Coming in to see your OBGYN once a year is an important part of every woman’s health. Even if you aren’t experiencing symptoms these examinations could prevent issues from happening and can allow your doctor to detect problems early on when problems are often much easier to treat. If we detect any suspicious growths or other symptoms during your pelvic examination then we may recommend getting a biopsy. There are different diagnostic biopsies that we may recommend depending on the symptoms and issues you are experiencing.

Cervical Biopsy

This biopsy is often performed if a Pap test or other diagnostic test detected abnormal cells in the cervix. In some cases, if you’ve been diagnosed with human papillomavirus (HPV) you may also require a cervical biopsy since some types of HPV can cause cervical cancer. A cervical biopsy may also help determine if the abnormal cells are potentially precancerous.

There are a few different ways that a cervical biopsy can be performed. Of course, no matter what technique is used, a cervical biopsy will need to remove a sample of the abnormal tissue for testing. Cervical biopsies are performed by a punch, cone or endocervical curettage method.

Endometrial Biopsy

Just like a cervical biopsy removes a sample of tissue from the cervix, this specific biopsy will remove a sample from the endometrium (the lining of the uterus). This biopsy may also be one way that your gynecologist can check hormone levels that can affect the health of your endometrium. This type of biopsy may also be recommended if you are experiencing irregular, heavy or long-term bleeding and aren’t sure of the cause.

Colposcopy

This procedure is a great way for your OBGYN to check the health of your cervix, vagina, and vulva to look for any signs or symptoms of the disease. Just like with a cervical biopsy, a colposcopy may be recommended if your Pap test came back abnormal. During your colposcopy, a small sample of tissue will be removed and examined. This diagnostic procedure is a great way to detect and diagnose certain issues such as cervicitis (inflammation of the cervix), precancerous tissue or genital warts.

If you have questions about your upcoming biopsy or if you are experiencing any symptoms or changes then it’s time you visited an OBGYN who can help you.

Osteoporosis weakens your bones and can cause them to break easily. The condition is particularly common in older people. In fact, more than 53 million people in the U.S. either have the disease or at high risk for developing it, according to the NIH Osteoporosis and Related Bone Diseases National Resource Center.

How does osteoporosis affect bones?

If you have osteoporosis, your bones gradually become less dense and more porous. You may also experience thinning in the outside edges of the long bones in your body. Because of these changes, it's very easy to break a bone if you fall, even if you don't fall very hard. Osteoporosis affects both sexes but is more common in women. If you're female, you're more likely to be affected by the disease because:

• Women's bones are generally smaller and thinner than men's.
• Estrogen, a hormone that helps protect bones, decreases at menopause.
• Women tend to live longer than men. The longer you live, the more likely you'll develop osteoporosis-related problems.

What are the symptoms of osteoporosis?

In the early stages of the disease, you probably won't notice any changes. Symptoms generally don't occur unless your bones have weakened considerably. If you have osteoporosis, you may notice:

• You are shorter than you once were.
• Your posture has changed, and it's hard to stand perfectly upright without stooping.
• You have back pain due to compression fractures in your vertebrae.
• Your bones break easily.
• Dental X-rays show that you've lost bone in your jaw.

How is osteoporosis treated?

Although your bones will never be as strong or as dense as they were when you were younger, treatment is available to strengthen your bones and prevent breaks. Your doctor can prescribe medication that will slow the rate of bone break down and reduce your risk of fractures. In addition to taking medication, it's important to participate in weight-bearing activity and exercises that strengthen your bones and help improve your balance. Eating a diet high in calcium and taking supplements that contain calcium and vitamin D can also help protect your bones.

If you're concerned that you may have osteoporosis, talk to your OB/GYN about your risk factors and symptoms. Prompt treatment is the key to preventing the potentially serious consequences of this disease.

Cycle monitoring is a method used by OBGYNs and fertility specialists to map out a woman's monthly menstrual cycle, in order to determine when ovulation is most likely to occur. Every woman has what is known as a fertile window; the days leading up to and including ovulation. This is the phase of the menstrual cycle when a woman is most likely to get pregnant. Because every woman's cycle is different, with many women experiencing irregular periods which can make it harder to predict ovulation, cycle monitoring is useful for couples trying to conceive, either naturally or with the aid of IVI (Intravaginal insemination) or IVF (Invitro fertilization).

Ovulation and the Menstrual Cycle

A typical menstrual cycle is approximately 28 days, but varies from woman to woman. Ovulation is the monthly process where an egg is released for fertilization by the sperm, and it is the only point in the menstrual cycle when conception is possible. Healthy sperm generally remain viable for up to five days, which is factored into the fertile window when calculating a fertility chart and menstrual cycle for a woman actively trying to conceive.

Many women are unaware of their ovulation schedule, and many myths abound about the length and duration of the fertile window. Because menstrual cycles can vary greatly from one woman to the next, a consultation with an OBGYN can help women determine their ovulation schedule once they have decided they are ready to become pregnant.

Determining Ovulation and the Fertility Cycle

The first step in cycle monitoring is measuring the basal body temperature. Although the variations in temperature can be slight, and OBGYNs have found the effectiveness of basal body temperature measurements in predicting ovulation to be inconclusive, it is still considered a basic step in charting fertility. During ovulation, the body releases elevated levels of the hormone progesterone, which can cause slight fluctuations in temperature. During ovulation, the cervix produces elevated levels of mucus designed to help the sperm make its way to the egg for fertilization. Monitoring mucus levels can help to predict ovulation. The mucus becomes more elastic, clear (resembling the texture and consistency of egg whites) during the fertile window.

The range varies from woman to woman, but days 1-5 are the beginning of the cycle, when menstruation occurs. Days 6-9 are dry with no visible mucus. From days 10-12 the mucus is sticky and thicker than during the fertile window. At the end of the fertile window the mucus becomes thick and sticky again, followed by dryness until the cycle begins again the following month. Measuring the cycle for a few months can help to determine both the duration and ovulation dates for each woman.

Worried that you may have PCOS? Find out more about this condition and what we can do to help.

Do you notice that you have irregular menstrual cycles? Do you sometimes skip your periods altogether? You could be dealing with polycystic ovarian syndrome (PCOS), a condition in which estrogen and progesterone levels are off kilter and can lead to to ovarian cysts. Find out more about this condition and how your OBGYN can help.

What causes PCOS?

Unfortunately, no one really knows what causes this condition, but it is believed that genetics and hormonal imbalances have some responsibility in who develops PCOS and who doesn’t. If your mother or immediate family member has this condition, you are also more likely to develop PCOS.

Women with PCOS also tend to have an overproduction of androgen, a male sex hormone. Androgen can affect how an egg develops or is released each month.

What are some telltale signs that I have PCOS?

Many women will start to notice that something is amiss one they start menstruating. Of course symptoms varies from woman to woman, but many people with PCOS notice that they have irregular menstrual cycles.

With the imbalance of hormones, some women may start developing more masculine characteristics such as:

• Excess hair on the face, chest, fingers or toes
• Thin hair
• Deeper voice

Besides these symptoms women with PCOS may also experience:

• Weight gain (usually caused by other chronic health problems like diabetes)
• Infertility
• Depression
• Abdominal pain
• Acne

How will a PCOS specialist treat my condition?

While there is no cure for PCOS, there are certainly ways to manage your symptoms. Your treatment plan will be tailored to what symptoms you are experiencing. Of course, a healthy diet and regular exercise are recommended for everyone who has been diagnosed with this condition.

Birth control pills may also be prescribed to help regulate hormones and your menstrual cycle, and they sometimes have the added bonus of improving your acne. For women with PCOS who are looking to get pregnant, fertility treatments may be recommended to help assist in successful ovulation.

If you are concerned that you may have PCOS, or if you are having issues with irregular periods, it’s time you talked to your gynecologist.

You're more likely to experience a birth control failure if you select a method that's not comfortable or convenient for you. Fortunately, there are plenty of effective birth control options available if you're not happy with your current method. Your OBGYN can help you evaluate the pros and cons of each option and make an informed choice.

Types of birth control available

Birth control options include:

• Barrier Methods: Barrier types of birth control physically prevent ejaculated semen from entering your cervix. Condoms are the most well-known type of barrier birth control. Other options include cervical caps, diaphragms and contraceptive sponges. Condoms also help protect you from sexually transmitted diseases (STDs).
• Spermicide: Spermicide is a cream, foam, gel or film placed inside your vagina to kill sperm. It's most effective when combined with other birth control methods, such as diaphragms, condoms or cervical caps.
• Intrauterine Devices (IUDs): IUDs are T-shaped devices inserted in your uterus at your OBGYN's office. The devices protect you from pregnancy for several years and provide reversible protection against pregnancy. Some IUDs release a hormone that thickens the cervical mucus and makes it difficult for eggs to attach to the uterine lining. Others secrete small amounts of copper to prevent sperm from moving.
• Hormonal Methods: Hormonal birth control thickens your cervical mucus and prevents you from ovulating, a process that occurs when you release eggs into the Fallopian tubes. Birth control pills are taken every day, while implants, patches, rings and shots can provide protection from three months up to three years, depending on the method.
• Natural Family Planning (NFP): If you choose NFP, you'll chart your monthly menstrual cycle and avoid sex during fertile periods. NFP doesn't work as well as other methods because ovulation doesn't always occur at the same time every month.

Factors that will affect your choice

Before you select a birth control option, you'll need to consider the method's effectiveness and ease of use. Will you remember to take a daily pill or use a condom every time you have sex? If not, a long-term birth control method may be a better choice.

Your health is an important consideration when selecting a birth control option, particularly if you're interested in hormonal methods. Although hormonal birth control is a good choice for many women, it may not be recommended if you smoke and are over age 35, or have a history of breast cancer, stroke, blood clots, migraine with aura, or other conditions.

Do you need a little help selecting a birth control method? Contact your OBGYN to schedule an appointment to discuss your options.