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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'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.


Is it safe to chew and spit out food?

I have been chewing and spitting large amounts of food (pretty much always sweet stuff — pastries, chocolate, etc.) almost every night for eight or nine months. I am eating a healthy, balanced diet otherwise, maybe a little on the lower caloric side (1300 to 1500 calories per day). My chewing and spitting sessions usually follow a balanced meal. I know this is a type of eating disorder. I have done a lot of research online and I know that there are side effects, although they vary depending on who you ask. Some sites mention that chewing and spitting activates the release of insulin and results in hyperinsulinemia, insulin resistance and weight gain. Is this true? How long would it take to develop these problems? Are these reversible if I were to stop this behavior?


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?


Why am I insatiably hungry and losing weight?

I've read a lot lately about midnight snacking and late night eating and obesity and calorie worries, but my problem lies in the opposite direction — I'm LOSING weight, and insatiably hungry, day and night! The only advice I get is, "Eat healthy," which is preaching to the choir, since I consume more fresh produce, mostly vegetables, and home-cook all my own meals. At a recent nutrition check-up, the nutritionist patted me on the back in congratulations for having one of the healthiest lifestyles he's seen, and shrugged at my inexplicable hunger. The fact is, I'm in the kitchen every other hour, and my body doesn't differentiate between awake and asleep anymore when it comes to hunger. I go to bed on a full stomach, and wake up every three hours to eat again. It's exhausting! I'm falling asleep during the day — but never more than an hour, because hunger strikes. And amid all this, my grocery bill climbs and my weight drops. I don't get it. What am I doing wrong?


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?


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? 


Can I lose fat and build muscle mass at the same time?

A friend of mine and I were disagreeing about this point and I thought maybe you could help. I have heard that it is not possible to both lose fat and build muscle mass simultaneously: ideally, a person should do cardiovascular exercise with dieting to lose extra body fat, and then start to focus on building up muscle mass. He says it's possible to both burn fat and build up muscle over the same period of time. Which is the case?


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.


Am I the right BMI and weight for my height?

1) A friend and I were discussing this. We both try to stay healthy by eating well (high fiber, low fat, lots of veggies, fruit, etc.) and living an active enough lifestyle (hiking, rock climbing, biking, etc.) that we stay in shape. The question we have, then, is what the current "rules" are for appropriate weight/height ratios? Or are such measurements now thrown out in favor of body fat percentage measurements? She's 5'1" and I'm 6'1" and we're curious what the medical rule of thumb would be for how much each of us "should" weigh...mostly because we're wondering if it takes into account things like muscle mass. What would the current medical/health industry recommend each of us weigh? Are these numbers accepted or are they seen as not as important as they might have been 20 years ago. If you have actual numbers, we'd be curious to see that too. Thanks! I have a dinner riding on this!

2) Could you clarify the Body Mass Index deal? According to one BMI chart, I am "slightly overweight" because I am 5' 5-1/2" tall and weigh 160 lb. I am also very muscular and have a large frame. The lower BMI readings are labeled "ideal," but I've heard muscle weighs more than fat, so if the chart does not include the muscle factor, is it basically saying that it's "ideal" NOT to have extra muscle? I look slender and have never been told by a doctor to lose weight. I'm a twenty-four-year-old female, lacto-ovo-vegetarian, and get lots of exercise, including walking and frequent "sweaty" workouts.


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?


Does exercising on an empty stomach maximize fat burning?

I have recently learned that in order to burn fat as a fuel, your body requires carbohydrate. Up until this point I had been doing cardio training first thing in the morning on an empty stomach, as I had read that this is optimum for fat burning. However, now I have a small carbohydrate snack before I train in order to prevent my body using lean muscle tissue as a fuel. Today I have again read in another book that training on an empty stomach first thing in the morning burns the most fat. I am a little confused over the best thing to do! I train with weights twice a week and do cardio three times per week. I do want to maintain my lean muscle, but am looking to reduce my body fat.


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?


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?


Can you lose weight if you meet your caloric goal early in the day?

My friends and I disagree — can you settle the dispute? I feel a calorie is a calorie no matter what time of day that you eat it. They say that if you eat all of your calories early in the day, that it is less fattening, because you will be moving around burning off those calories. I say that if you eat 1800 calories a day, it doesn't matter if you eat them in five meals or ten meals, it is still 1800 calories. I believe that the idea of not eating anything after 7 p.m. helps you to lose weight because you cut out the high calorie, high fat foods that are often eaten late in the evening. They say that by not eating after 7 p.m., you lose weight because you're not moving to burn off those calories. Please settle the dispute. Thanks.