Women's Sexual Health Archive

Articles

By the way, doctor: My Pap tests show insufficient cells. What does that mean?

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.

Genital herpes: Common but misunderstood

Studies report that at least a quarter of all adults are infected with the sexually transmitted herpes virus. A guide to managing its sympoms and protecting yourself from this highly infectious disease.

Ask the doctor: Heavy bleeding, fibroids, and polyps

Q.I am 53. I've had fibroids for some time but have experienced heavy menstrual bleeding lately. A recent ultrasound showed fibroids and polyps. What are my options?

A. As you know, you're almost certainly in perimenopause, the four to eight years leading up to menopause and the complete cessation of menstruation. Every woman's script for the transition to menopause is a little bit different, but it's very common for the menstrual cycle to be irregular and the amount of blood flow to vary. Erratic ovulation — the release of eggs from the ovaries — may result in hormonal changes that cause the lining of the uterus (the endometrium) to become thicker than usual, so when it sloughs off, the menstrual bleeding is heavier and more prolonged than women are used to.

By the way, doctor: Is vaginal estrogen safe?

My doctor prescribed a low-dose vaginal estrogen cream, applied twice a week, for atrophic vaginitis. I've heard this dose is so low that it carries no health risk. Do you agree?

Managing postmenopausal vaginal atrophy

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.

Attitudes about sexuality and aging

Fantasies can help rev up your sex life. Myths, on the other hand, can stop desire dead in its tracks. Such myths aren't the legends from classical history. They're the stories we tell ourselves and each other to support the notion that older people shouldn't, can't, and wouldn't want to have sex. This type of myth, however, bears as little relationship to reality as do the fanciful sagas of ancient gods and goddesses. Here are some examples of the most popular sexual myths and the myth-busting truths.

1. The myth: Only the young are sexually attractive.

The culture we live in exalts youth. Turn on the TV or open a magazine and you'll be barraged with images of supple skin, firm flesh, and lustrous locks. But if your mirror is reflecting a different picture these days, you may feel like the party is going on without you.

By the way, doctor: What can I do about strep B vaginitis?

Q. I'm 61 and recently began to have a vaginal discharge. It's not itchy, but sexual intercourse is painful. My doctor diagnosed it as strep B vaginitis and prescribed amoxicillin, which helped. But the discharge returned within a week. What do you recommend?

A. Some vaginal discharge is normal. It helps to protect against vaginal infections and provides lubrication for the vaginal tissues. The discharge consists of vaginal skin cells, mucus, and fluid, as well as Candida (a type of yeast) and vaginal flora, the bacteria normally found in the vagina. Strep B, or group B streptococcus, is one possible constituent of the vaginal flora. Most of the time, vaginal flora and Candida co-exist peacefully. But a change in the balance and in vaginal pH (acidity) may result in vaginal inflammation, or vaginitis.

How to have more sex

Believe it or not, when it comes to sex there is no such thing as normal. So says Dr. Teri Greco who has some helpful words for those who are wondering if they should have more sex and just what that really means.

Multiple yeast infections

When is a yeast infection not a yeast infection? Dr. Teri Greco advises that you visit your doctor to find out if you are experiecing what appears to be multiple yeast infections. Find out more about what else it could be.

Should teen girls get vaccinated for HPV?

While it is a family decision whether or not a girl should be vaccinated for HPV, Dr. Victoria McEvoy has some thoughts about the benefits of this vaccine and how it can even help open the doors to discussion.

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