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Women's Health

3 Private Health Questions Answered by a Doctor

Expert answers to your most intimate health questions.


During a doctor’s visit, you may get a little hesitant to ask questions relating to your private health. But, it’s still important to get those answers in order to stay healthy and feel comfortable. We spoke to gynecologist Barbara DePree, MD, to answer three questions relating to menopause, UTIs, and breast pain.

Q: I’ve had breast soreness that comes and goes for several weeks. My last mammogram was normal. I’m 59. What is this?

A: It sounds like you’re dealing with a postmenopausal condition called noncyclic mastalgia (breast pain not triggered by the hormone flux that occurs during menstruation). It can affect one or both breasts and be constant or intermittent. Typical causes are injuries from falls or breast surgeries and certain medications, including hormone therapy and cardiovascular drugs. Doctors sometimes call it “chest wall tenderness,” as the joint between the sternum and ribs often becomes inflamed and tender.

Rest assured: It will likely resolve over time. And although there’s probably no cause for concern, check with your doctor if the pain persists or you develop swelling, fever, redness, or nipple discharge. To relieve the pain, apply ice packs for 10 minutes several times daily and take ibuprofen as needed.

Q: I have one painful urinary tract infection after another, and my cultures always show the same stubborn E. coli bacteria. The infections always clear up with antibiotics but immediately return. Help!

A: Recurrent urinary tract infections (UTIs), marked by two episodes in six months or three in a year, become more prevalent in perimenopause and beyond. The reason? Declining estrogen causes a loss of infectionpreventing good bacteria in the vagina and tissues of the vulva; plus, the vagina and lower urinary tract become thin and more fragile, allowing infectious bacteria to more easily enter the bladder. E. coli accounts for up to 90 percent of all UTIs since the close proximity of the urethra (the tube that flushes urine from the bladder) to the anus, where E. coli flourishes, allows the bacteria to invade the urinary tract.

I suggest trying D-mannose powder, a supplement that works well for my patients. D-mannose is a natural sugar found in fruits and is proven to target and bind to E. coli in the urinary tract and flush it from your system. In fact, studies show D-mannose works as effectively as antibiotics at preventing recurrent UTIs. One to try: NOW D-Mannose (drugstores). Mix one teaspoon with 6 ounces of water; drink twice daily.

You’re probably already aware of other preventive strategies, such as wiping front to back, drinking plenty of water and emptying your bladder before and after sex, but they do help. And consider adding light exercise to your routine. In a study of over 18,000 people, scientists found that those doing four hours a week of low-to moderate activity had a significantly lower UTI risk than sedentary people. You can also talk to your doctor about vaginal estrogen to replenish good bacteria and improve tissue health to ward off infection-causing bacteria.

Q: So far the only menopause symptom I’ve had is hot flashes, and they’re well-managed. But I do feel blue and depressed lately. I’m not ready for the antidepressants my doctor is suggesting. I’m 52. Can you suggest a natural remedy?

A: Yes! Declining hormone levels during menopause have been shown to trigger sadness, anxiety, and irritability. And researchers have found that women who suffer from hot flashes are significantly more likely to experience depression.

Supplementing with mood-boosting vitamin D can help. That’s because estrogen works in tandem with an enzyme that activates the body’s ability to produce vitamin D, so a drop in estrogen levels during menopause can lead to a vitamin D deficiency. In fact, research shows that 75 percent of postmenopausal women are deficient — even during the summer, when they’re spending more time in the sun. To shore up your levels and boost your mood, I suggest taking 2,000 IU of vitamin D-3 daily.

Put FIRST to work for you!

Barbara DePree, MD, is a gynecologist in private practice and director of Women’s Midlife Services at Michigan’s Holland Hospital. A Certified Menopause Practitioner, she is the founder of, an educational resource for women’s sexual health in perimenopause and beyond. To ask her a question, send an email to

A version of this article originally appeared in our print magazine, First for Women.

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