Fifteen and Infertile?

Hello Dr. Kate,

I'm 15 years old and I'm worried about my irregular periods. My first period was when I was 13 years old and it lasted about 3 weeks! Then it came every 3 or so months, but I then went 7 months. When I finally got my period it lasted 28 days in total. I went to the doctor who prescribed me these birth control pills and then my period actually stopped the next day. But then it didn't come for about another 4 months, and in December 2009 I got a period and that lasted 6 days, but by the end of February I hadn't had my period. I'm so worried over this. I read posts about women having cancer or being infertile and it scares me so much, i just want to be like my friends who have periods every month lasting 7 days. I just want to be normal. I haven't seen a gynecologist, but I'm scared, I don't want anyone to look at my 'private parts' or anything like that. Please can you help me?

Fifteen and Infertile?

Dear Fifteen,

It's REALLY typical to have irregular periods all throughout your teenage years. Yes, you're at the extreme end of what's normal. But your body isn't used to ovulating each month yet--and when you don't ovulate, you don't get a period. If you're otherwise healthy, I doubt anything else is wrong.

I think that the best thing for you to do is to stay on birth control (pills, patches or rings, whichever you find easiest to take). If you use them in the standard way--three weeks of hormones, followed by a hormone-free (pill-free, ring-free, or patch-free) week--you should see a "period" most months. It may be light, and it may be short, but it will generally be something. The fact that you've had periods at all (even if only a few of them), means you have all the right "parts." We just need to wait for your hormones to get in sync, to give you that monthly bleed that you really want.

If you want to see a gynecologist, for more peace of mind, they DON'T NEED to do a pelvic exam to talk with you about birth control and your periods. You have every right to decline one, and still get care. And if you go to a doctor who insists on an exam, go to a different doctor. They can find out all they need to about your health with blood tests and maybe an ultrasound. But I want you to get help without being afraid to go (even though pelvic exams aren't really bad, I promise).

Best of health,
Dr. Kate

IUDs and Odors of Unknown Origin

Dr. Kate,

About six months ago I upgraded from the pill to a Mirena IUD and it was the best decision of my life. I haven't had any side effects or any weirdness during sex with the strings, etc. However, I've noticed that my vaginal discharge has become particularly pungent since my IUD and I'm rather concerned. Could it simply be some terribly rare side-effect of the IUD my doctor failed to mention? Or is this sign of my body somehow rejecting the implant?

Or (to throw a wrench in the whole scenario) could it be my boyfriend? I began dating my current beau about a month before getting my IUD and because the odor is more noticeable after we've had sex, I'm wondering if somehow our juices don't jive, so to speak, and the IUD is merely a coincidence? Either way I'm torn because I love them both so dearly!

Thanks,
Stand By Your Man & Your Implant

Dear SBYMAYI,

The good news is that the Mirena is not causing your discharge. The only part of the Mirena that's in your vagina are the strings--and these were designed to be bacteria-repellent (or at least, not attractive to them). And if your body were rejecting the IUD, you'd have crazy bleeding or cramping, and it doesn't sound like you've had to worry about that. So the Mirena gets to stay!

The bad news is that the change in your discharge may be due to bacterial vaginosis (BV), which is likely due to the increased amount of sex you're having. It's not so much as a bad mix of juices--sex just changes the pH of the vagina, and makes it more likely to have strange odors or BV (which is overgrowth of one of the native bacteria). See your gyno, and have her do a wet prep test in the office to see if you have BV. If so, a course of antibiotics should clear it up. And if you continue to have recurrent BV, you may want to go on prophylactic antibiotics (or see if using condoms makes a difference). So I think the boyfriend gets to stay as well.

Best of health,
Dr. Kate

Going Commando

Dear Dr. Kate,

I recently read in a women's health quiz that GYNs encourage patients to go without underwear when their clothing permits. I've tried this out for a couple of weeks and have actually noticed that I have less vaginal itching and irritation (and laundry), but is it really recommended?

Going Commando

Dear Commando,

I do recommend skipping underwear for patients with a lot of itching and irritation, since letting the vagina "breathe" seems to help (as it did for you). If they find it difficult or uncomfortable to do that during the day, they can simply go to sleep without underwear. And the nighttime nudity seems to work just as well. For women without any vulva worries, I don't particularly recommend it. But there's absolutely nothing wrong with going panty-less as often as you want.

Best of health,
Dr. Kate

Photo credit: the queen of subtle