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Pregnancy Bliss | Reproductive Health Hub

Missing menstrual periods at 45

Question:  For the last 2 months my period stopped. Is it possible that I am pregnant? I'm 45 yrs old and i've done the home pregnancy test and the result is negative. Or maybe i have already entered my menopause? R.P.

Answer: If a urine pregnancy test is negative, it is reasonable to assume that you are not pregnant. It is unusual with modern kits to get a falsely negative pregnancy test. It is somewhat more difficult to say whether the absent periods for two months at the age of 45 signify menopause. That is possible even though that will be rather early.

The most likely explanation is the condition generally called ‘dysfunctional uterine bleeding’ whereby periods become irregular. This irregular pattern tends to start in the late 30s for many women. However, experience of this varies from woman to woman. The practical advice I can give you is that you should repeat the pregnancy test. If it is still negative, arrange an appointment with your doctor for a hormone blood test which will tell you whether you are indeed going through menopause. The blood test is for hormones called LH and FSH.

Drug abuse and spina bifida

Question:  Drug abuse in pregnancy - does this cause spina bifida? M.H. (UK)

Answer: Effects of illicit drugs used in pregnancy vary depending on the type of drug abused. You will see in the section where we have discussed this subject that, for instance, potential effects of cocaine are quite different from those of cannabis. However, there is no direct association between illicit drugs and spina bifida. Indirect association does exist in the form of a poor diet and alcohol abuse which is sometimes associated with habitual drug abuse.

Vaccination against hepatitis

Question:  I've been vaccinated three successive shots against hepatitis, but I haven't injected booster yet since then. Am I still risk of being infected of the disease? R.

Answer: I take it this is Hepatitis B you are talking about. Unfortunately you did not say when you received the vaccinations. The three shots regime, presumably given over a period of 6 months, is meant to give you life-long immunity against Hepatitis B. In the UK, health care workers are usually given a booster after 5 years but there is no firm evidence that this is necessary. If you feel at risk of this disease, a simple blood test to check the specific antibody levels should be able to reassure you.

Previous history of pre-eclampsia and HELLP

Question:  I am pregnant with my second child. I had a lot of problems such as pre-eclampsia and HELLP Syndrome in my previous pregnancy. my blood pressure is usually in the low 100/60's. The last time i went to the doctor it was 127/76. I know this is still not high but it is exactly what happened last time. She was supposed to send me to perinatology at 23wks, I am now 32wks, but she keeps saying she can handle it. I’m just needing to know if I should be concerned and be more pushy are just see what happens?. W (USA)

Answer: I can understand your anxiety in view of your previous history. However, I think your doctor is completely right to reassure you as she has been doing. From what you have described here, there is really no indication for doing anything other than keeping a close observation. This includes regular monitoring of your blood pressure, checking urine for protein and blood tests for platelet count. Both pre-eclampsia and HELLP syndrome have a roughly 1 in 4 chance of recurrence in a subsequent pregnancy. This means you have around 75% chance this will not happen. As long as the surveillance is maintained, you should relax. There is more information on HELLP syndrome in the answer given to this question:

Tooth extraction and Distaclor antibiotic use in early pregnancy

Question:  I had traumatic lower tooth extraction one week ago. I found out 2 days later that I was 4-5 weeks pregnant. My GP prescribed distaclor MR for infection.  I am still in a lot of pain and at a loss as to where to go from here. What do you suggest, I am concerned about my pregnancy but also want to be free from pain and infection. S.M. (UK)

Answer: The use of this particular antibiotic is perfectly safe at any stage of pregnancy. Distaclor MR, the generic name of which is  Cefaclor is a cephalosporin. It is particularly useful in treating or preventing infections of the oral cavity. ‘MR’ in the name stands for ‘modified release’  which gives it an extended period of action allowing for it to be administered only twice a day. As for pain, it will be best to stick to Paracetamol. However, if a stronger pain killer is required, you can use Codeine. Avoid the so-called Non-steroidal anti-inflammatory drugs (NSAIDs) such as Aspirin or Ibuprofen.

Secondary amenorrhoea

Question:  What are the causes and treatment of secondary amenorrhoea? S.F. (Malaysia)

Answer: This is a broad subject. Amenorrhoea is absence of menstrual periods. Primary amenorrhoea is when periods have never happened. Secondary amenorrhoea is a state where periods stop in a girl or woman who was having periods before. There are many causes and I will mention them in a summary form:

There are a few other not so common causes. Treatment, ofcourse, depends on the cause.

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