Women's Private Health Concerns, Discussed


"These are issues that many primary care physicians cringe to hear a patient say," said Harper. "And the patient can feel that the physician is uncomfortable with the topic. [So], unless the woman is near dying from the abuse, she may choose not to say anything to the physician."

While women are much more resistant to discussing domestic abuse than almost any other subject, many doctors say that, once the trust is built, some women will begin to open up about their home life.

"We ask questions that give them the idea to talk about it," said Dr. Paula Hillard, professor in the department of obstetrics and gynecology at Stanford University School of Medicine. "For some, it takes several visits with me for them to feel comfortable enough to acknowledge [the problem]. They're ashamed."

LaValleur agreed that many women see abuse as a badge of shame, but those same women might be surprised by the prevalence of women who are affected by domestic violence.

"People have a mistaken idea that domestic abuse happens in people who are poor or in alcoholic homes, but it can happen in any socioeconomic strata," said Hillard.

Domestic violence comes in many forms, including physical aggression, sexual abuse, intimidation, stalking and neglect. Abuse does not have to be physical.

"Calling someone a bitch is abusive," said LaValleur.

When doctors find out that a patient is in an abusive household, the next question is almost always whether the woman has an escape plan for herself, and, if applicable, her children.

"A woman needs to know where she can go that is safe and who she can depend on," said LaValleur.

If you or someone you know suffers from domestic abuse, call the National Domestic Violence Hotline at 1-800-799-SAFE (7233) to gather information on a safe way out. The hotline is anonymous, confidential, and lines are open 24 hours a day, 7 days a week.

Urinary Incontinence

Urinary incontinence is another touchy subject for women. It is defined as an involuntary leakage of urine. It is a common problem in women of all ages, but leakage is most prevalent among older women. Approximately 13 million men and women experience incontinence in the United States. As women get older, their muscles relax in the body, causing a higher likelihood of leakage. Pregnancy, weight gain and various conditions like diabetes and stroke can also increase the risk of incontinence. Up to 50 percent of post-menopausal women may experience the condition.

"Incontinence usually is not caused by a serious problem," said Gass. "It's more of a quality-of-life issue and a nuisance," said Gass.

Treatment for incontinence varies, from bladder training and scheduled toilet trips, to Kegel exercises, medications, interventional therapies and surgery.

"Incontinence can be a reason that women end up in assisted care, or make choices to not exercise or have chronic infections related to anatomic abnormalities," said Dr. Joanna Cain, chair of obstetrics and gynecology at Warren Alpert Medical School at Brown University. "The important thing is that nowadays the majority of incontinence is treatable, including for women with other medical conditions."

Problem Bleeding

Many women experience some sort of problem bleeding at one point or another in their lives. Vaginal bleeding is considered abnormal if it occurs when a woman is not expecting her period, the period is much lighter or heavier than normal, she is bleeding while pregnant or after menopause.

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