Posts Tagged ‘Gynecologists’

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/

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

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.

The gynecologists that make up the Women’s Specialists of Plano in Plano, Texas (http://obgynplano.com) were interviewed for this article.

If you are a typical female between the age of 12 and 50, having your period each month probably passes like a leaf in the wind. For many women, having a period may cause a few symptoms that can easily be managed by taking a simple ibuprofen and using some feminine protection—and then just like that, it’s gone. For others, this monthly visit from mother nature is a dreaded and life altering time that sends some women into hiding.

Meet Amy.

Amy is a normal, active mother of three in her mid-thirties with a hectic life. Her schedule was very busy between work, working out, ballet for her girls, soccer for her little boy, PTA, and maintaining a happy marriage. Amy didn’t have time to be slowed down by her period, yet for a few days every month she felt incapable of maintaining her schedule because her periods were so heavy, and so painful. So heavy in fact, that she found herself in the bathroom every hour to deal with the side effects of her period. She knew that her cycles hadn’t always been this heavy, or this painful, but thought the abnormal menstrual bleeding was just the result of the birth of her three children, and her active lifestyle.

After Amy’s last period she felt fatigued, and light-headed. Soon after, she met up with her girlfriends for lunch. Exhausted by her life altering periods and abnormal menstrual bleeding she decided to bring it up with her friends. “At lunch, I explained to my friends just how heavy and painful my periods had been all these years, and I was surprised that none of them had similar experiences,” said Amy. “In fact, they all were very concerned and advise me to see my doctor. So the next week I visited my OBGYN and was ecstatic to learn that my condition actually had a name.”

Amy’s doctor diagnosed her with Menorrhagia.

Menorrhagia is defined as an excessively heavy period, but can also cause extreme discomfort. Periods are different for every woman. Some are short and painless, and some are long and painful. But it is not at all normal for a woman’s period to affect her everyday life or keep her from performing her normal activities. Reasons to see an OBGYN with the suspicion of Menorrhagia are things such as:

• Periods that last longer than 5 days
• Painful periods with severe pelvic pain
• Periods that require double sanitary protection (tampon and pad)
• Bleeding through a tampon or pad in an hour or less for several hours in a row
• The passing of large blood clots
• Fatigue, pain, headaches, nausea

Though depression and social anxiety are not symptoms that point towards menorrhagia, they often are results of the problem. Women such as Amy, who normally have a very active and busy life, begin to invert, afraid of excessive and abnormal menstrual bleeding while in public or the inability to get to the restroom before leaking.

Thankfully, Amy found out that there are multiple options to cure this condition. After considering the number of years she had been suffering from heavy blood loss, and that she had three beautiful children and did not wish for anymore, Amy’s OBGYN explained to her that she was a great candidate for an endometrial ablation. With this procedure, the entire lining of the uterus is removed with the intent of preventing any future menstruation. The NovaSure procedure is one such approved endometrial ablation treatments for menorrhagia.

According to the gynecologists at the Women’s Specialist of Plano, “The NovaSure procedure uses radio frequency energy to permanently remove the lining and is always effective in slowing the bleeding, and at times prevents it completely. 95% of women who receive the ablation are very happy with the outcome. The only down side to the procedure is that it can prevent future pregnancies.  We recommend the NovaSure endometrial ablation procedure when we can because it is a more conservative treatment option than procedures such as a hysterectomy.

Amy moved forward with the surgery. It was minimally invasive, almost painless, and had an extremely fast recovery. Amy was back to her busy schedule and fast pace life, but this time, without fear of leakage, and days spent at home due to pain and fear.

If you are a woman who is experiencing heavy periods that are interrupting your life, there is help. It is very important to track your period and be aware of changes in consistency, duration, and pain level. Don’t wait as long as Amy did, if changes arise consult your OBGYN today.

There are many reasons why a woman may choose to have, or need a hysterectomy. A hysterectomy is the removal, or partial removal of the uterus. The uterus is the large, hollow, female organ that resides in the female pelvis between the bladder and the rectum. It is where a fetus grows once an egg has been fertilized.

Hysterectomy statistics include:

• 10% of Hysterectomies are performed because of (due to) cancer
• 30% of Hysterectomies are performed because of (due to) Fibroid Tumors
• 20% of Hysterectomies are performed to eliminate pain caused by Endometriosis
• 16% of Hysterectomies are performed to repair a prolapsed Uterus.
• The remaining 24% of Hysterectomies are performed for reasons such as recurrence of pain and heavy bleeding, severe infection, and post delivery trauma.

Regardless of the reason a woman might be receiving a hysterectomy it is still a big decision, which accompanies an understandable amount of stress. Today, the complications following a hysterectomy can be lessened with new tools, techniques and medical technologies.  The gynecologists at the Women’s Specialists of Plano use a system called the da Vinci robotic surgery which makes the entire surgery and recovery process a lot simpler than it once was.

The robotics hysterectomy da Vinci system is a highly technical system of small, precise, electronic tools that robotically assist a physician in surgically removing the reproductive organs without causing major incisions or long recovery periods. The list of pros for a robotics hysterectomy includes:

• Less pain
• Fewer complications
• Less blood loss
• Shorter hospital stay
• Low risk of wound infection
• Quicker recovery and return to normal activities

What is robotic surgery? It’s a fairly simple process. The da Vinci robotic surgery allows doctors to see the organs through a microscope via a 3d screen without the need to make large incisions. The robotic arms of the da Vinci allows precise movement and act as the surgeon’s hands eliminating unsteadiness. The surgery leaves the patient with just a couple of very tiny incisions that usually do not require sutures.

OBGYN’s are constantly asked “What is robotic surgery and how will it benefit me?” from patients. Two Women’s Specialists of Plano recipients of robotics hysterectomy recently provided the following feedback regarding their recent procedures:

According to Patricia, “After battling breast cancer and going through numerous surgeries, the last thing I wanted to do was go under the knife again. But when my OBGYN found a benign tumor on my ovary, he recommended a hysterectomy. The first thing that came to my mind was that I would be left in a considerable amount of pain because of a huge incision and out of work for six to eight weeks. After looking at my specific situation, we decided on the robotic hysterectomy method. The surgery was fast and I was in recovery within a very short period of time. I barely had to take any painkillers and I had no complications whatsoever. My scars are barely visible.  Even after one week, I felt good enough to go back to work, but still stayed home because of my doctor’s advice. I would recommend the robotic hysterectomy to anyone considering a hysterectomy.”

Sharon, another patient who underwent a hysterectomy via da Vinci robotic surgery, shares a similar experience.

“After several years of experiencing inconsistent, crampy, long periods—coupled with abnormal and inconclusive pap smears, I was ready for a hysterectomy. My doctor recommended the robotic hysterectomy technique and after doing my own research on the technology, I knew it was for me. Not only was the surgery a breeze, but the post-op recovery was trouble-free and brought with it minimal pain and scarring. Technology is a beautiful thing and it has allowed this surgery to become easier and the result as if it has never happened.”

The benefits of the robotic hysterectomy have been documented by thousands of patients and doctors.  Because the procedure is highly technical, it requires a skilled, trained surgeon.  While not all patients are candidates for this procedure, more and more are and are turning towards the method because of the benefits it brings.

According to the doctors that make up the Women’s Specialists of Plano, “The skillfulness of the robotic tools and the dexterity of the 3D technology allows for the effectiveness of traditional open hysterectomy surgery and brings it to the minimally-invasive setting.”

Any woman considering or being faced with a hysterectomy, should discuss all of the options with their OBGYN. The robotic hysterectomy is one such consideration to be discussed.

The stage of life between a young woman’s fertility, and the menopause of a woman’s later years is called peri-menopause. Peri-menopause begins in a woman’s late 30s to early 40s and can last 3-15 years.  According to Drs. Fox, Greebon, Monier, Eisenberg and Newton, Plano, TX gynecologists that make up the Women’s Specialists of Plano (972.379.2416), “This number is different for every woman, but one fact that remains the same is that during this phase, undesirable effects will take place to a woman’s body.”

Peri-Menopausal Bleeding

Peri-menopause is onset by the fluctuations of the female hormones estrogen and progesterone. These normal hormone changes are the result of the ongoing decrease of eggs inside a woman’s ovaries.  As these eggs decrease, there is no more cyclic estrogen and progesterone production. The symptoms a woman will experience during due to these biological changes most often reflect peri-menopause. The most obvious sign that a woman may be in peri-menopause is the change in her menstrual cycle. It is important to highlight what a normal period looks like for most women:

• The start of one period to the start of the next should be at least 21 days
• Periods should last less than 10 days
• There is no spotting in between periods
• Periods should be no further apart than 90 days

Because all women’s cycles are unique, peri-menopausal bleeding changes will be unique to each woman. Some women notice a very heavy period one-month, followed by the absence of a period the next month. Others may experience more frequent periods that appear less than the average 28-32 days apart. Some woman may only spot during their period for several months, while others notice heavier bleeding throughout. Only you will know if your cycle has changed. The sporadic distribution of estrogen and progesterone is to blame for menopausal bleeding changes and is inevitable.

The natural hormonal imbalance that takes place inside of a woman’s body may cause other undesirable symptoms. Some of the symptoms of peri-menopause include:

• Hot flashes
• Sleep problems (which affects 75% of all peri-menopausal women)
• Mood changes
• Vaginal dryness
• Bladder problems
• Decreased fertility
• Increase in bad cholesterol
• Loss of bone mass
• Weight gain

Other common symptoms of peri-menopause include bouts of depression; it is also very common for a woman in these years to suffer from a loss in libido and decreased sexual arousal.

The Transition from Peri-Menopause to Menopause

Every woman is born with a certain amount of eggs. She will not produce anymore throughout her life. As a woman ages, so do the ovaries which is where the eggs reside. During pre-menopause the fluctuation of hormones within a woman’s body begin to make it difficult for the eggs to reach the point of ovulation, causing the above mentioned symptoms for a peri-menopausal woman. As it becomes increasingly difficult for an egg to reach ovulation, ovulation begins to cease. After an egg is no longer able to reach ovulation at all, ovulation ceases completely and so does a woman’s cycle. It is at this time that a woman’s transition from peri-menopause to menopause is complete.

It is important to remember that peri-menopause is the stage before menopause and does not mean that you have crossed over the bridge. A woman in peri-menopause has a decreased likelihood of getting pregnant, but it is still possible. A woman is not considered menopausal until she has been without a cycle for a full 12 months. If you are peri-menopausal and aspire to have a child, talk to your doctor about your options.

Peri-menopause shows itself differently in every woman. Some may find it alarmingly obvious that their body is changing, while others may soar through peri-menopause into menopause without ever noticing a single hot flash. However it is important to note that if you are noticing that the symptoms of peri-menopause are beginning to affect parts of your daily life you need to speak with your doctor. He or she will discuss your options with you and help you to find comfort during this transition.

There are several approaches to easing the transition from peri-menopause to menopause; only your doctor will be able to decide what option is best for you. Some methods that women have found helpful to help minimize the symptoms of peri-menopause include:

• Low dose birth control, for the relief of hot flashes and the changes associated with menopausal bleeding.
• Exercise, which is good for your health and known to help a woman receive better rest.
• Vaginal lubricants and sex therapy, to help recover the loss of libido.
• A diet full of calcium, to help protect against the loss of bone mass.
• Anti-depressants, to help control the mood swings and bouts of depression.

The Women’s Specialists of Plano in Plano, Texas include Dr. Murray Fox, Dr. Daryl Greebon, Dr. Jules Monier, Dr. Dennis Eisenberg, and Dr. Jennifer Newton.  They offer adolescent gynecology, obstetrics and treat women even past the menopausal years. As a woman’s body goes through the myriad of changes from teenage to menopause, it’s important to have a trusted resource to answer questions and receive regular well checks. Peri-menopause, while it can be a troublesome condition for many women, is treatable on some levels.  Contact your physician today to learn more.

An estimated 17 million women in the U.S. will cope with female bladder problems and urinary incontinence each year. According to the Women’s Specialists of Plano, TX, (972.379.2416, http://obgynplano.com), a large majority of these women do not discuss the symptoms associated with their incontinence with their family doctors and in many cases, the condition is left untreated.

Urinary incontinence is the medical term used to describe the loss of urine control. It can happen when you cough, sneeze, exercise or do any other type of activity that may put stress on the bladder. Urinary incontinence can exist where a woman might experience episodes of a slight dribble of urine, to the inability to hold urine all together; it can also be temporary or permanent depending on the underlying cause. While it is not a serious health concern, it can lead to anxiety, stress and embarrassment for sufferers.

Causes of Female Urinary Incontinence

Female urinary incontinence is usually caused by weakened or damaged pelvic muscles that prevent the urethra from closing tight enough to hold urine in the bladder. Many women will experience incontinence after giving childbirth where exceptional strain is put on the pelvic region. For many, this condition will go away, while for others, it will continue to worsen before female incontinence treatment is sought. Other causes of female urinary incontinence include:

• Childbirth
• The aging process
• Traumatic injury
• Weight gain
• Smoking
• Neurological disorders (spinal cord/head injuries)
• Infections (urinary tract, bladder infections, etc.)
• Certain diseases (such as Multiple Sclerosis)
• Medications, prescription drugs

Types of Female Urinary Incontinence

Drs. Daryl Greebon, Jules Monier, Murray Fox, Dennis Eisenberg and Jennifer Newton are Plano, Texas gynecologists that make up the Women’s Specialists of Plano. They offer female incontinence treatment and see various types of female urinary incontinence from patients that enter their office doors.

There are five basic types of urinary incontinence. Stress incontinence occurs when you leak urine during a physical activity such as lifting, jumping, exercising, sneezing and coughing. It is typically a result of both hypermobility (which occurs when the urethra and bladder neck shift from their normal positions) and an Intrinsic Sphincter Deficiency, which occurs when the urethral sphincter is unable to close tightly enough to hold urine in the bladder during physical exertion.

Urge incontinence is described as over-activity of the detrusor muscle, which is the smooth muscle that surrounds the bladder. It typically relaxes to allow the bladder to fill, then contracts to squeeze out urine when a woman goes to the toilet. During urge incontinence, the bladder will contract frequently creating an overwhelming need to urinate even if you just went. This condition is often referred to as “overactive bladder” and makes it difficult to hold your urine long enough to reach a toilet.

Other forms of female urinary incontinence include overflow incontinence where the bladder never completely empties causing urine to leak, and functional incontinence where a physical limitation or immobility may exist making it impossible for a person to reach the toilet in time.

Female Incontinence Treatment

There are solutions for female urinary incontinence and female bladder problems that have been proven to bring them a sense of normalcy. Every woman should discuss their symptoms with their physician so that the correct solution can be found.  For mild incontinence, Kegal exercises are usually effective; behavior therapies and small lifestyle changes such as decreasing the amount of fluids taken in or scheduling bladder elimination can also help.

For women who experience moderate incontinence, medications, protective undergarments and bulking injections such as collagen may be used. Some women find that their female bladder problems go away with the use of a pessary device. A pessary device is a stiff ring that is inserted into the vagina where it places pressure against the wall of the vagina and urethra. This pressure helps control leakage because it repositions the urethra.

For many women, surgery becomes the answer in order to get their incontinence under control. Retropubic suspensions are used to treat hypermobility. These suspensions elevate and restore the bladder neck and urethra back to their natural anatomical positions.  This procedure is often referred to as the Burch procedure.

A variety of slings are also available to help restore normal bladder function. Slings can be inserted via a minimally-invasive surgical technique to help support the bladder and urethra. Some slings use self-fixating anchors while others use sutures.  All are used to provide relief of the sensations and symptoms associated with urinary incontinence and most provide good results.

If you suffer from incontinence, make an appointment with your gynecologist to talk about your symptoms and options for a permanent solution so that your quality of life can be restored and the stress and anxiety from female urinary incontinence eliminated.

Every woman will go through menopause and will experience different symptoms. There is help that can be offered to treat these symptoms. Talk to your gynecologist today.

When I interviewed some of the physicians at the Women’s Specialist of Plano, Texas (http://obgynplano.com, 972.379.2416) for a women’s health feature on the topic of menopause, I assumed they would tell me the obvious: that menopause is simply a phase all women go through that causes unwanted symptoms and an end to all menstrual periods.

I was right, they did. But I also learned a lot more during my discussion with Drs. Murray Fox, Daryl Greebon, Jules Monier, Dennis Eisenburg and Jennifer Newton—all skilled and experienced gynecologists with WSOP—that really made me think differently about the “change of life.”

Menopause symptoms and treatments are different for every woman and there is a range of options for each specific case.  As a 37-year old female, I thought I still had a long time until I had to deal with the side effects of menopause. I distinctly remember my mom going through it at age 50 when she had a serious hot flash during the middle of my engagement party.

The truth—is that what I saw in her, were symptoms she had been dealing with for several years.

What Is Menopause?

Every woman is born with a certain number of eggs. These eggs are stored in the ovaries and it is in the ovaries that the hormones estrogen and progesterone are produced, which regulate ovulation and menstruation. Menopause occurs when the ovaries no longer produce an egg every month and menstruation stops. Natural menopause is a normal condition that occurs in all women between the ages of 40-58. Natural, meaning that menopause occurs without the side effects of any medical treatment such as a hysterectomy or chemotherapy. All women will experience some of the same symptoms from menopause as they age, but all will experience one common characteristic: their reproductive period will come to an end.

While the end to a menstrual cycle is a welcomed part of menopause, there are a number of unwelcome symptoms associated with this change. They include: irregular periods, missed periods, fatigue, mood swings and irritability, insomnia, depression, headaches, muscle aches and pains, bone loss (osteoporosis), incontinence and changes in sex drive (libido) as well as a decrease in vaginal lubrication.  In additions, many women will experience hot flashes and night sweats. Fortunately, many of the symptoms associated with menopause are temporary and will eventually disappear once menopause ends.

Help for Menopause

For women who choose to discuss menopause symptoms and treatments with their physicians, it is reassuring to know that there are many natural and home remedy steps one can take to help decrease and prevent some of the symptoms such as exercise, yoga, eating a healthy diet and getting plenty of rest.  Many women learn how to cool a hot flash by learning what triggers them. This helps them limit when hot flashes will occur and control them when they start.

For women that need additional help during menopause, there are medications that can be taken to help minimize the symptoms such as antidepressants, bone loss medications, Clonidine (a high blood pressure medication that helps ease hot flashes), vaginal estrogen creams and Progestin pills which help with irregular periods before menopause occurs.

Hormal Replacment Therapy:  Is It Right For You?

The onset of menopausal symptoms occur when the body stops producing estrogens. There are three types of estrogen produced in the human body and all three of these occur in balanced proportions, and although they are closely related, each has its own special function:

• Estradiol is the primary estrogen hormone and in nature it comprises 80% of the estrogen a woman’s body makes.
• Estrone is the least prevalent of the normal estrogens in women.  It increases significantly during pregnancy, but is a bit weaker than estradiol in its effect.
• Estriol is the third natural estrogen, and is also less potent in estrogen effect than estradiol.

Menopause symptoms and treatments will vary for each woman. For many women, hormone replacement therapy is used in the post-menopausal patient to minimize symptoms caused by the lack of a predictable estrogen-progesterone production. While hormone replacement is not for everyone, it has made a difference in millions of women’s lives. Patients are generally divided into two groups: those with a uterus and those without.  Patients without a uterus are usually treated with estrogen alone (estrogen replacement therapy – ERT); while those with a uterus are treated with estrogen and progesterone (hormone replacement therapy – HRT).

Likewise, hormone medications are also divided into groups: natural (made from soy, yam or other roots), bio-identical (compounded by a pharmacy) and synthetic (manufactured by pharmaceutical companies). In a woman who still has her uterus, ANY form of estrogen can stimulate the uterine lining and cause bleeding issues and the risk of endometrial cancer. The key in preventing this problem when estrogen replacement therapy is needed is to use progesterone with it in an adequate amount to protect the endometrium. For women who do not have a uterus, the endometrium is gone, and there is no need for progesterone, which can make estrogen therapy easier whether it is a cream, pill, or patch.

HRT and ERT:  Pill or Cream?

Is it better to take a pill, or use topical therapy?  This too has been debated for years.  Not all people respond equally well to the same product, so one woman may find it easier in her routine of life to take a pill.  Another may not react well with the pill, or may have trouble remembering to take a pill regularly and may be a better candidate for the patch, vaginal ring or for estrogen cream.  Each method works the same and it is important for a woman to find the best match for her and for her current lifestyle.

Hormone Replacement Therapy and Breast Cancer

The link between estrogen and breast cancer has been a highly discussed topic over the last decade.  According to Dr. Murray Fox, “Much of the data that has been reported in the media regarding the link between estrogen and breast cancer has been vastly misrepresented.  The media touts that 30% or 40% of women develop breast cancer while taking estrogen.  Those numbers are distorted. In recent tests that included several groups of 10,000 women, out of those who had no hormone treatment, 28 developed breast cancer; those with hormone treatment resulted in 36 women who developed breast cancer.  In a similar group of women who took estrogen alone, without any progesterone (because they had had hysterectomies), there were 7 fewer cases of breast cancer, suggesting that it is not primarily estrogen that causes the problem, but is the combination of estrogen and progesterone.”

Dr. Daryl Greebon agrees, “It is important for women to understand that estrogen poses greater risks for other medical issues than cancer. The primary risk of estrogen is blood clots (phlebitis); this can include blood clots in the leg, pulmonary embolus, or stroke. These risks exist with any estrogen replacement therapy whether oral or topical, and whether compounded or not.”

Dr. Jules Monier and the other physicians at the Women’s Specialist in Plano, Texas recommend their patients who are on estrogen replacement therapy use the lowest dose of estrogen possible for the shortest time possible, preferably no more than 5 years.  “However, quality of life is an important consideration, and as with all medical treatments one must weigh the benefits and the risks. For women who have incapacitating symptoms it may be worth the risks to have a better life style, this is an individual choice, “ says Dr. Monier.

Menopause symptoms and treatments and the best solution to handle the “change of life” can be a complex issue for many women. Each woman should discuss the options that are available with their doctor. The choice of using HRT or ERT should be made based on a balance of risks and benefits.  While there are risks to consider, for those women who suffer severely from menopausal symptoms, hormone replacement therapy and estrogen replacement therapy can make a major difference in their life.

About the writer:  Kristy Theis is the content editor for EmedicalMedia.  The physicians that make up the Women’s Specialists of Plano, Texas were interviewed for this article.