Case vignette A 46-year-old patient presented to our specialty women’s health clinic with vaginal bleeding. Previously, this patient was treated at our facility for early-stage breast cancer. As part of her treatment, she had a hysterectomy, oophorectomy and was on a long-term adjuvant course of aromatase inhibitors (AIs). The patient was very concerned that the etiology of the bleeding was cancerous. On exam, we determined that a urethral caruncle—a large friable red mass—was…

I have been on bioidentical hormone creams for 25 years with great results. I recently decided to try the pellet, which was inserted in my left hip. After one week, I had a shingles outbreak in my left foot and lower left leg. I had the first shingles shot 20 years ago, but have not had the new shot. I love the results and simplicity of the pellet, but I'm hesitant to get another, so I went back on the creams. Do you think there could have been a connection to the pellet and shingles or just a coincidence?

I am 67 years old and recently had my yearly blood work done. My vitamin B12 level is >1500. My liver enzyme ALT is 39. I have been told that I have a fatty liver.

Can you give me advice concerning the high level of B12?

Guest columnists, Heather Mekesa and Dr. Silvia Perez Protto discuss the importance of organ, tissue and eye donation. Heather Mekesa is the Chief Hospital and Clinical Services Officer at LifeBance and Dr. Silvia Perez Protto is a Cleveland Clinic physician.

A medical procedure that aims to allow women to delay the menopause for up to 20 years has been launched by IVF specialists in Britain. Doctors claim the operation could benefit thousands of women who experience serious health problems, such as heart conditions and bone-weakening osteoporosis, that are brought on by the menopause. But the specialists believe the same procedure could also improve the lives of millions more women by delaying the onset of more common symptoms of the menopause,…

Read Women’s Health Specialist Dr. Holly L. Thacker’s and Cleveland Clinic Rheumatologist Dr. Feyrouz Al-Ashkar‘s column on autoimmune diseases in women and what you need to know!

I have chronic migraines that are much more intense and frequent from ovulation to starting my period. I am on an estradiol patch, but it doesn't seem to be enough. Can this help with migraines?

I was wondering if I could use multiple vaginal estrogen therapies on alternating days? I cannot use the new DHEA Medicine (Intrarosa®).

I am 79 years old and have had urge incontinence for years. I have an InterStim, which is not doing much good and I am considering purchasing a pelvic stimulating device. Can I use the device with the InterStim in place if I turn it off?

(HealthDay News) -- Many older men take testosterone to boost their sex drive, but new research suggests that postmenopausal women who struggle with a sagging libido might want to follow suit. Applied topically, the hormone appears to increase women's sexual function and satisfaction, according to a new review of 36 clinical trials involving nearly 8,500 women. Women naturally produce testosterone as well as estrogen, said lead researcher Susan Davis, a professor of women's health at the…

Dr. Taryn Smith discusses migraine treatments and what treatments are best for the different symptoms.

Tamara A. Sussman, MD, Megan L. Kruse, MD, Holly L. Thacker, MD and Jame Abraham, MD Cleveland Clinic Foundation, Cleveland, OH Patients with breast cancer receiving antiestrogen therapy, specifically aromatase inhibitors, often suffer from vaginal dryness, itching, irritation, dyspareunia, and dysuria, collectively known as genitourinary syndrome of menopause (GSM). GSM can decrease quality of life and is undertreated by oncologists because of fear of cancer recurrence, specifically when…

Other than Estradiol vaginal cream and D-Mannose capsules, what can help the urinary urgency feeling I get at age 66? I have been checked for UTI and I usually don’t have one.

By Holly L. Thacker, MDRomosozumab-aqqg/Evenity®, a new osteoporosistreatment, was approved by the U.S. Food and Drug Administration in April and will be available in the summer of 2019. This new treatment is a sclerostin inhibitor, which works through a novel (Wnt) pathway and has both anabolic and antiresorptive effects, increasing new bone formation and preventing bone breakdown. The prescribing information indicates that—if warranted—patients be continued on antiresorptive-only…

A baby girl born last month at Cleveland Clinic has made history. She was the first baby in North America delivered by a mother who received a uterus transplant from a deceased donor. The mother, who is in her mid-30s, is part of a groundbreaking research trial involving 10 women with uterine factor infertility. Women who have UFI don’t have a uterus, or had their uterus removed, so they aren’t able to get pregnant. The study is testing whether receiving a uterus transplant from a deceased…