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What causes missed periods?

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Posted on Mon, 8 Sep 2014
Question: madam my wife has missed the period which was due on 11 july or 12th july ( in may 2014 we done second icsi ..tested on 10 XXXXXXX ..negative ,period happened on 12th XXXXXXX 2014).

1.Madam just wanted to know what should we do now ...today she is getting little pain in lower abdomen( no bleeding though till now )...so was worried ..is it something can be done to sustain this..i mean any tablets .. ...we didnt do urine preg test yet ..madam whats the usually time for that ..i am very much fearful what would happen .

2. And in this case/situation whether she can travel in two wheeler or not .can she eat everything ..And please tell every possible precautions to take ..

3. she is taking throid tablets 25mg ..thyronorm ..(which is in control ,as per doctor),,,shelcal 500 mg ,and berocin cz tablets daily one at night along with folic acid tablets ...

HHope to receive our helpful reply soon .
doctor
Answered by Dr. S Patra (1 hour later)
Brief Answer:
DO ONE HOME PREGNANCY TEST AT THE EARLIEST.

Detailed Answer:
Hello,

Thanks for writing to us on Healthcare Magic. Followings are my comments:

1) She needs to undergo one home pregnancy test at the earliest. 95 to 99% POSITIVE result is obtained 7 days after missed period and it is already 10 days past. Morning urine sample is MOSTLY preferred.

2) On POSITIVE test, I suggest her to undergo one Trans Vaginal Ultrasound scan to know the nature of pregnancy (Intrauterine or tubal) and fetal well being. In that case, you must consult with her gynecologist.

3) She would take healthy protein rich diet with green vegetables, Prenatal Vitamins and FOLIC acid supplements for at least 3 months, drink more water and take adequate bed rest. Maintain genital hygiene properly.

Thyronorm, Berocin-CZ should be continued and IRON-CALCIUM supplements can be started from 4th MONTH onwards if she is NOT anemic.

4) She must AVOID long journey, lifting heavy object, high heal shoe, uneven surface, sexual intercourse (1st & 3rd Trimester), more ups & downs. She can travel in two wheeler if she has NO H/O previous miscarriage.

She would take all her favorite foods which are cooked properly and mostly home made. Raw foods/ EGG, Unpasteurized JUICE/ MILK, soft cheese, Pine apple, processed meat, green papayas, caffeine drinks, crabs, Longan etc should be avoided throughout the pregnancy period.

5) Do periodic check up to her doctor with necessary investigation, blood test, ultrasound scan. It will help to assess fetal well being and overall pregnancy.

Hope, it helps for your information. Kindly, close the discussion if you don't have any other query.

Wish her good health and take care yourself.

Regards,
Dr Soumen

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S Patra (1 hour later)
hello doctor

thanks a lot for immediate and useful reply .Doctor i have question below to our reply ..

1. Doctor whr we had done icsi ..that doctor told to wait for two more days theen do the test ...anyway will ask my wife to carry the test tomorrow ...since no harm in that .

2.Sir all the medicine which you told above will be given b doctor upon seeing her right ..

3. throid tablets should be continue ..is it ....if positive also..

4. Sir please tell me more about what she should eat and what not ..i mean in breakfast ..like dosa and idlies ..rice etc...Since we are two in the family ...if she prepared food during this ..its advisable or not ..


5. You said unpasteurized milk/juice ..is it cold mik or juice right that needs to be avoided right ..today evening she had cold vanilla milk shake ...is it good ...will it do any harm ..

6.Wanted to know whether she can do day today jobs right like cooking ..(not heavy ) ..standing in the kitchen while cooking etc ..

Thanks again ...and waiting for ur reply.
doctor
Answered by Dr. S Patra (3 hours later)
Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for follow up queries.

1) She has missed period for 12 days and home pregnancy test can be done at this time to get accurate result.

2) YES, she will take above medicines only after consultation with her doctor and receiving complete prescription.

3) YES, thyroid medicine should be continued even after POSITIVE test and throughout the pregnancy period to AVOID certain fetal & maternal risk and complication. Dose should be adjusted according to test result of serum TSH.

4) FOODS TO BE TAKEN:

She would take her most favorite food stuffs (like Idlies, Dhosa, Rice, Bread etc) along with some extra Protein (like Chicken, Fish, Paneer, Pulses, Soybean etc) and green vegetables during this time. Drink more water (2.5 to 3 liter/ day) for better systemic circulation.

FOODS TO BE AVOIDED:

Raw foods/ unboiled egg, Unpasteurized JUICE/ MILK, Soft cheese, Pine apple, Processed meat, Green papayas, Caffeine drinks, Crabs, Sea Fish, Longan etc

5) Cold milk or juice can be taken after proper boiling or pasteurization. Frozen item (like Cold vanilla milk shake) can be taken occasionally. However, home made juice, slight hot milk are preferable. Outside foods and drinks should be limited to avoid gastrointestinal infection. Home made cooked food is the best.

6) Yes, she can do day to day activity like cooking. However, long time standing is NOT advisable. She will sit down after sometimes and do the rest works.

Hope, I have answered your queries and it will be helpful to understand properly.

All the best and good luck. Kindly, close the discussion.

Regards,
Dr S Patra
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S Patra (20 hours later)
Dear sir

thanks for reply with useful answers .

Doctor ..she donee the urine test at home with i can ..but result is negative ..i.e only C line is red ...the other T line is not red ..

Sir what does this means ...today she is not even getting the pain also in abdomen .I am very afraid ..dont know ..why the urine test is negative ..i know morning samples is it checked ..but in instructions it is alos written ..one can take sample anytime in the day.

Please advise ...
doctor
Answered by Dr. S Patra (1 hour later)
Brief Answer:
NEGATIVE TEST.

Detailed Answer:
Hello,

Thanks for your additional query.

It indicates NEGATIVE pregnancy test. I suggest you to undergo one blood test for beta-hCG after 5 days. It is more accurate and confirmatory test.

Sometimes LATE CONCEPTION may give POSITIVE result after 2 weeks of missed period. It is quite seen in ART (Assisted Reproductive Technique) like ICSI etc.

Hope, it helps for your understanding. Kindly, close the discussion.

Good luck and all the best.

Regards,
Dr S Patra
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S Patra (20 days later)
Hello Doctor

First of all i would like to ask ,I asked one question on 11 august by paying 599 for which i didnt get the answer and morever even the question itself is not here in the list of follow up question answer .So i paid again today to ask different question ( but it would be great if i get the answer for my previous question also ,which i guess healthcaremagic people had done mess )

Sir for this time my question has below :

Dear Sir

Since after two failed attempts of icsi and last period being late by 15 days (due date was july 11th or 12th but happened actual on 26th july ) ..So our last operated icsi doctor asked us to come on day 20th after the period i.e on 13th august( from july 26th,for uterus preparation for FET transfer ,since we have frozen embroyos).

When we went to doctor she straight away prescribed some tabelts and injections listed below,can you please tell what are this for..and does they harm in any way .

1.Folic acid and Ecospirin.

2.Name of Injection :BUSARLIN INJECTION 7mg/7ml
Injection daily for first five days starting 0000,once at 4pm 0.5ml at stomach ...
And if next period comes ,from 2nd day of period .2ml daily till 10th day.

3.Name OF Tablet:MEPRATE ( MEDROXYPROGESTERONE ACETATE TABLETS IP)
Daily two one night one morning ,for five days Starting 0000

4. Name of Tablets: Estradiol Valerate Tablets 2mg (Endofert)
Should be Taken from 2nd day of period ,morning 1 ,afternoon 2 ,night 1 ..till 10th day .

And after that she asked us to come by 10th day or call
doctor
Answered by Dr. S Patra (3 hours later)
Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for query.

1) Folic acid is useful for better development of fetal nervous system and to avoid Neural Tube Disease.

Ecospirin is provided to improve feto-placental circulation and avoid micro thrombus formation. It acts as blood thinner.

2) BUSARLIN injection is GnRH agonist. It is given to suppress natural hormone and leads to pituitary desensitization. This is maintained until she is ready to receive estrogen tablets.

3) Estrogen and progesterone tabs are given to develop lining of the womb at the correct time. Treatment can lasts for approximately 9-14 days and until the endometrium is sufficiently developed.

They are quite safe and useful during the procedure of FET. Kindly, consult with your treating doctor for proper management.

Hope, it helps for your information. All the best and good luck.

Regards,
Dr S Patra
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. S Patra (42 hours later)
Hello Doctor

1.Thank You for the above reply .Sir may i know whether this injection or tablets have any side effect ..since after starting taking this she is getting some pimples n face and body is also getting some heated .

2. About the question which i asked you on 11th august with another transaction ,but i dont know where it has gone..i had enquired the samae with this people ..anyhow below are those quesions.

1 . Sir i underwent circumcision surgery in FEB2013 ,and there is one obstruction like thing near the tip of penis( at bottom ,from where urine comes) ..obstruction is of streched muscle only ..if u insist will send snap of the same.Is this becoz of this that my sperm count are lower..i mean they get strucked bcoz of that.

2. Sir my sex time lasts only for a minute or two max( including intercourse).. is it normal ..erection and all r normal ..Sometimes i ejaculate early sometimes little lat e but not more than two minutes ..So wanted to know is it normal ..if not what can i do .

3. Which diet is best to increase sperm count sir ..if to try for .

Hope to get your reply .
doctor
Answered by Dr. S Patra (7 hours later)
Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for your query.

1) Above injections have some adverse effects and they will be minimum within therapeutic doses. If there is some prominent reaction, you should contact with your doctor for proper dosing of the same.

BUSARLIN can cause hot flushes, dry vagina, decrease sex drive, sweating, change in breast size, appetite, weight; headache, dizziness etc. They will be overcome with the time.

2) I don't receive any type of question on that day. Kindly, consult with healthcare magic support team regarding this.

A) There is NO relation between low sperm count and circumcision. That is probably surgical scar or frenulum. Don't be worried much.

B) According to your given information, you are mostly suffering from Premature Ejaculation (PE), which is the most common sexual dysfunction among men. It can cause sexual dissatisfaction after marriage, specially to your partner.

It is defined as male ejaculates within 1-2 min of intercourse or prior to intimate with partner. The problem is basically psychological more than physiological.

There are several causes that need to be ruled out like Smoking/ alcohol, Some drugs, Hypertension, Prostate Hypertrophy/ Prostatitis, Varicocele/ hydrocele, Diabetes, Thyroid problem, Neurological causes etc.

In this circumstance, I suggest to consult with SEXOLOGIST or UROLOGIST for complete clinical examination and some tests like Total and Free Testosterone, Vitamin-D level, blood sugar, thyroid profile etc to confirm diagnosis. Please do consult with any one of them to take suggestive measures.

Some life style modification can improve your present condition and control PE to some extent:

1) Quit smoking and alcohol if you have the habit. You may need psychiatric counseling or psychotherapy for that.

2) Doing masturbation before initiation of love making may improve ejaculation time temporarily and you need to do it each time.

3) Take healthy diet with Multivitamin & Zinc supplements. Antioxidant like Co-Q 10 can be taken regularly for 6 months.

4) Do physical exercise regularly to control body weight and overall fitness. You would maintain personal hygiene properly.

5) Avoid mental stress or anxiety/ upset by regular breathing exercise, yoga or meditation in the morning (15 to 30 min).

6) Specific treatment for Premature Ejaculation: a) Stop & Start Technique - It is very good exercise and much helpful.

Squeeze technique: In this, the female partner needs to start arousing the man. When the man feels that he is almost at the point of ejaculation, she should stop arousing him. She then needs to squeeze the head for between 10 to 20 seconds. She then lets go and waits for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur.

Stop-go technique- It is similar to the squeeze technique except that the woman does not squeeze the penis.

Kegel exercise or strengthening of PC muscle- by contraction and relaxation as on holding & releasing urine. Practice it several times (20-30 times daily). Here, you need to repeatedly contract and relax the muscles you use when you need to hold back urine. This needs to be done sitting on your chair when you are actually not trying to hold back urine.

b) Use anesthetic gel to desensitize penis or condom for temporary delay. You can get a prescription for this from your physician.

c) Certain drug like Dapoxetine, a class of SSRI, short acting and well approved. This is required only if the exercises don't work. Please try the exercises for 2 to 3 months before this.

d) Give more time on foreplay to heighten partner's excitation and do actual intercourse (vaginal penetration) at the time of partner climax. Here, both of you can get satisfaction/ pleasure.

7) Need proper sleep (at least 6-8 hrs daily) and avoid hot working place and tight underwear.

8) Proper psychological counseling under PSYCHIATRIST and further follow up if you need.

C) Foods for increasing sperm count: Asparagus, Avocado, Banana, Dark chocolate, Garlic, Oyster, Ginseng, Pomegranate, Walnut, egg etc.

Hope, it helps for your information. All the best and good luck.

Regards,
Dr S Patra
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S Patra (12 hours later)
Sir Thank you for the information and Great To Know such things .Sir still have few doubts/question .

1. You said do masturbation before love making ,then the sperm counts will further decrease right .since usually they says one should be abstinence for three days .

2.Sir u said about three execises ,Start and Stop , Squeeze technique and Kegel exercise or strengthening of PC muscle ...where can u know more about the same ..how to do this excerise specially kegel one .

3. Sir u said to take/apply some anesthetic gel ...Sir can you please prescribe one and how to use the same .

4.Sir whats the normal time span of loving making or intercourse ..at Normal levels without any medicines

5.Sir since my wife is getting some pimples ...should i give her some b capsules ...

6. And Sir since there was two failed attempts of icsi in our case ..i just wanted to know possible reasons ..for failures ..since doctor said embroyos were good ..we got some 16 eggs ,in that 2 were transfeered ..7 are frozen hs day 3 ones( 8 43,6 33,7 24,8 44,8 43,6 23,8 44 )..and 3 has day 5 blastocyst stage it seems ( 5AA,3BB,3CB).

7.Sir you said about one tablets also ..i.e Dapoxetine ..is that i can take one more two ..now and then when needed ...is this the tablet name which is avbl in medicals .Is there any ayurvedic type of medicines for PE .

Sorry for all this lengthy question ..Hope you will reply by taking some spare time .

Thank U

doctor
Answered by Dr. S Patra (2 hours later)
Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for your additional queries.

1) 3 days or more abstinence is required mainly before semen analysis or in ART (Assisted Reproductive Technique like ICSI, IVF, IUI etc). It is NOT required for day to day love making or sexual intercourse.

Masturbation before love making will increase sexual intercourse time. However, it is NOT recommended if you want her to be pregnant during fertile period.

2) Regarding all techniques (for Premature Ejaculation) and Kegel exercise, you can do google search or watch youtube video for demonstration and information.

3) Local anesthetic gel like lignocaine is used to delay ejaculation and prolong sexual intercourse time. There are several products available in the market.

However, I suggest you CLIMAX FOR MEN SPRAY instead of gel or cream. It gives better result. It should be used on erected penis and NOT before that. You can buy it from healthkart.com or medical store.

4) Normal time span for actual penetration or sexual intercourse is 5 to 10 min. However, it varies from men to men. Longer foreplay is important in this case.

5) She can take Vitamin B capsule. However, she has to maintain a healthy life style with balanced diet, avoid fast/ spicy foods, keep bowel habit regular, drink more water, control body wt, avoid stress and take sound sleep.

Clean her face with soap free face wash 2-3 times daily. Do regular cleansing, toning and moisturizing of skin. Take antioxidant (Vit E), apply benzoyl peroxide 5% cream at bed time.

6) There are some reasons of failed ICSI repeatedly. It includes the following:

a) Embryo transferred to uterus was incompetent due to an irregular number of chromosome in embryo or genetic abnormality (most common cause).

b) Implantation dysfunction may be due to immunologic reason or very thin endometrium.

c) Technical difficulty in the performance of embryo transfer. You should consult with your treating doctor regarding this.

7) Dapoxetine is a short acting Selective Serotonin Reuptake Inhibitor (SSRI), an Anti-depressant drug. It is used to treat premature ejaculation.

It should be started with low dose and taken 1 hr prior to sexual intercourse. It is prescription only medicine and you have to consult with your doctor.

Hope, I have answered your all queries with adequate explanation for proper understanding. Kindly, close the discussion and rate the answer.

All the best and good luck.

Regards,
Dr S Patra.

Use this link for direct query to me:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S Patra (1 hour later)
Thanks again
Sir

1. If i masturbate then i usually dont find interest for low making again ..is it normal .

2. Sir during intercourse or before doing it ..i always have urination sensation ..and i fear if whether urine will come out ..is it right that whens semen comes out urine dont ..they dont mix together right .And i always go to urination after intercourse ..is it normal .

3.Sir you said about embroyo faults ..i have sent u in previous query the quality of embroyos which are frozen now ..we are planning for FET after seeing the endometri linings i guess...so which emboryos you suggest for transfer ..


4. Sir in my first query i said busralin injection for 5 days ( i thougt i heard five days ) ..but in prescrition only tablets is wirttien has 5 days ..so this injection 0.5 ml should be taken daily ..is it good ..until 2nd day of period ..after that only .2ml daily .

5.Sir this climax spray ..is it safe to use ..are there any other which can be used .

Thank U
doctor
Answered by Dr. S Patra (13 hours later)
Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for queries.

1) It is NORMAL in some people. If you don't find any interest for love making after masturbation, then you can follow other measures to delay ejaculation.

2) You should undergo one urine examination (routine and culture) to rule out infection (if any). You must urinate before and after sex. You should practise KEGEL exercise to increase strength of pelvic muscle. It will be better.

3) FET is more better than ICSI and frozen embryo can be used in this purpose.

4) She should take the injection or tablet according to her doctor's prescription. Kindly, consult with your treating doctor if you have any confusion.

5) Yes, Climax For Men Spray is far better than usual anesthetic gel or cream. You can definitely delay your ejaculation time.

Hope, it helps for your information. Kindly, close the discussion.

All the best and good luck.

Regards,
Dr S Patra
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. S Patra

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What causes missed periods?

Brief Answer: DO ONE HOME PREGNANCY TEST AT THE EARLIEST. Detailed Answer: Hello, Thanks for writing to us on Healthcare Magic. Followings are my comments: 1) She needs to undergo one home pregnancy test at the earliest. 95 to 99% POSITIVE result is obtained 7 days after missed period and it is already 10 days past. Morning urine sample is MOSTLY preferred. 2) On POSITIVE test, I suggest her to undergo one Trans Vaginal Ultrasound scan to know the nature of pregnancy (Intrauterine or tubal) and fetal well being. In that case, you must consult with her gynecologist. 3) She would take healthy protein rich diet with green vegetables, Prenatal Vitamins and FOLIC acid supplements for at least 3 months, drink more water and take adequate bed rest. Maintain genital hygiene properly. Thyronorm, Berocin-CZ should be continued and IRON-CALCIUM supplements can be started from 4th MONTH onwards if she is NOT anemic. 4) She must AVOID long journey, lifting heavy object, high heal shoe, uneven surface, sexual intercourse (1st & 3rd Trimester), more ups & downs. She can travel in two wheeler if she has NO H/O previous miscarriage. She would take all her favorite foods which are cooked properly and mostly home made. Raw foods/ EGG, Unpasteurized JUICE/ MILK, soft cheese, Pine apple, processed meat, green papayas, caffeine drinks, crabs, Longan etc should be avoided throughout the pregnancy period. 5) Do periodic check up to her doctor with necessary investigation, blood test, ultrasound scan. It will help to assess fetal well being and overall pregnancy. Hope, it helps for your information. Kindly, close the discussion if you don't have any other query. Wish her good health and take care yourself. Regards, Dr Soumen For future query, you can directly approach me through http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326