What kind of birth control pill should i ask my doctor about?

Q. I want a birth control pill that does the following:
HIGHLY effective at preventing pregnancy
Makes acne go away
DOES cause weight gain. I am underweight and have struggled with gaining weight all my life.
Preferably makes my periods only 3-4 days? And only have periods 4 times a year instead of once a month?

-I have never been on birth control before
-I have not had a child

A. All combined pills have a 99.8% efficacy. The only pill licenced for acne is Dianette. I would generalise that I am unhappy about any long term use of Dianette. There have been risk benefit concerns about its use for many years. These MUST at least be explained to any patient using it, in order that they can give informed consent that they still wish to take the drug.

The problem is that Dianette quadruples the risk of DVT, leg clots, which may fire off into the lungs and produce fatal emboli.

http://www.nelm.nhs.uk/en/NeLM-Area/News/494080/494143/494162/
http://www.dailymail.co.uk/health/article-1195416/My-daughter-killed-lethal-drug-Charity-shop-worker-dies-DVT-just-weeks-switching-new-Pill.html

Also you need to be aware it only has a short use licence:

"Complete remission of acne is to be expected in nearly all cases, often within a few months, but in particularly severe cases treatment for longer may be necessary before the full benefit is seen. It is recommended that treatment be withdrawn 3 to 4 cycles after the indicated condition(s) has/have completely resolved and that Dianette is not continued solely to provide oral contraception. Repeat courses of Dianette may be given if the androgen-dependent condition(s) recur."

Yasmin is thought to improve acne in a similar way, but without the addition increase in clot risk, so that would be my choice.


What is the most pressing public health problem in Scotland?
Q. What do you think?I think it is binge drinking,alcoholism and drug abuse?What do you think has contributed to this problem and what measures do you think has the government and the NHS have taken to combat this problem.Have all the methods failed or is there still hope.Exact details and statistics welcome.

A. Drinking problems. It's deep rooted in Scottish behaviour and is now also a major problem in England. It is a huge social, as well as health problem. Targeting younger people with 'alcho-pops' is a cause. Years ago, when only beer & lager were easily accessible and affordable, people couldn't get so much alcohol into their systems as they can now, with the much stronger and sweeter drinks. They also have more money to spend than in the past so can afford to go out more often and drink more when they do go out.
The Government is waking up to this problem and I would expect more taxes imposed on alcohol in the future. More drink related legislation will be imposed too, with drinking in public places other than bars being outlawed.
The excessive drinking is closely linked to other social problems, such as violence, a sharp rise in sexual disease and unwanted pregnancies. People don't use common sense when drunk.


How long after delivery can a woman have vaginal surgery?
Q. Last year, my wife had our first child. She didn't get surgery to "fix" her in her vaginal area. She torn a little bit and they stitched her up. But from what I understand, the doctor mentioned surgery but she refused. Now she mentions that when he have intercourse, that it feels weird and that it feels loose. Is there anything she can do, would she have to wait for next pregnancy or is there surgery she can do now? Thanks for your mature and responsible answers.

A. Of course there is things that can be done, but i dont know if the NHS would do it? Get her to go see her GP :)


Can Indian women travel from India to the UK to give birth for free?
Q. because the NHS is free, i want to benefit from it, also i want to get the British citizenship for me and my baby and my husband also my mom.

Answer it.

A. No you cannot travel from India to the UK to give birth for free.

The NHS is only free for non UK residents for emergencies. A pregnancy is not considered an emergency.

f you are pregnant, you would not be granted a visa to travel anywhere near the due date UNLESS you have arranged for a private medical birth in the UK and have the documents and proof of funds as evidence.

It is a popular misconception that the NHS is free. It is not. UK residents pay through their National Insurance contributions and taxes for the privilege of non-charged health care. Basically if you don't pay in - you can't use the facility.

To access free NHS care you would need to be registered with a NHS doctor's surgery and to become registered, you would need to prove legal residence in the UK.

On the subject of British citizenship for your child, you are 27 years too late. Since 1 Jan 1983, anyone born in the UK must have a British parent or a parent legally settled in the UK to be British. Even if the child was able to claim British citizenship, it would give no rights to any other family member, even its mother, to British citizenship.





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Does anyone know about HCG levels before and after a partial molar pregnancy?

Q. i found out i had a partial molar pregnancy after my d and c. before the d and c my hcg level was at 166,000. two weeks after its still 5000. is it normal to still be so high? my doctor doesn't seem to know the answer to this question. the whole pmp is a big waiting game and i am just trying to find out more information.

A. I was googling something else and found this on Wiki:

Levels of hCG may be measured in the blood or urine. Most commonly, this is done as a pregnancy test, intended to indicate the presence or absence of an implanted embryo. Testing for hCG may also be done when diagnosing or monitoring germ cell tumors and gestational trophoblastic disease.

Most tests employ a monoclonal antibody, which is specific to the β-subunit of hCG (β-hCG). This procedure is employed to ensure that tests do not make false positives by confusing hCG with LH and FSH. (The latter two are always present at varying levels in the body, whereas the presence of hCG almost always indicates pregnancy.)

The urine test may be a chromatographic immunoassay or any of several other test formats, home-, physician's office-, or laboratory-based.[6] Published detection thresholds range from 20 to 100 mIU/ml, depending on the brand of test.[7] Early in pregnancy, more accurate results may be obtained by using the first urine of the morning when hCG levels are highest. When the urine is dilute (specific gravity less than 1.015), the hCG concentration may not be representative of the blood concentration, and the test may be falsely negative.
The serum test, using 2-4 mL of venous blood, is typically a chemiluminescent or fluorimetric immunoassay[6] that can detect βhCG levels as low as 5 mIU/ml and allows quantification of the βhCG concentration. The ability to quantitate the βhCG level is useful in the monitoring germ cell and trophoblastic tumors, followup care after miscarriage, and in diagnosis of and follow-up care after treatment of ectopic pregnancy. The lack of a visible fetus on vaginal ultrasound after the βhCG levels have reached 1500 mIU/ml is strongly indicative of an ectopic pregnancy.
As pregnancy tests, quantitative blood tests and the most sensitive urine tests usually detect hCG between 6 to 12 days after ovulation.[8]

Gestational trophoblastic disease like Hydatidiform moles ("molar pregnancy") or Choriocarcinoma may produce high levels of βhCG (due to the presence of syncytialtrophoblasts- part of the villi that make up the placenta) despite the absence of an embryo. This, as well as several other conditions, can lead to elevated hCG readings in the absence of pregnancy.

hCG levels are also a component of the triple test, a screening test for certain fetal chromosomal abnormalities/birth defects.


There's more but it's too long to post. Try the website below.


Molar pregnancy suspected after early miscarriage?
Q. I had a miscarriage when I was about 6 weeks along. Now, one month later, they are suspecting a molar pregnancy due to bleeding and increasing hcg levels.
The info that I have seen on the internet mostly deals with molar pregnancies that are 3-5 months along. I was wondering if anyone had one diagnosed this early, and what they went through.

A. I had mine when I was 3 months, but what they saw was grape like clusters on the ultrasounds and my HCG levels were extremely high. The important thing in any molar pregnancy is that you have a D&C (which your doctor will have you do anyways) and to be monitored for 6 months to a year after as molar pregnancies can (but dont always) lead to cancer. I was followed for 1 year after my molar pregnancy and was perfectly healthy. Good luck, I hope you dont have this as it can be very scary!


what questions should I be asking my dr about molar pregnancy?
Q. Is there things I should be doing or asking the dr about the molar pregnancy? is there somthing I should be doing that will lower my hcg level faster? Should I go have chest x-rays?

A. Is it a complete or incomplete mole? That means was it diploid (with the normal number of chromosomes-2, one from each parent) or triploid (three sets of chromosomes-one from mom, two from dad). With that answer should come some information about how likely it is to need long term monitoring.

One in a thousand pregnancies are molar pregnancies, some are blighted ova. Your physician will want to do sequential hCG levels at least until they get to normal, which should happen in about 2-3 weeks. Chest xrays are very safe as the amount of radiation you receive is very low, since the film is so sensitive.

I had one about 11 years ago, and had my daughter eight years ago. It is discouraging and disconcerting, but one day this too will be in your past, and you can advise others of your previous condition, and hopefully offer reassurance.

Best wishes.


What were your HCG levels when you had a molar pregnancy?
Q. There is a small chance that my dates weren't calculated correctly... but I believe I'm at 4 weeks (since last period) with a 4000 hcg... which is very very high. I'm obviously worried it's a molar pregnancy. Have you ever had a molar pregnancy? If so, what were your levels early on in pregnancy?
Thanks in advance. I have an ultrasound scheduled for this evening but I'm just trying to get through today. :(

A. I have had a molar pregnancy but i never knew what my levels were.

I had gone for my 12 weeks scan and they told me my baby had died at 6 weeks 6 days. i then ended up having a d&c and thats how they found out i had a molar pregnancy.

If they were worried about the levels they would have said something.

i wouldnt worry about molar pregnancy to much, it aint a common thing atall.

Just try and chill out and enjoy your pregnancy x





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