Private health

Expert answers to your most intimate health questions

Why did my home test miss my UTI?

Q: Last week I noticed burning when I urinated, so I did the usual, like loading up on cranberry juice and water. I also took a UTI home test my doctor had previously recommended. It came up clear, but two days later my symptoms worsened, so I went to my doctor. Turns out I did have an infection! Why didn’t my test work?

A: As helpful as DIY test kits for urinary tract infections (UTIs) can be, they’re screening tests only, which means they can miss an infection. Many are designed to detect nitrites produced by E.coli. And while E.coli is responsible for more than 90% of UTIs, yours could have been caused by a different bacteria that doesn’t produce nitrites.

There’s also a possibility that the steps you took to treat your symptoms impacted your results. Increasing your fluid intake, for example, can dilute your urine and lower the concentration of nitrites in it to undetectable levels. Plus, vitamin C can react with indicator substances on test strips to cause false-negative readings, so a high intake of the vitamin (from cranberry supplements or drinking cranberry juice) may also be to blame. Additionally, if you addressed your discomfort with an over-the-counter UTI relief remedy formulated with phenazopyridine hydrochloride, an analgesic that reduces pain, burning and itching, the dyes it contains may have skewed your test results.

I always advise seeing your doctor if UTI symptoms worsen or persist for 24 hours, regardless of DIY test results. She can make a more accurate diagnosis with the aid of lab tests that check urine for bacteria and substances that signal infection. She may also perform cultures that identify the specific organisms responsible for your UTI to determine the best treatment.

Are these “shock” sensations normal?

Q:

I’m 54, and lately I feel electrical shocks in my calves whenever a hot flash hits. Should I worry?

A:

There’s no need for concern. Leg shocks can be caused by several factors, but since yours coincide with hot flashes, I suspect waning estrogen is to blame. Estrogen helps regulate the nervous system, so the dips that trigger hot flashes can also jumble nerve signals sent between the brain and muscles, causing the shocks you describe.

Keeping hormones balanced helps, so I suggest taking 1,300 mg. of evening primrose oil (available at drugstores). The supplement can stabilize hormone levels and restore nerve function. Plus, daily dosing reduced hot flash frequency, severity and duration by as much as 42% in a study published in the Archives of Gynecology and Obstetrics. Also smart: Eat more foods rich in magnesium (leafy greens, avocados and almonds), a mineral key to nervous system activity. But if the shocks persist after four weeks, or if they become more frequent or severe, see your doctor for more options.

Q

Progesterone cream eased my mood swings and anxiety, but now I feel so tired and foggy. I’m 48.

Help! A Progesterone has a calming effect on the brain and body, which is why the cream is so helpful at easing perimenopausal symptoms like irritability and hot flashes. But if the dose is too high, it can trigger the fatigue and mental fog you describe. I suggest cutting the amount of cream you’re using in half. You should feel more clearheaded in three days, but if your anxiety or mood swings return, gradually increase your dose every other day until you find the level that eases symptoms without the side effects.

If you don’t get relief from your symptoms within a week or two, I advise seeing your doctor. She can pinpoint your optimum dose via saliva tests and may advise switching to a cream that’s lower in progesterone or suggest other remedies (like black cohosh or red clover extract) to alleviate your symptoms.