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Can I preserve my fertility?

I've heard so many horror stories of women who wait until their mid-thirties or later to have children, then find out that they are infertile. I'm 25 years old now and nowhere near getting married or having babies, yet I don't want this to happen to me when I'm ready. What can I do now to protect my fertility and make sure I am able to conceive when the time is right? It's causing me a lot of anxiety!!


What should I do if I'm successful but not happy?

I'm not in college anymore, but students could benefit from this question, too. I'm single with a 'great' job (pays well, insurance, pension, etc.), a decent place to live, no debt... in short, life could be much worse. But the only thing lately that makes me happy is doing kind things anonymously for people. I'm rather wealthy but don't want a big TV or a fancy car. I'd rather spend a vacation at a local monastery meditating and performing service. I'd be committing economic suicide to quit my job, and so many are worse off, but 'success through hard work' doesn't make me happy. I'm sure a number of students must have these feelings already. What are your feelings about this, Alice?


What's the process for egg donation and is it safe?

1) I have seen multiple advertisements for egg donation in my school's newspaper. I could sell my eggs for $25,000 or more! That's a year of tuition! There's got to be a catch. When I do some research to find out the procedure and the risks, I only seem to find oocyte donation "businesses" — not the most straight forward sources on the subject. Alice, I trust you! Can you tell me... what have I got to lose?

2) I see lots of ads in the paper here at my school about egg donors wanted. I think that I would like to donate an egg, but I can't find any information on the net about donating — only about receiving a donation. Can you tell me what the process is like, how long it takes, and whether there are side effects or permanent long-term effects? Or point me towards some other resource.


Does marijuana produce serotonin?

My girlfriend tells me she uses marijuana to calm herself if she is having a stressful day. She has been doing this for many years. She says smoking pot is like self-medicating — it is better than using anti-depressants. She also claims smoking pot helps with depression because of how it helps produce serotonin in the body. What is serotonin and how does it help depression? Does smoking pot really help with managing your anxiety, depression, etc.?


Why do I feel guilty after orgasming?

Every time I have an orgasm (alone or with a partner) I have intense feelings of guilt. I was not brought up in a religious household and was never told to "wait until marriage". I've been in long term relationships with all my sexual partners so it's not like I feel guilty for sleeping around. It's getting to the point where I'm not enjoying sex anymore because I dread the feelings I have after an orgasm. Is this normal?


How do I tell my girlfriend I'm sterile?

I am an 18-year-old male. And I lost my ability to reproduce in a bull riding accident at a rodeo I competed in about two years ago. I would like to father children more than anything. And now I have a girlfriend who is talking of wanting to have kids in the future. But I can't bring myself to tell her that I can't because I still haven't dealt with the problem of coping with it myself. I need to know how to deal with the fact I cannot have kids, especially now that my significant other wants them, but is ignorant to the fact that I am sterile. Please help me ASAP! This is tearing me apart.


Can I go off and on birth control pills on my own?

I've been on birth control pills for eight years and I'm thinking about trying a few months off them. They were prescribed when I was pretty young because of very irregular periods. I also was involved in a monogamous relationship for a number of years, so they were convenient. Now I have no steady partner, and am really curious to see how I feel without taking these pills. Would it be ok to go off them at the end of my pill pack or should I consult someone at health services first? If I go off for a few months and my periods are as horrendous as they were when I was younger, would it be safe to start up again on my own (I usually just see someone once per year for pill checks)?


What is my risk of postpartum depression as a mom-to-be with social anxiety disorder?

I'm an anxious person. My clinical diagnosis is social anxiety disorder, but I have anxiety in many other situations and a couple of phobias to boot. I've seen therapists on and off for the past 20 years and have been on multiple SSRIs (I am off of anti-anxiety medications currently). I manage my anxiety with plenty of exercise, sleep, and relaxation exercises, but mostly I just accept that this is the way I am. My husband and I are starting a family soon, and my new worry is post-partum depression or anxiety. If I'm already moody, will the hormones and stresses of pregnancy drive me completely crazy? Does having a history of mental illness put me at a greater risk for developing a disorder like post-partum depression? Thanks for your help!


When should I take a pregnancy test if I have a late period?

My period is late this month, and I'm afraid that I may be pregnant. The weird thing is, though, my partner and I never actually had actual sexual intercourse (in other words, there was no penetration). I'm wondering if the wet environment could still be a risk. I'm hoping that it's due to stress and fatigue with finals coming on that causing this delay. How long should I wait before getting tested?


Is it normal to spot with a NuvaRing?

I have been on the Nuvaring for three months now, and I am keeping it in for the four weeks then changing it because my doctor said there's no need for me to have a period. About two weeks ago I started having dark brown discharge and it has gotten more heavy, but only when I run or stand up real quick. Is this normal or should I call my doctor and find out what is going on?


Can I treat depression on my own?

I'm a first year college student. Since the holidays I started experiencing a very strong horrible feeling; so horrible I preferred to die than to keep on feeling it (the suicidal thoughts come and go still, but it's not as strong as in the beginning). It's very puzzling though because I don't have a reason to feel like this, not one that I know of at least.

I thought of going to a psychologist, or psychiatrist, but I don't have money to do so, and I thought that maybe I should try curing myself first. Is there any way to try to fight depression by myself? Also, if I don't have a reason to feel depressed, what reasons could there be for what's happening to me? I read in other things you wrote to people that depression may be also caused by chemical imbalances in the brain. How do I know if that's happening to me?


How do I learn to not judge interracial relationships?

I find that I get a feeling that I do not know how to explain; it is sort of a sad, discouraged feeling, when I see a black man with a white woman. I am a black female adolescent (20 y/o). I am not a racist. Also, I know of many people both black and white who are not racists but feel the same way. I am not angry at interracial couples when I see them together or anything of that sort. How can I be at ease when I see them, besides that it is not my business? I want to know what possible underlying causes can make people feel this way. How do I unlearn this habit?


Can excessive orgasming deplete endorphins?

Since orgasms cause a release of endorphins into one's cerebral-spinal fluid and endorphins are also somewhat responsible for the emotion of happiness, etc., is it possible that excessive masturbation and/or intercourse would lead to a depleted level of endorphins in the system that could in turn cause one's affect to become somewhat "flat"? Could a sustained low level of endorphins in the system induce depression and/or mood disorder?


Is Mirena safe for those who have yet to give birth?

I have recently been advised that my on-going migraines might be caused and/or increased by the use of contraceptives containing estrogen. To that end, I have been recommended to switch to a progesterone-only form of birth control. Which, in turn, basically means I get to choose between Implanon and Mirena (I really can't stand needles, so Depo is out for me!). I am only 23 years old, and have not yet started a family. I do want to have children someday, and am very enticed by the idea of Mirena lasting to the point when I might want to begin trying to get pregnant. However, all of the advertisements for Mirena state that ideal candidates have already had children.

Is Mirena still safe for use in women who have not yet given birth? If so are there any additional side effects to consider in this instance?


Am I depressed?

1) How can you tell if you are psychologically depressed? How do you ask? What if you are only depressed sometimes? I am a first-year psychology student, I live in college, and I seem to be having plenty of mood swings lately. I used to be very bubbly and enthusiastic and happy and relaxed all the time, but lately, I've just been edgy and sad, and I cry a lot. What's going on? I've been at university now for nine months. I'm only seventeen, and I live away from home (and I'm happy about that). I still have fun sometimes, and I get involved a lot, but then something will happen and I just bomb. I feel helpless and useless and angry because I am unappreciated. It annoys my friends and that makes me feel even worse. What's going on?

2) How do I know if I am depressed and need help? For about a year now, I have been easily irritated, angry, I cry when something sad or happy happens, I have lost seven pounds (last year), sometimes I have a hard time sleeping at night. I go over everything I did wrong in a day, and I have a hard time trying to concentrate on reading. I have wanted to mention this to my doctor, but I am very shy about it. He says I am physically healthy. I have tried exercising, and taking warm baths to help me feel better. What is wrong with me?


Why do I choose not to eat?

I really hope you can help me. I'm 21 years old and never had any problems with eating. At 18, I sunk into a very deep depression and since then my eating has not been the same. It started slowly, where I would just skip a meal every now and then, but now I sometimes choose to go for days without eating and it's not because I want to lose weight, even though I have lost quite a bit, I just feel like I can't change anything in my life. I love my friends and I always have a great time with them, but at the same time, I find it so much easier to not eat when with them. That's what I can't understand. Why, if I feel happy around my friends, do I still choose not to eat? I went for almost a week without eating when I was away with them. For some bizarre reason, I feel better about my life when I stick to my decision to not do something, but at the same time, I want to stop, but I'm afraid I'll get really depressed. It doesn't really hurt me, but my friends harass me and I can't help them to understand when I don't even understand. Why am I doing this??


Is it possible to have orgasms after childbirth?

My wife and I had our first child last July. Until about 3 months ago, she was unable to reach orgasm at all. Of late, she has very small one's, but they don't seem to be getting much better. Prior to having the baby, she had strong, very quick (3-5 minutes) orgasms 90% of the time. I know the stress of being at work rather than home with the baby could play a part in this. Is this common and is there a way to mitigate the problem? 


What are the health effects of only having one ovary?

I'm a 19-year-old female. I had my right ovary removed (oophorectomy) three years ago due to a very large ovarian cyst. I was assured by my gynecologist that I'm still capable of bearing children but wasn't informed thoroughly of all of the pros and cons in regards to this type of operation (e.g., can the estrogen loss have any negative physical affects?). If you could shed some light on this matter, it would be greatly appreciated. Thanks.


How can I help my friend who struggles with mental health and can't afford professional support?

1) I have a close friend who has a number of rather difficult issues. One of the most important is a long history of abuse (largely psychological) from her mother during her childhood. (She is now 19.) It is incredibly difficult to talk to her about any of these things. I would like her to see Psych Services, but I am worried about the fact that there are only a limited number of sessions available — that is actually one of the reasons she has offered to me as to why it would be a waste of time to go. Unfortunately, the only medical coverage she has is through her mother's medical insurance, she has no real money outside of her parent's control — it would be extremely difficult for her to pay for counseling, in other words, without alerting her parents. What can she do? What can I do?

2) I am actually asking for a friend of mine since this situation is getting worse, and I don't know how to help. The problem is that my friend is very depressed, and has very, very low self-esteem. While sometimes able to be cheerful and "happy," he claims to rarely feel that way and mostly just hates himself. He has mentioned suicide, although I think this is more an expression of the extreme self-hatred he feels than anything. I comfort him and often tell him how wonderful he is — what a good person, good qualities, etc., but I suspect he does not believe me at all. This has been going on for a long time now, and I think it stems from a somewhat unhappy childhood and adolescence. I don't know how to help him and I don't know what to do. I feel like being strong for him is just not enough, and I can't quite convince him that counseling may do some good. It seems to me that, recently, he has been feeling even worse about himself, to the point where nothing will comfort him. He cannot afford counseling, and he has no health insurance. Is there anything you can suggest for me to tell him or suggest to him? Any help will be greatly appreciated, because I just don't how to help him. Thank you so much.


How can I support a friend with mental health concerns when I’m struggling myself?

1) This is more of a coping question. I am a first-year who applied for a single room over the summer and was denied. I figured that everything would be okay nevertheless. I tried to look at the situation as a character-builder. Well, that is not the case. My roommate is very depressed. I talked to the RA on my floor, but she didn't take any action, except to talk with her. Unfortunately, my roommate is so ashamed of what's happening that she denied the facts, and the RA believed her. No one except me has realized yet that she is sleeping most of the day and all of the night, and that it is indeed a real problem. I have expressed my concern to her and encouraged her to go to counseling services. She went a couple of times and then started canceling appointments left and right. I have worried about her, but I have no backup whatsoever, so there is really nothing I can do to help at this point. We get along relatively well otherwise.

Right now, the concern I have is that her depression is pulling me down, too. I literally have not been alone anywhere for more than two to three minutes in weeks. I wanted a single because it's a requirement that I spend some time by myself, and I'm going crazy these days. The lights are always out in the room, and I've noticed that I'm sleeping more than usual myself as the situation has progressed. Also, I am having to deal with some personal issues of my own this semester, and I simply don't have the energy to take care of someone else who desperately wishes that I would do so. Any ideas would be greatly appreciated.

2) I know that when a friend is depressed, it's important to reach out, discuss the issue, and be there for the person as much as possible. But that's quite hard to do when I myself have a history with depression — I feel as if her emotions are taking me back to a place that I don't want to go. I really empathize with my friend and feel her pain, but at the same time know that I'd be useless to both of us if I'm in the troughs too. How can I help without sacrificing my always precarious emotional equilibrium?


What's polycystic ovary syndrome?

1) This is in reference to your Missed periods Q&A. Another cause of missed or late periods is PCOS (polycystic ovary syndrome). A lot of health care providers don't seem to be aware of this syndrome. In this syndrome, missed or irregular periods are caused by unusual hormone levels, sometimes in combination with insulin intolerance. Because missed and irregular periods cause scar tissue build-up in the uterus (which may cause endometrial cancer) and may cause infertility, it is important that your readers know to ask their health care provider about this syndrome. There are obviously other symptoms and complications, but I just thought that I might mention it to you so that you might read up on it for your readers. Thank you.

2) I was recently diagnosed with polycystic ovary syndrome (PCOS). I'm only 17 and am afraid that this will affect my chance of having children. Should I worry? Also, I know birth control pills will help me regulate my period, but if I take them, will it stop the effects PCOS has on me? Like me gaining rapid weight, missed periods, and losing my hair? This is really worrying me. Can you inform me on this syndrome?


If I'm recovering from anorexia, when should I expect to get my period back?

I was anorexic for three years and I have been in recovery for two. At the moment, I am doing well. I have a healthy weight, I eat a balanced diet, I work out regularly though not excessively, and I feel good. However, I haven't had my period in about three years now. I had been told it would come back once I reached a healthy weight, but so far, no deal, even though I've been at this weight for over a year now.

Before I became anorexic, I did get my period regularly. I am 23 years old. I am taking a calcium supplement daily to prevent osteoporosis, but I would feel more comfortable if I did get my period again. What is going on? How worried should I be? Should I go see a doctor? What can I do about this?


Is there a connection between cortisol, depression, and weight loss?

I recently went to my doctor because I've been unable to lose weight. I've been on a successful diet, accompanied with a reasonable exercise plan, but I've seen no real results. A series of tests were run — I've got optimum blood pressure, low cholesterol, and I am not diabetic. But, when my cortisol levels were checked — they were very high. The doctor suspected there was a possibility that I might have Cushings' Syndrome — but another test was run and that came up negative.

I was doing research on the internet, and I found that there was a link between excessive cortisol and depression. I was diagnosed with clinical depression when I was 12 (I am now 21). And I am currently untreated. What is the link between cortisol levels and depression? Are excessive cortisol levels a physical manifestation of depression? Or does an excess of cortisol for some other reason cause depression? Does an excessive amount of cortisol cause weight gain, or in my case prohibit weight loss? And if there is a connection — will treatment for my clinical depression (in the form of prescription pills) help me?

I've been unable to find answers anywhere, or at least a good source to tell me to stop worrying — any help would be appreciated.


If I don't take birth control pills at exactly the same time am I unprotected?

I have two questions, first: On my birth control pill box instructions it says to take a pill each day at ABOUT the same time. I was wondering, does this mean that I should set an alarm to make sure I take it the exact minute every day (which is what I've been doing) or can I take it within a couple of hours difference if I decide to sleep in on Saturday?

Secondly: My doctor told me that if I miss a pill to consider myself unprotected for that month. However, after I left I realized that in biology class we learned that a ovum (or egg) can only survive a few days inside the fallopian tubes and uterus and then it get absorbed into the body (or dies). If I missed a pill then wouldn't I only be unprotected for the next couple of days (if an egg was produced in the 24 hr period that I didn't take the pill) instead of the whole month?


Why do I pull my hair out as a form of self punishment?

Ever since I was in junior high, I have been pulling out my hair. I can remember not being able to pull my hair into a ponytail because the hair at the nape of my neck wouldn't reach. I still have this awful and shameful habit. I don't see it so much as just a habit, like the way one might bite one's nails, it's more like an obsession. I'll just sit and stare into space and pull clumps of hair out of my head. I remember having seen a program on T.V. which dealt with this habit as a medical problem that is curable with medication. Unlike the men and women represented on this program, I am not stripping myself bald — yet. I tend to consider it a form of self-punishment, perhaps. Just to give you some background information, I have a tendency towards bulimia (cycles of bulimia occur when my depression is at its worst) and am in general not a happy camper. What can you tell me about this?


Can lowered testosterone levels in women reduce sex drive?

Do you have any information on the effects of low testosterone concerning sexual desire in women? After I got pregnant, I have had a significant drop in sexual desire and think it could be related to low testosterone. Any info on the subject? By the way, this problem had nothing to do with stress, marital problems, or the baby. Everything in my life is great except I lost my sexual desire and want to get it back. THANKS.


What should I do if I'm pregnant where abortion isn't legal?

I am really nervous because my period is a week late so far and I am studying abroad in Egypt. I really don't know who to talk to about this. Premarital sex is a big taboo, abortion is illegal, and I can't even find a pregnancy test at a pharmacy. What should I do? I can't come back to the U.S. with a big belly — I can't tell my family! I am so afraid! I left the U.S. a month ago (my partner is still there). I read that jetlag can influence your menstrual cycle, as can weight gain or loss. I was jetlagged, but my weight is more or less the same (except I am eating more rice and oil than I do normally). Could diet change your cycle? Anyway, I guess my main question is, what should you do if you find out you are pregnant in a conservative country where abortion is illegal and don't have enough money to fly home and back? Thanks.


What should I do if I'm pregnant and undecided?

I am nineteen-years-old. I just found out that I'm pregnant. I have been with the guy for two years and in college for one year. We are not financially stable. We have given it a lot of thought, but still do not know what to do. I have looked at the pros and cons and still I'm not sure. I have three little sisters and know that raising children is a hard job. Throughout this time I have leaned more toward the abortion, but don't feel like I know enough about it. Can you please HELP?