expert type icon EXPERT

Mr. John B. Monaco, MD

OB-GYN (Obstetrician-Gynecologist)

Dr. John B. Monaco MD is a top OB-GYN (Obstetrician-Gynecologist) in Hartford, . With a passion for the field and an unwavering commitment to their specialty, Dr. John B. Monaco MD is an expert in changing the lives of their patients for the better. Through their designated cause and expertise in the field, Dr. John B. Monaco MD is a prime example of a true leader in healthcare. As a leader and expert in their field, Dr. John B. Monaco MD is passionate about enhancing patient quality of life. They embody the values of communication, safety, and trust when dealing directly with patients. In Hartford, CT, Dr. John B. Monaco MD is a true asset to their field and dedicated to the profession of medicine.
41 years Experience
Mr. John B. Monaco, MD
  • Nashville, TN
  • Wake Forest Univ School of Medicine (Bowman Gray)
  • Accepting new patients

Is Metformin a lifelong medicine?

Usually not. Sometimes after pregnancy, ovarian function returns to normal. Certainly after menopause, PCOS is no longer an issue.

Can a green color on a sanitary pad indicate infection?

Yes, it can. Even if you have no symptoms, I would have your GYN check for an infection such as Trichomonas or a bacterial vaginosis.

My delayed period

At your age, the most likely cause is stress which can interfere with the normal Brain-Pituitary-Ovarian function. Low body weight, poor nutrition and intense exercise can also READ MORE
At your age, the most likely cause is stress which can interfere with the normal Brain-Pituitary-Ovarian function. Low body weight, poor nutrition and intense exercise can also affect the menstrual cycle. While most GYN's would put you on the birth control pill, I prefer not to use OCP's. Rather cycling you on progesterone (not a progestin) works nicely to regulate your cycle and provides the many benefits of progesterone without shutting down your system which happens with the BCP.

What are ways to deal with menopause?

If she is still menstruating, cycling with compounded bioidentical progesterone can be like a miracle. I have my compounding pharmacist make 50mg SR capsules and my patients take READ MORE
If she is still menstruating, cycling with compounded bioidentical progesterone can be like a miracle. I have my compounding pharmacist make 50mg SR capsules and my patients take it from day 12 -26 of their cycle (1st day of flow is day #1) 1cap x5 days, 2x5, 3x5. If no mense occurs, this may be the first sign that you are menopausal. Your GYN or a doctor specializing in natural hormone replacement can help.

How is chlamydia usually treated?

Antibiotic therapy is the primary treatment usually with either tetracycline or erythromycin. Some other newer antibiotics may be used. Correct treatment and prevention is the READ MORE
Antibiotic therapy is the primary treatment usually with either tetracycline or erythromycin. Some other newer antibiotics may be used. Correct treatment and prevention is the key. Have your partner checked and treated as the male, especially if uncircumcised, can keep re-infecting you.

I masturbated and I am now suffering from urine incontinence. Are the two related?

There is no known association of masturbation and urinary incontinence unless you have used "toys" which can irritate the urethral opening from the bladder and can give symptoms READ MORE
There is no known association of masturbation and urinary incontinence unless you have used "toys" which can irritate the urethral opening from the bladder and can give symptoms like a UTI which may cause some urinary leakage. If you have symptoms like urgency, burning and frequency you should have a urinalysis done.

If I am planning to conceive by next year should I start folic acid tablets?

You can start folic acid supplements anytime, especially if you have a mutation of one of the genes that activates folic acid, which is quite common. The only concern with a mutation READ MORE
You can start folic acid supplements anytime, especially if you have a mutation of one of the genes that activates folic acid, which is quite common. The only concern with a mutation is that you may need to take a slightly higher dose of folate and may need the activated form L-5 MTHF, which you can purchase in most vitamin shops. Folic acid is important before conception to reduce neural tube defects. The usual dose in pregnancy is 1mg daily, the RDA in non-pregnancy is .4mg. There is a simple lab test that will check for this mutation. Check with your insurance company first to make sure they will cover this.

What are the long term side effects of consuming Primordial N tablets?

I would absolutely not take this medication. It is a synthetic progestin and not progesterone. Progestins have been shown to cause multiple issues including an increase in blood READ MORE
I would absolutely not take this medication. It is a synthetic progestin and not progesterone. Progestins have been shown to cause multiple issues including an increase in blood clotting, heart and possibly stroke issues and an increase in breast cancer. These progestins are often incorrectly referred to as progesterone which they are not. They are modifications of the progesterone molecule. Naturally formulated bioidentical progesterone cannot be patented and therefore, pharmaceutical companies must change the molecule in order to get a patent. In my practice, I use progesterone which can be obtained by prescription in your local drug store as Prometrium or it can be compounded by a compounding pharmacist, which is what I do.

Will my pregnancy leg pain get better after delivery?

Generally, the leg pain improves dramatically after delivery. This pain is usually due to several factors: change in the curvature of the spine (lordosis of pregnancy), loosening READ MORE
Generally, the leg pain improves dramatically after delivery. This pain is usually due to several factors: change in the curvature of the spine (lordosis of pregnancy), loosening of the ligaments of the pelvis, pressure of the enlarging fetus on the pelvic bones and nerves and muscle relaxation all (except the lordosis) a result of high levels of progesterone.

Can pregnancy cause changes in heartbeat?

It could be, but this is something that you need to discuss with your Obstetrician who may want you evaluated to rule out a more serious condition of the heart. Often, the stress READ MORE
It could be, but this is something that you need to discuss with your Obstetrician who may want you evaluated to rule out a more serious condition of the heart. Often, the stress of pregnancy will bring out an underlying condition and pregnancy is especially stressful on the cardiovascular system with many significant changes that occur. Usually a young healthy woman will have no issues.

I have had 2 ectopic pregnancies. I want to concieve again. How can I prevent another one?

Having 2 consecutive ectopic pregnancies is very unusual in a woman with a normal pelvis. You need to discuss with your gynecologist some of the possible causes such as endometriosis, READ MORE
Having 2 consecutive ectopic pregnancies is very unusual in a woman with a normal pelvis. You need to discuss with your gynecologist some of the possible causes such as endometriosis, pelvic infection, adhesion, and genetic anomalies of the pelvic organs. If not already done, a laparoscopic evaluation of pelvis could be done (you likely had this done to treat the ectopics, but a repeat exam may be helpful to assess things in the non-pregnant state and dye can be instilled into the uterus during the procedure to assess the patency of the fallopian tubes. When you do get pregnant, closely following blood levels of the pregnancy hormone Beta HCG and ultrasounds can help to pick up another ectopic early when minimally invasive treatment can remove the ectopic and lessen any scarring of the tubes. There is really nothing that you can take or do to prevent ectopics. It's most likely a structural issue affecting tubal patency and function.

What causes sudden thick white discharge?

The hormonal fluctuations commonly seen in menopause often start in the mid 30's. This may be the issue but infections such as yeast, trichomonas and bacterial infections, although READ MORE
The hormonal fluctuations commonly seen in menopause often start in the mid 30's. This may be the issue but infections such as yeast, trichomonas and bacterial infections, although unlikely, should be ruled out. While the discharge associated with these conditions is different, I have seen all of them in patients with a non specific white discharge. Your gynecologist can do a simple office exam and microscopic exam.

Do I have genital warts or herpes

The only way to tell for sure is to have your gynecologist do an evaluation which may mean visual inspection, perhaps colposcopic or microscopic inspection, culture or even biopsy. READ MORE
The only way to tell for sure is to have your gynecologist do an evaluation which may mean visual inspection, perhaps colposcopic or microscopic inspection, culture or even biopsy.

What can I do to prevent my vaginal infection from recurring?

A thorough exam by your gynecologist with accurate diagnosis and specific treatment is the only way to correctly identify the type of infection and eradicate it with the correct READ MORE
A thorough exam by your gynecologist with accurate diagnosis and specific treatment is the only way to correctly identify the type of infection and eradicate it with the correct treatment.

I had unprotected sex with my fiance. How can I make sure there is no pregnancy?

Unfortunately, it becomes a waiting game. You can get a pregnancy test in your local pharmacy. These tests have become quite sensitive and accurate. There is no natural way READ MORE
Unfortunately, it becomes a waiting game. You can get a pregnancy test in your local pharmacy. These tests have become quite sensitive and accurate. There is no natural way to prevent pregnancy after the fact. The morning after pill is most effective in the first 24-72 hours after intercourse.

Does metformin increase my chances of getting pregnant?

Metformin is often used to treat the insulin resistance commonly seen in patients with PCOS. It is more likely that that may increase fertility by addressing the metabolic process READ MORE
Metformin is often used to treat the insulin resistance commonly seen in patients with PCOS. It is more likely that that may increase fertility by addressing the metabolic process in the ovary.

Despite of following my ovulation calendar I am not pregnant. Why?

That is a question that can have many answers. Your gynecologist can discuss them with you and may refer you to a reproductive endocrinologist (a gynecologist specializing in READ MORE
That is a question that can have many answers. Your gynecologist can discuss them with you and may refer you to a reproductive endocrinologist (a gynecologist specializing in infertility). Some possibilities include endometriosis, pelvic infections, blocked fallopian tubes, the male factors low sperm count, low motility and a varicocoel. The most important factor is stress, so patience with the process is important. 80% of women will conceive within 1 year assuming they have intercourse 2-3 times per week. Having sex more than that usually results in depletion of the males sperm count and can actually prolong the process. If you have none of the female issues and have discussed it with your GYN, then relax and enjoy the process. If you have any of those issues then He/She can begin to address them.

menstruation

The best thing that you did was to stop the injectable synthetic progestin contraceptive. Perimenopausal hormonal changes can begin as early as 30. Fluctuations in estrogen levels READ MORE
The best thing that you did was to stop the injectable synthetic progestin contraceptive. Perimenopausal hormonal changes can begin as early as 30. Fluctuations in estrogen levels and declining levels of progesterone usually result in the many symptoms often seen, menstrual changes, frequent and heavy periods, depression, anxiety, sleep issues, moodiness, etc. You are basically on an hormonal roller coaster. I treat my patients with cyclic bioidentical progesterone (not provera, medroxy progesterone acetate of birth control pills). You need progesterone to balance the estrogen spikes, improve sleep, reduce anxiety and depression and protect both the breasts and endometrium (uterine lining). Of course, you should always rule out pregnancy. Natural progesterone will not adversely affect the fetus if you are pregnant and will increase your fertility, so if you go this route make sure that you are either accepting of a pregnancy or have another reliable method of contraception. You can usually find a doctor in your area that specializes in bioidentical hormone therapy or functional medicine.

oligomenorrhea

I am assuming that you are asking this for someone else, but light flow may be normal, due to low body weight and fat percentage, malnutrition, stress, intense exercise like marathon READ MORE
I am assuming that you are asking this for someone else, but light flow may be normal, due to low body weight and fat percentage, malnutrition, stress, intense exercise like marathon runners, etc. Of course, a pelvic exam should be done to rule out uterine anomalies and other structural issues.

I had two periods cycles in one month. What could be wrong?

This may just be a month where you had a shortened luteal phase, that is the follicle that forms after ovulation, the corpus luteum, and which makes progesterone may be short resulting READ MORE
This may just be a month where you had a shortened luteal phase, that is the follicle that forms after ovulation, the corpus luteum, and which makes progesterone may be short resulting in an early period. Pregnancy should always be ruled out. Depending upon your age, this may be the result of hormonal changes of perimenopause such as fluctuations of estrogen and falling levels of progesterone, the latter stabilizes the endometrium and prevents early breakdown and bleeding before the expect period.