Vim & Vigor - Summer 2019 - CH - 43

You're in your 30s, and your period comes every 28
days like clockwork. But sometimes you get a little
spotting midcycle.
Is this spotting normal, or is it a sign of something
more serious?
PROBABLY NORMAL. "For most premenopausal women,
midcycle spotting for a day or two can be a sign of ovulation," Millheiser says. "And it may not happen every month."
If you're spotting at other times, you should discuss it with
your doctor, as it could be a hormonal imbalance, a side
effect of birth control or a sign of a less-common condition.

Ever since you reached your 40s, you've noticed that
you leak a little urine during sex.
Is this a sign that you're getting older, or is it something you should discuss with your doctor?
MOST LIKELY BOTH. "If you're approaching menopause,
leaking a little urine is not uncommon during sex or orgasm,"
Millheiser says. It's more likely to occur in women who have
given birth vaginally. But talk to your doctor-this is treatable
with Kegel exercises, pelvic floor physical therapy or surgery,
so you don't have to live with it.

Your college-age niece appears to be in good health,
but she told you that every month she deals with bloating, nausea, diarrhea, severe cramping and sharp pain.
She's taking ibuprofen but still missing classes because of her
symptoms. She thinks it's bad PMS, but you wonder whether
it might be endometriosis.
Who's right?
IT COULD BE ENDOMETRIOSIS. Some women with endometriosis have no symptoms, some have symptoms only
during their periods, and some have symptoms throughout
the month. With pain that's severe enough to keep her out
of school, your niece should see her doctor. Often women
find relief with a more structured ibuprofen therapy plan.
If that doesn't work, a doctor might recommend hormonal
treatments. And surgery is an option for the toughest-totreat cases.

You never thought it would happen to you, but you're
feeling the symptoms of menopause-hot flashes,
night sweats, insomnia and, of course, irritability.
You're miserable.
Should you consider hormone replacement therapy, even
though you've heard it can increase your risk of heart disease and breast cancer, or tough it out?
CONSIDER HORMONE REPLACEMENT THERAPY. "It's
the most effective way of addressing perimenopausal or
menopausal symptoms," Millheiser says. "It's not as scary
as people made it out to be in the past." Treatment can be
as simple as low-dose birth control pills, and your doctor
can increase the dosage if you need more symptom control.
Hormone therapy might not be the right choice if you have
risk factors, such as a history of stroke, blood clotting or certain cancers. Your doctor can help you decide whether it's
appropriate for you.

Your daughter is 14, and her period hasn't started.
She's quite thin and dances four nights a week.
Should you give it time or talk to her doctor?

PROBABLY GIVE IT TIME. "At 14, it's not uncommon not
to have periods yet," Millheiser says. If her period doesn't
start by age 15, she should be checked. And don't wait to
talk to her doctor if you're concerned she might have an
eating disorder or might be underweight from exercising
too much. ■

QUIZ

The 411 on Cervical Cancer
Check your knowledge about preventing and
treating cervical cancer with a 10-question quiz at
cdc.gov/cancer/knowledge/quiz/cervical.htm.

SU MM E R 2019

http://www.cdc.gov/cancer/knowledge/quiz/cervical.htm

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