Women’s Health Glossary

An alternative medicine practice of inserting small, fine needles in the skin at specific points in the body, which is believed to stimulate the central nervous system. Used commonly to relieve pain among other symptoms, acupuncture is an important part of traditional Chinese medicine. According to Johns Hopkins Medicine, many people say they feel minimal pain as the acupuncture needle is inserted.

Acupuncture is not for everyone, but some perimenopausal women find relief in acupuncture because it can improve blood flow to ovaries and help support progesterone production. Learn more about acupuncture in women’s health here on Jumble & Flow: Perimenopause power? Yep, your hormones want to tell you more than you think.

Acne that continues to occur in people 25 years or older, which can also involve an onset of symptoms in a person’s teenage years and a late onset beginning after 25 years old. Also referred to as postadolescent acne, or adult-onset acne, adult acne is generally caused by the same sources as acne that occurs during a person’s adolescence. The different factors that contribute to the formation of acne include bacteria, excess oil production, inflammation, and skin cells that can clog pores.

There are also other environmental, biological, and hereditary factors that can contribute to adult acne. These factors can include stress, a diet that is high in dairy and/or refined carbohydrates, too many skin care and hair care and makeup products, highly oily skin or highly dry skin, environmental changes, menstrual cycles, some medications, and hormonal fluctuations. According to Healthline, “Hormonal changes can continue throughout your 20s and 30s as your body adjusts to adulthood…In the 40s and 50s, females may experience very different hormonal fluctuations that are related to menopause, and the years leading up to it, known as perimenopause.” Hormone fluctuation, in premenopause, perimenopause, and postmenopause, can influence adult acne because of the changes that hormones are responsible for throughout the body as well as the skin’s condition and environment. Hormonal changes that can produce acne may also occur during pregnancy, breastfeeding, postpartum periods, and starting or ending birth control pill use. According to the American Academy of Dermatology Association, instances of adult acne have been on the rise, and it affects approximately 15% of adult women.

Adult acne can present itself in a few different forms. Mild acne can manifest in the form of small pustules, whiteheads, or blackheads, while moderate adult acne may form as papules that can cover anywhere from 25%–75% of the face or body. Alternatively, severe forms of adult acne can consist of intense redness, deep cysts, swelling, and irritation. Treatment for adult acne can vary depending on the individual, and certain lifestyle changes can help to manage and regulate acne and flare-ups, including limiting foods that contain high amounts of refined carbohydrates, avoiding facial oil or hair care products that contain oils, avoiding going to bed with makeup still on, and only purchasing skin care and hair care products that specify that they are “oil free” or that they “won’t clog pores.” There are several different types of acne treatments that your doctor may recommend depending on the severity and type of acne that you may have. According to Harvard Health Publishing, “Topical tretinoin, which works by turning over skin cells faster to prevent clogged pores, is a mainstay in any acne treatment regimen, and has the added bonus of treating fine wrinkles and evening and brightening skin tone. Isotretinoin (Accutane, other brands), taken by mouth, is the closest thing to a “cure” for acne that exists and is used to treat severe acne.” If acne is hormone driven, another option includes prescribed oral birth control pills to help manage hormone levels, or a prescribed medication called spironolactone, which can help to check testosterone levels.

An emotion characterized by strong or unusual feelings of fear, tension, or worry. Anxiety can be a natural reaction to stress and can help to alert people to potential dangers or threats. However, when anxiety occurs excessively or during instances when there is no actual threat, it can interfere with a person’s day-to-day life and it may be a sign of something more serious, like an anxiety disorder. Anxiety can also be accompanied by symptoms such as increased heart rate, trembling or shaking, dizziness, sweating, and a feeling of an approaching threat. Learn more about anxiety here on Jumble & Flow: What to do when your COVID anxiety outlasts the pandemic.

A disorder in when a person experiences a strong, persistent, frequent, and in some cases debilitating, sense of fear or dread. Oftentimes, the feeling of anxiety does not go away, can become worse if left unaddressed, and may cause those experiencing it to avoid certain situations out of fear of triggering the anxiety. The anxiety that accompanies an anxiety disorder can interfere with daily activities, and it may manifest in the form of stressful or intrusive thoughts. There are several types of anxiety disorders, including: generalized anxiety disorder, panic disorder, post-traumatic stress disorder, and obsessive-compulsive disorder.

A condition that occurs when a person’s gastrointestinal tract is filled with gas or air, it often makes your stomach feel as though it is full, swollen, or tight, and it might actually cause your stomach to look bigger. Common symptoms of bloating include stomach pain or discomfort, stomach rumbling or other noises, excessive gas, and excessive burping. There are several things that can cause bloating, with one of the simpler causes being swallowing air. According to Healthline, “Gas builds up in the digestive tract when undigested food gets broken down or when you swallow air. Everyone swallows air when they eat or drink. But some people can swallow more than others, especially if they are:

• eating or drinking too fast
• chewing gum
• smoking
• wearing loose dentures

Other factors that cause bloating include overeating, weight gain, constipation, menstruation for some women, lactose intolerance or other food intolerances, and heartburn. There are also different types of medical conditions that can cause bloating, including gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), Crohn’s disease, ulcerative colitis, inflammatory bowel disease, hormonal fluctuations, medications, eating disorders, and other mental health factors like depression, stress, and anxiety. There are several different methods that can help manage or control bloating and most fall under the category of lifestyle changes. In order to avoid swallowing too much air, you may try things like avoiding chewing gum, eating slowly, avoiding drinking through a straw, trying to limit how many carbonated drinks you consume, trying lactose-free dairy products or avoiding dairy products altogether, eating more high in fiber foods, and avoiding foods that can cause gas like beans, lentils, brussel sprouts, and cabbage.

In some cases, lifestyle changes alone may not be enough to help prevent bloating, and your doctor may want to recommend medical treatment and/or medications. Medications like antibiotics, antidepressants, and antispasmodics have been used to help treat bloating in certain conditions. If bloating is more severe, it may be accompanied by more serious symptoms like nausea, vomiting, diarrhea, fever, noticeable weight loss, and vaginal bleeding between periods or during postmenopause. If bloating is severe and is accompanied by these symptoms, you should talk to your doctor, as they could be potentially linked to serious medical problems like colon cancer, ovarian cancer, pancreas problems or Pancreatic cancer, uterine cancer, pelvic inflammatory disease, liver disease, bowel or bladder blockage, or tumors.

A measurement that gauges a person’s nutritional status and body fat by taking an adult person’s weight in kilograms and dividing it by their height in meters squared. While the BMI test screens for weight categories in which a person may be more at risk for certain health problems, it does not diagnose a person’s health or body fatness. Due to the fact that BMI draws its measurement from height and weight alone, it’s not a perfect system, and does not take into consideration obesity levels based on a person’s age, sex, or levels of physical activity or exercise. Because of this, BMI tends to either overestimate or underestimate obesity in various cases.

According to the NHS, if a person’s BMI is below 18.5 they are considered underweight, between 18.5 and 24.9 is considered a healthy weight, 25–29.9 is considered overweight, and 30–39.9 is considered obese. Due to its height and weight measure, the BMI scale also doesn’t factor in muscle mass, so very muscular people may be classed in the obese category despite being a healthy weight overall.

One of the most plentiful proteins in the human body that plays an important part in the structure and strength of multiple parts of the body. Collagen makes up approximately one-third of the body’s protein and supports our bones, muscles, tendons, ligaments, and skin. According to News Medical, “Collagen is also present in all the smooth muscle tissues, blood vessels, digestive tract, heart, gallbladder, kidneys and bladder holding the cells and tissues together. Collagen is even the major component of hair and nails.”

There are approximately 16 types of collagen, but there are four main types found in the body, type I, II, III, and IV. According to Healthline, the four types of collagen in the body and the various parts that they play include:

• Type I collagen provides about 90% of your collagen through tightly packed fibers that create the structure of your teeth, skin, bones, connective tissue, tendons, and fibrous cartilage.
• Type II collagen consists of fibers that are less tightly packed and they create the elastic cartilage which provides cushioning for your joints.
• Type III collagen helps to fortify the structure of muscles, organs, and arteries.
• Type IV collagen is found in the layers of your skin and provides your body with a natural filtration system.

As a person ages, their body begins to produce smaller amounts of collagen and collagen that’s a poorer quality than it used to be. Women can experience a drop in collagen of up to 30% during their first five years of menopause, and a considerable decrease in collagen production by 60 years old is normal.

A disorder in which tissue similar to that which forms the uterine lining grows outside the uterus, commonly forming on the fallopian tubes, ovaries, the lining of the pelvis, and the outer surfaces of organs like the uterus, intestines, rectum, and bladder. Occasionally, the endometrial-like tissue that forms outside of the uterus, also referred to as endometrial implants, can form beyond the area containing the pelvic organs, but this is rare. The endometrial implants work in the same way that the tissue lining the uterus does, growing, thickening and building up, and breaking down over the course of a menstrual cycle. However, because the tissue has no way to leave the body, it becomes trapped in the pelvis and can cause irritation, swelling, the scarring of tissue surrounding the implants, and adhesions, which are tissues that can cause your pelvic organs to become stuck to one another.

Endometriosis affects up to an estimated 10% of women, and it is often diagnosed in women in their 30s and 40s. The actual prevalence of the disorder is unknown, however, since the most certain way of diagnosing endometriosis is through a laparoscopy. According to John Hopkins Medicine, “Laparoscopy is a minor surgical procedure in which a laparoscope, a thin tube with a camera at the end, is inserted into the abdomen through a small incision. Laparoscopy is also used to determine the location, extent and size of the endometrial growths.” Depending on a person’s doctor or gynecologist, an examination for endometriosis may first start with a review of the patient’s medical history, a pelvic exam, or other methods before or instead of a laparoscopy, such as an ultrasound, MRI scan, or a CT scan. One of the more common symptoms of endometriosis is pelvic pain, although this isn’t the case for all women, and some women may not experience any symptoms or pain at all. Common symptoms include abdominal and lower back pain that may also continue for several days before or after a menstrual period, infertility, heavy menstrual bleeding or bleeding in between periods, discomfort during bowel movements or urination, pain during intercourse, fatigue, bloating, nausea, and gastrointestinal problems like constipation or diarrhea.

The exact cause for endometriosis is not yet known, but there have been several theories as to what might cause it. According to John Hopkins Medicine, one possible theory offers that during menstruation, some tissue flows backwards through the fallopian tubes and into the abdomen where it attaches and forms more tissue like a “reverse menstruation”, while another theory suggests that endometrial implants spread more like cancer cells, by moving and forming by way of lymphatic or blood networks. Yet another theory proposes that cells in any location may be prone to turning into endometrial cells. While the exact cause is unknown, some potential risk factors for the disorder include having a first degree relative with the disorder (mother, sister, etc.), low body mass index, giving birth for the first time after 30 or never giving birth, reproductive tract disorders, and going through menopause at an older age. Endometriosis typically can present itself in four stages: minimal, mild, moderate, and severe; and these stages can present differently depending on the person.

Endometriosis can be treated with a wide range of treatment options from over-the-counter pain medications, hormone therapy, hormonal contraceptives like birth control pills, surgery to remove the endometrial implants, and as a last resort surgery, a hysterectomy. Depending on the severity of your symptoms, your treatment preference, how your body responds to some forms of treatment, and whether or not you want to have kids, your doctor or gynecologist will help you determine the best course of action.

A group of hormones that contribute to various aspects of women’s health, including reproductive development, female sexual characteristics, cognitive health, bone health, and cardiovascular function. In a woman’s body, the primary source of estrogen comes from the ovaries, with smaller amounts being produced by adrenal glands and fat tissues. According to the Hormone Health Network, the body produces three main types of estrogen:

• Estradiol (E2): the most common type in women of childbearing age
• Estriol (E3): the main estrogen during pregnancy
• Estrone (E1): the only estrogen your body makes after menopause (when menstrual periods stop)

Also, estradiol is estrogen that’s produced by both men and women. estriol levels peak right before birth and it helps the uterus to grow, and estrone is a weaker form of estrogen that the body can alter to form other types of estrogen if necessary. Levels of estradiol that are too high or too low can also pose a risk to a woman’s health.

Excessive levels of estradiol can cause acne, depression, loss of sex drive, potential weight gain, menstrual problems, and in cases where estrogen is very high, can increase a woman’s risk for breast cancer, uterine cancer, and cardio vascular disease. A low level of estradiol, on the other hand, can cause weight gain, slowed bone growth, slowed development, potential mood swings, and osteoporosis may develop.

Estrogen levels fluctuate in a woman’s body during perimenopause and can cause symptoms like hot flashes and/or night sweats, mood swings, irregular menstruation, and changes in sexual desire. Once a woman reaches postmenopause, estrogen levels drop significantly and women stop experiencing menstrual periods, but it also leaves them at a potentially increased risk for conditions like osteoporosis and cardiovascular disease.

Also known as uterine tubes or oviducts, fallopian tubes are long, narrow, muscular “J shaped” tubes that run through the female reproductive tract. The fallopian tubes are connected to ovaries and lead into the uterus, and their primary job is to help move the mature female egg cells from the ovaries to the uterus. The fallopian tubes also help to transport male sperm cells so that the mature egg cells can become fertilized, as well as to help provide a proper environment for any egg cells that may go through the development process. In order to move the egg cell from the ovaries to the uterus, the fallopian tubes are equipped with cells in the fallopian lining to help pass the egg along. According to Medicine Net, the fallopian tubes have small structures that are hair-like, called cilia, which grow from the cells of the fallopian tube’s lining. Referred to as tubal cilia, they are crucial to the egg passing through the fallopian tube and into the uterus. The fallopian tubes are also lined with a smooth muscle layer whose contractions help to move along egg cells and deposited sperm cells to their destinations.

Anatomically, the fallopian tubes are categorized as having four different parts to their structure. The four different parts to this structure all assist with moving the egg from the ovaries, through the tubes, and into the uterus. According to Teach Me Anatomy, “The fallopian tube is described as having four parts (lateral to medial);

Fimbriae: finger-like, ciliated projections which capture the ovum from the surface of the ovary.

Infundibulum: funnel-shaped opening near the ovary to which fimbriae are attached.

Ampulla: widest section of the uterine tubes. Fertilization usually occurs here.

Isthmus: narrow section of the uterine tubes connecting the ampulla to the uterine cavity.”

When it comes to what can pose a risk to the fallopian tubes and a person’s health, infection of the fallopian tubes can cause them to become blocked with scar tissue, either partially or completely, and this prevents the egg from traveling to the uterus.

Endometriosis, tumors, and pelvic adhesions can also cause the fallopian tubes to become blocked or narrowed, and these can all increase a woman’s risk of ectopic pregnancy if the egg cell becomes fertilized. An ectopic pregnancy is a pregnancy that develops in either the fallopian tubes or elsewhere outside of the uterus, and it is a medical emergency that can place a woman’s life at risk if not treated. An ectopic pregnancy can not be carried out in the way that a usual pregnancy can, and it requires surgery to be removed and end the pregnancy. If the ectopic pregnancy is not detected and diagnosed early, the fertilized egg cell can rupture and cause the fallopian tube that it is stuck in to hemorrhage.

If a woman decides that she does not want to have children or no longer wants to have them, she can have her uterine tubes ligated or sterilized, sometimes referred to as “tube tying”, by either fibre optic laparoscope or through an open abdominal incision. This will prevent eggs cells from passing into the uterus, preventing pregnancy from continuing. There are also several procedures that can be performed with either a laparoscopy or through an open abdominal incision that can help to increase a woman’s chances of fertility if she wishes to become pregnant as well.

Chemicals that are created by specialist cells, which are typically found in the endocrine system. Hormones travel through the bloodstream to various organs and tissues to help control and coordinate different functions and processes of those organs and tissues. These chemicals can help to control and regulate different systems like your brain, heart, skin, kidneys, and muscles. Hormones affect body processes like reproduction, metabolism, cognitive function and mood, responses to stress, injury, and environmental factors, sexual function, and growth and development.

It only takes very small amounts of hormones to create significant changes in your body, and too much or too little of a certain type of hormone can be serious. According to the Hormone Health Network, “Sometimes hormones get out of balance. That can lead to problems like diabetes, weight gain or loss, infertility, weak bones, and other problems.” Hormones are most commonly produced from the major endocrine glands, which include the thyroid, pituitary gland, adrenal glands, pancreas, thymus, pineal gland, and in women, the ovaries.

Read more about the hormone changes that women often experience in midlife here: What is perimenopause? An empowering guide to everything you need to know.

A sudden wave of warmth or heat that’s felt throughout the upper body and most strongly affects the neck, face, and chest. Blood vessels beneath the skin’s surface begin to dilate or enlarge, and blood flow increases to the skin’s surface in the body’s attempt to cool itself down. Hot flashes are usually caused by hormone changes during perimenopause and may continue into postmenopause.

It’s not entirely clear how hormone fluctuations cause hot flashes, but according to The North American Menopause Society, “hot flashes are thought to be the result of changes in the hypothalamus, the part of the brain that regulates the body’s temperature. If the hypothalamus mistakenly senses that a woman is too warm, it starts a chain of events to cool her down.” Symptoms of a hot flash can often include increased heart rate, your face feeling and becoming red and flushed, feelings of anxiety, upper body sweating, tingling in your fingers, and feeling chilled after the hot flash ends.

Despite the fact that hot flashes are rarely caused by anything other than menopause, hot flashes can also be caused by medication side effects, certain cancers, and thyroid problems. Hot flashes often come on suddenly, and the duration of a hot flash can vary from person to person, with some lasting for only a few seconds while others can last for longer than 10 minutes, with the average hot flash lasting for approximately four minutes.

The average number of years that women experience hot flashes is also variable, with hot flashes persisting for more than seven years on average, and with some women experiencing them for more than 10 years. Hot flashes can occur multiple times a day for some women, while others can experience them only a few times a week. The symptoms of a hot flash can be alleviated by wearing breathable clothing, dressing in layers that are easier to remove, avoiding potential triggers like caffeine, alcohol, and smoking, and practicing self-calming techniques.

A surgical procedure to remove the uterus that can be used to help treat certain types of cancers or infections, as well as chronic pain. After a hysterectomy, a woman no longer has any menstrual periods and is unable to become pregnant.

These are three main types of hysterectomies:

• The most common type of hysterectomy is a total hysterectomy, in which the uterus and the cervix are removed.
• A subtotal or partial hysterectomy removes just the main body of the uterus.
• A total hysterectomy with a bilateral salpingo-oophorectomy removes the uterus, cervix, fallopian tubes, and ovaries, and a radical hysterectomy removes the uterus and surrounding tissue, fallopian tubes, part of the vagina, lymph glands, fatty tissue, and the ovaries.

Recovering from a hysterectomy takes time, and while a doctor may send you home the same day that you have surgery, most women stay in the hospital at least one to two days after the procedure. According to the Office on Women’s Health, an abdominal surgery can take four to six weeks to recover from, while a vaginal, laparoscopic, or robotic surgery can take three to four weeks to recover from. Patients are advised to rest and avoid lifting heavy objects for up to four to six weeks.

A menstrual period that occurs outside of the typical time frame of the rest of a woman’s periods and that’s often accompanied by an abnormal uterine bleeding pattern. While the average time frame for a menstrual cycle is thought to occur every 28 days, the time frame for a normal menstrual cycle can occur anywhere from 21 to 35 days. Menstruation can be considered irregular when it includes certain symptoms such as periods that last longer than seven days, three or more missed periods in a row, bleeding or spotting that occurs in between periods, after menopause, or after sex, unusually light or heavy blood flow, blood clots that are larger than 2.5 centimeters in diameter, and periods that are accompanied by severe pain or cramping or nausea or vomiting.

Irregular periods can often occur when menstruation first starts, when it can take up to two years for a normal schedule to develop, and they can also occur in late perimenopause before a woman becomes postmenopausal and no longer has menstrual periods. On the other hand, irregular periods can also be caused by things like extreme weight loss or weight gain, emotional stress, endurance exercise, disordered eating, contraception changes, endometriosis, polycystic ovary syndrome (PCOS), pelvic inflammatory disease (PID), a thyroid disorder, or uterine fibroids or polyps.

According to Everyday Health, who quoted Becky Lynn, MD, who is the director of the Evora Center for Menopause and Sexual Health, “To determine whether your menstrual schedule is irregular, count from the last day of your previous period and stop counting on the first day of your next. Repeat this for three months. If the number of days between stopping and starting your period is outside of the 21 to 35 days range, you have an irregular cycle. Menstruation can also be considered irregular if your cycle length varies by more than 20 days from month to month.”

Standing for in-vitro fertilization, IVF is one of the more common assisted reproductive technologies (also known as ART), and it involves a series of different procedures and medicines to assist in fertilizing an egg extracted from a woman’s ovaries with a retrieved sperm sample. The egg and the sperm are manually combined in a laboratory dish to form an embryo which is then transferred back to the uterus. This procedure can be used to help treat infertility or to prevent potential genetic problems, and it can use a variety of egg and sperm combinations, from your eggs and a partner’s sperm, eggs or sperm from one partner and eggs or sperm from a donor, or both eggs and sperm from donors. The process of IVF can take longer for some people than it does for others, and not everyone gets pregnant after their first round of the treatment.

The process of in-vitro fertilization consists of five steps:

• stimulation
• egg retrieval
• insemination and fertilization
• embryo culture
• transfer

In the stimulation step, fertility medications are prescribed in order to boost egg production to several eggs per month instead of the usual one, as multiple are needed in the event that some do not develop or fertilize properly. You may also get regular transvaginal ultrasounds to examine the ovaries and monitor egg production, and regular blood tests to check your hormone levels and hormone production. During the egg retrieval step, the doctor performs a minor surgical operation called follicular aspiration in order to retrieve the eggs.

According to MedlinePlus, “The woman will be given medicines so she does not feel pain during the procedure. Using ultrasound images as a guide, the health care provider inserts a thin needle through the vagina into the ovary and sacs (follicles) containing the eggs. The needle is connected to a suction device, which pulls the eggs and fluid out of each follicle, one at a time.” This procedure is carried out on both ovaries. A woman may experience feelings of cramping or pressure after the procedure. After the eggs are retrieved, the male partner is asked to produce a sperm sample or the sperm sample from a male donor is used, and the eggs and sperm are mixed together in a container and incubated. If the doctor has concerns about the chances of fertilization, the sperm may be directly injected into the eggs through a process called intracytoplasmic sperm injection (ICSI).

After the eggs and sperm cells are incubated, laboratory staff will monitor them to make sure that fertilization, the division of cells, and proper embryo growth are all taking place. The egg and sperm cell officially become an embryo when the cells start dividing, and in about 5 days an embryo typically has several cells that have divided and are actively dividing. The transfer stage usually occurs approximately 3–5 days after the egg retrieval when the embryos are big enough to be implanted into the uterus. At the beginning of the procedure, the woman may be given a mild sedative, and then the doctor inserts a thin tube or catheter containing the embryos into the vagina, through the cervix, and into the uterus. The number of embryos that are used depends on the circumstances of the particular patient. Some patients may experience a minor cramping feeling at this stage of the procedure as well. If all goes successfully throughout this process, implantation takes place approximately 6–10 days after the egg retrieval process.

After the IVF procedure, you can resume your normal activities, though it is advised to rest after going home from the procedure as well. Some common side effects from the procedure that might be experienced include bloating, cramping, breast tenderness due to high estrogen, constipation, bleeding, headaches, and mood swings. In about 12–14 days after the egg retrieval, your doctor will test a sample of your blood to see if you are pregnant, and if you are, they will recommend you to an obstetrician or other pregnancy specialist. IVF procedures can be expensive and invasive, and they don’t always work for all patients on the first round of the procedure, so it is best to talk with your doctor and consider your options before investing in the procedure.

A low-dose x-ray image that is taken of a woman’s breast to check for any signs of breast cancer, benign tumors, cysts, or any other breast abnormalities. The procedure is performed by a technician having a patient stand in front of a special x-ray machine so that they can place the patient’s breast on a plastic plate. Another plastic plate compresses the breast from above, flattening the breast so that the tissue is spread apart and the x-ray may better examine the tissue and so that less radiation is required. Any risk of radiation involved in a mammogram is considered negligible, as the body is exposed to far less radiation in this procedure than it is exposed to on a regular basis. A woman may or may not be required to hold her breath while the image is being captured, and most women experience some pressure and discomfort, but the procedure is typically pretty brief. The technician will capture two images of both breasts, one from the front and one from the side.

According to the American Cancer Society, there are also three-dimensional mammograms which only compress each breast once and the machine takes several low-dose x-rays in an arc over the breast. A computer puts these separate images together to provide a 3D image of the breast for a doctor, and it may lower the odds of being called back for a follow up test, as it also seems to detect more examples of cancer and it can be useful for women with dense breasts. The two types of mammograms are screening mammograms and diagnostic mammograms, with screening mammograms being mammograms that are used as a routine test. If any abnormalities are detected in this routine test, a doctor will order a diagnostic mammogram, which will scan the breast for abnormalities more extensively and which may require more x-rays. If a woman has breast implants, she may need a diagnostic mammogram regardless, as breast implants hide some breast tissue and may make it more difficult to detect some cancers. Before receiving a mammogram, patients should not wear powders, deodorants, or perfumes as they can show up as white spots on the x-ray that may interfere with your results. Patients should also remove any necklaces or piercings that they have on, and it is recommended that they wear clothes that make it easy to undress from the waist up for the procedure. Patients should also avoid having a mammogram the week before or week of their period, as this timeframe can make breasts tender and swollen. Current medical guidelines state that women should have annual mammograms at around 40–45 years old until around 54 years old. Around this time, women can choose to switch to mammogram screening every two years instead.

Normal monthly vaginal bleeding caused by the shedding of the uterus lining that forms in preparation for a pregnancy. A menstrual cycle is the process that a woman’s body goes through to prepare for a potential pregnancy, and this process typically lasts for 28 days, but a menstrual cycle can vary in length from 21–35 days. At roughly around the 14th day of the cycle, an egg is released from the ovary in the process of ovulation and travels through the fallopian tubes to the uterus.

Estrogen and progesterone levels rise in the body to prepare the uterine lining for a pregnancy, and if there is no pregnancy, the estrogen and progesterone levels drop and the uterus lining is shed, signaling the beginning of a period. Menstrual blood is composed of part blood and part tissue from the lining of the uterus. According to the Cleveland Clinic, the average age that menstruation begins is around 12, but can vary from person to person and can begin as early for some people as 8 years old or as late as 16, with the average age of menstruation ending around age 51.

A menstrual period can last anywhere from two to seven days and can be accompanied with symptoms including cramping in the abdomen or pelvis, lower back pain, bloating, breast tenderness, acne, food cravings, and varying moods.

Repeated episodes of extreme perspiration or sweating that may drench clothes and bedding and that may also cause sleep disturbances or problems. Night sweats are often defined as severe hot flashes that occur at night, and according to the Cleveland Clinic, they occur when blood vessels expand, which increases blood flow, before they contract again. They’re often characterized by the spread of an abrupt wave of heat that travels throughout the body, sweating, increased heart rate, reddening of the skin, and they often end in a cold chill.

Night sweats can often be a sign of perimenopause for women in anywhere from their mid to late 30s to their 50s, and can continue for women who are postmenopausal as well. Night sweats during perimenopause are caused by a gradual drop or fluctuation in the estrogen hormone.

However, night sweats can also be caused by other factors aside from perimenopause, such as infections, certain medications, hormone treatments, certain types of cancers, and more. If night sweats occur on a regular basis, impact the quality of sleep, or are accompanied by symptoms like unexplained weight loss or fever, you should discuss your experience with a doctor or physician. You can also adapt certain lifestyle changes to help with night sweats, including wearing breathable clothing or using breathable bedding, dressing in layers for clothing removal or adjustment, using relaxation techniques, and drinking cold water before bed.

Read more about night sweats here: New to insomnia? How to get quality sleep when you’re in perimenopause

A procedure that’s used to check for cervical cancer by checking for the presence of precancerous or cancerous cells on the cervix. A Pap smear is performed by a doctor or gynecologist who will have the patient lay down on an exam table with their feet placed in stirrups, and the doctor will gently place a device called a speculum into the vagina. The speculum holds the vaginal walls apart so that the doctor is able to see the patient’s cervix. From here, a small spatula or a spatula and a brush are used to collect cells from the cervix so that they may be examined under a microscope for any abnormalities. The insertion of the speculum may cause the feeling of pressure in your pelvic area, and many women feel some sort of slight push or irritation while the doctor uses the spatula or spatula and brush to gently scrape cells from the cervix. Afterward, mild discomfort or cramping may occur and some women experience very minor vaginal bleeding right after the procedure. After the procedure, the patient is welcome to go about their day as usual.

If results from a Pap smear come back as normal or negative, it means that no abnormalities were found in the cells, and the patient doesn’t need to have another test for a little while. If Pap smear results are positive or abnormal, it doesn’t necessarily mean that you have cancer, but that you have abnormal cells on your cervix, some of which may or may not be precancerous. According to Healthline, “There are several levels of abnormal cells:

• Atypia
• Mild
• Moderate
• Severe dysplasia
• Carcinoma in situ

Milder abnormal cells are more common than severe abnormalities. Depending on what the test results show, your doctor may recommend:

• Increasing the frequency of your Pap smears
• Getting a closer look at your cervical tissue with a procedure called colposcopy.

Before having a Pap smear, patients should avoid vaginal douching, using any spermicidal products, and intercourse at least 24 hours before their test, as these factors can obscure abnormal cells or wash them away, which can interfere with your results. Patients may also want to avoid scheduling an appointment on a day where they are menstruating if possible, as this could make results less accurate. If results come back negative or you have no history of abnormalities, a woman in her 20s only needs a Pap smear done about every three years. Women ages 30 and older should have HPV testing done with their Pap smear, and once the virus is proven to not be present, testing can be extended to a test every five years. By age 65, if a woman does not have a history of cancerous or precancerous cells, she may be able to stop having Pap smears altogether. Pap smear testing usually starts at age 21.

This is the time frame from around the end of puberty and the beginning of a woman’s first menstrual period throughout a woman’s 20s and 30s when they are still having periods. Periods may be regular or irregular, and hormonal changes or fluctuations may occur, but there are mostly no noticeable changes in the body.

Perimenopause begins anywhere from as early as a woman’s mid 30s to sometime in their 40s, and is marked by the fluctuating levels of estrogen and other sex hormones as the ovaries gradually stop working. Perimenopause can last anywhere from 2–10 years with estrogen levels gradually decreasing over time, causing irregular periods as well as physical and emotional symptoms. Common indicators and symptoms of perimenopause include irregular periods, hot flashes, night sweats, trouble sleeping, mood changes, changes in sex drive or sexual interest, and trouble concentrating. According to John Hopkins Medicine, “Perimenopause does not need to be treated unless symptoms are bothersome. Treatments may include:

• Hormone therapy using estrogen or estrogen and progestins to level out hormone levels
• Antidepressants to stabilize mood”
• Lifestyle choices may also help to regulate some symptoms, such as finding out what triggers hot flashes, eating a balanced diet, and getting regular exercise.

Learn more about perimenopause in Jumble & Flow’s Adventures in Perimenopause series.

Postmenopause occurs when a woman has not had a menstrual period for 12 consecutive months, and it usually occurs in a woman’s 40s or 50s, with the average age range being around when a woman is 45–55 years old. Symptoms experienced in perimenopause, such as hot flashes, night sweats, and trouble sleeping, tend to ease for some women and may eventually stop. However, women can still experience perimenopausal symptoms to some degree for up to 10 more years or more. Once a woman reaches postmenopause, her hormones remain at consistently low levels, she will no longer be able to become pregnant, and she will no longer experience menstrual periods. Due to low levels of estrogen in the body, women who are postmenopausal may be at an increased risk for conditions like osteoporosis, cardiovascular disease, changes in vaginal health, and changes in mental health. Certain lifestyle choices like a balanced diet, regular exercise, limiting alcohol intake, and taking certain supplements can help decrease the risk of these conditions.

Many people make reference to the entire process as “menopause.” Menopause is actually a milestone rather than a phase. Technically speaking, a woman is not “in” menopause. You’re in one of the three phases!

A hormone that stimulates and coordinates various body functions, having a large part in maintaining pregnancy, regulating menstrual cycles, and preparing the body for the fertilization of an egg. Progesterone is primarily produced by a portion of the ovaries that forms during menstruation called the corpus luteum, but it is also produced by the placenta during a pregnancy and the adrenal glands. According to the Hormone Health Network, progesterone has a hand in preparing the uterine lining for a potential pregnancy by causing it to thicken to better accept a fertilized egg, while at the same time preventing uterine muscle contractions that would result in the body rejecting an egg. While high levels of progesterone are being produced, the ovulation process stops.

The corpus luteum forms from a follicle that releases the egg during ovulation, and progesterone is primarily produced from there, occurring after ovulation. If the egg is not fertilized, the corpus luteum breaks down, progesterone levels drop, and a woman begins the process of menstrual bleeding. If the egg does become fertilized, according to Verywell Health, “…the corpus luteum continues to produce progesterone until about 10 weeks of pregnancy. Then, your placenta takes over.” Progesterone also largely contributes to breast development, helping to stimulate the growth of breast tissue during puberty, and preparing breasts for lactation and milk production during pregnancy. Due to the increase in progesterone during a woman’s menstrual cycle, it is also thought to be the cause of breast tenderness, swelling, and pain that takes place before or during menstrual bleeding. If progesterone levels are low in the body, it can affect a woman’s menstrual cycle and cause irregular or heavy bleeding. On the other hand, there don’t seem to be any known medical drawbacks of too much progesterone, and progesterone can be used in hormone replacement therapy to help to relieve symptoms of perimenopause.

A butterfly-shaped endocrine gland typically located in the lower front of your neck, just above the collarbone. The thyroid produces hormones that help to control and regulate different functions throughout the body, including your heart rate, body temperature, how you burn calories and use energy, and it maintains the functions of the brain, heart, muscles, and other various organs. According to the British Thyroid Foundation, “Thyroid disorders are very common and tend mainly to occur in women, although anybody — men, teenagers, children, and babies too — can be affected. About one in 20 people has some kind of thyroid disorder, which may be temporary or permanent.” Despite their common nature, when your thyroid isn’t functioning as it should, it can affect your entire body.

The two most common forms of thyroid disorders are hypothyroidism and hyperthyroidism. Hypothyroidism is the more common of the two disorders, and it occurs when the thyroid is underactive and doesn’t produce enough of its hormones. Most cases of hypothyroidism are mild, and common symptoms include fatigue or tiredness, higher sensitivity to the cold, weight gain, depression, poor concentration or memory problems, and a slower heart rate. Hyperthyroidism on the other hand, occurs when the thyroid gland is overactive and produces more of its hormones than the body needs. Common symptoms of hyperthyroidism include feelings of anxiety or restlessness, increased sensitivity to heat, weight loss, increased sweating, a faster heart rate, and occasionally sore or gritty eyes.

Veins that become swollen, enlarged and twisted that are visible just under the surface of the skin. This can happen to any veins close to your skin’s surface, superficial veins, but the most common place to find varicose veins is in the legs. Veins become varicose veins when the walls of the veins or the valves of the vein become damaged or weakened and no longer function as they should. According to Mayo Clinic, “Arteries carry blood from your heart to the rest of your tissues, and veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity…Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward. If these valves are weak or damaged, blood can flow backward and pool in the vein, causing the veins to stretch or twist.” Varicose veins are a very common condition, especially for women, and about a quarter of all adults have them.

A person may be at more of a risk for varicose veins if they regularly stand or sit for extended periods of time, they live an inactive lifestyle, are overweight or obese, have a family history of varicose veins, are in perimenopause or postmenopause, if they are pregnant, or if they take birth control pills or are undergoing hormone treatments. The main symptom of varicose veins is that they are clearly visible against the skin and they are typically a dark purple or blue color. Other symptoms that may accompany varicose veins include swelling, an aching or throbbing pain, skin discoloration around the vein, a burning sensation, and muscle cramping that can typically occur at night. Severe cases of varicose veins may also produce long-term mild swelling, ulcers or sores that don’t heal, or significant bleeding. If varicose veins are not accompanied by symptoms, treatment may not be necessary, but lifestyle changes can also help to reduce symptoms and the likelihood of any more forming. Avoiding standing or sitting for long periods of time, exercising, maintaining a diet that is high in fiber and low in sodium, and elevating your legs can help to treat discomfort and prevent the formation of new varicose veins. According to John Hopkins Medicine, elevating your feet above the level of your heart for about 15 minutes three to four times a day can help to relieve symptoms and reduce the swelling in your legs. If you can’t avoid sitting or standing for extended periods of time, occasionally flexing your legs can help to maintain blood circulation.

If varicose veins are more severe and if they are causing you a lot of pain or if they are damaging your overall health, your doctor may suggest surgery or other medical procedures. Vein stripping is a surgical procedure in which a surgeon makes an incision in your skin to cut and remove the varicose veins. Treatments like sclerotherapy and microsclerotherapy are treatments that can also be used to block off veins to minimize symptoms. It’s best to talk with your doctor about if it’s best to pursue treatment for varicose veins, and if so, what kind.