DEAR DOCTOR K: I have a vaginal yeast infection. The itching and burning are unbearable. How should I treat it? And how did I get it in the first place?
DEAR READER: Vaginal yeast infections are caused by a fungus that is usually present in small amounts on our skin, particularly moist areas such as under the breasts and in the groin. They also are present in small numbers in the vagina. Sometimes the amount of fungus increases, causing a yeast infection.
DEAR DOCTOR K: I had an abnormal Pap smear. Now my doctor wants me to have a colposcopy. What can I expect during this procedure?
DEAR READER: Pap smears help determine if you might have cancer, or a precancerous condition, of your cervix. When a Pap smear raises such suspicions, the next step is a colposcopy. Colposcopy is generally safe and painless. It takes about 15 to 30 minutes and doesn’t require anesthesia.
DEAR DOCTOR K: It seems to be commonly accepted that women who live together or who are close friends get their periods at the same time. I’ve had the same experience. Is this a real biological phenomenon or just a coincidence?
DEAR READER: The idea that women who spend a lot of time together eventually begin to get their periods at the same time each month is called menstrual synchrony. But how this synchronization occurs — or even if it happens at all — is not well understood.
DEAR DOCTOR K: I just scheduled my first mammogram. What can I expect during the procedure?
DEAR READER: Unfortunately, I can’t tell you from personal experience. I know what every doctor knows, but only a person who has undergone a medical procedure firsthand really knows what it’s like.
DEAR DOCTOR K: I’ve been hearing a lot about “bioidentical hormones.” I’m curious about them, because I’d like a better way to treat my menopause symptoms. Are bioidentical hormones any safer than synthetic ones?
DEAR READER: In the past few years, there’s been growing interest in bioidentical hormones. That’s because advocates promote them as safer and more effective than FDA-approved, conventional hormone therapy (HT). Women have good reason to be interested in a new treatment option. Conventional combined hormone therapy (estrogen and progesterone) raises the risk of blood clots and breast cancer. It can increase the risk of heart disease, stroke and dementia in women older than 60 (or 10 years past menopause).
DEAR DOCTOR K: For years I thought I was at lower risk for heart disease than men because I was a woman. Now I know better. I’d like to take steps to reduce my chances of developing it. What can I do?
DEAR READER: Heart disease has carried a reputation as a “man’s disease” for years. But it is not now — nor was it ever — a disease that mainly targets men. In fact, these days more women die each year of cardiovascular disease than men. (Cardiovascular disease refers to heart disease, stroke and related blood vessel conditions.) Like you, a lot of my patients don’t think of heart disease as a problem for women. Here’s a pop quiz: Are women more likely to die of breast cancer or heart disease? The answer: More women die of heart disease each year in the United States than from all types of cancer combined. That includes breast, ovarian and cervical cancer, plus lung, stomach and colon cancer, plus leukemias, lymphomas and melanoma — all types of cancer.
DEAR DOCTOR K: I’m having my first baby in six months. I’m resisting the urge to find out the sex of my baby during an ultrasound, but I hear there are other ways to tell. Is this true?
DEAR READER: For centuries, pregnant women and their husbands have made guesses about whether their baby would be a boy or a girl. Some prospective parents think they can tell by things such as the shape of a woman’s pregnant belly or by her food cravings. Sometimes they’re right — in fact, they’re right about half of the time.
DEAR DOCTOR K: I am two months pregnant. I can’t decide what to do about getting the flu shot. What are your thoughts?
DEAR READER: I understand your concern, but I think the risks associated with getting the flu when you are pregnant far outweigh any possible dangers associated with the vaccine.
DEAR DOCTOR K: I had my first baby about a month ago, and ever since I have been feeling depressed and overwhelmed. I keep waiting for these feelings to go away, chalking them up to my adjustment to new parenthood, but they haven’t yet. At what point should I seek treatment?
DEAR READER: Most mothers experience the “baby blues” during the first few days after giving birth. Symptoms include anxiety, irritability and weepiness. They typically worsen by the fourth or fifth day after delivery. Then they go away over the next two weeks. The cause is unknown. It may be simply exhaustion from labor and delivery.
DEAR DOCTOR K: I’m 48 years old. Twenty-six years ago, I had a cone biopsy after an abnormal Pap test. Since then, all my Pap tests have been normal. But recently my doctor says that scar tissue from my biopsy has made it difficult to get adequate cells. What do I do about Pap smears now?
DEAR READER: A Pap test is done to catch a cancer of the cervix that is just beginning to start — and can be cured before it causes damage. Every type of cancer begins with a single cell. The cell starts to multiply uncontrollably. As it starts to do that, the cell changes its shape. Under the microscope, you can tell the precancerous and cancerous cells.
Dr. Anthony Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of Harvard Health Publications. Learn more »
Harvard Health Publications is the publishing division of Harvard Medical School, providing the general public with authoritative, trustworthy, and accessible health information. Learn more »
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