Nowadays, parents talk to their kids about almost everything. But anyone over 35 grew up with certain taboo topics. Sex? Anxiety and depression? Addictions? Our mothers would’ve told us about those things. Trouble is, no one told them. Here’s the truth about women’s health from an all-female panel of healthcare experts.
Myth: Women don’t always enjoy sex.
Truth: Intimacy is critical to a relationship—and sex should not hurt.
Pain during intercourse is so common that there’s a medical term for it: dyspareunia. Dr. Lynn Wang, a Main Line Health gynecologist and certified sexuality counselor, explains that dyspareunia can be caused by many things, including dryness, irritation from feminine products and infections. Other issues, like physical insecurities and the anticipation of pain, can turn into self-fulfilling issues. “They become cognitive distractions, which are thoughts and feelings that prevent women from being able to focus on pleasure during intimacy,” Wang says. “Fortunately, sexual health is becoming more recognized as an important part of overall health, and many of these types of issues are treatable.”
To find a certified sexual health professional in this area, visit www.aasect.org/referral-directory.
Myth: Urinary incontinence is part of getting older.
Truth: It’s not, and it can be a symptom of a larger problem.
Stress incontinence—releasing small quantities of urine when laughing, sneezing or coughing—has jokingly become known as “the squirts.” It’s no laughing matter to Hina Sheth, owner of ReBalance in Narberth and Center City. “It’s not normal, not even after several kids,” Sheth says.
It can be a symptom—along with pain in the lower back and elsewhere—that the abdominals and pelvic floor have been compromised. This can lead to long term issues that worsen as women age, explains Sheth, a mother of three who has training in women’s health and muscular skeletal systems. Sheth’s practice incorporates therapies for patients’ abdominals, diaphragms, low backs, pelvic floors and other areas. “People get physical therapy to address problems with other muscles,” Sheth says. “Women often need help with this part of their bodies, too.”
Myth: Kegel exercises improve intercourse.
Truth: Kegels can exacerbate problems with the pelvic floor.
Few women understand the mysteries of their pelvic floors. For starters, the pelvic floor is compromised of 14 muscles. “Each of those muscles can have different tightness and weakness,” Sheth says. “Tightening everything can be a mistake and lead to more problems.” Too much weakness is a different problem, one commonly encountered after vaginal births and C-sections. Women may then have a mix of pelvic floor weakness and tightness. Constipation, incontinence, urinary frequency, urethra pain, UTIs, vaginal pain and hip, back and GI problems can be caused by pelvic floor dysfunction. “Often, it’s all one in the same,” Sheth says. Addressing these problems begins with a proper diagnosis of which muscles are compromised followed by physical therapy.
Myth: Skincare products should have SPF 15.
Truth: SPF 30 is the minimum.
Not wearing the proper sunscreen is the biggest skin care mistake women make, says Dr. Christine Stanko of Bryn Mawr Dermatology. SPF 30 should be worn every day, even when women think they aren’t in the sun. Walking from a parking lot into a store, even on a cloudy day, can cause skin damage. UV rays can pass through glass, as well. “Bottom line, a woman doesn’t need to be lounging on the beach to be exposed to age-accelerating and cancer-causing UV rays,” says Stanko. “Sunscreen of SPF 30 or higher should be a part of the daily morning routine.”
Myth: Wrinkling? Get Botox.
Truth: Botox isn’t right for everyone. For natural-looking results, consult a cosmetic doctor.
Ask for Botox and you’ll get it, especially if you use a Groupon or a specific product. But that may not be the most effective anti-aging treatment, Stanko cautions. “It is easy to see ‘bad’ or over-done cosmetic treatments,” Stanko says. “Natural looking results, based on the skill of the provider, are hard to notice, if at all. It’s just a better, younger-looking you.”
Stanko explains the difference: Botox targets wrinkles like frown lines or crow’s feet that are caused by muscle contraction and movement. Fillers like Restylane and Juvederm can enhance sunken temples, lift skin back onto cheekbones, define jaw lines, plump thin lips and help eliminate dark circles under the eyes.
Myth: Hot flashes? Mood swings? Take estrogen.
Truth: Estrogen replacement can worsen menopausal symptoms.
Estrogen gets top billing as the “women’s hormone,” but a well-balanced system includes proper levels of progesterone, cortisol and estrogen. Balance is the key, says Amy Reardon, not replacement. A natural hormone specialist and owner of BeBalanced in Bryn Mawr, Reardon explains adding more estrogen through injections, creams or supplements throws the body further into chaos. “Women then become estrogen dominant,” says Reardon. “That can cause weight gain, heavy or irregular periods and insomnia.”
The solution, Reardon says, is to find a program that balances all of the hormones.
Myth: To lose weight, exercise more and eat less.
Truth: Without proper levels of progesterone, most women have trouble losing weight.
As women age, they produce less progesterone, the hormone that burns fat and stops the overgrowth of tissue in body. “My typical clients are moms who work out regularly and eat right but are not seeing results on their scales,” she says. “If you don’t have enough progesterone, you can do all the diets you want and you may still not burn fat.” Sensible eating and regular exercise are part of the plan that Reardon gives her clients, but the basis of it are homeopathics, probiotics, vitamins and a transdermal cream that promotes balanced hormones.
Myth: Keep calm, carry on and don’t talk about your problems.
Truth: Getting mental health help is a sign of strength.
Many people still equate mental illness with weakness, laments Elizabeth Bland, director of Main Line Health Women’s Emotional Wellness Center. “We do not think of the woman who has broken her leg as weak, so why do we do think that of the woman experiencing depression or anxiety?” Bland poses. “We need to remember those who ask for help are the strongest because they tap into the resources they need to empower themselves and feel better. Each time we talk openly about anxiety and depression, we break down stigma and move towards honest, supportive and open discussions.”
Myth: The baby blues are normal.
Truth: Don’t ignore post-partum depression. Help is available.
Post-partum depression is more serious than most people realize, Bland says. Women are at risk for PPD for the entire first year after they give birth. New moms and dads should be aware of PPD’s symptoms and get help if it’s needed. Too often, women dismiss their feelings, chalking them up to being tired and overwhelmed. “Don’t be your biggest road block,” Bland cautions. “If you are not feeling well, ask for help and make time to get the care you need. You will feel better.”
Myth: The most expensive rehab is the most effective.
Truth: Women benefit most from female-centric rehab.
Many women with substance use disorders find the traditional treatment model of recovery too confrontational, says Dr. Sarah Falgowski, division chief of adult psychology for Crozer-Keystone Health System and medical director of Community Hospital. More supportive approaches are often effective, especially for women who are mothers. “Child care needs can impede a woman’s ability to attend treatment,” Falgowski says. “Fear of losing custody of a child or having social welfare involvement can make a woman with substance use disorder less likely to seek treatment.”
Unfortunately, only 30 percent of treatment facilities offer programs specific for women.
Myth: Drug and alcohol abuse runs in families.
Truth: True, but men and women have different risk factors for addiction.
Genetics do play a big role in substance abuse, says Falgowski. “About half of the vulnerability to addiction is attributed to genetic factors,” she explains. But mental health issues contribute more heavily to women’s addictions than men’s. “Women with addiction have higher rates of mood disorders, anxiety disorders and childhood sexual abuse,” Falgowski says.
And a woman’s substance use is heavily influenced by that of her male partner.
Myth: Low-carb, high-protein, all-natural diets are the healthiest.
Fact: Those diets aren’t always low in fat, sugar or calories.
Fiber-fortified granola bars sound like a good snack option, right? “You can get one-third of your daily fiber in just one bar, but the rest of the ingredients are littered with added sugars, artificial flavors and preservatives.”
So says Melissa Barry, clinical nutrition manager at Mercy Fitzgerald Hospital. Healthy-sounding fruit-on-bottom yogurts can contain 29 gram of carbs and 24 grams of sugar—the equivalent of a candy bar. Nut butters can contain added sugars or trans fats. A single tablespoon contains nearly 100 calories. Barry’s advice: Ignore marketing gimmicks and read nutrition labels.
Myth: Omega 3, calcium and Vitamin D are great for women over 40.
Truth: Maybe, but they also need a lot of potassium.
Women in their 40s need 4700 mg of potassium per day, Barry says. Consider that a medium-sized banana has only 422 mg of potassium and the problem becomes clear. “Potassium helps maintain your blood pressure and potassium-rich foods contain phytochemicals that fight disease,” says Barry.
Don’t forget Vitamin C, E and antioxidants. “They fend off free radicals which can contribute to aging.”
Myth: Green, leafy vegetables are great sources of calcium.
Truth: Most women need supplements and calcium-rich foods to get the recommended amounts.
“The best way to get calcium is through dietary means, but unless you drink four to five glasses of milk a day, it’s hard to get that much,” says Jacqi Kernaghan of the Crozer-Keystone Osteoporosis Center of Delaware County. “Our providers recommend 500-600 mg of calcium through a supplement and the rest by foods.”
But Kernaghan cautions that too much calcium via supplements can cause cardiovascular issues. Despite what packaging suggests, don’t take more than 600 mg of calcium by supplement, she advises.
Myth: Cancer is the number one cause of death in women.
Truth: More women die from cardiovascular disease than all forms of cancer combined.
Genetics, diet, exercise, smoking. All of these factors contribute to heart disease, which affects women of all ages. “Even with a strong family history, there are many things that women can do to reduce their risk of developing heart disease,” says Dr. Kimberly Campbell, a Crozer-Keystone cardiologist.
Eat well, avoid unhealthy behaviors and get 150 minutes of moderate intensity aerobic exercise per week, she advises. And if there’s a family history of heart disease, consult a cardiologist for a complete physical.