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Caught in the snore snare....A real nightmare!Snoring is caused due to obstructed air movement during breathing while sleeping. It may suggest an underlying medical problem like obstructive sleep apnea. Studies have also revealed a correlation between snoring and risk of heart attack. There are different reasons for snoring and to find out the exact reason and the right solution is important. Snoring affects the quality of sleep can cause irritability and fatigue. Snoring causes poor quality of sleep, irritability, lack of concentration the day after the deed. Snoring is a tad like fingerprints , no two sets are the same and so it is with snoring, There are different rhythms or snoring patterns and even the reasons for snoring vary. Snoring or that irritating sound which people make through their mouths and nose while asleep happens because of narrow airways failure of air to pass through the respiratory system easily. The air vibrates against the obstruction in airway causing the sound of snoring. The air is unable to escape normally through the airways and hence it causes that grating sound with each inhale and exhale. Yes that sound which makes you wish you could smother the fella with a pillow. We say fella because men are more prone to it than women. Snoring can happen due to various reasons: Habits: Those who smoke and drink regularly are likely to have a more relaxed set of jaw muscles causing them to snore readily and loudly. Weight: People with excess weight and poor muscle tone are likely to snore more. Age: The wide open mouthed gape kind of snoring usually happens in old people as the breathing muscles lose their tone somewhat. Posture: General posture and sleep posture in particular can affect snoring patterns. Especially, sleeping with the back flat against the bed constricts free exhalation. How to put a clamp on your snoring? If you have a snoring problem evaluate how serious it is and then take the necessary elimination strategies. Understand that your snoring can cause sleepless nights to your partners, family or whoever is within ear shot so instead of going in for fancy anti-snore devices which don't do a thing to help If this is a recent habit then consult your doctor and have him re-evaluate any medications that might be responsible. Try and establish a regular sleep time and ensure that you follow it to the T. Exercise to lose weight as losing flab around the throat can lead to better sleep. Ask a partner to awaken you if you snore too loudly as regular jabs in the gut can help train the mind to behave. Blow your nose out before bed time as clear air passages is what you need. Any nasal constriction or chest congestion is really what gets you started. Sleeping on your side is a better option than sleeping on your back. Before hitting the sack try and hum a few bars of the blues as singing can help tone the vocal cords and they are less likely to go into vibrate mode. According to help-guide.org there is a rather quaint method to cure snoring and that is to play on a certain musical instrument called the 'Didgeridoo' which is supposed to strengthen the soft palate and throat muscles. If you have no Australian connections then don't despair as rolling your tongue out from all sides before sleep can work just as effectively.
Aging milestonesChanges in old age depends on attitude as much as person to person. In young old age some changes begin to take place in a person’s appearance. Wrinkles, warts, age spots begin to form on the body. Hair begins to thin or becomes grey and even height lessens because the bone density decreases. While in ‘old‘ old age these changes are already permanent. Men might look distinguished if in good health, but women all look grandmotherly. In ‘young’ old age, cells begin to decay and muscle mass declines and immunity is no longer as strong as it used to be. People lose energy as the age progresses.  ‘Old’ old age brings in a lot of physical decline, profound changes in appearance and motor abilities, as also in sensation. Skin gets less elastic and becomes thin and blood vessels can break under the skin. The senses also begin to become dull. Eye lenses get affected and color perception and reading ability becomes very low. Hearing loss may lead to paranoia and ‘old’ old age people begin to think everyone is plotting against them because they can’t hear properly about what others are saying. Sense of smell also declines, but the taste remains almost intact. In ‘young’ old age, reflexes also slow down and so do the motor abilities. By the time they reach ‘old‘ old age most adults find that their response time has become quite reduced. This can be seen most in driving situations where it is difficult for ‘old‘ old aged adults to operate their vehicles as they have poor spontaneous responses. The ‘young’ old adults do not lose as much of their motor abilities as the ‘old‘ old adults, especially when holding small things like needles and pins. Of course, there are changes in sexuality and there may be a decline in the ability to have sex as men may not have an erection and women become dry due to lack of female hormones. Cognitive decline in 40% to 60% of older adults can be arrested with remedial training. Despite all the changes, most people even in their 70s remain comparatively active if they do not suffer any illness. Mental, physical, and social activity is necessary to maintain the quality of life. Old people begin to withdraw from work and other important roles and allow the younger people to take over. They are a lot happier as is also advised in Vedic literature as vridhashram. While activities are important, disengagement is equally important. Memory loss becomes aggravated and other cognitive abilities begin to decline and there are many ‘old‘ old adults who get Alzheimer’s and lose the ability to look after themselves. Old people also dwell on questions of death and sometimes go through a phase of denial and then anger that they have so little time left. Acceptance of death comes, but after a struggle and the idea of losing the family saddens them. Old people require support in their declining years as they begin to lose their faculties.
Perfect partners in crime - Midlife crisis and dementiaThe responses we have to common stressful events in our daily lives have a lasting impact on our brain structure. The effects of a stressful event last a very long time, though apparently we seem to have recovered from it. Researchers say that the stress hormones keep circulating in our body long after the stress has passed. According to a recent Swedish research study, our response to common life events may trigger long-lasting physiological changes in the brain. These interestingly shocking findings come from the Prospective Population Study of Women in Gothenburg, a long term study on 800 women that lasted for almost forty years. The women who were a part of this study were all born before 1930, and underwent regular neuropsychiatric tests. The study started in 1968 assessed women for any baseline stressors like workplace problems, widowhood, alcoholism and illness in the family. Women who had serious issues at the start of the study had a 21% higher risk of developing Alzheimer's Disease and 15% higher risk of developing dementia later on in life. Interestingly, having to take care of a mentally ill family member like a sibling or mother, was found to be a major cause for development of dementia later on in life. The findings of this study show that accumulated stress from common life events has severe physiological and psychological consequences. These physiological consequences include adverse effects on the central nervous, cardiovascular and endocrine and immune systems. There have been several studies that state that the effects of stressful events like earthquakes, cyclones and floods can have a lasting impact on life and often shape the person's personality. What makes this study interesting is its finding that daily stressors accumulated over a period of time and often left unresolved, have a lasting impact that shows up in later stages of life!
Bow legsCauses: Physiological - As mentioned before, bow legs are normal below 18 months of age. Thereafter as the child continues to grow the bowing begins to improve slowly. By the age of 3 to 4 the deformity usually gets corrected. Blount’s disease - This disease results in bowing of legs due to abnormality of the growth plate of the upper part of shinbone known as tibia. Growth plates are the growing end of the bones. It is diagnosed after the child is 3 to 4 years old. Rickets - Rickets is a group of diseases that occurs due to deficiency of vitamin D. Rickets is characterized by bow legs and other bony deformities. Most commonly rickets occurs in children due to deficient intake of vitamin D. Signs and symptoms: The bony deformity becomes visible when the affected child walks or stands. The uncommon walking pattern of the child is the commonest symptom. Bow legs usually do not cause any pain. However, persistent and severe bow legs cause discomfort to other bony structures like spine and hip. Test and diagnosis: The doctor at first asks questions to the parents regarding the development of the child. This is followed by physical examination of the child. Physical examination often suggests bow legs. If the doctor suspects an underlying disease, necessary laboratory tests are done. The doctor always asks for an x-ray of the affected legs to evaluate the severity and extent of bowing. Treatment: If the bow legs persist after 3 to 4 years or an underlying disease is detected, treatment is undertaken. Medical and non-surgical treatment- In cases of physiological bow legs, no treatment is required. The parents are reassured by the doctor and spontaneous resolution takes place by the age of 2 years. Continuous followup is advised for borderline cases. Children with Blount’s disease need treatment with a brace. Children with rickets need medical management by a specialist doctor. Additionally, they need advice and regular followup by an Orthopedic surgeon. Surgical treatment  - If the bony defects persist in children with bow legs even after medical and nonsurgical treatment, surgery is required to correct the bowing. Two types of surgery is advocated to correct bony deformity of the legs. Guided growth:  Growth of the healthy part of the growth plate is stopped and that of the abnormal part is promoted. This allows straightening of the legs. Tibial osteotomy: The shinbone (tibia) is cut and reshaped to correct the deformity. Then bone is fixed with screws and plate. In both surgeries a cast is applied to promote healing of the bone. Crutches may be required for a few weeks to prevent weight bearing on the limb. Later, physical therapies are advised for complete recovery of range of movements and regular activities. Prevention The parents need to be vigilant about appearance of any bony deformity in legs of their child. The child must be given adequate amount of vitamin D in diet or vitamin D supplementation to prevent development of rickets.
Obesity is not just an adult problemWith fast food chains multiplying in the country faster than you can say Maharaja Mac, there is an urgent need to monitor our diet. While most of the nutritional advice is directed at adults, kids too are exposed to the dangers of empty calories. Childhood obesity is on the rise across the world including India. How does obesity affect children? And what can parents do to ensure this doesn't happen? We will try to answer some of your questions. What are the causes of obesity in children? Lack of physical activity: Nowadays, children spend more time sitting at home - doing their homework, watching TV, and playing games on PC, console tablets or smartphones. Play time on the ground outside has shrunk. As a result, they don't get enough exercise. Unhealthy food choices: Our busy lifestyles leave us with little time to plan for or prepare every meal. The alternative is to go for quick-to-cook food like Maggi. Food ordered from outside too is invariably unhealthy. While having it once in  few days is not a problem, making it a way of life leads to problems. Overweight parents: The eating pattern and lifestyle of parents has a big influence on a child's health and weight. Obesity can be hereditary. Lifestyle and environment: When parents are unable to pay much attention on their children due to their busy schedules. As a result children rely more on ready-to-eat food or junk food. Genetic factors:  For some kids, genetic factors may be the reason behind obesity. A rare genetic disorder called as Prader-Willi syndrome causes severe weight gain in kids. What health problems can obesity cause among children? Type-2 diabetes Eating disorders like bulimia or binge eating (excessive eating or drinking) Problems with foot structure Liver problems Respiratory disorders - breathlessness during exercise Difficulty in breathing while sleeping causing snoring or poor sleep What can parents do to prevent or control obesity in children? Parents must make kids understand the ill-effects of eating junk food. They must limit their snacking on junk foods. Encourage the kids to participate in physical activities and outdoor games. Make exercising a routine for the children. Join them during exercising to make it a fun time for the family. Set an example for your kids by following a healthy diet and eating habits yourself. Limit TV time and playing videogames. Parents must include whole grains, fruits and vegetables in the diet of their children. Limit fats intake to not more than 25%-30% of total calories. Make sure to go through the nutritional label while purchasing any processed food.  
Algophobia: The fear of painAlgophobia is the fear of pain:  an abnormal and consistent feeling that is far beyond what would be considered normal. The term is derived from the Greek words, Algos meaning pain and Phobos meaning fear. Our bodies are designed in a way that when there is a painful stimulus it reacts. How the body reacts to the pain is an individualistic phenomenon. Some people have a very low threshold for pain, and even the slightest pain evokes a huge response in them. Where as others can withstand a good amount of physical pain before their bodies give in. Some people dread even the tiniest amount of pain. They foresee situations that will cause pain in them. The way they react to even the smallest amount of pain is far more than the normal level of acceptance. Such people are said to be suffering from Algophobia. Algophobia is a learned behaviour, say behavioral psychologists. For example you may have heard from several people how hitting your shin on the furniture in the dark is the worst possible pain ever. So you tend to keep a watch and if it is dark, you move around extra-carefully to avoid bumping into the furniture and getting hurt. This would be considered normal, cautious behaviour. But if the same thought keeps buzzing in your head continuously and you go to extreme lengths to avoid that pain, you could be algophobic. Old people are the ones who have excessive fear. The age factor along with fear of death plays a vital role in old people developing this fear. For example an old lady may hear about all the ailments and pains that afflict old age people and may become apprehensive about it. She may develop irrational fears that more often than not, are also imaginary. She may start experiencing the pains even before anything actually happens to her. It may seem unrealistic to a normal person, but for algophobics pain can be a severely dreaded thing. Therefore they will go to great lengths to avoid pain at all levels, including day-to-day activities. They will not go into the dark, handle tools, avoid lifting heavy objects or even avoid playing any type of contact sports. If a task has a scope for injury and pain, they will avoid it! Frequently a pathological complaint of Hyperalgesia occurs along with algophobia. Hyperalgesia is a condition of increased sensitivity to pain due to damage to the peripheral nerves and pain receptors. Pain in such cases may be directly in the damaged tissues or in the surrounding areas. An interesting fact is that hyperalgesia can occur due to long term use of painkillers especially strong ones like opium and its derivatives. Algophobia is treated with behavioural therapy, psychotherapy and anti-anxiety medications. Hypnotherapy also has shown beneficial effects.  
What is megalomania?Bertrand Russell's quote on megalomania perfectly describes the condition:"The megalomaniac differs from the narcissist by the fact that he wishes to be powerful rather than charming, and seeks to be feared rather than loved. To this type belong many lunatics and most of the great men of history." Megalomania is a delusional bipolar disorder. The sufferer believes he is an all-powerful person and that he is superior to all other people. Megalomania comes from the Greek words megalo which means large or great and mania which means madness. It is a psychopathological disorder that has delusional fantasies of power, exaggerated self esteem and a sense of omnipotence. The sufferer may believe he is God or some famous athlete. Although megalomania is a term used for power hungry people, it is clinically described under the mental disorder of narcissism. Narcissism is self-love. Though self-love is a healthy concept, narcissism is a pathological state where one loves oneself to the extent that he starts despising others. Megalomania is caused by certain phobias and mental conditions associated with emotions and personality. In everyday life, megalomania can be a person's mental way of reacting to frustration, abandonment or some serious loss. In the social world, the term megalomaniac is often synonymous with control freaks, power-drunk army generals, executives and politicians. The treatment of megalomania includes medications. The challenge here is that the person may not believe he has anything wrong with him. He, in fact, believes that he is so great that no harm can come to him, so talking him into getting himself treated is very difficult. Adolf Hitler, the German dictator, was a power-hungry control freak. He believed that he was the supreme commander and that his race was the only race suited to inhabit earth. All other races, especially Jews, were inferior and had to be wiped off the face of the earth. Adolf Hitler was megalomaniac.
High heels can walk you to the hospital bedHigh heels make a fashion statement which makes us look tall, elegant and good but they cause injuries on a regular basis. High heel shoes have been luxury item once upon a time; today high heels have made themselves a part of every girl's life thanks to supermodels and stars. You will not find any health warning on shoes but they ought to, as they seriously put you at a high risk of numerous health problems. How are high heels and low back painrelated? High heels significantly affect your natural posture and your spine. The natural arch of spine becomes acute when walking in high heels. This poses high risk to the spine getting injured. This not only wears  and tears intervertebral cushions called discs but cause injury to the nerves too.  High heels put strain on muscles of lower back causing pain after a long day of wearing high heels. Nerve trapping, nerve pain and radiculopathy can result from wearing high heels for a long period. This is exhibited     as tingling, numbnessand pain. Arthritis, nerve pain, hammer toes, ingrown toenails and bunions are all common problems due to high heels. Calf muscle shortens and tightens after prolonged use. Jogging, playing, running with high-heeled shoes can tear and rupture calf muscles. What can you do to prevent damage? Firstly ensure your body is in top shape before you start. There is a much less chance of developing low back pain if you are strong and fit. So do activities like swimming, pilates, circuit class, box-exercise and whatever else thatmakes you feel good. Focus on activities that make the abdominal area strong includingyour deep core muscles. Secondly a regular regime of stretching will prevent a lot of problems occurring. Either get involved in a yoga class or make sure you do 10-15 minutes of stretching every day. Stretch your back, your calves and hamstrings especially. Thirdly get sports massage at leastonce-a-month. This will loosen the tightened structures, realign the spine and lengthen the hamstrings, calves and Achillestendon
The age of nutritionAdvantages of Healthy Eating: Increased mental acuteness Resistance to illness and disease Higher energy levels More strong immune system Faster recuperation times Better management of chronic health problems Eating Obstacles for Seniors:  Lifestyle changes: Lifestyle changes can be an eating obstacle. For example single seniors may not know how to cook or may not like eating alone. Activity level: Seniors often cut back on activity for physical and medical reasons. Weight gain can result from the decrease in calories burned. Metabolism: Every year over the age of forty, our metabolism slows down. This means that even if you continue to eat the same amount and kinds of food as when you were younger, you're likely to gain weight because you're burning fewer calories. In addition, you may be less physically active now. Taste and appetite: The senses of taste and smell diminish, so one may be inclined to season one's food more heavily than before even though seniors need less salt than younger people. One may struggle with loss of appetite due to lifestyle, loneliness or a medical condition. Health Issues: Physical ailments and prescription medications, become a daily exercise, and ends up often negatively influencing appetite. Digestion:Due to changes in your digestive system, you generate less saliva and stomach acid as you get older, making it more difficult for your body to process certain vitamins and minerals, such as B12, B6 and folic acid, which are necessary to maintain mental alertness, a keen memory and good circulation. Emotional Factors: Emotional factors such as loneliness and depression can affect your diet. For some, feeling down leads to not eating and in others it may trigger overeating. Specific Nutritional Recommendations for Seniors: Some important guidelines for seniors include Reduce sodium (salt) to prevent high blood pressure, Monitor fat intake in order to maintain healthy cholesterol levels Consume more calcium and vitamin D for bone health Eat more fibre-rich foods to prevent constipation Cut back on sugar and on dry foods Ensure getting recommended amount of important vitamins and minerals Increase water intake, and Perform regular physical activity Eating well as you age is easier than you think: Focus on good carbohydrates. Opt for whole grain nutrition (brown rice, whole wheat bread, rolled oats, barley, and millet), not refined "white" products, such as white bread, white rice, or products made with white flour. To manage weight and maintain optimum health, focus on eating efficiently. This means choosing foods that maximize nutritional value, not calories. Whole, natural, fresh foods such as fruits and vegetables, whole grains, nuts, legumes, healthy sources of protein (poultry, fish, eggs, and tofu) and dairy products that contain calcium constitute efficient eating. Highly processed and refined foods usually contain more calories and fewer nutrients. Raw equals roughage! Aim to eat at least one daily serving of your fruits and vegetables raw. This not only preserves their nutritional value, it's an easy way to eliminate constipation. Steaming is the best way to cook vegetables; it preserves nutrients. Light sauting is next. Bone up on calcium. All dairy products are not created equal. Milk, cheese and yogurt retain their calcium content; cream cheese, cream and butter do not. As part of a healthy senior diet, choose fat-free or low fat dairy products. Choose first-rate fats. Get your "good" fats from oils such as olive oil and sunflower oil, avocados and avocado oil, nuts and seeds. Keep it moist. In addition to drinking enough water each day, aim to consume foods with high water content. Staying properly hydrated flushes toxins from your body, relieves constipation, helps keep your joints flexible and your mind clear. High water content foods include melons, grapes, cucumbers, onions, apples, cabbage, and, of course, soup.
A primer on heart attacksIndians around the world have one of the highest rates of heart diseases. Heart attack, also called as myocardial infarction, is mainly caused by a blockage that prevents oxygen-rich blood supply to your heart muscle. In other words, it is the death of the heart muscle. What causes a heart attack? When cholesterol deposition, plaques of calcium and proteins on the walls of your coronary artery cause blockage of the artery, your heart fails to receive sufficient nutrient-rich blood. This leads to the permanent death of heart muscle, and it is unable to pump the blood to your vital organs. Symptoms that signal a heart attack   Chest pain is a symptom of a heart attack.  This pain can feel like tight ache, pressure on the heart as if an elephant is sitting across the chest. However, you may get confused with the symptom chest pain - whether it is a heart attack or an angina pain. Chest pain lasts for a longer time in heart attack whereas the chest pain in angina lasts for few seconds and goes away after rest. The pain experienced during a heart attack sometimes feels like indigestion or heart burn. Other warning signs of heart attack are: Shortness of breath. Lightheadedness or fainting. Upper body discomfort in arm, the back, neck, and jaw. Nausea, vomiting, dizziness. Sleep problems or fatigue. Not every person will have the same symptoms of the heart attack. But if you have any of these warning signs, you have to act fast and get the right treatment.
MigraineA Severely painful persistent headache can put anyone in distress. Migraine symptoms vary from person to person. Some people get intimation before the pain begins. It can be sparkling flashes of light, blind spots, or distortions. Some others experience tingling or "pins-and-needles" sensation in hands or face. This is called an aura. The headache begins within 30 minutes of seeing an aura and may last for 4 to 72 hours. Extreme sensitivity to light, noise, smells, nausea and vomiting, loss of appetite and fatigue, numbness, tingling, or weakness are all-common in migraine. There is no permanent solution to migraines. People suffer for years together and keep on taking painkillers for a long time. Pain killer helps only if taken right at the beginning of the headache. Keep a watch on things that trigger the migraine and try to avoid them. Make some lifestyle changes that can help prevent migraines to some extent. Taking good sleep. Lack of sleep can cause migraine. Appropriate hours of sleep as a routine will help to prevent the attacks. Regular meals at fixed time help to prevent migraines in people who get headaches due to hunger or not eating on time. Regular exercises help to rejuvenate the body and prevent migraines along with many other diseases. Stress is another important cause for migraines. Avoid stress. Learning to manage it will keep migraine at bay. Caffeine triggers migraine in many. Avoid caffeine. Reduce it if quitting is not possible. Limiting alcohol will again be very beneficial as alcohol and hangovers can be the cause. Meditation and relaxation therapies may also help prevent migraine headaches.  
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
Your questions about contraception, answeredFew couples want to have babies as soon as they are married. Most want to enjoy their sex life without having to worry about conceiving a child in the process. If you are in this group, then here are answers to the most commonly asked questions about contraception. What is contraception? Contraceptionis use of various methods to control and prevent the pregnancy. It allows you to choose when you want to have a baby. What are the various methods of contraception? There are two main methods. Temporary contraception: Caps, combined pills, male condoms, female condoms, contraceptive implant, contraceptive injection, contraceptive patch, diaphragms, intrauterine device (IUD), intrauterine system (IUS), natural family planning, progesteron-only pill, vaginal ring. Permanent contraception: Female sterilisation(tubectomy), Male sterilisation (vasectomy). No contraceptive is 100% reliable and some can have side effects. Find out about all the methods listed here, so you can decide which method is right for you. How soon can I conceiveafter stopping the birth control pills? It is difficult to predict exactly how long it will take for a woman to start ovulating again. Some women are fertile as soon as the pills are stopped and others might take couple of months. Once the periods return and are normalised with normal ovulation, you can conceive a child. What if my period doesn't resume after I stop taking oral contraception pills? If you don't get your periods for several months, you may have what's known as post pill amenorrhea. The pill prevents your body from making hormones involved in ovulation and menstruation. When you stop taking the pill, it can take some time for your body to return to normal production of these hormones. Normally, periods should start again within three months of stopping the pill. But some women, especially those who took the pill to regulate their menstrual cycles, may not have periods for many months. If you don't have a period within three months, take a pregnancy test to make sure you're not pregnant, and then see your doctor.
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