Menstruation, or a period, is a woman's monthly bleeding. Abnormal vaginal bleeding is different from normal menstrual periods. It could be bleeding that is between periods, is very heavy, or lasts much longer than usual. It also includes bleeding that happens before puberty or after menopause. Causes can include:

• Uterine fibroids or polyps
• Hormone problems
• Hormone pills, such as birth control pills and hormone therapy for menopause
• Cancer of the cervix, ovaries, uterus or vagina
• Thyroid problems

Bleeding during pregnancy can have several different causes. It is not always serious, but to be safe you should contact your health care provider right away.

Pelvic exams, blood tests, imaging tests, and other procedures can help your health care provider diagnose the problem. Treatment depends on the cause. Treatments may include medicines, hormones, and surgery.

Viruses are very tiny germs. They are made of genetic material (either DNA or RNA) inside of a protein coating. There are a huge number of viruses on earth. Only a small number of them can infect humans. Those viruses can infect our cells, which may cause disease. Some of the diseases that viruses can cause include the common cold, the flu, COVID-19, and HIV.

Viruses can be spread in different ways:

• Through droplets and particles that are breathed out by someone who has the infection. You might breathe in the droplets or particles, or they could land on your mouth, nose, or eyes.
• By touching surfaces or objects that have the virus on them and then touching your mouth, nose, or eyes.
• From the pregnant parent to the baby during pregnancy.
• Through contaminated food or water.
• By being bitten by an infected insect or animal.
• Through sexual contact (usually vaginal, anal and oral sex) with someone who has the infection.

Viruses are like hijackers. They invade living, normal cells. They then use those cells to multiply (make copies of themselves). This process is also called replication. The process can kill, damage, or change the infected cells. Sometimes this can make you sick. The symptoms can range from mild to very severe. Other times, your immune system may be able to fight it off and you may not have any symptoms.

Each different virus usually only infects one type of cell in your body. For example, hepatitis viruses affect the cells in the liver. HIV infects a certain type of immune system cell.

For most viral infections, treatments can only help with symptoms while you wait for your immune system to fight off the virus. There are antiviral medicines to treat some viral infections. Antibiotics do not work for viral infections.

Vaccines can help prevent you from getting many viral diseases. You may be able to prevent some viral infections by:

• Proper hand washing.
• Paying attention to food safety.
• Cleaning surfaces that may be infected with germs.
• Avoiding contact with wild animals.
• Preventing insect bites by using insect repellent when you go outdoors. If you travel to an area that has a high risk of diseases from insect bites, also wear long pants, shirts, and socks.
• Practicing safe sex (using a condom every time you have anal, vaginal, or oral sex).
• Avoiding close contact with people who are sick.

Vitamin D deficiency means that your body is not getting enough vitamin D to stay healthy.

Vitamin D helps your body absorb calcium. Calcium is one of the main building blocks of bone. Vitamin D also has a role in your nervous, muscle, and immune systems.

You can get vitamin D in three ways: through your skin, from your diet, and from supplements. Your body forms vitamin D naturally after exposure to sunlight. But too much sun exposure can lead to skin aging and skin cancer, so many people try to get their vitamin D from other sources.

The amount of vitamin D you need each day depends on your age. The recommended amounts, in international units (IU), are:

• Birth to 12 months: 400 IU
• Children 1-13 years: 600 IU
• Teens 14-18 years: 600 IU
• Adults 19-70 years: 600 IU
• Adults 71 years and older: 800 IU
• Pregnant and breastfeeding women: 600 IU

People at high risk of vitamin D deficiency may need more. Check with your health care provider about how much you need.

You can become deficient in vitamin D for different reasons:

• You don't get enough vitamin D in your diet
• You don't absorb enough vitamin D from food (a malabsorption problem)
• You don't get enough exposure to sunlight
• Your liver or kidneys cannot convert vitamin D to its active form in the body
• You take medicines that interfere with your body's ability to convert or absorb vitamin D

Some people are at higher risk of vitamin D deficiency:

• Breastfed infants, because human milk is a poor source of vitamin D. If you are breastfeeding, give your infant a supplement of 400 IU of vitamin D every day.
• Older adults, because your skin doesn't make vitamin D when exposed to sunlight as efficiently as when you were young, and your kidneys are less able to convert vitamin D to its active form.
• People with dark skin, which has less ability to produce vitamin D from the sun.
• People with conditions that make it difficult to absorb nutrients from food, such as Crohn's disease, ulcerative colitis, and celiac disease.
• People who have obesity, because their body fat binds to some vitamin D and prevents it from getting into the blood.
• People who have had gastric bypass surgery, a type of weight loss surgery which creates a bypass of part of the small intestine. Since vitamin D is absorbed there, bypassing part of it makes it harder to absorb enough vitamin D.
• People with chronic kidney or liver disease, which can affect your ability to change vitamin D into a form your body can use.
• People who take medicines that affect vitamin D levels, including certain cholesterol, anti-seizure, steroid, and weight-loss medicines.

Talk with your provider if you are at risk for vitamin D deficiency. There is a blood test that can measure how much vitamin D is in your body.

Vitamin D deficiency can lead to a loss of bone density, which can contribute to osteoporosis and fractures (broken bones).

Severe vitamin D deficiency can also lead to other diseases:

• In children, it can cause rickets. Rickets is a rare disease that causes the bones to become soft and bend. African American infants and children are at higher risk of getting rickets.
• In adults, severe vitamin D deficiency leads to osteomalacia. Osteomalacia causes weak bones, bone pain, and muscle weakness.

There are a few foods that naturally have some vitamin D:

• Fatty fish such as salmon, tuna, and mackerel
• Beef liver
• Cheese
• Mushrooms
• Egg yolks

You can also get vitamin D from fortified foods. You can check the food labels to find out whether a food has vitamin D. Foods that often have added vitamin D include:

• Milk
• Breakfast cereals
• Orange juice
• Other dairy products, such as yogurt
• Soy drinks

Vitamin D is in many multivitamins. There are also vitamin D supplements, both in pills and in a liquid for babies.

If you have vitamin D deficiency, the treatment is with supplements. Check with your provider about how much you need to take, how often you need to take it, and how long you need to take it.

Getting too much vitamin D (known as vitamin D toxicity) can be harmful. Signs of toxicity include nausea and vomiting, poor appetite, constipation, weakness, and weight loss.

Very high levels of vitamin D can damage the kidneys. It also raises the level of calcium in your blood. High levels of blood calcium (hypercalcemia) can cause confusion, kidney failure, and irregular heartbeat (arrhythmia).

Most cases of vitamin D toxicity happen when someone overuses vitamin D supplements. You cannot get too much vitamin D from sun exposure because the skin limits the amount of vitamin D it makes.

Voice is the sound made by air passing from your lungs through your larynx, or voice box. In your larynx are your vocal cords, two bands of muscle that vibrate to make sound. For most of us, our voices play a big part in who we are, what we do, and how we communicate. Like fingerprints, each person's voice is unique.

Many things we do can injure our vocal cords. Talking too much, screaming, constantly clearing your throat, or smoking can make you hoarse. They can also lead to problems such as nodules, polyps, and sores on the vocal cords. Other causes of voice disorders include infections, upward movement of stomach acids into the throat, growths due to a virus, cancer, and diseases that paralyze the vocal cords.

Signs that your voice isn't healthy include:

• Your voice has become hoarse or raspy
• You've lost the ability to hit some high notes when singing
• Your voice suddenly sounds deeper
• Your throat often feels raw, achy, or strained
• It's become an effort to talk

Treatment for voice disorders varies depending on the cause. Most voice problems can be successfully treated when diagnosed early.

NIH: National Institute on Deafness and Other Communication Disorders

The vulva is the external part of a woman's genitals. Some problems you can have with the vulvar area include:

• Vaginitis or vulvovaginitis, swelling or infection of the vulva and vagina
• Skin problems due to allergy
• Vulvar cancer
• Vulvodynia, or vulvar pain

Symptoms may include redness, itching, pain, or cracks in the skin. Treatment depends on the cause.