My menstruation has changed

I normally have my menstruation periods on the 15th every month. This month, I experienced them on January 1st, and this the first time my periods are changing. What could have happened? Need I worry?

Dinah

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Dear Dinah,

What is your age? Are you on hormonal contraceptives? Normally periods begin around puberty and end at menopause. For few months after menarche (beginning of periods), the periods are irregular. Then the cycle is set for each woman which is highly variable. It can be a cycle of 28-30 days, plus or minus one week. Duration of bleeding can be 3 to 7 days. This entire cycle is determined by the balance of the 2 hormones, estrogen and progesterone. Around menopause as well, cycles tend to be irregular. Use of hormonal contraceptives can disrupt the balance, leading to alteration in cycle. After stopping the pill, it can take 12-18 months for cycle to normalise. Hormonal disorders like those of pituitary or thyroid gland, ovarian diseases or disorders can also influence the menstrual cycle making it irregular. Menstrual cycle can also be disrupted due to drugs like corticoids. Uterine fibroids may change date of menses but also cause prolonged heavy bleeding and lower abdomen pain.

Weight gain is also known to alter hormonal equilibrium and also menstrual cycle. Both physical and mental stress is implicated in altering menstruation and the cycle.

If the date has changed only once, there is nothing to worry. Be relaxed, if overweight try to reduce weight, if on pills, try some other form of contraception. If subsequently the date of menses changes abruptly and drastically (difference of more than a week), it is advisable to undergo tests to know cause of altered date of menstruation.

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My 5-year-old son has a bad skin rash

I travelled upcountry with my family during the Christmas festive period. Just like our home in the city, even in the village we have piped water and live in a very clean environment. However, after about 4 days, my 5-year old son developed a bad skin rash out of no where. Please shed some light on what could have caused this and how we can prevent or treat the condition in future.

Sharon

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Dear Sharon,

By "bad skin rash”, do you mean the rash is infected, i.e. dirty looking with pus discharge or red, swollen and painful? Does it itch? Is there a single rash or multiple ones at different sites.

The most common cause for a rash in a child can be allergy. The allergy can be due to any substance in the atmosphere or used over body. Allergy and subsequent rash can be due to contact with some kind of weeds or grass, while playing outdoors. Certain food items can also cause allergy after their consumption. Protein containing foods like peanuts, ready to eat instant foods, synthetic fruit juices with preservatives are commonly implicated in causing allergy. If rash is due to allergy, it will become alright once the allergy producing substance is removed. If severe, anti allergy medication in form of tablets or local ointment can be used.

Viral infections like herpes zoster can cause a localized rash with eruptions and is painful. Herpes simplex is yet another viral infection that causes rash and eruptions, but is not painful. It is mostly located on lips or genital parts. Other viral infections like measles or chicken pox, may begin as rash, but then it will progress, multiple rashes and bumps will appear and will be very itchy.

Drugs like some painkillers can cause allergy, which manifests as a localized rash.

There is nothing to worry if the rash is not painful. If there is no dizziness, no fever or breathing problem, if the rash is not progressing rapidly, there is nothing to be anxious about. It will settle. If there are signs of added bacterial infection like redness, swelling, pain, with or without pus discharge, the child will need some antibiotic and pain killer.

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Must I have three meals a day?

I normally take only water in the morning, then a heavy balanced lunch at around 2pm. I rarely take evening tea or dinner, but I feel healthy overall. However, I have read severally from health experts that to live healthy it’s better to take at least three balanced meals daily. Are there any health risks my eating habits pose? How best can I adopt the recommended pattern without feeling ‘too satisfied’?

Dieudonné

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Dear Dieudonné,

It is always healthy to have frequent small meals in place of a single heavy meal. Regard the scenario, when one takes a heavy meal at one time, it places a load on the stomach causing bloating sensation with or without sense of heaviness after a meal. The digestive system is also loaded, which takes some more time to digest the food consumed and does so with some difficulty. Normally acid is produced from the inner lining of the stomach, which serves as protective barrier. This acid is neutralized by food. However if one takes excess food one time and skips the other meals, it is not neutralized and tends to build up. The result of these processes is, there can be abdominal discomfort, burning pain in chest or stomach, nausea, vomiting, i.e. one or more of these symptoms. The bowels may get loaded, but if adequate amount of water is not taken, some food is not taken at regular intervals, they may become sluggish causing constipation to some extent. This also adds to abdominal discomfort and can cause feeling of lethargy. Impaired digestion can also reduce appetite to some extent.

The excess load put on the entire digestive system mars its overall efficiency. Nutrients available in the food consumed are not absorbed by the intestines in proportion to the quantity taken. Thus several nutrients go waste. Every system of the body is linked to one another. A single heavy meal also puts heart under stress as it has to pump more blood to the gut for processing the food. The fat deposits in blood vessels can increase, particularly if the meal has more fats. These factors can result in problems like high blood pressure and heart attacks. In one suffering from diabetes, a single heavy meal can impair good glucose control.

Brain cells depend on glucose for their function. When one eats heavily one time and stays without food for long hours, the brain receives excess glucose one time and does not receive it other times. This can impair mental functioning over time. Moreover one would tend to overeat if he is eating only one time. This can cause lethargy immediately after the meal and contributes to obesity and its related problems over time.

Best way for you is to change your meal patterns. Try eating something in the morning, reduce quantity of food taken at 2pm. Satiety can be obtained by chewing food slowly and drinking more water. When less food is eaten, you would feel hungry after about 8 hours(when the meal consumed is digested). Follow this pattern every day. Soon as the body adapts to it, you would start feeling hungry three times a day and would want to eat at that time.