Symptoms Women in Their 20s and 30s Shouldn't Ignore
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In the U.S., endometriosis affects more than 11 percent of women ages 15 to 44, and it's often diagnosed in a woman's 30s. Still, it can be hard to spot—even for your ob-gyn. "It's a complicated story, since the symptoms overlap with normal menstrual cramps" and PMS, says Maura Quinlan, MD, MPH, an ob-gyn in Chicago and an assistant professor of obstetrics and gynecology at Northwestern University. The common hallmarks are painful periods, pain during sex and with bowel movements and urination, and excessive bleeding. "Typically, if the pain is hard to control with NSAIDS [non-steroidal anti-inflammatory drugs] like Motrin, the woman needs to take off work for painful periods and sex is painful nearly all of the time regardless of position changes, then it is worth considering endometriosis," she says.
Experts aren't sure what causes endometriosis, but they know what happens: Tissue that normally lines the uterus's interior (the endometrium) grows outside, usually around the ovaries, fallopian tubes and tissue lining the pelvis. This out-of-place endometrial tissue doesn't know it's not inside the uterus where it belongs, and it continues to go through the monthly cycle of thickening, breaking down and bleeding, but it can't be flushed out with your period like normal endometrial tissue. The trapped tissue can irritate the area and even eventually lead to scar tissue there, and down the line, it can lead to fertility problems. That's why clueing in your doctor is so important—the sooner you catch it, the better. "Endometriosis is typically first treated with birth control pills," Quinlan says, since pills can essentially stall that monthly cycle. Sometimes, surgery is needed to confirm the diagnosis and remove extra tissue.
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A sped-up heartbeat could stem from hyperthyroidism, a treatable condition that affects more than one in 100 Americans and tells your ticker to beat too fast. If you feel your heart beating super-fast for just a brief period without warning, you may have a heart condition called supraventricular tachycardia. Although it affects about one in every 300-500 people, the most common kind of SVT, atrioventricular nodal reentrant tachycardia, occurs more frequently in younger women than in other demographics.
Doctors aren't sure what causes some people to have SVT; while for some people, stress, lack of sleep or physical activity may trigger an episode, for others, there's no obvious cause. "If your heart rate is over 100 when you're just sitting around, or you can feel your heart pounding and you feel funny and lightheaded, that's worth talking to a doctor," says Ann Celi, MD, MPH, an internist at Brigham and Women's Hospital in Boston. Call your doc up ASAP (yes, even if you feel fine once the episode passes), because it can indicate that you're at a much higher risk for heart failure. She'll help you figure out what's up.
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If you find a tiny dot of clear discharge inside your bra (and you're not pregnant or breastfeeding), keep an eye on it. If it doesn't clear up on its own in a few days, as with all nagging symptoms that aren't improving, it merits a call to your doctor. It could be due to nipple stimulation, such as from a recent piercing or from sex, says Quinlan, who has patients come in with this symptom multiple times a year. But if a white, milky fluid is coming from one or both sides, definitely tell your doctor what's up. "Milky discharge could indicate prolactin elevation, which could be caused by medication," including drugs that target mental health conditions like bipolar disorder, she says. A pink or red discharge could be from blood, which Quinlan says could indicate a benign growth in the milk ducts; it's rare but should be checked out.
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It's normal to feel down sometime. But if the sadness, anxiety or tearfulness just won't quit, you're having issues with sleep, and you're feeling anxious and having problems with day-to-day life, that's something to be seen for, says Celi. Those signs of depression, among others, are surprisingly common: One in 10 women in the U.S. are affected by symptoms of depression, according to CDC data; and it is most prevalent among women between the ages of 25 and 44. "The problem is, sometimes people think their problems are too vague or feel like they should be able to power through it," says Celi, so they don't tell their doctors. If you feel sad or overly stressed-out nearly every day for two weeks or more, schedule an appointment with your healthcare provider.