DEAR DR. DONOHUE: I am 32. My husband and I have been trying for three years to have a baby. My periods are not regular, but I have spoken with many other women with irregular periods, and they all have had children. What do you think might be wrong with me? – J.J.

ANSWER:
Infertility and its causes are such vast topics that I cannot answer your question with any certitude. You need a fertility specialist, and your husband needs to be examined. Men are often the source of the problem.

I can suggest one possibility: polycystic ovarian disease. In the first descriptions of it in 1935, women with the problem were obese, had facial or chest hair, had absent or irregular periods and had ovaries enlarged with cysts. Now the disorder includes many other women without all of the above symptoms or who have additional problems not included in the 1935 description.

Today the emphasis is on two major problems – too much male hormone and irregular or absent periods. Infertility is also quite common, as can be other, seemingly unrelated troubles such as uncontrolled blood sugar.

The excess of male hormone can cause hair growth on the chin, above the lips, on the chest or on the lower portion of the abdomen. The hormone sometimes makes these women sweat excessively and develop acne.

Ultrasound pictures of these women’s ovaries frequently show them to be studded with cysts.

When all of the pieces fit in place, doctors can begin treatment of the disorder and focus on an individual woman’s particular wish. If fertility is desired, then the medicine clomiphene is prescribed. If male hair growth is the target, spironolactone can block male hormone action. Should menstrual irregularity be the biggest problem, birth control pills can restore normality. When a woman is obese, weight loss might eliminate all of the signs of the condition. Polycystic ovarian disease is only one example, J.J. It might not be the answer to your question.

DEAR DR. DONOHUE: If I could have one wish, it would be to have a tattoo removed. I had it done years ago, and I now realize how foolish I was. Is there any way of having it taken off? – B.B.

ANSWER:
There are many ways to either remove a tattoo or make it less visible. Dermabrasion (skin sanding), freezing, heat destruction and surgical excision have all been used to erase tattoos.

The best thing that has happened for people like you is the short pulse Q-switched laser. It might be the answer to your wish.

The laser emits beams specific for the pigments of a person’s tattoo. The short pulse quickly turns off the laser beam so adjacent skin is not damaged – something that can happen with older treatments.

The laser breaks the pigments embedded in the skin into small particles that the body can remove. It is a bit uncomfortable, but numbing the skin makes it quite tolerable.

If the tattoo has a variety of pigments, then different laser beams have to be employed. Removal of the tattoo can take eight to 12 treatments.

Talk with a dermatologist or a plastic surgeon for details on your tattoo. Your family doctor can recommend one who is experienced in tattoo removal.

DEAR DR. DONOHUE: I feel a kicking sensation in my chest every now and then. I tell my wife it feels like I am pregnant and the baby is kicking me. What could this be? – F.L.

ANSWER:
It could be extra heartbeats – specifically, premature ventricular contractions. Those are beats that originate in the bottom heart chambers – the ventricles, the heart’s pumping chambers.

The extra beat comes before the regularly scheduled beat. The heart is not completely filled with blood then. Therefore, the extra beat is very soft. However, the next normal beat comes at a time when the heart is overfilled. That beat produces the kicking sensation you feel.

You must have your doctor diagnose your symptom. If it is premature beats and if your heart is healthy in all other respects, these beats can most often be ignored.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


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