Every woman has unique, complex health needs. But women often pose similar questions to their doctors throughout their lifetimes. Here are the answers to some common questions women ask, fromfertilityto menopause, with a lot in between.
1. I’m trying to conceive. When am I most fertile?
A woman with a typical menstrual cycle has five days of fertility, explained Sanford Health OB/GYNJessica DickesinWatertown, South Dakota.
28天为一个周期，排卵第14天，排卵前3天、排卵当天、排卵后3天为5个受孕日。她说:“这是因为精子可以在女性的生殖道中保持活跃长达三天。”但排卵的卵子会在24小时内死亡。
The easy, “not really thinking about it” way, Dr. Dickes said, “is sex every other day, day 10 to 20. Most people are going to hit one of their fertile days.”
Of course, many people do not have that average 28-day cycle, so figuring out ovulation — which happens about 14 days before the start of a menstrual cycle — can get a little trickier, especially if cycle length varies from month to month.
排卵测试可在柜台测量排卵前12至24小时的促黄体生成素激增。迪克斯博士说:“我们告诉人们在当天和第二天做爱，这样他们就能赶上生育日。”
Women could also chart their daily basal body temperature. A temperature rise occurs after ovulation and might help predict future ovulation dates, she said. Changes in cervical mucus also can indicate ovulation. It becomes stringy and stretchy during the most fertile period.
如果女性确实有月经不调和受孕困难，迪克斯博士敦促她们与医生谈谈。一系列的检测可以帮助确定月经不定时的原因，包括多囊卵巢综合征。
2. Can I do anything to decrease the risk of miscarriage?
Many miscarriages occur because of chromosomal issues, where the fetus develops abnormally. Dr. Dickes reassures patients that they did nothing to cause the loss of the pregnancy.
她说:“找到一个你可以交谈的人……你会发现，流产的女性可能比你意识到的要多。”The miscarriage rate is about 25% in the normal population, she added.
To reduce the chances for a miscarriage with a healthy fetus, Dr. Dickes outlines some precautions women can take before and during pregnancy.
- 解决任何已知的医学问题，在怀孕前，从你的医生孕前护理。糖尿病、甲状腺和子宫异常都是可能导致流产的医学问题。
- Limit exposure to unneeded medications.
- Limit exposure to chemicals and radiation.
- Avoid alcohol and drug use.
- Avoid smoking.
- 限制咖啡因的摄入。
- Take a folic acid supplement.
3. How much grief is normal after a pregnancy loss?
Women who have had a miscarriage or other pregnancy loss can be surprised by the amount of grief they go through afterward, saidJohnna Nynas, a Sanford Health OB/GYN inBemidji, Minnesota.
“There’s no right or wrong way to grieve a pregnancy loss,” Dr. Nynas said. “It’s completely normal if women are really devastated and struggle with it for a long time. It’s also normal if women don’t feel particularly affected.”
Women may experience anxiety or depression. They may struggle with their perception of themselves as a woman capable of reproducing.
Most of the time, Dr. Nynas said, the symptoms will get better over time. However, women should talk with their primary care provider or OB/GYN if symptoms persist or get worse. Other red flags that warrant a visit would be if the pregnancy loss affects relationships at home or at work; if it changes sleeping or eating habits, leading to weight gain or loss; if it diminishes interest or pleasure in once-enjoyable activities; or if it leads to thoughts of self-harm.
Anxiety can also show up during a new pregnancy, too, Dr. Nynas said, as a woman may become hypervigilant for any signs of another miscarriage. “It’s those women that I try to provide extra support for and encouragement,” she said.
4. Do I have a UTI or something else?
The three common symptoms of a urinary tract infection (UTI) are increased frequency of urination, feeling of urgency and burning pain during urination, said Sanford Health OB/GYNPeter Klemin, who works inBismarck, North Dakota.
However, if a woman experiences one or more of these symptoms, they don’t necessarily have a UTI, he said. Pregnancy and menopause can increase frequency and urgency. So can pelvic organ prolapse, or bladder prolapse. An irritation of the urethra from a vaginal infection can produce symptoms similar to a UTI; so can a chlamydia infection. Vaginal atrophy in postmenopausal women or women who have had their ovaries removed can cause symptoms, too.
It’s best to confirm a UTI through a urine sample, Dr. Klemin said. A UTI requires treatment with antibiotics. Other issues may call for other types of treatment, so a course of antibiotics may do nothing for symptoms in those cases.
Dr. Klemin recommends seeking treatment within three to four days of experiencing symptoms of a UTI, although anyone with previous issues involving the kidney or bladder could be at risk for more severe issues and should seek help sooner.
More:A Q&A about UTIs
5. Is this odor normal?
When women ask Dr. Nynas about odor or discharge, she explains that the vagina has populations of healthy bacteria that prefer a balanced environment. Throwing off that balance can result in an infection or changes in odor.
“我的原则是，”尼纳斯说，“阴道是一个自动清洁的烤箱。别惹它。”
她不鼓励女性使用肥皂或面霜等产品来“治疗”已经健康的阴道。
“女人需要知道，你的阴道不应该闻起来像玫瑰花园。这不是故意的，”尼纳斯博士说。
“All you need to do to take care of your vagina is rinse it with clean, warm water,” she added.
在某些情况下，可能会产生明显不同的气味，包括在游泳池游泳，穿着湿泳衣坐在周围，或在锻炼后继续穿着运动服，并保留汗水。
此外，尼纳斯博士说，丁字裤、尼龙和缎面内衣、打底裤和紧身连裤袜会减少通风，导致异味。
“阴道最喜欢普通的棉质内衣，”她说。
一夜之间，忧心忡忡的女性可以只穿宽松的衣服而不穿内衣。
6. How do I know if I have a yeast infection?
酵母菌感染可刺激和瘙痒，在外阴或阴道内。
迪克斯医生说，感染通常伴随着厚厚的白色“白干酪”分泌物。
Yeast infections can occur in women of any age. They may be more common with hormonal changes such as the use of birth control or during pregnancy, as well as after the use of antibiotics. Antibiotics can change the flora of the vagina, Dr. Dickes said.
Eating yogurt or taking a probiotic can help some women keep the flora of the vagina in balance, Dr. Dickes said.
Tips for reducing the risk for a yeast infection are similar to those that can address odor: Don’t put anything into the vagina, such as douches or fragrances. Avoid wearing wet or sweaty clothing for long periods, in the hot tub or in the gym. Wear loose-fitting cotton clothing.
Yeast infections are simple to treat. Most women just need to take one pill.
7. What can I do about constipation?
Klemin博士说:“无论什么年龄段的人，甚至很多年轻女性，都会提到便秘问题。”
Common during pregnancy because of a more sluggish intestinal tract, constipation certainly isn’t confined to those patients.
Dr. Klemin attributes a lot of constipation, as well as bloating, to dietary habits that lack fiber, fruits and vegetables. Obesity can decrease intestinal movement as well.
So he spends time talking with patients about diet and lifestyle choices, such as:
- 吃富含纤维的食物——新鲜水果、蔬菜、豆类、豌豆、扁豆、麸皮麦片、西梅干和全麦面包。
- 保持肌肤水润。
- Breaking up your daily food intake into smaller meals, allowing for the stomach to digest food without having to work overtime. Eating large meals can overload your stomach and make it harder for your digestive system to process what you’ve consumed.
- Regular physical activity can help reduce constipation.
“如果这是更大问题的一部分，有些人需要物理治疗或更详细的测试，”他说。
他也见过一些病人，他们痛苦的腹胀其实是由子宫内膜异位症引起的。
8. Should I take a multivitamin?
Most women eat a pretty varying diet, saidAbrea Roark, a Sanford Health OB/GYN inSioux Falls, South Dakota. “However, almost all of us are lacking in some category.”
So she recommends that women take a once-a-day multivitamin. If they’re of reproductive age, then she recommends a prenatal vitamin, regardless of contraception practices.
“大多数维生素都是水溶性的，所以任何我们不需要的，我们都会通过肾脏排出，”罗克博士说。
她对选择复合维生素的最好建议是找到一种你能忍受的。“大多数复合维生素或产前维生素都是非常大的……所以如果人们感到恶心或有一点呕吐反射，有时很难咽下这些维生素。但现在有很多选择，有很多软糖。”
9. How much water should I drink in a day?
Drinking enough water in a day can be a tall order for some women, especially if their work situation prevents them from sipping constantly. But it’s important, Dr. Roark said.
“Generally, most people should do about 64 ounces of water a day,” she said, “which I tell people kind of sounds like a full-time job.”
你怎么知道你喝的水够不够?“尿液应该是清澈的”，这是罗克医生的经验法则。“你可以通过上厕所的频率来测量你的水合作用。”
Not drinking enough water may result in headaches and eyestrain.
不过，有两组患者需要更多的水。罗克医生鼓励孕妇尽可能多喝酒。这可以帮助消除头晕和头昏等模糊的症状。
And to women who are trying to lose weight, Dr. Roark recommends they drink half of their body weight in ounces of water. Sometimes when people think they’re hungry, they’re actually thirsty and dehydrated, she said.
10. How old will I be when menopause starts?
Jean Marie McGowan, an internal medicine physician inFargo, North Dakota, who is certified in menopause management, hears questions about menopause when women start wondering if their symptoms could be related to hormones.
虽然更年期的年龄可能会有所不同，但美国的平均年龄约为52岁，“相差一两岁，”麦高恩博士说。如果妇女的卵巢被切除，它也可以在任何年龄通过手术诱发。
The most common symptoms are hot flashes and vaginal dryness, Dr. McGowan said. Issues can include discomfort during intercourse, urinary urgency and pelvic floor weakness. Other changes may involve weight, hair, skin, mood and sleep.
Symptoms of menopause typically last a couple of years, though it could be longer for 10% of women. “But some women have no symptoms at all, so they’re the lucky ones,” Dr. McGowan said.
To help ease symptoms, “living a healthy lifestyle definitely helps,” she said.
Smoking makes symptoms worse. Weight loss can help make them better. Dr. McGowan also recommends limiting alcohol. Spicy food and hot beverages can worsen hot flashes, while dressing in layers and using cooling sheets and cooling pillows can help.
“When it comes to medication,” Dr. McGowan said, “hormone therapy is really the most effective treatment for hot flashes and vaginal dryness.”
She recommends usinghormone therapyin the smallest dose for the shortest time needed, which is usually about five years. In addition to addressing menopause symptoms, hormone therapy may also protect the heart and protect against bone loss.
Dr. McGowan cautions women to be sure to use FDA-regulated hormone therapies, which have gone through extensive testing and contain the dosage they say they do. “Bioidenticals or compounded hormones are not recommended because they’re not FDA-regulated,” she said.
11. What are some health issues that affect women differently?
Dr. Klemin said women are conscious of theirbreast cancer还有宫颈癌的风险，很多人都在努力进行筛查。But they may be overlooking their risks related toheart disease和高血压。因此，针对这些症状的筛查和预防措施也很重要，此外，女性应该注意的症状的意识也很重要，这与男性不同。
Sexually transmitted diseases can give women different symptoms than men as well, or no symptoms at all. But whereas bacteria may just affect a man’s urethra and possibly prostate, it can spread through the uterus and Fallopian tubes or even the rest of the pelvic area in a woman, resulting in pelvic inflammatory disease.
“Complications from it can be quite significant,” Dr. Klemin, including hospitalization and possibly surgery, as well as fertility problems and chronic pain.
Bone density检查是确定女性骨质疏松风险的关键。“女性平均在30岁之后就会开始骨质疏松，绝经后骨质疏松会加速，”克莱明博士说。因此，结合负重运动以及钙和维生素D可以帮助女性保持骨密度。
12. How can I try to stay healthy throughout my lifetime?
For all age groups, Dr. McGowan considers these elements key to living the best life: eating, sleeping, moving and loving.
“I really do believe we are what we eat,” she said. “Diet is so important.”
8小时的睡眠也很重要。“Otherwise, we can have high sugars, high blood pressures, fatigue, mood disorders, etc.”
Exercise and being active are important.
还有爱。“我认为爱自己是一部分，”麦高恩博士说。“性健康也是另一个问题。在任何年龄，拥有健康的性生活，或者最让人满意的性生活都是很重要的。”她驳斥了女性可能听说过的性欲会随着年龄的增长而下降的说法，并表示其他因素也可能起作用。
Dr. McGowan also offers these considerations for women at various stages in life.
- 20s and 30s:了解你的家族史。That helps determine if you need to start screening early for breast cancer,colon cancer或卵巢癌。宫颈癌检查从21岁开始，每3到5年进行一次。HPV疫苗现在可能是45岁以下妇女的一种选择。计划生育是另一个需要考虑的问题，一个女人是否对生孩子感兴趣，应该服用叶酸，或者她是否对生孩子不感兴趣，想要讨论避孕。安全性行为和控制体重是这个年龄段的另外两个因素。
- 40s and 50s:40岁的人需要接受乳腺癌检查。结肠镜检查也增加了。虽然这个年龄段可能没有症状，但心脏健康和骨骼健康很重要。麦高恩博士说:“他们现在所做的事情将帮助他们在60多岁甚至更老的时候。”
- 60s and older:Continue breast cancer, cervical cancer (till age 65) and colon cancer screenings. Bone health andbrain healthare key to keep in mind. Stay active and engaged, Dr. McGowan recommends.
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Posted InGynecology,Health Information,Healthy Living,Pregnancy,Specialty Care,Watertown,Women's
