Women's Health Archive

Ask the doctor

Q. In your discussions of breast cancer screening, you never mention ultrasound. Is it an alternative to mammography?

A. No. Although the FDA has approved an automated breast ultrasound system to be used in addition to mammography for asymptomatic women with dense breasts, there are not enough published data about its effectiveness in screening to support its use. Moreover, ultrasound alone is not an alternative to mammography for routine breast cancer screening because ultrasound cannot pick up the small deposits of calcium (microcalcifications) that can be a sign of breast cancer.

Ask the doctor

Q. My daughter had a miscarriage a few months ago and since then she has been depressed and withdrawn. Do you know anything I can do to help?

A. Miscarriage can involve a difficult emotional recovery, and many women and their partners are surprised at the intensity of their feelings. Many women who have experienced a miscarriage feel that they have done something wrong. They may worry that the miscarriage resulted from stress or lifestyle choices they made during pregnancy. In fact, most miscarriages are the result of chromosomal abnormalities, structural abnormalities of the uterus, or maternal endocrine or autoimmune disorders.

By the mid-20th century, most births took place in the hospital. But increasingly, some women are choosing to have their babies at home in an effort to avoid seemingly unnecessary interventions and find an alternative to hospital environments. We don’t have the best data to assess the safety of home birth. But a recent analysis offers insights that can help women make choices based on what they value the most.

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Flibanserin is the first treatment of its kind. But it comes with a steep price tag and severe health risks.

It's now six months since the FDA approved flibanserin (Addyi), which is the first medication for sexual desire disorders. The drug was hailed as a "female Viagra," but is it living up to the hype? "It's not the solution we were hoping for," says Dr. Hope Ricciotti, editor in chief of Harvard Women's Health Watch and an associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School.

For years, there has been concern about the high rate of cesarean births — but just how many cesareans are too many? A recent study suggests that a cesarean rate of 19% is about right. The reasons for high cesarean rates may be related more to each hospital’s circumstances and processes than to other, more commonly cited reasons. If you’re concerned, find out the C-section rate at the hospital where you plan to deliver your baby.

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Women can devise their own breast cancer screening schedules based on their risk and preferences.

If you tend to "go by the book" for preventive health care, you probably get a flu shot each fall, have a colonoscopy every 10 years, and generally follow the experts' recommendations. But what do you do about mammograms? For decades, the two most influential expert groups—the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF)—haven't agreed about when to start having mammograms, how often to have them, or how long to keep on having them. Although the two groups come a little closer together with their most recent guidelines, they still disagree about breast cancer screening for women ages 45 through 54.

Ask the Doctor

Q. I'm concerned about the heavy vaginal discharge I have been having lately. Could this be a sign of an infection?

A. Vaginal discharge is natural, and an increase may reflect normal changes in your body. However, it frequently raises concerns and is a common reason women decide to see a gynecologist.

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Several medications can maintain or increase bone density. You can choose one based on your health and preferences.

Most of what we read about hip fracture isn't good. It is a major cause of disability, nursing home admissions, and death in older women. But there is a promising trend: hip fractures in the United States have been on the decline since 1996. Although better nutrition, increased physical activity, and education on fall prevention may have played a role, the drop in fractures has also coincided with the widespread availability of bisphosphonates—a class of drugs first approved in 1995 to increase bone density.

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The wearable electronic devices may motivate you to stick to a diet or exercise plan.

If you've resolved to get more exercise, lose weight, or get more sleep in 2016, then a host of wearable electronic devices and apps are available to help you succeed. They will gently prod you to work toward your goal, encourage you along the way, and praise you when you get there. The gadgets record your activity, while the apps interpret the results and send you frequent messages to let you know how well you're progressing.