Women’s Health

Womens Health

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Womens Health

We Care About You

The woman’s body is complex! On these pages, we have tried to answer some of your possible questions. We hope you find it useful!

Probably the most important piece of advice our doctors can give you is to make and keep your yearly appointments. Your yearly exam is so important!

Please remember, the compiled information from our doctors is meant as a guide and does not take the place of meeting with your doctor. Your situation is unique to you and only your doctor can decide what is the best procedure for you.

Cervical Issues

Information coming soon!

Information coming soon!

While not cancer, cervical dysplasia (an abnormal growth of cells on the cervix) is considered pre-cancerous. It is categorized as either mild (CIN I), moderate (CIN II) or severe (CIN III), which will show up on your results from your lab work.

Most cervical dysplasia occurs in women between the ages of 25 and 35, however, less than 5% of all Pap smear test results find cervical dysplasia. The cause of cervical dysplasia, like many problems with the cervix, is unknown. It also falls into the same risk factors:

  • Multiple sexual partners
  • Starting sexual activity before age 18
  • Having children before age 16
  • DES exposure
  • Having had sexually transmitted diseases, especially HPV (genital warts) or HIV infection

Because there are usually no symptoms it is very important for you to have regular Pap smears. A colposcopy also can help in finding cervical dysplasia by revealing “white epithelium,” a mosaic-like pattern on the cervix. Your doctor may require more information and order a biopsy or endocervical curettage to discover the extent of the dysplasia and rule out cancer.

If your doctor determines you have cervical dysplasia, there are several treatments. While mild dysplasia usually goes away on its own, you will still be required to have close observation with follow-up Pap smears over several months. More severe dysplasia may require treatments like electrocauterization, cryosurgery, laser vaporization or surgical removal to destroy the abnormal tissue. However, expect your doctor to require consistent follow up with regular Pap smears over the months and years ahead.

Luckily, nearly all cervical dysplasia can be cured, but left untreated it could develop into cervical cancer. As with all cervical problems, it is very important that you keep up with your regular Pap smears.

Also, with the development of Gardasil, the medical world is fighting HPV, a major cause of many disorders of the cervix. Fayetteville Woman’s Care recommends that all girls and women, as early as age 9 through 26, get the Gardasil shots (3 in all.)

Occasionally, a woman develops a cervical polyp (more than one is rare.) These are harmless growths that appear on the cervix or endocervical canal. Typically, your doctor removes them when he finds them during a pelvic exam.

Often, the polyps are infected, so your doctor may prescribe an antibiotic. Cervical polyps are suspected of being associated with chronic inflammation, an abnormal response to increased levels of estrogen or clogged cervical blood vessels and are relatively common, especially in women over age 20 who have had children.

While polyps may not exhibit any symptoms, you may have a cervical polyp if you have:

  • Abnormal vaginal bleeding
  • After intercourse
  • After douching
  • Between periods
  • After menopause
  • Abnormally heavy periods (menorrhagia)
  • White or yellow mucous discharge (leukorrhea)

However, polyps may not exhibit any symptoms.

More than half of all women at some point will be affected by Cervicitis, an inflammation of the cervix, usually as a result of infection. Women who participate in high-risk sexual behavior (multiple partners, a history of STDs (sexually transmitted diseases), partners with STDs) are at an increased risk of getting Cervicitis.

Other risk factors include exposure to chemical devices inserted into the pelvic area, such as a cervical cap, diaphragm or spermicide.

While there may be no symptoms until you have a pelvic exam, make an appointment with your doctor if you exhibit any of the following:

  • Unusual, sometimes persistent, vaginal discharge, often accompanied by an odor
  • Abnormal vaginal bleeding after intercourse, between periods or post menopause
  • Pelvic pressure or heaviness
  • Painful sexual intercourse
  • Vaginal pain

Cervicitis, like other infections, is treated with antibiotics or antifungals.

Gynecological Cancers

With more than 80 percent of the world’s population afflicted with HPV — the most common sexually transmitted disease — chances are high that you have HPV, especially if you’ve ever had an abnormal pap smear. Human Papillomavirus (HPV) refers to a group of more than 80 viruses, most of which have no significant effects on the human body. So don’t panic.

A handful of those HPV infections, however, can cause genital warts (condyloma acuminate) or have been associated with abnormal pap smears and cervical cancer (dysplasia). While most women will not develop cervical cancer, HPV likely will appear in the form of abnormal pap smears and/or unsightly genital warts. These effects are treatable, although not curable.

But treatment isn’t that much fun. It can require multiple treatments, such as colposcopy, freezing the warts or electrical cautery removal of the cervix. Treatments also can result in cervical incompetence (not being able to carry a baby to term) and infertility. The emotional distress of having a sexually transmitted disease, along with multiple trips to the gynecologist for surveillance and uncomfortable treatments for warts or dysplasia should not be underestimated.

Of course, the best treatment is to prevent HPV in the first place. According to the Centers for Disease Control and Prevention (CDC), the only way to totally protect yourself against HPV is to avoid any kind of sexually activity that involves genital contact. This sounds familiar, doesn’t it? But let’s repeat that, the CDC specifically says “genital contact.” Intercourse is not necessary to contract HPV. Plus, many people who have HPV may not show any signs or symptoms and can pass along the virus without either partner even being aware of it.

The FDA (Food and Drug Administration) recently approved a vaccine to prevent infection with four of the most aggressive types of this virus. The HPV vaccine, Gardasil, can prevent up to 70 percent of cervical cancers and 90 percent of genital warts, if taken before exposure to these high-risk virus types. In short, before sexual activity. While Gardasil is currently recommended for girls and women between the ages of 9 and 26, the FDA is investigating expanding these age ranges to include women in their 30s and 40s.

We cannot stress enough how important it is to take this extra ounce of prevention. Because 74 percent of the cases of HPV in the U.S. occur in 15- to 24-year-olds, our doctors at Fayetteville Woman’s Care recommend that our younger patients get the Gardasil vaccine prior to becoming sexually active. The sooner, the better. It’s worth the peace of mind.

Even if a patient is sexually active already or is out of the at-risk age range, we still recommend the vaccine. There is no way to determine what type of HPV she has been exposed to. The vaccine will still target the remaining strains, thus reducing the cervical cancer risk.

The Gardasil vaccination comes as a three-shot series taken over six months and costs about $350. Most insurance plans are now covering it (call your insurance company to confirm). Plus, low-income families may qualify to receive the HPV vaccine through a federal program called Vaccines for Children.

If you are concerned about HPV infection and want to receive a simple vaccine to help prevent cervical cancer and genital warts, call our office today. Ask whether you should be immunized against HPV. Just one less thing to worry about.

Like all warts, genital warts (also called venereal warts) are caused by a type of human papilloma virus (HPV) and appear as flesh-colored, pink or grayish-white growths on the genital or anal areas of the body. Skin-to-skin contact during sexual activity (not necessarily intercourse) is what allows them to spread.

In addition to the growths around the genital and/or anal areas, some women may notice mild irritation, burning, itching or pain, increased or foul-smelling vaginal discharge or vaginal bleeding or pain with intercourse. Often, though, you may notice nothing at all, which is why your yearly exam and Pap smear is so important. Even though the warts themselves are benign and don’t cause cancer, they still indicate that you have HPV, which is a known cause of cancer.

While there is no treatment to cure HPV, there are very good treatments for the symptoms.

Genital warts can be removed as an out-patient procedure at the Fayetteville Woman’s Care office through cryotherapy (freezing off the warts with liquid nitrogen), electrocautery (burning them off with an electrical current, known as a LEEP) or with chemicals. More advanced or numerous warts may require surgery. Some procedures may require a local anesthetic.

Depending on the size and location of your warts, your doctor may recommend imiquimod, a cream you apply at home. Imiquimod enhances your immune system, helping your body rid itself of the warts and delaying or even preventing their recurrence.

It is very important that you not try to get rid of genital warts by using over-the-counter medicines meant for the types of warts found on the hands and feet. They’re too harsh for the genital area.

Menstrual Cycles

Are you out of energy? … Have swollen breasts? … Bloated? … Fighting a Headache? … Experiencing back pain? Have a change in your appetite? Having pain in your joints or muscles? … Is your acne flaring up? …. Irritated? … Angry? … Moody? …

Relax. It’s probably simply PMS (premenstrual syndrome) and it is not fun for you or anyone around you.

Almost every woman will endure bouts of PMS at some point in her life, but for an unlucky few – between 20 and 40 percent – PMS is a monthly ordeal.

If we knew for sure what causes PMS, we would be able to stop it. It is no longer believed that PMS is related to fluctuations in hormones. Instead, researchers are leaning toward changes in neurotransmitter levels, including mood-altering endorphins and serotonin, and diet — especially a lack of calcium.

PMS can be treated in the same ways as menstrual cramps. But don’t be afraid to talk to your doctor about prescription treatments, if you feel you can’t manage PMS on your own. Keep a diary of your complaints for a few months, so your doctor can determine the best treatment for you.

A note about exercise and diet

Getting up and about regularly and eating a healthy diet are good for you all around. But studies have shown that regular exercise relieves stress, boosts your metabolism and improves your circulation. The result, among other things, is that it carries much-needed oxygen and nutrients to your cells more efficiently, which helps PMS. In addition, aerobic activities like walking, biking or swimming, boost your mood and help you fight those crying spells. We suggest 30 minutes of aerobic activity five times a week. Try it and see if you notice a difference in how you feel and the effect PMS has on you.

It’s true. You are what you eat. Some studies have found that eating more carbohydrates (like potatoes or crackers) in the middle of your cycle can help relieve depression, tension, confusion and fatigue. No wonder you get cravings for chips! Starchy foods can boost serotonin, a brain chemical linked to mood. Avoid foods containing proteins and fats a few hours before and after each carb snack, because they can delay or destroy the chemical boost in your brain.

If you’re prone to bloating, avoid salt and drink more water! Ironically, drinking more water helps you retain less of it. Calcium supplements are also a good idea. They can decrease common premenstrual symptoms like pain, food cravings, mood swings and water retention. Try 1200 mg of calcium daily for three months and see if it makes a difference.

Through the ages, women have fought the battle with menstrual cycles. There has been a lot of progress made in treating the sharp spasmodic monthly pains, but, for many, it’s still a debilitating part of womanhood. If the cramps (known as dysmenorrhea) aren’t bad enough, you may be prone to backaches, headaches, pain in the inner thighs, diarrhea or constipation, nausea and vomiting, dizziness, bloating, weight gain and breast tenderness. In some older women, these aches and pains may be symptomatic of another disease that requires treatment (for example, endometriosis).

Some women describe cramps as being similar the contractions felt during birth. And they are not far from the truth. When you feel a cramp, that is your uterus contracting to push out the menstrual blood. Hormones and hormone-like chemicals in your body can actually increase the severity of cramps.

At Fayetteville Woman’s Care, we want you to be as comfortable as possible and sometimes there are treatments that can lessen the pain. Don’t be shy about asking your doctor about treating your menstrual pains. We are here to help.

Call your doctor for an appointment if:

  • your pain is severe or lasts longer than two to three days
  • your cramps don’t seem like normal menstrual cramps or are occurring at the wrong time of the month
  • you feel pain during or after sexual intercourse
  • you have an abnormal vaginal discharge
  • something just seems wrong

Try these treatment options first:

  •  non-prescription pain-relievers and anti-inflammatory drugs like ibuprofen and naproxen. If your periods are regular, it may help to take these medicines one day prior to when your period is due to start.
  • take a warm bath
  • use a heating pad or hot water bottle on your abdomen
  • exercise (believe it or not) often will make you feel better. Regular exercise can even decrease symptoms
  • daily calcium supplements with Vitamin D may even reduce your risk of getting cramps
  • avoid smoking, poor posture, caffeine and high-fat foods as well as salt
  • get enough sleep!
  • get a massage
  • try acupressure or acupuncture from a licensed therapist
  • add thiamin to your vitamin supplements
  • eat plenty of essential fatty acids, which are found in canned sardines, salmon, flaxseed oil, and ground flaxseed, among other things
  • Take extra magnesium and a multivitamin-and-mineral supplement
  • Take extra vitamin E during your menstrual cycles
  • As much as you can, eliminate trans-fatty acids from your diet (these are found in foods like commercially prepared pastries, which contain margarine, solid vegetable shortening, and other partially hydrogenated oils)
  • Cut down on stress
  • Try Yoga

Urinary Problems

While urinary incontinence will not cause severe medical problems, it is often made worse by underlying medical conditions, such as high blood pressure, diabetes, asthma and chronic bowel problems. It is also emotionally distressing and embarrassing. It often requires using feminine pads to prevent leaking through clothing. Many affected women simply avoid social activities and exercise because of the leaking.

There are a variety of causes for incontinence, so only your doctor can determine what treatment is right for you, but here are some treatment options you and your doctor may consider:

• Stress incontinence may be effectively treated with exercise therapy, medications, or both.

• Pelvic floor (Kegel) exercises can result in better control of the bladder when coughing, laughing, sneezing or exercising. Add biofeedback behavioral therapy and the results can improve dramatically.

• Medication may be used to tighten the bladder and prevent urine leakage, or reduce the urgency sensations that cause frequent urination or leaking on the way to the bathroom.

• Outpatient minimally invasive surgery, such as TVT (Tension-free Vaginal Tape), adds support for the bladder neck and is usually needed for severe stress incontinence.

• Other options for the treatment of incontinence include mechanical devices called pessaries, timed urination, vaginal estrogen, collagen injections and vaginal strength training devices.

• One promising advancement is Sacral Nerve Stimulation, an outpatient procedure that has had much success where other methods have failed. Fayetteville Woman’s Care is one of only a handful of local OB/GYN offices trained and able to conduct this new exciting procedure.

Whatever options you choose to consider, treatment for urinary incontinence is effective and well tolerated. Many women we see at Fayetteville Woman’s Care can’t believe they waited this long to seek help for their leaking. Most women say they were too embarrassed to bring up the subject with their gynecologist. Don’t be embarrassed. We are here to help you with all of your medical issues.

Call your doctor today to get control of your bladder. Stop letting your bladder tell you how to live your life.

Information coming soon!

This chronic, painful, inflammatory bladder disorder can be difficult to diagnose. Its symptoms are similar to many other conditions, such as urinary tract infections, endometriosis and even some gastrointestinal conditions.

The pain associated with IC is due to a damaged urothelium, or bladder lining. When the layer is damaged (via a urinary tract infection (UTI), excessive consumption of coffee or sodas, traumatic injury, etc.), urinary chemicals can “leak” into surrounding tissues, causing pain, inflammation and urinary symptoms. Oral medications like Elmiron and medications that are placed directly into the bladder via a catheter work to repair and rebuild this damaged/wounded lining, allowing for a reduction in symptoms.

Most people with IC experience:
• Sudden urges to urinate
• Frequent trips to the bathroom during the day or night to urinate
• Chronic pain in the bladder, pelvis and/or lower abdomen area
• Frequent urinary track infections
• Pain during sexual intimacy

If you are experiencing these symptoms, be sure to speak with your doctor about it. He can determine if you have IC and offer an effective treatment.

Painful and frequent urination are often symptoms of a bacterial infection to the urinary tract. Sometimes there is visible blood in the urine, which can be frightening if you’ve never had a UTI. Your doctor can complete a simple dipstick urinalysis to detect the bacteria. He will prescribe antibiotics and a painkiller to help until the antibiotics kick in.

If you cannot get to our office right away, drinking several glasses of pure cranberry juice may help ease the pain. Also, making a habit of drinking lots and lots of water will help you continuously remove bacteria through frequent urination.

Often called honeymoon cystitis, UTIs often occur after sexual intercourse. If you are prone to UTIs, we recommend that you urinate immediately after intercourse to flush out any bacteria.

If you have noticed the involuntary loss of urine during physical activity such as coughing, laughing or lifting, you may have Stress Urinary Incontinence. It is very common in women who have given birth, had previous pelvic surgery or who are experiencing hormonal changes. These can result in a weakening of the muscles that support the urethra (the small tube that carries urine out of the body) and the bladder neck (the opening that connects the urethra to the bladder).

Fayetteville Woman’s Care offers a surgical minimally invasive treatment, called a Mid-urethral Sling System, for Stress Urinary Incontinence. The treatment is designed to provide a ribbon of support under the urethra to prevent it from dropping during physical activity. The dropping of your urethra out of the correct anatomical position may be what causes your incontinence. Providing support that mimics the normal anatomy should prevent urine from leaking or reduce the amount of leakage.

We have had great success with the sling procedure, but it is not for everyone. Be sure to speak with your doctor about your stress urinary incontinence concerns.