Spotting. Itching. Tenderness. When below-the-belt symptoms crop up, your first impulse is probably to slip into a pair of pajamas and curl up on the couch. Holing away for a night or two with menstrual pain is fine, but what if your symptoms last for weeks or even months?

"When it comes to gynecological issues, many women adopt a grin-and- bear-it mentality," says Fred M. Howard, M.D., chief gynecologist at the Rochester Endometriosis and Pelvic Pain Center in Rochester, New York. Often they're simply too embarrassed to tell anyone—even their doctors—about their problems. “But left untreated, some can lead to more serious illnesses," he says.

Even when you do fess up, receiving the proper care for your gynecological problems can be tricky. Many of the symptoms are often vague and can be easily confused with other conditions. In fact, research reveals that it can take years for physicians to arrive at an accurate diagnosis. But the sooner you take charge of your health, the sooner you'll feel better. That's why we've asked experts to decipher some down-there symptoms and treatments—so you can get off that couch already!

YOU HAVE: Heavy menstrual bleeding and/or painful menstrual cramps that last for at least seven days; abdominal pain or fullness.
Ask your doctor about uterine fibroids.
You may be one of the 40 percent of women with uterine fibroids, or noncancerous growths that are usually found on the uterine wall. "Most people think of it as a condition that affects older women," says Bruce McLucas, M.D., founder of the Fibroid Treatment Collective at the University of California, Los Angeles. "But the truth is that fibroids are most common among women in their 30s and 40s." The majority of these tissue masses measure about 4 centimeters in diameter (picture a golf ball), but some can balloon to the size of a grapefruit.

About 75 percent of women with uterine fibroids don't experience any problems and, in most cases, won't need treatment. But when symptoms show up, they can be very uncomfortable and affect the quality of your life. "Heavy menstrual bleeding may occur because fibroids distort the uterine wall, causing more of the lining to shed," says McLucas. In serious cases, this bleeding can lead to anemia. Fibroids that block the fallopian tubes, womb, or birth canal may lead to infertility, miscarriages, and premature birth.

What Can Help: The most common treatment for uterine fibroids used to be hysterectomy, a surgery to remove the uterus. But today there are noninvasive options better suited to your lifestyle and needs.For example, if you still want to get pregnant, your best choice is myomectomy. This surgical removal of the fibroids is the only treatment that's known to preserve fertility. Don't want more kids? Consider uterine artery embolization, or UAE. Doctors inject particles into the arteries leading to the fibroids, blocking blood flow and shrinking them.

For symptomatic women who have a few larger (rather than smaller) fibroids, a newer treatment called magnetic resonance imaging ultrasound may be in order. During the procedure, an M.D. zaps growths with a high-intensity ultrasound beam. Fibroids are broken down and reabsorbed by the body; most patients can return to work in a day or two.

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