The flu and the common cold can have very similar symptoms, but are caused by different viruses. Overall, the flu is much more severe than the cold, symptoms are more intense and they last longer.

Colds are the most common illness in the world, and there are over 200 different types of virus that can cause a cold, the most common being Rhinoviruses, in the nose. Once you have been exposed to the cold germs, symptoms usually appear within 1-5 days, usually beginning with a feeling of irritation in the throat. A cold will normally last 1 week.

The flu (short for influenza virus) is a viral disease of the respiratory tract, and is highly contagious. It usually begins abruptly, most often with a high fever. The other symptoms usually appear between the 2^nd or 3^rd day you started feeling sick, and last for about 4-7 days. The fatigue often lingers long after the illness has passed. The flu causes much more severe symptoms, and you feel pretty terrible for about 2 weeks.

Although some symptoms are the same, there are distinguishing characteristics of these illnesses.

The only way to catch a cold or flu is from other people through direct contact, or if someone coughs or sneezes. There is no cure for the cold or flu, so the best thing we can do is to prevent catching them in the first place. Be sure to wash your hands frequently, avoid direct contact with someone who is sick, cover your mouth and nose if you cough or sneeze, don't smoke (smokers get more colds than non-smokers), and dispose of tissues immediately after use.

If you end up getting sick, you can treat the symptoms, but be sure to get enough rest and drink plenty of fluids. Illnesses can linger if you don't allow your body rest and recover. Over the counter medications such as decongestants and pain relievers can help. There are also some prescription medications that can help shorten the duration so speak to your doctor if you think that you have been exposed to the flu virus.

If your symptoms last for a prolonged period and do not improve, your fever is over 102 degrees, you have difficulty breathing, severe lethargy or your vomiting or diarrhea have lasted more than 24 hours, you should see your doctor. The flu in the elderly can lead to more serious problems so they also need to be evaluated by their physician.

My joints have been feeling achy and stiff, especially first thing in the morning. It hurts when I get out of bed. My mother had arthritis, is it possible that I do too?

Arthritis is the most common and even disabling chronic condition in American women. If you have a family history of arthritis then your risk for developing any type of arthritis is fairly high. In addition, contrary to what many think, some types of arthritis can occur in younger women, even in their 20s and 30s. There are two main types of this disease: Osteoarthritis and Rheumatoid Arthritis.

Osteoarthritis occurs from a breakdown of joint cartilage, which protects the ends of your bones. The wearing away of this cartilage causes pain and stiffness when the bones rub against each other. It generally affects the major weight-bearing joints such as knees, hips, lower spine and ankles. The onset is usually sudden and very painful. Having a family history of arthritis, being overweight, or having experienced a major joint trauma from an accident increase your risk.

Rheumatoid Arthritis causes pain and swelling in the lining of the joints. With this disease, you will experience overall stiffness and aches throughout the body, usually involving the same joints on both sides of the body. It can be felt in the hands, wrists, feet, knees, ankles, shoulders, neck and jaw. There is no known cause for Rheumatoid Arthritis, although genetics, hormones and environmental factors are found to be significant factors in women who develop this disease.

Talk to your doctor. Diagnosis of arthritis is done through an examination of your family medical history, a physical exam, lab tests and even imaging tests such as x-rays. In some cases an arthroscope is inserted into the painful joint through a very small incision in the skin to examine any possible damage. Try to be as accurate as possible in describing your symptoms. You might want to answer these following questions in advance:

• Are you taking any medications?
• Where is the pain - in one or more joints?
• When does the pain occur and how long does it last?
• When did you first notice the pain and what were you doing at the time?
• Does physical activity make you feel better or worse?
• Have you had any major accidents or illnesses?
• Has anyone in your family ever suffered from arthritis?

The treatment for arthritis will depend on the severity of the symptoms, and the type of arthritis. Your doctor may suggest over the counter medications such as Tylenol, or prescribe other drugs to help alleviate your symptoms. Exercise is very beneficial in treating arthritis, and if you are overweight, then weight loss will significantly improve your condition. Some alternative therapies such as Acupuncture have proven to help some women lessen their pain. If you have Rheumatoid Arthritis, you may also be referred to a Rheumatologist for special medical management. As a last resort, some doctors refer a woman with severe arthritis to an orthopedic surgeon for joint replacement. As with any chronic condition, seeking psychological support and even a support group to help manage the emotional impact of this disease may also be beneficial.

"I am a survivor of childhood abuse. Even though I have made a conscious decision to not get involved with an abusive partner again, how do I know for sure that I won't repeat the past?"

What you have described is what psychologists define as "re-victimization". This is commonly seen in women who have experienced childhood abuse. Unless you have received treatment with a mental health professional to understand how your abuse has affected you, it is very hard to recognize abusive behavior. Oftentimes, when a woman has been physically abused, she will vow to never be with someone who hits her. Unfortunately what often happens is that she may be involved with a partner whose abuse is not necessarily physical, but emotional. It is easy to see the scars from physical abuse, but very difficult to see when a woman is being emotionally abused. Examples emotional abuse include:

• nothing you ever do is right, or good enough for your partner
• your partner always knows better than you
• your partner never says anything positive or gives you a compliment.
• your partner is overly critical never takes the blame
• you are not given any choices or control in your relationship
• your partner is constantly angry

If you feel that you are in an emotionally abusive relationship, try to get some professional help. If you are unable to see a therapist, try to keep your friends that are close to you aware of what you are feeling, so that they can help you balance much of the negativity you are experiencing in your relationship, They can help you remember that it is not your fault that your partner treats you this way.

I have been engaging in self-destructive behavior lately, drinking a lot, cutting myself and taking sleeping pills. I am concerned because it all revolves around a boy saying he doesn't want a relationship - what is wrong with me?

Self-Destructive behavior can take many forms and vary in severity. Examples include neglecting our bodies by not sleeping or eating enough as well as some more serious problems such as eating disorders, drinking, taking drugs, excessive body piercing and tattooing, and self-mutilation (such as cutting or burning yourself).

Self-mutilation or injury is not something people like to talk about, but it is a widespread problem that affects millions of Americans. Most people who injure themselves are not attempting suicide, but instead do so to cope with stress, because the pain helps to dull other emotional trauma. It can also be a cry for help. Oftentimes a recent rejection, or feeling inadequate will precipitate this behavior. In the example of this writer, her connection to this relationship is very strong, and the rejection is causing her to be self-destructive and injurious. In addition, it is often found that those who injure themselves commonly experienced an early childhood trauma such as physical or sexual abuse.

Those who self-injure need to develop better coping mechanisms, and in this writer's case, learn to deal with the loss of a relationship. It is important to find other things to do in place of the self-injurious behavior such as exercise, writing or spending time with a friend. Know that you are not alone, this is a common problem, but you must seek professional help to find ways to cope with your feelings, so that you do not continue to injure yourself.

“My boyfriend wants to leave me and it is all my fault. Please help me before it is too late.”

Many women feel that if they were only prettier, thinner or smarter things would be different for us. This stems from having a low self-esteem. Even Marilyn Monroe, a beautiful, successful actress didn’t even think she herself was pretty.

Here are some of the signs of low self-esteem:

• You walk with your head down
• You don’t make and/or sustain direct eye contact with others
• You do not accept compliments well and put yourself down
• You apologize and feel guilty
• You get frustrated, impatient or angry often
• You use negative hopeless language
• You are depressed
• You take things personally
• You do not engage with others
• You do not take risks

Please remember that it takes two to tango, and you are not alone in this relationship, so your partner has to take some responsibility as well. The ending of any relationship is never one person’s fault.

Some ways to help improve self-esteem include:

Challenge the negative message of your “inner critic”. When someone pays you a compliment, try not to discount it in your head.

Take care of your self –get enough sleep, exercise do things that you enjoy, and reward yourself for your accomplishments. Constantly remind yourself of your strengths and achievements.

Find support - I suggest you try to find a support group or possibly seek a therapist who can help you with your self-esteem, so that you can stop blaming yourself. If you need help finding someone, let us know and we will help you.

"I am a survivor of childhood abuse. Even though I have made a conscious decision to not get involved with an abusive partner again, how do I know for sure that I won't repeat the past?"

What you have described is what psychologists define as "re-victimization". This is commonly seen in women who have experienced childhood abuse. Unless you have received treatment with a mental health professional to understand how your abuse has affected you, it is very hard to recognize abusive behavior. Oftentimes, when a woman has been physically abused, she will vow to never be with someone who hits her. Unfortunately what often happens is that she may be involved with a partner whose abuse is not necessarily physical, but emotional. It is easy to see the scars from physical abuse, but very difficult to see when a woman is being emotionally abused. Examples emotional abuse include:

• nothing you ever do is right, or good enough for your partner
• your partner always knows better than you
• your partner never says anything positive or gives you a compliment.
• your partner is overly critical never takes the blame
• you are not given any choices or control in your relationship
• your partner is constantly angry

If you feel that you are in an emotionally abusive relationship, try to get some professional help. If you are unable to see a therapist, try to keep your friends that are close to you aware of what you are feeling, so that they can help you balance much of the negativity you are experiencing in your relationship, They can help you remember that it is not your fault that your partner treats you this way.

I have a very short fuse and I am getting angry over stupid things, and even yelling at my family a lot. I have been more stressed recently, but I don't know if this anger is normal. What should I do to keep it from escalating?

Anger is a completely normal human emotion, but when it gets out of control and turns destructive, it can lead to problems - problems at work, in your personal relationships, and in the overall quality of our lives. Anger can lead to full blown conflict, damaged relationships and even aggressive or violent acts.

Instead of reacting impulsively, train yourself to keep a lid on angry feelings until you have cooled down. Then, confront the situation - or person - calmly. When we are flooded with negative emotions, the ability to hear, think and speak is severely impaired. Taking a "time out" can be enormously constructive. You may want to try to use some of these techniques for coping with and diffusing anger:

Anger Management Tips

Become aware of what precipitates your anger.
Many people have identifiable triggers. Once you know the roots of your anger, you can deal with it more constructively.

Monitor the feelings and bodily sensations you experience when becoming angry.
Learn to use these sensations as cues to stop and consider what is happening and what to do about it.

Change the thoughts that trigger anger - interpret the situation from a different point of view.
Often this involves looking at the situation from the other person's perspective.

Write down angry thoughts.
Once you have them on paper, challenge and reappraise them.

Identify and express the feelings that precede anger.
Anger is quite often a secondary emotion, erupting in the wake of other feelings, like frustration, resentment, humiliation or fear. Try to become more aware of the underlying emotion.

Respond assertively.
The goal is not to suppress anger, but to express it in non-aggressive ways. Calmly and assertively stating your thoughts and feelings about a situation, without blaming or accusing is a far more powerful way to respond in conflict.

Relax.
One of the most helpful things you can do is engage in an activity that lowers blood pressure and heart rate, such as yoga, stretching, deep breathing, massage, or meditation. Activities that you enjoy such as gardening, running, walking, dancing, swimming or other forms of aerobic exercise may work off anger.

Relinquish your anger.
If angry feelings about a particular person or situation are eating at you and none of the above techniques proves helpful, try doing the most courageous thing of all: Just let it go. If the anger is based on some old wound deep inside, letting go begins the healing process.

If your anger escalates, or you feel that you cannot manage your anger, you should consider talking to a therapist.

I am a single, sexually active woman in my 30's. A friend of mine was recently diagnosed with the HPV virus, and I have heard it is very common. What should I do to protect myself?

The HPV (Human Papillomavirus) is one of the most common sexually transmitted diseases (STD) in the world. It is usually impossible to know without testing who has acquired it because most people don't realize that they have it. HPV is passed by direct skin contact during sex. The virus itself cannot harm you, but can result in warts that appear in the genital and anal areas of both men and women. More commonly, the only sign is an abnormal pap smear. Genital warts can be so small that you can hardly see them, or may appear flat and flesh-colored. They often occur in clusters or groups.

Your doctor can test for precancerous changes and HPV virus through a Pap test. He/she can also apply a vinegar-like solution to genital areas where there may be a problem. This solution causes the warts to turn white making them easier to see. In addition, your doctor may perform a colposcopy, which is a magnified visualization of the vagina and cervix. Tissue from the cervix is taken and viewed under a microscope to look for pre-cancerous changes.

Once you have the HPV infection, it never goes away. This means that if you have HPV, you need to be sure to get regular check-ups with your doctor. If you have HPV, it does put you at a higher risk of cervical cancer so it is important to have regular pelvic exams and Pap tests. There is no way to treat HPV itself, but your doctor will treat the effects of the virus through chemical creams, freezing, burning and/or laser removal.

The following will help reduce your risk of contracting HPV:

Practice Safe Sex. Mutual monogamy and abstinence are the best possibilities of prevention. Most sexually active people will get HPV. Condoms prevent many bacterial and viral infections, but if HPV is present on uncovered skin, transmission is possible.

Know the sexual history of your partner. Open communication between partners is crucial in preventing the spread of STD's, and testing is encouraged.

Do NOT douche. Douching will increase your risk of HPV and other infections because it removes normal protective bacteria of the vagina.

Do NOT smoke. Studies have found that smokers who have contracted HPV are more likely to have an outbreak of warts. Smoking compromises your immune system and makes you more susceptible to infections. A healthy immune system suppresses the virus. It is difficult to predict when HPV is no longer contagious. Experts disagree on whether the virus is eliminated or more likely, reduced to undetectable levels.

If you think that you might be at risk of contracting HPV or any other STD, seek medical attention. Research is currently being done to discover a vaccine for HPV, but your best weapon against HPV/STDs is to stay educated, informed, and see your doctor regularly.

I am 37 years old and am wondering about my risk of breast cancer. Should I be worried about it at my age?

This is breast cancer awareness month, so I am glad that you wrote to us with your question. Breast cancer is the second leading cause of death from cancer in women after lung cancer. If detected early-on, the chances that you will be cured are much higher. This is why regular exams with your physician, breast self-exam awareness and getting mammograms at the appropriate age is critical. The following are some risk factors for this disease, but keep in mind some women who have breast cancer do not have any risk factors at all.

• A first degree relative with breast cancer (mother, daughter or sister)
• A personal history of other cancers such as breast, uterine, ovary or colon
• Advanced age - as you get older your risk increases
• No pregnancies before the age of 30
• Early menstruation (younger than age 12)
• Late menopause (age 55 and older)
• Never having breastfed a child
• Postmenopausal obesity
• Alcohol intake
• Prolonged hormonal therapy.

Regular examinations with your physician, breast self-exam and mammography are the three ways that breast lumps are detected. Not all lumps are cancerous. If a lump is found, other tests may be performed to determine its seriousness. Many women have what are called fibrocystic changes in their breast. This condition is benign, and can cause the breast to feel lumpy, tender, swollen and itchy. In women who are fibrocystic, it can be difficult to see lumps in a mammogram, so you should get to know the characteristics of your own breasts through self-exam, and talk to your doctor about any changes immediately.

You should perform breast self-exam after your period every month. The exam includes looking and feeling the breast for any changes in size or shape, any dimpling, puckering or redness of the breast skin or any discharge form the nipples. If you are past menopause, establish a regular date each month to examine yourself. Some women use the telephone bill as a reminder. If you find any changes, tell your doctor right away.

All women should get a baseline mammogram between the ages of 35-40. After 40 one every 1-2 years, and after 50, every year. If you are high risk, your doctor may determine that you should have them more frequently. A mammography examines your breast tissue by X-ray and can find tiny lumps before they can be felt. Sometimes the test can be uncomfortable, and if you still have your period, you should try to get a mammogram in the week after your period when your breasts are less tender.

Regular check-ups, familiarizing yourself with your own breast through regular self-exams, and talking to your doctor about getting mammograms are the best ways that you can catch a problem early-on.

Recently I became sexually active and need to choose a method of birth control. What are my options and which is the most effective?

One of the most important considerations when choosing a method of birth control is to pick one that meets your needs. A method is effective only if you use it properly and regularly. Considerations include the number of sexual partners you have and future fertility plans. If you have multiple sex partners, then a barrier method is essential in combination with another form. The following is an outline of some of the methods available:

Methods of Birth Control:

Barrier Methods include spermicides, condoms (male and female), the diaphragm, the cervical cap. Combining a spermicide and a barrier method provides more protection. In addition to preventing pregnancy, condoms also decrease the likelihood of transmission of some but not all sexually transmitted diseases (such as HPV and genital warts).

The Intrauterine Device (IUD) is a small device that is inserted and left inside the uterus to prevent pregnancy. The IUD is a highly effective method of birth control, and can be left inside for up to ten years. It is contraindicated, however, in women with more than one life long partner, a history of any pelvic infections or a history of irregular bleeding.

Hormonal Contraception comes in many new forms such as injections, rings, patches and uninterupted pills for 3 months at a time. These forms prevent ovulation from ever taking place. Although relatively safe, there are some possible side effects and risks for each form, which you should discuss with your doctor. An injection of hormonal birth control provides protection for 3 months but may delay return of fertility. A vaginal ring is placed in the upper vagina and provides protection for 21 days. It is then removed for 7 days and a new one is inserted. The skin patch is replaced every week, for a total of 3 weeks after which one week is taken off for menstruation. This may not be good for very obese women.

Classic Low Dose Birth Control Pills prevent ovulation as well. You take the pill at the same time each day for 21 days, and then a "dummy" pill for 7 days while you menstruate. There are many health benefits associated with this method, and it is a good method for women who may want to get pregnant in the near future. There are some health risks, but for most women, the doctor will decide that the benefits far outweigh the risks of unwanted pregnancy.

Other options that do not involve a mechanical device or hormones include Natural Family Planning (abstaining from sex during a woman's fertile period) and Abstinence. Natural family planning can be effective, but a woman has to know her body very well.

Laparoscopic Sterilization (Using a laparoscope to access and cut the fallopian tubes) and Post-Partum Sterilization (a surgical procedure after childbirth where the fallopian tubes are destroyed to prevent pregnancy) are options for women who are absolutely certain that they do not want to have any more children.

You should talk with your doctor to discuss the health benefits and risks of each method to determine which method is best for you.

I am 37 years old and recently married. My husband and I want to have a baby but I know that it is harder because of my age, and there are more risks. Is there anything that I should do before trying to get pregnant?

First, congratulations on your marriage and decision to have a family. After age 30, a woman's fertility rate does decline. Even with fertility treatments such as in vitro fertilization, women have more difficulty getting pregnant as they get older. If you are trying to get pregnant, maintaining a healthy lifestyle through the following will help:

• Do not smoke
• Avoid alcohol and caffeine
• Try to eliminate excess body fat. Body fat levels that are 10-15% above normal levels can throw off a woman's reproductive cycle
• Avoid being underweight - this will also impact the regularity of a woman's menstrual cycle
• Eat a balanced diet, limiting processed and sugar-rich foods and avoid excessive salt intake
• Exercise regularly and get a sufficient amount of sleep

In addition to having possible difficulty conceiving, older women also have more trouble staying pregnant as the rates of miscarriage and ectopic pregnancy go up with age. As you get older, you are at a higher risk for chronic disease such as high blood pressure, diabetes and thyroid disease. Your risk of complications such as gestational diabetes and preeclampsia also rise.

If you are considering getting pregnant, you should choose a doctor who will meet the specific needs of your pregnancy. I would recommend that you find a doctor who will offer you Pre-conception counseling. In addition to some of the healthy lifestyle recommendations above, Pre-conception counseling also includes:

• A detailed medical and family history of both prospective parents
• Update of any necessary immunizations
• Base-line blood work to test for amenia, thyroid disease and sexually transmitted disease
• Pre-conception vitamins

You may also want to consider genetic counseling. This will help you understand your particular risks and help you decide whether to have genetic testing to screen for and/or detect chromosomal problems. You can manage many of the risks of pregnancy at 35 or older by seeing your doctor regularly for good prenatal care.

My doctor told me that my Pap smear came back "atypical". She said it was nothing to worry about and I should come back to repeat it, but it does worry me. What exactly does "atypical" mean?

Until very recently, a Pap smear (when your gynecologist takes a sample of cells from your cervix to look for cancer of the cervix) was deemed "normal" unless the cells were found to be significantly unusual. To improve the accuracy of the Pap test and catch problems earlier on, pathologists now categorize anything that is less than perfect as an "atypical" result.

During a Pap test the cells are checked for signs that they are changing. A Pap smear can actually show if your cells are going through a series of changes before they turn into cancer. Cervical pre-cancer is not life threatening if it is caught early, which is why regular pap smears are important.

The lowest and most benign level of abnormality is ASCUS or "Atypical Cells of Undetermined Significance". These changes can be caused by common, minor irritations to the cervix such as vaginal infections, intercourse, douches, spermidicdes, tampons, or diaphragms. In addition, at the end of your menstrual cycles, you may be shedding the sloughed off cells of the lining of the uterus, before you actually notice the start of your period. These can sometimes be picked up on a Pap test taken at the end of your cycle. In this case you will also be asked to repeat the test.

If your test comes back ASCUS again, your doctor may also want to perform a colposcopy. This is an instrument that magnifies the cervix to look for problem areas. While performing this test, a biopsy may be taken and testing for a virus called HPV will be taken. As covered in our previous column, HPV is the most common sexually transmitted disease that often goes undetected, and can put a woman at a greater risk of Cervical cancer.

Just remember that there are many possible causes of an abnormal Pap smear. Just be sure when you go in for your pap smear, not to douche or have intercourse 48 hours before the test. It is advisable never to douche, as this is a cause for bacterial infection. In the worse case scenario, ASCUS takes several years to progress to even pre-cancerous stages, so the time spent trying to find the cause of ASCUS makes little difference. It is important that all women age 18 and older or who are sexually active, undergo an annual pelvic exam and pap smear. Take care.