Girl Talk With Dr. Nadine Zekam, January 10

Ob/Gyn Dr. Nadine Zekam will be online Tuesday, January 10, 2012, 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.

After earning her medical degree at the University of Paris V, Rene Descartes University in Paris, France, Dr. Zekam completed her residency in obstetrics and gynecology at Georgetown University Medical Center in Washington, DC. During her residency, Dr. Zekam delivered septuplets (seven babies). Board certified in obstetrics and gynecology, Dr. Zekam is a member of the American Medical Association and the Southern Medical Association. In 2008, she was named one of America’s Top Obstetricians and Gynecologists by the Consumers’ Research Council of America.

Note: The following is a transcript from the original Q&A posted January 10, 2012.

21 Responses to ““Girl Talk” with Dr. Zekam On January 10”

  1. Kayla says:

    I am currently pregnant but when I wasn’t my period came every 18 days and lasted 5 days. Sometimes i’d even end up having 2 periods in one month because of this. Could you explain how I ovulate and was I cycling too soon?

  2. Allison says:

    What exactly is a Colpo and Why would a doctor request that you have one done?

  3. Sade says:

    I have yeast infections at least once every two months sometimes each month right after my monthly cycle.. I’m not a dirty person. I try to watch using bubble baths, body washes with fragrances, avoid wearing tight bottoms, and wear cotton panties most of the time. Why does this occur? Do I have more yeast in my body than others? Are my hormones overly active or what?

  4. Dr. Zekam says:

    Dear Sade,
    Yeast infection are a common female problem. It is really an overgrowth of yeast which are part of the normal female vaginal flora.
    Certain factors may predispose to candidiasis (yeast infection): recent antibiotic therapy, use of steroids, diabetes, pregnancy, menopause or auto immune disorders. You have already taken the most important steps with avoiding body washes with fragrance, wearing appropriatly fitted cotton panties.
    It is important to make an appointment with your OBGYN to confirm that it is actually a yeast infection. Once the diagnostic is confirmed, the yeast needs to be tested in order to establish if it is resisitant to the treatment prescribed by your doctor.

  5. Dr. Zekam says:

    Dear Allison,
    A colposcopy is an examination of the female genitalia (vulva, vagina and cervix) with a magnifying device called colposcope ( think of a big microscope!)It helps your OBGYN examining lesions difficult to detect with a naked eye and help direct biopsies (tissue sampling)
    It is usually recommended after an abnormal pap smear results (to obtain biopsies) or after finding abnormal lesions of your vulva or vagina ( closer examination and biopsies)

  6. Dr. Zekam says:

    Dear Kimberly,

    It is not uncommon to experience some numbness at the level of the incision scar. The process of cutting create a disturbance of the nerves ending and created patches of numbness. It can take years to regain the feeling. Sometimes it does not come back, sometimes it becomes extra sensitive. 2 weeks is definitely not enough time to think that the deficit is permanent.

  7. Dr. Zekam says:

    Dear Jerrica,

    There are various causes to alopecia (baldness). It can be due to hair treatment, infections, hormonal changes, medications, vitamin deficiencies.
    To make an accurate diagnosis it is important to examine your scalp and take an hair sample. The treatment will be specific to the type of alopecia
    However a good balanced diet, biotin, vitamine B6, castor oil, scalp massages have demonstrated good results.

  8. Dr. Zekam says:

    Dear Priscilla
    Cerclages are usually removed at 36 weeks of gestation or if preterm labor occurs and the treatment fails to stop the contractions

  9. Dr. Zekam says:

    Dear Kayla,
    The menstrual cycle is divided in 2 phases:
    1-The follicular phase, which occurs before ovulation , this phase is under the domination of the estrogen
    2- The lutal phase which occurs after ovulation and during which the progesterone is the queen regent.
    The follicular phase does not change and is usually 12-14 days. Mostly when we have short cycles the problem resides in the luteal phase.
    It would have been helpful for me to know your age and if you had trouble getting pregnant.
    Some women suffer with luteal phase deficiency and may be treated by restoring progesterone production.

  10. Dr. Zekam says:

    Dear Kayla,

    Bad vaginal odor is an extremely sensistive and embarrasing issue. That is the reason why you just found out about this. It is not unusual to have excessive vaginal bleeding when you begin menstruating. It may cause a shift in the vaginal flora responsible of an overgrowth of bacteria. This condition is called bacterial vaginosis. It has a characteristic fishy odor and can be treated by a short course of antibiotics.
    Bad vaginal odor can also be caused by a forgotten tampon, need to change your pad more often. The use of some female hygiene products by causing irritation can result in a bad vaginal odor.
    overall, a good vaginal hygiene, avoiding uderwear made of synthetic material and very tight clothing is always a good idea.

  11. Terri says:

    I am a 29 year old mother of two, I am engaged to be married and my sex
    drive is at a minimum for the month of December I only had intercourse five
    times. What could the problem be? I’m hardly ever in the mood but I only
    have sex to please my fiancé and once we’ve started I’m ok but I’m never
    the initiater. My fiancé wants to have sex everyday all day help me

  12. Dr. Zekam says:

    Dear Regan,

    Pain during intercoursemay be due to a kyrielle of reasons.
    It would have been helpful to know your age , if it is a new onset or you have always suffered from dyspareunia (painful intercourse).
    The most common causes are vaginal dryness and vaginal atrophy.
    During sexual arousal, there is an increased in the blood flow in your vagina that leads to increased secretion of vaginal fluid. The lack of lubrication results in pain. You can use water based lubricant or prolong the prelude!
    Sometimes the dypareunia is due to vaginismus or involontary contraction of the female pelvic floor especially seen when the patient has been a victim of abuse.
    It may also result from a bad laceration during delivery or episiotomy causing residual pain, a genital infection, menopause, breastfeeding..
    Treatments are available for every condition, all you need is the appropriate diagnosis

  13. Dr. Zekam says:

    Dear Greta,
    Birth control pills are 99.9% effective when taken correctly and that does not change with the duration of use

  14. Dr. Zekam says:

    Dear Kay,

    The most important factors to consider when one wants a tubal reversal are:
    1-The length of the tubal segment that has been removed
    2-The type of tubal ligation performed (Pomeroy, Parkland method, clips)
    3-The age of the patient
    Typically we like the removed segment to be less than 2.5 cm and the remaining tube to be at least 3 cm. Most of these information can be obained form the operative report or if need be a diagnostic laparoscopy
    I recommend hormonal testing (FSH, estriol) on all females undergoing tubal reversal because there is always a risk of premature menopause.
    The chances of success with a greater than 3.5 cm remaining segment in the hands of a surgeon experienced in tubal reversal are around 60%.
    For the other cases I recommend IVF

  15. Dr. Zekam says:

    Dear S Wilson,
    Many women experienced some spotting at some point after using a birth control method. Although frustrating, it is usually self limited and stops after a few cycle. In your case, the fact that you have never experinced it in 4 years of using nuva ring makes me think that there may be a trigger to this breakthrough bleeding. Maybe you have been sick and prescribed a new medication(antibiotic), maybe you have waited more than 7 days to replace your ring . The first thing is to check a pregnancy test and consult your obgyn if the bleeding persits.

  16. Dr. Zekam says:

    Dear Sandra
    Although you have not given me the name of the prescribed medication, I can assure you that the medication that we use for the treatment of endometriosis (oral and injectables) do not cause permanent “menopause like” symptoms (hot flashes, vaginal atrophy). A low dose of Hormone replacement therapy can be used to alleviate the symptoms.

  17. Dr. Zekam says:

    Dear Bianca,
    we typically call advanced maternal age any women who deliver after the age of 35 and very advanced maternal age if they deliver after 45. However nowadays, 1/5 women has her first child after 35 and most of those babies are usually healthy.
    Age affects fertility, increases the risk of having a child with birth defect, the risk of miscarriage, gestational diabetes, pregnancy induced hypertension, pretem labor and delivery, and stillbirths.
    After 35 years old a preconception consultation is primordial to assess health status , start a prenatal vitamin regimen and folic acid supplementation.
    If you decide to get pregnant, an early prenatal care , an healthy diet are always a plus.
    I would also recommend combined first trimester testing which is very helpful in the screening of genetic defects and certain trisomies.

  18. Dr. Zekam says:

    Dear JGray,

    Hot flashes may be a sign of menopause but also of other endocrine pathologies. You may be suffering from a thyroid disorder, it may be the result of medication that your are taking for example for the treatment of endometriosis. It may also be genetic; in the case of premature ovarian failure, it would be helpful to know at what age menopause occurs in your family, or if any other family menber suffers from the same pathology.
    Sometimes, it is the result of a cancer treatment or a surgical intervention like a tubal ligation or even smoking.
    At this point the next step is to consult a physician and diagnose your disease.

    A balanced diet enriched in vitamine B6 biotine, castor oil and olive oil as well as scalp massages promote healthy hair growth.

  19. Dr. Zekam says:

    Dear Shalonda

    Hypoactive sexual desir disorder affects 40 % of women. The causes range from physical, hormonal to psychological. Every detail needs to be examined like why did you become abstinent, were you victim of an abuse?
    There are many ways of to help you. I would like to continue this discussion in private and be able to ask you more question.
    Feel free to contact my office.

  20. Dr. Zekam says:

    Dear Patrice,

    Normal pregnancy is not a contraindication to sexual intercourse. it is not unusual to experience a decreased in your sex drive during pregnancy due to fact that your body image, the fluctuation of your hormones. The best thing is to relax and take your time and find the posistion that is the most confortable for you. Embracing is the recommended position but being on top is not dangerous.

  21. Dr. Zekam says:

    Dear K.

    During pregnancy as your uterus enlarged, your diaphragm rises by 4 cm and your lung capacity falls by 5%. Also, while in horizontal positoion the weight of your gravid uterus on your great vessels is responsible of a drop in pefusion. For all those reasons, elevate your head feels more confortable.
    Pregnancy is also responsible of increasing your respiratory rate, starting after 20 weeks.
    You don’t described any chest pain and it appears as if everything is trigerred by position. You have taken the appropriate measures but I would like to see you in consultation soon.



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