Mayo Clinic Q & A - December 2014 Archives

DEAR MAYO CLINIC: I have been diagnosed with vaginal prolapse and am not sure where to begin with treatment. What is the best long-term treatment? I am only 53. ANSWER: Surgical and nonsurgical treatment options are available for vaginal prolapse. The treatment you choose usually depends on the severity of the condition, as well as how much the symptoms bother you. For long-term relief of vaginal prolapse that is causing persistent symptoms, surgery is often recommended to repair the vagina’s support. Vaginal prolapse happens when the muscles, connective tissue and ligaments that support the vagina weaken and stretch, causing the tissue to drop down, or prolapse, into the lower portion of the vagina or out the vaginal opening. Prolapse of the uterus, bladder (cystocele), and rectum (rectocele) can accompany vaginal prolapse and lead to a feeling of pelvic pressure or fullness, or a feeling of a bulge within the vagina. In some cases, these symptoms may be mild in the morning but get worse as the day goes on.

DEAR MAYO CLINIC: At my last physical, my doctor suggested that I should be screened for lung cancer. I used to smoke about a pack of cigarettes a day, but I quit 12 years ago. I am 63 now and in good health. Is screening really necessary for me? What does it involve? ANSWER: Screening programs are used to find lung cancer at an early stage, when it is more likely to be successfully treated. In general, screening is recommended for people at higher risk of developing lung cancer. That often includes people like you who smoked heavily at some point in their lives. Lung cancer is currently the number one cancer killer in the United States. More people die in the U.S. each year from lung cancer than from colon, breast and prostate cancer combined. But studies have shown that a properly organized screening program can reduce the number of people who die from lung cancer by 20 percent.

DEAR MAYO CLINIC: I am 58 and asked my doctor for a prescription for erectile dysfunction. He recommended I also have tests done to evaluate my heart. How are ED and heart disease related? ANSWER: In some cases, erectile dysfunction, or ED, may be an early warning sign of heart disease. It is often a good idea for men diagnosed with ED to have tests to make sure that ED is not a symptom of a heart condition. That is especially true if you have risk factors that increase your chances of developing heart problems. If a heart condition is found, treatment for that disorder also may help reverse ED. The connection between ED and heart disease involves a condition known as atherosclerosis — sometimes called hardening of the arteries. Atherosclerosis happens when plaques build up in your arteries. When plaques start to accumulate, the smaller arteries in the body, including those in the penis, are the first to get plugged up. The plaque lowers blood flow in the penis, making an erection difficult. Erectile dysfunction alerts doctors to look for atherosclerosis in larger arteries that supply your heart and other organs and, if found, to take steps to treat atherosclerosis. In addition to heart problems, atherosclerosis also increases your risk of other serious health problems, including aneurysm, stroke and peripheral artery disease.

DEAR MAYO CLINIC: My husband is 68 and has some hearing loss but won’t go to see the doctor. He says it’s a normal part of aging and thinks there’s not much that can be done for it anyway. How is age-related hearing loss treated, other than a hearing aid? Is there a benefit to having his hearing evaluated now as opposed to waiting until it gets even worse? ANSWER: This is a great question and something we frequently hear from our patients. It is often because of concerned family members and friends — rather than the patient — that people come to a doctor for hearing loss evaluation. There are two main reasons why it is important to have hearing loss evaluated as soon as it is recognized: first, to determine the cause and second, to review possible treatment options. Early intervention may be associated with a better outcome, depending on the cause of the hearing loss.

DEAR MAYO CLINIC: My 16-year-old granddaughter was recently diagnosed with a low white blood cell count after going to the ER twice with a migraine headache, vomiting and temporary loss of sight. What could cause a low white blood cell count in someone her age? I am worried it’s something serious and am wondering what other tests should be done. ANSWER: Many diseases and conditions can lead to a low white blood cell count. It is difficult to say what the specific cause might be in your granddaughter’s situation without more information. It is unlikely that the low count is related to her migraine and other symptoms. It would be wise to do another blood test to see if the problem persists. Her doctor can then decide if she needs to be evaluated further. Blood has a number of components. In addition to white blood cells, which fight infection, red blood cells carry oxygen and platelets help blood clot. Bone marrow, the spongy tissue inside bones, makes the blood cells.