Women everywhere dread going to the OBGYN. It’s not just the cold metal stirrups. Sometimes invasive medical procedures can make us anxious to get out of the office ASAP. Meanwhile, some of the questions we were dying to ask the doctor are forgotten. If you’ve ever worried about your low sex drive or wondered what you can do for mild PMS, now's the time to get your questions answered.
Q. I don’t enjoy sex very much because I often experience discomfort. Is there anything a doctor can do for this?
A. Physical and emotional factors alike can contribute to painful intercourse, or dyspareunia. Certainly there are gynecological conditions that manifest as sexual discomfort, and most of them can be resolved with a physician’s guidance. It’s important to be evaluated.
Common conditions represented by superficial pain include yeast infections, dryness and vulvodynia (pain in the vulva). Vaginismus, a spasmodic tightening of the vaginal muscles, can have roots in a medical malady or be a psychological reaction to sex.
If your pain is physically deeper, it could signal anything from ovarian cysts to endometriosis to a pelvic inflammatory disease. But don’t get spooked by the possibilities. Talk to a physician about your symptoms.
Q. I’m having trouble conceiving. What can my husband and I do before resorting to expensive treatments?
A. “Healthy bodies allow you to have a baby, and healthy bodies produce healthy babies,” says Jill Blakeway, a licensed acupuncturist and fertility specialist based in New York City. “It’s really not rocket science.”
Moms-to-be should exercise in moderation to reduce stress and achieve a comfortable body weight. Eat a lot of organic fruits and vegetables and other healthy foods. “We can be pretty sure that the collective burden of all the toxins and chemicals we take in on a regular basis stresses our reproductive cycle,” Blakeway explains.
Holistic solutions can be an excellent, affordable option. And remember, getting pregnant is a team effort. Women and men alike can give fertility a strong head start by minding the following:
- Avoid alcohol
- Avoid coffee
- Eat healthy, unprocessed foods
- Reduce stress
- Don’t smoke
- Don’t use marijuana or other drugs
- Take multivitamins
- Have sex!
Many factors will come into play—age, body weight, medical history—but there are several avenues of treatment to pursue. Not all are expensive, and you might even get some assistance from your insurance carrier.
Q. Is there anything I can do about my terrible PMS? I only have it a few days each month, but those days are wretched.
A. There are over 150 symptoms associated with premenstrual syndrome, from acne to swollen feet to wishing your spouse would get hit by a bus. But if you’re having extreme symptoms such as incapacitating pain, significant depression or cramps outside your normal cycle, consult a doctor to rule out more serious conditions.
Although there’s no cure-all, the right diet and exercise can bring physical and emotional relief.
Dial back the caffeine, which can bring on mood swings as well as breast soreness, and avoid alcohol. Reduce your intake of salt, sugar, fatty foods and red meat. Instead, seek sources of calcium, magnesium and vitamins B6 and E. The evidence on herbal remedies like primrose oil and chaste tree berry is anecdotal; some women swear by them, some swear at them.
Moderate aerobics (running, walking, swimming) and relaxation techniques (yoga, massage) tend to reduce fatigue, anxiety and depression.
While over-the-counter ibuprofen and diuretics can be helpful, there is better medical evidence that low doses of SSRIs—the same drugs used to counter depression—will relieve PMS symptoms effectively and rapidly.
Q. My doctor doesn’t want to prescribe hormone replacement therapy, but my hot flashes and insomnia are destroying my daily life. What can I do to get some relief?
A. The first line of defense against menopausal symptoms is keeping a healthy diet, exercising and avoiding hot-flash triggers such as alcohol and caffeine. But for many women it’s not enough to sit near a fan eating soy.
“For women who do not get relief from lifestyle measures, a retreat from all therapy does not make sense,” says Dr. Nanette Santoro of the Albert Einstein College of Medicine in the Bronx, N.Y. “Quality-of-life studies indicate that women who do get relief are better off with the therapy. And for about 85 percent of women, this is going to be short-term treatment.”
Hormone replacement therapy (or HRT) treats menopausal symptoms by replenishing estrogen and/or progesterone, which the body stops producing in menopause. Studies show a small degree of risk relating to breast cancer, cardiovascular disease, stroke and blood clots. Establish whether your doctor is drawing a hard line against the therapy or if your personal medical history puts you at higher risk.
Low doses of SSRIs, the serotonin uptake inhibitors used to treat depression, are a fast-acting, non-hormonal alternative. Dr. Santoro notes, “The way these drugs work in low doses is distinct from how they treat depression. As anyone who’s ever had a hot flash can tell you, it’s not psychiatric.”
Q. This is really embarrassing, but I suffer from constipation and gas a lot. Is that a sign of something serious or should I just try to live with it?
A. The body is designed to work correctly; any malfunction signals a problem worth investigating.
In the greatest number of cases, patients find complete relief with a modification of eating habits. Nonetheless, constipation and gas can signify digestive conditions such as ulcers, lactose intolerance and acid reflux. The concurrent presence of the two could imply an obstruction in the lower GI tract, which is sometimes caused by diseases of the colon. Or you could be pregnant. Oops.
Over-the-counter and home remedies can bring relief—active charcoal tablets, or antacids for gas; plenty of fiber and water for constipation—but prolonged self-medication can mask real problems or even create new ones. A gastroenterologist can help you treat the cause rather than the symptoms. And if you’re over 50, the doctor will want to rule out colon cancer.
Make an appointment with a gastrointestinal specialist. Bring with you a log of your diet and the symptoms that arose in the previous two weeks. The impact of digestive complications on lifestyle can be substantial. There’s no reason to “just live with it.”
