Depression linked to medication

Dear Dr. Gott: I’m 20 years old and have been on birth control from the time I was 13. I’ve been depressed all my life. I think the medication causes my depression to worsen. I also have polycystic ovary syndrome. I tried metformin instead of birth control. It made me sick but less depressed. Can you tell me of a birth-control medication that will not cause depression?
Dear Reader: Medications can definitely cause feelings of sadness, despair and discouragement. All are feelings commonly associated with depression.
The metformin you were prescribed is commonly used to treat type 2 diabetes or pre-diabetes. It helps control the amount of sugar in the blood and decreases the amount of glucose absorbed from food and the glucose made by the liver. It can also be prescribed to regulate menstrual cycles but does not prevent pregnancy. Common side effects include nausea, vomiting and diarrhea, but not depression.
Your polycystic ovary syndrome (PCOS) can cause erratic or prolonged menstrual cycles, obesity, acne and excessive hair growth. Women with the diagnosis may have difficulties becoming pregnant because of the infrequency of ovulation.
My guess is that you were prescribed birth control to help regulate your cycles, because low-dose birth control with a combination of synthetic estrogen and progesterone can decrease androgen production, correct any abnormal bleeding, and decrease your risk of endometrial cancer. An alternative to this would be to take progesterone for up to 14 days every month, which will reduce your risk of endometrial cancer and regulate your menstrual cycle but will not improve your androgen levels. Treatment for PCOS is geared toward management of obesity, acne, hair growth and infertility.
I don’t know if you have a weight problem as a result of your PCOS, but exercise will go a long way toward lowering your blood-sugar levels. Speak with your physician before beginning any exercise regimen. Request a referral to a gynecologist familiar with PCOS who can direct you in terms of treatment and your depression. Perhaps counseling is in line. A nutritionist can get you on the right track regarding your diet.
It appears you have a lot going on at 20 years of age. You deserve a better outlook, and the help is out there.
To provide related information, I am sending you a copy of my Health Report “Consumer Tips on Medicine.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
Dear Dr. Gott: You had a recent article in my paper on chronic vaginal inflammation and repeated yeast infections. I’ve been battling this problem for the past six months and have been on Premarin cream for years. Can you tell me when the article was written or how to find out if the “delivery system” was ever corrected?
Dear Reader: Newspapers don’t always run my column on the same day, but you can go to www.AskDrGottMD.com and hit the search button. Type in “yeast infection” to view the complete column or columns on the same topic. The search button and a key condition or phrase works well. Good luck. Friday, Oct. 29, 2010

Dear Dr. Gott: A few years ago, my mother read something in your column that led her to believe that because urine is sterile, she doesn’t need to wash her hands after urinating.
Not having read that particular question and response, I don’t know what information you conveyed. The problem for us now is that she is clinging to that “advice.” She lives in an assisted-living community, and the hygiene issue affects many other people. So, between whatever it was she gleaned from your column and a false claim to being allergic to soap, we have a real problem.
She reads your column faithfully, so it would be of great benefit to all who are in similar living circumstances if you would revisit the necessity of hand washing and other hygiene issues for those who live in healthcare communities. I’m a concerned daughter.
Dear Reader: Indeed, I must admit that in the past I indicated that hand washing wasn’t vital following urination. Well, I got raked over the coals (and rightly so) for that one by my readers and quickly realized the error of my ways. My beliefs are exactly that — mine — and I should not have passed them to others.
Generally speaking, urine is sterile until it leaves the body — free of bacteria and viruses. However, it contains waste products, fluids and salts. Infection occurs when organisms from the digestive tract cling to the opening of the urethra and multiply. The urethra carries urine from the bladder to outside the body. The most common bacterium is Escherichia coli, otherwise known as E. coli. Any abnormality of the urinary tract that obstructs the flow of urine can trigger an infection. Furthermore, people with diabetes or disorders that suppress the immune system have a higher risk of UTI.
When we are young, we are oblivious and don’t think about things like this. But as we age, we may become a little less diligent about personal hygiene. It doesn’t matter whether we live alone, with an aging spouse or in a healthcare facility. We may feel that we are relatively inactive and don’t need to shower daily, wash our hair, keep our fingernails trimmed, and wash our hands. After all, if we sit around all day, we can’t get dirty and don’t need to take such measures, right? Well, no matter what bacterial or viral infection is mentioned today, one of the key things to do is to wash our hands. If we take the time to think, we are exposed to an overwhelming amount of bacteria and germs on door handles, shopping carts and telephone receivers every day of our lives. The safest and best protection is to keep our hands clean, including washing our hands after using the bathroom.
Tell your mother that she has a special place in my heart because of her beliefs, but hand washing prevents the spread of germs, bacteria and viruses. She should find a mild soap that she isn’t “allergic to” and wash her hands.

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