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Drexel Health Q&A Series: Women's Health

I've been having trouble getting pregnant. My doctor thinks I may have PCOS. What is this and does it mean I won't be able to conceive?

PCOS stands for Polycystic Ovary Syndrome. If you have two of the following three signs, you may have PCOS:

  • Irregular menstrual periods
  • Multiple small cysts on the ovaries
  • High levels of male hormones, which may cause excess facial hair, hair loss or severe acne

In PCOS, you may not ovulate every month, which can cause irregular periods or difficulty conceiving. However, many women with PCOS do conceive, and have healthy pregnancies and healthy babies. Although PCOS indicates a problem with the ovaries, women with PCOS may be predisposed to diabetes, abnormal cholesterol, high blood pressure, obesity and thyroid problems. If you have been diagnosed with PCOS, it's important to address the risk of these possible problems.

I have pain during sex and sometimes I get an irritating discharge. Do I have a sexually transmitted disease?

It's hard to know. A number of STDs do cause pain with sex and an abnormal discharge. Genital herpes, which affects about 20% of Americans, can cause painful ulcers and an irritating discharge. Gonorrhea and chlamydia can also lead to the symptoms you describe, as can the common parasite, Trichomonas. On the other hand, plenty of women who don't have an STD can have these symptoms. Non-STD causes include yeast infections, vaginal atrophy from the loss of estrogen in menopausal women, and vulvar skin conditions. Since many women can get minor symptoms here and there, occasionally having discharge and a little pain with sex may even be normal. If the symptoms persist or worsen, the only way to know the cause is an evaluation, which should include a history, physical examination and laboratory tests. Once a diagnosis is established, appropriate treatment can be started.

Paul Nyirjesy, MDPaul Nyirjesy, MD is director of the Drexel Vaginitis Center and a professor in the Department of Obstetrics and Gynecology at Drexel University College of Medicine. A leading expert in gynecological infectious diseases, Nyirjesy has been a consultant on the Centers for Disease Control's guidelines on sexually transmitted diseases treatment since 2005 and wrote the American Congress of Obstetricians and Gynecologists' most recent guidelines on vaginitis. He sees patients in Center City.

My mother had terrible osteoporosis and I'm really concerned about bone loss as I get older. I'm postmenopausal and take calcium supplements. Should I be doing something more?

Yes! Your age and family history put you at increased risk for osteoporosis, so you should be focused on calcium, vitamin D, and exercise. A postmenopausal woman needs 1200 milligrams of calcium a day. The best source is your diet. Milk, yogurt, and cheese are the most calcium rich foods, but you can also get calcium in soy milk, fortified orange juice and vegetables such as broccoli and kale. If it is difficult for you to eat enough foods with calcium, then consider a supplement. Vitamin D is also critical for bone health. Without it, you will not absorb the calcium that you eat. Unlike with calcium, the best solution is to use a supplement. Adult women up to 71 years old are recommended to take 600 IU daily and older women 800 IU daily of Vitamin D3. Aim for 30 to 60 minutes daily of weight-bearing exercise, such as walking, running, or even dancing. Finally, consider a bone density measurement, also known as a DEXA scan, to check for osteoporosis. See your doctor after the test to review the results and plan your care.

I'm 41 and for the past year my menstrual cycle has become more irregular. Could I be going through menopause already?

It is unlikely that you are going through menopause at age 41, but it is quite common for slight irregularities in menstruation to begin to happen around this age. Physical signs of menopause begin many years before a woman has her final menstrual period. This phase is called perimenopause and can last six years or more. Menopause is confirmed when a woman has missed her periods for 12 consecutive months in the absence of other obvious causes. This occurs usually between the ages of 45 and 55. During perimenopause, shifts in a woman's hormone levels can cause changes in the menstrual cycles making them irregular, sometimes lighter and shorter, but sometimes heavier and longer. To be sure if your bleeding pattern is normal, it is best to keep a record of your cycles and any irregular bleeding and to see your women's health provider for regular well woman visits. If you have very heavy bleeding, bleeding that lasts more than a week, or cycles that occur less than three weeks apart, see your provider sooner.

Owen Montgomery, MDOwen Montgomery, MD is chairman of the Department of Obstetrics and Gynecology at Drexel University College of Medicine. A specialist in female pelvic reconstructive surgery, Montgomery has explored a range of concerns throughout his career, including gender education; the provision of care to underserved women, both nationally and internationally; electronic medical records; and the prevention of sexual assault. He sees patients in Center City.

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

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