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Feminine Odor and 5 Other Embarrassing Health Conditions

 
Feminine odor isn't exactly a topic for cocktail conversation—sure, you'll complain about cramps and kvetch about cravings when you're out with friends, but vaginal odor? Some problems—like bad breath, excessive sweating or painful sex—are often just too embarrassing to share, even among your closest confidantes. "Many women avoid talking to anyone, including their doctor, about symptoms they're ashamed of," says Susan L. Ivey, M.D., an associate professor at the UCB/UCSF joint medical program at the University of California, Berkeley. "But it's important to come clean, because these health conditions may indicate a more serious issue.” In fact, one survey found that more than two-thirds of physicians say it's difficult to properly treat patients who won't fess up (which is just one reason it's key to be honest with your doctor). In many cases a simple prescription or even an over-the-counter drug can remedy the situation. That's why we turned to the experts for the straight talk on feminine odor and five other health woes women hide.



Bad Breath: I have morning breath—all day



Hemorrhoids: It hurts to sit down



Painful Intercourse: Sex Hurts



Excessive Sweating: I sweat so much, even on cool days!



Feminine Odor: I smell bad "down there"



Leaking Urine: I pee a little when I sneeze or cough—or even laugh really hard

Bad Breath: I have morning breath—all day

It's normal to be self-conscious after munching on a garlic bagel. But for the more than 40 million people with halitosis, bad breath is a chronic, not an occasional, issue, says Richard Price, D.M.D., a spokesperson for the American Dental Association.



The culprits for all-day morning breath are usually bacteria that live in the back of the mouth and produce sulfuric compounds. Because these bacteria breed in cavities and bleeding gums, even those in the earliest stages of gum disease and tooth decay are at a greater risk.



Another common trigger: sinusitis and postnasal drip. Bacteria in your mouth feed on the proteins found in mucus, making everything in your mouth reek. If your breath smells sour and your mouth is dry, however, take a look at the over-the-counter and prescription drugs you're taking. Some, like allergy medications and insulin, can alter your body chemistry or inhibit the production of saliva. A rotten-fruit odor, on the other hand, is a sure sign of a buildup of ketones, a by-product of fat digestion, which plagues diabetics and those following high-protein diets.



Bad breath fixes

First, cut back on odor-causing food like garlic and onions. Then adjust your dental routine: Brush and floss twice daily, and use a tongue scraper in the morning and before bed. "Like a squeegee, this device gets rid of mucus in the back of the mouth, where the smell-generating bacteria congregate," says Price. Drinking plenty of water can also help wash away the water-soluble halitosis bacteria.



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Just as important: twice-yearly visits to your dentist. She can examine your mouth and, if necessary, irrigate it with an antimicrobial rinse or prescribe an extra-strong mouthwash. If your dentist can't pinpoint the underlying cause of your bad breath, consult your doctor to make sure you don't have a more serious issue like a chronic sinus problem. She may need to swap your medication or prescribe a treatment for dry mouth or sinusitis.

Hemorrhoids: It hurts to sit down

About half the population will suffer from hemorrhoids by age 50, according to the National Institute of Diabetes and Digestive and Kidney Diseases. This painful condition is caused when the blood vessels inside or on the surface of the rectum and anus become inflamed and sometimes start bleeding. "The discomfort can make it difficult to work or engage in exercise or sexual activity," says Philip Jaffe, M.D., an associate professor of clinical medicine at Yale School of Medicine.



Prolonged sitting, straining when going to the bathroom, pregnancy (which exerts extra pressure on the pelvis), and childbirth are common causes of hemorrhoids, says Jaffe. Anxiety can also trigger flare-ups, as you're more likely to get constipated when you're under stress.



Get relief: hemorrhoid treatments that really work

If your hemorrhoids are caused or irritated by constipation, Jaffe suggests increasing your liquid and fiber intake by drinking at least eight 8-ounce glasses of water daily and getting at least 25 grams of fiber a day. Look for a combination of insoluble fiber (found in veggies, wheat bran, and whole-grain cereals) and soluble fiber (in oats, beans, and psyllium-fiber supplements).



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Treatment for hemorrhoids and their itching and burning: soak in a tub or sitz bath (a pan that fits over the toilet) full of warm water. Over-the-counter creams and suppositories can also help; many contain steroids that shrink the hemorrhoids' swollen tissue. If you don't get relief within 10 days of using the product, or you have rectal bleeding or severe pain, schedule an appointment with your doctor ASAP. "Your physician will want to rule out serious diseases, like colorectal cancer," explains Jaffe.

Painful Intercourse: Sex Hurts

"The most frequent cause of irritation during intercourse is vaginal dryness, or a lack of natural lubrication," says Ashwin Chatwani, M.D., a professor of obstetrics and gynecology at Temple University Medical School in Philadelphia. Breast-feeding and smoking (which lower estrogen levels) and some medications (like decongestants and antidepressants) can all trigger dryness in that area.



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But feeling pain or tenderness inside the vagina, pelvis, or abdomen means there's an underlying problem. Because any number of conditions may be to blame, it's best to see a gynecologist.



Put an end to painful sex

Start with a few lifestyle changes, like avoiding scented or colored toilet paper (which may irritate the vagina) and always using a lubricant during sex. If these simple solutions don't ease the pain, take note of what exactly you're feeling during sex:



• If the area around the vaginal opening is sore (foreplay and inserting tampons also hurt), the culprit is likely vulvodynia, or chronic pain of the vulva. While experts aren't sure of the exact cause, it's often treated with prescription medications.



•If your vagina is red and swollen in addition to being in pain, you probably have a yeast infection or vulvitis, an inflammation of vaginal skin caused by an allergic reaction to some soaps or laundry detergents. (If this is your condition, use unscented products.)



•If you have a stabbing ache in your pelvis, it could be a sign of an ovarian cyst, a benign growth on your ovary. (Other symptoms include agonizing menstrual cramps or lower-back aches.) Most of these cysts go away on their own, but your ob-gyn will want to rule out ovarian cancer with a blood test.



•If you have pain and need to urinate frequently, you may have fibroids. These benign tissue growths on your uterus are usually treated with a procedure to remove or shrink the fibroids.



•If you have sharp twinges in your entire abdomen, you may have endometriosis, a condition in which uterine tissue attaches to other organs in the pelvis. Depending on your case, your physician can recommend a hormonal pill to slow the growth of the tissue. Minor surgery, like laparoscopy, will remove the tissue altogether.

Excessive Sweating: I sweat so much, even on cool days!

Everyone's glands are on overdrive in the heat or during a tough workout, but some four million women have a condition called hyperhidrosis, which causes them to perspire up to five times more than average, says DeeAnna Glaser, M.D., professor of dermatology at St. Louis School of Medicine. This condition usually affects one specific area of the body, such as the underarms, hands, face, feet, or groin. Attacks are sudden and random; sufferers never know when they'll wind up with drenched hands or a wet blouse.



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In the majority of cases, your genes are to blame: Hyperhidrosis is typically a hereditary disorder that affects the nervous system. Most sufferers develop the condition as kids or teens. "The brain sends abnormal signals to the glands telling them to start sweating," says Glaser. But in cases of adult-onset hyperhidrosis, the cause is often a medical condition or a prescription drug, like the antidepressant fluoxetine or the sleeping pill eszopiclone. Both may trigger excessive sweating.



What to do about excessive sweating


Have a mild case? Try applying an antiperspirant, like Secret Clinical Strength ($8.29; drugstore.com), in the morning and at night. (If feet or hands are a problem, you can apply antiperspirant to them, too.) And be sure to wear breathable fabrics, like cotton, whenever possible.



For more persistent cases, a dermatologist can prescribe an extra strong antiperspirant or an oral medication that dries out sweat glands. One of the most effective solutions, however, is Botox, injections of which deactivate sweat glands by temporarily immobilizing them. The effect lasts seven months or so and costs about $1,000 for each affected area.



Another treatment for hands and feet, called iontophoresis, involves soaking for 20 minutes a week in a tray of water that's charged with a very mild electrical current. You can find over-the-counter versions of iontophoresis, but the treatment has been shown in studies to be 83 percent effective when done under a doctor's guidance.

Feminine Odor: I smell bad "down there"

That not-so-fresh feeling usually indicates "a change in the chemical balance of the vagina," explains Sumeeta Nanda, M.D., an ob-gyn in private practice in Oklahoma City. "Vaginal odor can occur for a variety of reasons, including intercourse, oral sex, or just sitting around in a wet swimsuit. And sometimes there's no known cause."



But if it's a chronic problem, you may have a medical issue. In most cases, the culprit is bacterial vaginosis, an infection that results from an overgrowth of organisms normally present in the vagina. (Other signs include vaginal itching and a grayish discharge.) A yeast infection, some sexually transmitted diseases like chlamydia and trichomoniasis, or pelvic inflammatory disease, an infection of the uterus and other reproductive organs, could also be responsible.



Get relief from feminine odor with these simple solutions.

Regular washing with warm water and a mild, unscented soap when bathing or showering will keep the outside of the vagina clean and healthy. Also steer clear of douching: Studies have shown that these prepackaged mixes of water and vinegar, iodine, or baking soda can introduce new bacteria into the vagina, disrupting its delicate chemical balance and making any infection worse.



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If the odor persists, your best bet is to make an appointment with your doctor immediately. "It's tempting to ask for a prescription for antibiotics over the phone, but your gynecologist can give you a better treatment in person," says Nanda. A quick swab of your vagina will result in a speedy, accurate diagnosis (and keep you from taking antibiotics unnecessarily). If your physician determines that an infection has been causing your symptoms, it can be treated effectively with a prescription antibiotic cream or pill.

Leaking Urine: I pee a little when I sneeze or cough—or even laugh really hard

More than half of all women experience some kind of urinary leakage at some point during their lives. There are two types: stress incontinence, which occurs during exercise or when you cough, and urge incontinence, a strong, sudden need to urinate.



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"The vast majority of stress incontinence occurs after childbirth," according to Theodore Benderev, M.D., medical director of the Incontinence and Pelvic Support Institute in Mission Viejo, California. Labor and weight gain can stretch out the pelvic-floor support structure, he explains, which causes the urethra to sag and prevents it from closing. Less common triggers include urinary tract infections and high-blood pressure medications.



Get relief from leaking urine

Regular Kegel exercises can strengthen the pelvic floor, says Benderev. (To do, imagine you're trying to stop the flow of urine, holding those muscles for a count of 10. Then relax for two or three breaths; repeat 10 times three times a day.) Combining Kegel exercises with vaginal weights, coneshaped devices that you insert into the vagina, is also effective, according to a study in The Cochrane Library. Another lowtech option is a pessary, a stiff vaginal ring that helps support the nearby urethra, preventing leakage.



Still need help? Your doctor may be able to prescribe a medication for urge incontinence, says Benderev. She might also recommend biofeedback, a technique that monitors bodily processes and helps you gain control of them, or an electrical stimulation device, which causes the muscles to contract in a Kegel-like manner.



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