Frequently Asked Questions About Women's Health
From the Office On Women's Health
When should I get a bone density test?
If you are age 65 or older, you should get a bone density test to screen for osteoporosis. If you are younger than 65 and have risk factors for osteoporosis, ask your doctor or nurse if you need a bone density test before age 65. Bone density testing is recommended for older women whose risk of breaking a bone is the same or greater than that of a 65‑year‑old white woman with no risk factors other than age. To find out your fracture risk and whether you need early bone density testing, your doctor will consider factors such as:
- Your age and whether you have reached menopause
- Your height and weight
- Whether you smoke
- Your daily alcohol use
- Whether your mother or father has broken a hip
- Medicines you use
- Whether you have a disorder that increases your risk of getting osteoporosis
How might problems in my mouth be linked to health problems in other parts of my body?
The health of your mouth can be a sign of your body's health. Mouth problems are not just cavities, toothaches, and crooked or stained teeth. Many diseases, such as diabetes, heart disease, HIV, cancer, and some eating disorders are linked with oral health problems. Regular dental exams help you maintain good oral health and avoid related health problems.
Cancer. If you are being treated for cancer, you may develop sores or other problems with your mouth. Pay attention to your mouth each day, and remember to brush and floss gently. Call your doctor or nurse if you notice a mouth problem, or if an old problem gets worse.
Diabetes. People with diabetes are at special risk for gum disease. Gum disease can lead to painful chewing and even tooth loss. Dry mouth, often a symptom of undetected diabetes, can cause soreness, ulcers, infections, and tooth decay. People with diabetes can also get thrush. Smoking makes these problems worse. By controlling your blood glucose, brushing and flossing every day, and visiting a dentist regularly, you can help prevent gum disease. If your diabetes is not under control, you are more likely to develop problems in your mouth.
Heart disease. Before some dental treatments, patients who have certain heart conditions or joint replacements may take antibiotics. These people may be at risk of getting an infection when bacteria that lives in the mouth goes into the bloodstream during treatment. Antibiotics lower this risk. Talk to your doctor or dentist if you are not sure whether you should take antibiotics before dental treatment.
HIV. Oral problems are common in people with HIV because of a weak immune system. These problems can make it hard to eat. If mouth pain or tenderness makes it hard to chew and swallow, or if you can't taste food like you used to, you may not eat enough. The most common mouth problems linked with HIV can be treated.
Nutrition problems. Sometimes people who are missing teeth have to limit their food choices because of chewing problems. This can lead to a lack of vitamins in the body. If you are missing teeth and have trouble chewing, check with your doctor to make sure you are eating the right foods.
How can I get enough calcium if dairy foods make me sick or I don't like to eat them?
If you're lactose intolerant, it can be hard to get enough calcium. Lactose is the sugar that is found in dairy products like milk. Lactose intolerance means your body has a hard time digesting foods that contain lactose. You may have symptoms like gas, bloating, stomach cramps, diarrhea, and nausea. Lactose intolerance can start at any age but often starts when you get older.
Lactose-reduced and lactose-free products are sold in food stores. There's a great variety, including milk, cheese, and ice cream. You can also take pills or liquids before eating dairy foods to help you digest them. You can buy these pills at the grocery store or drug store. Please note: If you have symptoms of lactose intolerance, see your doctor or nurse. These symptoms could also be from a different, more serious illness.
People who are lactose intolerant or who are vegans (eat only plant-based foods) can choose from other food sources of calcium, including canned salmon with bones, sardines, Chinese cabbage, bok choy, kale, collard greens, turnip greens, mustard greens, broccoli, and calcium-fortified orange juice. Some cereals also have calcium added. You can also take calcium pills. Talk to your doctor or nurse first to see which one is best for you.
What are autoimmune diseases? How common are they?
Our bodies have an immune system, which is a complex network of special cells and organs that defends the body from germs and other foreign invaders. At the core of the immune system is the ability to tell the difference between what's you and what's foreign. A flaw can make the body unable to tell the difference between self and nonself. When this happens, the body makes autoantibodies (AW-toh-AN-teye-bah-deez) that attack normal cells by mistake. At the same time special cells called regulatory T cells fail to do their job of keeping the immune system in line. The result is a misguided attack on your own body. This causes the damage we know as autoimmune disease. The body parts that are affected depend on the type of autoimmune disease. There are more than 80 known types.
Overall, autoimmune diseases are common, affecting more than 23.5 million Americans. They are a leading cause of death and disability. Yet some autoimmune diseases are rare, while others, such as Hashimoto's disease, affect many people.
Who gets autoimmune diseases?
Autoimmune diseases can affect anyone. Yet certain people are at greater risk, including:
Women of childbearing age — More women than men have autoimmune diseases, which often start during their childbearing years.
People with a family history — Some autoimmune diseases run in families, such as lupus and multiple sclerosis. It is also common for different types of autoimmune diseases to affect different members of a single family. Inheriting certain genes can make it more likely to get an autoimmune disease. But a combination of genes and other factors may trigger the disease to start.
People who are around certain things in the environment — Certain events or environmental exposures may cause some autoimmune diseases, or make them worse. Sunlight, chemicals called solvents, and viral and bacterial infections are linked to many autoimmune diseases.
People of certain races or ethnic backgrounds — Some autoimmune diseases are more common or more severely affect certain groups of people more than others. For instance, type 1 diabetes is more common in white people. Lupus is most severe for African-American and Hispanic people.
Am I at risk for diabetes?
Risk factors for diabetes include:
- Age – being older than 45
- Overweight or obesity
- Family history – having a mother, father, brother, or sister with diabetes
- Race/ethnicity – your family background is African American, American Indian/Alaska Native, Hispanic American/Latino, Asian American/Pacific Islander and Native Hawaiian
- Having a baby with a birth weight more than 9 pounds
- Having diabetes during pregnancy (gestational diabetes)
- High blood pressure – 140/90 mm HG or higher. Both numbers are important. If one or both numbers are usually high, you have high blood pressure.
- High cholesterol – total cholesterol over 240 mg/dL
- Inactivity – exercising less than 3 times a week
Abnormal results in a prior diabetes test
- Having other health conditions that are linked to problems using insulin, like polycystic ovarian syndrome (PCOS)
- Having a history of heart disease or stroke
What foods should I eat to help prevent heart disease and stroke?
You should eat mainly:
- Fruits and vegetables
- Grains (at least half of your grains should be whole grains, such as whole wheat, whole oats, oatmeal, whole-grain corn, brown rice, wild rice, whole rye, whole-grain barley, buckwheat, bulgur, millet, quinoa, and sorghum)
- Fat-free or low-fat versions of milk, cheese, yogurt, and other milk products
- Fish, skinless poultry, lean meats, dry beans, eggs, and nuts
- Polyunsaturated (pol-ee-uhn-SACH-uh-ray-tid) and monounsaturated (mon-oh-uhn-SACH-uh-ray-tid) fats (found in fish, nuts, and vegetable oils)
Also, you should limit the amount of foods you eat that contain:
- Saturated fat (found in foods such as fatty cuts of meat, whole milk, cheese made from whole milk, ice cream, sherbet, frozen yogurt, butter, lard, cakes, cookies, doughnuts, sausage, regular mayonnaise, coconut, palm oil)
- Trans fat (found mainly in processed foods such as cakes, cookies, crackers, pies, stick or hard margarine, potato chips, corn chips)
- Cholesterol (koh-LESS-tur-ol) (found in foods such as liver, chicken and turkey giblets, pork, sausage, whole milk, cheese made from whole milk, ice cream, sherbet, frozen yogurt)
- Sodium (found in salt and baking soda)
- Added sugars (such as corn syrup, corn sweetener, fructose, glucose, sucrose, dextrose, lactose, maltose, honey, molasses, raw sugar, invert sugar, malt syrup, syrup, caramel, and fruit juice concentrates)
Eating lots of saturated fat, trans fat, and cholesterol may cause plaque buildup in your arteries. Eating lots of sodium may cause you to develop high blood pressure, also called hypertension. Eating lots of added sugars may cause you to develop type 2 diabetes. Both hypertension and diabetes increase your risk of heart disease and stroke.
Are there natural treatments for my menopause symptoms?
Some women try herbs or other products that come from plants to help relieve hot flashes. These include:
Soy. Soy contains phytoestrogens (FEYE-toh-ESS-truh-juhns). These are substances from a plant that may act like the estrogen your body makes. There is no clear proof that soy or other sources of phytoestrogens make hot flashes better. And the risks of taking soy products like pills and powders are not known. If you are going to try soy, the best sources are foods such as tofu, tempeh, soymilk, and soy nuts.
Other sources of phytoestrogens. These include herbs such as black cohosh, wild yam, dong quai, and valerian root. There is not enough evidence that these herbs — or pills or creams containing these herbs — help with hot flashes. Also, not enough is known about the risks of using these products.
Make sure to discuss any natural or herbal products with your doctor before taking them. It's also important to tell your doctor about all medicines you are taking. Some plant products or foods can be harmful when combined with certain medications.
What is "bioidentical" hormone therapy?
Bioidentical hormone therapy (BHT) means manmade hormones that are the same as the hormones the body makes. There are several prescription BHT products that are well-tested and approved by the U.S. Food and Drug Administration (FDA).
Often, people use the term "BHT" to mean medications that are custom-made by a pharmacist for a specific patient based on a doctor's order. These custom-made products are also sometimes called bioidentical hormone replacement therapy (BHRT). Despite claims, there is no proof that these products are better or safer than drugs approved by the FDA. Also, many insurance and prescription programs do not pay for these drugs because they are viewed as experimental.