Private health

Expert answers to your most intimate health questions

What’s causing this breast change?

Q:

Lately one of my nipples gets so hard and prominent, it actually feels sore. Plus, it’s so noticeable that it’s embarrassing! I’m 48. Why is this happening now?

A:

Although this phenomenon is perfectly normal, its cause is a mystery. Here’s what we do know: The areola (the ring-like skin around the nipples) is rich in sensitive nerves that are part of the autonomic nervous system, which readies your body for sexual activity. When breasts are stimulated, even by the nipple rubbing against clothing or sudden changes in temperature (like when you go in and out of air-conditioned buildings), the nerves send a message to the muscles in that area to contract—and one or both nipples can harden and become erect. Hormonal changes that occur during perimenopause (including upticks in prolactin, the hormone that regulates mammary glands) also increase nipple sensitivity, causing the symptoms you’re experiencing.

What I suggest is using soft nipple guards like Medela Tender Care Hydrogel Pads (Amazon.com), which have a cooling gel to ease discomfort. I also advise taking 1,000 mg. of evening primrose oil (available at drugstores) daily. It contains gamma linolenic acid, a fatty acid that helps balance hormones. Additionally, you may want to supplement with 100 mg. of vitamin B-6 daily. A study in The Journal of Clinical Endocrinology & Metabolism found that B-6 can suppress prolactin release to alleviate symptoms. Finally, avoid wearing tight-fitting bras since the friction they produce can stimulate the nipple, increasing soreness.

These remedies should ease your discomfort and embarrassment within three weeks. But if they don’t, or you develop other symptoms such as redness, heat or discharge, it’s a good idea to see your ob-gyn.

Should I be worried about this rash?

Q:

The day after a pool party, I got an itchy rash between my buttocks. I started using an anti-itch cream, but it’s been three days and the rash is worse. Help!

A:

This sounds like a rectal yeast infection, which is often caused by the same candida that triggers vaginal infections. Candida thrives in warm, moist environments, so wearing a wet bathing suit for long periods of time is a common culprit.

Anti-itch creams won’t eliminate the infection, but a twice-daily application of a cream that contains clotrimazole (like Lotrimin AF, drugstores), an antifungal that kills candida, can. You can also apply a cooled chamomile tea compress before using the cream (chamomile eases inflammation to soothe itching and it has mild antifungal properties). Also smart: Avoid harsh soaps and scented products, both of which can irritate skin and worsen itching.

If these strategies don’t resolve your outbreak within a week, your doctor can prescribe stronger treatments.

Q I’m 56 and still get hot flashes.

I’ve tried soy supplements, with no luck, but my sister said there’s a new one that

might help?

A She’s probably referring to Equelle, and it may indeed help. The supplement contains S-equol, a compound with estrogen-like effects that eases hot flashes, which are caused by waning levels of the hormone. Some women produce S-equol naturally when they eat soy or supplement with soy isoflavone supplements (strategies I often advise to tame hot flashes), but many don’t. That’s where a supplement can help. In a Journal of Women’s Health study, women who don’t make S-equol but supplemented with it daily reduced their hot-flash frequency by 50%— and relief started in just one month.

I advise taking the study-backed dose of 10 mg. of S-equol daily (available at Equelle.com). But I don’t recommend that women with a history of breast cancer take soy, and I suggest all women check with their doctor before supplementing.