Women’s Health

Women's Health

Gynecology

Gynecology is the practice of medicine that deals with functions and diseases specific to women and girls, especially those affecting the reproductive system, which also includes menopause. As a woman, Dr. Bahareh Fazilat understands that a gynecologist is more than just a physician, but an integral part of her patient’s life. A gynecologist is involved in the most personal and intimate aspects of a woman’s health. 

Gynecology

INFERTILITY TESTING AND TREATMENTS

INFERTILITY TESTING
AND TREATMENTS

If you and your partner are having a hard time getting pregnant, you may be one of the millions of couples struggling with infertility. In the United States, infertility affects roughly 15% of couples. Fortunately, reproductive technology has advanced in recent years and couples have multiple pathways to achieve a healthy pregnancy.

What are the main causes of female infertility?

  • Endometriosis
    Endometriosis is a relatively common disorder in which endometrial tissue grows outside the uterus.
  • Disordered ovulation
    Certain hormonal disorders — such as PCOS — can prevent proper ovulation. In fact, PCOS is the leading cause of infertility in women. Eating disorders, excessive exercise, tumors, or trauma can also inhibit ovulation.
  • Tubal factors
    Some conditions cause scarring or blockages of the fallopian tubes, which prevents the egg and sperm from joining.

    Your fallopian tubes, which move the mature egg from your ovaries to your uterus, may be partially or completely blocked by adhesions. Adhesions are areas of scar tissue that cause organs to become stuck together and prevent the egg’s movement. Diseases such as endometriosis, salpingitis, pelvic inflammatory disease, and certain sexually transmitted infections can cause adhesions. They are also often the result of tubal surgery.

  • Abnormal conditions in the uterus
    Some conditions prevent the fertilized egg from properly implanting in the uterus — such as uterine fibroids, uteruine septum, or an abnormally-shaped uterus.
  • Early menopause
    Some patients experience early menopause — also known as primary ovarian insufficiency — before age 40. Perimenopause refers to the years before menopause when the ovaries gradually start to produce less estrogen. During this time, estrogen levels fluctuate, which can cause heavy, irregular menstrual cycles and cramping. If you’re experiencing these symptoms, early menopause may be the cause of your infertility.
  • Cancer, cancer treatment, hypothyroidism or hyperthyroidism
    All are known to potentially interfere with the ability to conceive. Many cancer patients take advantage of fertility preservation technology before beginning cancer treatment. Freezing eggs early improves your chances of a healthy pregnancy later.
 

What are fertility tests for women?

There are several tests that can be performed to evaluate the function of your reproductive system and determine what fertility care is best for your situation. In addition to a physical exam, your gynecologist can conduct:

  • Ultrasound
    A pelvic ultrasound or a hysterosonography can help detect the presence of disease or abnormality
  • X-ray imaging
    Hysterosalpingography is an X-ray imaging technique that can show your doctor the shape of your uterus and fallopian tubes — as well as determine if there are any blockages.
  • Hormone testing
    Reproductive endocrinology is an entire area of medical care dedicated to the hormonal aspect of fertility. Your doctor can check your hormone levels, as well as evaluate the function of your thyroid and pituitary glands to see if they’re contributing to your fertility problems.
  • Ovarian reserve testing
    Your doctor can test the quality and quantity of your eggs with blood tests.
  • Genetic testing
    In rare cases, a genetic defect may be affecting your ability to get pregnant.
  • Laparoscopy
    This is a minimally-invasive surgical technique that can help your doctor diagnose problems inside your pelvis that may be causing infertility. A small incision is made in your lower abdomen, and a slender, flexible tube fixed with a camera is inserted to examine your uterus, ovaries, and fallopian tubes.
Gynecology

GENETIC TESTING

Genetic testing may be recommended for parents who have a family history of genetic disorders, or who belong to certain ethnic backgrounds.

If neither parent or only one parent, is a carrier of the gene, the disorder will not be passed on to the children. If both parents are carriers, however, then their children have a 25% chance of inheriting the disorder.

Neither you nor your partner has to have a genetic disorder in order to pass one on to your children. Prenatal genetic testing refers to a number of blood tests that two prospective parents can take before getting pregnant to determine whether their children are likely to inherit a harmful genetic disorder.

Empower is a genetic test for those who want to know more about their risk of developing cancer, why it might be common in their family, or want to inform treatment options following a cancer diagnosis.

Empower screens for genes associated with increased risk for common hereditary cancers. Our Empower multi-cancer panels include commonly screened-for genes associated with 12+ types of cancer.

Getting Started with the Empower Hereditary Cancer Test

Gynecology

WELL WOMAN EXAMS

WELL
WOMAN EXAMS

Your well-woman visit is all about you, your body, and your reproductive health. Well-woman visits may also be called gynecological exams, pelvic exams, or annual exams.

The well-woman exams are an annual preventive health care examination for women. At your well-woman visit, your OB-GYN will perform a complete physical exam along with a pelvic exam, breast exam, pap test, and screen for diseases. Typically, your weight and blood pressure are taken as well. They will also talk about your lifestyle behaviors, reproductive goals, and any concerns you may have about your sexual health.

We recommend that women have their first well-woman exam, as a preventive service, at age 21 or three years after beginning intercourse, whichever comes first.

Gynecology

BLADDER CONDITIONS

Painful urination is often a symptom of something more serious, such as a urinary infection or interstitial cystitis.

Cystocele
A cystocele (pronounced SISS-toe-seal) is essentially a prolapsed bladder (fallen bladder). A woman’s bladder lies in front of the vagina, and it is supported by strong muscular and connective tissue. When that tissue becomes weak and loses some of its elasticity, the bladder can begin to bulge into the vaginal wall. This is also known as anterior prolapse. The word anterior refers to the front wall of the vagina.

You may not notice any symptoms if your cystocele is mild. However, some symptoms that are commonly reported are:

  • The sensation of pressure in your pelvis
  • Pain or discomfort when lifting heavy objects, coughing, or straining your pelvic muscles
  • The feeling of incomplete emptying of the bladder
  • Leaking urine during sex or strenuous activities
  • Pain during sexual intercourse
  • Persistent bladder infections, common with urinary retention
  • A palpable or visible bulge protruding outside your vaginal opening (severe prolapse)
 

Interstitial Cystitis
Interstitial cystitis (IC) is a collection of chronic symptoms affecting the bladder and is also known as painful bladder syndrome. IC may also be referred to as bladder pain syndrome (BPS), and chronic pelvic pain. When the kidneys filter liquid waste products from the bloodstream, the waste is called urine and is stored in the bladder. When the bladder is full, the nerves and muscles send signals to your brain, giving you the urge to urinate.

Symptoms of interstitial cystitis are difficult to pin down. The IC symptoms may come and go, or they may be a constant for months or even years, lowering your quality of life. IC/BPS is not an infection, but it may feel like a bladder infection. In some cases, IC symptoms disappear without any treatment. Some common symptoms include:

  • Chronic pain and pressure that increase as the bladder fills with urine
  • Sharp or dull, aching pain in the pelvis, lower back, vulva, vagina, or urethra
  • Painful, stinging, or burning urination (dysuria)
  • Urinary frequency (more than 8 times per day)
  • Immediate and urgent need to urinate, even after emptying the bladder
  • Painful sexual intercourse
 

Another complication of IC is the possibility of bladder ulcers. IC causes inflammation in the bladder, which may lead to ulcers in some patients, called Hunner’s ulcers.

Symptoms may sometimes worsen during your period, or as a result of stress. The symptoms may also be aggravated by certain foods or drinks.

Although signs and symptoms of IC may resemble those of urinary incontinence or a chronic urinary tract infection, there’s usually no infection. However, symptoms may worsen if a person with IC gets a urinary tract infection. The more severe cases of interstitial cystitis/painful bladder syndrome can affect your life and your loved ones. Some people with interstitial cystitis/painful bladder syndrome have other health issues such as irritable bowel syndrome, fibromyalgia, and other chronic pain syndromes.

Pyelonephritis
Pyelonephritis, infection, and inflammation of the kidney tissue occur when a urinary tract infection has traveled to the upper urinary tract (which includes the ureters and the kidneys). The infection is usually bacterial. The most common type of renal disorder, pyelonephritis, may be chronic or acute.

In acute pyelonephritis, the lining of the renal structures into which urine drains, the renal pelvis and the calyces, may be inflamed. Abscesses may form in the kidney tissue, and some of the urine-producing structures may be destroyed. Medical treatment will fight the infection over a period of one to three weeks. Scar tissue will form at the site of infection, but there is usually sufficient healthy tissue to maintain relatively normal renal functions. Acute pyelonephritis symptoms usually include fever, chills, pain or aches in the lower back and flanks, bladder inflammation, tenderness in the kidney region, white blood cells in the urine, and high urine bacterial count. Treatment usually requires suppression of bacterial growth by means of antibiotic drugs. Frequent sexual intercourse is listed as a cause of UTIs and a risk factor for acute pyelonephritis.

Most kidney infections begin as lower urinary tract infections, which worsen as they progress up the urinary tract. The symptoms of a UTI include:

  • Painful, stinging, or burning sensation with urination (dysuria)
  • Urinary frequency
  • Persistent urge to urinate, even after the bladder has just been emptied
 

The symptoms of a urinary tract infection, plus these additional symptoms, may indicate a case of pyelonephritis:

  • Fever, chills, nausea, abdominal pain, and/or vomiting
  • Back pain or flank pain
  • Disorientation or confusion (especially in seniors)
  • Changes in the urine (bloody, cloudy, or smelly)

Urinary Incontinence
Urinary incontinence refers to an inability to manage or control urine leakage. Types of incontinence can be small and sporadic or heavy and frequent. Urinary incontinence is a common and, most often, embarrassing problem. The severity ranges from an occasional leakage of urine when you cough or sneeze to having the urge to urinate that’s so sudden and strong that you don’t get to a toilet in time.

Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently.

Women with urinary incontinence can experience symptoms beyond the leakage of urine. It’s important to note which symptoms are affecting you so that you can relay the information to your gynecologist. Some symptoms include:

  • Frequency – Urinating more often than normal
  • Urgency – The urge to urinate, even if the bladder is empty
  • Feelings of pressure or discomfort in the lower abdomen
  • Dysuria – Pain or burning while urinating
  • Nocturia – The need to get out of bed to urinate several times a night
  • Enuresis – Urinating the bed while asleep

Urinary Tract Infection
A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder, and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.

Symptoms of a UTI, even in mild cases can be uncomfortable.

  • A strong and persistent urge to urinate. One of the most common signs of a UTI is the sensation of urgency. The urge to urinate can return just moments after emptying the bladder.
  • Frequent urination.
  • Pain or stinging sensation while urinating.
  • Aching in the pelvis, back, sides, or lower abdomen.
  • Change in the odor of the urine.
  • Cloudy or bloody urine.

Severe UTIs – infections of the upper urinary tract including the ureters or kidneys – may cause these symptoms:

  • High fever, chills
  • Nausea or vomiting
  • Back pains

     

There are many serious medical conditions that are associated with these symptoms. If you’re experiencing any of these symptoms, please call your doctor right away. If you do have a kidney infection, you will need to seek immediate treatment.

Gynecology

BIRTH CONTROL OPTIONS

BIRTH
CONTROL OPTIONS

Today, women have an embarrassment of riches when it comes to options for preventing pregnancy. There are different options to suit different lifestyles and medical needs, so finding one that’s right for you is a matter of sitting down with your doctor to discuss your particular situation.

There are so many choices, each with their advantages and disadvantages, that choosing the right method of birth control can be a bit overwhelming. To help you get started in learning about some of the choices available, here is a quick overview of some popular birth control methods, along with the pros and cons of each one.

It is important to note that while all of these forms of contraception are designed to prevent pregnancy, none of them offer protection against sexually transmitted diseases (STDs). Only condom use can help prevent STDs.

These are the birth control options most commonly prescribed at our office:

  • Birth control pills
  • Vaginal ring (NuvaRing)
  • Birth control patch (Xulane)
  • Birth control injections (Depo Provera)
  • Intrauterine device (IUD)
  • Implantable subdermal contraceptive (Nexplanon)
  • Hormone Free Birth Control (Phexxi®)
Gynecology

BREAST CONDITIONS

Breast health is an important part of a woman’s wellness. Each breast is mostly comprised of fatty tissue, as well as 15-20 milk-producing glands called lobes. Milk reaches the nipples through a series of ducts.

Breast Cancer
Breast cancer is one of the most common cancers in women, following skin cancer. Currently, research shows us that one in eight women in the United States will develop breast cancer in their lifetime.

It’s also the second leading cause of cancer death in women after lung cancer. The survival rate has increased in recent years due to greater awareness, breast cancer research, and breast cancer screening, as well as better breast cancer treatments.

Breast cancer is a disease that occurs when cells in breast tissue mutate and keep reproducing. When these abnormal cancer cells cluster together, they form a tumor. A tumor is malignant when these abnormal cells invade other parts of the breast or when they travel (or metastasize) to other parts of the body through lymph nodes, or the bloodstream, a network of vessels and lymphatic system in the body that plays a role in fighting infection.

Some breast cancers can be treated if they are caught early, but they may become untreatable and deadly if caught in the later stages. Although many breast cancers have no symptoms in the earliest stages, you can sometimes catch the warning signs of a developing tumor. This is why it is important to perform a monthly breast self-exam and to attend your annual well-woman appointments. The warning signs include:

  • A lump in the breast or armpit that lasts throughout your menstrual cycle. Lumps are usually painless, although some may produce a prickling sensation when touched. A mammogram can often detect a lump before it can be felt.
  • A lump or a mass that is at least the size of a pea
  • Pain or tenderness in the breast
  • A change in the size or shape of the breast
  • A change in the texture or appearance of the breast skin or in the nipple (becomes puckered, flattened, dimpled, scaly, red, marbled, or swollen)
  • Itching or burning nipples, or ulceration of the nipples
  • Bloody or clear discharge from the nipple
  • A change in the look or feel of one isolated region of the breast

 

Breast Infections and Disorders
Breasts are complex organs made up of fat, fibrous tissue, and tiny glands that produce milk. Like your uterus and other reproductive organs, your breasts change in response to the hormones estrogen and progesterone. This is why you may notice changes in size and sensitivity during different times of your menstrual cycle, pregnancy, breastfeeding, and menopause.

If you discover breast lumps or bumps while you are conducting regular self-breast exams at home, or if your doctor finds an irregularity during a physical examination or screening, you might fear the worst, such as breast cancer. However, not all breast problems are an indication of breast cancer. Non-cancerous diseases of the breasts are common.

Gynecology

CERVICAL CONDITIONS

Women sometimes report symptoms resulting from Cervical conditions, but in many cases, there are no immediate symptoms. The cervix is very difficult to view without a gynecologist’s tools so it’s essential to routinely visit your gynecologist to check the health of your cervix.  A number of the common conditions that affect the cervix are:

  • Abnormal Pap Smears & Cervical Dysplasia
  • Cervical Cancer
  • Cervical Cryotherapy
  • Cervical Myomas
  • Cervical Polyps
  • Stenosis of Uterine Cervix
  • Cervicitis
  • Colposcopy
  • Human PapillomaVirus (HPV)
  • LEEP Procedure vs. Cold Knife Cone Biopsy
  • Nabothian Cyst

The cervix is a small, doughnut-shaped organ located at the top of the vaginal canal, and forming the opening of the uterus. During childbirth, the cervix dilates – meaning the doughnut hole opens up – to allow the baby to exit the uterus, into the birth canal. The cervix also dilates a tiny bit during menstruation, to allow a woman to shed her uterine lining as period blood.

Gynecology

ENDOMETRIOSIS

Endometriosis is a fairly common disorder that can cause terribly painful periods and affects over 10% of American women during their childbearing years. Most patients I diagnose are between the ages of 30-40.

I have more patients than I could ever count who have come to me after seeing a dozen or more doctors, all of whom failed to diagnose them properly. It is one of the tragedies of modern women’s health that so many women must suffer needlessly for years from painful periods.

Here is something extremely important to remember: painful periods are not normal! 

Because endometriosis is so difficult for most doctors to diagnose, most women who come to me for a diagnosis and care have been suffering for an average of eleven years before being properly diagnosed!

For most women, common symptoms of endometriosis feel like severe PMS symptoms, such as:

  • Chronic pelvic pain and cramping, especially before and during your period
  • Heavy bleeding
  • Painful sexual intercourse
  • Painful bowel movements or urination (due to implants hampering organ function)
  • Bloating
  • Diarrhea or constipation
  • Urinary frequency
  • Low back pain
  • Fatigue
  • Infertility
Gynecology

FALLOPIAN TUBE CONDITIONS

FALLOPIAN
TUBE CONDITIONS

Fallopian tubes are the thin ducts that carry a mature egg – or ovum – from the ovary to the uterus. The fallopian tubes may be affected by scarring, endometriosis, cancer, or inflammation known as salpingitis. Fallopian tube conditions and treatments may affect your fertility. 

Ectopic Pregnancy
An ectopic pregnancy happens when a fertilized egg implants and starts growing outside the main cavity of the uterus. Pregnancy begins with a fertilized egg. Normally, the fertilized egg attaches to the lining of the uterus.

Some women with an ectopic pregnancy have the usual signs or symptoms of early pregnancy — a missed menstrual period, breast tenderness, and nausea. You may not notice any symptoms of ectopic pregnancy early on.

The pregnancy test will be positive. Still, an ectopic pregnancy can’t continue as normal. Signs and symptoms of ectopic pregnancy increase as the fertilized egg grows in an improper place.

Light vaginal bleeding and pelvic pain are usually the first symptoms; others include:

Sharp, acute abdominal pain/back pain on one or both sides
Some women report persistent abdominal pain/back pain, while others say that it comes and goes.

Abnormal vaginal bleeding
Either light spotting or heavy vaginal bleeding that occurs between periods.

Feeling weak, dizzy, or faint
Blood loss due to internal bleeding can cause dizzy spells and fainting.

Shoulder pain
Some women feel shoulder pain when the blood from the ruptured tube collects underneath the diaphragm, putting pressure on the chest and shoulders.

Endometriosis
The endometrium is the normal mucous membrane on the lining of the uterus. During the menstrual cycle, it responds to hormones by thickening blood vessels in preparation for pregnancy. Once this does not occur, it breaks down and becomes your period.

Endometriosis (en-doe-me-tree-O-sis) is an often painful disorder in which tissue that normally lines the inside of your uterus, the endometrium, grows outside of the uterus. Most endometriosis commonly involves ovaries, fallopian tubes and the tissue lining the pelvis. Rarely, endometrial tissue can and may spread beyond pelvic organs.

Symptoms of endometriosis usually feel like severe PMS symptoms, such as:

  • Chronic pelvic pain caused by cramping, especially before and during your period
  • Painful periods
  • Lower back pain
  • Abdominal pain
  • Excessive menstrual cramps
  • Abnormal or heavy menstrual flow
  • Painful sexual intercourse
  • Painful bowel movements or urination (if implants are affecting these organs)

 

Fallopian Tube Cancer
Like most cancers, Fallopian Tube Cancer starts when abnormal cells are rapidly produced, causing tumors. Some tumors are harmless, which are known as benign tumors. Cancerous tumors are called malignant and can be spread to other parts of the body.

The fallopian tubes are two narrow ducts that extend out from either side of the uterus, reaching toward the ovaries. They provide a pathway for eggs to travel from the ovary to the uterus.

In the United States, fewer than 1% of gynecologic cancers are fallopian tube cancers. Cancer that starts in the fallopian tubes is rare. Most cancers that affect the fallopian tubes originate elsewhere in the body.

The key to a good prognosis for patients with fallopian tube cancer is to catch it in its early stage. Unfortunately, many patients do not report any symptoms at all, or their symptoms are confused with an unrelated medical condition. Some common symptoms of fallopian tube cancer include:

  • Abnormal vaginal bleeding
  • Clear, white, or bloody vaginal discharge
  • Heavy or irregular bleeding, especially post-menopause
  • Abdominal pain or pressure
  • A pelvic mass or lump
  • Pelvic pain or cramping
  • Lump or swelling in your lower belly

 

Hydrosalpinx
Hydrosalpinx is a form of tubal factor infertility. A hydrosalpinx is a fallopian tube that becomes filled with fluid. It can cause infertility and ectopic pregnancy. Most often it occurs at the fimbrial end of the tube next to the ovary, but it can also occur at the other end of the tube that attaches to the uterus. If you are diagnosed with a hydrosalpinx and are trying to get pregnant, you may want to seek the help of a fertility specialist.

In many cases, hydrosalpinx produces no symptoms. However, when symptoms are present, the chief complaint is pelvic pain. Some women are unaware of their condition until they seek help for fertility problems. Common symptoms include:

  • Infertility
  • Aching, constant pain in the lower abdomen
  • Increasing pain during and after a period
  • Vaginal discharge

 

Paratubal Cyst
A paratubal cyst, also known as a paraovarian cyst or hydatid cyst of Morgagni, is a closed, fluid-filled mass that develops beside or near the ovary and fallopian tube (also referred to adnexa), but is never attached to them. The adnexa refers to the “appendages” of the uterus, meaning the fallopian tubes, ovaries, and supporting ligaments. Paratubal or paraovarian cysts represent approximately 10% of all adnexal masses. Unlike some ovarian cysts, paratubal cysts or paraovarian cysts are generally benign, but may, on rare occasions, give rise to paraovarian tumors, borderline tumors, and malignancies.

Most paratubal cysts cause no symptoms at all, and women who have them may not be aware of their presence. However, large cysts can cause pelvic pain and may cause acute abdominal pain. This is the most common symptom of a paratubal cyst. In most cases, a misdiagnosis as an ovarian mass remains to be a problem. Paratubal cysts can become extremely big before causing symptoms. Adnexal torsion is another urgent issue regarding paratubal cysts, necessitating urgent surgery for the preservation of the ovary and the tube.

Salpingitis
Salpingitis is the inflammation of the fallopian tube or tubes and is associated with pelvic inflammatory disease. It’s commonly caused by sexually transmitted diseases, such as chlamydia and gonorrhea. Up to 1 out of every 5 of cases of Chlamydia trachomatis or Neisseria gonorrhea can progress to salpingitis if left untreated.

Besides c. trachomatis and n. gonorrhea, and other infections that can cause salpingitis including mycoplasma, staphylococcus, and streptococcus. These microbes may be introduced through contact with an infected person or during a medical procedure, birth, or miscarriage.

Often, cases of salpingitis are asymptomatic. They may be caught during a regular pelvic examination. When symptoms do appear, they typically begin after your period, and can include:

  • Pelvic pain, especially during ovulation and menstruation
  • Abdominal pain
  • Bloating
  • Changes in the color or smell of vaginal discharge
  • Lower back pain
  • Fever
  • Nausea or vomiting
  • Painful sexual intercourse
Gynecology

HORMONAL CONDITIONS

The typical female body produces a cocktail of hormones – including estrogen, progesterone, and androgens, to name a few. However, an imbalance of hormones can cause unpleasant symptoms or even painful conditions. Fortunately, many women’s hormonal conditions can be treated easily.

Hormonal Acne
Acne is commonly the result of hormonal fluctuations, which is why it often occurs in puberty. Over 85% of teenagers will have problems with hormonal acne on their face, neck, shoulders, chest, back, and/or upper arms. Hormonal acne can range from mild to severe, and while it can sometimes be annoying or painful, acne can usually be managed with diligent treatment.

Hormones generally aren’t a factor in adult acne, hormone levels may contribute to hormonal acne in adult women with underlying medical conditions. It may be this imbalance that gives rise to acne flares.

The primary characteristic of acne is clogged pores, which appear on the surface of the skin as whiteheads or blackheads.

Polycystic Ovarian Syndrome (PCOS)
PCOS is a disorder of the endocrine system — the system of glands that produce hormones that regulate the body’s functions. Between 5% and 10% of women of childbearing age (between 15 and 44) have PCOS. Most women find out they have PCOS in their 20s and 30s when they see their healthcare provider about trouble getting pregnant.

Patients with PCOS symptoms typically experience:

  • Unpredictable and or irregular periods – Menstrual periods may be absent or infrequent or occur too frequently
  • Several small ovarian cysts
  • Severe acne or acne that doesn’t respond to treatment
  • Oily skin
  • Acanthosis nigricans – abnormal patches of skin that appear dark and velvety
  • Skin tags – small excess flaps of skin in the armpits or neck area
  • Hirsutism – abnormal hair growth on the chest, face, upper thighs, and abdomen
  • Male-pattern hair loss or baldness
  • Severe weight gain – affects about 80% of women with PCOS
  • Infertility
 

If you’re experiencing these symptoms, please make an appointment with your OB/GYN. Keep notes of your symptoms, and be sure to ask any questions. Your OB-GYN will diagnose based on your symptoms, hormone levels, and ultrasound findings.

If you’re overweight and have PCOS, you’re at higher risk of obstructive sleep apnea — a condition where breathing repeatedly stops during sleep.

Prolactinoma
Prolactinoma occurs when a benign tumor, called an adenoma, affects the pituitary gland located at the base of the brain. The pituitary gland regulates your body’s hormone production and influences blood pressure, growth, and reproductive systems. The major effect is decreased levels of some sex hormones — estrogen in women and testosterone in men. Prolactinoma is the most common type of pituitary tumor that produces a hormone. It makes up at least 30% of all pituitary adenomas. Almost all pituitary tumors are noncancerous (benign).

An excess of prolactin production in the bloodstream can cause sexual and hormonal problems. A prolactinoma affects the reproductive systems of both sexes by decreasing the level of sex hormones. For women, this causes symptoms such as:

  • Irregular or no menstrual periods (amenorrhea)
  • Acne
  • Increase or thickening of body hair and facial hair
  • Cloudy white discharge from the nipples, unrelated to pregnancy or breastfeeding
  • Vaginal dryness
  • Painful sexual intercourse
  • Decreased desire for sex
  • Infertility
  • Low bone density, osteopenia, or osteoporosis

Additionally, the pressure of a large tumor in the brain, even when it is benign, can cause uncomfortable symptoms such as:

  • Headaches
  • Vision problems

Usually, women tend to notice hormone-related symptoms before they experience headaches and vision problems. Your doctor will test for prolactin blood levels in women with unexplained milk secretion, or irregular menses or infertility, This is because the tumor will affect the function of the pituitary gland first, and then press on the surrounding brain tissue later as it grows larger.

Hair Loss
Although hair loss is normally considered a male problem, women can suffer from hair loss as well. Women are almost just as likely to experience hair loss or encounter hair thinning as men. It’s more likely to happen to women in their 50s and 60s.

Gynecology

LOW SEX DRIVE

Female sexual dysfunction is affected by many physical, psychological, and social factors. Emotional, physical, and mental health, as well as life experiences, personal or religious beliefs, socialization, perimenopause, menopause, and current partnership, can all play a role in shaping a woman’s sex drive.

Although many women continue to have and enjoy sexual intercourse in menopause, others find that sex begins to feel like a chore with such low libido. And while many women and their partners can still enjoy a sense of intimacy without sexual intercourse, other couples struggle to cope with these changes, causing relationship issues.

Some common conflicts that my patients experience that can lead to less interest in sex are:

  • Lack of intimate connection with their partner
  • Conflict over sexual needs
  • Reluctance to discuss the decrease in sexual activity with your partner may strain your relationship
Gynecology

MOOD DISORDERS

Everyone feels sad or anxious every once in a while, but chronic or severe feelings of depression, hopelessness, or anxiety may indicate a serious mental health issue. Often referred to as Mood Disorders, your gynecologist is committed to listening to your questions and concerns and providing you with compassionate and respectful care so you can live a fulfilling life. 

Anxiety
It is completely normal and even healthy to feel anxious once in a while. Most people experience anxiety in the days or moments leading up to a big decision, a job interview, a first date, or a final exam. However, some people may be so overwhelmed by feelings of fear, and worry that they have a difficult time functioning day-to-day, lowering their quality of life and well-being.

If you feel that your anxiety is out of your control, you might have anxiety and mood disorder, types of mental disorders.

During an episode of anxiety, a person with an anxiety disorder may experience:

  • Intense feelings of panic and fear
  • Insomnia
  • Clammy or sweaty palms or feet
  • Numbness or tingling
  • Increased or irregular heartbeat
  • Hyperventilation/shortness of breath
  • Restlessness and uneasiness
  • Tense muscles
  • Cottonmouth
  • Nausea
  • Dizzy spells

 

Depression
Feelings of sadness or anxiety once in a while, or following a major life event, are a normal part of life. Typically these feelings subside after a few days or weeks. However, if you’re suffering from long bouts of depression or if your mood changes are significantly affecting your ability to get out of bed, go to work, care for children, or enjoy hobbies, then you may have some form of a depressive disorder, affecting your mental health.

Depression is one of the most common mental illness diagnoses in the U.S., and in women’s health, American women are roughly 70% more likely to suffer from depression than men. This may be due to the several fluctuations of the hormone levels that women undergo throughout their lifetime. Fluctuations during the menstrual cycle, during pregnancy and postpartum, and transitioning into menopause can all contribute to the stresses and chemical imbalances that are related to depression and mood disorders.

Although the average age of onset is around 32 years, about 3% of teenagers will experience some form of depression. After age 15, girls are twice as likely as boys to have experienced a major depressive episode. Depression in young girls is often linked to substance abuse, anxiety, and eating disorders.

Many women with depression feel as though they cannot or should not seek help, but it’s important to remember that depression is a recognized illness that can be treated effectively with medical intervention. If you or someone you care about may have depression, please call a healthcare provider for an evaluation.

Postpartum Depression
Postpartum depression is a type of clinical depression that women suffer following the birth of their child. It is characterized by feelings of extreme anxiety, sadness, or hopelessness that begin sometime during the first year after having a baby and persist longer than two weeks.

Some new moms may experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme mood disorder called postpartum psychosis also may develop after childbirth.

Postpartum depression often goes undiagnosed or dismissed as the “baby blues,” but postpartum depression is a distinct and serious mental illness. If you are suffering from depression following the birth of your child, you are not alone, and help is available.

Hormonal changes may trigger symptoms of postpartum depression. When pregnant, levels of the female hormones estrogen and progesterone are the highest, they’ll ever be. On the first day after childbirth, hormone levels quickly drop back to normal, to pre-pregnancy levels. Researchers think this sudden change in hormone levels may lead to depression.

  • Depressed mood or severe mood swings
  • Excessive crying
  • Feelings of sadness
  • Difficulty bonding with your baby
  • Withdrawing from loved ones, family, and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep (insomnia) or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Fear that you’re not a good mother
  • Hopelessness
  • Feelings of worthlessness, shame, guilt, or inadequacy
  • Diminished ability to think clearly, concentrate or difficulty in making decisions
  • Restlessness
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Suicidal thoughts

Untreated, postpartum depression may last for many months or longer.

Premenstrual Syndrome
Women’s health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Researchers do not know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role. These changing hormone levels may affect some women more than others. Many feel physical or mood changes during the days before menstruation.

Each patient experiences PMS in different ways, but there are common PMS symptoms that typically mark the onset of PMS.

  • Mood swings
  • Irritability
  • Depression/anxiety
  • Crying easily
  • Short temper
  • Confusion
  • Difficulty concentrating
  • Social withdrawal
  • Increase or decrease in sexual desire
  • Insomnia

Many patients report physical symptoms as well as emotional ones. These mild to severe symptoms can include:

  • Food cravings
  • Increased or decreased appetite
  • Breast tenderness and swelling
  • Abdominal bloating
  • Weight gain (less than 4 lbs)
  • Abdominal pain
  • Back pain
  • Gastrointestinal problems
  • Fatigue
  • Headaches
  • Swollen hands and feet
  • Skin problems

Furthermore, PMS can aggravate the symptoms of other disorders. Women who suffer from depression, anxiety, migraines, allergies, and asthma all report worsening symptoms in the few days before their menstrual period starts.

Gynecology

UTERINE CONDITIONS

The uterus is a very strong, elastic, and hollow organ that is central to the female reproductive system. Its primary function is to hold and nourish a fetus as it develops from a fertilized egg, implanted in the uterine lining, to a full-term unborn baby. Some of the more common uterine conditions we treat are:

  • Endometriosis
  • Abnormal Uterine Bleeding
  • Adenomyosis
  • Uterine Adhesions and Scarring
  • Uterine Fibroids
  • Uterine Malformations
  • Uterine Polyps
  • Uterine Prolapse

Normally, it is about the shape and size of a closed fist, but towards the end of a pregnancy, it can stretch to the size of a small watermelon, and contract to push a baby out of the body through the small cervical opening and birth canal.

The inside of the uterus is lined with a layer of bloody tissue called the endometrium. The endometrium thickens and sheds in cycles, in response to menstrual hormones. This is what’s known as a woman’s period. Each month, a fertilized egg may implant in the lining, which would trigger the start of a pregnancy. The endometrium would then cushion and nourish the embryo as it grows, instead of shedding.

Gynecology

VAGINAL CONDITIONS

The vagina is the canal that provides a path to and from a woman’s uterus. It’s a delicate environment and can be susceptible to many different types of illnesses, including sexually transmitted infections (chlamydia, gonorrhea, HPV) and bacterial or yeast overgrowth.

  • Abnormal Vaginal Bleeding
  • Benign Vaginal Cysts and Lesions
  • Congenital Vaginal Abnormalities
  • Cystocele
  • Pelvic Organ Prolapse
  • Precancerous Vaginal Conditions
  • Vaginal Cancer
  • Vaginal Infections

  • Vaginal Intraepithelial Neoplasia (VAIN)

  • Vaginismus

The vagina is comprised of strong muscular and elastic tissue, as well as nerve endings that produce sensation during sex. During natural childbirth, the baby exits its mother’s body through her vagina – this is known as the birth canal.

The thin membrane of tissue that partially covers the opening of the vagina is called the hymen. Some people believe that the hymen breaks during a woman’s first time having sex and that an intact hymen means the woman is a virgin. This is a myth, however; the hymen can break in any number of ways, such as during exercise or while using a tampon.

Gynecology

vulval conditions

The vulva is the “package” of external female genitals, which includes the labia majora and labia minora, the clitoris, and the openings to the vagina and urethra. We treat the following:

  • Bartholin Gland Cysts
  • Benign Vulvar Lesions
  • Genital Herpes
  • Genital Warts
  • Vulvar Cancer
  • Vulvar Intraepithelial Neoplasia(VIN)

In everyday language, many people mistakenly call the vulva the vagina; however, these terms refer to two different parts of a woman’s body. You should wash your vulva with soap and water just like you do the rest of your body. Most experts caution women against using douches, fragrances, or anything other than soap to clean the vulva.

Vulvas can vary greatly in appearance. Some women have larger or smaller labia, or the two sides of the labia may be asymmetrical. Vulvas can be different colors and have different textures. This variability is perfectly normal – each vulva is as unique as the woman it belongs to.

Your vulva will periodically flush itself out with a naturally-produced discharge. This discharge may have an odor, and this is considered normal and healthy. However, if it smells bad or the odor changes in color or texture, this may be a symptom of illness. Some other common symptoms that can indicate one of several vulval conditions are itching, burning, tenderness, sores, or bumps.

And, as always, call your gynecologist if you have questions or concerns about any symptoms you may be having.

Gynecology

PAINFUL CONDITIONS

Pelvic or abdominal pain, genital pain, and pain during sex are some of the most common indicators of Painful Gynecological Conditions such as illness or infection. Pain can be caused by a wide variety of conditions of the reproductive, urinary, or digestive system, and must be treated according to its particular cause. 

  • Endometriosis
  • Painful Intercourse
  • Painful Periods(dysmenorrhea)
  • Pelvic Pain

Gynecological Pain can also have multiple related causes. Some pain is located in the muscles and connective tissues in the pelvis while other pain is triggered by some irritation to the pelvic region’s sensitive nerves.

Many women tend to ignore abdominal pain, dismissing it as normal menstrual cramps. Whatever the cause of your pain, your gynecologist can help you manage it. If you’re experiencing acute, chronic, or intermittent pain, make an appointment to visit your doctor.

Gynecology

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a problem with hormones that happens during the reproductive years. If you have PCOS, you may not have periods very often. Or you may have periods that last many days. You may also have too much of a hormone called androgen in your body.

With PCOS, many small sacs of fluid develop along the outer edge of the ovary. These are called cysts. The small fluid-filled cysts contain immature eggs. These are called follicles. The follicles fail to regularly release eggs.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may lower the risk of long-term complications such as type 2 diabetes and heart disease.

Symptoms of PCOS often start around the time of the first menstrual period. Sometimes symptoms develop later after you have had periods
for a while.

The symptoms of PCOS vary. A diagnosis of PCOS is made when you have at least two of these:

  • Irregular periods. Having few menstrual periods or having periods that aren’t regular are common signs of PCOS. So is having periods that last for many days or longer than is typical for a period. For example, you might have fewer than nine periods a year. And those periods may occur more than 35 days apart. You may have trouble getting pregnant.

  • Too much androgen. High levels of the hormone androgen may result in excess facial and body hair. This is called hirsutism. Sometimes, severe acne and male-pattern baldness can happen, too.

  • Polycystic ovaries. Your ovaries might be bigger. Many follicles containing immature eggs may develop around the edge of the ovary. The ovaries might not work the way they should.

PCOS signs and symptoms are typically more severe in people with obesity.

Women's Health

Gynecology Minimally Invasive Surgery

Gynecology Minimally
Invasive Surgery

Today, minimally invasive surgeries are very common in gynecology thanks to advances that allow surgeons to work with tiny incisions (in some cases only a few
millimeters long).

Gynecology Surgery

LAPAROSCOPIC HYSTERECTOMY

Hysterectomy is a gynecological surgery to remove the uterus. It is a very common treatment for patients with severe uterine health problems. Often (far too often, if you ask me), this procedure is done as a “traditional open surgery” with hospital admission, multi-day hospital stay, a large abdominal incision, and a recovery that can last multiple months.

Nowadays, hysterectomies don’t have to be like that. With advances in women’s healthcare, we can (and should!) turn hysterectomies into minimally invasive procedures where the patient goes home the same day and can return to normal activities in just a few weeks.

Many patients choose a hysterectomy after they have exhausted all other treatment options. However, it’s not uncommon to wait to have a hysterectomy until you’re finished having children. Because any hysterectomy involves surgical removal of the uterus, you can no longer become pregnant after a hysterectomy.

Some women with a family history of some cancers may choose this procedure to help reduce the chances of such problems as they age.

Some gynecological conditions that may be treated with a hysterectomy include:

  • Severe endometriosis
  • Uterine fibroids
  • Uterine prolapse
  • Cancer of the uterus or other nearby reproductive organs
  • Abnormal uterine bleeding
  • Chronic pelvic pain
Gynecology Surgery

HYSTEROSCOPIC MYOMECTOMY

Uterine fibroids — also known as myomas — can be removed with a myomectomy. This surgical technique treats fibroid symptoms and improves fertility outcomes while leaving the uterus intact.

With our minimally-invasive laparoscopic myomectomy procedure, we can relieve your fibroid symptoms and have you back on your feet with minimal pain and scarring and extremely decreased recovery time.

A myomectomy removes uterine fibroids and relieves their symptoms. A myomectomy can treat the following symptoms of uterine fibroids:

  • anemia
  • abnormal uterine bleeding
  • menorrhagia (heavy menstrual bleeding)
  • pelvic pain and pressure that cannot be managed with medication
  • infertility or recurring miscarriages

Unlike a hysterectomy, a myomectomy leaves the uterus intact, making it a popular choice among patients who still wish to get pregnant.

Gynecology Surgery

SALPINGECTOMY PROCEDURE

Salpingectomy surgery is the surgical removal of either one fallopian tube (unilateral salpingectomy) or both (bilateral salpingectomy). Your doctor may recommend having your Fallopian tube(s) removed as a treatment for fertility problems or tubal disease, including cancer or infection.

The Fallopian tubes are the two narrow tunnels extending from the uterus to the two ovaries. During menstruation, an egg is released from the ovaries and guided into the Fallopian tubes by the tiny finger-like fimbriae. The egg then travels through the Fallopian tube into the uterus. An egg can either be fertilized by a sperm in the Fallopian tube, prompting a pregnancy, or it will be shed with the uterine lining during the woman’s next period.

Removal of both Fallopian tubes makes natural conception impossible but other fertility options, such as in-vitro fertilization (IVF), may still be available. Some patients may be able to preserve their Fallopian tubes with alternative tubal surgery.

A salpingectomy or salpingostomy can be performed to treat several serious gynecological conditions.

  • Endometriosis
  • Infection due to sexually transmitted or other diseases
  • Tubal adhesions
  • Scarring or blockage due to previous tubal surgery
  • Ectopic pregnancy
  • Blocked fallopian tube
  • Ruptured fallopian tube
  • Hydrosalpinx
  • Fallopian tube cancer. Though fallopian tube cancer is rare, it’s more common in women who carry the BRCA gene mutation. Almost half of women with BRCA gene mutations have fallopian tube lesions. A prophylactic salpingectomy can be performed on women who are at a high risk of developing ovarian cancer.
  • Infertility. Although it may seem counter-intuitive, removing one or both Fallopian tubes can often lead to better fertility outcomes than repairing the tubes. For some infertile women, having a salpingectomy has been shown to increase the chances of implantation via IVF. Furthermore, defective Fallopian tubes may put you at risk for ectopic pregnancy or adhesions.
Gynecology Surgery

DIAGNOSTIC LAPAROSCOPY

Diagnostic laparoscopy is a surgical procedure that allows a doctor to view a patient’s pelvic organs directly through an instrument called a laparoscope.

A laparoscope is a thin, flexible tube with a lighted lens at the end. When inserted into the body, the doctor can use the laparoscope to see the internal tissue, including the uterus, fallopian tubes, ovaries, bladder, and bowel.

Laparoscopy is often used when other less-invasive tests, like X-ray, MRI, or ultrasound, are unable to confirm a diagnosis.

Laparoscopies are very low-risk medical procedures. About 0.3% of women will experience complications during their laparoscopy. Complications may include:

  • Infection
  • Damage to nearby tissue (uterus, fallopian tubes, ovaries, bowel, or bladder)
  • Possible scarring to pelvic organs, known as adhesions
  • Internal bleeding

Your surgeon will discuss the possible risks and answer any additional questions.

Gynecology Surgery

DILATION AND CURETTAGE (D&C)

Dilation and curettage (pronounced “dye-LAY-shun” and “KYUR-uh-tedge”) is a surgical procedure to scrape the uterine lining, either to remove tissue or take a sample for testing. The procedure involves dilating the cervix and scraping the inside of the uterus with a surgical tool. Dilation and Curettage (D&C) can be used for several different reasons:

  • Remove tissue following a miscarriage
  • Extract residual pieces of the placenta following childbirth
  • Terminate an early pregnancy

It also is used to diagnose and treat conditions such as:

  • Abnormal bleeding
  • Uterine polyps
  • Uterine fibroids
  • Uterine cancer
  • Imbalances of hormones

Dilation and curettage can be performed in a hospital setting, but they are also routinely performed at your gynecologist’s office as an outpatient procedure. The procedure usually only takes about 10-15 minutes, but you may need to remain in recovery for a few hours before going home.

Depending on your medical history and the extent of the D&C, your doctor may choose one of three types of anesthesia for your procedure:

  • Local anesthesia – Your cervix will be numbed to minimize your discomfort
  • Nitrous Oxide (laughing gas) – This is often used for many in-office procedures to minimize pain
  • General anesthesia – You will be asleep during the procedure and won’t feel any pain

During the procedure, you will be positioned on your back with your feet in stirrups. The doctor will place an instrument called a speculum into the vagina so that the other instruments can access the cervix and uterus.

Gynecology Surgery

HYSTEROSCOPY

A hysteroscopy is a procedure that allows a surgeon to diagnose or treat uterine problems. The procedure involves inserting a narrow, lighted lens through your vagina and cervix in order to view the inside of the uterus projected on a screen.

Your gynecologist may recommend a hysteroscopy for one of several reasons:

  • Determine the cause of abnormal or heavy bleeding
  • Remove adhesions (scar tissue) that formed during a previous surgery or disease
  • As part of a sterilization procedure
  • Diagnose problems with fertility or recurring miscarriages
  • Locate an IUD (an intrauterine device for birth control)

Every gynecological surgery carries some inherent risk, but complications due to hysteroscopy are very uncommon. Risks may include:

  • Adhesions (scarring)
  • Infection
  • Blood loss
  • Perforation and/or burns of the uterus
  • Damage to other pelvic tissue, including fallopian tubes, bladder, or bowel
Gynecology Surgery

LAPAROSCOPIC OVARIAN CYSTECTOMY

LAPAROSCOPIC
OVARIAN CYSTECTOMY

First, you should be having regular gynecology exams. These are your opportunity to talk about any (and ALL) unusual, painful, new, or just curious symptoms you may be experiencing. Even seemingly minor symptoms can indicate an issue.

Your gynecologist or general health care provider can recommend any necessary follow-up tests to find the cause of your symptoms.

These regular check-ups are generally where we discover signs of ovarian cysts. Early detection of issues can make a world of difference in your long-term health.

Ovarian cysts are fairly common. Most cysts are not harmful and usually resolve on their own. However, some cysts can cause infertility, cause painful symptoms, or become cancerous.

A laparoscopic ovarian cystectomy may be a recommended treatment option if:

  • The patient has cysts or other masses in both ovaries.
  • An ovarian cyst has not shrunk or disappeared after three months.
  • A cyst is larger than three inches in diameter.
  • A cyst appears to be abnormal or malignant.
  • Your doctor suspects ovarian cancer.

If you have an ovarian cyst, your OB/GYN may recommend an ovarian cystectomy if you also:

  • Take birth control pills.
  • Have not yet started your period (children or teenagers).
  • Have already undergone menopause.
Gynecology Surgery

LEEP PROCEDURE & COLD KNIFE CONE BIOPSY

LEEP PROCEDURE & COLD KNIFE
CONE BIOPSY

If your doctor finds precancerous cell changes in your cervical tissue, also known as cervical dysplasia, the area around the tissue may need to be surgically removed to reduce the risk of cancer and the spread of cancer. There are two common ways that this can be done: a cold knife cone biopsy and a Loop Electrosurgical Excisions Procedure (LEEP Procedure).

Both of these procedures can be used to treat abnormal tissue that your doctor has found during a colposcopy or cervical biopsy, including:

  • Moderate-severe precancerous cell changes
  • Low-grade squamous intraepithelial lesions (LSIL). These are minor cell changes that do not resolve after a few months.

As far as surgical procedures go, these techniques are quite safe. There are, however, some risks involved that you should discuss with your doctor, including:

  • Cervical stenosis. This is a complication in which the cervix narrows, making it more difficult to become pregnant naturally.
  • Premature birth. Studies have shown that LEEP and Cold Knife Cone Biopsy can lead to a syndrome known as an incompetent cervix, which may result in a premature delivery if you become pregnant.
  • Cervical scarring. Adhesions on the cervix may cause pain during your period, fertility problems, and delivery problems.
  • Tissue damage, including damage to the bladder or bowel.
  • Hemorrhaging
  • Infection
Gynecology Surgery

OOPHERECTOMY PROCEDURE

An oophorectomy (pronounced “oh-uff-uh-RECK-tomy”) is the surgical removal of one or both ovaries. Oophorectomies can be performed alone, but they are often performed alongside a hysterectomy (removal of the uterus) or salpingectomy (removal of the fallopian tubes). This is because many diseases that affect the ovaries will also affect the surrounding tissue.

The ovaries are the small, round organs that lie on either side of the uterus, at the end of each fallopian tube. The ovaries hold a woman’s eggs and are also responsible for producing the hormones associated with menstruation and pregnancy: estrogen and progesterone.

Removal of one ovary is called unilateral oophorectomy. Most patients will continue to menstruate and could conceive naturally following surgery. The removal of both ovaries is called a bilateral oophorectomy. Patients will no longer have periods and will enter early menopause.

Oophorectomies are performed as a treatment for several different gynecological conditions, including:

  • Ovarian cancer
  • Noncancerous ovarian tumors
  • Ovarian cysts
  • Tubo-ovarian abscesses – pockets of pus that develop on the ovaries and fallopian tubes
  • Ovarian torsion – a condition in which the ovary twists over itself

Patients who are at an increased risk for breast or ovarian cancer may choose to have an oophorectomy as a preventative measure.

Gynecology Surgery

VAGINAL REJUVENATION SURGERY

Vaginal rejuvenation surgery refers to procedures that can be performed for cosmetic reasons or to relieve symptoms of vaginal relaxation. Vaginal rejuvenation, or vaginal reconstruction, involves the repair of loose, stretched, or torn tissue to tighten, strengthen, and support the vaginal walls and pelvic organs.

Vaginal walls are naturally elastic and supple, thanks to the hormone estrogen. Over time, and after childbirth, the vaginal muscles can stretch and loosen. If a woman’s body stops producing estrogen, due to a hormonal imbalance or menopause, the vaginal tissue can atrophy. This weakened and loose vaginal tissue can cause pelvic organ prolapse and incontinence.  Also, some women find that sex becomes less pleasurable, or even painful.

Vaginal rejuvenation surgery can treat many of these unpleasant symptoms. Here are some reasons why patients seek vaginal rejuvenation:

  • Restoring vaginal tightness following multiple births or a large birth
  • Repairing torn tissue due to injury, childbirth, or an inadequately healed episiotomy
  • Treating pelvic organ prolapse
  • Treating urinary incontinence
  • Tightening the vaginal opening for improved sexual pleasure for a woman and her partner
Women's Health

Menopause

Menopause and Perimenopause is a stage in reproduction that every woman will experience, some earlier than others, some later. Menopause is a normal condition in which the body stops producing the hormones necessary for ovulation.

Menopause

DECREASED LIBIDO AND DESIRE

A low libido (or sex drive) can be attributed to many physical, psychological, and social factors. Emotional and physical health, as well as life experiences, personal or religious beliefs, socialization, and current partnership, all play a role in shaping a woman’s sex drive.

In some ways, menopause is both a physical and psychological factor that can decrease the desire for sex. During menopause, estrogen levels drop dramatically, resulting in a decreased interest in sex. Lower estrogen levels also reduce lubrication causing dry vaginal tissues, which might lead to discomfort or even pain during sex, which can have a rippling effect on sexual desire. Decreased blood flow also affects vaginal lubrication and overall arousal. As a result, a woman may not enjoy sex as much and may have difficulty achieving orgasm.

During the menopause transition, the physical side effects of falling estrogen levels—including hot flashes, night sweats, and vaginal dryness—can undermine sexual motivation and drive. Although not directly related to menopause, the age-related decrease in testosterone may reduce desire in midlife women, as these hormone levels play a role in women’s sex drive and sexual sensation.

The precise role of testosterone in desire is complex, however, because low sexual desire in women has not been shown to be related to testosterone levels in scientific studies. Also, some women who undergo abrupt menopause (caused by the removal of both ovaries or by chemotherapy), which leads to an immediate drop in both estrogen and testosterone, suffer a greater reduction in desire than women who experience natural menopause. Interestingly, other women in the same situation do not have a decrease in desire.

A lower estrogen level is not the only culprit behind a decreased libido; there are numerous other factors that may influence a woman’s interest in sexual activity during menopause and after. These include:

  • Bladder control problems
  • Sleep disturbances
  • Depression or anxiety
  • Mood swings
  • Stress
  • Medications
  • Health concerns
  • Relationship issues with a partner

Other symptoms that lead to loss of libido, such as night sweats, do eventually go away for most women. Without the protective effects of hormones such as estrogen, women face an increased risk for heart disease, weight gain, and other new health challenges.

Although many women continue to have and enjoy sexual intercourse in menopause, others find that sex begins to feel like a chore. Menopausal and postmenopausal women may notice that they’re not as easily aroused, and they may be less sensitive to touching and stroking. And while many women and their partners can still enjoy a sense of intimacy without sexual intercourse, other couples struggle to cope with these changes.

Menopause

BREAST CHANGES AND MENOPAUSE

Though breast changes might have an impact on your self-esteem, rest assured that it is normal. Almost all menopausal women will notice some breast changes from menopause when they look in the mirror.

The greater cause for concern is the increased risk of cysts, fibroids, and other abnormal growths in the breast tissue. Women can develop abnormal growths at any age, but menopausal women are certainly in a higher risk category. But if you notice a breast lump, don’t wait to be offered to screen – see your health care provider rule out breast cancer. Breast cancer is most common in women over 50.

You may feel discomfort in one breast or both breasts. Not all women experience breast discomfort in the same way. Breast pain in the postmenopausal years may be coming from the chest wall, arthritis of the spine, or, only rarely, from cancer.

Menopause

DRY AND ITCHY SKIN IN MENOPAUSE

Most women approaching menopause to know about hot flashes and night sweats, but other side effects of menopause are not often discussed, such as dry and itchy skin after menopause. Hormonal changes during menopause can cause a range of skin complaints, including hot flashes, sweating, and itchiness.

Dry skin actually results from the decreasing estrogen levels in the bloodstream at the onset of menopause. Estrogen stimulates the body’s production of collagen and oils, which keep the skin naturally moisturized through most of a woman’s life. Once your estrogen levels begin to decline, your body’s ability to produce oil slows down, leaving your skin dry and itchy.

One of many menopause symptoms, you might start to notice your skin drying out on the elbows and the T-zone – the area of your face covered by a capital T, which includes the forehead, nose, and chin. However, dry patches can appear anywhere, including your chest and back, arms, legs, and even genitals.

Menopause

FATIGUE IN MENOPAUSE

While around two-thirds of post-menopausal women have difficulty sleeping at night, about 90% report feeling worn out in general. The symptoms of menopause fatigue come standard with menopause – anxiety, depression, hot flashes, and night sweats – may make it nearly impossible to get a good night’s sleep.

Remember that menopause is a natural transition in the life of many women, not a medical condition characterized by a debilitating fatigue. Constantly feeling tired is a common complaint from many menopausal women.

When you’re feeling fatigued with low energy levels due to poor sleep, you might find it more difficult to concentrate on day-to-day tasks. Activities that you once enjoyed may sound more like a chore than a good time.

When you’re in the menopause transition, the symptoms may seem challenging. Lifestyle changes can help. Please talk to us about these changes.

Menopause

PAINFUL INTERCOURSE AND MENOPAUSE

PAINFUL INTERCOURSE
AND MENOPAUSE

Painful intercourse – or dyspareunia (“dis-pah-ROO-nee-ah”) – is persistent or reoccurring pain in the genitals that can strike just before, during, or immediately after sexual intercourse. Another medical condition is vaginal atrophy (atrophic vaginitis).

Vaginal atrophy is thinning, drying, and inflammation of the vaginal walls that may occur when your body has less estrogen. Vaginal atrophy occurs most often after menopause.

Sexual pain as a category of female sexual dysfunction is relevant at any age. For women dealing with vaginal dryness as a result of estrogen deficiency, it may well be the dominant issue.

For many postmenopausal women, dyspareunia is caused by inadequate lubrication resulting from low estrogen levels. Often, this can be treated with topical estrogen applied directly to the vagina. The vaginal tissues tend to become less elastic, more fragile, and more susceptible to bleeding, tearing, or pain during sexual activity or during a pelvic exam. It can make sex painful or even impossible. The loss of estrogen can also cause urinary problems.

It’s fairly normal for women going through menopause to experience pain during intercourse. The most likely cause is a lack of lubrication resulting from lower estrogen levels. For those entering perimenopause or menopause, you may experience:

  • Pain in a normally pain-free sex life
  • Pain at entry (initial vaginal penetration)
  • Pain at each instance of penetration, including inserting a tampon

If these symptoms are present, you may be suffering from vaginal dryness, which is often also a symptom of menopause. Over-the-counter lubricants can help make intercourse more comfortable, however, there are other treatments that can provide additional relief.

Menopause

PERIMENOPAUSAL ACNE

On average, women enter menopause at 51 years, meaning that most women today live about 30 years into their post-menopausal period. This intimate experience varies greatly for each woman. Besides other prevalent physiological changes like fatigue and hot flashes, it is common for women to report skin problems during menopause. Sadly, this issue is often neglected and there is a lack of research exploring it.

There is no denying that skin changes during menopause can be both uncomfortable and distressing. Hormonal changes, stress, and genetics, just to name a few, are possible culprits. It is usually hard to narrow down acne to a single cause.

Perimenopausal Acne develops in women for much the same reasons that it curses our years in puberty. The changes and imbalances in hormone levels during this stage of life impact our skin’s natural defenses and trigger acne.

In most cases, adult acne is caused by hormonal imbalances in which the body produces too much androgen (male sex hormones), or increased sensitivity to normal levels of androgen at the level of the skin. In addition, anything that compromises the immune system, whether it is emotional stress or nutritional deficiency, is likely to upset your cortisol and insulin balance, which can affect your skin, as well. For some women, it may also be responsible for a deepening of the voice and the appearance of facial hair.

Menopause often comes with a plethora of skin changes. Sometimes, these changes include acne. It doesn’t seem fair to have to battle pimples, wrinkles, and menopause symptoms at the same time, but please know that you are not alone.

Acne in perimenopausal women is rarely severe enough to warrant medical treatment, and once your hormones balance out, the acne usually disappears.

Estrogen is a powerhouse hormone. It stimulates the maturation of a girl’s body at puberty. It helps keep a woman’s bones strong. The decline of estrogen levels during this stage of a woman’s life may affect skin change.

Another thing estrogen does is stimulate the formation of skin-smoothing collagen and oils. That’s why, as menopause approaches and estrogen production diminishes, dry skin, and at times itchy, become very common.

Menopause

HAIR LOSS AND MENOPAUSE

HAIR LOSS
AND MENOPAUSE

With all the changes your body is going through during menopause, it may feel as though you’re enduring something like puberty all over again – you’re dealing with mood swings, putting on weight more easily, and hair growth is happening in places that it never did before. Well, now let’s add menopausal hair loss to the list of side effects women experience with menopause.

Many post-menopausal women find that the hair on their scalp thins and won’t grow like it used to. For some, this can cause a lot of social anxiety. Many women experience hair loss at this stage of their lives making them feel more vulnerable.

This type of hair loss is very common for post-menopausal women. In fact, about half of women have experienced some hair thinning (also known as androgenetic alopecia) by the age of 50. The main type of hair loss in women is the same as it is in men. It’s called androgenetic alopecia, or female pattern hair loss. Luckily, androgenetic alopecia hardly ever leads to balding. A complete loss of hair, as seen in men who sometimes go bald, is much rarer in women and is generally caused by a medical condition.

Causes of Menopausal Hair Loss
During menopause, the effects of androgens (male hormones) increase. This hormonal imbalance, as a result, hair to grow at a much slower rate and hair follicles to shrink, which produces weaker hair and ultimately causes hair loss. Some research also suggests that the pattern of hair loss in senior women may actually result from decreases in both estrogen and progesterone hormone levels during menopause.

Most women’s health care providers agree that replacing these hormones can alleviate many of the other troubling symptoms of menopause, unfortunately, hormone replacement alone does not seem to radically alter a woman’s “follicular fate,” and can even sometimes make matters worse.

However, other factors might lead to hair loss as well. Some women are genetically predisposed to hair loss, while others may lose hair due to stress or illness. Hair loss can also result from an excess of androgen, which is a hormone that fuels male characteristics. Your doctor can determine the cause of your hair loss and recommend the best treatment options.

Menopause

HEADACHES, MIGRAINES AND MENOPAUSE

HEADACHES, MIGRAINES
AND MENOPAUSE

Millions of Americans deal with regular migraine headaches, but did you know that 7 in 10 migraine sufferers are women? This is largely due to fluctuations in the production of estrogen levels. During menopause, a woman’s estrogen hormone levels decrease, and this may have an impact on your headaches and migraines. Menopausal women may experience a change in their migraine attacks in association with menopause, the change occurred perimenopausal or postmenopausally.

Women experience headaches and migraines in many different ways. In some women, headaches are linked to hormonal fluctuations, and they tend to come and go with their menstrual cycle. For these women, menopause may actually provide some welcome relief from migraines.

For others, migraines may worsen or just start for the first time during perimenopause. A large number of women suffering from migraines are either perimenopausal or postmenopausal. Many of those who are perimenopausal believe they will be cured of migraines after completing the hormonal changes of menopause. If you’ve begun hormone replacement therapy, you might find headaches springing up as a side effect. Some may first experience migraines while using hormonal contraception. If you experience migraines while using hormonal contraception, please speak to your women’s health care provider.

Menopause

IRREGULAR BLEEDING

Throughout the reproductive years, a woman’s body increases and decreases the production of the hormones estrogen and progesterone in a regular pattern, causing monthly menstrual cycles. The regular pattern of hormone production is what gives your monthly bleeding its predictable quality.

During perimenopause – the period preceding menopause – your body begins to slow its production of these hormones, and the pattern becomes irregular. As a result, you can experience some irregular periods and bleeding. Some months, your period may seem lighter, heavier, shorter, or longer. Your period may come sooner or later than expected, or you may skip a period altogether.

Irregular bleeding during this time is normal and is no cause for alarm. However, it would help if you always let your gynecologist know when you start to experience changes in your bleeding.  Abnormal bleeding can also be a symptom of several other gynecological conditions.

Menopause

JOINT PAIN AND MENOPAUSE

JOINT PAIN
AND MENOPAUSE

The list of menopausal side effects is extensive – from mood swings to hot flashes, fatigue, night sweats, and more. And now we add joint pain to the list.

Joint pain affects many people as they get older, but unfortunately, it’s also common among menopausal women. As if we don’t have enough to worry about as we approach midlife.

Aches, stiffness, and swelling around the joint are common symptoms of menopausal joint pain. As a woman approaches menopause, her body goes through drastic hormonal changes that can affect her in many ways.

What Does Joint Pain Feel Like?
Menopausal joint pain usually hits the worst in the morning and eases as the joints loosen up with the day’s activities. Most women complain of back pain, neck pain, as well as pain in the jaw, shoulders, and elbows. Wrists and fingers can also be affected.

The pain can be accompanied by stiffness, swelling, or even shooting pain traveling down the back, arms, and legs. Some women report more of a burning sensation, especially after a workout.

Menopause

MEMORY & CONCENTRATION LOSS

Poor memory, forgetfulness, and difficulty concentrating can cause problems at work and at home. Around 60% of women in menopause or perimenopause report feeling like they’re in a “brain fog”. It’s common to experience lapses in memory and concentration during the early and middle stages of menopause. This menopausal memory & concentration loss can be alarming.

One major change to the body that may cause normal forgetfulness during menopause is a reduction in the body’s hormone levels. During perimenopause, your estrogen levels go up and down a lot. This is when many women experience symptoms associated with the transition to menopause. Estrogen is one major hormone that can impact memory before or during menopause. While absolute hormone levels could not be linked with cognitive function, it is possible that the fluctuations that occur during this time could play a role in the memory problems that many perimenopausal and menopausal women suffer from.

While memory lapses in old age are popularly associated with dementia or Alzheimer’s disease, studies have shown that most menopausal women have improvements in their memory after menopause is complete.

What Causes Memory Loss During Menopause?
In women’s health, declining estrogen levels can lead to many discomforts, and common symptoms like hot flashes, night sweats, anxiety, and mood swings. These menopause symptoms can keep you up at night and leave you feeling fatigued and mentally drained. A particular type of memory known as working memory — your ability to assimilate and manipulate new information — does not perform as well as usual during menopause.

In addition, researchers believe that estrogen may play a role in attention, mood, language, and memory. When your estrogen levels fluctuate, your brain functioning can suffer. In one study, researchers linked the severity and frequency of hot flashes to lapses in verbal memory.

Menopause

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Menopause

MOOD CHANGES, IRRITABILITY, AND MENOPAUSE

MOOD CHANGES, IRRITABILITY,
AND MENOPAUSE

For many women, menopause can feel like an emotional rollercoaster. Much like the mood swings and irritability of PMS (pre-menstrual syndrome), mood changes during menopause are caused by fluctuating production of the hormone estrogen. Menopausal mood changes and irritability, aggression, depression, fatigue, and other feelings are not uncommon.

Hot flashes, night sweats, lack of sleep, fatigue…these symptoms of menopause would make anyone irritable. But irritability is also its own menopause symptom. You know what we’re talking about. The reduction in estrogen levels during perimenopause and menopause can lead to uncomfortable symptoms, like vaginal dryness, irregular periods, hot flashes, and disturbed sleep. These causes menopausal and perimenopausal depression symptoms like low mood, anxiety, irritability, fears, and mood swings. Menopause mood swings can wreak havoc on your psyche.

If you’re feeling a range of emotions that have not been as present in the past, you might be experiencing some of the negative mood changes that with menopausal symptoms.

Common Mood Changes During Menopause Can Include:
Perimenopausal and menopausal women experience the following during this stage of their lives:

  • Irritability
  • Sadness or depression
  • Lack of motivation
  • Aggression
  • Anxiety or stress
  • Fatigue
  • Forgetfulness or the inability to concentrate

It is important to remember that emotional symptoms can also be associated with other psychiatric or medical conditions. In other words, knowing the cause of these feelings can be rather complicated, which is what we as medical professionals are here to help you figure out.

Menopause

NIGHT SWEATS AND HOT FLASHES

Night Sweats and Hot Flashes are one of the most common complaints in women’s life experience during menopause and perimenopause. Over two-thirds of women experience hot flashes during perimenopause, which is the gradual slow-down of a woman’s reproductive system as she approaches menopause. Just one of many menopause symptoms. Menopause causes a variety of familiar symptoms, such as hot flashes, mood swings, and vaginal dryness among others. Hot flashes are the most common symptoms of menopause and perimenopause.

What can I do about Menopausal Night Sweats and Hot Flashes?
There is no estimated length of time that perimenopausal and menopausal women will have to endure hot flashes and night sweats. Some women will experience only a handful of them at the onset of menopause, while others will have them for life. The good news is that generally hot flashes tend to decrease in severity over time.

While you probably cannot completely prevent menopausal hot flashes, there are some known triggers that you can avoid to decrease their impact on your life:

  • Hot Environments
  • Spicy foods
  • Alcohol
  • Caffeine
  • Cigarette smoke
  • Tight clothes
  • Stress

Keep your bedroom cool at night and wear light pajamas made with natural fibers, like cotton. You may also find that daily exercise eases hot flashes. If you’re not used to exercising, you could try activities that are easy on your body, like swimming, biking, and walking.

Relax and reduce stress. Slow and deep breathing and meditation are techniques that can help relieve stress and reduce hot flashes.

Menopause

OSTEOPOROSIS AND
OSTEOPENIA IN MENOPAUSE

OSTEOPOROSIS
AND OSTEOPENIA
IN MENOPAUSE

Like our other organs, bones are living tissues going through their own “circle of life.” Different types of bone cells are each responsible for forming, maintaining, and reabsorbing bone tissue. When we are young and still growing, bone cells create bone tissue faster than the tissues die and are reabsorbed. Osteoporosis is a bone disease in which the bone cells can’t make new bone as fast as the old bone degenerates.

For those with osteoporosis, bones are brittle and fragile and at risk of fracture. It can be so severe that a minor impact, or even a cough, can be a fracture risk. Osteopenia is not a diagnosis. It’s a description, a state. This is a key difference between osteopenia and osteoporosis. The word “osteopenia” means “low bone mass”— stating an observation that your bone mass is lower than that of a woman in her late 20s—someone at the peak of their bone-building and strength. Women’s peak bone mass occurs in their late 20s.

Osteopenia, if it happens at all, usually occur near age 50. The exact age depends on how strong your bones are when you’re young. If you have hardy, healthy bones, you may never get osteopenia. If your bones aren’t naturally dense, you may get it earlier.
Osteopenia usually doesn’t have any outright symptoms. This makes it difficult to diagnose unless you have a bone mineral density test. Osteopenia will lead to osteoporosis but may lead to full-on osteoporosis if ignored.
As we age, our bone strength decreases, hence the risk of developing osteoporosis increases. Women, especially white and Asian women, are more susceptible to the disease than men. This is why we encourage pre- and post-menopausal women to talk to their physician about their concerns, and start taking preventative measures while their bones are still relatively healthy.

Symptoms of Osteoporosis
One of the dangers of osteoporosis is that there are no outward symptoms to warn you until you already have the disease. After many years, you may notice signs like back pain, a loss of height, or a stooped posture. For some people, the first sign they have of the disease is a broken bone, usually in the spine or hip. However, there are some things you can do to reverse some of the effects of osteoporosis even after you’ve developed some symptoms.

Bones weakened by osteoporosis may cause:

  • Back pain
  • Stooping or slouching posture
  • Shrinking stature over time
  • Unexpected bone fractures

If you’re experiencing these symptoms, it is important to talk to your health care doctor about how to prevent further bone loss. You may also be at higher risk if you went through early menopause, if your parents had any hip fractures in their old age, or if you took corticosteroids (i.e. cortisone, hydrocortisone, and prednisone) for a long period of time.

Menopause

SLEEP DISORDERS AND MENOPAUSE

Many female patients in their late 30s and 40s with symptoms of insomnia are actually experiencing the beginning of their menopause transition, which is called perimenopause.

Menopause can bring with it significant challenges to sleep. Menopause is notorious for interfering with sleep due to bothersome hot flashes and night sweats. Insomnia and sleep disruptions from hot flashes are common in women going through menopause. At least three out of every four menopausal women will experience hot flashes, and about 60% of women will report menopausal sleep disorders due to hot flashes causing some serious sleep problems. Many menopause – or perimenopausal women – have sleep difficulties; and the same goes for postmenopausal women, who have gone without a menstrual cycle for more than one year or who are in menopause after surgical removal of their reproductive organs.

Poor sleep quality and sleep disturbance are lesser-known menopausal symptoms during this phase of life, but they’re very common.

You might think that a good night’s sleep is nothing but a dream once you reach a certain age. Many women experience sleep problems during perimenopause, the period of time before menopause when hormone levels and menstrual periods become irregular. Often, poor sleep sticks around throughout the menopausal transition and after menopause.

What’s “good” sleep?
Women should aim for between seven and eight hours of quality, uninterrupted sleep per night. The rule isn’t hard and fast, though; some people need less sleep, and others need more. In general, if you’re waking up regularly during the night and feel that your sleep isn’t restful, those are signs that maybe you’re not getting good sleep.

Both these sweats and tiredness resulting from insomnia can have a large negative effect on their subjective quality of life.

How to Get a Better Night’s Rest
The good news is that you don’t have to kiss a good night’s rest goodbye once you hit menopause. There are steps you can take to get better sleep.

  • Set a Routine
    Go to bed and get up at a regular time. Routine is very important for establishing a good sleep pattern. Establishing and sticking to set times may take a few weeks, so bear that in mind. Keep a regular bedtime schedule to train yourself to sleep at the same time every night, and avoid napping during the day.
  • Exercise
    Regular exercise can help menopausal women fall and stay asleep. Athletes, for example, tend to be highly efficient sleepers. But even for those of us who aren’t professional athletes, exercise may help with sleep quality. Exercise daily, but avoid exercise before bed.
Menopause

UNWANTED FACIAL
HAIR AND MENOPAUSE

UNWANTED
FACIAL HAIR
AND MENOPAUSE

Your hormone levels shift periodically and throughout your life because of aging, weight gain, and other factors, including pregnancy and menopause.

Many post-menopausal women find that their hair just won’t grow like it used to. The hair on their scalp thins, while the chin or upper lip sprouts patches of “peach fuzz.” These changes are very normal. In fact, one study found that almost 40% of women age 45 and older have an excess of facial hair growth, especially on the chin. According to another study, it is very likely you will experience unwanted facial hair after menopause.

What Can I Do About Unwanted Facial Hair?
There’s nothing wrong or unhealthy about growing sparse facial hair. There’s nothing dangerous about a few extra chin hairs, after all. But if it bothers you, there are things you can do to remove the hair or minimize its appearance. It is understandable that some women won’t welcome this change in appearance. Waxing, shaving, and tweezing are perfectly acceptable ways to deal with unwanted hairs. Based on the degree of growth, plucking, tweezing, threading, or waxing may do the trick.

Your doctor can also prescribe a topical cream to slow the growth or refer you to a clinic that can perform electrolysis or laser treatment for hair removal. Electrolysis eliminates hairs by killing hair follicles with a targeted electric current. If you can afford it, electrolysis or laser hair removal may be options. These result in the permanent destruction of the hair follicle so it can’t grow back.

But this technique works best on dark hairs and is less effective for blonde or peach-fuzz type hair growth.

Menopause

URINARY PROBLEMS
AND MENOPAUSE

The hormone estrogen is partly responsible for maintaining elasticity in the vaginal and urethral tissues. Unfortunately, during menopause, what happens is the body begins to slow the circulation of estrogen. The result of which is a thinning out of the urogenital tissue. This then weakens the muscles that control the bladder and urinary functions.

This is what causes bladder control and urinary problems during menopause that some women report. Low estrogen at menopause, combined with normal aging, may result in annoying symptoms of vaginal dryness, incontinence, and urinary tract infections.

Unlike other symptoms of menopause, such as hot flashes, urogenital atrophy symptoms can become worse as the woman ages.

Symptoms of Urinary Incontinence During Menopause
Urinary incontinence, bladder control problems are common for women going through menopause.

After the end of your menstrual cycles, your body stops making the female hormone estrogen. In addition to controlling your monthly periods and the changes during pregnancy, estrogen also helps keep the lining of the bladder and the urethra healthy.

As we age, many factors can weaken the pelvic floor muscles responsible for bladder control resulting in urinary incontinence. This includes damage during pregnancy, childbirth, and weight gain.

Women with urinary incontinence can experience symptoms beyond leakage. It’s important to note which symptoms are affecting you so that you can relay the information to your gynecologist. Some symptoms include:

  • Frequency – Urinating more often than normal
  • Urgency – The urge to urinate, even if the bladder is empty
  • Feelings of pressure or discomfort in the lower abdomen
  • Dysuria – Painful urination or burning while urinating
  • Nocturia – The need to get out of bed to urinate several times a night
  • Enuresis – Urinating the bed while asleep
Menopause

URINARY TRACT INFECTIONS IN MENOPAUSE

URINARY TRACT INFECTIONS
IN MENOPAUSE

Recurrent UTIs are common among both young healthy women and healthy women at midlife. Here’s why. There are many types of bacteria that normally live in the vagina and happily coexist. And they keep each other in check, like a mini-ecosystem. The hormone estrogen allows the “good” bacteria called Lactobacillus to thrive. These bacteria produce acid, which lowers the pH in the vagina, which helps keep the “bad” bacteria in check.

For women at midlife, the main culprits behind recurrent UTIs are physical changes, including thinning of vaginal tissue, pelvic organ prolapse, incontinence, and trouble completely emptying the bladder. The lower levels of estrogen after menopause are also a factor.

Perhaps you’re no stranger to urinary tract infections (UTIs), or maybe you’re the opposite, and you’ve been spared by the urinary health gods. Whichever the case, UTIs after menopause can happen to anyone. They are the second most common type of bacterial infections seen by healthcare providers.

A urinary tract infection (UTI) occurs when bacteria from the bowel enters and travels up the urethra. Women are fairly prone to urinary tract infections because of the shortness of their urethra and the close proximity of the urethra to the vagina and anus. Bacteria that live in this moist environment can spread to the urinary tract during sex or with the use of certain vaginal birth control methods.

Bacteria that travel up the urinary tract can affect the urinary organs beyond the urethra. The urethra and bladder are known as the lower urinary tract. If the bacteria reach the bladder, the woman may develop a bladder infection, also known as cystitis.

If the infection spreads to the upper urinary tract, it affects the ureters and kidneys as well. A kidney infection is known as pyelonephritis and can be a serious medical condition.

What are UTI Symptoms for Women after Menopause?
UTIs may present themselves differently in postmenopausal women. The typical features of UTI should next be examined: urinary urgency, frequency, dysuria, hesitancy, and low back pain. Because postmenopausal women may not present to the clinician with “typical” UTI symptoms, it is important to investigate for atypical UTI presentations. Symptoms of increasing mental confusion, incontinence, unexplained falls, loss of appetite, and nocturia are atypical clinical manifestations that may occur in the older postmenopausal female:

  • Urosepsis or septic shock (severe hypotension, fever, tachycardia, tachypnea).
  • Have symptoms only of urinary incontinence or a combination of symptoms.
  • Mental changes or confusion, nausea or vomiting, abdominal pain, or cough, and shortness of breath.
  • A study of women aged 18 to 87 years revealed that a generalized sense of “feeling out of sorts” was frequent in adult women with acute uncomplicated lower UTI.
Menopause

VAGINAL DRYNESS IN MENOPAUSE

VAGINAL DRYNESS
IN MENOPAUSE

Vaginal dryness can be a problem for many postmenopausal women. About one-third of women experience it at menopausal onset and that number only grows as women age.

Vaginal dryness is a hallmark sign of the genitourinary syndrome of menopause, also known as atrophic vaginitis or vaginal atrophy. With this condition, vaginal tissues become thinner and more easily irritated — resulting from the natural decline in your body’s estrogen levels during menopause.

Vaginal dryness might not impact your day-to-day activities, but it can lead to itching or stinging. Many women also report that it has negatively affected their sex life leading to decreased sexual activity, causing frustrations for both partners.

Painful intercourse can then have a knock-on effect contributing to a loss of sexual desire causing sexual problems. The relief of symptoms often leads to increased sexual desire and arousal and better sexual health.

Pain during other times – in many cases vaginal dryness does not only cause pain during sex it can make it uncomfortable to sit, stand, exercise, urinate, or even work. Vaginal dryness can affect everyday life, whether women are sexually active or not. This can have a detrimental effect on the quality of life.

There are some minimally-invasive effective treatments for vaginal dryness that can help ease the symptoms and restore vaginal health.

Menopause

WEIGHT GAIN IN MENOPAUSE

WEIGHT GAIN
IN MENOPAUSE

It seems cruel that just as we begin to relax because we no longer menstruate, we get hit by a host of new challenges instead, like menopausal symptoms. Not only does menopause (and perimenopause) cause hot flashes, incontinence, vaginal dryness, and more in some women, it can also cause us to gain weight!

Most menopausal women can expect to see some weight gain, especially around the waist. The hormonal changes of menopause might make you more likely to gain abdominal fat than gain weight around your hips and thighs.

Not all weight gain is a threat to your health, but gaining too much weight can tax your body and lead to hypertension, diabetes, and heart disease. A larger waistline raises these risks even more. There’s a link between estrogen and body fat storage. Post-menopausal women burn less fat than they did in their pre-menopausal years.

During the menopause transition, night sweats, sleep disturbance, and mood problems are common and may affect a woman’s ability to adhere to a healthy diet and exercise.

With your medical professionals’ help and some lifestyle changes on your part, you should be able to manage your weight and stay healthy through menopause.

Exercise During Menopause
Exercise has so many health benefits. The more active you are, the less weight you’re likely to gain.  Exercise is one of the most effective ways to:

  • Manage your weight
  • Retain bone density, lowering risks of osteoporosis
  • Relieve mood issues and depression
  • Reduce your odds of having a heart attack
  • Lower the risks of cardiovascular disease
  • Improve insulin resistance
  • Lower chances of developing type II diabetes
  • Strengthen your muscles and joints
  • Increase sexual health
  • and the list goes on and on.
Women's Health

Medical Weight loss

Medical
Weight loss

Medical weight loss through prescription medications can be used to treat obesity in overweight adults in a variety of ways. Some medications will make you feel full sooner or less hungry, reducing the amount of food consumed daily. Other medications will change how your body absorbs fat from foods, successfully helping you lose fat.

Frequently Asked Questions

Medical Weight loss

Medical
Weight loss

These medications are typically reserved for medically obese or overweight people who may be experiencing health problems due to their weight. Your provider will conduct a thorough medical history before prescribing.

Noticeable benefits of actual weight loss may include the lowering of blood sugar and blood pressure. There can also be a reduction in significant health concerns like joint pain, breathing problems, and insomnia.

The duration of treatment will depend on whether or not it is effectively assisting with weight loss. If there are no side effects, the treatment may continue for an extended period of time.  However, if the weight loss is not significant or there are side effects, then the treatment may be discontinued. Regardless of how long the treatment continues, lifestyle changes need to be permanent to maintain the weight loss or continue losing weight.

After you stop taking your medication, there may be a bit of weight gain. This is why it is important to develop and maintain healthy habits during treatment, like eating the right foods and increasing exercise.

Weight loss medications are a consideration for those who have been unable to lose weight by diet and exercise alone.

Qualifications may include:

  • Have a BMI of greater than 30
  • BMI is greater than 27 along with medical conditions
Intravenous (IV) Fluid hydration

IVF hydration

IV fluid hydration is a treatment most commonly used in hospitals to treat severely dehydrated patients. The treatment involves the insertion of an IV (intravenous line) into the patient’s arm. Then, rehydrating fluids will be injected into the IV line and circulate directly into the patient’s bloodstream. 

Doctors use IVs for rehydration because they allow the fluids to go directly into your bloodstream, bypassing the wait time that occurs when you drink fluids. IV fluids usually also include electrolytes which also help to speed up the recovery time and replenish the body’s fluid supply. 

When Do You Need IV Fluid Hydration?
IV fluids are usually used in cases of severe dehydration. For example, children who contract the flu may end up losing fluids from diarrhea and vomiting. If the dehydration is severe enough, it may be safer to rehydrate via IV, as opposed to drinking lots of fluids. 

Dehydration isn’t just a problem in children, though. It can happen in adults, too.

Mild dehydration can cause an increased desire to drink, headaches, light-headedness, nausea, and fatigue. If the dehydration gets bad enough, it can lead to unconsciousness, so it’s important to keep track of your fluid intake throughout the day.

Intravenous (IV) Fluid hydration

Immune Booster IV hydration

Healthy nutrition is essential for maintaining a strong immune system. Although a well-balanced diet can provide you with many necessary vitamins and minerals, the ability to absorb nutrients from food decreases with age. 

Taking vitamin supplements is not always sufficient, since only a limited amount can be processed by the body. What’s more, supplements can be harmful if taken in high doses.

The best way to make sure you’re getting all the nutrients you need is immune boost IV therapy. IV immune boosters are specifically designed to support your immune system with valuable vitamins, minerals, and amino acids. 

These nutrients are delivered directly into your bloodstream. Because immune booster infusion completely bypasses the digestive system, no nutrients will be lost as they break down in your body. 

Taking immune boosters intravenously can help with: 

  • Increasing your energy levels
  • Combatting tiredness and fatigue
  • Restoring hydration
  • Preventing seasonal illnesses
  • Accelerating recovery from cold and flu
  • Preparing your body for medical procedures
  • Relieving seasonal allergies
  • Healing wounds
  • Recovery from injuries. 
Diabetes

Ozempic®

Lowering A1C is an important part of managing type 2 diabetes. But so is managing your potential risk of major cardiovascular (CV) events if you also have known heart disease, and also losing some weight. Ozempic®, along with diet and exercise, is proven to improve blood sugar in adults with type 2 diabetes. In adults with type 2 diabetes and known heart disease, Ozempic® reduces the risk of major cardiovascular events such as stroke, heart attack, or death.

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