Dr. Robert W. Vera, M.D.

The burning is from the urine contacting the skin where the herpes blisters are located. So, unless you can get the urine stream to come out straight without contacting the skin, you will continue to have discomfort. You can try to protect the skin with Vasoline or maybe Zinc Oxide 20%(like a baby salve to protect against diaper rash). A lidocaine jelly may help numb the area before you have to urinate.

Not likely, but possible. Sperm swim.

The symptoms you have could be nothing, however, without knowing you or examining you, I would be concerned about an ectopic pregnancy and I would seek care now. Hypochondriacs get sick too. Other diagnosis could be gastritis or gall bladder disease.

Hello, It sounds like your cervix is dilating and labor wants to start. Bleeding can be worrisome. It might be good to have a sonogram if you havent had one by now to check the position of the placenta. Dr. V.

There are higher circulating levels of a chemical called prostaglandin just before and during your period. It can cause nausea. I dont know about the association with phone use, however. Dr. V

Not likely if your periods are regular.

I guess you are checking your cervix somehow. Anyway, the cervix can feel open. Whether or not this is a problem depends on some issues from what happened at the delivery of your child to what the cervix will look like when it is examined by ultrasonography during your next pregnancy. If there was a laceration to the cervix that happened during your delivery and it was not repaired or if it was repaired, but failed to heal properly, then, yes this could impact your next pregnancy. In particular, it could cause pregnancy loss in the second trimester or it could be a factor in causing premature delivery. At your next examination, this needs to be brought up to your gynecologist so that he/she can examine the delivery record as well as the cervix. If you do get pregnant, the cervix can be evaluated as the pregnancy progresses to see if it is shortening or attempting to open prematurely. If this is the case, a suture could be strategically placed into the cervix to keep it from opening before the fetus is mature.

Bleeding after intercourse can come from the vagina, the skin of the outer vagina(the labia), the urethra, or the rectum. If you are sure it is coming from the vagina, then it and the cervix should be examined in detail. Most commonly there is an inflammation of the cervix, from whatever cause, and it causes the cervix to bleed when manipulated as it can be with intercourse. Sometimes, there is a lesion, like a polyp or a fibroid, in the canal of the cervix and it cannot readily be seen on examination. Polyps, which are benign and not cancerous, can bleed as well as fibroids. It may take more than one examination for the cause of the bleeding to become apparent. If you are having pain with urination, the most common cause is a bacterial infection of the urethra or the bladder. There are other causes, but this is the most common.

Two days late is not a sign that you are pregnant. As the instructions say, the Ella should be taken within 120 hours of unprotected vaginal intercourse and will prevent 60-80% of pregnancies. I would advise waiting a week before taking another home pregnancy test. I am not sure how the ella could affect your period. It works to antagonize progesterone, so my educated guess is that it could be affecting the lining of the uterus from acting in a normal way and, thus, affecting your expected period. Note that the warning on the Ella insert says that it could cause birth defects if the pregnancy is not prevented. I would consult your doctor if you do think you are pregnant.

Someone, either a doctor or a nurse practitioner, will have to look at it in order to know what it is because it could be a number of problems or it could be nothing. What immediately comes to mind is a sebaceous cyst. This is like a plugged skin gland and the sweat or oil it makes cannot make it to the surface and so this material backs up into the gland and makes
the gland swell. Sebaceous cysts are benign. The human papilloma virus can create growths that look like bumps. This can readily be diagnosed in the office. There is a gland called the bartholin gland which has duct that empties into the vagina. It, too, can become plugged (usually due to infection, but not always). This will make the duct back up with fluid and
it will look like a bump just on the inside of the vagina. If the duct becomes infected, the duct and the gland will suddenly swell painfully and antibiotics and drainage will be needed. A family nurse practitioner or doctor should look at it.

RWV, M.D.

Late periods are fairly common. The period has a timing mechanism, so to speak. That timing mechanism is ovulation. The cycle starts with the first day of the period. The cycle is usually 28 days(it varies, but not by much). The first 14 days of the cycle after the first day of the period is controlled by estrogen, which comes from the developing follicle in the ovary. As the follicle matures, it ovulates on day 14 (an egg is extruded from the follicle and picked up by the fallopian tube). After this ovulation, the ovary switches to producing progesterone. Those are the two main hormones of the ovary that control the period (estrogen and progesterone). Progesterone is then made for another 14 days and if there is no pregnancy, both estrogen and progesterone decline, and the first day of the period arrives and the cycle repeats. Again, the timing mechanism is ovulation.

I know you tried to get a good picture, but it is still a bit difficult to view for detail. These look like pustules. A skin infection with a staphylococcus or streptococcus bacteria is more likely than an STD. Ideally, you should have it looked at by a gynecologist. Most likely, you need a good antibacterial soap and a short course of antibiotics. The gynecologist may want to get a bacterial culture of the fluid in those "pimple-like" lesions.

If you took the pill the first day of your period, you should be protected. If you took the pill after your period started, you may not be completely protected, but the chances are still good that you have protection. You will not "damage'' your fertility by taking plan b.

Dr. Robert W. Vera

Four days before ovulation? Everyone says trust the science, but the body has a lot going on to follow the exact science. Could your cycle be a day off? Could the sperm actually live a few more hours than is normal for them to live?

https://www.cdc.gov/ncbddd/folicacid/about.html

This link should answer your question.

Dr. V

This is a common problem. Menstrual problems like the one described is usually diagnosed as dysfunctional uterine bleeding and the cause is usually anovulaton. To be brief, the timing mechanism for regular timely periods is ovulation. If there is no or irregular ovulation, the periods are irregular, light, or sometimes very heavy. Anovulation has various causes and the patient would need an exam and laboratory work up in order to find a cause. Anovulation, if left untreated for months to years, can be dangerous as it can stimulate abnormal cell growth in the uterus and this could lead to precancerous or cancerous changes.

There is not enough information to make a diagnosis. Likely causes:

1. Anovulation...a common hormonal aberration that causes the ovary not to ovulate, thus preventing normal menstrual cycles.
2. Complications from the tubal ligation...causing adhesive disease that may cause sticking or binding of the intestines causing cramps and pain.
3. Pain and cramps could be caused by pelvic infection.

Again, there could be other explanations, but there is not enough information here to make a diagnosis.

I do not have the statistics at hand, but a number of pregnancies start out as twins and only one survives to term. A twin may be “absorbed” by the mother’s body very early in the first 3 months of pregnancy. This situation is not uncommon. Genetic abnormalities occur more frequently in twins and this may be one reason why one twin does not go on to survive. There may be other reasons. This can be followed by ultrasounds to give you more information.

This is Dr. Robert W. Vera. I am a gynecologist. Menopause in the United States occurs at age 51. Still having periods at age 53 is not common, but it occurs. Saying this, the periods in the perimenopause should not be characterized as you have described, that is, hemorrhage with passage of clots and associated with pain. This is abnormal. Hormones may be a part of it, but there may be other associated problems. These may include fibroids (i.e., iomyomas), endometrial polyps, and/or cancer (endometrial cancer or cervical cancer). A diagnosis must be made. This should start with a good pelvic examination, possible ultrasound of the pelvis, pap smear or biopsy of the cervix, and an endometrial biopsy. Most of these, except, perhaps, the ultrasound, can be done in the gynecologist's office. I would not hesitate in getting all this done. In the meantime, I would go to the pharmacy and ask the pharmacist for some good over-the-counter iron pills you could start taking daily to help avoid severe anemia, which would complicate your care, especially if you need surgery. Again, do not hesitate in finding a good gynecologist or gynecologic oncologist in your area and setting up an appointment within a few weeks.

Because the menstrual cycle is dependent on your overall health as well as reproductive issues, there are many conditions that can affect it. Delayed periods are usually a hormonal problem, usually because the ovaries are not ovulating. Not ovulating, again, can be caused by a number of issues and some of the more common ones are being overweight, being underweight, thyroid problems, increased prolactin (a hormone that can be abnormally produced), and stress. Of course, the most common reason for not having a period is pregnancy, but you seem to have ruled that out. I would see your doctor to see if any of the other issues I mentioned may be in play.
Other issues involve genetics and without more information or an examination, I can't really address this.