Menopause is a natural event that will occur in all women at some point as they age. Menopause occurs when menstruation stops and fertility ends. Once a woman has missed her period for one year she is considered menopausal. While the age at which a woman reaches menopause varies, it’s common for this transitional period to occur between the ages of 45 and 55.

For some women, menopause causes little to no symptoms; however, other women may experience:

• Hot flashes
• Vaginal dryness
• Memory problems
• Mood swings
• Night sweats
• Insomnia
• Weight gain
• Dry skin
• Decreased libido

Some of these symptoms such as hot flashes and night sweats will go away after menopause. To reduce the frequency and severity of their symptoms, it’s important that menopausal women maintain a healthy lifestyle.

When should I see my gynecologist?

No matter your age, you should visit your gynecologist for routine checkups ever year. During these visits it’s important that you ask any questions or address any concerns you might have regarding your health. Your OBGYN is able to address everything from birth control options and fertility treatments to hormone replacement therapy.

The type of symptoms you are experiencing as well as their severity will determine whether it’s worth visiting your gynecologist or your general practitioner to rule out other conditions that could be responsible for these symptoms. As we mentioned earlier, some women go through menopause and don’t experience any issues; however, women who are struggling to get their symptoms under control should talk to their gynecologist.

If you are experiencing symptoms of menopause but you’re under 40 years old you should also schedule a doctor’s appointment to determine what’s causing your symptoms. Hormonal issues and imbalances could be to blame and they should be treated as soon as possible.

What can be done to ease symptoms of menopause?

Once a woman reaches perimenopause (the stage right before menopause) she may start to notice a heavier or irregular menstrual cycle. Sometimes your gynecologist may prescribe birth control pills at this time to treat these issues. Birth control may also alleviate vaginal dryness and hot flashes.

Hormone therapy is the standard treatment when it comes to managing menopause symptoms. For example, estrogen therapy has been know to treat hot flashes and vaginal dryness and can be administered as a cream, patch, or pill.

During menopause your gynecologist may also recommend getting a blood test to check your hormone levels. Hormone therapy isn’t right for every woman. Women who have a high cholesterol, gallbladder, or liver disease, a history of blood clots or breast cancer shouldn’t undergo hormone therapy. In this case, non-hormonal treatment options such as prescription medications like gabapentin may be able to treat mood swings, night sweats and other common symptoms of menopause.

If you are experiencing menopause symptoms it’s important to consult your gynecologist. When you come into our office we can help you determine the best methods for getting your symptoms under control. Call us today to schedule an appointment.

Have you been screened for STI's, or Sexually Transmitted Infections? Surprisingly, most Americans do not prioritize this important health testing. Plus, many health care providers do not routinely offer testing for STI's of any kind; so, patients must ask them about it, says the American Sexual Health Association.

How often should you be screened for STIs?

The short answer is that everyone from ages 13 to 65 should receive a baseline screening for HIV, or the Human Immunodeficiency Virus, states the Centers for Disease Control (CDC). STIs, including HIV, often show no symptoms but can cause serious health issues over time. Also, says the CDC, routine testing, treatment, and follow-up limits transmission of disease from sexual partner to partner. So, all adults should ask their doctors for testing once a year. In fact, they should insist upon it.

Who is at risk for an STI?

Potentially anyone is at risk. However, some populations definitely are more prone to infection. They include:

• Male homosexuals
• People who have several sexual partners
• Women under the age of 25
• Sex workers
• Individuals who have unprotected sex

Transmission of STIs is easier than most people realize. Oral, anal, or vaginal sex can spread the microbes or insect vectors responsible for these often dangerous and hard to treat diseases. While many people believe they cannot ever have a Sexually Transmitted Infection, WebMD says the vast majority of Americans actually have had an active form some kind of STI.

What do tests look for?

Screening tests look for:

• Syphilis
• Gonorrhea
• Chlamydia
• HIV, or Human Immunodeficiency Virus
• HPV, or Human Papillomavirus, which is linked to oral and cervical cancer
• Hepatitis B and C, caused by viruses
• Herpes
• Trichomoniasis, a parasite infection

Tests are simple, utilizing a urine sample, blood draw, or swab of oral or genital tissues.

Don't ignore the obvious or not so obvious

STIs can impact your health and interpersonal relationships. So, be sure you know where you stand. Women, talk to your OB/GYN about testing, and men, do the same with your primary care physician. It's what you do not know that can truly harm you and your loved ones.

The human papillomavirus (HPV) is one of the most common sexually transmitted diseases. According to the CDC, approximately 79 million Americans are infected with HPV. There are many strains of this infection, some of which can cause cancer. This is why it’s important that you visit your gynecologist once a year for annual checkups and screenings.

Symptoms of HPV

Unfortunately, men and women can have HPV and never know, since symptoms aren’t common with this STD. Some strains of HPV cause genital warts, a cluster of bumps that can be found on the vulva or cervix of a woman and may develop on the penis or scrotum of a man. Once infected, genital warts can appear as early as 3 months after exposure; however, it can sometimes take longer.

Since high-risk HPV (HPV that causes cervical cancer) doesn’t often cause symptoms this means that the best action you can take to protect your health is to visit your gynecologist once a year for an annual exam. During this exam, your OBGYN can perform a physical examination, as well as a PAP smear and HPV test to check for changes in cervical cells that could be a warning sign of cancer or pre-cancer.

HPV Screening

While there is no test to determine if you have HPV or not, there are tests available that can check for cervical cancer that is most likely caused by HPV. These screenings usually begin around the age of 30. Of course, if you develop vaginal bumps, sores or other changes it’s important that you see your doctor right away.

During a Pap smear, your gynecologist will scrape cells from the cervix and send them to a lab, where they will look for any cellular changes. A Pap smear only takes a couple of minutes to perform and those who’ve never had abnormal results may only need to get a Pap smear every three years. Those who have had positive results in the past may need to get tested more regularly.

HPV Vaccine

Luckily, there is now a vaccine available to protect against certain types of HPV, particularly the strains that are the greatest risk for developing cervical cancer. Before recently, the vaccine had only been approved for people ages 9 to 25 but now the FDA has approved the vaccine for adults ages 27 to 45. These vaccines only work on patients who’ve never had HPV before; this is why it’s important to vaccinate teens early on to protect against certain strains of high-risk HPV.

Is it time for your annual women’s appointment? If you are interested in getting tested for HPV, you can easily schedule an HPV screening to be performed during your next checkup.

Endometriosis is a female condition in which tissue that's similar to uterine lining begins growing on the outside of the uterus, often affecting the ovaries, fallopian tubes, and pelvic tissue. During your cycle, the endometrial tissue then becomes thicker until it breaks down and bleeds, and due to how this tissue can’t be removed from the body, it gets trapped. Over time, this can lead to scar tissue (known as adhesions) on the reproductive organs.

This condition affects as many as 11 percent of US woman between the ages of 15 and 44, most often affecting women in their 30s and 40s. This condition can also make it more challenging for women to get pregnant.

What are the symptoms of endometriosis?

The classic symptom of endometriosis is abdominal pain that is usually worse during your menstrual cycle. While a lot of women complain of some abdominal discomfort during menstruation, women with endometriosis often complain of very painful periods, which may even radiate to the lower back.

Women with endometriosis may also experience very heavy periods or breakthrough bleeding (bleeding between cycles). You may also notice pelvic pain during sex or with bowel movements, as well as bloating, constipation, diarrhea, nausea, or fatigue.

All symptoms will vary from woman to woman. For instance, some women may have very severe symptoms but only have milder cases of endometriosis, while those with more severe cases may experience little-to-no-discomfort. Everyone is different; however, if you are experiencing new, persistent, or worsening pelvic pain, it’s important that you talk with your gynecologist.

If you are trying to conceive you may also find it more difficult to do so. Sometimes women don’t often find out that they have endometriosis until they visit their OBGYN to discuss problems getting pregnant.

How is endometriosis diagnosed?

During your evaluation, your OBGYN will ask you questions about the symptoms that you are experiencing. From there, a couple of tests will be performed in order to pinpoint specific signs and symptoms of endometriosis. These tests include a traditional pelvic exam or an ultrasound. In some instances, an MRI exam or a laparoscopy (a minor surgical procedure that allows a doctor to examine the inside of the abdomen and uterus) may be recommended to make a definitive diagnosis.

How is this condition treated?

Since there is no cure for endometriosis the goal of treatment is to manage your symptoms. As with most conditions, we will recommend more conservative treatment options at first to see if they are effective. Common treatment options include,

• Pain medications (either over-the-counter or prescription-strength)
• Hormone therapy (e.g. birth control pills; progestin therapy)
• Fertility treatment (for women who are having trouble conceiving)
• Laparoscopic surgery to remove excess endometrial tissue

If you are experiencing symptoms of endometriosis, it’s important that you talk to a gynecologist as soon as possible.

At some point all women will need to receive routine pelvic exams in order to check their vaginal and reproductive health. This exam allows your gynecologist to be able to examine the vagina, cervix, ovaries, fallopian tubes, and uterus to look for early warning signs of infection or other problems.

Unless otherwise recommended by a physician, most women will undergo their first pelvic exam at the age of 21. After which, this simple exam should become a regular part of your well-woman care.

Getting a Pelvic Exam

We know that any kind of new exam or procedure can make anyone a little nervous. That’s why we want you to know what to expect before coming into the office for your first pelvic exam. Here’s what to expect:

We will provide you with a dressing gown, which you will change into in private. From there, you will lie down on the exam table and place your feet into elevated footrests. You will move your body towards the end of the table and our gynecologist will instruct you on what to do to make sure they can perform the exam. Relaxing as much as possible during the exam is important as it will make the process more comfortable for you.

There are usually three different parts involved in a pelvic exam:

• The external exam: This allows us to look at the external tissue of the vulva to detect any irritation, abnormal discharge or warning signs of other problems like genital warts or cysts.
• The internal exam: A special instrument known as a speculum will be carefully inserted into the vagina to open up the walls so that your gynecologist can examine the uterus and cervix. Sometimes a small brush is inserted into the vagina to collect cells from the cervix for testing. This is known as a Pap smear and it allows your doctor to check for precancerous and cancerous cervical cells.
• The bimanual exam: The speculum is removed and your gynecologist will then place one or two gloved fingers into the vagina and press on the abdomen to check the size and shape of the uterus and to feel for any enlargements, tenderness, or pain.

While the first pelvic exam may feel a bit awkward and weird it should never feel painful or uncomfortable. If you are experiencing any discomfort please let us know. We will talk you through the entire process so you know what’s going to happen before it does. If you have any questions or concerns for us this is also the time to let us know.

How often should I get a pelvic exam?

This will depend on several factors. Based on your current health, medical history and any past medical test results we will determine whether you will only need to come in once a year or whether you could benefit from visiting us more often.