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Uterine Fibroid or Polyp? Ever Wondered What they 'Look' Like?

Check out this amazing 'life-like' computerized graphic video of fibroids from simulated Myosure procedure!

 

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Time to visit your Gyno? Tips to Prepare for your visit with the Gynecologist

Who really likes going to see the Gynecologist?  For some women, it probably ranks right up there with getting a tooth drilled at the dentist, or like nails to a chalkboard.  But let’s face it, the gynecologic exam/Pap smear is a necessary part of preventative Women’s Health screening.  Whether it’s your first visit, or you’re seeing the Ob/Gyn you’ve known for years, here are a few tips that may help to make your visit go more smoothly…

 

Prepare your questions/concerns

Make a list of your concerns/questions, include your medical history, medications, allergies, ect…

In that the average patient-physician interaction is 10-20 minutes, it’s helpful when your list of problems/concerns is concise.  Know your medical/surgical history, medication allergies, and list your current medications. Think about (or write down) your problem list/symptoms, when they began/worsened, what aggravates/or improve the symptoms, and from a gynecologic perspective, if they’re cycling with your menstrual period.  Understand that if your list of questions/concerns is long, we may have to address some of them at a subsequent visit.

 

 


 

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I can get pregnant at any time in my menstrual cycle



We’re fertile at the ovulatory time in our cycle, which with regular menstrual cycles, is around cycle day 14. This is approximately 2 weeks from the first day of your period (and also, 2 week from your next period, if you have regular cycles.) The issue is, not all cycles are regular, and therefore the timing of ovulation may be unpredictable. Tracking your menstrual cycle/ovulatory time (the rhythm method) can be used for contraception (natural family planning) or to predict ovulation when you’re trying to conceive
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Menopausal Hormone Therapy: Understanding 'FDA-Approved' vs 'Bio-Identical' Hormone Options

Confused about Menopausal Hormone Replacement Therapy? Let's discuss the differences in FDA-Approved versus Bio-Identical Hormones...


I often use analogies when explaining concepts with patients in the office.  Though the issue of Menopause/Hormone Replacement Therapy (HRT)  is a complex one,  with many different considerations…We have to start somewhere in grasping the array of options.  Here’s my bit.  In my analogy we’ll start with 3 options:

1) FDA-approved HRT,

2) Bio-Identical HRT

3) Herbal options.

One of the main differences in FDA HRT and Bio-Identical HRT is their derivation.  FDA/HRT may come from plant or animal sources, whereas the Bio/HRT and herbal options come from plant sources only.  I explain to patients, you can take certain plants (mostly soy containing yams) and “squeeze out’’ products  EQUAL  to “human hormones” (there are both FDA-approved HRTs and Bio-identical/HRT options.)  Certain other plants have “plant hormone” with similar qualities, but not equal to human hormone (isoflavones like soy, Siberian rhubarb.)

 


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What is This HPV Vaccine? Should I Give It To My Kids?

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?

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Yaz/Yasmin...Putting Potential Risks into Perspective

 

The use of estrogen/progesterone containing Birth Control Pills have long been known to slightly increase one’s risk for Venous Thromboembolic  events (i.e., deep vein blood clots.)  Recent reports have put into question additional increased risk by use of BCPs containing the progesterone, dropserinone (Yasmin, Yaz, Beyaz, and their generics.)  Available studies on this issue are inconsistent,  some studies showing a fractional increased risk, others showing no increased risk.  In comparing risks of VTE, the increased risk from any Birth Control Pill (3-9/10,000) is still significantly less than the increased risk of VTE in pregnancy (5-20/10,000), and the immediate post-delivery time period (40-65/10,000)…  According to the FDA’s advisory committee, the benefits of all contraceptive methods still outweigh the risks.

drsuzyyhall

(See WXYZ's interview with Dr. Suzanne Hall on their recent story on Yaz

at http://www.wxyz.com/dpp/news/health/mom-warns-birth-control-killed-her-daughter)

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Libido...Is Testosterone the Answer

We frequently hear from our patients that sex isn't what it used to be.  In the younger patient, it am be pain secondary to previous pelvic infection, endometriosis, or uterine fibroids.  There maybe new physical issues involving their relationship, their children, or work.
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When Should I Get My First Mammogram?

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

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Does a Pelvic Exam Mean Pap Test

False.  The speculum exam is just a way we can look at the
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What Is This Quad All About?

We spend a good amount of time explaining tests and test results to patients during routine office visits.  One particular test often leads patients’ to anxiety and misunderstanding: The Quad Screen.

 

The Quad Screen is a test from the mothers blood, drawn between 15 and 20 weeks of pregnancy.  The goal of the test is to evaluate the risk (or chance) that the current pregnancy is affected by Down’s Syndrome, or, more rarely, other chromosome abnormalities.

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Types of Hysterectomies

There are always confusion regarding the type of hysterectomy that we do.  The term “partial hysterectomy” or “total hysterectomy” is often used by our patients.  Unfortunately, these terms are used so loosely that it gives us little information.

The key thing with hysterectomy is whether the ovaries are left in or not.  Some one that undergoes a hysterectomy and have both ovaries removed is termed hysterectomy with bilateral oophrectomy (removal of ovary).  If the right ovary is removed, its termed right oophrectomy and vice versa for the left.  Hysterectomy with both ovaries left in is just a hysterectomy.  Supracervical hysterectomy is when we take the uterus out but leave the cervix behind.

Hopefully this clears it up a bit.

docbchen
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Oops...Do I Need Emergency Contraception

A woman may utilize emergency contraception after a sexual encounter without protection or contraception.  Common indications include condom breakage and individual missing doses of oral contraception.

The US market offers two major products.  One contains estrogen and progesterone taken 12 hours apart.  The other contains progesterone only taken in a single dose or 12 hours apart.

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When Should I Take My Daughter For Her First "Female" Exam?

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

 

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"My Daughters' Periods Are Terrible!"

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

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Is HPV a STD?

Sexually transmitted diseases are generally understood to be transmitted through sexual contact, though implied, is the concept of ‘disease’, generally meaning some visible sign of infection (vaginal discharge, burning on urination, pain or a sore/bump.)  With HPV, there may not be visible signs of infection, you may only learn of it because of an abnormal pap smear result.  HPV is an extremely common virus, the CDC noting that 50% of men and women may get the virus at some time in their lives.  HPV causes genital warts and cervical cancer, and can be detected early on a pap smear, without any noticeable sign of having the infection.  The CDC uses the terms sexually transmitted disease and sexually transmitted infection simultaneously, recognizing that some STD’s may be present even in the absence of any symptom.  So in answering the question is HPV a STD, I’d say it’s a sexually transmitted infection, but the general answer is still YES…condoms everyone!

Suzanne Hall, MD

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Is It Hot?

Is it hot…or is it just me?

Well if you’re experiencing menopause related hot flashes, it’s not just you. Approximately 60-80% of menopausal women have hot flashes.  Hot flashes are described as wave of warmth or heat sensation involving mostly your chest, head, and neck area.  Some women feel a bit anxious with it happens, others may feel their heart beating faster.  For many women the sensation is more intense or may occur mostly at night, thus the term night sweats.  The episode generally resolves on it’s own within 2-4 minutes, but may leave you feeling chills, clammy or wet from the sweat. Night sweats can be especially bothersome because they may interrupt sleep, leading to next day fatigue.  The mainstay of treatment for significantly disturbing hot flashes has been hormone replacement therapy.  Others suggest herbal or plant derived products. There’s so much to discuss regarding menopause, we’ll be covering it over several posts. Look for more on symptoms of menopause, and risk versus benefits of various treatment options in the next few posts…

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Causes of Miscarriages

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

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Miscarriage

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

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When Can I Stop My Pap?

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

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A Colorful Explanation of...Endometriosis

I often jokingly comment to my patients, “No matter what our skin color is on the outside, We’re all the same color on the ‘inside’…literally.” And it’s the truth. From an anatomical perspective, our inner organs are all the same color, despite skin color or race!

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