Posts Tagged ‘Jennifer Newton, MD’

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 Women’s Specialists of Plano (972.379.2416, http://obgynplano.com) specializes in pelvic floor dysfunction and vaginal prolapse. When Jean, a 74-year old resident of Plano, Texas, began having unusual and at times frightening symptoms during bowel movements, she decided to make an appointment with the Women’s Specialists of Plano.  “What should have been an everyday normal bodily function for anyone, created stress and anxiety for me because every time I attempted to take a bowel movement, I felt as if my internal organs were coming out—and in most cases, they were,” said Jean.

Jean’s OBGYN, Dr. Murray Fox, diagnosed her condition as pelvic floor dysfunction, or in her case, a vaginal prolapse. It is a common disorder seen by the entire group of doctors at WSOP including Drs. Jules Monier, Dennis Eisenberg, Daryl Greebon and Jennifer Newton.

Pelvic floor dysfunction is a condition in which the muscles that uphold the reproductive and digestive organs of a female weaken, and fail to work properly. The immediate result of this muscle failure is “falling of the female organs”, or, a sensation of pelvic pressure or an actual falling of the organs dropping through the vagina. Difficulty passing stools and urinary incontinence are the most common immediate symptoms eventually causing pain, and even more alarming symptoms such as what Jean was experiencing.  With the insertion of a vaginal pessary, Jean’s symptoms went away and she was able to resume life as normal.

During the early stages of pelvic floor dysfunction, it may be possible to re-strengthen the pelvic muscles through physical therapy and repair the damage before the dysfunction progresses. But due to the nature of the symptoms, it is commonly missed at an early stage, and the dysfunction becomes much worse.

When pelvic floor dysfunction is not treated properly or immediately it can cause problems of much larger proportions such as:

• Cystocele-The protrusion of the bladder into, and at times through the vagina.
• Rectocele-The protrusion of the rectum into, and at times through the vagina.
• Enterocele-The protrusion of the bowel into, and at times through the vagina.
• Urethrocele-The protrusion of the urethra into, and at times through the vagina.
• Vaginal Prolapse-The protrusion of the top of the vagina into the lower portion of the vagina completely inverting it. (This is most common in post-hysterectomy patients.)

Statistics suggest that 40% of women between 60-80 years of age will experience some degree of pelvic floor dysfunction or vaginal prolapse. At this age the dysfunction is the resort of multiple things including age, gravity, number of children, constipation, childbirth etc. However, it is important to note that 1 of every 3 women of 25 and up will suffer from the dysfunction as well. The most common causes being pregnancy, obesity, vaginal delivery, and menopause.

If you begin to notice symptoms that lead you to believe that you may be suffering from any degree of pelvic floor dysfunction, consult with your physician as soon as possible. Pelvic floor dysfunction is diagnosed through a series of testing. Your doctor will begin their testing with a careful study of your medical history, symptoms, and physically or emotionally traumatic experiences that could be contributing to the physical and emotional pain of this disorder. Specific tests will be administered to determine which muscles are not properly performing their job.

Pelvic floor dysfunction may be treated with specialized physical therapy known as biofeedback if the dysfunction is found at an early stage. With biofeedback, a person may be able to strengthen the pelvic floor muscles and remind the body to perform these tasks as it should. Approximately 75% of individuals with pelvic floor dysfunction experience significant improvement with biofeedback.

Many times, pelvic floor dysfunction patients and those suffering from vaginal prolapse will need corrective surgery.  Using a vaginal pessary or a mesh device is often effective for curing the problem. A vaginal pessary can be inserted into the vagina to support the prolapsed organs. Meshes to secure organs into place are also commonly used. Using sutures, a mesh is used to help keep the bladder, uterus or other pelvic organs secure.  Using a pessary or a mesh will commonly alleviate symptoms.

If you are experiencing unusual symptoms that you believe may be associated with pelvic floor dysfunction, consult with your doctor and learn about the treatment options that are available to help you with your specific situation.

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.

The associates at Women’s Specialists of Plano, OBGYN, are pleased to launch this new website to assist patients in the North Texas communities of Plano, Frisco, Richardson, Dallas and surrounding areas in finding up to date information on leading-edge services offered in this area.  Women’s Specialists of Plano has been a long standing obstetrics and gynecology practice and its physicians are affiliated with Medical Center Plano, Baylor Regional Medical Center at Plano, and Baylor Medical Center at Frisco.  Murray Fox, MD, Daryl Greebon, MD, Jules Monier, MD, Dennis Eisenberg, MD and Jennifer Newton, MD are all experienced physicians and surgeons who are committed to bringing new and innovative technologies, such as da Vinci robotic surgery, and  laparoscopic and hysteroscopic procedures to their patients.  By staying current with new developments in the medical industry, these gynocologic surgeons help to save their patients time and money while providing minimally invasive procedures with reduced recovery time and less scarring.  They also provide a wide array of obstetric services from genetic and preconception counseling, to fertility to regular and high risk pregnancy.  For patient convenience, WSOP provides in-office services including, endometrial ablation, mammogram screening, DEXA bone density scan, 2D / 3D sonograms.

To meet our OBGYN’s please visit their physician profiles.  For a full list of WSOP services and treatment please visit the specialties page.