Thursday, May 17, 2012

Ask Naughty Nurse Kimpy 5/16/12


Ask Naughty Nurse Kimpy is an advice column that addresses reader’s most burning questions on sexual health/relationships. STIs, birth control, is it real or is it fic, sexual positions--you name it. There are no stupid questions, only ones that are too embarrassing to asks someone you know. If Naughty Nurse Kimpy doesn’t know the answer, she’ll find an expert who does!

DISCLAIMER: The information and advice from Ask Naughty Nurse Kimpy is for entertainment/educational purposes only and is not intended to be used as expert medical advice. It is not meant to replace the advice of your physician. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.

Dear NNK, I started dating a guy in December, and in February I decided to give the Depo-Provera shot a try so that I wouldn't have to remember to take a pill every day (for the record: we used condoms during every encounter). I got the shot while I was in the middle of a period, and it just kept flowing! It went on for three weeks. I called my doctor and she prescribed some 1 mg estrogen tablets that made it go away pronto. But in the middle of March (three weeks after I'd gotten rid of my last period), it came back again (ironically, I got dumped that same day). And it's been flowing--heavily!--ever since. I've taken estrogen tablets--2 mg for 10 days--which did nothing. My doctor even did a thyroid test two weeks ago (fine), and put me on a new pill (Loestrin) since I'm close to the end of the 3-month Depo timeframe. I've been taking the pill religiously every day, and my period got a lot lighter the first week, but in the last three days, it's just gotten heavier. Of course, I'm calling the doc first thing tomorrow morning, but I was wondering if you had any other insight as to what might be causing this crazy period cycle? This has never happened to me in my life--never had a period this long, this heavy. I'm starting to seriously worry!

OY. Nurse Kimpy gives you her specialty brand of nursie hugs. Regular periods are bad enough, but periods that go on ad infinitum? No, thank you. Sadly, she doesn’t have a lot of ideas for you at this point, because she suspects that the Depo triggered your hormones to act in an unusual way. It could be that something is awry with your endocrine system, which is responsible for regulating your hormone levels. That’s likely why your doctor checked your thyroid levels, since the thyroid maintains your metabolic rate--if something is amiss with your periods, it could be related to a wonky thyroid gland. She suggests that you talk to your physician about testing other hormone levels, too, like glucose, estrogen, and progesterone, to see if some other endocrine gland might be the cause of your unruly cycle. Best of luck to you.

Hi NNK. This is a multi part question about periods. The first part is that i get really, really awful periods. I'm talking almost every symptom or side effect of period I have heard of. But the worst symptom i get is terrible, awful, immobilizing cramps every month. Is there anything I can do to make my periods less miserable? I've tried every home remedy but nothing seems to work. With advil and icy-hot patches I can dull the pain but nothing really makes my cramps go away. Please help!

You have Naughty Nurse Kimpy’s deepest sympathies. She has an aunt who suffered from endometriosis and a sister who has been on the pill for 35 years for the same reason you mention in your question--heavy, painful bleeding with every cycle. You’ve probably missed out on lots of different things in life because your periods are so heavy and disruptive. Nurse Kimpy suspects that you may have endometriosis or possibly uterine fibroids that might be contributing to your significant monthly pain. It’s also possible that you are simply a heavy bleeder. Your gynecologist can help you determine what the likely cause for your pain is, and then offer you some solutions. Nurse Kimpy’s guess is that you could try a hormonal contraceptive like the pill, the patch, or the ring, to see if that helps your symptoms improve. Most women who go on the pill tend to get lighter, shorter periods. There is even an option called Seasonale, where you have a period once every three months. The most important thing for you to do is consult with a gynecologist, and go from there. Clearly, the over-the-counter pain remedies you’ve tried aren’t going to cut it when it comes to your particular cycle. Please don’t give up; there is hope.

Hi Naughty Nurse Kimpy- first off, thanks so much for your column. It’s super helpful and I look forward to reading it each week. My question about tampons. I've been using tampons for a while now, but it has gotten to the point where they irritate my vagina. It hurts a bit when I put them in and take them out and I feel like they dry me out down there. Why do you think that is? I can't bring myself to go back to pads because it just makes everything so messy and because I'm a dancer, I just can't imagine dancing with a pad instead of a tampon. Is there something I can do to help this?

Nurse Kimpy is *very* glad that you asked this question. Your observation is absolutely correct--tampons have a tendency to dry out the vagina. While they are an effective, easy alternative to pads, they also come with a down side. Tampons work via absorbency, which they do very nicely. The problem with that is that the vagina’s preferred state of being--whether you’re bleeding or in the middle of your cycle--is moist. This moisture is one of the things your cooter uses to maintain its pH balance. When this pH level is upset, you’re more prone to yeast or bacterial infections.

Not only do tampons tend to absorb all the moisture they encounter in the vagina, they can dry it up so much that it causes tiny micro-tears in the vaginal lining when you remove them. Its most likely these tears that are causing most of the pain you feel upon removal of the tampon. Some women counteract this dryness by alternating tampons and pads. For example, they’ll wear tampons during the day, then use a pad overnight. This could be an option that would enable you to keep up dancing while wearing a tampon. To help minimize the discomfort you feel when you insert a tampon, Nurse Kimpy recommends that you use a dab of lube or KY Jelly on the tampon tip to help ease it inside.

Of course, any Naughty Nurse Kimpy conversation that focuses on periods, tampons, and pads would be incomplete without the mention of menstrual cups. There are several different brands on the market--softcups, Mooncups, Ladycups, and Lunette-- but Nurse Kimpy’s experience is with the Diva Cups. For many women, these little gems are the ticket to menstrual nirvana, should that actually exist somewhere. The great thing about menstrual cups is that they have the convenience of tampons, but they help to maintain your vagina’s moisture/pH balance naturally. The other benefit is that there is virtually no smell associated with using them, because it’s actually the bacteria that grow on moist pads and tampons that create the telltale scent of a woman. *wink* With a menstrual cup, it acts as a barrier against these bacteria, and--voila!--no smell. They’re even more amazing in the summertime, when smells tend to get exacerbated by sweat and heat. While you might be concerned about the cups leaking while you’re twisting and turning as you dance, never fear--the shape of the vagina and cervix actually work to keep it nicely in place. Naughty Nurse Kimpy even uses these herself, so she can tell you that based upon her own experience, menstrual cups are WIN. She has also heard from many readers about how much they love their cups, too.

Do you have a question for Naughty Nurse Kimpy? Click the banner below, fill out the form, and get your answer in the next installment of Ask Naughty Nurse Kimpy.



bjr70 said...

Menstrual cups are absolutely WIN! I use the Diva Cup and I also own a smaller Meluna cup that I keep in my purse in case my period starts when I'm out and about. I highly recommend every single woman reading this try them - I wish I'd discovered them sooner. They are the most comfortable and dependable thing I've ever used.

I too found tampons painful, and pads were a pain. I've never had an issue with my menstrual cup, though I will say it does take a couple of cycles to really get the hang of it.

Anonymous said...

A tip for the painful periods lady:
Evening Primrose Oil. This is an inexpensive supplement available at Target, Walmart, GNC, etc. It comes in capsules and looks very similar to vitamin E. It works wonders. Helps with PMS, cramps, bloating..basically all the icky period side effects. Take it everyday and hopefully you'll see results within a month.

fayted17 said...

My favorite thing about the menstrual cup, (I'm also a Diva user) is that since they are non-drying and not associated with TSS, you don't have to wait till your period actually begins to put it in. You can put it in a day or so before you expect it to start and just check and rinse it morning and night till it does; that way you never ruin underwear or sheets or get caught unprepared. Also helpful for those with abnormally heavy periods, is the fact that (at least on Diva) there are ounce measure markers on the side, so you can accurately track how much you're flowing per day, which may make your doctor take things more seriously. They can be a little intimidating at first, but once you get over the learning curve they are AMAZING! This community has the most comprehensive information on every type of cup and advise for any problems you might have with them.

Jennifer said...

RE: Depo and periods. I was successfully on Depo for 4 years and then I started having similar problems. Towards the end of the fourth year I would have breakthrough bleeding almost all the time. I wouldn't call them periods bc they were more like spotting. Then I would get constant bleeding. I finally stopped taking the Depo, my doctor ran tests, ultra sounds, blood work, did several pelvic exams and could not come up with a reason for the bleeding. I finally stopped the Depo in August 2010. My gyno told me to wait until I got a
Regular period and we would put in mirena. I didn't get a period until October 2010 and ha the mirena inserted. Mirena uses the same hormone as Depo but at a significantly lesser dosage. I haven't had a period since insertion, no bleeding, or breakthrough bleeding, no spotting and feel great!

kimpy0464 said...

Jennifer, thanks so much for sharing your experience! I'll be sure to pass it along to all my readers.