Archive for the ‘Daryl Greebon, MD’ Category

It’s a medical fact that most women, regardless of age, will experience a gynecological health problem at one time or another in their life.  Most of these conditions result in minor symptoms that can easily be treated, while others may require prompt medical attention or possibly even surgery. According to a Dallas, Texas group of gynecologists, the Women’s Specialist of Plano, “Many women will experience bouts of cramping and menstrual bleeding throughout their reproductive years. While it is normal for women to have pelvic pain and menstrual bleeding during their normal menstrual cycle, it is not common to have pain and bleeding so severe that it disrupts the normal activities of life. This almost always signals an underlying health problem that should be assessed by a skilled gynecologist.”

Persistent and consistent symptoms that normally raise a red flag include:

• Painful, severe cramps and pelvic pain
• Persistent pelvic bloating
• Intense pelvic pressure
• Abdominal tenderness
• Pain during urination or intercourse
• Heavy, ongoing bleeding outside of a normal menstrual cycle

The symptoms listed above can occur alone, or in combination with each other.  Most often, these symptoms may indicate:

• Uterine Fibroids:  Non-cancerous (benign) tumors of solid muscle tissue that develop in the uterus
• Uterine Cysts:  A fluid filled sac found in the pelvis that usually originate in the ovaries
• Uterine Prolapse:  When the uterus falls or descents from its normal position into the vaginal area
• Endometriosis: A condition where the cells from the lining of the uterus grow in other areas of the body
• Cervical Cancer: A disease that forms when cancerous tumors develop and grow in the cervix
• Uterine Cancer:  A disease that forms when cancerous tumors develop and grow in the uterus
• Menorrhagia:  Very heavy, abnormal menstrual bleeding
• Dysmenorrhea:  Very painful periods, excessive menstrual cramping and pelvic pain

When a woman has been diagnosed with one of these gynecological conditions, if the symptoms are severe enough, surgery by way of a hysterectomy may be the best recommendation and often yields effective outcomes. A hysterectomy is a surgery in which the uterus is removed. This can be done partially or in full. Today, many gynecologists are turning to a minimally invasive approach to performing a hysterectomy by using the da Vinci robotic surgical system.  While the robotic surgery technique is still considered relatively new, it is becoming a popular alternative for women throughout the Dallas, TX area as they contemplate the right hysterectomy approach to take.

Robotic surgery has been effective in the treating conditions that cause uterine fibroids, uterine cysts, endometriosis, and other gynecological symptoms.  According to Dr. Murray Fox, a Dallas, TX gynecologist and an early robotic surgery pioneer, “Increasing numbers of women are choosing this approach when faced with a myomectomy (removal of/treatment for uterine fibroids) or hysterectomy (the full or partial removal of the uterus), for example. Robotic surgery continues to result in excellent clinical outcomes, while offering patients an overall easier recovery period.”

The technology of the da Vinci robotic surgical system uses very tiny incisions allowing surgeons to use miniature instruments and a 3D camera and microscope to view the inside of the uterus and operate with precise movements.  While the arm of the robot does the actual movement, the surgeon is responsible for controlling and directing these moves with absolute accuracy and precision. The approach leaves minimal scarring and reduces the loss of blood, pain, and overall trauma that historically accompanies an open hysterectomy.

Not all gynecological practices in the Dallas, Texas area have adopted the robotic surgery approach. Despite the revolutionary advancement, it is a big investment with a large learning curve. The gynecologists with the Women’s Specialists of Plano state, “It will only be a matter of time until the robotic way is the only way.  We have seen the difference it has made in the hundreds of patients that have walked through the doors of our North Dallas practice. It is revolutionary to say the least.”

To learn more about the da Vinci Robotic Surgery, please visit the Women’s Specialists of Plano, a board-certified group of Dallas, TX gynecologists, at: http://www.obgynplano.com/dallas-frisco-allen/minimally-invasive/robotic-surgery/.

We have all heard the saying, “If only I would have known then what I know now.”   While this popular phrase can be used for any given topic relating to life, it isn’t until someone makes a change in his or her own life that it is used most intently.

According to Sabrina, a 45-year old patient of the Women’s Specialists in Plano, a group of gynecologists serving the women’s health needs in Plano, Texas, “I have been heavier than most of my peers my whole life. For years, I didn’t eat right, I never exercised, I often stayed up late and slept in too long, and the effects of these poor living habits began to take their toll on me.”

Realizing that the youth of her 20s and 30s was long gone, Sabrina decided it was time to take control of her health and make some positive changes in her life so that the years that lie ahead could be marked with health and well-being.

“In one year, under the guidance of my gynecologist, I made small changes to my life; but these changes, as subtle as they were, made a huge impact on how I felt both physically and emotionally. By omitting salts and sugars from my diet, and implementing a regular exercise regime into my daily routine, I noticed these changes almost immediately. Aside from a 35-pound weight loss, there are so many other benefits to having a healthier lifestyle.  I never really paid attention to things like bone density, heart disease, or cancer, because when you are young, you think you are invincible. The good news is that it is never too late to change…and I’m living proof.”

Sabrina’s story is one that resonates with millions of women across America, and it is the reason why the most popular questions in a gynecologist’s office revolve around diet, exercise, and weight loss.  The Women’s Specialists of Plano offer the following health tips for women to help kick-start a new you:

Get a Full Physical Work-Up

Sometimes it’s hard to know where to go if you don’t know where you presently stand. Aside from the annual gynecological exam, women who are in their 40s often find that this is the time where their bodies tend to change the most. They have to work harder to fight the bulge and feel active.  This is often a good time to have a complete physical work-up from a women’s specialist physician so that any chronic health problems such as heart disease, diabetes, or obesity can be discussed and managed.

Implement Daily Exercise

While exercise is important regardless of age, it is crucially important during the mid-life years, especially for a woman.  As the risk for certain health problems stack up, including cancers, heart disease, obesity and osteoporosis, incorporating a fitness routine that consists of aerobic activity, strengthening, stretching, and yoga can help balance life and keep the body physically fit. For women, exercise helps to regulate the menstrual cycle, and makes the transition into menopause easier to manage.

The American Heart Association (AHA) recommends aerobic activity for at least 30 minutes on most days of the week. Maximum heart rate during aerobic activity is usually calculated as 225 minus your age (225 – 50 for a 50 year old = 175) and different percentages apply from that number. Women should strive to work up to 50-60% of their maximum heart rate for a warm-up activity; and attempt to reach 60-70% for a healthy, fat burning, fitness zone.

Strength training is equally important. As women age, and the estrogen in the body decreases, they naturally lose muscle mass. Strength training with simple dumbbells can be done at home, any time during the day to help build muscle and keep bones strong and healthy.

Change your Diet

It’s easy to get good diet tips by doing a simple Google search on the Internet.  Implementing a new, healthier diet, however, sometimes takes a stronger resolve.  It helps by writing down everything you eat in a day and keeping this journal close by. Eating smaller meals, 3-5 times per day, helps increase the natural metabolism.  Eating a plentiful supply of fruits and vegetables, and eating low-fat, lean meats, while avoiding salts and sugars whenever possible, will help kick start healthier eating habits. Avoiding alcohol, sugary drinks, and too much caffeine, while drinking plenty of water all day long, helps to regulate the body.

It’s important to note, that a diet that worked for you when you were 21, most likely will not work when you are 40. As you age, your metabolism naturally slows down, thus you need fewer calories to maintain a healthy weight. An inactive 40-year-old woman with a normal body weight will require approx. 1,800 daily calories to maintain her weight. Any exercise that is added in will ultimately call for an increase in calories to maintain a healthy weight.

Get Your Full Daily Dose of Vitamin C and D

Vitamin C offers endless health benefits for women including common cold prevention, cancer prevention, cataract prevention for the eyes, and it is helpful in preventing heart disease and high cholesterol. Women 19 and over should be getting close to 75 mg of vitamin C a day; this can be a combination of supplements and foods such as fruits (strawberries, cantaloupe, kiwi) and vegetables (Brussels sprouts, broccoli, green peppers) all of which are high in Vitamin C.

Vitamin D is also a crucial element of a healthy diet and is essential in order to maintain strong bones and muscles. Adults need to maintain approximately 600-800 IUs (International Units) of Vitamin D daily. Using supplements, those numbers could increase to 1,000 units per day. Vitamin D is found in such foods as salmon, tuna and mackerel; as well as cheeses, egg yolks, mushrooms and milk.

These health tips for women can make a huge impact on a female at any time during her life. At age 45, some women say they feel better than they did when they were 21.  You can feel great at any age, and live the best life possible by implementing these healthy tips into your everyday regime.

Kristy M. Theis, editor and content writer for eMedical Media in Plano, Texas, worked closely with the Board-Certified gynecologists that make up the Women’s Specialists in Plano, Texas.  This article on health tips for women is part of an on-going series on how women can achieve a healthier lifestyle.  For more information on women’s health topics, please visit the Women’s Specialist of Plano blog located at:http://www.obgynplano.com/news/

For generations, the differences between men and women were always defined from a social aspect.  Historically speaking, men were considered superior over women, and it was this ideology that managed to rule the co-existences of the two sexes for hundreds of years. As the goal of equality has continued to become a reality in modern societies, many of the differences between men and women have evened out to an equal playing field.  When it comes to the physical gap, however, there will never really be equality.

Men and women will always differ in shape, weight, height, and anatomy.  Both will experience their own range of physical, emotional and health problems as they relate to the specific sex.  They have different problems, with different needs.

It’s why at some point in time, men will look towards finding a qualified urologist or male specific physician they can trust, and why women look towards finding a resourceful women’s health center or gynecologist (doctor for a female who specializes in the health needs of women) so that the problems and needs specific to the male or female body can be addressed.

While heart disease, cancer, weight management, the risk for diabetes, and many other ailments are common concerns for both men and women, there are specific conditions related to the female anatomy that a man will never experience.  It’s the reason why annual visits to a gynecologist are so crucial to the long-term health of a woman.

According to the Women’s Specialists of Plano, a women’s health center in Plano, TX, there are a handful of common problems that women will experience that a man never will. These conditions and reasons to visit a doctor for a female, specifically, are why millions of young women begin seeing a gynecologist at a relatively early age.

• PMS

When a woman is on her menstrual cycle, PMS can kick in and for some, it is bad enough that all normal activities will come to a halt.  The symptoms of PMS can range from mild to severe and will include (for most women) cramping, bloating, mood swings, headaches and fatigue.  Experts believe that hormones play the biggest factor in the severity of symptoms associated with PMS.  Once a woman is under the routine care of a gynecologist, these symptoms can often be treated and managed each month.

• Endometriosis

Endometriosis is somewhat common among women. It is a female health disorder that occurs when the cells that typically reside in the lining of the uterus, grow in other parts of the body. The most common symptoms are very heavy bleeding and cramping, irregular periods, long-lasting menstrual cycles, and problems getting pregnant (infertility).  Many gynecologists offer specialized treatment for endometriosis such as endometrial ablation, hysterectomy, and other minimally invasive techniques.

• Ovarian Cysts

Ovarian cysts are very common among the female population. These are small, fluid-like sacs that develop and grow in the uterus. Many women may have these benign growths and not experience any symptoms, while other women may have problems associated with ovarian cysts such as bleeding, cramping, and rupture.  Gynecologists treat ovarian cysts as a routine procedure and today, many progressive treatments are an option including laparoscopic surgery, and robotic surgery for hysterectomy.

• HPV Virus

Genital human papillomavirus is notably the most common sexually transmitted infection among young women. There are varying types of HPV that can lead to a myriad of symptoms including pelvic pain, genital warts, and other conditions that can lead to larger problems such as cervical cancer. HPV can be prevented and it is a topic of discussion among gynecologists and their female patients.  These conversations generally involve the discussion of prevention and treatment.

• Vaginal Infections

Bacteria and fungi are the culprits that lead to vaginal infections among women. It is one of the most common reasons why a woman will visit her gynecologist outside of her annual visit. Discharge, itching, vaginal burning and irritation are the symptoms associated with a vaginal infection.   Antibiotics can usually cure most vaginal infections effectively.  A gynecologist will be able to discuss prevention techniques to help keep future infections at bay.

• Pregnancy Prevention

Something that will surely differentiate a man and a woman until the end of time is pregnancy.  Millions of women in the United States visit their gynecologist each and every year to discuss pregnancy prevention, birth control, and pre-natal care for if and when a pregnancy occurs. It is a topic of discussion at most OBGYN visits until a woman has had all of her children and begins the next phase of life (menopause). A gynecologist is the best resource to discuss pregnancy and pregnancy prevention with a woman.

• Hysterectomy

Thousands of women will undergo a hysterectomy in a given year. A gynecologist may recommend a hysterectomy for many reasons, including for the treatment of fibroid tumors, PID, ovarian cysts, and endometriosis. Today’s technology has allowed skilled gynecologists to do hysterectomies robotically which leads to quicker recovery and a decrease in unwanted side effects. Robotic hysterectomies are not yet offered by all gynecologists as it takes extensive training and time to be able to master the technology; it is becoming more popular and a preferred choice among women.

Every city and state has a women’s health center that can offer a doctor for a female’s medical needs. Sometimes referred to as a women’s health physician, gynecologist, or OBGYN, they all meet the same challenge—keeping a female healthy both physically and in some case, emotionally.  It’s important to see your doctor annually and sometimes more often if problems or an untreated condition persists.

The gynecologists from the Women’s Specialist of Plano (OBGYN in North Dallas) contributed to this feature.

Expert interviews conducted with the Women’s Specialists of Plano (OBGYN in Plano, TX)

By the time a female turns 21, her body has already experienced a myriad of emotional and physical changes.  With the onset of cyclic hormone production from the ovaries, secondary sexual characteristics such as breast development and pubic hair growth begins.

Approximately 18 months after this, and at about 100 pounds, the menstrual cycle begins. Frequently, these developmental milestones create individual issues that require a specialist’s input. The adolescent time (pre-teen to age 21) may also require consultation regarding infection, vaginal discharge, and contraception. As women age, the body continues to change, making gynecological “well-woman” visits and a trusted resource regarding healthcare for women even more important.  This article discusses the importance of healthcare for women, and more importantly, finding a trusted, skilled practitioner who is in practice solely for the health of a woman, and understands the issues, conditions, and underlying factors that ultimately affect the health and well-being of the female body.

According to the Women’s Specialists of Plano, a group of gynecologists in Plano, Texas who provide women’s healthcare throughout North Texas, new guidelines in the area of Pap smears have evolved over the past several years. However, many of the other guidelines surrounding well visits and women’s physical health remain the same.

Pap Smears

The new guidelines in the area of gynecological care state that a woman should have her first Pap smear around the age of 21. During a routine Pap smear, a gynecologist will insert a small instrument called a speculum into the vagina to visualize the cervix and collect a sample of cells to be checked under a microscope.  If a Pap smear appears abnormal once it is analyzed, additional tests will be needed to diagnose the underlying cause of the abnormality.

Most women will continue to have a Pap smear every year following the first, but after the age of 30, it may not be required as often and many will begin having one every other year, or at the advice of their physician.  One known fact is that Pap smears are crucial to a woman’s health.  Medical professionals state that the occurrence of cervical cancer is higher in patients in whom a Pap smear was not performed, with the majority of diagnosed cases being in patients who have not had a Pap smear test in five or more years.

Pelvic Exams

Even though the first Pap smear may not take place until around age 21, it is recommended that teenage girls begin seeing a gynecologist around the age of 15 for problems related to the female organs and puberty. By this time, they have most likely started their menstrual cycle and it is a good time to begin establishing a relationship with a trusted resource and talk about questions regarding contraceptives, gynecological issues such as menstrual cramps, abnormal bleeding, and hormonally-related mood swings, as well as STD’s.

In time, before the first Pap smear, a routine pelvic exam will be performed. During a pelvic exam, a gynecologist will look and feel the external and internal reproductive organs. This exam helps to make sure that these organs are healthy and that no underlying condition exists. Many medical professionals recommend a woman have their first pelvic exam if they have not started their menstrual cycle by age 16, by the time they have become sexually active, or have reached the age of 18. If a woman is a virgin it is still important to have this exam. Problems with bleeding, cramping, pain, or discharge, can be diagnosed and treated with this exam will help determine if there is a medical problem.

Women’s Healthcare—What Next?

After the age of 21, a woman should visit her gynecologist every year.  Topics surrounding healthcare for women will become very important in the years that follow as additional body changes occur, and the topic of pregnancy and childbirth become more relevant. Routine Pap smears, pelvic exams, breast exams, weight, blood pressure and nutritional health will be at the forefront of these visits.  Some gynecological conditions, such as Endometriosis, are often detected in women who are in their 20s. Endometriosis is a condition in which uterine endometrial tissue grows outside of the uterus on the fallopian tubes and ovaries leading to abnormal bleeding and cramping, and in some cases, infertility. Vaginal infections such as yeast infections are also more prevalent in this age group.

By age 30, the body will continue to change. The transition into menopause can last more than 10 years, but the average age for perimenopause can start as early as 35. During a woman’s 30’s, estrogen begins to naturally decrease within the body.  In addition, between the ages of 30 and 40, a good percentage of American women will develop fibroids—small, benign growths that develop inside the uterine wall.  If a woman has given birth and had difficult deliveries, issues such as incontinence or pelvic floor dysfunction may also arise.  The American Cancer Society recommends that women have their first baseline mammogram between the ages of 35-40. After the age of 40, a mammogram needs to be an annual, consistent test so that if breast cancer is detected, the chances for a cure can be higher.

By age 40 and 50, a woman will begin to slowly transition into menopause.  Other factors such as diet and exercise, bone density, osteoporosis, hormone therapy, and other important issues in women’s health may become a more prominent topic of discussion.

A Healthy Future

Women’s healthcare will always be an important topic.  While there are known facts that are able to help guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur, the most important aspect is education.  Every woman should educate herself and understand the various transitions and common gynecological conditions so that each phase of life is healthy, productive, and happy.

For more information about finding the right OBGYN doctor in Plano to serve your specific needs, please contact the Women’s Specialist of Plano for a list of services and locations.

Photo Credit:  Creative Commons, Mike Baird

Plano, Texas Gynecologist Group Pioneers in Performing the da Vinci Robotic Surgery

The Women’s Specialists of Plano offer the robotic hysterectomy and robotic myomectomy as treatment for uterine fibroids and many other gynecological conditions

Every woman will experience a gynecological problem at one time or another in her life. Two of the most common gynecologic symptoms that women experience include pelvic pain and excessive or irregular menstrual bleeding. While it is common for women to have pelvic pain and menstrual bleeding during their normal menstrual cycle, it is not common to have pain and bleeding so severe that it disrupts normal activities of life.

According to the Women’s Specialists of Plano, a group of gynecologists in North Dallas, while it is common for women to have bleeding and pain associated with the normal period, more acute symptoms such as ongoing pelvic pressure, severe cramps, abdominal tenderness, pain during urination or intercourse, and heavy, ongoing bleeding, usually signals an underlying problem

The symptoms listed above can occur alone, or in combination with each other.  Most often, these symptoms may indicate:

• Uterine Fibroids
• Uterine Cysts
• Uterine Prolapse
• Endometriosis
• Cervical Cancer
• Menorrhagia

When a woman has been diagnosed with a gynecological condition, medication and conservative treatment (for uterine fibroids as an example) are usually recommended first. When medication and non-invasive procedures are unable to relieve symptoms, surgery is often the next step and has proven to be effective in eliminating a range of gynecologic conditions.

Traditionally, open surgery using a large incision has been the standard approach to many gynecological procedures. Open gynecological surgery often leads to a longer recovery process and it is common for women to have increased pain and larger scars. Today, many surgeons are turning to a minimally invasive gynecology surgery by choosing the da Vinci Surgical System. Robotic surgery has been effective in the treatment for uterine fibroids, uterine cysts, and other conditions. Many women are choosing this new approach when faced with a myomectomy (the removal of uterine fibroids) and hysterectomy (the full or partial removal of the uterus).

For complex hysterectomies and other gynecologic procedures such as the myomectomy, robot-assisted surgery using the da Vinci robotic surgery system has proven to be effective. The technology uses very tiny incisions allowing surgeons to use miniature instruments and with a 3D camera and microscope, operate with precise control and movement.  The approach leaves minimal scarring and reduces the loss of blood, pain, and overall trauma that historically accompanies a hysterectomy.  Robotic surgery is growing in popularity and continues to result in excellent clinical outcomes.

Treatment for uterine fibroids and other gynecological conditions is made easier using the robotic surgery system.  If you are considering having a hysterectomy, discuss all of the options with your doctor.  A robotic hysterectomy might be a viable choice to treat your condition.

Not all gynecological practices have adopted the da Vinci robotic surgery and robotic hysterectomy approach. Despite the revolutionary advancement, it is a big investment with a large learning curve. The Women’s Specialists of Plano are pioneers using the system.  According to the physicians that make up this practice, “It will only be a matter of time until the robotic way is the only way.  We have seen the difference it has made in hundreds of patients that walk through the doors of our Plano, Texas practice. It is revolutionary to say the least.”

The Women’s Specialists of Plano (Texas) a group of gynecologists servicing the greater North Dallas and Collin County areas, participated in this feature on permanent birth control for women.

Whether or not to have a baby is a choice that most women are free to make. There are times in a woman’s life when she will desire to be sexually active, but not become pregnant. When a woman is not ready to have children, or if she is unsure whether or not she would like to have children in the future, a temporary (reversible) contraception method is recommended. These types of contraception methods include birth control pills, intrauterine contraception devices (such as an IUD), a diaphragm, contraceptive foam, gels, condoms, etc.

When a woman is sure that she does not want to have children in the future a surgical procedure is usually recommended. In a traditional family, a discussion of a vasectomy or a tubal ligation ensues. These recommended procedures are considered “permanent birth control”.

Image: ©Healthwise, Incorporated

Tubal ligation surgery is a procedure in which a woman’s fallopian tubes are cut, tied, or blocked to prevent future fertilization and implantation during sexual intercourse. According to the Women’s Specialists of Plano, there are many approaches to this surgery, which is considered female sterilization, and only your doctor will know which procedure is most suitable for your body and lifestyle. A few of the tubal ligation approaches are:

• Laparoscopic Tubal Ligation:  During this procedure your gynecologist will insert a small camera and surgical instruments through a very small incision made in the abdomen. The tubal ligation will take place via this method which is considered a more minimally invasive approach.

• Mini-Laparotomy:  During this procedure your gynecologist will perform the surgery by making an incision in the abdomen about 2 inches in length.

• Post-Partum Tubal Ligation:  This procedure is very similar to the mini-lap, except that the incision will be made just below the belly button because the fallopian tubes are higher in body after childbirth.

• Open Tubal Ligation:  This procedure is performed when a woman desires a tubal after delivering via caesarean section, because the abdomen is already open. This procedure is also performed when a woman has pelvic inflammatory disease, or is already receiving a surgery which requires the opening of the abdomen.

• Trans-Uterine Tubal Occlusion: This procedure is performed with anesthesia.  The cervix is dilated and a hysterscope is placed in the uterine cavity.  The opening of the tube into the uterus is identified and a “plug” is placed into the fallopian tube as it passes through the uterine wall.

A lot of women choose to receive a post-partum tubal ligation while they are pregnant with their last child. This procedure is popular because it eliminates the issue of having two recoveries periods. Most women have recovered from their tubal ligation long before they recover from childbirth. This procedure is especially productive when a woman receives a C-Section, though a vaginal birth does not make the procedure impossible.

If you change your mind after receiving a tubal ligation surgery and decide that you may want to have children in the future, there is a reversal procedure. But the reversal procedure is not 100% effective; hence the reason a tubal ligation is considered permanent birth control for women.

The recovery period after most tubal ligations is about a week though you will most likely leave the hospital within a few hours after surgery. Because the procedure is immediately effective, you can maintain sexual activity as soon as you feel well enough. You will be permitted to shower (not bathe) 24 hours after the surgery, though scrubbing of the incision is not permitted.

As with every surgical procedure, a tubal ligation surgery has both pros and cons:

Pros:

• Female sterilization that is effective immediately
• It can be done at the same time as other surgeries like C-section or the removal of ovarian cysts
• It is a very reliable form of permanent birth control
• Requires no daily attention
• More cost effective in the long run then a daily procedure
• Allows for sexual spontaneity

Cons:

• It is a surgery
• Every surgery has associated risks
• Is not 100% reversible in the event of regret
• Does not protect against STD’s (only the proper use of condoms can do this)
• Is more expensive than the male form of permanent contraception (vasectomy)

If you are researching permanent birth control for women, it is suggested that you do proper research and reflection to be sure that you will not regret the decision in the future. If you are sure about your decision to receive permanent birth control (female sterilization), join your doctor so that the two of you can discuss which procedure will be most fitting to your life.

(Resources:  Women’s Specialists of Plano, Texas)

The Women’s Specialists of Plano, a group of gynecologists in Plano, Texas, were used as resources for this article.

Many women suffer from abnormal menstrual periods.  For many, a very heavy menstruation is the primary symptom. An average of 90% of women will complain of lengthy or heavy periods at least once in their adolescent years. But when heavy and lengthy periods become a monthly occurrence for a longer period of time than what is deemed normal, a medical procedure might be necessary to cure the problem.  For women who experience on-going, very heavy menstrual periods and who are finished having children, one option to consider is endometrial ablation.

Endometrial ablation is one treatment for heavy periods and is the removal of the uterine lining called the endometrium. Endometrial ablation will not be performed for the removal of cancerous tissue and is not a successful cancer treatment. Endometrial ablation is performed to cure abnormally heavy menstruation, and should only be performed when other non-surgical procedures have failed, and the patient does not desire to become pregnant in the future.

Before the endometrial ablation procedure is performed a biopsy of the endometrium will be performed to ensure that the uterus is free of cancer. Once the biopsy is found to be cancer-free an examination will be performed to ensure that polyps or an infection are not the causes of the heavy bleeding. If all tests come back clear then your doctor may choose to move forward with the endometrial ablation procedure. The best candidates for an endometrial ablation for the treatment of heavy periods usually meet the following criteria:

• A woman who suffers from heavy menstrual bleeding monthly
• A woman who wishes to cease menstruation but wants to avoid hysterectomy
• A woman who is finished bearing children
• A woman whom is clear of genital infection
• A woman who does not have polyps or any other malformation of the uterus
• A woman who has not been diagnosed with cancer
• A woman who has attempted non-surgical therapies to no avail

To begin the ablation, a woman’s cervix is dilated so that instruments can be inserted through the cavity. The instrument used depends upon the type of ablation you and your doctor have chosen. The different types of ablation can be performed by laser beam, electricity, freezing, heating, or microwave energy. The type of procedure depends upon a number of things including but not limited to:

• The preference and experience of the surgeon
• The presence of fibroids
• The size and shape of the uterus
• Whether or not pretreatment medication was given
• The type of anesthesia chosen by the patient and surgeon

The type of procedure most commonly chosen by experienced gynecologists is the FDA approved NovaSure.  NovaSure is a minimally invasive and extremely effective endometrial ablation procedure with up to 90% of patients claiming significantly lighter periods after the procedure. NovaSure can usually be performed in office in a few minutes and has been known to cause the patient very little pain. During the NovaSure procedure a woman will come in to the office during her cycle. She will receive a general anesthesia in the cervix prior to the procedure. The cervix will then be dilated and a small wand will be inserted into the cervix. A mesh device will expand from the wand into the uterus fitting the uterine cavity precisely. Then a carefully measured radio frequency is delivered through the mesh for 90 seconds deteriorating the endometrium. The device and the mesh are then removed from the uterus.

The procedure typically lasts about 5-10 minutes and most women are able to return to their daily activities after 24 hours. Some cramping and discharge is associated with the procedure but is normal and should not cause alarm.  It is necessary to sustain from sexual intercourse and to avoid tampon usage for several weeks after the procedure or until your doctor has cleared you to do so.

NovaSure is not performed on women who hope to conceive in the future, not because it is not possible, but because it is unsafe for both the mother and the child. Once you return to normal sexual activity after NovaSure it is important that you use some type of contraceptive, you and your doctor should discuss this and decide which contraceptive would be right for you.

Some side effects may follow after the procedure is performed. These symptoms do not occur in every case and should not cause alarm. The truth is that 90% of women who receive this surgery are very pleased with the outcome, and claim to have suffered from very minimal side effects.

If you are suffering from heavy menstrual bleeding, talk to your doctor today and rid yourself of this heavy burden.  Treatment for heavy periods by way of endometrial ablation has changed the lives of many women. Talk to your doctor today and get more information on the endometrial ablation procedure that might be best for your situation and learn if NovaSure for heavy periods is your answer.

According to the Women’s Specialists of Plano, a group of gynecologists in the Plano, Texas area, if you are a woman that has delivered multiple children, has experienced a difficult childbirth delivery, or if you have gone through menopause, you may experience the unwanted and frustrating symptoms associated with a cystocele. Pelvic floor dysfunction is a common disorder among both males and females, but even more commonly found in females because of the pelvic and vaginal pressure associated with the above scenarios.

A cystocele (also referred to as a prolapsed bladder) is a pelvic organ prolapse that is explained as the result of a drooping bladder. This condition most commonly affects women between the ages of 50-60. There are many reasons why a woman may experience a prolapsed bladder. A woman’s bladder can droop and cause a cystocele after pushing to deliver children, years of straining to have bowel movements, or heavy lifting over an extended period of time. Another common cause of a cystocele is a previous hysterectomy. Many gynecologists state that when women go through menopause, estrogen begins to naturally decrease within the female body. Estrogen regulates the strength of the muscles around the vagina. When Estrogen is no longer produced these muscles loosen and can lead to a prolapsed bladder.

Many women will have a cystocele and not show symptoms, while others will deal with a variety of unwanted symptoms.  Symptoms of a cystocele include:

• Pressure in the vaginal area
• A feeling of fullness in the pelvic region
• Discomfort in the pelvic area when you cough, bend, jump, lift, etc.
• Urinary incontinence ranging from mile to severe
• Bladder infections
• Pain or urinary leakage during sexual intercourse

All of these symptoms will vary depending on the stage and type of cystocele that is presented at diagnosis. There are three types of cystoceles that are classified by their severity.

They are classified as follows:

Grade 1 Cystocele

A grade 1 cystocele will show milder symptoms initially but may worsen if not treated.  During this phase the bladder droops just slightly into the vagina causing discomfort and urine leakage. The treatment for this type of cystocele may be rest and recovery, and avoiding heavy lifting or straining which may cause the problem to worsen.  Daily exercises of the vaginal muscles through Kegel movements is also recommended.

Grade 2 Cystocele

A grade 2 cystocele is a bit more severe.  During this phase the bladder droops until it can be seen through the opening of the vagina causing the complete obstruction of the vagina. This type of cystocele causes major discomfort and severe urinary incontinence. The treatment for this type of cystocele is usually some form of cystocele repair surgery but the cystocele may also be treated with a pessary device.

Grade 3 Cystocele

A grade 3 cystocele is the most severe of cystoceles. This is the diagnosis when the bladder droops low enough to bulge completely out of the vagina. Symptoms are similar to those of a grade 2 cystocele—but worse. Treatment for this type of bladder prolapse is cystocele repair surgery to move the bladder back into its proper place.

Treatment of grade 2 and grade 3 cystoceles are A.) The placement of a pessary device or B.) A cystocele repair surgery to place the bladder back into its place and keep it there.

A Pessary Device is a device that it placed against the uterus inside the vagina to hold the bladder in place. They are made of many types of materials in several different sizes. You and your OBGYN will discuss which is right for you, how to remove and replace it, and the proper procedures for cleaning it. A pessary must be removed on a regular basis to avoid infection or any other complications. Many women are fitted for a pessary device and yield very positive results.

Some women will require cystocele repair surgery for the treatment of their cystocele.  In this repair surgery sutures are used to reattach the fascia thus giving enough support to allow the bladder to remain in place. Patients receiving this surgery should be prepared to stay in the hospital for several days and take 4-6 weeks to fully recover. This surgery is very successful in replacing the bladder thus eliminating the cystocele. The surgery can be performed through open and laparoscopic techniques depending on the grade and severity of the defect. The percentage of recurring cystoceles is very small after a cystocele repair surgery.

If you are suffering from discomfort and urinary leakage or incontinence do not assume it could be the result of age, you need to see your doctor. In the early stages, cystocele treatments are minimally invasive and maximally effective.  Contact the Plano, Texas group of OBGYNs from the Women’s Specialists of Plano and learn more about cystocele out treatment options and cystocele repair surgery today.

When to go to the gynecologist for the first time is a question that women have been asking for years. Once upon a time the answer to this question was around 21. But because women are becoming sexually active at progressively younger ages this question does not have a definitive answer. According to the gynecologists that make up the Plano, Texas based Women’s Specialists of Plano, “The most important concept to remember is that once you become sexually active, at whatever age, it is important to begin receiving regular pap smears. A pap smear test is the only way to be sure that you are free of STDs, ovarian, cervical or uterine cancer, or any other issues or underlying conditions that may occur with the reproductive organs.”

Your first OB appt and first Pap smear test is a common fear for every young woman. Oftentimes, the fear and anxiety can be so great that young women will purposely put off making that very first appointment.  Most women are anxious about exposing their most intimate parts to a stranger and are also afraid that there may be an amount of pain associated with the checkup. Both of these fears are normal thoughts.

Drs. Murray Fox, Daryl Greebon, Jules Monier, Dennis Eisenberg and Jennifer Newton (Plano, Texas gynecologists) answered several questions for this Q and A designed to help you decide when the best time is to visit an OBGYN for the first time.

Q. First OB appt:  When should I go to the gynecologist for the first time?

A. You should see your gynecologist for the first time upon becoming sexually active. Other reasons to visits the gynecologist would be:

• Abnormal bleeding outside of your normal menstrual cycle
• Menstrual periods become longer
• Menstrual periods become heavier and more painful
• An overall change or disruption in your menstrual period
• Severe pelvic cramps outside of your normal menstrual cycle
• Infections such as a bacterial infection or yeast infection that would cause itching, redness, burning or unusual discharge

Q. At what age should I have my first pap smear test?

A. The recommended age for a woman to receive her first pap smear is at age 21. Keep in mind that this age applies to a woman who is not sexually active, and has had regular, similar periods since the beginning of her menstruation.

Q. Why is it important to get annual pap smears?

A. It is important to return to your gynecologist annually because there are complications that arise without symptoms. This means that something could be wrong with your reproductive organs though you have no symptoms and no reason to believe so. The early stages of ovarian and cervical cancer will cause your pap smear to test abnormally; through a routine pelvic exam which is usually also included in these annual appointments, such abnormalities as tumors and cysts can also be diagnosed. Annual pap smears and pelvic exams allow your doctor to catch specific conditions at early stages so that proper treatment can be implemented and fertility can remain healthy. In addition, your gynecologist will check your breasts for any abnormal lumps during each annual visit. This is important because most women do not begin receiving regular mammograms until they are in their forties. Your gynecologist may be able to help you detect breast cancer in its early stages at your annual.

Q. Does it hurt to have a pap smear?

A. No, pap smears do not hurt.  There will be a mild discomfort during the exam and for most women the first check-up will be uncomfortable. However, the majority of the discomfort is the result of the unknown. There should be no pain associated with your pap smear and all future visits will become easier each and every time.

Q. What does the gynecologist do during a pap smear?

A. Before the check-up a nurse will bring you a sheet and ask you to undress waist down. As your doctor comes into the room you will be asked to lie down and place your feet in stirrups which will keep your feet in place during the exam. Your doctor will then use a lubricated speculum to gently open your vagina. It is important to relax and take deep breaths during this part. The more relaxed you are the less uncomfortable you are likely to be. Your doctor will then use a long q-tip to swab the inside of your vagina. This swab is what is tested to determine if the cells are healthy, or abnormal. After your doctor swabs you using the speculum, the tool is removed and the exam will be finished.

Most women find that their anxiety about their first pap smear test disappears just as quickly as the actually procedure. But for some the anxiety returns every year when they go back for their annual. It is important to remember that your health should be rated much higher than your fear.

It is important to receive your checkup annually. But it is important to call your gynecologist sooner if:

• Your periods become irregular or cease
• Your periods become heavy
• You experience odor and/or discomfort
• If intercourse becomes painful
• If you think you may be pregnant

When the examination portion of your appointment is complete, your gynecologist will most likely meet with you and discuss a health follow-up with you and answer any questions you may have about such topics as birth control, etc. Finding the right OBGYN is just as important as going every year. Some women see the same doctor through their twenties, the birth of their children and into their mid-life years.  If the time is now for you to find and visit an OBGYN, ask around to friends and family for a solid recommendation and make the appointment sooner than later.

Severe Menstrual Cramps? A group of local Plano, Texas OBGYN doctors offer  information about the causes of painful periods and promising treatment for dysmenorrhea.

For some of us, those dreadful menstrual cramps are a sign that our period is lurking just around the bend, and then occur in sync with the first few days of our cycle. Like our mothers and grandmothers before us, this is just one of the beautiful and ugly parts of being a woman. But what does it mean when your pain becomes life changing, and alarming, causing the mere idea of getting up and out to send you into a panic? You see your OBGYN.

Painful periods, or dysmenorrhea as it is medically referred to, affects about 50% of women of post-pubescent age, and is most common in women during their early to mid-twenties. The occurrence of these severe menstrual cramps tapers off as a woman ages and most commonly disappears once a woman has reached her thirties. Dysmenorrhea is the scientific name for painful periods, in which a woman describes her cramps to be debilitating. Dysmenorrhea is further divided into two categories one being Primary Dysmenorrhea, and the other being Secondary Dysmenorrhea. Upon visiting with your OBGYN you will be diagnosed among one or the other. Of the 50% of women suffering from painful periods, 85% will be diagnosed with Primary Dysmenorrhea.

Primary Dysmenorrhea is usually the diagnosis if your OBGYN is unable to find any internal obstruction or problem that may be causing painful periods and severe menstrual cramps. Primary dysmenorrhea usually becomes a problem between 12 months and 2 years following a woman’s first cycle. The painful menstrual cramps usually begin a few hours prior to or just after the onset of menstruation. Pain is most severe during the first 2 days of the cycle. Characteristically the pain is described as spasmodic in nature and strongest over the lower abdomen and lower back. In severe cases the menstrual pain is also felt in the thighs. The pain is most commonly referred to as “labor-like” and accompanied by nausea, diarrhea, fatigue, and headache.  Symptoms that occasionally accompany these painful periods are anxiety and dizziness. Seldom do any symptoms persist beyond the third day of the cycle. Though Primary Dysmenorrhea does not appear to be prevented by any amount of or lack of activity, a few activities seem to help with menstrual cramps relief:

• Avoid stressful situations
• Take a warm bath, or use a warm compress
• Go for long slow paced walks
• Avoid fatty foods
• Participating in Yoga
• Pain-relieving medications
• Oral contraceptives

Secondary Dysmenorrhea will be the diagnoses if your OBGYN finds that the pain is caused by some sort of gynecological problem. Secondary Dysmenorrhea does not begin shortly after a woman’s first cycle, but usually 3+ years following. The painful menstruation is likely to begin at the onset of the cycle and last throughout the entirety of menstruation. The occurrence of secondary painful periods requires medical attention and at times medical procedures in order to help with severe menstrual cramps relief. Unlike Primary Dysmenorrhea, medical treatments are often the only hope for relief from pain. The cause of Secondary Dysmenorrhea will determine the proper treatment of it. A few of the procedures on the market for the treatment for dysmenorrhea include:

• Intrauterine Contraceptive (Mirena)
• Oral Contraceptives (such as birth control pills)
• Vitamin B supplements (For pain related to lack of nutrition)
• Antibiotics (for Pelvic Inflammatory Disease—also referred to as PID—or an untreated STD)
• Surgery (For a Cyst, or Fibroid Tumor)
• Dilation & Curettage (Removal of small amount of uterine lining, often as a cancer precaution)
• Hysterectomy (if the pain is caused by a malfunctioning reproductive organ)
• Endometrial Ablation (Permanent removal of uterine lining to prevent further pain and/or limit bleeding)

Treatment for dysmenorrhea varies according to severity of the issue and the problem causing the pain. The bottom line is if you are suffering from abnormally painful periods, it is of utmost importance that you check in with you OBGYN and discuss what is causing it, and your options for pain relief.