Reader 1: I had a complete hysterectomy 25 years ago and have not had a pap smear since. My internist says it is not necessary. Is it?

Dr. Carolle: A woman should have a pelvic exam with her annual exam, which should also include a breast exam and a rectal exam with testing of the stool for occult blood, if she is over 50. During the exam, the vulva, perirectal area, vagina, and cervix are inspected. Cancer of the vulva and vagina are more prevalent in older women. If a woman had a hysterectomy for a benign disease, it is recommended that a pap smear be performed every three years. However, if the hysterectomy was done because of a pre-cancerous lesion or cancer, the pap smear should be done yearly with the annual check up.

Reader 2: I have horrible mood changes (very depressive/ negative) during the week before my period. Taking birth control has seemed to help some, but the pill makes me swell and retain water. Have you heard if the new Tums® PMS tablets are very helpful for mood swings?

Dr. Carolle: One study did show that women who took 1,200 mg of calcium supplement a day were less likely to experience PMS symptoms. A regular exercise routine as well as a diet low in salt during that time may help. Regarding the Pill, sometimes switching to another kind may decrease the side effects.

Reader 3: I have swollen lymph nodes in the groin area. They are tender at times. What could cause this? Could a urinary tract infection be the cause?

Dr. Carolle: Women who shave part of their pubic and groin hair sometimes do experience swollen lymph nodes in the groin. If it is related to shaving you should not have to worry about it. Otherwise, you need to be evaluated by a health care provider.

Reader 4: I recently came off the pill and noticed that I have more headaches than normal. I have one child and do not remember having this problem. My headaches usually start after I have eaten a meal and linger for the rest of the day or night.

Dr. Carolle: There are many reasons why a person has a headache. I have never heard of a correlation between headaches and stopping the Pill. If they persist you should be evaluated by a health care provider.

Reader 5: I am a 24 year-old woman who has never visited a gynecologist. I have irregular periods and I have facial hair and some chest hair. The main reason I am going to make an appointment is because I am planning to get married in the fall and I want to get my periods regular so I can pick a date. With what I have told you, could I have a hormone imbalance and what can I do besides laser surgery to get rid of all my body hair? It is really embarrassing, and my fiancé and I are both virgins, so we haven't seen each other naked. I want to get this corrected so he won't be grossed out.

Dr. Carolle: You could indeed have a hormonal imbalance. It is very common for young women to be in your situation. Your gynecologist may be able to help you come up with a diagnosis. Unfortunately, it is difficult for women to totally get rid of excess body hair. There is a new cream on the market for unwanted facial hair. You will need a doctor's prescription in order to get it. Go to: www.vaniqa.com to learn more about it.

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