Women’s Health

What are the benefits of breast-feeding?

DEAR DOCTOR K: I'm pregnant and am getting a lot of pressure from family and friends to breast-feed. I'm not ruling that out, but I'd like to know what the research shows about the benefits of breast-feeding.

DEAR READER: Breast-feeding can be a contentious issue. On the one hand, there's no question that breast-feeding is healthy for babies. But some mothers prefer not to breast-feed, and others simply can't for a variety of reasons. So how much difference does breast-feeding make to a baby's health? A series of articles recently published in the journal Pediatrics gives us an idea.

Does estrogen therapy increase the risk for heart problems?

DEAR DOCTOR K: I'm 68 years old and have been on low-dose estrogen therapy since I had a hysterectomy (and started menopause) at age 50. My doctor won't prescribe it anymore because he says it increases my risk of heart problems. Is that true?

DEAR READER: The effect of hormone therapy on the heart is a controversial area. Hormone therapy usually involves "combination therapy," with both estrogens (the main female hormones) and progestins (other important female hormones). Estrogen helps reduce symptoms of menopause, such as hot flashes. Progestin reduces the risk of cancer of the uterus.

Is there evidence the HPV vaccine has real benefits?

DEAR DOCTOR K: My daughter's pediatrician would like her to have the HPV vaccine. I'm not sure. Is there evidence the HPV vaccine has some real benefit?

DEAR READER: Yes, there is evidence -- overwhelming evidence. And with this vaccine, the benefit is not that it will reduce the risk of a short-lived illness, like the flu. This vaccine will reduce your daughter's risk of getting a common and life-threatening cancer. Human papillomavirus (HPV) is the main cause of cervical cancer and genital warts

What can I do about my heavy periods?

DEAR DOCTOR K: I bleed very heavily during my menstrual periods. Is there anything that can be done about this? Or do I just have to put up with the discomfort and inconvenience every month?

DEAR READER: Excessive menstrual bleeding (the medical term is menorrhagia) is a common problem. In my experience, a few primary-care doctors tell their patients just to "live with it." Not surprisingly, obstetrician/gynecologists are more likely to recognize excessive menstrual bleeding as a problem that needs treatment.

I’m a woman in my mid-50s — what could cause my decline in sexual arousal?

DEAR DOCTOR K: I'm a woman in my mid-50s. Lately I haven't been able to become sexually aroused. What could be wrong?

DEAR READER: Sex is complicated. You probably already know that. Sexual desire surely resides in the head, but other parts of the body can affect desire as well. In particular, the genital organs communicate with the brain. Likewise, the brain communicates with the genital organs. Desire in the brain causes changes in the pelvic organs. Perceiving these changes can, in turn, enhance sexual desire.

Should I have a mammogram and a MRI if I’m at high risk for breast cancer?

DEAR DOCTOR K: I'm at high risk for breast cancer. Should I have screening mammograms, MRIs or both?

DEAR READER: Many factors can put a woman at high risk for breast cancer. The most common and important are these: (1) inheriting certain high-risk genes from one of your parents; (2) having a parent, sibling or child with breast cancer; and (3) having received radiation treatment to the chest (usually for some type of cancer) before age 30.

What can I take to ease my hot flashes?

DEAR DOCTOR K: I have terrible hot flashes. My doctor no longer recommends hormone replacement therapy because he says it has heart risks. Is there anything else I can take?

DEAR READER: Hot flashes are a common symptom of menopause. They probably result from changing hormone levels. My patients describe them as a sudden, intensely uncomfortable onslaught of heat. They are often accompanied by a rapid heartbeat, headache, nausea or dizziness.

What does anovulation mean — can it effect the ability to get pregnant?

DEAR DOCTOR K: I've always had infrequent periods, but I never thought much of it. My doctor recently used the word "anovulatory" to explain why I've had trouble getting pregnant. What does this mean? Could the two be connected?

DEAR READER: "Anovulation" means you are not ovulating -- releasing eggs. A woman's ovary should release approximately one egg each month. Once released, the egg travels into the fallopian tube. There, it can be fertilized by the entry of a sperm. The fertilized egg then enters the uterus. When a woman does not ovulate, no egg is available to be fertilized by sperm. As a result, a woman cannot become pregnant. Women who are anovulatory have irregular, few or no periods.

Is my urinary incontinence caused by giving birth vaginally?

DEAR DOCTOR K: I've had urinary incontinence ever since I gave birth last year. Why?

DEAR READER: Many women who give birth vaginally go on to develop loss of bladder control. This is called urinary incontinence. Childbirth can cause two types of incontinence. If urine leaks out when you jump, cough or laugh, or during any activity that puts pressure on your bladder, you have stress incontinence. You have urge incontinence (overactive bladder) if you feel a strong, overwhelming urge to urinate, even when your bladder isn't full. You probably also release some urine before you make it to the bathroom.

Is there a drug-free way to relieve PMS symptoms?

DEAR DOCTOR K: Every month I have awful PMS. Can you suggest drug-free ways to relieve my symptoms?

DEAR READER: Premenstrual syndrome (PMS) is a collection of symptoms that occur just before and during menstruation. The most common symptom is unusual mood swings. In addition, women with PMS also experience irritability, anxiety, depression, headaches, hot flashes, bloating, abdominal cramping, breast tenderness and food cravings.