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Mysteries of the Female Body

What to do about painful sex, a busy bladder and more

spinner image Mysteries of the Female Body
Why do women's feet grow larger as they age?
Travis Rathbone

A survey of some of the very human and vaguely embarrassing conditions that plague women. And just to be fair, we have a men's edition, too.

1. If the shoe won't fit, go shopping

After years of faithful service, your go-to pumps are now squishing your toes.

The reason: Your feet can get flatter and wider as you age or if you've gained weight, says Georgeanne Botek, head of podiatry at the Cleveland Clinic. If you're like many women, your feet may have already gotten longer during your first pregnancy. Now they are spreading out. Bunions, calluses and corns can also change the size and shape of your feet — plus cause pain. Try this...

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Start over. Have your feet measured for size and choose new shoes that offer support, padding and room for your tender toes.

Insert here. If sturdy shoes don't ease your foot pain, you may need shoe inserts to realign your feet. A podiatrist can fit you for customized inserts, but even store-bought ones can help.

Act now if. Your feet suddenly look markedly different. If one is swollen or red, this could be a sign of a stress fracture or circulation issues.

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What women can do to alleviate pain during sex.
Kyle Hilton

2. When getting busy gets awkward

Sex has gone from exciting to excruciating.

The reason: declining estrogen levels. The hormone is needed for arousal, vaginal lubrication and elasticity, which is why many women experience painful sex after menopause, says gynecologist Lauren Streicher, author of Sex Rx: Hormones, Health, and Your Best Sex Ever. Try this...

Lubricate. If you're lacking moisture, help things along with a silicone lubricant.

Go local. A low dose of estrogen — delivered to your vaginal lining via a cream, ring or suppository — restores tissues without the risks of systemic hormone replacement therapy.

Check out this med. Talk to your doctor about Osphena, a nonhormonal oral drug that acts on the estrogen receptors in the vagina.

Use laser focus. The MonaLisa Touch is a CO2-laser treatment that rejuvenates vaginal tissue. It's costly — up to $3,000 for three treatments — and may require a yearly booster.

Act now if: You have unusual bleeding. It could mean ovarian or cervical cancer.

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What women can do about overactive bladder issues.
Travis Rathbone
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3. Surprise! Someone turned on the tap

Without warning, you sometimes feel a sudden need to urinate.

The reason: an overactive bladder (OAB), which affects nearly 40 percent of women at some point in their lives. OAB happens because your bladder muscles start contracting while the bladder is still filling, says Tomas L. Griebling, M.D., professor of urology at the University of Kansas School of Medicine.

Get up and go. Hit the restroom every two to four hours to prevent your bladder from overfilling.

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Put the squeeze on. Kegel exercises aren't just for new moms. When you feel the urge to urinate, quickly squeeze and release your pelvic floor muscles several times in a row (imagine you're trying to stop your flow). This will decrease urgency and give you more time to get to the bathroom. "It's important not to strain your abdominal muscles at the same time," Griebling says.

Play diet detective. Give up bladder-irritating triggers like caffeine, carbonated drinks, alcohol, citrus fruits and spicy foods. Then reintroduce them one at a time to see if your symptoms come back.

Act now if: Lifestyle changes haven't worked. Next step: medications to relax the bladder, Botox injections or surgery.

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Hormone changes can cause spider veins in women as they age.
Kyle Hilton

4. The grim colorful march of nature's doodles

Red and purple squiggles are cropping up on your skin.

The reason: telangiectasias, aka spider veins. That's when tiny blood vessels near the skin's surface dilate and become visible to the naked eye. Heredity is the biggest cause. Having fair skin also puts you at risk, says New York dermatologist Diane Berson, as do hormone changes and prolonged exposure to sun and wind. Studies suggest that long-term use of birth control pills might contribute, too. Go figure. Try this...

Stick it to them. In sclerotherapy, a dermatologist injects veins with a chemical solution that causes them to collapse. You might need a few sessions at several hundred dollars each; insurance usually won't pay for cosmetic treatments.

Zap them away. Laser treatments send short bursts of light into a vein to make it disappear. Warning: The veins can come back later.

Act now if: You notice a thick, bulgy varicose vein. Your doc may recommend lifestyle changes (exercise, compression stockings) as well as meds or surgery.

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Helpful solutions to issues with sleeping well.
Travis Rathbone

5. The sweet distant dream of sleeping through the night

Hot flashes may be keeping you up — and insomnia can actually get worse after menopause. The reason: Various age-related ailments can lead to sleep issues, and so can the medicines we take for them, says internist and sleep-medicine specialist Raj Dasgupta, spokesperson for the American Academy of Sleep Medicine. "Depression is linked to insomnia, for example, but the drugs we prescribe for it — selective serotonin reuptake inhibitors — can also cause insomnia." Try this...

Sleep in a cave. Get blackout shades for your bedroom, cover power lights on electronics and dim your clock's display. Keep your room at a cool 60 to 65 degrees, which can help fend off hot flashes.

Ban gadgets in bed. The blue light from your smartphone or tablet screen suppresses melatonin, the sleep-inducing hormone. A study in the journal PNAS showed that people who read print books right before bed slept better than those who read e-books on a tablet.

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Don't just lie there. When you're counting sheep, get up, go to another room and do something low key, like knitting or reading (no TV!), until you feel sleepy again.

Act now if: Bad sleep is affecting your ability to function during the day. Insomnia can be a symptom of other health issues, such as arthritis, hyperthyroidism and acid reflux. It also increases your risk of serious accidents. Tell your doctor about it.

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How to keep wrinkles at bay as you age.
Steve Sanford

6. Think I’d better wear that scarf

Wrinkled skin in your cleavage area is mostly due to decades of sun damage, according to dermatologist Adam Friedman of George Washington University School of Medicine and Health Sciences. Adding to the problem, the skin all over your body gets progressively drier and thinner as you age. Try this…

Get topical. Prescription retinoid creams (such as Retin-A, Tazorac and Differin) turn on genes in the skin that make collagen and elastin, the materials that maintain firmness and resilience in your skin. The creams also break down extra pigments, says Friedman. And they help your skin maintain moisture, adding buoyancy back to it.

Go deeper. Your dermatologist can do an in-office alpha hydroxy peel, which sloughs off the top layer of damaged skin.

Be a screen star. Put SPF 30 on your chest and neck every single day (not just when you’re at the beach) to stave off future damage.

Act now if: You notice a mole, bump or skin growth that’s growing larger, has uneven edges or bleeds. Any of these could be a sign of skin cancer.

7. Are you freezing?

Sure, blame your hormones — a little bit. During menopause there are the too-common hot flashes, often followed by bouts of shivering as your body tries to cool itself down, explains JoAnn Manson, M.D., chief of preventive medicine at Brigham and Women’s Hospital in Boston. But hot-cold issues go beyond hormones. Your body’s ability to regulate temperature can lessen over time, due to increasingly sluggish circulation, slower metabolism and even the aging of your skin. Try this…

Take a quick walk. If you’re cold, exercise gets blood flowing, warming you up.

Dress in layers. AC temperatures in many office buildings reportedly are based on a male “thermal comfort model” that’s too chilly for the average woman. Solution: Stow a sweater in your bag. If heat is the problem, embrace sleeveless shirts and cardigans, so you can peel layers off as needed.

Eat for heat. If you’re often cold, you might need to eat more. As your body burns calories, it creates heat.

Act now if: You’ve become extra sensitive to the cold, which may mean you have an underactive thyroid.

8. I’d much rather he started to look like me

There is nothing peachy about fuzz on your upper lip, chin and cheeks, which grows when your hormone ratios start fluctuating. With less estrogen in your postmenopausal body, you struggle to keep androgens, the malelike hormones produced by your adrenal gland, in balance, Berson says. The result: facial hair. Try this…

Do it yourself. If you have just a few visible whiskers, use the ol’ standby solutions: Pluck carefully with clean tweezers, wax them, or gently shave the area (yes, this is OK now — just avoid dull razors, and don’t borrow someone else’s).

Have ’em zapped. Laser hair removal works by targeting the pigment in the hair shaft, damaging the hair follicle. The results can be long lasting, although occasional touch-up treatments may be required. For a more permanent solution, consider electrolysis, which zaps the hair follicle itself.

Act now if:  You’ve got a severe amount of new facial hair. This could signal a metabolic disorder or a tumor in your adrenal gland or ovary. Let your doctor know about the change; she may wish to run tests.

9. The pipes are falling!

If you feel something inside your body pressing on your vagina, don’t freak out. At least 40 percent of women develop pelvic organ prolapse, a condition in which the connective tissues in your pelvic area weaken, allowing your uterus, bladder or rectum to push against the wall of the vagina or into the vaginal cavity. The symptoms vary from nearly unnoticeable to intrusive and even painful. Try this…

Enlist an expert. Kegels alone won’t fix this, says urogynecologist Christina Lewicky-Gaupp of Northwestern University’s Feinberg School of Medicine. See a physical therapist who specializes in pelvic-floor therapies (which can include exercise, electrostimulation and biofeedback).

Hold it up. A device called a pessary — a small ring that your gynecologist inserts into the vagina and replaces every month or so — provides support for the sagging organ.

Act now if: You notice blood when there shouldn’t be any. If you have postmenopausal bleeding, get it checked out by a doctor, since it might be a sign of certain cancers.

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