Women

It's a strange phenomenon: We fib about our behavior to the exact people who could help steer us in a better direction. Read on to hear why-and how-you should always fess up.

In theory, your doctor's office is a safe place to lay it all out there: your health triumphs, your health lapses, your nagging health concerns. But many women omit details, twist facts, or blatantly lie when being grilled by an M.D. Big mistake. With- holding the truth can be dangerous, if not deadly. "And your doctor can't help you if she doesn't have all the info," says women's-health expert Jennifer Ashton, M.D. Guilty of any of these little white-gown lies? It's time to come clean.

1.    Your doctor asks: "How are you doing?"

You say: "Good! Fine! Everything's just fine"

The reality: You've been feeling sad for a while.

The fib risk: High. The longer you let depression symptoms linger, the more likely you are to self-medicate with alcohol or drugs, or to isolate yourself from friends and family. Don't suffer in silence: "Try to say exactly what you're thinking and experiencing, even if you don't have the right words," says clinical psychologist Sari Shepphird, Ph.D. "Or if you're too nervous, just say that. Your doctor can take it from there."

"Good! Fine! Everything's just fine"

Remember, just because you feel blue doesn't mean you are clinically depressed or will surely be prescribed meds (nearly 25 percent of people hide their symptoms for fear of being put on an antidepressant). Hormonal imbalances can also cause emotional upset. Give your physician the chance to get to the root of your mood and recommend a course of action that you're comfortable with.

2.    Your doctor asks: "Do you smoke?"

You say: "Not really. Maybe every once in a while."

The reality: You puff at least once a day, or sometimes several times a week.

The fib risk: High. OK, so you don't feel like hearing another lecture, but just one social cig exposes your body to a cock- tail of carcinogens. Frequent smoking raises your risk for certain cancers (lung, breast, cervical), so your doctor might want to start screening for them early or more often, says Lynn Westphal, M.D., director of women's health at Stanford University. Smoking can also raise your blood-clot risk if you're on the Pill, so your physician might switch you to another form of birth control and explain how cigarettes affect fertility.

You puff at least once a day, or sometimes several times a week.

You puff at least once a day, or sometimes several times a week.

Always be straight about how often you light up, and your doctor can work with you to devise a solid quitting plan. It's well worth any shame: Women who stop smoking cut their premature death rate by more than half.

3.    Your doctor asks: "What's new in your life?"

You say: "Not much. Same old, same old."

The reality: You were recently laid off or passed over for a big promotion, or you're just working around the clock.

The fib risk: Moderate. Because the average working woman spends a third of her time at work, her job health has a direct effect on her medical health. A little professional stress is totally normal; an upheaval at (or exit from) the office, however, is something your doctor needs to know about.

You were recently laid off or passed over for a big promotion, or you're just working around the clock.

You were recently laid off or passed over for a big promotion, or you're just working around the clock.

"Many people don't know that work-related stress is the root cause of a lot of health problems," says Shepphird. For example, unemployment has been linked to heart disease, and extreme stress can make you 69 percent more likely to misuse birth control, leaving you vulnerable to unplanned pregnancies or STDs.

When your physician asks "What's new?" be sure to touch on what's happening at work (as in: it feels like you're under tremendous pressure on the job). She can decide what's relevant.

4.    Your doctor asks: "How often do you drink?"

You say: "Socially, and only on weekends"

The reality: Well...and at a handful of happy hours each week.

The fib risk: High. Most women grossly understate how much they imbibe, often more than even they realize: "Thanks to oversize glasses and generous pours, two drinks may really contain the alcohol equivalent of four drinks," says Ashton. "And four drinks in one night is considered binge drinking."

Well...and at a handful of happy hours each week.

Well...and at a handful of happy hours each week.

Regularly guzzling more than seven drinks a week can lead to sleep disruption, weight gain, or even breast cancer, so it's imperative to do the math. Don't fall back on the vague "socially" answer or downplay your boozing for fear of being tsk-tsked; use your datebook as a guide, and clue in your doctor so she can check you for booze-related issues.

5.    Your doctor asks: "Is your knee still bothering you?"

You say: "It's all right. I take OTC meds a few times a week"

The reality: You're popping 'em like candy so you can get through your workouts.

The fib risk: Moderate. Overuse of pain pills can cause stomach irritation or ulcers. Perhaps more important, though, is that the meds maybe masking a worsening problem (that knee pain, for example, could morph into a stress fracture), says orthopedic surgeon Sabrina Strickland, M.D., of the Hospital for Special Surgery in New York City.

Women often lie about how much they exercise when injured, she says, for fear of being told they can't hit the gym. But it's important to describe your precise fitness routine and type of pain. Sure, being up-front might result in some physical therapy, but that sure beats stomach trauma or eventual surgery- two things your M.D. wants to help you avoid.

6.    Your doctor asks: "How's your sex life?"

You say: "Umm...it's OK."

The reality: Nooky kinda hurts, but only sometimes. And you'd rather chew off your arm than go into the ultra-intimate details.

The fib risk: Moderate. Up to 75 percent of women experience painful sex at some point. Typically, it indicates a fixable issue (vaginal dryness, a yeast infection). In some cases, though, it can point to more serious concerns such as endometriosis or ovarian cysts, so speak up before your feet are in the stirrups. Feel free to start with, "This is awkward, but..." Keep in mind that there's very little that can shock or embarrass a doctor. "Blood, fluids... we've seen and heard everything," says Ashton.

And you'd rather chew off your arm than go into the ultra-intimate details.

And you'd rather chew off your arm than go into the ultra-intimate details.

7.    Your doctor asks: "What medications are you on?"

You say: "None." Or: "Just birth control."

The reality: You're a supplement champ, taking vitamin D, fish oil, probiotics, and, oh yeah, St.-John's-wort.

The fib risk: Moderate. They maybe all-natural, but health supplements can be very powerful drugs, says Leslie Mendoza Temple, M.D., of the Integrative Medicine Program at North Shore University Health System in Illinois. Certain ones might interact with prescription medications (e.g., St.-John's-Wort can interfere with birth control) or can be harmful in high amounts (excessive fish oil can cause skin bruising or bleeding after surgery).

To make sure you don't overlook anything, bring along the actual bottles of each supplement you're taking to show your M.D. "People sometimes fear their conventional doctors will ridicule alternative therapies," says Temple. If yours laughs at them, find a new doctor.

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