Posts for category: OBGYN Care
Endometriosis is a female condition in which tissue that's similar to uterine lining begins growing on the outside of the uterus, often affecting the ovaries, fallopian tubes, and pelvic tissue. During your cycle, the endometrial tissue then becomes thicker until it breaks down and bleeds, and due to how this tissue can’t be removed from the body, it gets trapped. Over time, this can lead to scar tissue (known as adhesions) on the reproductive organs.
This condition affects as many as 11 percent of US woman between the ages of 15 and 44, most often affecting women in their 30s and 40s. This condition can also make it more challenging for women to get pregnant.
What are the symptoms of endometriosis?
The classic symptom of endometriosis is abdominal pain that is usually worse during your menstrual cycle. While a lot of women complain of some abdominal discomfort during menstruation, women with endometriosis often complain of very painful periods, which may even radiate to the lower back.
Women with endometriosis may also experience very heavy periods or breakthrough bleeding (bleeding between cycles). You may also notice pelvic pain during sex or with bowel movements, as well as bloating, constipation, diarrhea, nausea, or fatigue.
All symptoms will vary from woman to woman. For instance, some women may have very severe symptoms but only have milder cases of endometriosis, while those with more severe cases may experience little-to-no-discomfort. Everyone is different; however, if you are experiencing new, persistent, or worsening pelvic pain, it’s important that you talk with your gynecologist.
If you are trying to conceive you may also find it more difficult to do so. Sometimes women don’t often find out that they have endometriosis until they visit their OBGYN to discuss problems getting pregnant.
How is endometriosis diagnosed?
During your evaluation, your OBGYN will ask you questions about the symptoms that you are experiencing. From there, a couple of tests will be performed in order to pinpoint specific signs and symptoms of endometriosis. These tests include a traditional pelvic exam or an ultrasound. In some instances, an MRI exam or a laparoscopy (a minor surgical procedure that allows a doctor to examine the inside of the abdomen and uterus) may be recommended to make a definitive diagnosis.
How is this condition treated?
Since there is no cure for endometriosis the goal of treatment is to manage your symptoms. As with most conditions, we will recommend more conservative treatment options at first to see if they are effective. Common treatment options include,
- Pain medications (either over-the-counter or prescription-strength)
- Hormone therapy (e.g. birth control pills; progestin therapy)
- Fertility treatment (for women who are having trouble conceiving)
- Laparoscopic surgery to remove excess endometrial tissue
If you are experiencing symptoms of endometriosis, it’s important that you talk to a gynecologist as soon as possible.
At some point all women will need to receive routine pelvic exams in order to check their vaginal and reproductive health. This exam allows your gynecologist to be able to examine the vagina, cervix, ovaries, fallopian tubes, and uterus to look for early warning signs of infection or other problems.
Unless otherwise recommended by a physician, most women will undergo their first pelvic exam at the age of 21. After which, this simple exam should become a regular part of your well-woman care.
Getting a Pelvic Exam
We know that any kind of new exam or procedure can make anyone a little nervous. That’s why we want you to know what to expect before coming into the office for your first pelvic exam. Here’s what to expect:
We will provide you with a dressing gown, which you will change into in private. From there, you will lie down on the exam table and place your feet into elevated footrests. You will move your body towards the end of the table and our gynecologist will instruct you on what to do to make sure they can perform the exam. Relaxing as much as possible during the exam is important as it will make the process more comfortable for you.
There are usually three different parts involved in a pelvic exam:
- The external exam: This allows us to look at the external tissue of the vulva to detect any irritation, abnormal discharge or warning signs of other problems like genital warts or cysts.
- The internal exam: A special instrument known as a speculum will be carefully inserted into the vagina to open up the walls so that your gynecologist can examine the uterus and cervix. Sometimes a small brush is inserted into the vagina to collect cells from the cervix for testing. This is known as a Pap smear and it allows your doctor to check for precancerous and cancerous cervical cells.
- The bimanual exam: The speculum is removed and your gynecologist will then place one or two gloved fingers into the vagina and press on the abdomen to check the size and shape of the uterus and to feel for any enlargements, tenderness, or pain.
While the first pelvic exam may feel a bit awkward and weird it should never feel painful or uncomfortable. If you are experiencing any discomfort please let us know. We will talk you through the entire process so you know what’s going to happen before it does. If you have any questions or concerns for us this is also the time to let us know.
How often should I get a pelvic exam?
This will depend on several factors. Based on your current health, medical history and any past medical test results we will determine whether you will only need to come in once a year or whether you could benefit from visiting us more often.
What is an IUD?
An IUD (intra uterine device) is a temporary form of birth control for women. It is a small, plastic device that is implanted into the uterus by an OBGYN to prevent pregnancy.
How Does an IUD Work?
There are two different forms of the device - hormonal and copper. The device prevents pregnancy in several ways. The copper version prevents fertilization by targeting and killing the sperm. The hormonal version releases daily low levels of levonorgestrel, thickens the mucus produced by the cervix during ovulation and thins out the uterine lining, all of which prevent the sperm from fertilizing an egg.
Do IUDs Provide STD/STI Protection?
No. IUDs only offer protection from pregnancy, and will not protect against sexually transmitted diseases and infections. Discuss sexual activity and risk factors with your OBGYN to determine the best methods for protection and safe sex with an IUD.
Who is a Good Candidate for an Intra Uterine Device?
IUDs are safe and effective for both younger women in their teens and older women, and can be used whether or not a woman has already given birth.
Will an IUD Affect the Ability to Get Pregnant in the Future?
No. The device does not affect fertility, and the woman's ability to conceive will be the same as before the device was implanted once it is removed, according to the woman's age and individual fertility levels. Once a woman is ready to become pregnant, an OBGYN can help to establish a fertility chart to determine ovulation and the best time to conceive.
Is the Device Painful?
Some women, particularly those who have never had children, may experience some initial discomfort when it is first implanted. Over the counter pain killers like Advil or Motrin prior to insertion of the device can help to minimize any pain or discomfort during and immediately following implantation.
If your OBGYN has recommended that you get a sonohysterogram done find out more about this procedure and what to expect.
Are you dealing with abnormal between-cycle bleeding, infertility or repeated miscarriages? While ultrasounds are often the first diagnostic test performed, if an ultrasound has come back normal and you’re still experiencing symptoms, then a gynecologist may recommend getting a sonohysterogram.
What can a sonohysterogram detect?
This procedure still uses an ultrasound to examine the inside of the uterus, but instead of just an ultrasound a saline solution is administered in the uterus beforehand. By injecting this solution inside the uterus we can obtain more details of the uterus that you wouldn’t be able to see with a regular ultrasound alone. A sonohysterogram can often be performed right in your gynecologist’s office and it usually takes about 15 minutes to complete.
When will a sonohysterogram be performed?
For obvious reasons this procedure will be performed when you don’t have your menstrual cycle, since bleeding could make it more difficult to see the uterus. This test isn’t performed on women who are pregnant or could be pregnant, as well as women with pelvic infections.
What should I expect from my procedure?
During the first portion of your treatment we will perform a regular transvaginal ultrasound. Then the solution will be injected into the uterus, and the ultrasound will be performed again.
After your procedure it is normal to experience some slight cramping and spotting, but most women are able to return to their normal activities the very same day as their procedure. But if you are having any symptoms that are concerning, you need to call your OBGYN.
If you are dealing with unusual uterine bleeding or having fertility issues, it’s certainly time to talk to a OBGYN specialist who can help provide you with the answers you need.
Treating Irregular Periods
Irregular periods are common when you first start menstruating. It’s common for them to be early or late, but as you get older, your menstrual cycle should become more regular, with the average length of the cycle lasting 28 days.
You have chronic irregular periods if:
- The length of your menstrual cycle keeps changing
- Your periods are coming early or late
- You experience severe abdominal pain and very heavy bleeding during your period
There are many causes of irregular periods, including:
- Puberty, pregnancy, or menopause
- Contraceptive measures including the pill or intrauterine device
- Extreme weight fluctuations, excessive exercise, or stress
- Medical conditions including thyroid issues, endometriosis, uterine fibroids, or polycystic ovary syndrome
You should see a doctor if:
- Your periods are suddenly irregular and you are under age 45
- Your periods are more frequent than 21 days
- Your periods are less frequent than 35 days
- Your periods last longer than 7 days
- You have severe abdominal pain and heavy bleeding with your periods
- You are trying to have a baby, but you have irregular periods
There are several ways to treat irregular menstruation. The first step is determining what is causing it. If it is due to a medical issue like thyroid problems, medication or treatment of the underlying condition is vital. Additional treatment measures include:
- Losing weight, if irregular menstruation is due to being overweight
- Hormonal therapies, including birth control to regulate menstruation
- Surgical therapy, if irregular menstruation is due to uterine fibroids or other structural issue.
There is also a 5-year intrauterine device known as Mirena, which can lessen bleeding. It also works as a contraceptive. Your doctor can help you decide which treatment option is best for you.
Irregular menstruation may be self-limiting, but it may go on for months or years. It can affect your life, especially if you are trying to get pregnant. It can also be a sign of a serious underlying condition. It’s important to seek out your doctor to find the cause, protect your health, and give you peace-of-mind.