Women’s Health

Miscarriage: Keep breaking the silence

Hope Ricciotti, MD
Hope Ricciotti, MD, Editor in Chief, Harvard Women's Health Watch

Many public figures have begun speaking up about their experiences with miscarriage. While it’s wonderful that they’re breaking the silence, a recent survey has revealed that the general public still has a lot of misconceptions about this surprisingly common event. Dr. Hope Ricciotti shares her reactions to the survey results, and her advice to women experiencing miscarriage.

New mammography guidelines call for starting later and screening less often

Julie Corliss
Julie Corliss, Executive Editor, Harvard Heart Letter

The age at which women should start having screening mammograms, and how often, has been controversial for some time. Reputable national organizations have differed in their recommendations. Accumulating data suggest that for women under 45, screening mammograms may bring more harm than good. As a result, the American Cancer Society has radically shifted its screening guidelines for women in their early 40s at an average risk for breast cancer.

Premenstrual dysphoric disorder: When it’s more than just PMS

Hope Ricciotti, MD
Hope Ricciotti, MD, Editor in Chief, Harvard Women's Health Watch

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) share physical symptoms, but the psychological and emotional symptoms of PMDD are much more severe. No woman should struggle with debilitating symptoms associated with her menstrual cycle. Carefully tracking symptoms and having a discussion with your doctor, as well as trying one of several medications available to treat these conditions, can pave the way to relief.

“Not Again!” — When UTIs won’t quit at midlife

Hope Ricciotti, MD
Hope Ricciotti, MD, Editor in Chief, Harvard Women's Health Watch

Urinary tract infections (UTIs) occur in women of all ages. Physical and hormonal changes can leave women at midlife particularly vulnerable. No woman should have to put up with the inconvenience and discomfort of recurrent UTIs. Self-help measures can be effective, but if they don’t do the trick, see your doctor. He or she can identify and treat any underlying problems and recommend other strategies to keep UTIs at bay.

Draft recommendations on screening mammography continue to stir debate

Gregory Curfman, MD
Gregory Curfman, MD, Editor in Chief, Harvard Health Publications

The release of new guidelines on mammography never fails to renew the heated controversy over the potential benefits and harms of this procedure. The latest draft guidelines from the U.S. Preventive Services Task Force (USPSTF) are no exception. The USPSTF recommends that women begin having mammograms at age 50 and stop at age 75. (The American Cancer Society and other medical organizations recommend that women begin getting regular mammograms at age 40.) The draft recommendations say there isn’t enough evidence to recommend or discourage the use of a new technique called 3-D mammography for screening, and also say there isn’t enough evidence to recommend that women with dense breasts, who are at higher risk of breast cancer, should have an ultrasound or MRI in addition to screening mammography. Comments can be made on the USPSTF draft until 8:00 pm Easter Time today. A final version of the recommendations is expected to be released in the fall of 2015.

No “best” treatment for common uterine fibroids

Urmila Parlikar
Urmila Parlikar, Senior Content Editor, Harvard Health Publications

Fibroids are noncancerous tumors that grow in the uterus. They may be smaller than a seed or bigger than a grapefruit. Depending on their size, number, and location, fibroids can cause heavy bleeding and long menstrual periods (which can, in turn, cause anemia), pelvic pain, frequent urination, or constipation. Fibroids can also cause infertility and repeated miscarriages. About 7 in 10 women will develop this condition at some point. Given how common uterine fibroids are, it’s surprising how few randomized trials have been done to compare treatment options. A clinical practice article in today’s New England Journal of Medicine lays out the options for treating uterine fibroids and discusses the factors women and their doctors should consider when making treatment decisions.

Menopause-related hot flashes and night sweats can last for years

Nancy Ferrari
Nancy Ferrari, Senior editor, Harvard Health

According to conventional medical wisdom, menopause-related hot flashes fade away after six to 24 months. Not so, says a new study of women going through menopause. Hot flashes and related night sweats last, on average, for about seven years and may go on for 11 years or more. The new estimates of the duration of these symptoms come from the Study of Women’s Health Across the Nation (SWAN), a long-term study of women of different races and ethnicities who are in the menopausal transition. The “reality check” the SWAN study provides on hot flashes should encourage women to talk with a doctor about treatment options. These range from estrogen-based hormone therapy to other medications and self-help measures.

Full bladder wakes 2 in 3 women at night

Howard LeWine, M.D.
Howard LeWine, M.D., Chief Medical Editor, Internet Publishing, Harvard Health Publications

Getting up at night to use the bathroom is often thought of as a problem mainly for older men. Not so—two in three women over age 40 wake up at least once each night because of a full bladder. And nearly half of them make two or more nighttime trips to the bathroom. Factors that increased the likelihood that a woman woke at night to urinate included older age, having had a hysterectomy, having hot flashes, and using vaginal estrogen. Many of the women had no other urinary problems, such as an overactive bladder or leaking urine when coughing, and many weren’t especially bothered by having to get up at night to urinate. Getting up once or more each night to urinate may not be “bothersome,” but it can still cause problems. It can interfere with sleep. It can also lead to falls and injury.

Cold hands: Could it be Raynaud’s?

Patrick J. Skerrett, Former Executive Editor, Harvard Health

If your fingers turn ghostly white and numb when they get cold, you may have Raynaud’s syndrome (or disease or phenomenon). This common condition Raynaud’s is an exaggeration of the body’s normal response to cold. It usually affects fingers and toes, but may also affect the nose, lips, ears, and nipples. Named after the French physician who first described it in 1862, Raynaud’s is a problem in the body’s arteries. They spasm and collapse in response to cold or stress. Without a steady supply of warm blood circulating through them, the affected body part becomes pale. When the spasm ends and the arteries reopen, allowing blood to flow again, the finger, toe, or other body part turns pink or red. It may throb or tingle. Prevention—staying warm—is the best medicine. It’s possible to cut an attack short by running your hands under warm water, putting them in your arm pits, or waving your arms in circles to get the blood flowing. Other options include thermal feedback and relaxation techniques. More experimental options include Botox injections and sildenafil (Viagra).

New guidelines recommend Kegels, other lifestyle treatments for urinary incontinence in women

Heidi Godman
Heidi Godman, Executive Editor, Harvard Health Letter

New guidelines from the American College of Physicians offer drug-free ways women can use to reduce or stop urinary incontinence, a potentially embarrassing condition that affects millions of women. The guidelines recommend that women first try Kegel exercises, bladder training, exercise, and weight loss if needed. These approaches can work for both of the leading types of urinary incontinence: stress incontinence (leakage with laughter, sneezing, or other things that put pressure on the bladder) and urge incontinence, also known as overactive bladder, which is caused by unpredictable contractions of muscles in the bladder wall. Other lifestyle changes, like watch fluid intake and minimizing bladder irritants like caffeine, alcohol, carbonated drinks, and other may also help. If these approaches aren’t effective, the next step might be treatment with medication, surgery, or even an injection of botulinum toxin to relax overactive bladder muscles.