Dr. Mark S. Garrison, DO

Emptying the bladder before sexual activity may be helpful.
female ejaculation can occur and can be interpreted as urine. A urine dip test of the fluid can distinguish between the two fluids. An alkaline phosphatase test on the fluid is definitive for ejaculation.
This process can be physiologic and does not mean there is anything wrong. And hopefully will not be emotionally troublesome.

See an obstetrician as soon as possible this is not normal. It may be the signs of an ectopic pregnancy which can be life-threatening, or the beginning of a miscarriage.

The short answer is it will not interfere with the production of breastmilk. Factors that influence breast milk production include hormones, such as prolactin, and whether or not breast-feeding is full-time or part-time. Also, medications may influence the effect such as birth control pills. Also, genetic factors may play a role in milk production.

PCOS is a hormone in balance and can be influenced by the weight of the individual. Patient diet and exercise in balance are recommended as the first line.MetForman may be helpful. And for some patients may normalize menses and improve chances of fertility.Hypothyroidism can also influence the menstrual cycle and although thyroid replacement if the TSH has not been checked recently, it may be time to do so for many patients.A pelvic ultrasound and if sexually active a pregnancy test may be indicated.

See an obstetrician as soon as possible many patients with this problem need an ultrasound and a quantitative beta-hCG repeated every other day to make sure that this is a normal pregnancy and not ectopic pregnancy, or a miscarriage.

10 days of bad mental health equals more than 100 days of bad mental health for a year, possibly due to PMDD (PreMenstrual Dysphoric Disorder). A copper IUD will not help this condition but birth control pills help about 25% of patients with the symptoms. Randomized placebo-controlled crossover studies have shown that 10 to 20 mg of Prozac (fluoxetine) can be helpful just taking on the days of symptoms for those that it doesn’t help that can be taken every day. Mnemonic for depression SIG E CAPS: stands for Sleep disturbances, either too much or not enough particularly early morning awakening. Lack of Interest in the usual things that bring pleasure this could include sexual activity, you can also i hobbies and other enjoyable activities. Guilt such as taking things personally blaming yourself the critic in your heads talking too loudly. Energy loss feeling tired all t. Guilt such as taking things personally blaming yourself the critic in your head talking to loudly. Energy loss feeling tired all the time with no motivation. Lack of Concentration, difficulty prioritizing activities feeling like everything comes at you all at once. Appetite changes he’s include too much eating or no appetite. P is for Psychomotor agitation flying off the handle with little provocation, rage, and other anger issues that are not in character with baseline personality. The last S is for Suicidal thoughts or ideation.
Depression is every day for two weeks or more. Where PMDD is limited to two weeks or less before or around the menstrual cycle the symptoms overlap one another and sometimes PMDD can magnify other underlying psychological issues, including depression, and bipolar affective disorder.

Ultrasound can detect blood in the endometrial cavity. This can be related to abnormal or normal menstruation.A pregnancy test should be done. Other causes could be fibroid or polyp in the endometrial cavity.
PID is a separate problem and stands for pelvic inflammatory disease. This is generally related to a bacterial infection. And is treated with antibiotics, but unfortunately, long-term consequences can include scarring of the inside of the fallopian tubes that either blocks the Tube, or makes transport Of the egg or sperm, not possible for conception.(Pregnancy).
Further evaluation is warranted. This may include a hysterosalpingogram done in the x-ray department, or laparoscopy with retrograde dye study. For some patients either one of these studies may be not only Diagnostics but therapeutic. Meaning doing a study can help improve the chances of getting pregnant for some patients.

Pelvic pain prior to the onset of menses raises the possibility of endometriosis.
The certainty of the diagnosis is made it laparoscopy, a pelvic ultrasound may be helpful empiric treatment with birth control pills. May be helpful.
The diagnosis is important to make and treat the underlying cause of a patient’s pain.
Keep in mind that two days a month equals 24 days a year and if you throw in occasional pain on day five of the cycle, the place is a person in bed. This could easily add up to a month or more of paying per year. Many doctors would consider this unacceptable loss of quality of life, especially over, the mini years of the reproductive history of a woman which includes 400 cycles per reproductive lifetime on average. This could easily add up to 1000 days of lost time from ages 11 to 50.

Vaginal discharge may or may not be related to a sexually transmitted infection, that would be the first thing to rule out. This would be done with a vaginal swab during a gynecological exam.
The odor if related to a classic fish odor may be related to bacterial vaginosis, which may or may not be related to sexual activity.
This would also be diagnosed at the time of gynecologic examination with a PCR (polymerase chain reaction) swab. Rare causes of a watery vaginal discharge could be a sign of fallopian tube cancer pelvic ultrasound could be done to evaluate this. If suspicious pelvic MRI would be even more helpful.

with a regular periods, I recommend a pregnancy test if sexually active within the last five months.
It is possible the steroids are interfering with the normal hormone balance.
You did not mention weight or acne, both of which could be signs of PCOS, which is a common cause of irregular menses,
A pelvic sonogram would help assess polycystic, ovarian syndrome and the endometrium for possible pathology. And could indicate further evaluation with possible endometrial biopsy. If ultrasound and hormone work up or negative, I would recommend oral contraceptives to help regulate distressful menstrual irregularity of menses.