DEAR DR. GOTT: I just had my menstrual cycle on my birthday last month and now have it again. Can you please explain to me what’s wrong?
DEAR READER: I will attempt to respond to your question in a general manner because you do not provide enough information in your letter.
A menstrual cycle is not the same for every woman. Generally speaking, it occurs every 28 days and lasts between four to seven days. Variation in flow, regularity and more are extremely common in young women just starting their cycles, as well as in women approaching menopause. Other causes of abnormalities include recent weight gain or loss, a new rigorous exercise or workout routine, a change in birth-control medication, illness, bleeding disorders such as von Willebrand disease, the insertion of an intrauterine device (IUD), uterine fibroids, uterine infection (pelvic inflammatory disease) and the use of specific drugs – specifically, steroids and anticoagulants and more.
Menopause is the name given to the transition period in a woman’s life when the ovaries cease producing eggs. If you are in your 30s or 40s with irregular, longer, shorter, heavier or lighter cycles, hot flashes, problems sleeping, headaches, mood swings, a lack of interest in sex, palpitations and vaginal dryness, you may have perimenopause, a prelude to menopause. Once a female has gone through 12 months without a period, perimenopause is technically over, a woman reaches menopause and is no longer able to conceive. Some women may become symptom-free rather quickly; however, for others, symptoms can last five years or longer.
There are a number of steps a woman can take to avoid side effects while going through menopause. They include dressing in lighter clothing or in layers to combat hot flashes; avoiding spicy foods, caffeine and excessive alcohol; adding sufficient calcium and vitamin D to your foods or in supplements; and practicing yoga, tai chi or other relaxation techniques.
I recommend that you visit your primary-care physician or gynecologist to discuss the situation. Allow him or her to help put the pieces of the puzzle together to determine whether you are in the early stages of menopause or whether something else is going on that should be addressed.
DEAR DR. GOTT: You receive a lot of requests about knee-pain treatments versus surgery, but I have never seen you mention Synvisc-One. I’m 80 years old and have had two injections over the past 2 1/2 years. They last a year or more and take effect a few weeks following the injection.
DEAR READER: This 2009 FDA-approved medication contains hylan polymers, produced from chicken comb. It is similar to the fluid that surrounds the joints of your body and acts as a lubricant. It is injected directly into the intra-articular space inside the knee and is prescribed for the treatment of osteoarthritis pain in patients who have failed to respond to more conservative therapy. A single dose is reported to reduce pain for up to 26 weeks.
The theory is not a new one. Hyaluronic acid derived from chicken comb was recognized 14 years ago as an alternative treatment for people who wanted to delay surgery.
Because Synvisc-One is relatively new, I don’t know its long-term effects. Therefore, I can only thank you for bringing it to my attention. It is certainly an option for readers to discuss with their orthopedic surgeons.