Women's Health Archive

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.

Research we're watching

A study published Oct. 15, 2015, in the International Journal of Cancer adds to evidence that the risk of breast cancer increases—but not very much—with every drink a woman takes. Researchers from five Spanish universities followed 334,850 women, ages 35 to 70, from 10 European countries. During an 11-year period, 11,576 were diagnosed with breast cancer.

When the researchers compared alcohol intake among women who developed breast cancer and those who didn't, they found women who averaged two drinks a day had a 4% higher risk than those who limited their consumption to one daily drink. Those who averaged three drinks a day had a 6% higher breast cancer risk.

Research we're watching

A study reported at the 2015 annual meeting of the North American Menopause Society shows that some types of physical activity have a greater impact on body composition in postmenopausal women than in premenopausal ones.

Researchers at the University of Massachusetts asked 630 premenopausal and 274 postmenopausal women to wear accelerometers (motion trackers) to estimate the amount of time they spent doing physical activity. Although the postmenopausal women, on average, logged fewer active hours and more sedentary time than the premenopausal women, they gained more from the time they did spend in motion. Increased activity was associated with greater reductions in body mass index, waist size, and percentage of body fat in postmenopausal women than in their premenopausal counterparts.

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Research we're watching

A long-term study from researchers at Johns Hopkins University School of Medicine has found that men's hearts typically grow with age, while women's shrink. The researchers used magnetic resonance imaging (MRI) to study the left ventricle—the main pumping chamber of the heart—in around 3,000 men and women who were enrolled in the Multi-Ethnic Study of Atherosclerosis. All of the participants—who ranged in age from 54 to 94—were free of cardiovascular disease when they entered the study. They had heart scans at the start and 10 years later.

Comparing the MRI scans of men and women, the researchers found that both had declines in left ventricular volume (the amount of blood the chamber holds) over the decade. However, the mass of the ventricle itself increased in men, while it decreased slightly in women. And having a bigger heart seemed to be a disadvantage. It was associated with higher blood pressure and body mass index and lower levels of HDL (good) cholesterol. The study was published online October 20, 2015, by the journal Radiology.

Ask the doctor

Q. I'm a 48-year-old woman, and I've never had a mammogram. Different guidelines seem to say different things. What do you recommend?

A. You're right, there are several different guidelines. Probably the two most often consulted by doctors are those of the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS). Recent changes by the ACS bring its recommendations nearer to those of USPSTF. They disagree slightly about you. ACS says you should have a mammogram (because you are over 45), but USPSTF says to begin at age 50. Both expert committees stress that these recommendations apply only to women who are not at extra risk of breast cancer (extra risk includes, for example, having a parent, sibling, or child who's had breast cancer). If a woman is at extra risk, she should start getting mammograms earlier.

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News briefs

The guidelines for routine breast cancer screenings are changing again. The American Cancer Society (ACS) published its new recommendations Oct. 20, 2015, in The Journal of the American Medical Association, suggesting that women at average risk for breast cancer now wait until age 45 to begin getting yearly mammograms (it had been age 40) and then get yearly mammograms until age 54. After that, the ACS now recommends that average-risk women ages 55 to 74 transition to screening every other year (instead of annually). It's a big shift for the ACS, and the recommendations are now more in line with the guidelines that came from the U.S. Preventive Services Task Force (USPSTF) in 2009, which recommended mammograms every two years for average-risk women ages 50 to 74 and advise against routine screening before age 50 in these women. The USPSTF guidelines have been controversial since they came out. But no one is saying that women at increased risk for breast cancer should wait to get a mammogram; it's a decision that must be made by a woman and her doctor, based on her risk factors. One other big change to the ACS guidelines: that women continue screening mammography only if they have a life expectancy of 10 years or longer.

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Research we're watching

Women who have heart attacks before age 60 may be less likely to receive a lifesaving procedure to restore blood flow to the heart (an angioplasty plus a stent) than men in that age group, according to a study in the Oct. 26, 2015, Journal of the American College of Cardiology. (Stents are tiny mesh tubes that help keep arteries open.)

Data for the study came from a nationwide sample of more than 630,000 people ages 18 to 59 who had heart attacks. Younger women also were more likely to die in the hospital compared with younger men (4.5% versus 3%, respectively). However, men may be more likely to die before reaching the hospital than women, which may partly explain that difference, the researchers say.

Q. What do you know about taking extra folic acid to boost the immune system?

A. Folic acid is the synthetic form of folate, a B vitamin that occurs naturally in some foods, including vegetables, fruits, and dried beans and peas — and is essential for health. Folate is vital for the production and maintenance of our bodies' cells, especially during rapid periods of growth, such as pregnancy and infancy. It's needed to make DNA and RNA, the genetic material that dictates cell functions, and it helps prevent changes to DNA that may lead to cancer.