How do I know the right time of the month to conceive?

Dear Doc,

How do I know the right time of the month to conceive?

Elizabeth

Dear Elizabeth,

Pregnancy happens when there is fertilisation of an ovum, which is usually released once in the middle of the menstrual cycle. The time when the ovum is released (ovulation) varies depending on the individual’s menstrual cycle, but it is usually 14 days before the next periods start.

For example, if you have a 21-day cycle, you will ovulate on day 7; if you have a 32-day cycle, you will ovulate on day 18; if you have a 28-day cycle, you will ovulate on day 14.

To increase your chances of getting pregnant, then you should have intercourse on this day and two or three days before and after.

However, for individuals with irregular cycles, predicting when ovulation will take place is difficult. For those with regular cycles, environmental and bodily changes may also change when ovulation will happen. Because of this variability, it is possible to get pregnant on any day of the cycle, including the last day of the periods.

There are test kits dispensed by pharmacies that can be used to predict ovulation. You can also learn from a natural family planning expert or gynaecologist on how to check cervical mucus for changes associated with ovulation.

Dear Doc,

How do I deal with recurring cold sores, and what causes them?

Tando

Dear Tando,

Cold sores are blisters that form on the lips or around the mouth and nose every time you have a cold. They are caused by the Herpes simplex virus. Most people get infected in childhood from other children. The virus never goes away, it hides in the body and is reactivated when you are stressed, have a cold or when there are hormonal changes in the body. You cannot completely eradicate the sores.

To manage them, gargle with some salty water or mouth wash, use some topical creams to relieve the pain and inflammation, and use anti-viral medication for the cold sores. Avoid very hot food or drinks and very salty, spicy or acidic foods. Take a lot of water and have good dental care.

You may also benefit from vitamin B and folic acid supplements. If a sore lasts for more than two weeks without healing, it is important that you be reviewed by a doctor. 

Dr Flo,

During a recent visit to a doctor, I had blood tests done and the doctor said I had vitamin D deficiency. I was also told that I can get the vitamin by sitting in the sun. Kindly shed light on this and its implications.

Alnashir

Dear Alnashir,

Vitamin D is an important vitamin as it influences almost all systems in the body. It is made from cholesterol when your skin is exposed to sunlight. It can also be found in fatty fish, fish liver oils, egg yolk and fortified dairy and grain products. Levels in blood of between 20 and 50 ng/ml are considered normal.

Vitamin D deficiency can occur if you do not have enough exposure to sunlight; if you always wear sunscreen; if you have a strict vegan diet; if you are not able to absorb vitamin D well from the intestines; if your kidneys are not able to convert Vitamin D to its active form; if you are elderly; if you are obese; or if you have dark skin and live far from the equator.

Vitamin D deficiency can lead to weak bones, bone and muscle pain, frequent infections, fatigue, depressed mood, poor wound healing and hair loss. Adequate vitamin D also helps protect against diabetes, hypertension, multiple sclerosis, cancer and dementia.

Adequate sun exposure, a vitamin D-rich diet and supplements help to restore Vitamin D levels. Living in an equatorial country is not enough to get adequate sun exposure, you must get direct sun exposure on your skin.

Dear Dr Flo,

I have this swelling on the left side of my abdomen slightly above my penis. It has been there for a while and it’s painless. I, however, feel discomfort and pain when it gets bigger, like when I need to go to the toilet. What could be issue? Please help.

Dear reader,

You may be having a hernia, which is a swelling that occurs when underlying organs push through a weakness in the muscle or tissue that holds it in, for example, when intestines protrude through a weakness in the abdominal wall so that in that area, they are lying just under the skin.

Hernias commonly appear in the abdomen, at the umbilicus, inguinal region (upper thigh), groin or at the site of a previous abdominal surgery.

In the early stages, it can easily go back in and come out when internal pressure increases, such as when you cough or strain your muscles to lift something or to pass stool. Complications can arise when a part of the intestine gets trapped, causing severe pain, nausea and vomiting and constipation. If the trapped intestine does not get blood supply, then the tissue can die, which leads to perforation, serious infection and possible death.

Because it happens due to a weakness or an opening in the overlying tissue, the only way to manage it permanently is through surgery to close up the weak or open area. It is advisable for you to have an ultrasound scan done to properly define the swelling and then be reviewed by a surgeon for the way forward.