Ask the Doctor: Why does my hair fall out when I take pills?

Dear doctor, my hair keeps falling out when I take pillplan. Is this curable? Can I change to another pill, if yes, which one?
Diana Naiggaga

Dear Diana, we are more used to women losing their treasured hair during pregnancy, a few months after delivery or during menopause. However, contraceptive pills that have progesterones just like pillplan may lead to hair loss. A male hormone is responsible for hair loss.

During menopause, the female hormones dip, leading to a relative rise in male hormones. This may make a woman get a bald head, beards and a deep voice. Progesterone in the pillplan is easily converted into a male hormone so that those women with a family tendency to scalp hair loss may lose hair even in their teens.

If a woman loses hair when on contraceptive pills, she should visit her family planning clinic to rule out other causes of hair loss like stress and iron deficiency. Then the clinic will discuss other contraceptive alternatives with the couple.

Dear doctor, whenever I am in my periods, I also nose bleed. Sometimes the nose starts first. Other times, it is the menstrual flow which is heavy. Don’t you think I lose lots of blood?
Petua Atuhaire

Dear Petua, losing lots of blood from periods alone can lead to anaemia but losing blood through the nose in addition to that can lead to more serious anaemia.

When a woman discharges blood from a site other than the uterus at the time she expects her period, this is known as vicarious menstruation. This usually happens because of the presence of cells meant to be in the lining of the womb, in the nose. These cells respond to menstrual hormones just like those in the womb and this is called endometriosis. Though it usually happens in pelvic areas, it can happen elsewhere including in the nose leading to nasal bleeding as the periods also happen.

Since there may be other reasons leading to vicarious menstruation and the fact that endometriosis, one of the causes has other complications including painful, irregular and heavy periods and problems getting pregnant (infertility), you require a proper investigation.

The investigations may include nasal direct lighting examination (rhinoscopy) or even imaging studies of the nose just before menstruation when the nasal bleeding cells are prominent.

Infertility is theorised to be due to various causes, including excessive production of substances involved in implantation of a fertilised egg called prostaglandins which apart from affecting implantation, when excessive will also cause painful and heavy periods .

Excessive periods also call for checking out cells (platelets) which help our blood to clot and prevent unprovoked bleeding. The cells when low could indicate menstruation related lowered platelets (thrombocytopenia) in which case apart from nasal bleeding and heavy periods, one may easily bruise.

The hormones involved in menstruation may also directly affect the nasal lining leading to nasal bleeding during periods.

Dear doctor, whenever I am hungry, I get severe pain in one eye. So what I do is keep sweets in my desk or even biscuits. Is there a condition of low blood sugar and headache which is cured by taking something sweet?
Baingana Baingi Araal

Dear Baingana, much as headache may be discomforting, it is usually harmless and once its cause is found, and eliminated, it goes away.

For that reason and because headache may be due to dangerous conditions like infection of coverings of the brain or a brain tumour, medical investigations are necessary before treatment is given or before one declares headache as harmless.

Severe headache that is associated with hunger is likely to be of a hereditary type called migraine.

Migraine “half head” though may affect one side of the head, and in some people, may affect both sides with one having symptoms like sight problems, nausea and vomiting.

A typical migraine may frequently start with changes in mood and feelings of general hunger or particular food cravings. Hunger can result from a stomach empty of food but it can also result from low blood sugar.

When the amount of sugar reaching the brain is low, hunger then comes as a nasty reminder that one needs to eat.

Low sugar reaching the brain can result from taking long to eat or starvation but may also be a side-effect from drugs for diabetes and upon correction by eating or like in your case, taking a sweet or biscuits both the hunger and headache may wane.

Dear doctor, I am allergic to earrings. Last week, I wanted to go for a coil but feared because I was told coils have copper. What can I use for contraception?
Trust Aryakunda

Dear Trust, allergy to metal in earrings is fairly common leading to swelling, itching and rashes around the area containing the earring.

Though a few people with allergy to one metal may be allergic to others, allergy to one metal does not mean allergy to another. Intra Uterine Contraceptive Devices (IUCDs) contain copper which is a metal that is inert and usually does not cause allergic reactions.

Allergic reactions are very serious and keep increasing with continued or recurrent exposure. If one develops an allergic reaction to an inserted IUCD, it requires that it is immediately removed and another method of contraception instituted.

This then makes it necessary to consult with a nearby family planning clinic to suggest the best method of contraception for you instead of self-prescribing a type of family planning.

Dear doctor, Is it normal for my baby’s breasts to swell and look like those of women? Even more strange, is the white fluid coming out of her private parts.
Annete Nakawere

Dear Annete, many babies, boys or girls, may develop swollen breasts days after birth resulting from breast development hormones passed to the baby during pregnancy. Pregnancy hormones however, usually stop milk production both in the mother and baby until the baby is born.

Once the baby is born and is no longer exposed to these milk stopping hormones, the resulting milk production (witches milk) will fill and swell the breasts a few days after birth. In the same vein, the baby may develop a discharge or even produce period like blood due to withdrawal of pregnancy hormones.

These events though worry mothers a lot, require no treatment as they clear with time.

That said, massaging the breasts may risk the breast milk continuing longer with a likelihood of infection (breast abscess). Unless the discharge persists, nothing apart from cleaning with cotton wool dipped in dilute salt solution should be done.

Dear doctor, whenever my little sister and I get pregnant, about one or two months later, we bleed. Is this genetic? Will my girls also bleed when they are pregnant? Do other people menstruate when pregnant?
Sandra Akullo, Mengo

Dear Sandra, bleeding in early pregnancy is quite common and as such, it can occur coincidentally in sisters but it is unlikely that the bleeding is genetic.

Vaginal bleeding may occur from the vaginal canal, an infected or delicate cervix disturbed by pregnancy hormones and this bleeding usually poses less problems to the unborn.

If bleeding is from the womb, usually the pregnancy is threatening to come out.

This happening in early pregnancy shows how unstable a pregnancy can be and usually pregnancy losses may start with unprovoked bleeding.

Pregnancy loss usually happens earlier but if an ultrasound shows that a pregnancy is normal at 13 weeks, it usually survives to delivery.

Any woman bleeding unexpectedly in pregnancy requires proper investigations because this might mean the pregnancy is at risk or it has already been lost and the womb is naturally trying to eliminate it.

An ultrasound scan will show whether the unborn is viable or not and the treatment then will depend on this. It is true that once the pregnancy is viable, even with repeated unprovoked bleeding in about 95 per cent of cases, it will survive and be delivered.

The fact that many women may bleed and still go on to deliver their babies has caused many folks to wrongly believe that such bleeding is normal.

You and your sisters then should visit your doctors before and after getting pregnant for proper care.

Saying that bleeding in pregnancy runs in your family only serves to take the problem lightly and may result in pregnancy loss or putting the mother’s life at risk.

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