Did contraceptives make me infertile?

Did contraceptives make me infertile?

What you need to know:

  • Dear Doctor: I am a 36-year-old mother of three who wants a child with my new spouse badly. Before I decided to get him a baby, I got a shot of Injectaplan. Did the injection burn all my “eggs”?
    — Kaswarra C
  • Dear Doctor: When I laugh or get excited I experience pain at the back of my head (not on the skin but within). Sometimes, I have to restrain from laughing to ease the pain. What could be the cause? I have had this discomfort for years now.
    — Anita
  • Dear Doctor: I am 21-year-old and l have many pimples on my back and face. A pharmacist gave me pills but they have not been helpful. Recently I started getting a pimple in my private parts just before my periods. I suspect I have a big problem. Please help.
    — Samalie

Dear Doctor: I am a 36-year-old mother of three who wants a child with my new spouse badly. Before I decided to get him a baby, I got a shot of Injectaplan. Did the injection burn all my “eggs”?
— Kaswarra C

Dear Kaswarra C: Depo Provera, a reliable injectable contraceptive given every three months, has side effects including irregular periods and delaying getting pregnant when it is stopped. Therefore, before getting the shot, you need to get counselling. The drug works by inhibiting ovulation and making the uterus hostile to implantation and may cause a few months delay to return to full fertility. There is no evidence that it burns “eggs” eventually leading to infertility when it is stopped.
At 36 years, a woman will be less fertile hence delaying to get pregnant. You may also have other factors preventing you from getting pregnant including the injectaplan delay, fibroids, blocked tubes, among others.
Your failure to get pregnant could have another manageable cause requiring you to visit a gynaecologist.

Injected contraception
Depo-Provera is very effective in preventing pregnancies. About 3 in 100 women who use it become pregnant. However, Depo also carries the risk for many mild and serious side effects.
Advantages. Provides highly effective reversible protection against pregnancy without placing heavy demands on the user’s time or memory. Does not increase risk for breast, ovarian, or cervical cancer. May protect against endometrial cancer. May be useful for women with painful periods, heavy bleeding (including heavy bleeding caused by fibroids), pre-menstrual syndrome and endometriosis.
Disadvantages. The injections do not provide protection against sexually transmitted diseases.
Weight gain. Most women gain an average of 8-15 kgs.
Getting help. Other common side effects include menstrual irregularities (bleeding or cessation of periods), abdominal pain and discomfort, dizziness, headache, fatigue, nervousness.

Painful laughter

Dear Doctor: When I laugh or get excited I experience pain at the back of my head (not on the skin but within). Sometimes, I have to restrain from laughing to ease the pain. What could be the cause? I have had this discomfort for years now.
— Anita

Dear Anita: Laughter is the usual response to humour, comprising of gestures and the production of a sound which happen simultaneously. Laughing releases feel-good brain chemicals, which also relieve pain including headaches. That said, headache which is a pain in the head with the pain being above the eyes or the ears, behind the head (occipital), or in the back of the upper neck can be triggered by many things including laughter.
One of the commonest headaches is tension headache that is caused by muscle contractions in the head and neck regions leading to nape pains or a tight band on the head.
Tension headaches are usually caused by stress and a hearty laughter is known to release feel-good brain chemicals, which relieve pain including headaches.
However the tension created in the facial and back of the head (nape) muscles when laughing can also lead to pain there. This kind of pain apart from laughter can be provoked by coughing, sneezing and straining at stool as well.
It is true that your kind of laughter induced pain may result from other causes including an abnormality of the part of the brain called cerebellum (Arnold-Chiari malformation).
Most headaches are harmless and nape pain may be caused by neck problems including pressure by the neck bones on outgoing nerves whose related pain may be increased by tension in neck muscles while laughing. You, therefore, require investigations including a brain CT scan and a neck x-ray.

Help! I have a
pimple attack

Dear Doctor: I am 21-year-old and l have many pimples on my back and face. A pharmacist gave me pills but they have not been helpful. Recently I started getting a pimple in my private parts just before my periods. I suspect I have a big problem. Please help.
— Samalie

Dear Samalie : Pimples or acne mainly affect adolescents and usually abate by early 20s. But some people may continue to breakout until their 40s. The face, ears, back, chest and shoulders are the most commonly affected.
A few people still may get pimples in the pubis where they are even more painful and more likely to turn into boils. This is because lots of skin bacteria hang on to the pubic hair and the pubis being moist.
A pimple or two anywhere in the areas that get acne can happen every month related to periods due to a rise in progesterone hormones after ovulation.
The hormone causes oily areas of the skin to produce more oil (sebum) leading to clogging of oil glands and skin bacteria, which then come to feed on the oil causing pimples.
Progesterone causes pimples to get more swollen because of water retention.
Acne is usually associated with an increase in male hormones at puberty. But a drop in female hormones before periods will make male hormones, whose levels remain constant, to seem higher leading to pimples towards periods.
Pubic pimples should always be distinguished from STDs like Herpes before any treatment is given.
Proper shaving and pubic hygiene, pimple peroxide lotions, and combined contraceptive pills, or drugs that work against male hormones may help in some people but proper treatment requires a doctor’s prescription.