True or false? Medical old wives' tales exposed

Dr. Judith Reichman 'Today' show contributor • Profile • E-mail

We’ve all been influenced and even rely on certain “well known” medical facts. But often they come from less than certain, reliable or up-to-date sources. New information allows us to dispute many of these dictums, and as they become history, they have been given the dubious moniker of old wives’ tales. We should, of course, object to using a gender put-down, even if it is intended to discredit medical inaccuracies. (Are men not as likely as women to base their behavior on antiquated information; are there no old husbands out there?) In any case, medical contributor Dr. Judith Reichman was invited on the “Today” show to address some of our widely held medical beliefs.  Are they true or should they be relegated to health mythology?

I can’t get pregnant during my period.
False. Sperm can live in the cervix for up to a week. And the presence of blood makes no difference. You generally ovulate 14 days before your next period. So if you have a 28-day cycle, you ovulate on day 14. If your periods last seven or eight days and you have intercourse toward the end of your period, you may have less than a week before ovulation and, voila, sperm can wait in the cervix, meet an egg a week later and fertilize it.

The only time you can be relatively certain that you won’t conceive is if you have intercourse a few days after you ovulate, possibly up to the time that you get your period.

My mom had a late menopause, (in her mid-50s) so I expect to have the same.
Possibly true. The timing of menopause is dependent on the number of follicles or primitive eggs in your ovaries at time of birth and the subsequent quantity that remain once you hit puberty (this usually declines from about 1 million at birth to 400,000 at puberty.)  During your next three reproductive decades, thousands of these follicles continue to die each month come rain, shine, ovulation or pregnancy. 

There are factors that can potentially “kill off” the eggs at a faster rate, such as infection in childhood or smoking.  But in the absence of these insults, the number of eggs present in your ovaries may be quite similar to the number that your mother had. And if she had a late menopause, ergo, ovaries with initial follicular “superiority,” she may have passed that feature to you so that you have the capacity of producing estrogen (and will continue your periods) beyond 51, the average age of menopause.

I should take all my calcium just before I go to sleep.
False. You can’t absorb more than 500 or 600 milligrams of calcium at a time. Most women should be getting 1000 to 1200 milligrams of calcium a day through their food (mostly dairy products) and/or supplements. If you do use a calcium supplement that is composed of calcium carbonate, you should take it with meals for better absorption.

If you use a supplement that is made of calcium citrate, it does not have to be taken with food.  But once more, any calcium should be taken in divided doses.  If you try to cheat and take it all at once, your body simply does not let it get through your intestines and into your system. And remember to look at the back of your calcium pill bottle in order to know how many pills you have to ingest in order to get that 500 or 600 milligrams.

I need to go off birth control pills for at least three months before I try to get pregnant.
False. You don’t need a “wash-out” period before you attempt to conceive.  The hormones in birth control pills do not remain in your system for longer than 24 to 48 hours.  Remember, when you stop the pill each month, you get your period within several days.  That’s because the hormone level the pill is giving your body drops, which no longer keeps the lining of the uterus built up, so it sloughs, creating your period.

Moreover, if you miss a pill for several days, you can ovulate (it only works to suppress ovulation as long as a critical amount is in your system). There’s no need to stay off the pill to “clear your body” when you use it for years of contraception or in anticipation of trying to get pregnant. Many years ago doctors were concerned that it might be more difficult to calculate the date of conception if a woman conceived directly upon stopping her birth control pills.  That’s certainly not a concern today; ultrasound can “pinpoint” gestational age with great accuracy.

Moreover, studies have shown that women who get pregnant within the first month of stopping the pill have no higher rate of miscarriage, malformation, or pregnancy problems than those who wait several months to conceive.

My doctor should do a Pap smear during my annual physical exam.
True if you’re between the ages of 21 and 30.  False if you are over the age of 30, have had three consecutive normal Pap smears, are in a mutually monogamous relationship, don’t smoke and have never had cervical cancer.  If HPV (human papilloma virus) is checked and this too is negative, you can wait three years between Pap smears if the above apply.

If you’ve had a hysterectomy with removal of the cervix and this was not done for cancer, you don’t need a Pap smear at all, nor do you need one after the age of 70 if you’ve had normal Pap smears for the last decade.

I need to take folic acid once I’m pregnant.
True but that may be too late.  In order for folic acid to help prevent neural tube defects (such as spina bifida) you have to be taking it before you conceive. Once your period is late, the neural tube and spinal tissue of the fetus has been formed, and starting folic acid at that point will not make a difference.

Most doctors recommend 1 milligram of folic acid prenatally (before pregnancy). Some studies have shown that 4 to 5 milligrams may be more effective, especially if a woman has had a previous pregnancy in which the fetus or baby had a neural tube defect.

If I’m itchy “down there” it’s probably a yeast infection.
Not necessarily.  The most common form of vaginal infection may be bacteria that does not like oxygen (called non-specific bacterial vaginosis). This can cause irritation and an itchy feeling.  However, if you have taken antibiotics, or are on some form of estrogen, including birth control pills, or have a history of recurrent yeast infections and recognize the symptoms, the chances are excellent that this indeed is a yeast infection. Trying over the counter anti-yeast medication is warranted, and if it works, great.  If not, see your doctor.

Breakfast is my most important meal of the day.
True. There are studies that show that individuals who do not have breakfast develop low blood sugar (hypoglycemia) during those 16 or more hours between dinner and lunch. Once food is ingested, insulin levels shoot up and then vacillate.  This can lead to increased hunger later in the day as well as deposition of fat in the abdomen. Non breakfasting individuals are more likely to become obese, and to develop heart disease. They also have higher and earlier rates of mortality!

Moreover, breakfast is a time that you can get important nutrients into your diet — fiber; milk products that supply calcium; fruit (orange juice, strawberries, or even raisins); and protein (soy products and eggs). Those with cholesterol problems might want to consider egg whites. And note that I have not included bacon as an important nutrient.

A good moisturizer will prevent wrinkles.
False. A moisturizer will make wrinkles less noticeable, which is different from preventing their development.  Moisturizer protects loss of water from the skin to the air (think of your body as a radiator that loses heat and moisture). Cracks and crevices in the skin seem deeper when they are not filled out with fluid. The formation of these cracks and crevices occur as a result of sun exposure and age, not simple water loss. 

If you want your skin to stay younger and less creased, stay out of the sun as much as possible, and use sunblock daily. Talk to your doctor about prescription creams and ointments that have been shown to decrease wrinkle formation and even help with fine lines. (Less than prescription doses of some of these medications have been put in over-the-counter creams that include moisturizer.) Please note, all those ads that tout the miracles of cosmetic creams and lotions state that they decrease “the appearance” of fine lines and wrinkles.

My daughter doesn’t need to see a gynecologist until she’s sexually active (hopefully after she is 21).
False. She doesn’t need a Pap smear until she’s been sexually active for three years (that’s how long it takes HPV to cause pre-cancerous cells in the cervix.) However, a visit to a gynecologist or a female health care practitioner is recommended by the American College of Obstetricians and Gynecologists as early as age 15 or 16. A pelvic exam may not be necessary but it’s important to discuss the potential for contracting sexually transmitted diseases and, if the young woman is sexually active, to test for these diseases. She should also discuss her menstrual cycles; if they are very irregular, heavy or painful, appropriate pelvic exams (or ultrasounds) and blood tests should be done.

I often suggest that mothers give their daughters a doctor’s name and make sure they understand that it’s perfectly okay to go see a gynecologist if they have concerns about contraception, STDs or just want to discuss what they can or should do in the future if they become sexually active.


These are just a few of the young and old wives’ and husbands’ tales that I encounter in my gynecologic practice. There are many more. Remember, even if you have heard a “medical fact” from your mother or friends or remember that you read it somewhere ... it’s best to discuss it with your doctor.

Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of HarperCollins.

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