Why isn’t she getting pregnant?

What you need to know:

  • How long does it take for a woman to conceive and is diabetes a lifestyle disease?

Exactly how long does it take for a woman to conceive and is diabetes a lifestyle disease? These are some of the querries Dr Vincent Karuhanga is responding to.

I am 27 years old and my wife is 26. This is our fourth month in marriage. We got married as virgins- my worry is four months into our marriage my wife is still getting her monthly periods (i.e. no pregnancy). We have sex regularly. What could be our problem?
— Kenneth

Dear Kenneth: Four months into your marriage is not long enough for you to worry that your wife is not getting pregnant. If you take one year while having regular sex, that is thrice a week, without using any contraception barrier, then you can start worrying and visit a doctor. A woman produces one egg in a month and if this is not fertilised within 12-24 hours, then she will not get pregnant that month. Delay in getting pregnant has nothing to do with getting married when still virgins and therefore being novices on how to make babies.

Money and diabetes

Recently it was claimed that diabetes was on the increase. Does this mean that since diabetes is associated with the rich, Ugandans are getting richer?
— Kasiita

Kasiita: Diabetes mellitus is a disorder in which blood sugar (glucose) levels are abnormally high. This is because the pancreas does not produce enough insulin or the insulin is there but not effective to adequately remove the glucose from blood and channel it to other body parts that need to utilize it.

Many Ugandans unfortunately live below the poverty line. The likely cause of this being tagged to malnutrition, poverty, stress, poor feeding, and drugs especially for HIV. Poor feeding in Uganda hinges on poverty and ignorance. People feed on foods such as cassava that may unknowingly destroy the pancreas.

There are two major types of diabetes. Type 1 the pancreas is completely destroyed and requires insulin injections to treat. This is also known as insulin-dependent diabetes and occurs in children. In type 2 diabetes, insulin is present but it may be inadequate because the target areas are resisting it. Here genetic factors play a big role, though obesity, age and pregnancy may determine its onset.

Treatment is by diet, exercise, and tablets but eventually insulin injections are given.

Are there two prostate glands?

My uncle’s prostate gland was removed 15 years ago. Recently, he got problems urinating and it was discovered that he has cancer of the prostate. What prostate was removed then?
— Ikona Buntu

Dear Ikona Buntu: A prostate is a sexual gland that produces about 30 per cent of seminal fluid that carries sperms and because it surrounds the upper part of the urethra, it may interfere with urine passage when it grows bigger it happens as men get older. When it grows bigger but is not cancerous, this is known as benign prostatic hyperplasia (BPH) but it can also grow bigger due to cancer, with both cases obstructing urinary flow. When the urinary flow is obstructed, a man will find it difficult to pass urine, requiring surgery as a relief to prevent other urinary tract complications especially those affecting the kidneys. Surgery may then be done to remove all (if it is due to cancer) or part (if it is BPH) in what is called prostatectomy. Both BPH and prostate cancer happen at older ages, with the cancer generally happening at an older age than BPH.
The prostate gland is divided into areas called zones. The peripheral zone is affected most by the cancer, while the transitional zone usually is hit by BPH. Even when the affected part is removed, this may leave parts which can later be affected by cancer.
So, the first doctor could have done his bit, but as your uncle grew older he got cancer in the part that was not scrapped off.

What are vital tests?

Dear Doctor: I am due to marry very soon. Which tests can I take before I make the leap?
— Balalondemu

Dear Balalondemu: Any man due for marriage is worried he may pass an unknown ailment to his spouse, offspring, or himself may get infections from his wife.
That said, a person due to get married requires having checks about his general health because apart from keeping one sick this may also impact on fertility. The checks should include conditions such as heart disease, obesity, diabetes, hypertension and the rampant cancers today. Infections such as tuberculosis also require checking though they may have no direct impact on the couple’s fertility.
Today because HIV infection is rampant, people solely check it out forgetting Hepatitis B, gonorrhea, human papilloma virus and herpes simplex, among others.
Unfortunately, the tests for the last two are not easily done in our labs.
Fertility tests can be carried out on both the man and woman, though these may not guarantee 100 per cent success even when a couple is found normal.
Some diseases that run in families such as sickle cell anaemia can be avoided if tests on couples are done and appropriate advice given. Genetics may determine diseases in an offspring and so genetic tests, may be necessary in some cases as advised by ones doctor. Unfortunately, genetic tests are not commonly done in Uganda.