Women’s Health

How is vaginal dryness treated?

DEAR DOCTOR K: I've been bothered by vaginal dryness. Sex is painful. My doctor believes it's vaginal atrophy due to menopause. Can you tell me more about this condition? How is it treated?

DEAR READER: During a woman's reproductive years, the lining of the vagina is kept moist and lubricated in part by female hormones made by the ovaries -- particularly estrogen. With the start of menopause, estrogen levels decline. This often leads to vaginal atrophy: The lining of the vagina becomes thin and dry.

Which type of birth control is right for me?

DEAR DOCTOR K: I've recently become sexually active and I'm planning to go on the pill. But there are so many different types of birth control pills. Which one is right for me?

DEAR READER: I don't know enough about you to give an answer that's right for you. From my general remarks about these pills, I'm hopeful you can pinpoint the ones that seem right for you -- and discuss them with your doctor.

My doctor recommended Monistat for my strong “fishy” vaginal odor but that hasn’t helped. What can I do?

DEAR DOCTOR K: I have a strong "fishy" vaginal odor and a little discharge. My doctor recommended Monistat, but that hasn't helped. What can I do?

DEAR READER: Miconazole (Monistat) is an antifungal medication. It treats vaginal yeast infections, which are caused by a fungus. If Monistat didn't work, you most likely don't have a yeast infection. Instead, you probably have bacterial vaginosis (BV).

How do I talk to my teenager about sex?

DEAR DOCTOR K: I'm the parent of a teenage girl. I know it's time to talk to her about sex, and I'd appreciate any advice.

DEAR READER: Many parents feel anxious or uncomfortable talking with their children about sex. But remember that if you don't, somebody else will. Teens get lots of information (and misinformation) about sex from their friends, the Internet, television, magazines, books and movies. It's up to you to make your child understand what it really means to have sex, both physically and emotionally.

Does having dense breast tissue increase my risk of breast cancer?

DEAR DOCTOR K: After my last mammogram, the doctor told me I have dense breasts. Does this increase my risk of breast cancer?

DEAR READER: A woman's breast contains different types of tissue, including fat. Women with dense breasts have relatively less fat in their breasts. Specifically, if more than 50 percent of your breasts is made up of other breast tissue (as opposed to fat), then by definition you are said to have "dense breasts." It's not uncommon: About 40 percent of women have dense breasts.

I was diagnosed with polycystic ovary syndrome — What can you tell me about this condition?

DEAR DOCTOR K: I was just diagnosed with polycystic ovary syndrome. My doctor said it explains why I haven't been able to get pregnant. What else can you tell me about this condition?

DEAR READER: Polycystic ovary syndrome (PCOS) is a group of symptoms that results from an imbalance of certain hormones in the female body. It is relatively common: About 7 to 8 percent of adult women in the United States have PCOS.

What are the treatment options for fibroids?

DEAR DOCTOR K: I saw my doctor for intense pain and heavy bleeding during my periods. It turns out I have fibroids. What are my treatment options?

DEAR READER: A fibroid is a lump or growth in the uterus. Fibroids are balls of uterine muscle. They are almost never cancerous, but they can cause severe pain and discomfort, most often during menstrual periods. In some cases, fibroids can cause infertility or repeated miscarriages. Fortunately, many treatment options exist.

How often should I get a Pap test for cervical cancer?

DEAR DOCTOR K: I'm a woman in my 30s, and I've never had an abnormal Pap test. Do I still need one every year?

DEAR READER: The answer used to be yes. This helped ensure that you had regular Pap tests to screen for cervical cancer. But new guidelines recommend less frequent Pap tests for younger women, and no Pap tests for many older women.

Do any health conditions affect men and women differently?

DEAR DOCTOR K: It's obvious that there are some health problems that affect only women, and others that affect only men. But for the health problems that affect both women and men, are there differences in symptoms, or in reactions to treatments?

DEAR READER: That's an interesting question. Perhaps surprisingly, the answer is yes. Heart disease is a good example.

Should I take tamoxifen longer than five years?

DEAR DOCTOR K: I was diagnosed with ER-positive breast cancer a few years ago. My doctor told me to take tamoxifen for five years to prevent my cancer from coming back. I recently read that taking tamoxifen longer further decreases the risk of a cancer recurrence. What should I do?

DEAR READER: The simple answer is: Ask your primary care doctor if you should talk to a breast cancer specialist, because it may well be a good idea to continue on the tamoxifen. But I know you won't be satisfied with a simple answer, so here's a more elaborate one.