Doctor's Column: After how long does Injectaplan take to work?

Dear doctor, after how long does Injectaplan take to work? Is it after one week? I got the injections and had sex, about five hours later. Can I get pregnant?
Cathy

Dear Cathy, Injectaplan (Depo-provera) is an injectable hormonal contraception given every three months. It is given during one’s menstrual period or within five days from the first day of the period. This is not only because at that time one is aware she is not pregnant but also, because the contraceptive will be effective immediately or within 24 hours.

If the injection is given later than the five days, one should use other contraception methods in addition to the Injectaplan to protect her for the next two weeks because the egg will have already formed and the inside lining already receptive to the fertilised egg.

Injectaplan works by preventing ova (eggs) from being released from the ovaries (ovulation). It creates thick mucus at the neck of the womb, (cervix) making it more difficult for sperm to enter the womb and fertilise the egg even if it is produced. The hormone also thins the inner womb lining so that it does not allow the egg to implant there.

If a woman takes an injection after the said five days, all these preventions may not have been ready, risking pregnancy. Condoms should be used for at least two weeks to avoid any surprises.

I do not know when you took your injection. If it was after five days, may be you were not protected but continue using a condom for two weeks. If you took it within five days, you are unlikely to be pregnant.

Even in women who are not on contraception, a single sexual encounter does not always lead to pregnancy. If you, however, miss a period, please test for pregnancy.

Dear doctor, I delivered two weeks ago and expected my usually supportive husband to be happy. Instead, he is withdrawn and keeps shouting at me. I feel let down, what can I do? I am contemplating going back to my parents.
Kalangi

Dear Kalangi, l do not know what could have gone wrong. Do you think he doubts he is the father of the child? Please discuss this with him because he may deny you both psychological and physical support resulting in what is called post-natal depression.

Post-natal depression, which occurs when a mother gets depressed usually in the first month following delivery or miscarriage, can affect, especially first-time fathers as well.

Life after a baby is born may not be rosy for both the father and mother. Spending sleepless nights without paternity leave to pay a sleep debt, a woman being drawn to the baby and not tending to the husband can cause psychological problems in men just like the women.

You and your husband may need professional counselling. Vitamins, omega 3 and prescribed anti-depressants have all been used to treat the depression in women. However, in your case, it should be considered together with counselling or after counselling

Dear doctor, educate me about peptic ulcer treatment using milk. Is it true those who take milk never get ulcers? If so, the pain I have may not have resulted from ulcers because I have been taking milk since birth.
Yakobo Bashasha

Dear Yakobo, peptic ulcer refers to painful sores in the lining of the stomach or the first part of the small intestine- (the duodenum) or the part of the gut before the stomach due to acid going backwards from the stomach (reflux oesophagitis).

Though normally, a thick layer of mucus and a strong membrane protect the stomach from the effect of stomach acids, infection (helicobacter pylori), painkillers called nsaids (for instance, diclofenac, indocid aspirin), or excess production of acid (Zollinger-Ellison syndrome) may reduce this protective layer, causing wounds (ulcers).

Originally, it was said that stress causes a lot of stomach acid leading to peptic ulcers but this is no longer held true though in cases of severe burns, one may get curling’s stress ulcer due to physiological stress. However, missing meals, or taking spicy foods can make ulcers more painful, but are not a cause of ulcers.

Treatment of ulcers includes lifestyle changes like stopping smoking and taking too much alcohol, stopping use of the said painkillers and eradication of h pylori .

Milk provides brief relief of ulcer pain because it coats the stomach lining, mixes and dilutes stomach acid. Milk in some people may stimulate the stomach to produce more acid and digestive juices, which can aggravate ulcers. The milk-alkali syndrome whereby the body has too much calcium, disturbed acidity of blood and kidney problems was coined as an association of consumption of too much milk and sodium bicarbonate to treat ulcers.

Dear doctor, I am a 31-year-old man, who started masturbating after I lost the woman I thought was my future wife to a sugar daddy. I do not trust women. I get difficulty in swallowing and I am afraid I have a big problem. What can I do?
James Bond, Balaga, Kamuli

Dear James Bond, it can be very stressing to separate with a woman whom you had hope of marrying. Your lack of trust in women and masturbation is a sign of stress. Stress is the body’s reaction to any change that requires an adjustment or response.

One may experience stress from the environment, the body and thoughts. Stress can be positive, keeping us alert and ready to avoid danger.

Stress becomes negative when it continues for too long without relief leading to physical symptoms including headaches, upset stomach, elevated blood pressure, chest pain, and mental problems like depression and anxiety. Existing medical problems like skin conditions, asthma, and arthritis may also worsen. Feeling a lump in the throat (globus pharyngeus) may also appear as a symptom of stress.

You need to visit a counsellor otherwise you are likely to get worse.

Dear doctor, I am four months pregnant. Is it safe for me to tattoo my body? I want to do this to please my man.
Salma, Kitezi

Dear Salma, I suppose you are talking about a usual cosmetic tattoo, which is a permanent ink design inserted into the skin, usually with a needle.

Since it is done for cosmetic reasons, depending on where you put it, stretch marks of pregnancy, may distort it making it look ugly instead. Also, the outcome may change after delivery given the skin changes that take place in pregnancy.

Unfortunately, tatoos are permanent or even difficult to remove, making one regret putting them on their bodies.

There are several concerns about tattoos, though it is not known how used dyes or inks may affect a developing baby, so it is probably best to wait until after delivery to get one.

Many pregnant women are overly sensitive probably as a way of protecting the unborn child from introduced substances that may harm its health.

This is why some pregnant women commonly get a stuffy and runny nose. Tattoo dyes, especially red, green, yellow and blue can cause allergic skin reactions, which may persist or occur even years after getting a tattoo.

Hepatitis B, C (the dangerous liver infections), and HIV can be passed on if one gets a tattoo from a used contaminated needle. And these may be passed on to the unborn baby. You can get other ways of expressing love to your man.

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