Vaginitis is an inflammation of the vagina. As many as one third of women will have symptoms of vaginitis sometime during their lives. Vaginitis affects women of all ages but is most common during the reproductive years.
A change in the balance of the yeast and bacteria that normally live in the vagina can result in vaginitis. This causes the lining of the vagina to become inflamed. Factors that can change the normal balance of the vagina include the following:
To diagnose vaginitis, your health care provider will take a sample of the discharge from your vagina and look at it under a microscope. Your health care provider also may suggest other tests.
Treatment will depend on the cause of the vaginitis. Treatment may be either with a pill or a cream or gel that is applied to the vagina.
Yeast infection also is known as candidiasis. It is one of the most common types of vaginal infection.
A yeast infection is caused by a fungus called Candida. It is found in small numbers in the normal vagina. However, when the balance of bacteria and yeast in the vagina is altered, the yeast may overgrow and cause symptoms.
Use of some types of antibiotics increase your risk of a yeast infection. The antibiotics kill normal vaginal bacteria, which keep yeast in check. The yeast can then overgrow. A woman is more likely to get yeast infections if she is pregnant or has diabetes. Overgrowth of yeast also can occur if the body’s immune system, which protects the body from disease, is not working well.
The most common symptoms of a yeast infection are itching and burning of the area outside the vagina called the vulva. The vulva may be red and swollen. The vaginal discharge usually is white, lumpy, and has no odor. Some women with yeast infections notice an increase or change in discharge.
Yeast infections can be treated either by placing medication into the vagina or by taking a pill.
Over-the-counter treatments are safe and often effective in treating yeast infections. But many women think that they have a yeast infection when they actually have another problem. In these cases, a medication for a yeast infection will not work and may cause a delay in proper diagnosis and treatment of the actual problem.
Even if you have had a yeast infection before, it may be a good idea to call your health care provider before using an over-the-counter medication to treat your symptoms. If this is the first time you have had vaginal symptoms, you should see your health care provider. If you have used an over-the-counter medication and your symptoms do not go away, see your health care provider.
Bacterial vaginosis is caused by overgrowth of the bacteria that occur naturally in the vagina.
The main symptom is increased discharge with a strong fishy odor. The discharge usually is thin and dark or dull gray, but may have a greenish color. Itching is not common, but may be present if there is a lot of discharge.
Several different antibiotics can be used to treat bacterial vaginosis, but the two that are most commonly used are metronidazole and clindamycin. They can be taken by mouth or inserted into the vagina as a cream or gel.
Trichomoniasis is a condition caused by the microscopic parasite Trichomonas vaginalis. It is spread through sex. Women who have trichomoniasis are at an increased risk of infection with other STDs.
Signs of trichomoniasis may include a yellow-gray or green vaginal discharge. The discharge may have a fishy odor. There may be burning, irritation, redness, and swelling of the vulva. Sometimes there is pain during urination.
Trichomoniasis usually is treated with a single dose of metronidazole by mouth. Do not drink alcohol for 24 hours after taking this drug because it causes nausea and vomiting. Sexual partners must be treated to prevent the infection from recurring.
Atrophic vaginitis is not caused by an infection but can cause vaginal discharge and irritation, such as dryness, itching, and burning. This condition may occur any time when female hormone levels are low, such as during breastfeeding and after menopause. Atrophic vaginitis is treated with estrogen, which can be applied as a vaginal cream, ring, or tablet. A water-soluble lubricant also may be helpful during intercourse.
The American Congress of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Vaginitis
Urinary tract infections (UTIs) are responsible for more than 8.1 million visits to physicians’ offices per year and about five percent of all visits to primary care physicians. Approximately 40 percent of women and 12 percent of men will experience at least one symptomatic urinary tract infection during their lifetime. How do you know if you have one? What is the best treatment? The following information should help you.
The urinary tract makes and stores urine, one of the waste products of your body. Urine is made in the kidneys and travels down the ureters to the bladder. The bladder serves as a storage container for urine, which is then emptied by urinating through the urethra, a tube that connects the bladder to the skin. The urethra connects to the end of the penis in a male and connects to an area above the vagina in a female.
The kidneys are a pair of fist-sized organs located in the back that serve as a filtration system to filter liquid waste from the blood and remove it from the body in the form of urine. Kidneys adjust the body’s balance of various chemicals (sodium, potassium, calcium, phosphorous and others) and monitor the blood’s acidity. Certain hormones are also produced in the kidneys. These hormones help regulate blood pressure, stimulate red blood cell production and promote strong bones. The ureters are two muscular tubes that transport the urine down to the bladder.
Normal urine is sterile and contains no bacteria. However, bacteria may get into the urine from the urethra and travel into the bladder. A bladder infection is known as cystitis and a kidney infection is known as pyelonephritis. Kidney infections are much less common — but often more serious — than bladder infections.
When you have a urinary tract infection (UTI), the lining of the bladder and urethra become red and irritated just as your throat does when you have a cold. The irritation can cause pain in your abdomen and pelvic area and may make you feel like emptying your bladder more often. You may even try to urinate but only produce a few drops and/or feel some burning as your urine comes out. At times, you may lose control of your urine. You may also find that your urine smells unpleasant or is cloudy.
Kidney infections often cause fevers and back pain. These infections need to be treated promptly because a kidney infection can quickly spread into the bloodstream and cause a life-threatening condition.
UTIs are often categorized as simple (uncomplicated) or complicated. Simple UTIs are infections that occur in normal urinary tracts. Complicated UTIs occur in abnormal urinary tracts or when the bacterium causing the infection is resistant to many antibiotic medications.
Large numbers of bacteria live in the rectal area and also on your skin. Bacteria may get into the urine from the urethra and travel into the bladder. It may even travel up to the kidney. But no matter how far it goes, bacteria in the urinary tract can cause problems.
Just as some people are more prone to colds, some people are more prone to UTIs. Women who have gone through menopause have a change in the lining of the vagina and lose the protective effects of estrogen that decrease the likelihood of UTIs. Postmenopausal women with UTIs may benefit from hormone replacement. Some women are genetically predisposed to UTIs and have urinary tracts that allow bacteria to adhere to it more readily. Sexual intercourse also increases the frequency of UTIs.
Women who use diaphragms have also been found to have an increased risk when compared to those using other forms of birth control. Using condoms with spermicidal foam is also known to be associated with an increase in UTIs in women. Women are more prone to UTIs because they have shorter urethras than men so bacteria have a shorter distance to travel to reach the bladder.
You are more likely to get a UTI if your urinary tract has an abnormality or has recently been instrumented (for example, had a catheter in place). If you are unable to urinate normally because of some type of obstruction, you will also have a higher chance of a UTI.
Disorders such as diabetes also put people at higher risk for UTIs because of the body’s decrease in immune function and thus a reduced ability to fight off infections such as UTIs.
Anatomical abnormalities in the urinary tract may also lead to UTIs. These abnormalities are often found in children at an early age but can still be found in adults. There may be structural abnormalities, such as outpouchings called diverticula, that harbor bacteria in the bladder or urethra or even blockages, such as an enlarged bladder, that reduce the body’s ability to completely remove all urine from the bladder.
If you are concerned about a UTI, then you should contact your doctor. Frequently, you can be diagnosed and treated without going to your doctor’s office. Ways to diagnose a UTI are via urinalysis and/or urine culture. A sample of urine is examined under a microscope by looking for indications of infection — bacteria or white blood cells in the urine. Your physician may also take a urine culture if needed. If you ever see blood in your urine, you should contact your doctor right away. Blood in the urine may be caused by a UTI but it may also be from a different problem in the urinary tract.
If you are having fevers and symptoms of a UTI, or persistent symptoms despite therapy, then medical attention is advised. You may need further tests, such as an ultrasound or CT scan, to assess the urinary tract.
A simple UTI can be treated with a short course of oral antibiotics. A three-day course of antibiotics will usually treat most uncomplicated UTIs. However, some infections may need to be treated for several weeks. Depending on the type of antibiotic used, you may take a single dose of medication a day or up to four daily doses. A few doses of medication may relieve you of the pain or urge to urinate frequently but you should still complete the full course of medication prescribed for you even if all symptoms have been relieved. Unless UTIs are fully treated, they can frequently return. You should also remember to drink plenty of liquids, especially around the time of a UTI.
If the UTI is a complicated UTI, then a longer period of antibiotics is given and usually is started intravenously in the hospital. After a short period of intravenous antibiotics, then the antibiotics are given by mouth for a period up to several weeks. Kidney infections have usually been treated as a complicated UTI.
Simple UTIs routinely improve with the three days of oral antibiotics and you do not need a urine culture to prove that it is gone. If you have a complicated UTI, however, you should have a urine culture to show that the UTI is gone. If your symptoms continue even with medication, then you may need a longer course of medications, a different drug or different delivery method (for example, if you are taking medication by mouth, then you may need it intravenously).
If the UTI is treated early, then there will probably be no lasting influence on your urinary tract. Recurrent or unrecognized UTIs could cause damage if not remedied expeditiously.
Most UTIs are solitary events that, if treated, will not recur. Some patients have anatomical and genetic predispositions that tend to make one person more susceptible than another.
If you have symptoms of a UTI and are being treated without improvement in your symptoms or you have symptoms of a UTI accompanied by nausea and vomiting, then you should seek medical attention. If you ever see blood in your urine, you should contact your doctor immediately.
If you are pregnant and have symptoms of a UTI, then you should contact your doctor immediately. UTIs during pregnancy can put both mother and baby at risk if not addressed quickly and properly.
If you are having recurrent UTIs (three or more per year), then you should see your doctor for possible further testing like a urinalysis. You may also need an ultrasound or CT scan to look for any abnormalities of the urinary tract. If you continue to have UTIs, you may benefit from a longer course of low-dose antibiotics or by taking an antibiotic after sexual intercourse. There are also methods of self-testing that your urologist may help coordinate with you to institute both diagnosis and treatment of UTIs at home.
Urology Care Foundation. The Official Foundation of the American Urological Association. http://www.urologyhealth.org/urology/index.cfm?article=47
Common PCOS signs and symptoms include the following:
Although the cause of PCOS is not known, it appears that PCOS may be related to many different factors working together. These factors include insulin resistance, increased levels of androgens, and an irregular menstrual cycle.
Insulin resistance is a condition in which the body’s cells do not respond to the effects of insulin. When the body does not respond to insulin, the level of glucose in the blood increases. Higher than normal blood glucose levels may eventually lead to diabetes mellitus. Insulin resistance also may cause more insulin to be produced as the body tries to move glucose into cells. High insulin levels may cause the appetite to increase and lead to imbalances in other hormones. Insulin resistance also is associated with acanthosis nigricans.
When higher than normal levels of androgens are produced, the ovaries may be prevented from releasing an egg each month (a process called ovulation). High androgen levels also cause the unwanted hair growth and acne seen in many women with PCOS.
Irregular menstrual periods can lead to infertility and, in some women, the development of numerous small cysts on the ovaries.
PCOS affects all areas of the body, not just the reproductive system. It increases a woman’s risk of serious conditions that may have lifelong consequences.
Insulin resistance increases the risk of type 2 diabetes mellitus and cardiovascular disease. Another condition that is associated with PCOS is metabolic syndrome. This syndrome contributes to both diabetes and heart disease.
Women with PCOS tend to have a condition called endometrial hyperplasia, in which the lining of the uterus (theendometrium) becomes too thick. This condition increases the risk of endometrial cancer.
A variety of treatments are available to address the problems of PCOS. Treatment is tailored to each woman according to symptoms, other health problems, and whether she wants to become pregnant.
Combination birth control pills can be used for long-term treatment in women with PCOS who do not wish to become pregnant. Combination pills contain both estrogen and progestin. Birth control pills regulate the menstrual cycle and reduce hirsutism and acne by decreasing androgen levels. They also decrease the risk of endometrial cancer.
For overweight women, weight loss alone often regulates the menstrual cycle. Even a small weight loss of 10–15 pounds can be helpful in making menstrual periods more regular. Weight loss also has been found to improve cholesterol and insulin levels and relieve symptoms such as excess hair growth and acne.
Insulin-sensitizing drugs used to treat diabetes frequently are used in the treatment of PCOS. These drugs help the body respond to insulin. In women with PCOS, they can help decrease androgen levels and improve ovulation. Restoring ovulation helps make menstrual periods regular and more predictable.
Successful ovulation is the first step toward pregnancy. For overweight women, weight loss often accomplishes this goal. Medications also may be used to cause ovulation. Surgery on the ovaries has been used when other treatments do not work. However, the long-term effects of these procedures are not clear.
The American Congress of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Polycystic-Ovary-Syndrome-PCOS
Painful urination (dysuria) is pain or burning with urination, usually felt in the tube that carries urine out of your bladder (urethra) or the area surrounding your genitals (perineum). Anyone may experience bouts of painful urination. Painful urination is the most common symptom of a urinary tract infection, especially in women. In men, urinary tract infections are less common, so painful urination is most commonly caused by urethritis and certain prostate conditions.
Painful urination can be caused by a number of conditions and certain substances, including:
Make an appointment to see your doctor if:
*If you’re pregnant, tell your doctor if you have any pain when you urinate.
Overactive Bladder (OAB) isn’t a disease. It’s the name given to a group of troubling urinary symptoms.
The major symptom of OAB is a “gotta go” feeling—the sudden, strong urge to urinate that you can’t control. You may also worry that you will not be able to get to a bathroom in time. You may or may not leak urine after feeling this urge.
If you live with OAB, you may also experience:
The bladder and kidneys are part of the urinary tract—the organs in our bodies that produce, store and pass urine. You have two kidneys that produce urine. Then urine is stored in the bladder. The muscles in the lower part of your abdomen hold your bladder in place.
When it isn’t full of urine, the bladder is relaxed. When nerve signals in your brain let you know that your bladder is becoming full, you feel that you need to urinate. Then the bladder muscles squeeze and push urine out through the urethra, the tube that carries urine from your body. The urethra has muscles called sphincters. They help keep the urethra closed so urine doesn’t leak before you’re ready to go to the bathroom.
OAB can happen when the nerve signals between your bladder and brain tell your bladder to empty even when it isn’t full. OAB can also happen when your bladder muscles are too active. Then your bladder muscles “contract” to pass urine before your bladder is full, and that causes a sudden, strong need to urinate. We call this “urgency.”
: As you grow older, the risk for OAB symptoms increases. Both men and women are at risk for OAB. Women who have gone through menopause (also called “change of life”) and men who have had prostate problems seem to be at greater risk for OAB. Also, people withneurological diseases, such as stroke and multiple sclerosis (MS), have a high risk of OAB.
Eating a diet that is rich in “bladder irritating” food and drinks (such as caffeine, alcohol and highly spiced foods) can increase some people’s OAB symptoms.
In order to diagnose OAB, your health care professional will first gather facts about your past and current health problems, the symptoms you’re having and how long you have had them, what medicines you take, and how much liquid you drink during the day.
Your health care professional may also conduct a physical exam to look for something that may be causing your symptoms, including examining your abdomen, as well as the organs in your pelvis and your rectum in women, or prostate and rectum in men.
He or she may collect a sample of your urine to check for infection or blood and, in some cases, conduct other tests, such as a urine culture or ultrasound.
Your health care professional may also ask you to keep a “bladder diary” to learn more about your day-to-day symptoms.
There are several treatments available to help manage OAB. These include:
This may include changing your diet to see if less caffeine, alcohol, and spicy foods will reduce your symptoms. Your health care professional may ask you to keep a daily “bladder diary” to track your trips to the bathroom. Behavioral changes may include going to the bathroom at scheduled times during the day, and doing “quick flick” Kegel exercises to relax your bladder muscle. Most patients don’t get rid of their symptoms completely with lifestyle changes. But many do have fewer symptoms using this type of treatment.
Urology Care Foundation. The Official Foundation of the American Urological Association. http://www.urologyhealth.org/urology/index.cfm?article=112
An ovarian cyst is a sac or pouch filled with fluid or other tissue that forms on the ovary. Ovarian cysts are quite common in women during their childbearing years. A woman can develop one cyst or many cysts. Ovarian cysts can vary in size. In most cases, cysts are harmless and go away on their own. In other cases, they may cause problems and need treatment.
There are different types of ovarian cysts. Most cysts are benign (not cancerous). Rarely, a few cysts may turn out to be malignant (cancerous).
Most ovarian cysts are small and do not cause symptoms. Some cysts may cause a dull or sharp ache in the abdomen and pain during certain activities. Larger cysts may cause torsion (twisting) of the ovary that causes pain. Cysts that bleed or rupture (burst) may lead to serious problems requiring prompt treatment.
An ovarian cyst may be found during a routine pelvic exam. If your health care provider finds an enlarged ovary, tests may be recommended to provide more information:
Birth control pills may be prescribed to treat some types of ovarian cysts. This treatment will not make cysts you already have go away. But it will prevent new cysts from forming.
If your cyst is large or causing symptoms, your health care provider may suggest surgery. The extent and type of surgery that is needed depends on several factors:
Sometimes, a cyst can be removed without having to remove the ovary. This surgery is called cystectomy. In other cases, one or both of the ovaries may have to be removed. Your doctor may not know which procedure is needed until after the surgery begins.
The American Congress of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Ovarian-Cysts
Planning healthy meals during pregnancy is not hard. The United States Department of Agriculture has made it easier by creating www.choosemyplate.gov. This web site helps everyone from dieters and children to pregnant women learn how to make healthy food choices at each mealtime.
With MyPlate, you can get a personalized nutrition and physical activity plan by using the “SuperTracker” program. This program is based on five food groups and shows you the amounts that you need to eat each day from each group during each trimester of pregnancy. The amounts are calculated according to your height, prepregnancy weight, due date, and how much you exercise during the week. The amounts of food are given in standard sizes that most people are familiar with, such as cups and ounces.
1. Grains—Bread, pasta, oatmeal, cereal, and tortillas are all grains.
2. Fruits—Fruits can be fresh, canned, frozen, or dried. Juice that is 100% fruit juice also counts.
3. Vegetables—Vegetables can be raw or cooked, frozen, canned, dried, or 100% vegetable juice.
4. Protein foods—Protein foods include meat, poultry, seafood, beans and peas, eggs, processed soy products, nuts, and seeds.
5. Dairy—Milk and products made from milk, such as cheese, yogurt, and ice cream, make up the dairy group.
Although they are not a food group, oils and fats do give you important nutrients. During pregnancy, the fats that you eat provide energy and help build many fetal organs and the placenta. Most of the fats and oils in your diet should come from plant sources. Limit solid fats, such as those from animal sources. Solid fats also can be found in processed foods.
Vitamins and minerals play important roles in all of your body functions. During pregnancy, you need more folic acid and iron than a woman who is not pregnant.
How can I get the extra amounts of vitamins and minerals I need during pregnancy?
Taking a prenatal vitamin supplement can ensure that you are getting these extra amounts. A well-rounded diet should supply all of the other vitamins and minerals you need during pregnancy.
Folic acid, also known as folate, is a B vitamin that is important for pregnant women. Taking 400 micrograms of folic acid daily for at least 1 month before pregnancy and 600 micrograms of folic acid daily during pregnancy may help prevent major birth defects of the baby’s brain and spine called neural tube defects. It may be hard to get the recommended amount of folic acid from food alone. For this reason, all pregnant women and all women who may become pregnant should take a daily vitamin supplement that contains the right amount of folic acid.
Iron is used by your body to make a substance in red blood cells that carries oxygen to your organs and tissues. During pregnancy, you need extra iron—about double the amount that a nonpregnant woman needs. This extra iron helps your body make more blood to supply oxygen to your baby. The daily recommended dose of iron during pregnancy is 27 milligrams, which is found in most prenatal vitamin supplements. You also can eat iron-rich foods, including lean red meat, poultry, fish, dried beans and peas, iron-fortified cereals, and prune juice. Iron also can be absorbed more easily if iron-rich foods are eaten with vitamin C-rich foods, such as citrus fruits and tomatoes.
Calcium is used to build your baby’s bones and teeth. All women, including pregnant women, aged 19 years and older should get 1,000 milligrams of calcium daily; those aged 14–18 years should get 1,300 milligrams daily. Milk and other dairy products, such as cheese and yogurt, are the best sources of calcium. If you have trouble digesting milk products, you can get calcium from other sources, such as broccoli; dark, leafy greens; sardines; or a calcium supplement.
Vitamin D works with calcium to help the baby’s bones and teeth develop. It also is essential for healthy skin and eyesight. All women, including those who are pregnant, need 600 international units of vitamin D a day. Good sources are milk fortified with vitamin D and fatty fish such as salmon. Exposure to sunlight also converts a chemical in the skin to vitamin D.
The amount of weight gain that is recommended depends on your health and your body mass index before you were pregnant. If you were a normal weight before pregnancy, you should gain between 25 pounds and 35 pounds during pregnancy. If you were underweight before pregnancy, you should gain more weight than a woman who was a normal weight before pregnancy. If you were overweight or obese before pregnancy, you should gain less weight.
Overweight and obese women are at an increased risk of several pregnancy problems. These problems include gestational diabetes, high blood pressure, preeclampsia, preterm birth, and cesarean delivery. Babies of overweight and obese mothers also are at greater risk of certain problems, such as birth defects, macrosomia with possible birth injury, and childhood obesity.
Although there have been many studies on whether caffeine increases the risk of miscarriage, the results are unclear. Most experts state that consuming fewer than 200 milligrams of caffeine (one 12-ounce cup of coffee) a day during pregnancy is safe.
Omega-3 fatty acids are a type of fat found naturally in many kinds of fish. They may be important factors in your baby’s brain development both before and after birth. To get the most benefits from omega-3 fatty acids, women should eat at least two servings of fish or shellfish (about 8–12 ounces) per week and while pregnant or breastfeeding.
Some types of fish have higher levels of a metal called mercury than others. Mercury has been linked to birth defects. To limit your exposure to mercury, follow a few simple guidelines. Choose fish and shellfish such as shrimp, salmon, catfish, and pollock. Do not eat shark, swordfish, king mackerel, or tilefish. Limit white (albacore) tuna to 6 ounces a week. You also should check advisories about fish caught in local waters.
Food poisoning in a pregnant woman can cause serious problems for both her and her baby. Vomiting and diarrhea can cause your body to lose too much water and can disrupt your body’s chemical balance. To prevent food poisoning, follow these general guidelines:
Listeriosis is a type of food-borne illness caused by bacteria. Pregnant women are 13 times more likely to get listeriosis than the general population. Listeriosis can cause mild, flu-like symptoms such as fever, muscle aches, and diarrhea, but it also may not cause any symptoms. Listeriosis can lead to miscarriage, stillbirth, and premature delivery. Antibiotics can be given to treat the infection and to protect your unborn baby. To help prevent listeriosis, avoid eating the following foods during pregnancy:
The American Congress of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Nutrition-During-Pregnancy
Menopause is the point in a woman’s life when regular menstruation has stopped permanently, usually between the ages of 45 and 55. It is a normal consequence of the aging process.
Often called the “change of life,” menopause is the last stage of a gradual biological process in which the ovaries reduce their production of female sex hormones — a process which begins about three to five years before the final menstrual period. This transitional phase is called the climacteric, or perimenopause. Menopause is an individualized experience. Some women have severe symptoms that disrupt their lives, while others have only mild symptoms and notice little difference in their bodies or moods.
During the transition period preceding menopause, a woman’s fertility is reduced as the supply of eggs in her ovaries diminishes and ovulation becomes irregular. Also, the production of estrogen and other hormones drops. At menopause, the ovaries stop releasing eggs completely and the production of estrogen decreases significantly.
Estrogen is a hormone that plays many roles in the body. In addition to regulating a woman’s menstrual cycle, it affects the reproductive tract, the urinary tract, the heart and blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles and brain. It is the enormous drop in estrogen levels that causes the most common symptoms during menopause. Some women pass through menopause without any significant problems, although most women experience at least some symptoms.
Many woman find that the first sign of menopause is irregularity in their menstrual cycle. Symptoms disappear when menopause is complete (which usually lasts between one and five years).
Other symptoms can include:
Treatment for menopause depends on many things, including how bad your symptoms are, your overall health, and your preference. It may include lifestyle changes or hormone therapy.
Hormone therapy may help if you have severe hot flashes, night sweats, mood issues, or vaginal dryness. Hormone therapy is treatment with estrogen and, sometimes, progesterone.
Talk to your doctor about the benefits and risks of hormone therapy. Your doctor should be aware of your entire medical history before prescribing hormone therapy (HT). Learn about options that do not involve taking hormones.
American College of Physicians. Internal Medicine. http://www.acponline.org/patients_families/special_topics/womens_issues/menopause/
A screening test is used to find diseases, such as cancer, in people who do not have signs or symptoms. This allows early treatment. The earlier cancer is treated, the greater the chance of survival.
Screening for breast problems includes mammography, clinical breast exams, and breast self-awareness.
Mammography is an X-ray technique used to study the breasts. No dyes have to be injected or swallowed, and no instruments will be put in your body.
Mammography is done for two reasons:
1) as a screening test to regularly check for breast cancer in women who do not have signs or symptoms of the disease, and
2) as a diagnostic test to check lumps or other symptoms that you have found yourself or that have been found by a health care provider.
When should I start having annual mammograms?
Age 40 years is recommended as the starting point in order to find cancer at an early and more treatable stage.
What if the result of my mammography reveals a lump?
Mammography by itself cannot tell whether a lump or other finding is benign (not cancer) or malignant (cancer). If a mammography finding is suspicious for cancer, a biopsy is needed to confirm that cancer is present. In a biopsy, the lump or a small sample of cells from the lump is removed and looked at under a microscope.
How do I prepare for a mammogram?
The day you have a mammogram, do not wear powders, lotions, or deodorants. Most of these products have substances that can be seen on the X-ray and make it hard to read.
To get ready for the test, you will need to completely undress from the waist up and put on a gown. You will be asked to stand or sit in front of the X-ray machine. One of your breasts will be placed between two smooth, flat plastic or glass plates. You will briefly feel firm pressure on your breast. The plates will flatten your breast as much as possible so that the most tissue can be viewed with the least amount of radiation. After the first X-ray, the plates may be removed so that another X-ray can be obtained from one or more other positions. The test then is done on the other breast.
You may be concerned about the risk of cancer from the radiation used in mammography. Mammography uses a low level of radiation. The risk of harm from the level of radiation used in mammography is low. Having a yearly screening mammogram does not increase cancer risk.
Digital mammography is a type of mammography technique. It differs from standard mammography only in the way the image is stored. Instead of using film, the image in digital mammography is stored as a digital file on a computer. A computer program allows the image to be enlarged or enhanced or specific areas to be magnified. Digital mammography may be better at detecting cancer in some groups of women, such as those with dense breast tissue, women younger than 50 years, and women who have not gone through menopause.
What is a clinical breast exam?
Your health care provider will examine your breasts during routine checkups. This is called a clinical breast exam. Women aged 29–39 years should have a clinical breast exam every 1–3 years. Women aged 40 years and older should have one every year.
The exam may be done while you are lying down, sitting up, or both. You may be asked to raise your arms over your head. The breasts are first checked for any changes in size or shape. Your health care provider also looks for puckers, dimples, or redness of the skin. He or she then feels for changes in each breast and under each arm. The nipple may be gently squeezed to check for discharge.
Breast self-awareness is an understanding of how your breasts normally look and feel.
In the traditional breast self-exam, you use a precise method to examine your breasts on a regular basis, such as once a month. Breast self-awareness does not require you to examine your breasts once a month or with a precise method. Instead, it focuses on having a sense of what is normal for your breasts so that you can tell if there are changes—even small changes—and report them to your health care provider.