Dear Dr Mitchell,
My problem is that my friends are telling me that if your girlfriend's period cycle changes that means she is having a relationship with another man. Can you tell me the truth please?

Changes in the menstrual period definitely does not indicate that your girlfriend is having a relationship with another man. You should definitely not entertain any such thoughts unless you have reason to think otherwise. You should have a honest and open discussion with your girlfriend and express any anxiety or doubts that you might have as it relates to your relationship, but a change in her menstrual cycle is definitely not suggestive of any unfaithful behaviour.

The normal menstrual cycle is usually every 21 to 35 days with an average of 28 days. The menstrual cycle might change due to several factors. The most common is a failure to release an egg every month. Factors such as stress, excessive exercise, excessive weight loss in the form of anorexia nervosa, obesity and abnormal function in the thyroid and pituitary glands may be causes of failure to ovulate, thus resulting in a change in the menstrual cycle. In some cases if there is an infection in the lining of the uterus (Endometritis) or pelvic inflammatory disease this can cause the menstrual period to be heavier than usual or cause bleeding in between the periods or bleeding after intercourse.

In this situation the underlying problem may be a sexually transmitted infection. If the abnormal bleeding is due to an infection then there is usually worsening pain associated with the menstrual cycle. This sexually transmitted infection may actually be passed on from a male partner who has absolutely no symptoms despite the fact that the woman has significant problems.

Absence of symptoms or signs of infection in the male does not mean that you are not the source of the problem and treatment should be given to both partners. Now this might suggest a third party involvement and so in a situation where you have reasons to think that your partner is unfaithful then you should confront her and deal with the matter in an open and honest manner.
Best wishes.

Dear Dr Mitchell,
My mother-in-law says I should start taking calcium supplements in case I get osteoperosis later in life. I am just 26 and have a baby. Do I need to take supplements or can I wait a few more years? I'm really not a pill person.

The risk of developing osteoporosis later on if calcium supplement are not taken at age 26 years is definitely not significant. It is important to consume a balanced diet containing calcium rich foods such as milk, cheese, broccoli and sardines. It is also important to do some form of physical activity such as walking, jogging or aerobic exercises. You should also avoid cigarette smoking and excessive use of steroids.

There is definitely no need to routinely take extra calcium tablets at this stage, so you should not be overly concerned. Your mother-in-law means well, but keep her advice for your late years when you are in the perimenopausal or menopausal years. During this time your oestrogen levels fall off significantly and the risk of osteoporosis is significant.
Best wishes.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions and comments via e-mail to allwoman@jamaicaobserver.com or fax to 968-2025.

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