Dr Sarah Brewer, iVillage's resident expert, answered questions about gynaecological and sexual health from members on the Your Health message board.
When can I have sex again after miscarrying?
Can I trust faint lines on a pregnancy test?
Why do I get spotting after sex?
How do I know if it's chlamydia?
What can I do about abdominal adhesions?
When will my period return after breast-feeding?
When can I have sex again after miscarrying?
Q: I am 29 and have two children, but have also had four miscarriages. I would like to know if you think I should have my hormone levels tested to see if low progesterone levels are causing my miscarriages. I would also like to know how long we should wait before resuming normal sexual relations after a miscarriage?
nickix2002
A: It is important to talk to your doctor, who can advise whether or not you need further tests or even a referral for investigations to see if there is any obvious cause for your recurrent miscarriages. In many cases, however, no obvious cause is found. You will also find it helpful to contact the Miscarriage Assocation Helpline 01924 200799 or visit their website www.miscarriageassocoation.org.uk.
It is still early days and many women need time to grieve and recover from a pregnancy loss. Usually, you can return to a normal sex life once any discharge has stopped, and you feel ready. However, it is usually best to give yourself a few months to recover both physically and emotionally before trying to conceive again. It is important to continue taking a supplement designed for preconception/pregnancy, which includes folic acid.
Dr Sarah Brewer
A: Breast pain that is worse before a period is thought to result from hormonal imbalances that occur as part of the menstrual cycle. Symptoms usually improve when menstruation starts, but may be continuous. Discomfort is often described as dull and aching. Often, the pain is greatest in the upper-outer quarter of the breast, from the nipple back toward the armpit. Sometimes the pain may radiate into the armpit and the upper arm. Both breasts are usually affected, but the problem may be worse on one side. Breast tissue may also be swollen and lumpy - a combination often called `chronic mastitis?, although there is no inflammation or infection involved. A better term is chronic (meaning long-term) mastalgia (meaning breast pain).
Lumpiness and pain is usually linked with an increase in the number and size of gland-cells in the breast (adenosis). Because these cells are hormone sensitive, the onset of menopause usually relieves the symptoms. Cyclical mastalgia (breast pain that comes on at a particular point in the menstrual cycle?usually in the run up to the period) is usually helped by simple painkillers such as paracetamol or ibuprofen, reducing the intake of dietary fat, and by wearing a good support bra.
Some cases of cyclical breast pain are linked with lack of essential fatty acids, which act as building blocks for sex hormones. Taking evening primrose supplements at a dose of 3g per day helps 70% of sufferers after 3-4 months of use. Other treatments include drugs to correct hormone imbalances, such danazol, bromocriptine and the combined oral contraceptive pill, but some of these treatments are only used as last resort if breast pain is seriously interfering with your life.
Dr Sarah Brewer
A: Pregnancy test kits vary, but check the instructions on the one you are using to see if it says to ignore any faint lines appearing after a certain period of time. These are usually false lines due to the test being exposed to air. You have done the right thing in making an appointment with your doctor. He or she can arrange a super-sensitive blood test to see whether or not you are pregnant.
Dr Sarah Brewer