Women's Health Archive

Q. For two years in a row, the lab that handles my Pap smears has reported "insufficient cell count." My doctor says it's nothing to worry about, but my health insurance company considers these "abnormal" Paps and has put me in a higher-risk category because of it. Should I be concerned?

A. When lab pathologists evaluate Pap tests for abnormal cells, the goals are to identify cancer that should be removed and precancerous conditions that should be followed closely to watch for any changes. Sometimes the results are unclear because the lab sample doesn't contain enough cells to evaluate ("insufficient cell count") — or because the cells are obscured by inflammation, mucus, or blood from a heavy menstrual period. In these cases, the Pap test is not necessarily abnormal; the specimen is simply inadequate to make any determination.

Vaginal dryness is one of the most irritating symptoms of menopause. Here are some ways to relieve it.

Within a few years of menopause, roughly 50% of women develop symptoms related to vaginal atrophy, also called atrophic vaginitis — the deterioration of vaginal tissues due to loss of estrogen. The most common symptoms of vaginal atrophy are dryness, irritation, and pain during intercourse.

Although menopause is the most common cause, vaginal atrophy can result from anything that lowers estrogen production. That includes chemotherapy, radiation, removal of the ovaries during hysterectomy, and use of anti-estrogenic therapies such as aromatase inhibitors, tamoxifen (Nolvadex), and drugs like leuprolide (Lupron) and nafarelin (Synarel), which are used to treat fibroids and endometriosis. Unlike hot flashes, which usually subside with time, vaginal atrophy is likely to persist and become worse without treatment.

Digital breast tomosynthesis may also reduce the number of unnecessary and nerve-racking callbacks for additional testing.

If you're in your 40s, you may want to consider switching from digital mammography to digital breast tomosynthesis (DBT) for your next breast cancer screening, say the authors of a study published online February 28 by JAMA Oncology.

A review of more than 170,000 screening mammograms using the two technologies determined that DBT — sometimes referred to as 3D mammography — did a better job at accurately detecting cancers in women of all ages. The advantages were most pronounced for women in their 40s. DBT was also better at finding cancers in women with high breast density, which can make cancers more difficult to spot on screening exams. High density indicates a larger proportion of active tissue in the breast and is a risk factor for breast cancer.

Infections from a drug-resistant fungus have been occuring around the world for the past decade. It’s not cause for panic, but it’s wise to understand the facts and ways to protect yourself.

A drug holiday is one recommendation to reduce the risk of a rare bone condition that affects the jaw.

A dentist refers a woman to an oral surgeon because she needs a tooth pulled. But upon reviewing her chart, the oral surgeon turns her away.

The reason? She's taking a common medication to treat her osteoporosis, a condition that causes bones to become thin, brittle, and prone to fracture.

Ask the doctors

Q. I have endometriosis, and I recently heard that it might increase my risk of certain cancers. Is this true?

A. Researchers have linked endometriosis, an often painful condition that causes endometrial-like tissue to grow outside the uterus, to a higher risk of two types of ovarian cancer — endometrioid and clear-cell subtypes. That said, even though your risk of these cancers may be higher than that of the average woman who doesn't have endometriosis, your chances of developing one of these cancers is still very small — less than 1%.

People attempting to conceive through in vitro fertilization may face the question of what to do with extra embryos, especially if they reach a point where they feel their family is complete.