Private health

Expert answers to your most intimate health questions

When will I hit menopause?

Q:I picked up a pamphlet for Menopause Awareness Month and noticed that there’s a blood test that can tell me how close I am to menopause. I’m 49 and still get occasional periods, but my mother had gone through menopause by the time she was my age. Should I ask my doctor for the test?

A:There is a new test that was recently approved by the Food and Drug Administration for use in women ages 42 to 62. It’s called the PicoAMH Elisa test, and it measures the amount of anti-Müllerian hormone (AMH), which is produced by the ovaries; the results are significant because the amount of AMH in the blood declines as women approach menopause. The test reportedly does a good job of determining levels of AMH in the blood, and it’s an improvement over previous methods, but the results don’t provide the definitive word on when you’re likely to enter menopause, which is defined as a year after a woman’s last period (the average age is 51).

Personally, I don’t use this test for my patients because in my opinion, the best way to know if you’re close to menopause is not with blood tests, since levels of AMH and follicle-stimulating hormone (FSH) can be abnormal for a long time before a woman has her last period. I believe a better menopause gauge is to keep track of the time between your periods. Late perimenopause is defined as going more than 60 days without a period—and that’s a good indication that menopause may be on the horizon.

If you really want to know when you’re likely to go through menopause, talk to your doctor. This is especially important if you want to make decisions about how to treat bothersome symptoms like heavy bleeding, or take steps to prevent conditions, such as osteoporosis, that you may be at risk for.

Help for ’down there’ odor

Q:I’ve been on the keto diet, and it’s helping me slim. But lately I’ve had an unpleasant odor coming from my vagina. Is there a connection?

A:There could be. Some women who adhere strictly to the low-carb ketogenic diet say they’ve noticed a strong vaginal odor. There’s no research on this issue, but the diet has been associated with changes in breath and urine odor. As far as your private parts go, the smell may stem from changes in your vagina’s acid/alkaline balance. Because you’re eating lots of acidic foods like meat and cheese and few alkalinizing vegetables, the diet can make your whole body, including your vagina, more acidic. Plus, a strict keto diet may upset the vagina’s bacterial balance, which can result in odor.

It’s fine to wait a few days to see if this new, intense odor goes away; some women’s bodies adjust to the diet. If the smell persists, try taking oral probiotic supplements twice a day. If this doesn’t bring an improvement, see your ob-gyn to find out if you have developed a vaginal infection.

QI’ve heard that adopting a certain breathing pattern can reduce the severity of hot flashes. Is this true?

AYes. It’s called paced respiration and involves slow, deliberate, deep breathing. There’s evidence it can reduce hot flashes up to 52% when done regularly. The goal of paced breathing is to slowly and smoothly take six to eight breaths per minute. The easy how-to: Inhale for 2 to 4 seconds, then exhale for 4 to 6 seconds, making sure your exhalations are longer than your inhalations. The breaths should be deep enough to make your diaphragm move.

Doing this for 15 minutes twice a day, especially at the onset of a hot flash, can decrease the number and severity of episodes. How? Paced breathing boosts oxygen flow throughout the body, reduces stress chemicals and induces the relaxation response, all of which can offset the heat of a hot flash. Doing it before bed could even improve your sleep and reduce night sweats.