Q
I still have a healthy libido, but I'm experiencing vaginal dryness that I haven't before. Is there anything that I am lacking in my diet? Or anything I could do that would help this?
—Shelly, Hilliard
A
First, vaginal dryness is typically a symptom of a problem, which is often psychological (nervousness) or due to hormones (or lack of hormones). Patients who are taking hormonal birth control for prolonged periods of time (a few years) can have difficulty with lubrication. Women who are menopausal can also have problems due to decreasing estrogen. Unfortunately, there is no perfect fix. A diet rich in estrogen sources such as soy may help. There are many good lubricants on the market, but often something as simple as plain olive oil (a small amount) can be beneficial. Prescription creams are also helpful for some women.
—Melissa Goist, MD, Ob/Gyn
Q
It's been years since I had my children, but I still have to be careful of a bit of urine leakage when I laugh or sneeze. Is this normal, and will it get worse with age?
—Maureen, Dublin
A
While it is never normal to leak urine, it is common for women to struggle with this problem. Risk factors for incontinence include child bearing, aging, obesity, chronic heavy lifting and genetics. The severity of the leaking may remain stable or worsen over time. There are a number of potential interventions available including physical therapy, behavior modifications, vaginal inserts and in some instances either surgery or prescription medications. Women should seek treatment if the incontinence is adversely affecting their quality of life.
—Andrew Hundley, MD, Ob/Gyn
Q
Ever since I gave birth, I've had problems with hemorrhoids. What can be done to help eliminate them? Can they be removed?
—Anna, Columbus
A
Hemorrhoids are swollen veins inside or outside of the anus or rectum. They can be worsened by pregnancy and delivery. Commonly, they get smaller after delivery when the area has had time to heal. Symptoms can include blood in the stool, pain with bowel movements and pain, itching or pressure in the rectal area. Options to reduce symptoms include using sitz baths, witch hazel pads or steroid cream/suppositories. Stool softeners are helpful to avoid constipation and straining with bowel movements. If symptoms do not resolve, hemorrhoids can be removed surgically.
—Jacqueline Rohl, MD, Ob/Gyn
Q
My periods have become increasingly heavy, so much so that some days I'm afraid to leave the house. Is there treatment available?
—Deanna, Pickerington
A
This is a problem for many women, and it can greatly affect a woman's quality of life, causing worry, absence from work or school and problems having a normal sex life. See your gynecologist or women's healthcare practitioner, who can find the cause. Based on the findings, there are several treatment options that will work for you depending on your age, the severity of your bleeding, whether or not you desire pregnancy and your overall health.
—Jennifer Dush, MSN
Q
I haven't breastfed in more than a decade, but lately I've been having nipple discharge. What is it and should I be concerned?
—Amy, Westerville
A
Nipple discharge is a very common complaint among women in their reproductive years. The good news is that most often it is a benign finding, but it is important to have it checked out by your doctor. Discharge may range in color from white to yellow to green. This is called physiologic discharge, and most often it is normal. Cloudy or milky nipple discharge may be due to an underactive thyroid, certain medications or a growth in a part of the brain called the pituitary gland. Your doctor can check your blood for hormones or prolactin.
—Linbee Sayat, MD, Ob/Gyn
Q
I'm unable to control my bowel movements and sometimes have accidents. What treatment options are available?
—Jan, Columbus
A
There are several diagnostic tools your physician can use to determine the level of function of your rectum, including a physical exam and endoscopic ultrasound. These studies are relatively simple and painless and are done in our Gastrointestinal Motility Lab. Most patients who suffer from fecal incontinence can be offered some successful form of therapy. Therapy includes biofeedback sessions in which the anal sphincter muscle is strengthened. Sometimes, surgical therapy is needed if significant defects in the anal sphincter muscle are found.
—G. Nicholas Verne, MD, Gastroenterology
Q
I am 43 and hot all the time. I'm still having regular periods, so my doctor doesn't think I'm beginning menopause. Could it be perimenopause or something serious? I don't even wear a coat in the winter!
A
A few women who still have periods may have hot flashes when they are closer to menopause. However, hot flashes generally last only a few minutes. If you feel hot all of the time, something else may be going on. Also, it is important to distinguish hot flashes from other symptoms such as night sweats. Night sweats can occur with menopausal hot flashes, but there are many other causes of night sweats from very simple to very serious. Discuss the problem with your physician. Your physician will ask about other symptoms you may have and perform a physical exam and laboratory studies. In particular, your physician will want to check your thyroid hormone. One of the most common causes of "heat intolerance," or a feeling of being hot all the time, is an overactive thyroid, or hyperthyroidism. Left untreated, hyperthyroidism can be serious. However, hyperthyroidism is very manageable with medical treatment.
—Jennifer Dush, CNP, Center for Women's Health
Q
What can be done to help eliminate/reduce facial hair for postmenopausal women?
A
This natural consequence of aging can be very embarrassing for many postmenopausal women. Nonprescription methods for hair removal such as shaving and topical depilatories are easy and inexpensive. However, they can irritate the skin and need to be repeated so often that they may not be satisfactory options. Plucking and waxing are relatively inexpensive, and while the effects may last as long as 6-8 weeks, the process can be painful and the results are short-term. You can also speak with your physician about other options. Prescription cream is available and may be a good option, but it requires ongoing treatment to control hair growth and may be costly. There are ways to permanently eliminate the growth of hair through laser methods and electrolysis. However, these methods can be expensive and require multiple treatments. Each woman will have to weigh the benefits and costs of each method and find one that is right for her.
—Jennifer Dush, CNP, Center for Women's Health
Q
I am 43 and have gained about 60 pounds since I got married and had children. I watch my food intake and walk, but can't seem to lose any weight. I hear after menopause it is almost impossible to lose weight. What can I do now?
A
It is always advisable to monitor both nutrition and exercise in a log, utilizing as much detail as possible — everything you eat and drink daily and the time of day and portion size. The exercise log should include what type of exercise, duration, speed and distance.
For most individuals, it is simply a lack of change in exercise intensity. For example, an individual may walk for 30 minutes three to five days a week, but walking at a quicker pace for the same 30 minutes would produce more distance and greater caloric burn. This increase doesn't have to be drastic, but a minor tweak should promote change.
Strength training can increase muscle development, which is active calorie-burning tissue. Using free weights, machines, bands and tubing help promote muscle development. You must have proper form to gain the most benefits and eliminate risk of injury when performing strength-training exercises. Those who incorporate strength/weight training often become discouraged if the scale does not move in accordance with their clothes fitting better and feeling stronger. Muscle is more dense than fat, so it takes up far less space than an equivalent amount of weight in fat. Sometimes it is advisable to take body measurements, body composition testing and monthly pictures to help monitor change. Hiring a qualified personal trainer and a dietitian can be beneficial to those who have reached a plateau and are unable to break through.
—Leslie Hammond, Wellness and Prevention Team Leader, Center for Wellness & Prevention and James Randal Crawford II, Exercise Physiology Tech, Center for Wellness & Prevention
Q
I trained for a 5K run a few years ago. Ever since, my feet feel like they've been disconnected and I experience pain all the time. Is this just from being out of shape or should I see a doctor?
A
If the pain has been consistent for the last few years, we highly recommend you see your primary care physician or OSU Sports Medicine, as this could be a very serious issue. Rule of thumb: typically if pain symptoms persist for two weeks or more, you should see a doctor.
—Leslie Hammond, Wellness and Prevention Team Leader, Center for Wellness & Prevention, and James Randal Crawford II, Exercise Physiology Tech, Center for Wellness & Prevention
Q
What is the best exercise for women?
A
There is no gender-specific exercise that is recommended. A combination of consistent aerobic and strength training exercises is best: two to three days of aerobic exercise, like walking, biking or swimming to start with, and one to two days of muscle-building exercises with weights, bands tubing or fitness balls.
You want to make sure that you change your exercise routine every six to eight weeks. For example, an individual may walk for 30 minutes three to five days a week, but walking at a quicker pace for the same 30 minutes would produce more distance and greater caloric burn. This increase doesn't have to be drastic, but a minor tweak should promote change.
—Leslie Hammond, Wellness and Prevention Team Leader, Center for Wellness & Prevention, and James Randal Crawford II, Exercise Physiology Tech, Center for Wellness & Prevention
Q
Is it true if you don't vary your exercise, you could stop toning up or stop losing weight?
A
A plateau may occur, which may hinder weight loss and your ability to increase muscle mass. The recommended way to prevent this from happening is to make sure that you change your exercise routine every six to eight weeks. This increase doesn't have to be drastic, but a minor tweak should promote change.
For muscle toning, you may want to change or add an exercise for the same muscle group, the number of reps or sets or the weight resistance. Some individuals will incorporate periodization training, pyramids, negatives, plyometrics and high-intensity training as a way of promoting physical changes in the body. It is best to seek the advice of a professional trainer and always make sure to consult a physician before engaging in activities that may be detrimental to your physical being.
—Leslie Hammond, Wellness and Prevention Team Leader, Center for Wellness & Prevention, James Randal Crawford II, Exercise Physiology Tech, Center for Wellness & Prevention
Q
I have heard that diet soda actually is worse for you than regular soda. Is that true and why?
A
Concern with noncaloric sweeteners periodically surfaces. According to the National Cancer Institute, there is no scientific evidence that sweeteners approved for use in the United States cause cancer, but there are other concerns with their use.
On products containing aspartame (NutraSweet®/Equal®), there is a warning to individuals with the rare hereditary disease phenylketonuria to avoid these products. There have been suggestions from animal studies and observational studies on humans that noncaloric sweeteners may contribute to weight gain, obesity, insulin resistance and type 2 diabetes. We cannot say for certain that this is true without well-controlled studies.
Since the 1980s, regular soft drinks have been sweetened almost exclusively with high fructose corn syrup (HFCS) because of its lower cost. HFCS has also been implicated in the development of obesity, diabetes, metabolic syndrome and a condition known as nonalcoholic fatty liver disease.
An occasional soda, regular or diet, is probably not a problem, but a steady diet of either would not be advisable.
—Shirley Kindrick, Wellness & Prevention Team Leader, Center for Wellness & Prevention, and Angela Blackstone, RD, LD, Staff Dietitian, Center for Wellness & Prevention
Q
I wonder if low-fat food is making me fat. Is it better to eat a little of real sugar or stick with artificial sugar? Will either make me more prone to diabetes?
A
Obesity is a major public health problem in the United States, but we cannot blame the problem on a particular food or food in general. It is a multifactorial problem that includes lifestyle, behavior and environment as much if not more than individual foods. Sometimes a low-fat food is not as satisfying as its full-fat counterpart, so large portions of the low-fat food are consumed, resulting in a higher intake of calories than would have occurred with the full-fat food.
Diabetes is not caused by eating sugar. A diet high in sugar can contribute to overweight and obesity, which increase the risk for diabetes.
—Shirley Kindrick, Wellness & Prevention Team Leader, Center for Wellness & Prevention, and Angela Blackstone, RD, LD, Staff Dietitian, Center for Wellness & Prevention
Q
Is it true that a glass of wine is good for you?
A
There are both pros and cons to drinking wine moderately. On the pro side: moderate wine drinking may help prevent heart disease and improve your bone density. On the other hand, it appears to increase breast-cancer risk. And don't forget the added calories especially if that added glass of wine results in more cheese!
—Shirley Kindrick, Wellness & Prevention Team Leader, Center for Wellness & Prevention, and Angela Blackstone, RD, LD, Staff Dietitian, Center for Wellness & Prevention
Q
As a medical professional, what is one food/drink you make sure you eat/drink each day and what do you steer clear of?
A
The one drink I include daily is water, but instead of steering clear of foods or beverages, I prefer to take the "all foods fit approach." This means I do practice moderation.
If I want a piece of cheesecake, I will plan my day accordingly so I can enjoy that food – I just don't eat it every day! I also focus on including a variety of foods especially vegetables, fruits and whole grains, and the portion size does matter. Staying healthy is important so I don't leave my eating to chance.
—Angela Blackstone, RD, LD, Staff Dietitian, Center for Wellness & Prevention
Q
Why do woman get so many more urinary tract infections than men do?
A
Urinary tract infections are much more common for women than for men because the urethra (the tube that carries urine from the bladder to the outside) is much shorter. Bacteria that can cause an infection don't have to travel as far to reach the bladder where they can grow and multiply.
To prevent urinary tract infections, women who are prone to them should always be careful to wipe front-to-back to avoid bringing bacteria from the rectum toward the urethra and avoid holding urine inside for long periods of time. They should also wash promptly after intercourse, since having sex can push bacteria up into the urethra.
—Jonathon Schaffir, MD, in Obstetrics and Gynecology, CarePoint Gahanna