Hormonal condition that can make you infertile

Dr Flo,

I have polycystic ovarian syndrome and I am afraid I may never get children. I have never told my partner and we have been together now for three years and are planning to get married. Please advise

Judy

Dear Judy,

In polycystic ovarian syndrome, the ovary has many cysts containing immature eggs that do not reach the stage of ovulation. Hormone levels are altered, which disrupts the menstrual cycle. Extra androgen hormones (testosterone) are also produced. The symptoms include irregular periods, heavy bleeding, acne, excessive hair growth, weight gain, hair loss on the scalp, and dark patches on some areas of the skin.

It can be managed by maintaining a low glycemic index diet (get most of the carbohydrates from fruits, vegetables and whole grains), exercise, some contraceptive pills and metformin.

Because ovulation rarely happens, it is difficult to conceive, but not impossible. With the help of a gynaecologist, you can get medication to induce ovulation for several cycles to see if conception will happen. If it doesn’t, the other options include intrauterine insemination (IUI) and in vitro-fertilisation (IVF). It is advisable to communicate about this with your partner before you get married so that he makes an informed decision and avoid conflict later.  A partner’s support is also very helpful. At the same time, your partner may also need to be tested at some point in the process and put on fertility treatment.

Lately, I have developed chronic cough (dry) at night and in the morning. What’s causing it?

Alnashir D Walji

Nairobi

Dear Alnashir,

The dry cough may be as a result of an allergic reaction in your airways, specifically triggered by cold in the evenings and early morning. Another possible cause is post nasal drip due to sinusitis, or it could be due to a lung condition like asthma or chronic bronchitis. If you sleep in a room with air conditioning or a fan, the cough may also be due to dehydration due to drying of the air.

Other possible causes of this cough include acid reflux, other lung conditions or heart disease. It is advisable for you to visit a doctor for a check-up and relevant tests. If there is a specific trigger such as air conditioning, then avoiding the trigger can resolve the problem. In addition, avoid eating heavy meals close to bed time – if possible, eat two to three hours before you sleep and stay upright after the meal. If there are any underlying issues such as sinusitis or asthma, then these should be treated.

Dr Flo,

I have an itchy rash near my testes, on the thighs on both sides. It is white in colour though when I shower the colour disappears. Previously, I have taken tablets and at other times I have been given a cream to apply after which it disappears for a while and then comes back again. What might be the problem or cause of the rash?

Mike

Dear Mike,

The white patches are likely to be due to fungal infection. Recurring fungal infections could be due to misdiagnosis, not completing treatment or a poor immune system. It could also be due to a genetic condition where the skin does not recognise the fungus as foreign matter and therefore the body does not try to get rid of it.

Many times the fungi that cause infection usually live naturally on or in our bodies and only cause a problem when they multiply too much. This also means it is easy to get a fungal infection from another person since they are also carrying fungi, and also from clothing, towels, lanyards, floors, among others. Fungi like warm and wet environments, which is why it is easy to get fungal infections between the toes, between the thighs or groin, under the breasts and where there are other skin folds.

Fungi also shed spores, which are like tiny seeds that collect in our clothes or shoes, waiting for the right conditions for them to grow again. This means that if there are spores present, you can have proper treatment and then the infection comes back when the spores start growing. 

This condition can be managed though it may not be possible to get rid of it permanently. You need to visit a dermatologist to get a proper diagnosis. A sample of the skin from the white patch will be taken and examined. It would also be beneficial to check for any conditions that could lower your immunity like diabetes, HIV, among others. When you are put on medication, take it for the prescribed duration even if the skin rash has disappeared. You may be put on medication for a long time since the problem has been there for a while. You can also take tablets or use a cream or anti-fungal shampoo occasionally after treatment to prevent re-growth. You can apply antifungal powder to the shoes daily if you have infection on the feet Also clean shoes regularly and get rid of old shoes. Clothes should be washed and sun dried in an airy place and if possible, ironed inside-out. Avoid sharing clothes, shoes and towels. Avoid wearing tight fitting clothes, wear cotton clothes and leather shoes.

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