no harm in trying to get pregnant in the meantime. If you are ovulating, and you have sex on a regular basis, you will get pregnant. You don't need to time sex to ovulation in order to conceive.

Sincerely,
Amy

Sex at the end of pregnancy

Dear Dr Amy,

My wife is 20 years old and is in the 9th month of pregnancy. Is sex is safe during this period of pregnancy? Are orgasms for women safe during pregnancy? Plus , what about fingering (masturbating) her , is it safe for her and our baby?

AY

Dear AY,

Sex, orgasm and masturbation are all safe at the end of pregnancy, as long as there is no bleeding and the membranes have not ruptured.

Sincerely,
Amy

Worried about pre-eclampsia

Hi,

I am 21 years old i am 16 weeks into my second pregnancy. This time it is totally different. I had pre eclampsia at the end of my pregnancy with my little boy and I was in a bad way. I am scared that I will get it again and find it hard to sleep, worrying that this time I won't be so lucky and I've got too much too leave behind. If you have had it once, what are the chances of getting it in the second pregnancy. I panic when I get a headache, worrying that it is my blood pressure, which is fine at the moment. Thank you for listening and if you would get back to me maybe I could get a decent night's sleep.

Thank you,
Rebbecca

Dear Rebbecca,

There is a chance that you could get pre-eclampsia again, but it is in the range of 20%. The key, this time, is close monitoring.

You don't need to worry now, because it is too early to develop symptoms. At the earliest, you could start getting symptoms after 22 weeks or so. At that point, you can be monitored with weekly visits to check your blood pressure, reflexes and urine protein. You can also have blood tests to detect more subtle signs of pre-eclampsia. With careful monitoring, you can be hospitalize and delivered before you get severe pre-eclampsia.

You might consider asking to be switched to a perinatologist (a specialist in high risk pregnancy) for your care. Perinatologists have a great deal of experience with pre-eclampsia.

Sincerely,
Amy

Bleeding every 14 days

Dear Dr. Amy,

I am 17 years old and have had a regular cycle up till now. I am now getting my period every 14-17 days, whereas before they were every 28 days since I was twelve. They are also now much lighter. I am concerned!

I have also never been able to use tampons and feel defective.

Thank you,
E

Dear E,

It sounds like you may not be ovulating regularly. The best thing to do is to make an appointment with a gynecologist (or your regular doctor) to figure it out.

Being unable to use tampons does not mean that you are defective. You can try small tampons (junior size) and lubricate them with a water soluble product like K-Y Jelly (don't use vaseline). If you practice trying different angles, you'll probably get the hang of it.

The most common reason for difficulty is that many women don't realize how the vagina is angled. For example, when you are standing up, the vagina is not straight up. it is actually pointing toward your back. So if you try to insert a tampon straight up, it won't go in; you need to point it toward your back.

Sincerely,
Amy