Published on December 03, 2018

Ask Dr. Ancy

When it comes to questions about feeling good, looking great and leading a fit lifestyle, Dr. Ancy is just what the doctor ordered for women of all ages. Dr. Ancy doesn't just know about healthy living - she's also a great example of it. "I love running, cooking and Pilates. I keep my mind active by reading and learning about a wide variety of topics ranging from skincare to science to art."

Dr. Ancy provides valuable guidance to Club W members. However, please be aware that she can't diagnose or provide specific advice for specific medical questions.


How do you keep your skin, hair and nails healthy?


Is chronic bad breath the sign of a serious health problem?



How do I Create a Good Work-Life Balance?



Are My Periods Normal?



What are your secrets to creating a good work-life balance?


Every busy woman can use help with creating a good work-life balance. Ancy Maruthanal, MD, is the medical director of Club W, North Kansas City Hospital’s women’s affinity program. She’s also an internal medicine physician with Meritas Health North Kansas City. Dr. Ancy shares how she balances her medical practice, marriage and motherhood. She offers advice in this video.


My friends swear by products like Cold-EEZE® and Zicam®. Are they safe and effective?


Research data to date doesn’t 100% support the effectiveness of these over-the-counter cold remedies. That said, there’s no harm in trying them. If you feel good after taking Zicam, great! However, following the doctor-recommended standard of care is just as beneficial, not to mention cheaper. That means:

  • Drinking plenty of fluids
  • Getting extra rest
  • Boosting your vitamin C intake by either eating/drinking citrus or taking a vitamin

The best way to keep from catching a cold is to wash your hands with soap and water often, or use an alcohol-based hand sanitizer. Remember, if you do get sick, stay home to avoid spreading germs. Hope everyone has a healthy and happy holiday season!


What is a UTI? How do I know if I have one, and how can I treat it?


UTI stands for urinary tract infection. It’s an infection of the urinary system, which includes the bladder and kidneys. Symptoms include: Burning sensation while urinating

  • Confusion (in older people)
  • Constant urge to urinate with little passage of urine
  • Fatigue
  • Fever
  • Foul-smelling urine
  • Frequent urination
  • Pain in the upper abdomen or back and sides (flank pain)

You may have all or only some of these symptoms. Or, you may not have any symptoms, just a general feeling that something’s not right.

Your doctor can very easily check with a urine analysis in either the office or a lab. If it’s a simple urinary tract infection, your doctor will prescribe oral antibiotics. More severe infections, such as one that travels to the kidneys, may require IV antibiotics.


What are macronutrients and should I be tracking them?


Macronutrients are the carbohydrates, proteins and fats in your diet. They provide your body with calories and energy. Being aware of your macronutrient intake instead of counting calories can help you balance your diet so you feel fuller longer, which helps with weight loss.

  • Carbohydratesfuel the body and provide energy for the central nervous system. Aim to get 40%-60% of your calories from carbs.
  • Protein helps maintain tissue structure and can boost your metabolism. Around 35%-40% of your caloric intake should come from protein.
  • The body stores fat as an energy reserve. Fat protects vital organs and transports fat-soluble vitamins (A, D, E, and K) through the body. About 20-25% of calories should come from fat.

Your activity level, age, weight and muscle mass factor into how much you need of each macronutrient. By eating a balanced diet with fruits, vegetables, whole grains and lean meats, your body will get the proper nutrients.

If you are concerned about your macronutrient intake, talk with your primary care doctor, who can refer you to one of our registered dietitians for outpatient nutrition counseling.


What do I need to know about shingles?


Shingles is a condition caused by the same varicella zoster virus that causes chickenpox. The main symptom is a raised rash with fluid-filled blisters. The rash appears in a band-like pattern on one side of the body, and it never crosses the midline of the body. You can get shingles on any body part, but it becomes a medical emergency if it affects in your eyes.

Shingles isn’t life threatening, but it can be extremely painful. It typically causes a burning, throbbing sensation, and the skin is sensitive to the touch. It’s not uncommon for the pain to start before the rash appears.

If you develop a rash like this, and you are in severe pain, call your doctor immediately because treatment is time sensitive. Antiviral medications are the best treatment, but if you miss the 48-hour window from symptom onset, the medicine may not be as effective.

The virus can spread to others when it’s in the blister stage, so try not to itch your skin, and wash your hands often. Lastly, try to avoid people who haven’t had chicken pox, who are pregnant, or who have a weakened immune system.

The good news is that shingles is vaccine-preventable. (See our Feel Great article this month!) The Centers for Disease Control and Prevention recommend that people age 50 or older get vaccinated.


How can I prevent and/or treat stretch marks during pregnancy?


I did a lot of research on stretch marks when I was pregnant with my first baby. Genetics play a part. If your mom had stretch marks, you’re likely to have them. If you had stretch marks during puberty, you’re likely to get them during pregnancy.

The bottom line is, there’s nothing that 100% prevents stretch marks. Cocoa butter lotion and other moisturizers help with the itching that can occur with stretching skin, but they aren’t guaranteed to prevent the marks.

Staying hydrated, exercising and using a topical moisturizer throughout your pregnancy can help reduce the number of stretch marks. If you do get them, prescription retinoids and lasers may reduce the appearance. However, don't stress about a few stretch marks. Most women have them!


How do you keep your skin so healthy?


Thank you for the compliment! I follow a very simple beauty routine.

In the morning, I wash with a gentle cleanser. I prefer Cetaphil®. After washing my face, I apply toner and a moisturizer with SPF 35.

I remove my makeup every evening before going to bed. Sleeping in makeup is the worst thing you can do for your skin because your pores can’t breathe. I also apply moisturizer and a retinol-based cream. Skip the retinol cream if you’re pregnant.

Finally, the saying is true: You are what you eat. I drink a lot of water and eat tons of fruits and vegetables. Eating healthy also helps your hair and nails.


What’s the difference between an MD and a DO? Which one should I see?


Medical doctors (MDs) and doctors of osteopathic medicine (DOs) are highly trained to care for a wide range of health conditions. Which one you choose is a matter of personal preference.

All MDs and DOs:

  • Complete four years of medical school, plus additional residency training
  • Treat complex health conditions
  • Provide preventive care
  • Can practice in any medical specialty
  • Are fully licensed medical doctors

When choosing a primary care physician, do your research. Ask your friends and family members for recommendations, and check Healthgrades reviews. Ideally, you want to find a provider who can be your healthcare partner. You can also use our Find a Doctor search tool or call our referral line at 816.221.HEAL (4325).


I’m so confused about which tests and screenings I need and when. Help!


Annual screenings are such an important part of preventive health, but knowing what you need and when can be confusing. There are three primary gynecological-related screenings for women: Pap smear, HPV test and pelvic exam. Your primary care physician or a gynecologist can perform them.

Pap smear. The term refers to the actual sample of tissue taken from the cervix. The tissue is analyzed for signs of cervical changes or cancer. A woman typically starts getting a Pap smear around age 21. Current guidelines recommend that women ages 21-29 get one every three years.

HPV testing. HPV stands for human papillomavirus. HPV is the most common sexually transmitted infection. It’s typically harmless, and goes away on its own. However, some types can cause serious health problems, including genital warts and cancer. An HPV test checks for the virus and should start after age 29. At this point, it’s done every 3-5 years in conjunction with a Pap smear (also called co-testing). If your results come back abnormal, your doctor may order a biopsy or repeat testing in one year versus three years. If all of your Pap smears have been normal for at least 10 years, you can stop having Pap smears and HPV testing at age 65.

Pelvic exam. Your doctor can do a routine pelvic exam yearly to check for any dryness or skin changes. Good for you for being proactive about your health!


I keep hearing about premenstrual dysphoric disorder. What is it? How do I know if I have it?


PMDD is a more severe form of premenstrual syndrome. It occurs in the second part of the menstrual cycle and affects 3%-5% of menstruating women. Emotionally, you may feel angry, irritable and tense. Physically, you may feel bloated and extremely fatigued. Headaches and dizziness can also occur. The symptoms are similar to PMS, but they are severe enough to impact daily life.

A PMDD diagnosis is based on the timing of symptoms with the menstrual cycle. A woman must be symptom-free during the first half, or follicular phase, of her cycle. Tracking your symptoms on a daily basis and sharing that information with your doctor can help obtain an accurate diagnosis.

As the first line of treatment, I always recommend exercise and meditation. If this doesn't work selective serotonin reuptake inhibitors, or SSRIs, can be taken from Day 14 of your cycle, when symptoms start. Sometimes, oral contraceptive pills can help regulate symptoms. Your primary care physician or OB-GYN can help you determine which treatment option is best for you.


How do I know if my vagina is normal?


Q: Why do I have so much discharge?

A: The amount of vaginal discharge varies with a woman’s cycle. You only need to be concerned if the discharge is itchy, has very strong odor and/or has a greenish color. If you think something’s not right, make an appointment with your doctor for a pelvic exam.

Q: I have a yeast infection. Does my partner need to be treated?

A: No, a yeast infection is not a sexually transmitted infection. Partners do not need to be treated.

Q: I have a painful cyst on my vagina.

A: It could be an ingrown hair from shaving or waxing your pubic hair. Try putting a warm compress on the area. If you don’t see any improvement, or if the cyst is large, call your doctor. The cyst may need to be drained.

Q: Are my labia too big?

A: Labia size varies by individual woman. It’s nothing to worry about.

The bottom line? Be proud of your body. Love it. It is perfect.


Short, 15-minute workouts seems to be popular right now. Can I really workout for just 15 minutes and achieve my wellness and/or weight loss goals? What do you recommend?


I encourage my patients to follow the American Heart Association’s exercise guidelines, which suggest getting moderate exercise 30 minutes a day at least five days a week. Following that advice will give you the best results in terms of weight loss and overall health.

That said, exercising for 15 minutes a day is better than not exercising at all. It’s a great starting point from which you can work your way up to longer intervals. Walking, bicycling, swimming and playing sports are all good aerobic activities that will get your heart pumping.


I’m ready to start a family, but I’m overweight. Will my weight affect my pregnancy and my baby? What can I do now to help me have a healthy pregnancy?


Congratulations on making this big decision! It’s good that you’re thinking ahead. Being overweight puts you at a higher risk for developing gestational diabetes, preeclampsia, high blood pressure and other serious health conditions during pregnancy. It can also make delivery more difficult.

That’s not to say you can’t have a healthy pregnancy and delivery. But, ideally, you want to be at a healthy weight before you get pregnant. The first step is talking with your doctor about your plans, goals and options.

From personal experience, I found it beneficial to establish a regular exercise routine before getting pregnant. I exercised during my pregnancy and kept it up after I delivered, modifying the exercises as needed. Swimming and walking are great activities to do before, during and after pregnancy.

Lastly, when you do become pregnant, don’t fall for the old saying, “I’m eating for two.” Yes, your caloric intake will increase, but it doesn’t need to double.

Good luck!


I don’t want to be an overprotective mom, but I don’t want my new baby to catch a cold, the flu or another disease. What can I do?


It’s perfectly natural to want to protect your baby from germs and viruses. Your baby’s immune system won’t start developing on its own until about three months old. And, it takes about a full year for the immune system to grow strong. In the meantime, you’ll have to step in. Here’s what I recommend for keeping your baby, and the rest of your family, healthy this winter.

  • Get a flu shot. The Centers for Disease Control and Prevention recommends that everyone six months and older get the flu vaccine every season.
  • Keep sick visitors at bay. Everyone wants to meet the newest member of your family, but avoid bringing the baby and other family members in close contact with people who have a cold or the flu. Likewise, keep sick family members at home so they don’t put someone else at risk.
  • Stay hydrated. Make sure everyone in the family is drinking plenty of water, and that the baby is receiving proper nutrition.
  • Wash hands. Washing your hands frequently with warm soap and water is the best way to prevent the spread of germs. Help every member of your family remember how important it is, and ask visitors to wash before they cuddle with your new little one.

Remember, your pediatrician or primary care doctor is a great resource. Don’t hesitate to call with questions or concerns. If nothing’s wrong, you get peace of mind. If your baby is sick, treatment comes that much faster.


Why should I get a flu shot? Are there any natural ways to fight and/or treat the flu?


The best way to prevent the flu is the flu shot! I know this is a heated topic for people, but the flu can cause serious illness, hospitalization, and in rare cases, death.

The season can start as early as October and last until May. Even the healthiest people can get very sick. The vaccine, which becomes effective about two weeks after you get it, protects you against strains of the virus by producing antibodies that fight of the flu. It also reduces your risk of spreading it to others.

The best way to fight the flu is to stay hydrated and that means drinking plenty of water. Eating the following foods might also help you fight off symptoms:

  • Antioxidant-rich foods such as ginger, blueberries and turmeric
  • Foods filled with vitamin C
  • Fresh fruits and vegetables

Talk with your doctor before getting the flu shot if:

  • You have severe allergies or have had a life-threatening allergic reaction to a flu shot in the past.
  • You’ve ever had Guillain-Barré syndrome.
  • You’re not feeling well. It’s usually OK to get the flu vaccine if you have a mild illness, but you might be asked to come back when you’re feeling better.


I’m concerned about memory loss as I grow older. How can I keep my brain sharp?


Most of us can expect to experience some degree of memory loss, along with a slight change in other thinking skills, as we grow older. It’s normal, and doesn’t keep you from enjoying life.

To keep your brain sharp, it’s important to keep it active. Here are some ideas:

  • Eat healthier. Bake or grill foods, cook with heart healthy oils, eat your fruits and vegetables.
  • Find a hobby. If you don’t have one already, it’s never too late to start one. Having something to look forward to keeps the mind youthful.
  • Mix it up. If you’re right-handed, try using your left hand. Or, drive a different route to work.
  • Play mind games. Sudoku and crossword puzzles are excellent options.
  • Socialize. Make dinner dates or plan trips to parks and museums.
  • Stay active. Physical activity can help boost your memory.
  • Try turmeric. This spice has anti-inflammatory and pro-memory properties.

If you’re concerned about memory loss , your doctor can help diagnose any problem and recommend appropriate treatment.


I think I have adult ADHD. How do I know? What should I do?


When we hear the term attention deficit hyperactivity disorder, we tend to think of children. However, up to 70% of kids with ADHD still have symptoms as adults. The condition can also develop in adulthood, with most adults never realizing they have it. ADHD is difficult to diagnose because there are many overlapping symptoms, which may include:

  • Being easily distracted
  • Difficulty concentrating
  • Forgetfulness
  • Running late often
  • Trouble prioritizing, starting or finishing tasks

If you’re concerned you may have ADHD, start tracking your symptoms, including how often you have them and when. For example, do they tend to occur during high stress periods? Discuss the list and your concerns with your primary care physician, who can recommend next steps, which may include lab work and an evaluation by a psychiatrist and/or behavior specialist.


The smallest things irritate or anger me. How do I know if it’s just life/hormones/a phase or if I need professional help?


It’s not always easy to know what’s causing a change in your mood. If you’ve been feeling like this for more than two weeks every month, make an appointment with your primary care doctor, who can help you determine whether how you’re feeling is caused by physical or psychological factors.

Physical Causes

If the cause if physical, your doctor can work with you to develop a plan to address those needs.

Psychological Causes

Your doctor can screen for these condition and offer recommendations for treating them. Recommended treatment often includes counseling, meditation and exercise.

Remember, your doctor is your partner in health. Honesty truly is the best policy when talking with your doctor. Before your visit, write down questions, concerns or examples that you’d like to discuss. And, be prepared to take an active role in your treatment and healthcare decisions.


As I grow older, what do I need to do to keep fit but injury-free?


Here are a few tips to staying fit and injury-free:

  • Keep moving! When you become sedentary, your joints stiffen and muscles weaken. Move as much as possible. Make it a point to stand often, take the stairs and walk every day.
  • Try Tai Chi, yoga, and Pilates. All help with core strength and flexibility
  • Join classes! NKCH offers several group fitness classes with instructors who make sure you are doing the moves right.
  • If you feel any pain or think you hurt yourself, make an appointment to see your doctor. Many times, a doctor’s visit and physical therapy can be the trick to getting you back to exercising.


Arthritis vs. joint pain. How do I know which it is?


There are two kinds of arthritis.

Rheumatoid arthritis is an autoimmune disease that develops when your own immune system attacks the joints and causes pain. The condition is more serious than osteoarthritis, which is joint pain from mechanical wear and tear.

If you’re having significant pain and/or swelling in your joints (hands, knees, elbows, hips, ankles), speak with your doctor. Because it’s hard to differentiate between the two conditions, your doctor will talk with you about your medical history, conduct a physical exam and possibly order blood work and X-rays.

If you have rheumatoid arthritis, specific medications can control the autoimmune destruction of the joint. If the condition goes untreated, it will eventually cause bone breakdown and complete erosion. The treatment goal is to control the bone erosion and manage the pain.

Osteoarthritis can’t be reversed, but there are some natural and over-the-counter medications that can help alleviate the pain. These include turmeric, glucosamine chondroitin, Aspercreme and Arnicare Gel. Other medications, such as nonsteroidal anti-inflammatory drugs or steroid injections, can help with the pain. Sometimes, a person has so much wear and tear that joint replacement is the best option.


I know I need to drink more water, but I hate it. What tips do you have for boosting my daily intake?


There are so many ways staying hydrated contributes to good health. Water keeps your skin looking good, gives your muscles energy, helps control calories and keeps your bowels working well, to name just a few benefits.
Here are few suggestions to help you get more water:

  • Buy a BPA-free water bottle you like, and take it with you everywhere. A good water bottle will keep your water cold and tasting fresh.
  • Set a goal to drink 2 liters (about 8 cups) of water every day. I prefer a 1-liter water bottle because I only have to refill it once. I place it at my desk and try to finish the first bottle by lunchtime. Then, I refill it, and finish the second bottle by the time I’m home.
  • Drink a cup of water when you wake up in the morning before your morning coffee. It’s a good way to start your day off with a positive fluid balance.
  • If you don’t like the taste of plain water, buy a water bottle with an opening that lets you add fruit to infuse some flavor. Add cucumber and mint, melons, grapefruit and rosemary, or any combination of your choice. The combinations are endless. Fruit-infused water is healthier than adding an artificially-flavored water enhancer.


How do I know if I need an anti-depressant or if my feelings are hormone-related?


Our moods are influenced by multiple factors: family, work, politics and the performance of our favorite sports teams are just a few. Sometimes, during an exciting period such as the holidays, our emotions are high. Then, after the holidays, our emotions fall. Depression is defined as living more than two weeks with five or more of the following symptoms occurring daily. (At least one symptom must be either a depressed mood or a loss of interest and pleasure.) These symptoms include:

  • Depressed mood
  • Feeling worthless or guilt-ridden
  • Insomnia
  • Loss of energy
  • Restlessness or slowed behavior
  • Reduced interest in activities
  • Significant weight loss or weight gain/change in appetite
  • Suicidal thoughts
  • Trouble concentrating

If you notice these signs, talk to your doctor. He or she can check your hormone levels and diagnose depression. Many times, talk therapy or counseling can help boost your mood back to normal. In some cases, you may need a combination of medication and counseling.


I’m a fairly healthy person and typically only see my primary care doctor once a year. How do I build a good doctor-patient relationship when we have such limited contact?


I have several patients who are healthy and only come in for their annual screenings or an occasional ache or pain. And, that’s great!

Ideally, you and your doctor should be partners in health. Studies have shown that having a trusting relationship with your doctor can improve your health outcomes. But, creating that relationship can be difficult when you only see your doctor once a year. However, it’s certainly possible.

The best way to develop a partnership with your doctor is to write down and discuss your healthcare goals with him or her. We want you to actively engage in your diagnosis, treatment and any decisions that need to be made. With this common focus, you and your doctor will keep you healthy.

Happy New Year!


Women get pulled in so many different directions, making it difficult to focus on any one task. What are some quick, easy ways to boost concentration?


Remaining focused on the task at hand is tough! I use a few different tools.

  • Create To Do lists and divide the tasks into what needs to get done today, what can wait until next week, and goals that can span over a longer period of time.
  • Stay hydrated and eat high protein snacks
  • Go for a walk or try another low-impact form of exercise, like yoga
  • Make time to meditate.
  • Get a good night’s sleep
  • Breathe. Trying different techniques to bring your mind into focus.

You won’t notice a change overnight. Like any new habit, it takes time to develop the ability to focus on one thing at a time. But, keep trying and always be on the lookout for strategies that work for you.


What online resources do you recommend for general health and wellness information?


I recommend reading to get general background information, but the art of medicine involves integrating many facts and symptoms to accurately diagnose and treat a patient. What you read online may not directly relate to you, so it’s always best to talk with your doctor.

However, I recommend a few sites for building your general health knowledge.

They are:

  • WebMD and/or MayoClinic. I trust these sites because the contributing authors are medical doctors.
  • U.S Preventive Services Task Force. This site is geared more toward healthcare professionals, but it’s full of information on evidence-based recommendations for preventive medicine.
  • My Fitness Pal. This is such an easy fitness app to use. BabyCenter. I love this app for pregnancy, baby and parenting information.


What are three things that surprised you as a first-time mom?


First, the instant and indescribable love I felt for my sweet baby boy. Before I had Sebastian, I thought I might be bitter about giving up certain aspects of my life, but I felt the opposite. I was also surprised to find how simple things like lying on the floor together can make me happy. That’s not to say every single second is fun and games, but I couldn't be happier to do anything and everything for Sebastian.

Second, the first few weeks were harder than medical school! The sleep deprivation is no joke!

Lastly, I had no idea how many outfits and onesies I would go through in one day!


Farmers Markets are popular this time of year. What foods do you typically buy at local stands?


I love visiting Farmers Markets in the summer. Buying fresh fruits and vegetables from a local farmer is a great way to support the community. They also tend to be a little healthier than what you buy at the store. They retain more of their nutrients because they aren’t stored in a warehouse first. Local produce tastes better, too, because the farmers pick it at its peak.

Some of my favorite foods to buy locally:

  • Beets
  • Cabbage
  • Carrots
  • Cucumbers
  • Edamame
  • Eggplant
  • Green beans
  • Herbs
  • Micro greens
  • Okra
  • Peppers
  • Summer squash
  • Tomatoes
  • Turnips

Did you know North Kansas City Hospital participates in the Farmers Market at the Gladstone Hy-Vee? Our next two events are coming up soon. We hope you’ll stop by!

NKCH and Gladstone Hy-Vee Farmers Market

July 16
Eating Healthy & Exercise
7 a.m.-noon

August 17
Making Positive Choices
2-6 p.m.


What are your favorite summertime health and beauty tips?


Some of my favorite summer tips are:

  • Wear sunblock every day! Remember to reapply it after swimming or if you do something that makes you sweat a lot.
  • Freeze aloe vera in ice cube trays for quick and convenient sunburn relief.
  • Use topical hydrocortisone cream for heat rash relief. It the rash isn’t better in three days, call your doctor.
  • Use cream-based makeup instead of powder-based.
  • Wear waterproof mascara to prevent your makeup from running.
  • Grill out every time you get the chance. I love to splash some oil, fresh grated ginger and pepper onto squash, zucchini and bell peppers and grill them up.


What are three questions patients should ask during an office visit?


I love talking with my patients and taking the time to get to know them better. Open communication is so important in building a trusting relationship with your doctor. Of course, I want patients to feel comfortable asking me anything. But, I also feel discussing the following topics helps me better understand overall health and wellness needs.

  1. Do I need all of these medications? Am I taking the right medications for my condition(s)? The best thing you can do is bring an up-to-date list of your medications to each visit. It’s important to understand each medicine’s purpose and its possible side effects. Then, we can talk about if they are the right ones for you and make adjustments, if needed. >
  2. Am I up to date on my cancer screenings? Early detection of cancer is essential to getting effective treatment. Talk to your doctor about mammograms, PAP smears and colonoscopies.
  3. Am I a healthy weight? I have a passion for healthy living, and all doctors want to help their patients take steps toward a healthier lifestyle. Weight management plays such a big role in our long-term health that it should be discussed. I work with my patients to help them achieve their weight goals. I encourage you to take an active role in your care by asking questions and being open about your health history. A simple conversation can open the door to a lifetime of health and wellness.


Your complexion is absolutely beautiful! What are some of your skin care secrets?


Thank you for the compliment! I work hard to keep myself looking and feeling healthy. Here are a few of my “not-so-secret” secrets.

Hydrate. Staying hydrated keeps the skin cells full. I try to drink at least 2 liters of water each day and avoid coffee and alcohol because they can leave your skin dry.

Wear sunblock daily. I cannot emphasize this enough. UV rays from the sun are the No. 1 cause of wrinkles and premature aging. Wear sunscreen even if you work indoors or it is cloudy outside. I recommend wearing at least SPF 30. It can be tricky to find the right sun screen, and you’ll have to do some trial and error to find one that isn’t too greasy for your skin.

Wash your face every night. Sleeping with makeup on can clog your pores and cause acne or irritate your skin. My skin tends to be dry, so after I wash my face at night, I moisturize with argan oil. Every two or three days, I use a prescription-strength retinoid.

Try a retinol cream. Retinol creams are great and can help refine pores and keep skin smooth. I like RoC Retinol cream, which you can buy over the counter. Talk with your doctor or dermatologist to see if a prescription strength retinoid is a good option for you.

Stop smoking. You can’t have youthful-looking skin if you smoke. Smoking causes premature aging and a dull, dry complexion. The toxins in nicotine work against the natural cell barriers in your skin and weaken them.

I would caution that the cosmetics industry is heavy in advertising. There is no miracle cream that erases all wrinkles and dark spots. A hefty price tag does not mean one product is better than the other.


I struggle with packing a healthy lunch. What’s in your lunch bag?


I try to pack foods that are quick and easy. If you looked in my lunch bag on any given day, you’d find:

  • 1 liter of water
  • Apple or pear slices with a scoop of peanut butter
  • A Greek yogurt cup
  • A handful of dark chocolate covered almonds (I buy a large bag at Costco)
  • 2 Babybel cheeses, original

I don’t eat everything in one sitting. I like to have extra food close at hand to keep me energized throughout the day. I also keep a supply of tea bags (and a water boiler), KIND granola bars and dried fruit in my office for a quick pick me up.


What are the first signs of menopause? What advice can you give regarding how to cope with it?


The first signs of menopause usually start around age 47, but they can show up earlier than that, depending on the woman. Clinically speaking, you’ve officially entered menopause when you’ve gone through 12 months of absent periods, and you are over 45 years of age. The initial signs are:

  • Irregular periods
  • Sleep disturbance
  • Vaginal dryness
  • Sudden hot flashes

Hot flashes are typically the most debilitating symptom of menopause. Sleep with a fan by your bedside, exercise to keep your energy level up during the day and make sure you’re getting enough sleep at night.

When you start to experience symptoms of menopause, it’s important to let your doctor know so you can have the proper tests done to ensure it’s menopause and not thyroid disease. Your doctor can also prescribe a variety of medications to help with irritability and hot flashes.


I’m feeling run down and unmotivated more than usual this winter. Is this common? How can I deal with it?


Yes, it’s common. You’re probably feeling this way due to seasonal affective disorder (SAD). Long, dark winters can disrupt the body’s circadian rhythm (your sleep cycle), causing more fatigue. Getting quality shut-eye is your best bet, but there are other helpful tricks.

  • Exercise. Get your blood pumping, and your heart rate going! Whether it’s taking a fun aerobics class or jogging around the block, exercise is proven to improve your mood. If the sun is out, even better. We don’t get as much vitamin D as we should in the winter, so any time you can spend in the sun is a valuable opportunity.
  • Light up your house. Increasing the amount of light in your house just a little bit will boost your mood during the winter. So go ahead and buy that cool floor lamp while you’re shopping online. It will literally lighten your mood.
  • Spend time with the girls. Don’t let your social calendar suffer just because you’re too chilly to move! Invite your friends to a happy hour or host a watch party for your favorite TV series. Making commitments with other people will force you to be more active, and spending time with others is guaranteed to brighten the blues.

If you’re making a serious effort but still can’t relieve sadness, then you might have a more severe form of depression and should consult your doctor.


I want to make a New Year's resolution, but I want to promise myself more than simply "going to the gym more often." Can you suggest some other ideas for staying happy and healthy in the new year?


Try resolving to work healthy habits into your lifestyle where and when you can. Did you know just 30 minutes of exercise four or five times a week can make a difference? Anything from a brisk walk to dancing to your favorite tunes while cooking will help. And imagine how good you’ll feel about yourself if you eat something green every day – a smoothie, a salad or even green pepper on your pizza.

Remember that mind is as important as body. If meditation isn’t for you, just try staying positive. Write down three good things about your day, every day, and after just a few weeks you’ll notice a happy difference.

Dr. Ancy
Ancy Maruthanal, MD

Meritas Health NKC
Club W Medical Director

Ancy Maruthanal, MD

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