How long is it safe for a woman to remain on oral contraception?

In a healthy woman, there is no limit to the number of years she can remain on birth control pills. There is no need to "give your body a break" from the pill, unless you are ready to get pregnant. Use of birth control pills does not alter the chance of getting pregnant in the future. Use of birth control pills is safe in healthy, non-smoking women older than 35 years and can be used until a woman goes into menopause (which is usually between the ages of 50 and 55).

Taking birth control pills offers many benefits in addition to providing effective contraception. Perimenopausal women benefit from more regular periods, reduced hot flushes and strengthening of bones. Women on oral contraceptives have a decreased chance of ovarian and uterine cancer. They often have lighter periods of shorter duration, less cramps and less irregular bleeding. There is a decreased chance of benign breast disease, as well as a decreased incidence of pelvic inflammatory disease. In the right woman, the birth control pill is an excellent long or short-term choice for contraception.

Latrice Allen, M.D.
Diplomate, American Board of Obstetrics and Gynecology
Member, South Bay Independent Physicians Medical Group, Inc.

Are hemorrhoids a common problem?

Hemorrhoids are one of the most common ailments known. Millions of Americans suffer from hemorrhoids. More than half of the population will develop symptomatic hemorrhoids, usually after age 30. The average person suffers in silence for a long time before seeking medical care. It is common for pregnant women to have symptomatic hemorrhoids. It is important to have all rectal bleeding evaluated by a physician, as it may not be from hemorrhoids.

One half of people seeking treatment for hemorrhoids do not actually have hemorrhoids and may have another anorectal problem such as a fissure, skin tag or simple anal irritation. Office treatments for hemorrhoids are usually relatively painless. Only a small number of people with hemorrhoids need surgery.

Stuart R. Grant, M.D., F.A.C.S., F.A.S.C.R.S.
Diplomate, American Board of Colon & Rectal Surgery
Member, South Bay Independent Physicians Medical Group, Inc.

Does teething cause fever?

A baby's first teeth come in anywhere from 4 to 12 months of age. When babies are born they usually have antibodies (proteins that protect against infection) that have come from the mom. By 4 months of age these protective agents begin to decrease. Around this same time, babies begin putting everything in their mouth. This exposes them to many germs. These germs are responsible for the symptoms that many people attribute to the eruption of teeth including diarrhea, fever, and irritability.

The most important treatment for teething is something safe for the baby to chew on. This could be a "teething" toy or a corner of a blanket or any baby safe toy. Some parents use an ice cube wrapped in a washcloth to gently rub the baby's gums. If the baby seems to have a lot of discomfort, acetaminophen (e.g. Tylenol) can be given to relieve the symptoms. Oral anesthetics are rarely needed. The pediatrician should be called if the fever lasts for more than 2 days, the baby is unable to drink, or appears very sick.

David W. Berman, M.D., F.A.A.P.
Diplomate, American Board of Pediatrics
Member, South Bay Independent Physicians Medical Group, Inc.

I've developed brown spots on my face. How do I get rid of them and keep them away?

Brown spots typically are brought about by too much sun. Pregnancy or birth control pills can make it worse. The best prevention is a sunscreen specifically formulated to block UVA rays

For women, discontinuation of birth control pills may help to fade the pigmentation. Alternatively, you can use fade creams containing hydroquinone. These creams work best when combined with exfoliating or peeling agents such as Retin A cream. There are some newer medications, which combine both a bleaching and peeling agent. The Obagi skin care line, available in dermatologists' offices, combines hydroquinone, Retin A and several peeling agents in a very effective combination for combating brown spots.

When home treatment doesn't erase the spots, a series of "lunchtime" peels are often the answer. A TCA peel often eradicates brown spots in one treatment

Susan Goodlerner, M.D.
Diplomate, American Board of Dermatology
Member, South Bay Independent Physicians Medical Group, Inc.

What over the counter medications are safe for pregnancy?

An estimated 10 percent of birth defects are thought to be connected to drug exposure during the mother's pregnancy. Therefore, it is important to remind health care providers of your pregnancy.

Acetaminophen for headaches and fever, kaolin and pectin preparations for stomach and bowel distress, and chlorpheniramine for allergies and colds are all considered among the safer medications. Some medications are considered safe during the first six months of pregnancy, but not safe during the last three months. These include ibuprofen, ketoprofen, and naproxen.

Smoking deterrents, such as nicotine patches, are possibly dangerous. On the other hand, smoking is thought to be even more dangerous. Physicians, in the end, must weigh the risks of medication use in pregnancy against the treatment benefits. Your doctor can explain how the Food and Drug Administration classifies the safety profile of a particular medication that you may be taking and can advise you whether or not you should be taking the drug.

Mark C. Howard, M.D.
Diplomate, American Board of Family Practice
Member, South Bay Independent Physicians Medical Group, Inc.

"I have diabetes and my feet are tingling and burning. What is that from?"

Diabetes can affect people in many ways, with the feet often being one of the first areas to be affected. Tingling, burning and numbness are frequent signs of "peripheral neuropathy", where the patient loses the ability to feel normal sensations on the foot. The loss of sensation, along with the development of corns and calluses and injuries from sharp objects greatly increase the risk of developing open sores and infections. Diabetes limits the blood flow and decreases the ability of the body to fight off infections; when infections or diminished blood flow become severe and amputation is necessary.

Diabetes is the leading cause of non-traumatic amputations in the United States. Diabetic patients must be cautious of the presence of corns and calluses and avoid using acid callus removers. Avoiding extremes of hot or cold temperatures also help prevent open sores and amputations. Lastly, frequent examinations evaluating risk factors greatly reduce the possibility of amputations.

Jonathan M. Labovits, D.P.M.
Diplomate, American Board of Podiatric Surgery

I'm 35 years old and not yet pregnant. My cycles are regular. Should I be concerned regarding my fertility?


There is a slow decline in fertility from age 30 onward. This decline typically becomes much more rapid after the age of 35. Women over the age of 35 are misled regarding their potential fertility because they feel well and are still having regular menstrual cycles. There are sufficient eggs available to control the hormones necessary for regular menstrual cycles well into the 40's. However the eggs that have the ability to fertilize are more rapidly lost; in fact they are mostly depleted by age 42.

If a woman over 35 is unable to conceive after 6 months of unprotected relations, she should begin a basic infertility evaluation. The evaluation should include tests for ovulation, blocked fallopian tubes, and the partner's semen analysis.

Unknown to many, a blood test that evaluates the number and quality of remaining eggs is also available! Many effective therapies exist to help ensure couples over the age of 35 will have the family they desire.

Mark Rispler, M.D., FACOG
Diplomate, American Board of Infertility and Reproductive Endocrinology