Ob/Gyn Dr. Erica Ory will be online Tuesday, August 9, 2011, from 8 to 9 p.m. CST to answer your “girl talk” questions. Post your questions at any time. Check back Tuesday to ask a question while she is online.
To ask a question, submit a comment on this page in the “Leave a Reply” box.
Dr. Ory is a native of Louisiana and attended Louisiana State University in Baton Rouge. She received her medical degree from Louisiana State University School of Medicine in New Orleans. Dr. Ory and her husband, Jeremy, moved to Jackson in 2004 when she began her obstetrics and gynecology residency at the University of Mississippi Medical Center. They fell in love with Mississippi and are delighted to make Jackson their home.
I have been diagnosed with uterine fibroids. I decided to get an IUD to control my cycle. My question is, can the fibroids affect my fertility before I get the IUD? I ask this because for the past 3-4 months my cycle has been consistently 1-2 weeks late with a negative pregnancy test reading.
Also, can the fibroids along with 2 hernia repairs affect my pregnancy if I do become pregnant?
I started taking birth control pills two years ago before I married my husband. I noticed after taking the birth control for a few months that my cycle was not as heavy and the cramps were more bearable. For the last few months, I have noticed that my cycle is much lighter than before and I am concerned because it does not seem as if it is a real cycle. It reminds me of a discharge. Is this normal? Should I stop taking the birth control?
What is the procedure like when a woman wants to get on birthcontrol patches? Is there an exam involved?
My husband and I have been trying to conceive and we have been tracking ovulation days, lately I have been having irregular cycles such as spotting for like 2-3 days, but I have also been cramping all month long as if I’m having a cycle but not. The other day I had some severe sharp pelvic pain, it wasn’t like a cramp it was sharp and unbareable. Can you give me some idea of what may be going on? I would consult and OB/GYN but I have no health insurance at the moment.
Dear Dr. Ory:
I am Angelique Freeman and I am a student at Jackson State University. I am a junior Business Management major and I am a Community Assistant on campus. I was hoping that I could schedule a live girl talk with you on campus for the young ladies of my hall in Alexander West. I know that it will be great for you to come and share some valuable information with them about safe sex and birth control. I would love to discuss this with you in depth whenever you are available. My phone number is 985 351-7973. My email is firstname.lastname@example.org.
I want to thank you in advance for the help that you may give me.
I have been experiencing abdominal pain…mainly RLQ. This pain is on and off throughout the month. My Gyn says that I have a cyst, but that it is rather small. I’ve had ultrasounds to rule out appendicitis, and have been cleared by my GI doc. (upper & lower scopes)My periods have become more and more painful as the months go on, and the pain is getting worse. I’m on birth control to regulate my cycle, as it was extremely irregular before.Could it be endometriosis?Could there be something else that I’m missing?
Thanks so much for submitting your questions. An IUD is a good choice to help control heavy and irregular cycles caused by fibroids. Fibroids are actually very common. It estimated that 70-80 percent of women have fibroids. They can have no symptoms at all, but commonly will present as heavy or irregular cycles.
Fibroids usually only affect fertility if they are a certain type. There are several types of fibroids based on where in the uterus they are located. The fibroids that most often affect fertility are termed submucosal which means they are closest to the cavity of the uterus. During pregnancy, this is the area of the uterus where implantation of the pregnancy occurs. The other way fibroids can affect fertility if they are close to the fallopian tube and block it. If this occurs, the egg may not be able to get to the uterus in order for fertilization to occur.
I want to reassure you that PLENTY of women who have fibroids get pregnant and have no problems. Usually, only very large fibroids cause problems during pregnancy which include pain and occasionally preterm labor. Also, if the fibroids are close to the cervix, you may not be able to dilate fully, sometimes leading to a cesarean section – but this usually only occurs after trying to have a vaginal delivery – there is usually no way to predict that before.
As far as the hernia repair goes, the only time that it may affect pregnancy is if you have to have a cesarean delivery, so be sure the doctor who delivers you is aware of this. Again thanks for your questions! Dr. Ory
Birth control is often used to help with heavy and painful cycles. Depending on the pill, having a much lighter cycle and even just spotting can be very common. Some formulations of birth control only have 4 days of “blanks.” Sometimes this is not long enough for your body to have a full withdrawal bleed, so your cycle might be lighter. Also, the hormones that are in the pill, often affect the lining of the uterus resulting in much lighter cycles. So in short, this is likely normal. I would not stop taking your birth control until you are ready to get pregnant. If you are thinking about stopping your pills, I would recommend starting a prenatal vitamin. This can even be done a few months prior to stopping the pill in order to decrease the likelihood of having a child with an open neural tube defect like spina bifida. Thanks for your questions! Dr. Ory
The exam for starting birth control will likely depend on your age and also your history. Unless you are 21 years old or older OR you are having female related problems, a female pelvic exam may not be necessary. If you don’t meet that criteria, your doctor may just talk to you about you medical and family history and discuss all of your options so that you can make a informed choice. Hope this helps! Dr. Ory
The first thing I would recommend doing is taking a pregnancy test. Even though your cycles have been irregular or ovulation tests may be negative, does not mean that you cannot get pregnant. Unbearable pain is always something for which I would recommend seeing a doctor or even going to the emergency room if it starts suddenly, no matter if you have insurance or not. I do not want to cause anxiety, but there are occasions when a pregnancy is actually in the tube and not the uterus which can cause sudden unbearable pain and be an emergency.
If your pregnancy test is negative, then it could be that you have formed an ovarian cyst. When a woman is not on birth control and ovulates each month, she can form a cyst after ovulation. The vast majority of small cysts are completely normal and will go away over the course of your next cycle, but some persist and can become large. Occasionally you can have bleeding into the cyst OR the cyst may rupture and cause sharp, sudden pain. Also, when a woman has a large ovarian cyst, this can affect her cycle, causing it to be irregular. Not ovulating also causes irregular cycles AND problems getting pregnant.
I would recommend starting an over the counter prenatal vitamin if you are not on birth control. If you have not become pregnant after trying to conceive for 1 year OR your cycles remain irregular, I would recommend seeing an OB/GYN. There are tests that can be done to see if you are ovulating, as well as medicines to help you ovulate if this is the problem. TIMING is also something to consider. When your cycles are irregular, it is hard to know the optimal time to have intercourse which is typically between days 10-20 of your cycle (day 1 is the first day of your period.) If your cycles become monthly, then usually this is a sign that you are ovulating. Hope this helps. Dr Ory
Thanks for your interest in having me come to your campus and do a talk. I would be GLAD to do it. I will forward your contact information to someone who will help coordinate the talk through Baptist!
Your pain could be due to the ovarian cyst that your Gyn found, especially if the cyst was on the same side of your pain. Birth control pills will help prevent future ovarian cysts from forming. I think that endometriosis is definitely a possibility. Pain is the most common symptom of endometriosis. First line treatment is usually anti-inflammatories for pain and birth control pills to help suppress your cycle when you have endometriosis. Not all pelvic pain is caused by endometriosis, but 75% of women with endometriosis will have some type of pain. Endometriosis can be clinically suspected, but is usually diagnosed by laparoscopy (a scope put in the abdomen to SEE the endometriosis implants.) If your pain is controlled on birth control, then a laparoscopy may not be necessary.
I understand that you have had a GI work up that is negative which will typically rule out inflammatory bowel diseases and diverticular disease. Other causes of pain to consider is a pelvic infection (especially if you are not in a monogamous relationship and have unprotected intercourse), irritable bowl syndrome, urinary tract infection, kidney infection, kidney stones, and interstitial cystitis (painful bladder syndrome) to name a few.
Hope this helps. Dr. Ory
I have a question? If I have an appointment with my obgyn and I think my period will come on that day, can I still go to the appointment on my period?
I have PCOS and i am getting married soon. What are thne likelyhood of me becoming pregnant. Are there any vitamin orm meds i can take now to help me get pregnant quick….
Dr. Ory,Is it normal to lose your desire for intimacy after having a baby and a hysterectomy?
Each OB/GYN has a different preference. If your appointment is for your annual exam and pap smear, we can usually go ahead and do it. Sometimes the blood can make reading the pap smear more difficult. Some of the newer technology that is used for performing pap smears makes this less likely. Occasionally if you were on your cycle, especially if it was heavy, we might have to repeat the pap smear. If you are coming in for another reason, then it is not a problem.
Also, YOU may not be as comfortable during the exam if you are on your cycle. If this is the case, I would recommend rescheduling. We want you to be comfortable and would not want being on your cycle to add any extra anxiety or pain for you.
Just to be safe, I would check with your OB/GYN’s office for their preference. Dr. Ory
Do you have any recommendations for the treatment of recurring ovarian cysts, other than a hysterectomy? I had a bilateral cystectomy last year, but continue to get painful cysts almost every month which cause painful intercourse. I am unable to take birth control pills because of a family history of stroke, and the Darvocet I had been prescribed for pain has been pulled from the market. I am open to any suggestions, as I am tired of hurting. Thanks!
PCOS can sometimes cause problems becoming pregnant BUT not always. I can’t quote you a likelihood because every individual is different. If your cycles are monthly and regular, this means that you are likely ovulating and can become pregnant. We recommend starting a prenatal vitamin for all women who may become pregnant. There are not any non-prescription medications that will help you become pregnant. We usually recommend actively trying to become pregnant for about a year prior to treatment for infertility. IF your cycles are irregular, then treatment might be considered earlier. We don’t typically put you right on the medications for ovulation before trying because they can have some unwanted side effects for you AND increase your risks for twins, triplets and higher multiple pregnancies which are considered high risk pregnancies. Thanks for your question. Dr. Ory
Hi Dr. Ory, my cycles are very very irregular. It sometimes say on for 6 or 7 months. I was on provera and they took me off thinkin my cycle would become regular but it got worse. I have done everything to lose weight ( i am 5’8 and 299 pounds) and i have lose 28 pounds and still its not regular. Please please help me…. This situation is depressing me and i am now not under a dr because i have no insurance anymore…
I wish I had an easy answer for you. First I want to say that decreased libido is a common problem I hear from women of all ages. Often, the common denominator is the stress of multiple roles that women have – wife, mom, career etc. Fatigue, stress and lack of privacy contribute significantly to low libido and sexual problems for women. Often reducing stress with support groups, relaxation techniques or exercise, or assistance with childcare responsibilities and housework results in improved sexual interest and satisfaction. Encouraging couples to establish a regular “date night” and to spend an occasional night or two away from family responsibilities can lead to significant improvements in sexual interest.
Psychological and relationship issues often underlie, exacerbate, or are amplified by, sexual dysfunction in one or both partners. As an example, a major cause of decreased sexual desire and response is a relationship with limited communication or underlying conflict. Women with sexual dysfunction will often benefit from referral to a sex and/or couples therapist. Couple’s counseling is effective when there is relationship conflict or limited communication.
As far as physical changes, both the postpartum period (especially while breastfeeding) and after a hysterectomy with removal of ovaries, can lead to decreased estrogen levels and vaginal dryness. Although you may not notice it right away, this dryness may cause intercourse to be uncomfortable and can lead to an “aversion” to sex. Lubrication can help greatly. I recommend a water based “liquid” type of lubricant as opposed to “jelly” types. After a hysterectomy with removal of ovaries, one may consider vaginal or systemic hormones.
A woman’s view of her own body also affects her sexual interest and satisfaction. Many women note improvements in their sex lives when they initiate a regular exercise program.
Irene – don’t feel alone. I hope this helps. Dr. Ory
That is truly a difficult situation. Typically the only way to treat recurring ovarian cysts without surgery is with hormones. If you have a history of a blood clotting disorder or high blood pressure (both of which can lead to stroke), we usually do not recommend estrogen containing birth control. Progesterone only formulations do exist and some feel comfortable using this type of medication in women who ONLY have a family history but no personal history of a blood clot or high blood pressure. These include progesterone only pill, depo provera, Implanon and Mirena. Although these medications usuallly prevent ovulation/ovarian cyst formation, they may not do that as well as estrogen containing contraceptions. I would possibly discuss these with your doctor. Thanks for your question. Dr. Ory
Lashelle,Depending on you medical history, I would likely recommend a estrogen containing birth control. Women who are overweight oftentimes do not ovulate. When you do not ovulate, your body does not get a signal to have a cycle. The inside lining of the uterus continues to thicken until it outgrows its blood supply and you start to have a lot of irregular bleeding and sometimes almost daily spotting. By putting you on birth control, your body gets a signal each month to have a withdrawal bleed. When you start to cycle regularly, it prevents the cells within the uterus from becoming abnormal and precancerous, but also fixes the irregular bleeding.
I think that it is WONDERFUL that you have lost 28 pounds!! I want to encourage you to continue. Oftentimes, as weight loss continues, cycles will become more regular, but until then, I would definitely consider birth control pills. Thanks for your question. Dr. Ory
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