SELF's Medical Expert Answers Your Questions

From fighting fatigue to switching birth control, our on-call expert, Henry Lodge, M.D., shares his tips for a healthier you. Have a question for Dr. Lodge? Submit your questions (about aging or anything else!) to or right here on our site.
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First, understand what it means: You have more glandular tissue than fat in your breasts, which sounds alarming but is actually somewhat common in young women—breasts tend to get fattier as you get older. But you should know there's a possibility that you might be at a higher risk for breast cancer, though researchers are still sorting this out.

So don't panic, but do work with your doc to ensure you know what to look for in a breast self-exam and to design the best screening strategy for you. If you have additional risk factors (family history, say), she may suggest that you start scans pre-40; when you do begin, she might add a breast ultrasound or an MRI, as it's more difficult to detect cancer in dense breasts using mammograms.

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Arthur Belebeau

Any change in routine, including starting a new gig, can lead to weight gain. Consider what's different: Maybe you're "treating" stress with chocolate, or your new coworkers love bringing in doughnuts to share, or your longer commute is messing with your workout schedule. Something is making you take in more calories than you're burning.

The great thing is, you've noticed already—you have time to get rid of that weight and get back on track before your body becomes too comfortable in those new bad habits and extra pounds.

Start by bringing plenty of healthy food to work—a banana for a snack, turkey on whole-grain bread for lunch—so you won't be tempted by office goodies or too sluggish to make it to the gym. Take plenty of strolls around the cubicles to fight off desk-chair butt. And if you think work stress is the culprit, spend five minutes at the end of the workday writing the next day's to-do list before going home, and then leave those worries at the office. Trust me—they'll still be there tomorrow, so focus on relaxing for now.

François Halard

It could be anxiety, which can feel worse when you're in bed with no distractions. Calm your mind by writing down your worries—and possible solutions—during the day.

Do you also have nausea or burning? You may have acid reflux, and your M.D. can suggest meds that will help. More likely, what you're feeling is a by-product of circulation. When you're upright, some blood can pool in your legs; when you lie down, it flows back into your heart, making it beat harder.

It also could be a simple matter of anatomy: The heart lies in a hammock of ligaments, and it can touch—and thump against—an organ (the esophagus, for instance) when you recline. Try switching positions to swing the hammock into a quieter place. You should drift off more easily.

Easy Tips to Better Sleep

Coliena Rentmeester

That's annoying—and also very common. If it started suddenly or is getting worse, see your doctor to rule out a urinary tract infection.

But assuming it's not an infection, reduce the urge by cutting off most fluids after 6 p.m. and sticking to one glass with dinner. Don't forget that alcohol is a diuretic, so the more you can avoid it—especially in the evening—the better.

Side note: Nighttime urges can be related to gravitational flux (see the previous slide). Throughout the day, fluid leaks out of your blood vessels into your tissues. When you lie down, the fluid comes back into your blood. You store water all day and "drink" it at night; it's your body's natural hydration system.

Easy Tips to Better Sleep

Stephanie Rausser

You're likely waking up hungry for one of two related reasons. First, you may have had too many refined carbs (the sugars in cake and candy) close to bed, sparking a blood sugar surge early in the night and a crash later on—your body begs for energy so loudly it wakes you up. Second, at dinner you may not have eaten enough slow-burning fuel, like healthy fats, proteins and unrefined, high-fiber carbs (legumes, vegetables and whole grains).

So eat a well-balanced dinner—a lean protein, a whole-grain side, plenty of veggies and a small sweet treat for dessert—and cut off sugary snacks from then on. A handful of high-fiber popcorn or whole-grain crackers is fine.

If you're still staring into the fridge in the wee hours now and then, a small, filling snack can help. Stick with a turkey slice on whole-wheat bread or an apple with peanut butter, however good that leftover cake may look.

Easy Tips to Better Sleep

François Deconinck

Definitely not. Here's the idea: You pay about $100 per month online for human chorionic gonadotropin, a pregnancy hormone that, when injected or consumed orally, supposedly lowers your appetite. But it's illegal to sell hCG for weight loss (although it is legal for doctors to prescribe it as part of infertility treatments) and the FDA and Federal Trade Commission have nixed the diet.

Why? It's dangerous: Even if the hunger-squashing theory were true (and researchers say it's not), the diet also requires limiting yourself to as few as 500 calories a day. Bottom line: You're starving yourself. You need at least 1,500 calories each day, and taking in much less is unsustainable. Worse, consuming so few calories can lead to dehydration, constipation and even fatal heart problems. For a safer, more effective choice, try SELF's Drop 10 Diet. You get to eat and lose weight at the same time!

Terry Doyle

Absolutely! Exercise, especially outside, is a powerful way to reset your emotional chemistry. Even a regular 10-minute walk can pep you up for hours. And don't forget that nutrition and hydration contribute to energy, too. After all, junk in equals junk—those blahs—out. Start the day with a decent breakfast containing lean protein, unsaturated fat and complex carbs, and go from there.

But remember that major life stress—a job you hate, trouble at home, even a long commute—can seriously drain your spirit. Over time, such anxiety can lead to depression, but more often, you'll encounter fatigue or ennui. If you can change the stressful circumstances, by all means, do it. If not, focus on what you can control: sleep, exercise, diet and reaching out to friends. (Spending time with people we love can energize us.)

When you're down, making the effort to do even these things might be tough; stress triggers your body's stay-in-and-eat-to-avoid-starvation instinct, so start small by going for a short workout or inviting a pal to meet for coffee. Soon, the old high-stepping you will be back in action.

Thayer Allyson Gowdy

That's a great question because sleep is extremely important—and more under your control than you might think. But to find the answer, you have a lot to consider.

First, genetics: Some people are predisposed to need more sleep, whereas others might jump out of bed totally refreshed after five hours. (Irritating but true!) The standard seven to eight hours recommendation is only an average; you might need nine.

Next, how's life? In my practice, I've noticed how stress, fitness and happiness levels can have a huge impact on the quality of your sleep and how much you need. When things are great and you're feeling fit and energetic, you may need less. If life isn't so terrific right now, you may need more rest to deal with the extra physical or mental toll.

To figure out the amount for you, snooze 30 extra minutes per night for one week and see how you feel; if you're not bright-eyed, try 30 minutes more. Can't squeeze in extra time at night? I'm a fan of half-hour naps during the day (before midafternoon), if your schedule allows, to beef up your daily totals. If you are still fatigued every A.M. after adding naps or nighttime sleep, it's time to talk with your doctor: Your sluggishness might be a symptom of depression, anxiety or illness and not related to your sleep at all.

Terry Doyle

It's great that you're losing weight and feeling good. Now the not-so-great news: There is no magic bullet for fixing stretch marks and no reputable research to prove that one product or another can make them vanish. Some studies have shown that Retin-A or laser treatments can help lighten (although not completely erase) the marks; it's worth asking a trusted dermatologist if these solutions might work for you.

But whether you get stretch marks is mostly a matter of genes and luck. Some women's dermis, the layer of tissue right below the surface, is more prone to microscopic tears during puberty, pregnancy or other periods of rapid weight gain; the scars show up on the epidermis as stretch marks. If you're planning to have a baby, maintaining a healthy pregnancy weight will help keep them in check.

But the most important thing you can do is celebrate progress. Exercising and eating well are huge wins, and you've taken charge of your health in a powerful way.

Todd Plitt

Nope. This is a good place to save money. Researchers have pitted brushes head-to-head and found little long-term difference for your teeth or gums. Good brushing mostly comes down to doing it thoroughly and regularly—twice a day with fluoride toothpaste.

What studies do show is that people with gum disease also have more heart trouble and stroke. Heart disease is the leading cause of death in women, making flossing and annual teeth-cleaning visits matter more than a fancy toothbrush. As with most preventive measures, you don't have to like them; you just have to do them!

Bill Diodato



William Meppem

Double-dipping is gross, but it's unclear how bad it is for your health. One study did show there are more bacteria in the salsa after someone dunks twice, but they're the kind that normally live in our mouth and are pretty innocuous. (That's why we can kiss healthy people without getting sick. You could even kiss a double-dipper...if you want to lower your standards that much.)

Of more concern are the flippers: those who turn the carrot stick over after one bite and go for a second round with the unbitten end. They may think they are finessing the issue, but in reality, they can expose you to the bacteria from their hands, which may be much worse. If you're worried, skip the dip. You'll avoid a few extra calories—and maybe a bug or two.

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With your love life and with the Pill, timing is everything. As long as you finish your old pack and begin the new pills on time (after you've taken the inactive or placebo tablets), you will still be protected from getting pregnant. If you swap midcycle, start your new pack late or accidentally miss more than one daily dose, you will need to use a backup method for the remainder of your cycle. That said, always discuss your plans to change birth control with your gynecologist to avoid any surprises.

The Scary Side Effect of the Pill

Melanie Acevedo

In general, yes. People have been doing it for thousands of years, and it's unlikely you can apply enough force to your own spine to cause nerve or muscle damage. Chiropractic back manipulation creates problems so rarely, you can consider it safe, too. (But do see a pro and avoid having your cousin Joe crack your back.)

You might wonder what, exactly, is cracking in there. Your vertebrae may be changing position as they slip back into alignment; in other cases, the sudden pressure shift inside a spinal joint forms gas bubbles, as when you open a bottle of seltzer. The bubbles reabsorb into the joint fluid quickly, so it's weird but harmless.

Still, long-term studies on joint damage are lacking, and you can overdo anything. If you need to crack your back often, or if you experience pain, weakness or numbness anywhere, go to your doctor right away. A warning about neck manipulation: Women have reported strokes after neck treatments, possibly triggered by an artery tear. Do your cracking only from the shoulders down.

Peter Dazeley/Photographers Choice

In flight, snack on dried tart cherries and walnuts; both are high in sleep-inducing melatonin. Skip onboard cocktails to avoid dehydration, which spikes hormone levels and puts stress on your body (especially in a dry, cramped plane). After landing, limit naps to 30 minutes and get moving, to adjust to local time. Exercise promotes circulation, sending oxygen to your cells and reducing fatigue. Why not take in the sights on a bike?

Stewart Shining




Riccardo Tinelli

Your comfy shoes could actually be part of the problem. Padded soles can deaden your connection with the ground, making your gait sloppy and foot muscles lazy; and flimsy flats don't absorb impact. Look for a balance: plenty of arch and heel support and toe room but not too much cushioning. The semi-custom inserts that running stores sell can also bring relief at any age.

Also, consider whether you're doing anything to stretch and strengthen your legs and feet. If you aren't, you may stand or walk off-kilter, and your feet have to compensate, which can lead to more pain. Twice a day, to bolster your calves, feet, Achilles tendons and the muscles along your shins, stand up straight and go up and down on the balls of your feet for 10 reps, then place heels on the floor and lift toes 10 times.

If your pain continues and seems to be worsening, don't shake it off. You could have a stress fracture, a torn ligament or something else that's crying out for a doctor's or podiatrist's professional attention.

Stephanie Raussser

No. You may think you're rescuing your bedmate from misery, but rousing someone simply means he'll need several frustrating minutes (or longer) to calm down and get back to sleep. The truth is, nightmares are normal. They're the brain's way of processing what you experienced or thought about (whether consciously or not) during the day. And although some may last a while or remain in your memory during waking hours, bad dreams are generally nothing to worry about.

Now, if the person lashes out, bangs his head against the wall or does anything else physically dangerous to himself or you, it's probably a good idea to gently wake him. Forget the myth that you'll give him a heart attack. And remember, you both deserve to sleep soundly.

Cathrine Wessel

Doctors don't always agree on what's "normal" for iron, but generally 150 to 170 mcg/dl is considered the healthy upper limit. But don't stress about your number too much: Mild elevations such as yours aren't a worry. Still, asking for a more detailed test might be smart, particularly if your family has a history of high iron; some disorders are genetic and could bring on liver or spleen damage or infertility.

Serious complications are rare though. In fact, iron deficiency is more common, especially in women who have heavy periods. Low iron can lead to anemia, which causes fatigue or, in more severe cases, heart problems. Iron-rich foods (soybeans, fish, lean red meat) can help. Talk to your doc if you're anemic.

Alessandro D'Andrea

Statistically, you are, but that's not the whole story. It depends entirely on why your mother had trouble. Some issues such as polycystic ovary syndrome (PCOS) and endometriosis can be genetic, but beyond specific problems, it's not a given that your mother's biology bears on your risk for infertility or miscarriage.

Don't be discouraged if your mom and dad had trouble, and don't get a false sense of security if she got pregnant right away. Talk with your mom about exactly what happened and discuss it with your gynecologist. If your parents don't know what the problem was—and they might not because testing in their era was far behind today's technology—then do what you can now to improve your odds later. If you have the choice, having children early is the most important factor.

Your lifestyle is totally under your control: Smoking, heavy drinking, obesity and being significantly underweight can all interfere with fertility. It's increasingly clear these habits affect the quality and function of sperm as well. Because your partner's behavior can keep you from getting pregnant, ask him to toe the line right along with you.

Melanie Acevedo

Unpleasant but true: We all have many types of bacteria in our mouth. It's normal. But for certain people, often because of diet or illness, their mouth is an environment ripe for the germs that yield bad breath. Let's talk illness first. Bad breath can signal serious conditions such as diabetes and kidney problems, although it's rare for halitosis to be the only sign. It can also be a side effect of medications, including some for acid reflux, allergies and depression; ask your M.D. if she thinks switching prescriptions would help.

If you and your mouth are in good health, it's time to look at your diet. The aroma of stinky foods like garlic can linger; and bits of sticky foods like bread and sugary treats can sneak into tiny crevices on your tongue, eventually rotting. On the other, healthier hand, crunchy veggies and fruit seem to help, both immediately—eating an apple after garlicky pizza—and over time. This may be because the high water content hydrates you, helping your mouth make cleansing saliva. I know, such a shocker for a doctor to recommend having more produce and fewer doughnuts. But you (and your pals who get close) will thank me.

Larsen & Talbert

I have visions of my teenaged daughters running out and getting full-body tattoos, so I want to say they're deadly, but they're not. Anesthesiologists may insert the epidural needle through an unaffected area of skin to be safe, but there's no evidence the ink can enter your bloodstream or spinal canal.

There have been reports of melanoma at tattoo sites, but no scientific data suggests a link between the two. More likely, the cancer developed coincidentally in the place where the tattoo was inked. That said, body art could hide skin changes from your dermatologist, so leave moles—and a little ring of skin around them—ink-free.

Pigments used for tattoos may contain metals, and I've been asked whether people experience burning or swelling at their tattoo site during magnetic resonance imaging, or an MRI. The answer: rarely. Apart from suffering from a case of buyer's remorse, the real risk lies in getting inked in the first place. You could contract infections such as HIV or hepatitis B or C from tattoo needles. Ask to see your tattooist's license (if your state requires one). Make sure she uses fresh tubes of ink, new gloves and single-use needles for each client. If you get any uneasy feelings, find a new tattoo parlor.

Anne Menke



Terry Doyle



Chris Craymer



Sang An




Stewart Shining



François Deconinck



Riccardo Tinelli

