Gyno Groupie

Hi all, I wanted to discuss something that plagues a lot of women with pelvic pain, and that is endometriosis.  Many of you know what that is. For those of you that are not familiar with it, please referred to previous post on this blog.

Traditionally, endometriosis is diagnosed via laparoscopic surgery.  We can see the active lesions and cauterize them. Once the lesions are cauterized the pain will improve. It is well known that these lesions typically have a dark brown or "chocolate" color appearance.  However, it is now agreed that these lesions have a wide range of colors depending how active they are. Some of these are clear which is difficult to see with traditional laparoscopy.

So what is this HPV all about?  HPV (human papilloma virus) is a virus that causes 90% of genital warts in men and women, 75% of cervical cancer in women.  It also causes 70% of vaginal cancers and 50% of vulvar cancers as well.

So it is a big deal?

The recommended time for getting mammograms is at age 40 and yearly thereafter.  However, I like to get one around age 35 as a baseline and age 40 thereafter.  The reason is that in my practice area, there seems to be higher incidence of breast cancer, especially in younger women.  So because of this demographic I get the earlier screening.

Talk to your doctor about what is best for you!

Thanks and I’ll talk to you soon.

docbchen

I get this question from moms all the time.  The current recommendation is that for both sexually and non-sexually active teen, age 21 should be the first Pap.

However, I feel that if they are sexually active, they need to be screened for sexually transmitted diseases, and the first Pap should be done within 3 years of sexual activity.

But, if they have problems with periods or other gynecologic issues, then they should be seen at the time of problems.

Hope that clears it up.

docbchen

This is something we encounter daily as gynecologists.  Patients will often have questions regarding their daughters.  Whether just starting their periods or have terrible periods.

When girls start their periods, it means that their reproductive function is becoming active.  She is doing what evolution dictates.  Mainly reproduce.  However, sometimes it doesn’t work out as smoothly as people think.

The reason is that it takes a myriad of “hormone-dance” in order to have the perfect cycle.  It is not uncommon for girls that start the pubertal process to have hiccups in this hormonal-dance.  The resultant fluctuations in hormones can lead to irregular and unpredictable periods, painful periods and heavy periods.  Not to mention mood swings.

So those of you out there that are experiencing this, know that it is normal in most instances.  However, there are things we can do to help these poor girls to feel better and cope better with their periods.  Talk to your gynecologists and they should guide you through these interesting times.

docbchen

Today we are going to discuss miscarriages.  Miscarriages happens in 1-2 out of every 10 pregnancies.  The majority of them will happen in the first 12 weeks of pregnancy. When you lose more than 2-3 in a row, it may be called recurrent miscarriage.  There are multiple reasons that can cause miscarriages.  Unfortunately, more than half of them are unknown.

Some of the known causes are chromosomal or genetic issues, medical conditions in the mother, and problems with the mom's uterus.  By far the most common is chromosomal issues. This accounts for more than 50-60% of the losses.  Some other causes are maternal medical conditions such as autoimmune disease like Lupus, uncontrolled high blood pressure, heavy smoking, clotting disorder and uncontrolled diabetes.  In addition, some women's uteri may have formed abnormally at birth. This is called uterine anomaly. This can also contribute to miscarriages as well.

For those of you that have experienced a miscarriage, there is no better way of describing it other than that it "sucks".  It is a lost of life. You'll feel sad just as if you would if you had loss someone.  In a way you did.

However, what I try to tell my patients is this. Know that the majority of the losses are from a chromosomal issue that is out of your control. So don't beat yourself up. Don't think back and say "maybe I shouldn't have done that, drank that, or taking that medicine".  There will be a natural feeling of guilt. But that's ok. Your human.  But understand that the majority of the times it's NOT YOUR FAULT.  This is very important to understand.

The good news is that even if you had 2 or 3 miscarriages, the chances of you having a healthy baby is still very high.  With the advances in medicine, we can correct uterine anomalies and treat the mom's medical conditions, and hopefully, help you achieve a healthy baby.

Until next time...

docbchen

Today we are going to discuss miscarriages.  Miscarriages happens in 1-2 out of every 10 pregnancies.  The majority of them will happen in the first 12 weeks of pregnancy. When you lose more than 2-3 in a row, it may be called recurrent miscarriage.  There are multiple reasons that can cause miscarriages.  Unfortunately, more than half of them are unknown.

Some of the known causes are chromosomal or genetic issues, medical conditions in the mother, and problems with the mom's uterus.  By far the most common is chromosomal issues. This accounts for more than 50-60% of the losses.  Some other causes are maternal medical conditions such as autoimmune disease like Lupus, uncontrolled high blood pressure, heavy smoking, clotting disorder and uncontrolled diabetes.  In addition, some women's uteri may have formed abnormally at birth. This is called uterine anomaly. This can also contribute to miscarriages as well.

For those of you that have experienced a miscarriage, there is no better way of describing it other than that it "sucks".  It is a lost of life. You'll feel sad just as if you would if you had loss someone.  In a way you did.

However, what I try to tell my patients is this. Know that the majority of the losses are from a chromosomal issue that is out of your control. So don't beat yourself up. Don't think back and say "maybe I shouldn't have done that, drank that, or taking that medicine".  There will be a natural feeling of guilt. But that's ok. Your human.  But understand that the majority of the times it's NOT YOUR FAULT.  This is very important to understand.

The good news is that even if you had 2 or 3 miscarriages, the chances of you having a healthy baby is still very high.  With the advances in medicine, we can correct uterine anomalies and treat the mom's medical conditions, and hopefully, help you achieve a healthy baby.

Until next time...

docbchen

One misconception among women is that a Pap equates a speculum exam or vice versa.  A Pap smear is a simple smearing of the cervical cells when we do a speculum exam.  A speculum is the way we can visualize the cervix itself.  There are many other reasons we’ll do a speculum exam without actually doing the Pap smear (i.e. check for vaginal infections).

The current recommendation is that it is reasonable to discontinue Pap smears at either 65 or 70 years of age if they had 3 consecutive normal Paps.  They also have to have had normal Paps in the last 10 years.  If screening is discontinued, risk factors should be assessed yearly to see if it needs to be reinstituted.

Now this doesn’t mean you don’t need a pelvic exam ladies.  Even though a Pap may not be needed, you still need yearly breast, pelvic and rectal exams to screen for other problems.

I know many of you were hoping that you can get out of pelvic exam.  Sorry :(

docbchen

Let’s admit it, who really wants to have a colonoscopy?  I’m not in line to volunteer yet.  But I will when I turn 50.  It can save your life.

Colonoscopy is when a small camera is inserted through the rectum and it is snaked around your entire colon to look for polyps or cancerous lesions.  It is recommended for both men and women starting at age 50 for colon cancer screening.  If you have a family history of colon cancer (first degree relative), you may need to get it earlier.

The prep is probably the worst.  You have to drink a bowel prep of your doctor’s choice until you run clean.  The procedure itself is not terrible since most people are sedated.

So don’t put it off too long.  Talk to your doctor about screening colonoscopies.  I will be getting one when I turn 50.

docbchen

This is a topic that a lot of patients have questions on.  When women are told they need a hysterectomy, questions start swirling in their heads.  One of the most common question is WHY?

So what should you expect in the first trimester of pregnancy?  For many of you, this is a very exciting time.  Especially if you’re a first time mom.  There is A LOT happening in your body both hormonally and physically.  Some will experience emotional swings because of the hormone surges.  So husbands, please be understanding.

From a physical standpoint, it is not uncommon to feel menstrual type cramps because everything is growing and being stretched.  This type of pain is typically cramping and sharp shooting in nature.  This is because there are ligaments that are attached to your uterus.  The easiest way to describe them is that they are like rubber bands that attach to your uterus.  So as you grow, they stretch.  And sometimes, if they stretch too much, they’ll spasm and you’ll experience a sudden sharp shooting pain.  This pain can feel like someone is jabbing you from the vagina up (doesn’t that sound good), and sometimes it’ll feel like a shooting vaginal pain down wards or across your lower abdomin.  These typically don’t last long, but it can be quite uncomfortable.  This is completely normal.  It does not mean you are trying to have a miscarriage.  It’s normal growth.  However, most Ob/Gyn’s will order an ultrasound to make sure everything is ok.

The other thing that can happen early on is nausea and vomiting.  This is normal because of the hormonal changes that is occurring.  It typically peaks between 8-10 weeks for most women, but some will continue beyond the 12th week.  There are a wide range of treatment including vitamins, pressure point stimulator, and medicine that can help.  Please talk to your health care provider if your experiencing severe nausea or vomiting.

The first trimester can also be a time of anxiousness.  This is true for anyone that has had a miscarriage.  Most miscarriage will happen in the first trimester, and the majority of these are related to chromosomal abnormalities.  While there are certain behavors that may increase the risk of miscarriage such as smoking and high caffeine intake, the majority of miscarriages are uncontrollable.  Symptoms of miscarrage are usually severe recurrent cramping that doesn’t ease up and vaginal bleeding.  If you have these symptoms, please notify your health care provider.

Hope this quick synopsis helped answer some of your questions.  Good luck!

docbchen