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Over half of all women don't tell their doctors the whole truth about symptoms they're experiencing—and many men go years without even seeing a physician. However, keeping quiet about things that embarrass you is unwise and unhealthy. "Major and even minor symptoms may indicate a serious condition, which you don't want your doctor to overlook," says Michael Roizen, M.D., coauthor of You: The Smart Patient (Free Press) and cofounder of RealAge.com. If you're suffering in silence from one of the following problems, it's time to start talking.
Likely cause: Sucking in too much air when you eat or drink.
What to do: Burping is almost never cause for concern—it's simply your body's way of releasing gas from the stomach or esophagus after you eat. But if you're tired of belching so much, try to take in less air. "Train yourself to drink and eat more slowly," says Dr. Roizen. Put down your fork or food between every bite, and time your meals until you get used to eating for 30 minutes instead of 10. Skip carbonated beverages and gum. When you must have caffeine, opt for coffee. If none of this helps, make an appointment with your doctor. In rare cases frequent burping can indicate a problem in the upper digestive tract, such as an ulcer or gastroesophageal reflux disease (GERD).
Likely cause: Dryness.
What to do: Pain is usually due to inadequate lubrication, so first try a water-based lubricant. If that doesn't help, talk to your M.D. Since levels of estrogen—the hormone that keeps the vagina healthy and moist—drop with menopause, he may prescribe vaginal estrogen (often a topical cream). You also might have a yeast infection (telltale symptoms are itchiness and thick white discharge), which your doc can diagnose with a vaginal culture. "An over-the-counter treatment like Monistat will clear it up," says obstetrician-gynecologist Mary Jane Minkin, M.D. "One-day products are generally effective, but some women get better results with three-day varieties." Finally, ask your doctor if a medication you take may be to blame. In rare cases, painful sex can signal endometriosis, a condition in which uterine tissue grows outside the uterus and forms scar tissue or cysts.
Likely cause: Medications.
What to do: Depression or an underactive thyroid can hurt your libido, but most people lose their sex drive because of a medication they are taking. "Selective serotonin reuptake inhibitor [SSRI] antidepressants are probably the biggest culprit," says Dr. Minkin, a clinical professor of obstetrics and gynecology at Yale University School of Medicine. But other items in your medicine cabinet may be to blame: Drugs that lower blood pressure, for instance, can dull nerve signals, and antihistamines often dry up lubrication necessary for pleasurable intercourse. Hormonal contraceptives—such as birth control pills, the patch, and the ring—can interfere with your libido. It's worth bringing up this side effect with your doctor. If it's not your meds, it could be menopause—declining estrogen levels reduce the blood supply to the vagina. "Lots of my patients ask me why there's no Viagra for women. I tell them that I already have a drug that increases pelvic blood flow—estrogen [it comes in prescription pills, patches, or topical creams]," says Dr. Minkin.
Likely cause: Sweaty shoes.
What to do: The damp, dark inside of your sneaks is a breeding ground for smelly bacteria, so wear absorbent cotton socks with shoes made from breathable materials, like canvas and leather. Wash your feet daily with antibacterial soap, and throw a tea party for your toes a few times a week (pour a pot of green tea made with several tea bags into a basin; let cool until warm, then soak for 30 minutes). "The tea contains powerful polyphenols that knock out organisms that make your feet smell," says Dr. Roizen. If this doesn't help, talk to your doc because the odor could signal a fungal infection. Athlete's foot, a fungus that makes skin itch and burn, is treatable with OTC creams, while toenail fungus, which often starts with nail discoloration, requires prescription antifungal pills or ointment.
Likely cause: Bacteria.
What to do: Your first line of defense is pretty obvious: Brush your teeth (and tongue) at least twice daily, and floss every night to get rid of trapped food particles that can rot and leave an unpleasant odor. But if stinky breath continues, talk to your doc. The smell could stem from an infection in your stomach caused by Helicobacter pylori (the bacteria responsible for ulcers). Your doc can do a urea breath or a stool test to check for H. pylori, which requires antibiotics. An overgrowth of other bacteria in your gut can also raise a stink. "A probiotic can help repopulate your intestines with good bacteria," says Dr. Roizen. "An over-the-counter pill often works better than yogurt or other food sources." Bad breath is also sometimes caused by sinus problems or liver or kidney problems.
Likely cause: Urinary incontinence.
What to do: This condition affects at least 25 million women, says women's health expert Judith Reichman, M.D, author of Relax, This Won't Hurt: Painless Answers to Women's Most Pressing Health Questions (HarperCollins). When the pelvic floor is weak or stretched out, often due to pregnancy, vaginal births, or obesity, leaking can be brought on by a chuckle, as well as coughing, sneezing, or exercise. Here's how to stay dry: Lose excess pounds, since too much abdominal weight puts extra pressure on the pelvic organs. Skip soda and coffee, because caffeine is a diuretic, which increases bladder activity. Strengthen the muscles in your pelvic floor with Kegel exercises (simply tighten your vaginal muscles as if you were going to stop urinating midstream). Start with 20 (10 slow contractions, 10 fast) daily and gradually increase to three sets per day. Your doctor may also prescribe an anticholinergic agent, a medication that quiets the bladder muscle and lessens the likelihood of leaks.
Likely cause: Your diet.
What to do: Track meals in a diary and note when you have gas, which may occur within a half hour of eating certain foods. Beans aren't the only culprit—other known triggers are veggies (broccoli, cabbage, and onions), fruit, dairy products, and whole grains. If dairy's the problem, try over-the-counter lactase supplements to help you digest milk and cheese. When another food is to blame and you don't want to eliminate it from your diet, try a product like Beano. Drinking through a straw, sucking on candy, and sipping carbonated drinks can also introduce air into the GI tract and cause gas. If things don't improve in a couple of months, see your doctor to explore other causes, such as irritable bowel syndrome.
Men typically don't get as embarrassed by errant bodily functions, but they do keep their doctors in the dark about certain topics. "They won't talk about things they feel reflect failure, such as memory problems or not being able to perform sexually," says Dr. Roizen. "It's a good idea to go with your husband to make sure he's telling the whole story." These are the conditions they're least likely to mention:
When you're perched on an examination table in a paper gown, it's hard to feel dignified or relaxed. "Just remember that your doctor isn't there to judge you but to help you," says Dr. Minkin. "And there's almost nothing she hasn't seen or heard before!" Here's how to say what's on your mind:
Copyright © 2008. Used with permission from the March 2008 issue of Family Circle magazine.