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.