Four crucial updates you've just gotta have before your next gyno visit

By Marisa Cohen
May 19, 2011

waiting-gyno-officeRennie Solis

Your yearly visit to the gynecologist is critical to your health—period. What's also key: going in with a list of specific questions, so your gyno can tailor her recommendations to your needs, says Jill Maura Rabin, MD, a spokeswoman for the American Congress of Obstetricians and Gynecologists. To get more out of your time in the stirrups, consider discussing these important findings with your doc.Update #1: New relief for heavy periods

If you have menorrhagia—periods so heavy and painful they interfere with daily life—your gyno may have suggested going on the Pill or taking some other hormonal medication. If that didn't work, your only other option was surgery, from endometrial ablation (which destroys the uterine lining) to a hysterectomy (total removal of the uterus). Now there's a new nonhormonal way to lighten the flow: tranexamic acid, a prescription drug that works by stabilizing a protein that helps blood to clot. While the drug does carry a risk of side effects, such as unwanted clotting, Dr. Rabin says it's "a great option for women who can't or don't want to take hormonal treatments."Update #2: A surprise upside to hormone therapy

Talk about confusing: First, hormone replacement therapy (HRT) was hailed as a miracle drug that might not only ease menopause symptoms, such as hot flashes and insomnia, but also reduce the risk of osteoporosis and heart disease. Then the landmark Women's Health Initiative (WHI) study found that an HRT treatment of estrogen plus progestin increased the stroke and breast cancer risk in some women. But in April, a WHI report yielded some good news: For one group—postmenopausal women in their 50s who'd had a hysterectomy—taking an estrogen-only form of HRT for up to six years lowered the rate of breast cancer without increasing any other risks. If you're seeking relief from menopause, talk to your doctor about HRT's pros and cons—whether you still have your uterus or not.
Next Page: Update #3: Beat fibroids without surgery [ pagebreak ]Update #3: Beat fibroids without surgery
in-out-openerRennie Solis

Fibroids—or benign tumors in the uterus—don't always cause symptoms. But for an unlucky minority, they can lead to heavy bleeding, pain, and even infertility. Hysterectomy is a traditional treatment for the condition, but a recent study shows that two less-invasive options preferred by patients can help them just as much. One, called uterine artery embolization, involves injecting particles into the arteries supplying blood to the fibroids to block them. The other, a focused ultrasound, heats and kills fibroid cells. "Though all treatments may not be suitable for all patients, they all lead to a significantly improved quality of life," says lead author Fiona Fennessy, MD, a radiologist at Brigham and Women's Hospital.Update #4: You may need even more folic acid

Sure, you know you need folic acid right before and during pregnancy to help prevent neural-tube defects, such as spina bifida. Since 1996, many common foods, like breads and pastas, have been fortified with this B vitamin. But you still may not be getting enough. While fortification has cut spina bifida rates in half, "many women now miss out on fortified foods because they're cutting back on carbs," says OB-GYN Diana Ramos, MD, consultant to the March of Dimes. Even if you're a carb addict, she says, not all the folic acid from food is absorbed by your body—and you need it in your system at least a month before you conceive to reap the benefits. Play it safe by taking a multivitamin with at least 400 milligrams of folic acid even if you're not pregnant or trying (half of all pregnancies are unplanned!); bump it up to 600 milligrams if you are.