Ask the Doctor: How long after stopping family planning will I get pregnant?

I have been using family planning, including implants and injections for five years but want to stop. How long after stopping will I be able to get pregnant? Edith 

Dear Edith,

Although a number of women expect to get pregnant immediately after the removal of contraceptive implants and/or stopping to use contraceptive injections, the time taken may vary from woman to woman with some never getting pregnant at all.

Usually, when a woman stops using contraception, they are older and in this case, older age and its associated effects such as fibroids may delay a woman’s chances of getting pregnant.

Many Ugandan women also fear pregnancy more than Sexually Transmitted Infections (STIs) and HIV infection so that while using contraception (it is only condom contraceptive that protects against both pregnancy STIs and HIV), they engage in unprotected sex much more, risking STIs that may not only delay but stop pregnancy altogether. 

The contraceptive implant referred to as Nexplanon used most nowadays is a small matchstick-like plastic rod that is placed under the skin of the upper arm where it releases the hormone progestogen to prevent pregnancy. 

Since the implant releases small, continuous amounts of hormone into the body for three years, once removed, the body immediately goes back to its original fertility range with a woman then getting pregnant immediately or as early as one week after removing the implant. 

After using contraceptive injections (effective for three months), some hormone still remains in the body. Because of this, fertility may take longer to return with affected women taking anywhere from six months to two years to get pregnant after stopping the contraception.

It is difficult to know how long you might take to get pregnant since you kept mixing different types of contraceptives apart from the other factors mentioned above coming into play. 

What causes an itchy vagina before a period?

When my period is about to start, my private parts itch a lot. I was advised by a nurse to put yoghurt in my privates to stop it. Is this okay? Eunice

Dear Eunice,

Many women before, during or after their periods may suffer vaginal itching due to period-related  female hormone changes, a yeast infection, bacterial vaginosis infection or an allergic reaction to say, pads.

Candida, a common cause of vaginal itching, naturally occurs in the vaginal canal in low numbers. Reduced activity due to the presence of useful bacteria (lactobacilli), which create an acidic environment to limit the growth of candida and other germs including those that cause a fish-like smelling vaginal discharge (bacterial vaginosis).

It is envisaged that the destruction of lactobacilli bacteria and other normally vaginal canal occurring bacteria and overgrowth of candida here could be the cause of itching, requiring to apply yoghurt (because it has a type of lactobacillus) to reintroduce the lactobacilli.

Since there are numerous causes of vaginal itching, it is important to see your doctor who will investigate the cause of your itching before properly dealing with it to stem the itching. If the cause is overgrowth of candida, drugs that can be prescribed. These are more effective than using yoghurt, which may end up irritating the vaginal canal and cause worse symptoms.

Why do I over sweat?

I sweat too much and when this happens, I develop an uncontrollable odour. Sometimes, someone will know I have been to a certain place since this odour lingers. What can I do to stop it? Anonymous

Dear Anonymous,

Sweat itself has substances which do not cause it to smell. However, sweat may smell when left on the skin where the contained substances are broken down by skin germs, especially bacteria, resulting in body odour.

Therefore, the more one sweats the more the likelihood of the body getting the odour. This may be the reason why when you sweat a lot you experience the body odour more.

Whereas one may sweat a lot without a known cause (Primary hyperhidrosis, which is believed to be due to faulty nerve signals to the sweat glands) with the palms, soles and sometimes the face being affected, some people may sweat say all over the body due to certain causes (secondary hyperhidrosis).

This secondary hyperhidrosis may be due to conditions including infections, diabetes, menopause, thyroid problems, some cancers and use of drugs such as pain relievers.

Washing and drying the body often and properly, shaving hair in areas such as the armpits and using antiperspirants can all help minimise body odour.

If these measures do not help, then seeing one’s doctor could be more important.