Sooner or later, every mom realizes an important truth: You don't have time to get sick. So it becomes second nature to overlook the messages your body is sending you -- symptoms that would send you straight to the doctor if your kids complained of them. Stomach pains? Just gas, or menstrual cramps. Tired and feeling sad? Must be PMS. Heart racing? Everyday stress.
But some body signals are cries for help. After having a baby, you go through physical and emotional changes that can trigger -- or mask -- certain health problems. And as your kids get bigger, the pressures of motherhood can make it easy to continue to put off your own checkup.
Aches and pains often have innocent causes, of course. But be sure you talk to your doctor if you have any of the following:
If you feel pain at the start of intercourse, the culprit may be vaginal dryness, which usually stems from lowered estrogen levels after childbirth and during breastfeeding. Your doctor may prescribe an estrogen cream or suggest that you use a vaginal lubricant, such as KY Jelly. But if the real reason is lack of arousal, the cause may be a problem in your relationship, which can best be handled by spending more time together or perhaps even seeking couples therapy.
Another common reason for discomfort is a yeast infection, which can cause irritation and pain during sex. Over-the-counter antifungal medications are effective, but see your doctor for an accurate diagnosis first.
If you've recently had a baby and you underwent an episiotomy, you'll heal in one to two months, but you may still feel pain and tenderness, especially during the beginning of sex, for three months to a year.
Pain that comes later in the act of sex, however, may mean something else entirely. "If the start of intercourse goes smoothly, but pain occurs upon deep penetration or thrusting during intercourse, the most common reason is endometriosis growth of uterine tissue outside the uterus or cysts or tumors, benign or malignant, in the vagina or uterus or on the ovaries," says Donna Sweet, M.D., professor of internal medicine at the University of Kansas School of Medicine, in Wichita.
Such problems can be detected during pelvic exams or through a vaginal ultrasound (a noninvasive procedure) or a laparoscopy (a minimally invasive surgical technique in which a tiny endoscopic tube is inserted through a small incision in the pelvic area).
Be sure to tell your doctor if pain during sex tends to be worse right before your period -- that could be a sign of endometriosis.
Of course you're tired; you're a mom! Sure you've gained a little weight -- or maybe you've lost some; ever since the baby, your eating schedules have been crazy. And your periods have been a little irregular, what with the hormonal roller coaster you've been on. What else could it be?
Quite possibly, a problem with your thyroid, a small hormone-producing gland in your neck that helps regulate metabolism.
"It's easy to overlook fatigue and weight fluctuations, since these are so common in moms of young children," says Christine Laine, M.D., senior deputy editor of the Annals of Internal Medicine. But, she says, thyroid problems are not only more common in women than men, they typically surface in the 20s to 40s. They're often discovered after a pregnancy, though it's unclear whether that's a trigger.
Your doctor can diagnose a thyroid problem with a blood test that measures levels of thyroid stimulating hormone (TSH). But first you may need to recognize the symptoms. An underactive thyroid (hypothyroidism) can cause irregular or very light periods, fatigue, unexplained weight gain, and/or constipation. It's easily treated with prescription medication -- thyroid-hormone pills.
An overactive thyroid (hyper-thyroidism) may announce itself with diarrhea, anxiety, and/or heavy, irregular periods. Your doctor may suggest surgery, medication to reduce levels of thyroid hormone, or radioactive iodine to destroy the thyroid -- usually followed by pills to replace an appropriate amount of thyroid hormone.
Sometimes, no treatment is necessary. About 1 in 10 women will have thyroid problems after pregnancy, says Dr. Laine. In most cases, they last up to a few months after delivery, and then the thyroid begins to function normally again on its own. So careful monitoring by your doctor is all that's needed.
Excessive Thirst/Frequent Urination
These are common symptoms of Type 2 diabetes, in which the body gradually loses its sensitivity to insulin, leading to unhealthy high blood-sugar levels. The incidence of Type 2 diabetes is skyrocketing, and in women it's often diagnosed in the childbearing years. The main cause is obesity, which can be exacerbated by pregnancy. "Some women gain a lot of weight during pregnancy and don't lose it all, and that excess weight gain puts them at risk of diabetes," says Dr. Sweet. (In contrast, Type 1 diabetes, an autoimmune disease in which the body loses its ability to make insulin, is usually diagnosed in childhood or adolescence.)
If you developed diabetes when you were pregnant, it usually goes away after childbirth, but you're at higher risk of becoming a diabetic again in later years, says Dr. Sweet. "If you don't eat well or exercise, and you live long enough, you'll get it again." But if you do lose weight and work out during your 30s, you can help prevent the disease. Even if you have diabetes, doing both now may actually clear up the problem. For others, medication may also be needed to bring the disease under control.
Diabetes is easily diagnosed by your primary-care physician through a blood test. But left untreated -- or poorly controlled -- the condition can increase the risk of heart disease, as well as kidney and nerve complications. "That's why early diagnosis and treatment are so important," says Dr. Sweet.
A New/Changing Mole
Caught early, melanoma -- the deadliest form of skin cancer -- is more than 90 percent curable. But if it spreads to the lymph nodes or beyond, survival rates drop below 50 percent.
It's particularly easy to ignore a mole that looks a little darker. That happens a lot after pregnancy, due to hormonal changes. (Hormonal contraceptives -- the Pill, the Patch, NuvaRing -- may also darken moles.)
"Any time a mole changes, you should get it checked by a dermatologist," says Dr. Laine. Follow the ABCD's of melanoma detection when you're keeping an eye on your skin: Look for Asymmetry (an irregular rather than a normal round or oval shape); Border (a wavy, unclear border); Color (multicolored, with bits of brown, black, red, even blue in it rather than the uniform brown of a normal mole); and Diameter (larger than a standard pencil eraser). Plus, if a mole is itchy, bleeding, or painful, have it checked.
Shortness Of Breath
Shortness of breath, especially if accompanied by fatigue, pale skin and nails, dizziness, problems concentrating, or difficulty exercising for more than a few minutes -- these could be signs of anemia. That means you've run through the iron stores in your body and there's not enough for the red blood cells, which carry oxygen to every cell in the body.
You can become anemic if you lose a lot of blood each month through heavy periods, if your diet is low in iron, or both. (Normal blood loss during childbirth may also contribute.) If the problem is due to heavy periods, birth control pills may help.
Your diet may be low in iron if it's short on red meat, iron-fortified cereals, beans, or dark greens -- and you're not taking a multivitamin with iron. A blood test can detect if you're anemic -- or iron-deficient, which increases your anemia risk. If so, your doctor will probably prescribe a high-dose iron supplement.
7 smart ways to prepare for your doctor visit
1. Keep a diary of symptoms you want to discuss, noting when they occur and relevant details -- such as what you ate or drank beforehand, where you were, and what you were doing.
2. Write down questions so that you won't forget them.
3. Know your family medical history -- especially if your parents or siblings had heart disease or cancer. Make notes of your own medical history: the start date of your most recent period, dates of your most recent checkups, pelvic exams, etc.
4. Bring with you any medication (including nonprescription medications and herbal or dietary supplements) that you take regularly, as well as files of exams by other doctors or test results you want to discuss. If you've gotten information from the web or a magazine, bring along a hard copy.
5. Confess your worst fear. If you're really worried that your lower-back pain is a sign of ovarian cancer, come out and say it. The doctor may be willing to do some tests to look into your concerns or be able to quell your fears in other ways.
6. Be honest and answer your doctor's questions fully. Try not to be embarrassed, even if the symptom is personal.
7. Take notes, and ask if it's best to pose follow-up questions via e-mail, a call to the nurse or doctor, or in another visit. Inquire about learning more: Is there a good book or website that the doctor can recommend?
Bloated StomachWell, if lunch was raw broccoli or cooked beans and the bloating goes away in a few hours, never mind. And if you tend to feel bloated a few days each month before your period, that's hormones. But if the bloating is constant, doesn't get better when you have a bowel movement, and tends to worsen over time, see your doctor; it can be an early sign of ulcer disease, irritable bowel syndrome, or even ovarian cancer, says Dr. Sweet. If your doctor takes a thorough history and does a pelvic exam and possibly a vaginal ultrasound exam, he can pinpoint what's causing the problem and treat it.
Most little aches and pains mean nothing. But when something is bothering you, you owe it to yourself -- and your family -- to make sure.
Health writer Laura Flynn McCarthy's last feature for Parenting was "Feeding Your Baby," in the February issue.
What Not To OverlookAnd don't overlook these emotional symptoms...
Of course, we all feel anxious, angry, or down sometimes. But how do you know if your feelings are getting the better of you? If you have any of these kinds of symptoms, it's the right time to seek help, says Ellyn Kaschak, Ph.D., professor of psychology at San Jose State University:
* A significant change in your day-to-day personality. For example, you've always been easygoing, but lately you've been getting angry more easily or feeling unusually frustrated.
* People who are close to you comment on your behavior or say you just don't seem like yourself.
* Disturbing emotions are surfacing more frequently or not going away. If you've been feeling unusually sad, anxious, or mad for weeks rather than for a day or two, make an appointment with your primary-care physician, who can then refer you to a therapist.
Anxiety, depression, and anger are the most common emotional problems, and you can pinpoint each by the following signs:
You may have anxiety problems if...
* You avoid situations, such as meeting with your child's teacher, because you fear you'll run into certain people there. And the number of situations you avoid is growing.
* You wake up often with nightmares or panic symptoms, such as a racing heart, feeling hot all over, trembling, or sweating.
* You find yourself worrying all the time -- even about things over which you have no control, such as whether your child will develop a life-threatening disease.
You may be depressed if...
* You get little or no pleasure out of doing things that used to make you happy, such as spending time with family or friends, or a hobby.
* You feel lethargic.
* You're sleeping or eating more or less than usual, especially to avoid facing your problems.
* You're feeling stressed to the point where you're forgetting things.
* You're shying away from people, even your kids and your husband, preferring to be alone almost all the time.
You may have anger problems if...
* You're yelling at your children more than usual.
* You've fantasized about hitting your kids, stopped yourself from doing so, or have hit them.
* You resent your kids or blame them for things they didn't do -- or can't really help doing.
* You have trouble keeping perspective; your child spills juice on the floor, and as you clean it up, you yell, "You're ruining my life!"
* Your rage is affecting other relationships too.
* You don't get over things quickly; anger builds, even after an incident has passed.
"For each of these problems, even short-term therapy -- ten sessions or less -- can be very helpful. So can, in some cases, short-term use of medication," says Kaschak. Problems usually occur together -- you feel both anxious and blue, or depressed and very mad. Often, treating one negative emotion helps the others.