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.
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 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:
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.
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.
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.
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.
Painful urination is often a symptom of something more serious, such as a urinary infection or interstitial cystitis.
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 (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, 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 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.
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®)
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 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.
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
- 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.
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)
- Diarrhea or constipation
- Urinary frequency
- Low back pain
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.
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.
Some women feel shoulder pain when the blood from the ruptured tube collects underneath the diaphragm, putting pressure on the chest and shoulders.
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 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:
- Aching, constant pain in the lower abdomen
- Increasing pain during and after a period
- Vaginal discharge
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 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
- Changes in the color or smell of vaginal discharge
- Lower back pain
- Nausea or vomiting
- Painful sexual intercourse
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.
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
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 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)
- 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
- 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:
- 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.
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.
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
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.
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
- Clammy or sweaty palms or feet
- Numbness or tingling
- Increased or irregular heartbeat
- Hyperventilation/shortness of breath
- Restlessness and uneasiness
- Tense muscles
- Dizzy spells
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 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
- Feelings of worthlessness, shame, guilt, or inadequacy
- Diminished ability to think clearly, concentrate or difficulty in making decisions
- Severe anxiety and panic attacks
- Thoughts of harming yourself or your baby
- Suicidal thoughts
Untreated, postpartum depression may last for many months or longer.
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
- Crying easily
- Short temper
- Difficulty concentrating
- Social withdrawal
- Increase or decrease in sexual desire
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
- 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.
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:
- Abnormal Uterine Bleeding
- 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.
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
- Pelvic Organ Prolapse
- Precancerous Vaginal Conditions
- Vaginal Cancer
- Vaginal Infections
Vaginal Intraepithelial Neoplasia (VAIN)
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.
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.
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.
- 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.
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.
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