Why do I leak pee when I sneeze? And other women’s health questions answered

Q: Why did I start gaining weight around my middle instead of my hips or thighs?

Gaining weight around your waist instead of your hips or thighs is a common change most women face, usually as they age.

"Decreasing muscle mass, decreasing bone density and decreasing estrogen as we age can give our bodies the signal to increase fat around the middle," Bonde said. "The first things I recommend are exercising and eating healthier."

Bonde recommends adding 150 minutes of exercise per week, making it a mix of cardio and strength training. She also recommends an anti-inflammatory diet, such as the Mediterranean diet, with whole grains, a variety of fruits and vegetables, fish and minimal red meat.

Q: Can I get pregnant during my period?

Women can get pregnant when an egg is released (ovulation), and there's a sperm there to meet it. Ovulation typically happens mid-cycle, while your period occurs at the end of your cycle.

"It's not usually possible to get pregnant on your period, but nothing is zero percent risk," Bonde said. "In general no, but it's not 100 percent impossible."

When people have regular periods once a month, they usually have a cycle where they're ovulating at a different time than their period. For people who experience spotting or irregular periods, it's harder to tell whether they're at mid-cycle or the end of the cycle.

Q: Is 30 too old for the HPV vaccine?

No. The human papillomavirus (HPV) vaccine protects against the most dangerous strains of HPV, 16 and 18, the types that can cause cancer. People can get the vaccine until age 45. Pediatricians typically administer the vaccine to kids around age 11.

Q: Are there ways to boost fertility naturally?

One of the best ways to boost your fertility naturally is to optimize your overall health, Bonde said.

"If you weigh more than you should, work in exercising more and getting healthier so you can get to a healthier ratio of weight to height. I've seen people do that and get pregnant right away," she said. "If you have habits that you wouldn't want to continue if you were pregnant, like drinking alcohol or using a lot of marijuana or other drugs, those are also things you would want to decrease to boost fertility."

There are no supplements that are backed by scientific literature that increase fertility, Bonde said. But she recommends starting prenatal vitamins before trying to get pregnant because folic acid has been proven to reduce the risk of birth defects, which can develop in the first few weeks of pregnancy - often before someone knows they are pregnant.

Q: Why am I leaking pee when I sneeze, cough or laugh? And what can we do about it

If you leak pee when sneezing, coughing or laughing, that is called stress incontinence. It happens when support muscles are weakened by pregnancy, childbirth, aging and even obesity.

"It's common, but it's not normal and you shouldn't have to live with that," Bonde said.

She typically refers patients to physical therapy to help strengthen the muscles controlling the bladder and urethra.

"It's something we can treat with physical therapy or medication," she said. "And if that doesn't work surgery is an option."

Q: How bad should period cramps hurt?

"It's amazing to me how some people don't have cramps at all, and for other people it's excruciating," Bonde said. "If you have cramps that are so terrible that you're not able to go through your daily life - like missing school, you can't go to work, you can't do the things you enjoy - I would recommend seeing your provider to help get those cramps under control."

If over-the-counter pain medication, heat or rest don't help, talk to your doctor about your symptoms. There are several ways to treat severe period cramps, including hormonal birth control. Your doctor may also look for an underlying condition causing the pain, such as uterine fibroids or endometriosis.

Q: Is it normal to bleed or feel pain during ovulation?

When you feel pain mid-cycle, around the time of ovulation - when your body releases an egg - it's called mittelschmerz. Not everyone feels it, Bonde said, but it's normal. Light bleeding or spotting is also normal. It can happen when estrogen levels temporarily dip right before an egg is released.

"It usually lasts for a few hours, or even on and off for a day or two," she said. "You can always use over-the-counter pain medicine if needed, but many people say it's an annoying pain that happens and then it goes away."

Q: It looks like my breasts aren't the same size, is something wrong?

"Symmetry is a factor in human beauty, it's an ideal we see in photographs and sculptures, but it's not always reality," Bonde said. We might find that one foot is a little bigger than the other. You might see a difference in your hands. It's the same with your breasts, too. And that's OK, it's just a normal part of being human."

"Some women have two different cup sizes, and that's OK too," she said. "It doesn't mean that there's anything wrong."

Q: Are there ways to prepare for hormonal changes?

When we're young, we're told that our bodies will hit puberty and will change. But we're not told that our bodies are always changing throughout our lives, Bonde said.

"The best way to prepare for hormonal changes is to know that they're going to happen," Bonde said. "Try to keep your body as healthy as possible, not just [through] exercise and nutrition but also not consuming a lot of alcohol or drugs. Have a rich social life and get enough sleep."