Question: Is it okay for a married woman, pregnant or not pregnant, with fibroids to have sex? I ask this question because my findings are that fibroids are primarily caused by the oestrogen hormone imbalance which is also found in semen. And so am thinking that having sex increases the amount of oestrogen in the uterus thereby facilitating for rapid growth of fibroids. Therefore, does this finding mean the concerned woman should abstain from sex upon finding out that she has uterine fibroids? C.S. (Zambia)
Answer: it is certainly true that growth of uterine fibroids is partly promoted by oestrogen hormone, among other things.
However, your hypothesis, though apparently logical, is slightly misleading. Here is why: Whilst there may be some oestrogen in semen; the quantities are really small and, in the greater scheme of things, quite insignificant. Secondly, the oestrogen that could fuel fibroid growth is that found in the woman’s circulation and therefore gets to the target tissues through the blood supply. Only a small proportion of oestrogen delivered vaginally is actually absorbed. This adds a minuscule amount to the total oestrogen concentration in circulation at any one point in a woman’s life. Sexual intercourse is therefore of no significance whatsoever with regard to fibroid growth or size. It is probably instructive that one of the groups of women known to be troubled by large fibroids are catholic nuns. It, of-course, couldn’t be due to their active sex lives! Instead, it is because they never have children and therefore their wombs are exposed to oestrogen more persistently; but this is oestrogen produced by their own bodies, mainly ovaries.
Question: I am 12 weeks pregnant and have just received a letter telling me I am a carrier of alpha thalassaemia and my partner now needs to go for testing. I have 4 children already (2 with this partner) and they are all o.k. I don’t really understand what this is or what the implications are for my baby, please can you help? N.W. (UK)
Answer: Alpha thalassaemia is a rather complex condition. In essence, there are a number of genes which are essential for the manufacture of the blood pigment haemoglobin. Some of these genes are called alpha genes. Carriers of alpha thalassaemia like yourself will have one or two missing alpha genes ( there are supposed to be four). Carriers are almost always healthy with no problems. In some cases, pregnancy could trigger anaemia but this is rarely serious.
So, what are the implications? Your partner needs testing for carrier status. People of South East Asian origin have the highest carrier rate of this condition but it is found throughout the world. If your partner was found to be a carrier, the chances of the baby being affected can then be quantified and appropriate individualised advice given. If, on the other hand, your partner is completely unaffected, the most that your baby can inherit is a carrier status similar to you. There is more detailed information on alpha thalassaemia here:
Question: Can i do a safe withdrawal off methadone? is it ok to reduce my methadone intake in the latter part of my pregnancy ? L.C. (UK)
Answer: The issue of weaning off methadone during pregnancy needs to be approached with a great deal of care.How it is done, the rate of withdrawal and the timing, all need to be planned carefully to avoid unwanted consequences. There is credible evidence that coming off Methadone in the first trimester might increase risk of miscarriage. Withdrawal in the third trimester is also discouraged as it can cause distress to the baby in the womb. I would strongly advice against a solo effort to come off methadone during pregnancy. Whilst laudable, make sure that you involve your specialist midwife and doctor to plan and execute it properly. Best wishes.
Question: Is it possible to catch chlamydia or herpes through oral sex? M. (UK)
Answer: You cannot acquire the pelvic chlamydia infection through oral sex but you can certainly contract herpes through oral sex. It is estimated that over 18% or 1 in 6 of all women in the child-bearing age in the United States carry herpes. Many experts agree that many of these especially among women may have been acquired through oral sex.
Question: My sister is 33 yrs has secondary infertility after long use of contraceptive pills which was general low dose progesterone. She has 2 children and had been subjected to c/s in both. Menstrual cycle is irregular, hormonal profile regarding prolactin and FSH is normal but LH is too high (27) in follicular phase. She tried induction of ovulation orally and parentally and failed. Please, what is the suggested treatment? Thanks. H. (Egypt)
Answer: If your sister is indeed affected by polycystic ovarian syndrome then she may not be ovulating regularly hence the delay in a successful conception. It is also possible that since her successful conceptions and deliveries in the past she has put on a significant amount of weight, something that tends to make the features of polycystic ovaries (including sub-fertility) worse. If this is the case, trying to lose weight is her first practical step that she can and should take. All in all, induction of ovulation is generally the way to overcome sub-fertility in women with polycystic ovaries. It may surprise some but the old war-horse Clomiphene (Clomid) is still a very effective induction agent. It is important to get the dose of this right for each individual. This can range from 50 to 150 mg daily for five days at the beginning of a cycle. Were she not to respond to Clomiphene, injectable (parenteral) agents based on hCG can be employed. I also need to mention here that Metformin which, for a while, was promoted as a potential fertility booster for women with PCOS has been shown to be ineffective in this regard.
If there is one thing to be taken from all this is that, if your sister is significantly overweight, getting the weight down is the single most effective measure she can take to maximise her ability to conceive and carry a pregnancy successfully.