Women’s Health

Is my birth control what’s causing me nausea and severe headaches?

DEAR DOCTOR K: I started taking combined birth control pills a few months ago. Ever since then, I sometimes feel nauseous and get severe headaches. Should I switch to a different pill?

DEAR READER: Nausea and headaches are common side effects of birth control pills, but they usually can be eliminated by adjusting the pills. Combined birth control pills contain the hormones estrogen and progestogen. When taken correctly, they are 98 percent to 99 percent effective in preventing pregnancy. But these hormones can cause side effects.

What can I do to relieve uncomfortable hot flashes?

DEAR DOCTOR K: What can I do to relieve uncomfortable hot flashes?

DEAR READER: Yesterday I discussed new research showing that menopausal hot flashes can last for much longer than the "several years" the textbooks say they are supposed to last. We are beginning to understand why women in menopause (and sometimes for years after) get hot flashes. There is a center in the brain that is constantly measuring the inner temperature of our bodies. For example, body temperature rises on a hot day, or when we exercise. When the brain center thinks the body needs to cool off, it causes little blood vessels near the skin to open wide.

How long can I expect hot flashes to continue?

DEAR DOCTOR K:I just experienced my first, full-blown menopausal hot flash. It was awful. How long can I expect hot flashes to continue?

DEAR READER: Your question reminds me of a patient I saw when I had recently finished my training. (Believe it or not, I was even younger then than I am now.) She said she had come to see me because of hot flashes. Then she said: "I had heard about hot flashes since I was a girl, and I thought I knew what to expect. But you can't really imagine it until you've experienced it."

Can you discuss how menopause might affect my sex life?

DEAR DOCTOR K:

I have recently entered menopause. Can you discuss how menopause might affect my sex life?

DEAR READER: As a woman approaches and enters menopause, her ovaries gradually make less and less of the hormones estrogen and progesterone. The drop in these hormones -- of estrogen in particular -- can affect how a woman experiences sex. Estrogen stimulates the growth of breast tissue. It maintains blood flow to and lubrication of the vagina. The decline and eventual end to estrogen production provokes a host of symptoms. These include hot flashes, fatigue, vaginal dryness and loss of libido. Many of these changes can have unwanted effects on a woman's sex life.

What could cause irregular bleeding all month long?

DEAR DOCTOR K: My periods used to be pretty regular. But for the past few months, I've been spotting all month long. Why is this happening?

DEAR READER: There are many possible explanations. Fortunately, few of them can turn into serious problems. Before talking about the causes of abnormal bleeding from the uterus, it's worth reviewing the menstrual cycle. Normally, the cycle is triggered by signals from sex hormones. Hormones made in the brain travel to the ovaries, leading to the production of other hormones by the ovaries: estrogen and progesterone.

What is cervicitis and how do you get it?

DEAR DOCTOR K: My doctor diagnosed me with cervicitis. What is this? And how did I get it?

DEAR READER: Cervicitis is an inflammation and irritation of the cervix, the doughnut-shaped opening to the uterus. (I've put an illustration of the area affected by cervicitis, below.)

Cervicitis is usually caused by a sexually transmitted infection (STI). Most common are chlamydia and gonorrhea. Trichomoniasis and genital herpes can also cause the condition. In some cases, cervicitis may result from trauma, frequent douching or exposure to chemical irritants. Cervicitis often causes no symptoms. When they do occur, symptoms can include pain during intercourse.

What are drug-free ways to relieve menstrual pain and cramping?

DEAR DOCTOR K: Can you recommend drug-free ways to relieve menstrual pain and cramping?

DEAR READER: For most women, menstruation is accompanied, at one time or another, by pain and cramping known as dysmenorrhea. For some women, the pain is so severe that it causes them to miss work and social events. Some doctors don't regard menstrual pain as a "serious" problem. But any symptom that interferes with your personal or work life needs to be attended to and not dismissed. The cause of menstrual pain appears to be overproduction of the chemicals known as prostaglandins.

What is toxic shock syndrome?

DEAR DOCTOR K: I saw a warning about toxic shock syndrome on a box of tampons. What is it, and what does it have to do with tampon use?

DEAR READER: Toxic shock syndrome (TSS) is a rare, life-threatening illness triggered by certain bacteria. The two bacteria most often involved are streptococci ("strep") and staphylococci ("staph"). The cases caused by streptococci tend to be the most severe. In TSS, toxins (poisons) produced by these bacteria cause a severe drop in blood pressure that can lead to organ failure.

Does menopause cause weight gain?

DEAR DOCTOR K: Does menopause cause weight gain?

DEAR READER: In the United States, women typically go through menopause between 47 and 59 years of age. And the average woman gains about one pound per year around the time of menopause. Not surprisingly, we tend to assume that menopause causes weight gain.

What are fibroids and how are they treated?

DEAR DOCTOR K: I saw my doctor because of pain in my pelvis and heavy menstrual bleeding. Tests showed that I have fibroids. What are fibroids and how are they treated?

DEAR READER: A fibroid is a lump or growth in the uterus that is not cancerous. Fibroids can be as small as a pea or as large as a basketball. They are usually round and pinkish in color, and they can grow anywhere inside or on the uterus. The number of fibroids, their size and how fast they grow varies from one woman to another.