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Love and Sex Prescription

By Anandhi Narasimhan, M.D.
and Dipika Dandade, M.D.

QUESTION
I have been dating the same guy for a year and a half now. He is great and we really love each other. I recently spent Christmas with his parents who live out of town. I have come to suspect that my boyfriend is helping his family financially. My boyfriend and I are very serious and have even shopped for engagement rings. However, after meeting his parents, I now have doubts. The part that bothers me the most is that they ask him for money so that they can live significantly above their means (i.e. buy a home and furniture/electronics that are very expensive). How can I approach this topic with my boyfriend? I want to find out how he expects us to help out his family fiscally after we get married, as this may be a deal breaker in our relationship.

ANSWER by Anandhi Narasimhan, M.D.
First of all, I’m glad you started thinking about finances, even though it can be difficult! Issues such as finances are often avoided prior to a marriage because they might be uncomfortable to talk about and, quite frankly, unromantic. However, since it is one of the most common things that couples fight about in a marriage, it is all the more important to talk about it prior to making a lifetime commitment.

Photo by Rodrigo Torres

It is important to clarify what your boyfriend’s financial relationship is with his family. There are many ways to bring up the topic. For example, using "I" statements instead of "You". You could possibly say "I wanted to talk about how we both feel about finances" and "It is something I worry about occasionally, how about you?" That might set the stage for more of an open dialogue.

Prior to your talk with him, I would ask you to evaluate your own expectations and fears about this. Some women may unintentionally worry that if their partner is generous with their family, then maybe he won't be as generous with them. Also, what are your expectations in regards to what your financial role is in a marriage? Do you envision marriage as a union where you and your partner will contribute equally to all expenditures, including family obligations?

There are no right or wrong answers to these questions, and you may not even know for sure what you want. Your boyfriend, on the other hand, may be wondering, why shouldn’t his parents live above their means if he can ensure that, especially after they gave him life.

One thing to note is that roles and responsibilities often change over time. Parents age and can get sick, leading to their adult children taking more responsibilities as caretakers. South Asian culture, in particular, tends to be more family-oriented rather than individualistic. Therefore, some Desis may have a stronger feeling of familial obligation, including the financial care of parents. Historically, it has been a common tradition for sons to take on that kind of responsibility, and many still feel attachment to that sentiment today. Sometimes old norms still have a place in modern day thinking. For instance, a woman may want to be both very successful and ambitious and also feel that she is taken care of.

Be sure to think it through and know that communication is key. When you can care about someone, a lot of difficulties can be worked through with open communication.

QUESTION
My menstrual cycle is usually very consistent, but sometimes I miss a period. Is that normal? And will I have trouble conceiving when the time comes?

ANSWER by Dipika Dandade, M.D.
Regular menstrual periods usually occur every 21 to 35 days. Missing a period does occur relatively commonly. The causes can be both physical and emotional in nature. Whatever the cause, the end result is a change in your hormonal status.


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Obvious causes of a missed period are pregnancy and breastfeeding. Women at the extremes of ages, in other words, preteens and teens, who have just started their periods or women approaching menopause, will have irregular periods commonly, and this can include missed periods. Also, women at the extremes of weight are at risk. Very thin women, especially those with anorexia or those who exercise excessively, can stop having their periods. Conversely, women over their ideal body weight may suffer from polycystic ovarian syndrome (PCOS). This is associated with infrequent periods, obesity and infertility. Various diseases such as thyroid disease or a mass in the brain also may cause infrequent bleeding. Medications, including the birth control pill, can potentially cause missed cycles. Life stressors can lead to hormone changes as well. Relationship problems or issues with school and work may lead to irregularity.

You should be evaluated by your doctor if you do not have a period for three to six months in a row. Most likely, your doctor will ask about any other associated symptoms such as breast discharge, vision changes or headaches. These symptoms may suggest a brain tumor. Your doctor may screen you for sexually transmitted diseases if applicable. She might also order blood tests, including checking the thyroid level and various hormone levels. You might be offered hormonal treatment, such as oral contraceptive pills, to help regulate your period.

When it comes to getting pregnant, you really won’t know until you try. If you miss a period every now and then, it is unlikely you will have a problem. If you are actively trying to get pregnant for six months without success, it’s worth seeing a doctor. Blood tests can determine whether you are ovulating. If you aren’t ovulating, there are prescription medications that can induce ovulation. Your doctor will be able to discuss other infertility options with you as well.




Anandhi Narasimhan, M.D. is a Board-Certified Physician, accredited by the American Board of Psychiatry and Neurology, specializing in Adult, Child, and Adolescent Psychiatry. Dr. Narasimhan currently serves on clinical faculty at Cedars Sinai Medical Center in Los Angeles, runs a private practice in Los Angeles and serves as a child and adolescent psychiatrist for Aviva Family and Children's Services, a non-profit contract agency with the Department of Mental Health. For more information, visit www.doctoranandhi.com.

Dipika Dandade, M.D., 31, is an obstetrician/gynecologist practicing in the Los Angeles area.

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