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There isn't a lot your body can hide in one of those crinkly numbers. Maybe that's why so many women refuse to reveal much else at doctor visits. About a third of men and women in the United States admit to lying to their M.D.'s, according to a 2010 survey. But keeping secrets can be dangerous, especially if the information you're withholding leads to a wrong diagnosis. Besides, "a doctor's job is to advocate for your health, not judge," say Gary Fischer, M.D., a general internist at the University of Pittsburgh Medical Center. Here's why it's time to tell the whole truth -- and nothing but."I never smoke."
The real deal: Jean Thilmany has been lighting up a couple of times a month for the past 20 years. But because the 42-year-old Saint Paul resident doesn't consider herself a smoker, she never mentions it to her doctor. "I don't smoke often enough for it to affect my health," she says. Actually, if you puff even the occasional cigarette at happy hour, your doctor needs to know. Yes, cancer is a concern, but equally important, those smokes affect your circulation and increase your risk for blood clots. Be especially careful if you're on the Pill. "Estrogen, found in combination birth control pills, the Patch and the NuvaRing, makes blood more prone to clotting," explains Mary Jane Minkin, M.D., clinical professor of obstetrics and gynecology at Yale School of Medicine.
Your doc can recommend estrogen-free contraceptives, like the progestin-only mini pull, an IUD or the Depo-Provera injection, but only if you're up-front with her. Still on the fence about fessing up? You may not have your habit under control as well as you think: One study found that one in five social smokers eventually starts lighting up daily."Nothing's changed since my last visit."
The real deal: Really? When your doctor asks "What's new?" she doesn't mean only medically. Whether you're in a tense relationship or fretting about work woes or money matters, chronic stress can trigger high blood pressure, migraines, tummy troubles and heart palpitations, Dr. Fischer says. "The stress hormone cortisol throws other hormones, like estrogen and progesterone, out of kilter," says Jerilynn Prior, M.D., director of the Centre for Menstrual Cycle and Ovulation Research at the University of British Columbia. This does more than mess with your period: Estrogen helps prevent bone loss, and progesterone aids bone growth.
The good news: Although prolonged periods of stress can have serious health consequences, there is a lot you can do. Talk to your physician; she can suggest stress busters, like relaxation exercises and yoga. In some cases she may recommend that you speak to a mental health professional who can help you work through your problems."I'm not taking anything."
The real deal: More than 50 percent of Americans take supplements, according to the Centers for Disease Control and Prevention. The few natural remedies that you use may not seem noteworthy to you, but they are to your physicians. "A decade ago many women took Saint-John's-wort for PMS only to learn that it can make birth control pills less effective," says FITNESS advisory board member Mark Moyad, M.D., director of preventive and alternative medicine at the University of Michigan Medical Center. And that's not the only interaction your physician wants to watch out for. Using ginseng with antidepressants puts you at risk for serotonin syndrome, a potentially fatal condition that causes diarrhea, fever and seizures. Because fish oil can thin the blood, you should stop taking it a week before dental work or surgery and don't combine it with another blood thinner, like aspirin, without checking with your doctor. Too much vitamin D can cause kidney stones, while too much viamin C can cause heartburn. So make a list of the pills you pop, including vitamins, supplements and meds (OTC and prescription), and bring it with you to your appointment."I always use condoms."
The real deal: Your date didn't don his raincoat. It happens -- more often than it should, given all that we know about STDs and unplanned pregnancy. Two-thirds of single Americans occasionally have unsafe sex, according to a 2010 survey from the Center for Sexual Health Promotion at Indiana University in Bloomington. It's not that we're na´ve about the risks. "I know what I should do. It just doesn't always happen," says Anna Sowa, 28, of Winston-Salem, North Carolina. "I've witnessed friends struggle with repercussions from reckless behavior, but I still don't discuss my sexual indiscretions with my doctor."
Bottom line: Your doc needs to know if you've had unprotected sex, multiple partners, or STDs in the past. If you're too embarrassed to speak up, Dr. Minkin suggests jotting this info down on your medical history form. "STDs aren't always apparent," Dr. Minkin says. In fact, two of the most common ones, genital human papillomavirus (HPV) and Chlamydia, rarely cause symptoms. Antibiotics clear up Chlamydia, but if you're not tested for the disease and it goes untreated, you could permanently damage your reproductive organs and experience fertility problems and chronic pelvic pain. And while nearly 60 percent of HPV infections go away on their own within six months, certain strains linger and increase your risk for cervical cancer."I eat a healthy diet."
The real deal: After three days of swigging nothing but a concoction of lemon juice, maple syrup and cayenne pepper, Catherine Howe Bryant, 32, felt light-headed, lethargic and, not surprisingly, famished. "I dropped a few pounds, but I felt awful," admits the Winston-Salem resident. Still, Bryant does a liquid cleanse whenever she wants to "feel better" about her body. She's never told her doctor. What she and other women don't realize is that extreme diets can do real damage. "When your body doesn't get the protein it needs to generate new cells and tissue, it starts to burn muscle tissue, including the heart's cardiac muscle," says Arthur Frank, M.D., medical director of the George Washington University Weight Management Program in Washington, D.C. This can lead to heart palpitations, arrhythmias and many other cardiac problems. Putting yourself into starvation mode slows your metabolism in the short term and ultimately makes it difficult to maintain weight loss.
Whether you're trying to slim down for a beach vacay or training for a race, clue your doc in. She can help you devise a sensible plan and refer you to a nutritionist for a dietary tune-up that's safer than a detox or cleanse."I feel fine."
The real deal: About one in eight women struggle with depression at some time, but recognizing that you need help isn't easy. Twice as many women as men are affected. In addition to having persistent feelings of sadness, guilt, hopelessness and irritability, depressed women may gain or lose weight. "Tell your physician about any significant changes in your mood, thinking or behavior that affect your ability to function at home, at work or with your friends," says David Fassler, M.D., clinical professor of psychiatry at the University of Vermont College of Medicine in Burlington. She'll probably rule out other potential causes, such as viruses, thyroid disorders and medication side effects, and then conduct a psychological evaluation herself or refer you to a mental health expert. The happy news is that there are many treatment options, including psychotherapy and antidepressants.
Doorknob dawdlers: "Many patients bring up their biggest worry when the physician is leaving the room. Jot down a list of concerns and share them the moment the doctor walks into the room, before the exam or any procedure starts, so there is time to talk." - Mark Moyad, M.D.
Scale scaredy-cats: "Lots of women refuse to step on the scale, but weight plays an important role in overall health. If I can't follow your weight from year to year, I can't give you the best counsel about your health." - Mary Jane Minkin, M.D.
Pill stoppers: "I can't tell you how often I write prescriptions only to find out that the patient never had any intention of taking the medicine or that she stopped taking it without letting me know. Tell me if you're concerned about side effects and we'll find a different treatment plan." -Gary Fischer, M.D.8 Questions You Should Be Asking Your Doctor
Use our checklist to ask all the right questions at your next visit:
-How would you rate my health?
-What can I do to improve my health?
-How soon can I expect a call with test results?
-How should I take this medicine and for how long?
-What side effects are likely?
-What do I do if they occur?
-Whom do I contact if I have questions later about my diagnosis or treatment?
-When do you want to see me again?
Originally published in Fitness Magazine, October 2011.