Marnie Lahtinen
A patient proactively acquaints herself with new options in women's healthcare. (Marnie Lahtinen)

Dr. Shannon Bradley, OB-GYN, visits with a patient regarding her healthcare options at Mid Dakota Clinic in Bismarck. (Marnie Lahtinen)

Call it female intuition. A sixth sense, even. Women are generally (generally, gentlemen) the first to notice if a child is unwell, a spouse is stressed or an aging parent is suffering memory loss. Across time, cultures and generations, caregiving seems encoded in the female DNA.

And yet -- all this looking outward may actually prevent women from looking in. Forgot to schedule your daughter's sports physical? What about the BRCA genetic testing you've been postponing? The dog needs a booster at the vet? Have you talked with your healthcare provider regarding the dryness and discomfort you are experiencing, well, down there? And what about your questions about flibanserin, the "female Viagra" the FDA recently approved?

Perhaps it's not procrastination. Maybe it feels taboo to talk about. Maybe it's just not knowing that you have options. But here's the thing: There are options. Many.

The last ten years have seen a plethora of medical and surgical advancements for women, young and old. With the advent of social media, more and more women are discovering that they have alternatives to "standard" care, and they are getting more and more involved in those choices.

"There are many new, cutting-edge treatments that can benefit a woman's quality of life," says Dr. Shannon Bradley, OB-GYN at Mid Dakota Clinic in Bismarck. "Our gender has suffered in silence assuming that menopausal changes are 'how things have to be,' and that's just not the case anymore."

Approximately 64 million American women are postmenopausal, and close to 50 percent suffer from symptoms of menopause, such as increased anxiety, hot flashes or pain during intercourse due to vaginal dryness and atrophy. The vaginal laser therapy MonaLisa Touch, which received FDA clearance last year, is an in-office procedure that requires no anesthesia and is practically painless. Patients undergo three treatments -- five minutes each, spaced six weeks apart -- to treat vaginal atrophy, vaginal pain and urinary issues associated with menopause.

"Vaginal atrophy is traditionally treated with estrogen therapy, but many patients are not candidates for estrogen therapy or just don't want to use the messy, expensive, life-long estrogen creams," explains Bradley. "After years of practicing medicine, it's significant to finally have a procedure that's nearly 100 percent effective, but is non-invasive, painless and not time consuming.

It's always a good thing when patients have more choices."

Another choice women can make is one that allows them to assess their risk for breast cancer, which the American Cancer Society lists as the second leading cause of cancer death among American women (after lung cancer). A BRCA gene test can analyze DNA to identify inherited, harmful mutations in two breast cancer susceptibility genes: BRCA 1 and BRCA 2. While everyone has BRCA genes, women who have inherited mutations in these genes are at an increased risk for developing breast or ovarian cancer; about 50 percent of women with a genetic mutation will develop cancer, according to the Centers for Disease Control.

The BRCA gene test should be offered to women who, based on personal or family history, are likely to have an inherited mutation.

"Finding out you have a cancer gene is literally like winning a medical lottery ticket (because) with the information ... physicians can save and prolong life by minimizing cancer risk," says Dr. Rhonda Schafer-McLean, an OB-GYN with a special interest in genetic medicine at Mid Dakota Clinic. She adds emphatically: "Get tested!"

Healthcare professionals want patients to understand that although women's health issues run deep, options do, too. "Sometimes getting the discussion going takes a simple question, like 'Are your periods affecting your quality of life?'" explains Bradley.

Women who suffer from heavy, painful or irregular menstrual bleeding often believe that their only options are hormones or hysterectomy. But there is an alternative surgical approach. The NovaSure Endometrial Ablation is an in-office procedure that attempts to burn the lining of the uterus, thereby decreasing or even eliminating menstrual blood loss. Patients are in and out of the office quickly, with typically just one day of recovery. For many, the results are life changing.

Sexual health -- more specifically, dysfunction -- has been exam room talk since the advent of that little blue pill, Viagra. And until recently, those conversations have focused on men.

Addyi (flibanserin) is the recent FDA approved medication for pre-menopausal women with decreased sexual desire. Also now available is the O-shot, which uses the patient's own platelet-rich plasma to attempt to achieve an increased sexual response, Bradley explains.

"What is exciting -- and overdue -- are the new options for women in regards to sexual health," says Bradley.

Be proactive. Learn more at under obstetrics and gynecology.

Marnie Lahtinen is the mother of five children and a Mandan-based freelance writer. In addition to her family, she loves travel, hiking, skiing, food, knitting, red wine and music.