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Chattahoochee Gynecology, PC Blog

Why Yearly Gynecological Exams are Important

June 26th, 2015

The American College of Obstetricians and Gynecologists recommends an annual gynecological exam for all women.

Maintaining your sexual and reproductive health should be a priority for any adult woman. An OB/GYN can detect and treat problems and help prevent future health issues.

Annual Exams Save Lives

The truth is, certain diseases such as breast cancer, cervical cancer, and ovarian cancer may not have obvious symptoms. As a result, many problems of this kind are first discovered through annual exams. Experts say that avoiding these exams increases risk factors for unintended pregnancy, pelvic infections, and delays diagnosis of other health problems. And early detection of issues increases a woman’s chance for survival. It’s recommended that all women start having gynecological exams starting around age 21 or earlier if you are sexually active.

Other Benefits of GYN Exams

Your gynecologist can help you make informed birth control choices, deal with issues in menstruation or unexplained pelvic or breast pain, and check your thyroid and cholesterol. Visiting your OB/GYN yearly will promote prevention, help you recognize risk factors, and assists in fostering a relationship with your OB/GYN – an important aspect for many women, especially if pregnancy will be a factor.

What Can I Expect from My Exam?

Your doctor will take a comprehensive medical history, do a physical exam, and perform a Pap smear. She may also do an internal examination of the uterus and ovaries. If you are between the ages of 35-40, she will order a screening mammogram, and you will be instructed on how to perform breast exams on yourself. You can discuss birth control, sex, managing the symptoms of menopause, osteoporosis, periods, nutrition, vaccines, and pregnancy.

How Often Should I Have a Pap Smear?

Pap smears are recommended every three years for women over age 21. Pap smears are just one component of an exam, however, and your doctor may recommend a different schedule. The Pap smear tests for cervical cancer in women, and involves taking cells from your cervix. This exam can detect changes in your cells that suggest the future development of cancer, and early detection can increase your chances of being cured.

But regardless of whether or not you’re due for a Pap smear, you should have a routine gynecological exam each year. This will help evaluate your risk for health problems, provide early detection for serious problems, and provide guidance on your health and well-being for the future.

University of Michigan Study Finds Overuse in Hysterectomies

February 4th, 2015

A new study conducted by the University of Michigan has found that, although the number of hysterectomies is decreasing, women are still getting them when they don’t need to. The study also found that alternatives to hysterectomy are being underutilized.

About Hysterectomies

These surgeries, which remove all or part of the uterus, are among the most common significant operations that women undergo in the U.S. It’s estimated that one in three women in the U.S. will undergo a hysterectomy by the age of 60; that comes out to more than 400,000 hysterectomies being performed per year in this country.

Currently, about 68 percent of these surgeries are done for benign conditions, which include uterine bleeding, uterine fibroids, and endometriosis. A previous study had determined that in 2010, 36.4 percent fewer hysterectomies were performed in 2010 than in 2002, which means that the popularity of hysterectomies is certainly decreasing.

Findings

This study, published in the American Journal of Obstetrics and Gynecology, focused on 3,997 women. It examined medical records and looked at data from 10 months in 2013 from 51 Michigan hospitals. The results indicate that 18 percent of women who had a hysterectomy for benign conditions may not have needed it – and a pathology analysis for 38% of women under 40 did not support undergoing a hysterectomy at all.

Among the findings: nearly fewer than 30 percent of women received medical therapy, and alternative treatment was considered more strongly among women under age 40 and women with larger uteri. In general, the older the woman, the more a hysterectomy was supported by the pathology and the less likely it was for alternative treatments to be considered.

Study Recommendations

What’s clear from the findings of the study is that both patients and doctors need to consider alternatives to hysterectomy more often. In any case, it’s always advisable to know all the options that are available before committing to potentially unnecessary surgery.

And there are alternatives to hysterectomies that may be less invasive and less risky, but which could do the job just as well. These include hormonal management, the insertion of IUDs, operative hysteroscopy (a minimally invasive gynecological procedure), and endometrial ablation (a procedure that destroys the uterine lining).

This study on the overuse of hysterectomies shows that there’s some work to be done. The trend is improving, in that hysterectomies are decreasing, but gynecologists and their patients should try to be proactive in finding other ways to manage non-cancerous uterine problems without removing women’s healthy reproductive organs.

To find out if hysterectomy is right for you, contact  Dr. Tsakiris to schedule an appointment.

IUDs: Hormonal vs. Copper – Which is Right for Me?

January 21st, 2015

An IUD, or interuterine device, is designed to provide safe and continuously effective birth control for healthy women. It lasts multiple years and requires no maintenance. If you believe an IUD is the right family-planning option for you, there are options – both hormonal and non-hormonal IUDs.

What is an IUD?

Basically, an IUD looks like a small, plastic T-shape with a string attached. It’s placed inside your uterus by your OB/GYN. There are two main types of IUDs; both of these damage or kill sperm and thicken the cervical mucus, preventing sperm from reaching the egg and limiting fertilization.

An IUD is a fully-reversible form of birth control, but it does have some minor risks, including uterine perforation at the time of insertion and accidental expulsion. There is also a risk of pelvic inflammatory disease if you have an STD at the time of insertion of an IUD. This can be tested for prior to the insertion.

Hormonal IUDs

Currently, hormonal IUDs are represented on the market by the brands Mirena and Skyla. These IUDs release a small amount of progestin, a synthetic hormone that kills sperm and makes the uterine lining (endometrium) thinner so that the environment inside is not conducive to the growth of a fertilized egg. Both IUD brands have been known to reduce menstrual bleeding and cramping.

Hormonal IUDs may also protect against conditions such as endometrial cancer and endometriosis. There are some side effects, however, including the formation of benign cysts in the ovaries, which usually go away on their own.

Hormonal IUDs may (rarely) also cause acne, breast tenderness, mood swings and headaches, just like birth control pills – especially within the first few months after insertion. Skyla, the smallest IUD on the market, is recommended for women who have not have children yet, and works for three years. Mirena is approved for five years.

Non-Hormonal Copper IUDs

Copper IUDs, currently available under the ParaGuard name, do the same job through a copper wire wrapped around the T-shape.

Copper acts as a spermicide; copper ions kill sperm and triggers an immune response that creates a hostile environment for both sperm and eggs. Copper IUDs may also disrupt the formation of eggs.

The main disadvantage of copper IUDs is that they may actually increase your menstrual flow and cramping, and women who already have heavy periods may not be able to tolerate one. However, they can be used as emergency contraception, and remain effective in your body for upwards of 10 years.

IUDs remain a safe and dependable form of birth control, although each version has its advantages and disadvantages, and may be covered under your insurance plan.

You should consult Dr. Tsakiris to help determine whether hormonal IUDs or copper ones are right for you and your family.

Causes of Infertility Issues

December 17th, 2014

Becoming pregnant is actually a very complex process, and about 10 percent of couples will find it very difficult to conceive a child. Of this 10 percent, about a third of the cases are caused by a problem that relates to the female anatomy. Becoming pregnant is a complex business because it involves ovulation and fertilization, processes that must work exactly right in order for conception to occur.

Ovulation Disorders – In this type of problem, ovaries are somehow prevented from releasing eggs. This can be caused by hormonal conditions, which prevent an egg from getting released or create changes in the thickening of the lining of the uterus (endometrium). If the lining fails to thicken, this can prevent the uterus from being ready for the fertilized egg. Problems in ovulation also occur when you exercise excessively, or have eating disorders, injuries, or tumors.

Fallopian Tube Blockage – Inflammation of the fallopian tube, often caused by pelvic flammatory disease, endometriosis, benign tumors (uterine fibroids) or polyps, or sexually transmitted infections, can damage or block the tubes that run from the ovaries to the uterus. This may result in no contact between the egg and sperm.

Cervical Abnormalities – If there is a problem with the cervix (the necklace passage at the end of the uterus) or cervical mucus, or something unusual in the shape or cavity of the uterus, this might be one cause of female infertility. The distortion of the shape makes implantation of a fertilized egg more difficult. It may prevent sperm from passing through the cervical canal.

Other Possible Problems – Medical conditions such as cancer (and cancer treatments), kidney disease, celiac disease, thyroid problems, immune system diseases, and pelvic infections can cause infertility as well. Abdominal surgeries and certain medications have also been associated with conception difficulties. Age is another factor; women are born with a limited number of eggs, and as they get older the number and quality of eggs diminish. Also, a third of infertility issues are a result of issues within the male reproductive system, and about 20 percent of couples may never know why they are infertile.

If you are experiencing difficulty in getting pregnant, there may be solutions. You should consult with an OB/GYN to pinpoint which of these problems you might be experiencing – your doctor will know ways to narrow down the possibilities. Once that is determined, you and your OB/GYN may be able to find a course of treatment that will make it possible for you to become pregnant after all.

How Obamacare Impacts Sterilization Procedures

November 13th, 2014

Sterilization is one option women have for permanent birth control. The different sterilization procedures, both surgical (such as tubal ligation) and non-surgical (such as Essure) block the fallopian tubes to prevent sperm from reaching an egg.

Under Obamacare, access to sterilization has become easier because women with health insurance do not have to pay out of pocket. This means that sterilization might be a good possibility if you are looking for a safe and effective way of preventing pregnancy that cannot be reversed.

Before Obamacare

Prior to the Affordable Care Act, known more commonly as Obamacare, your insurance carrier was not required to pay for sterilization procedures, and every woman had to consult her own plan in order to figure out what was covered, how much money she would have to contribute to the cost, and how to proceed.

Often, individual insurance policies made women pay more than men for similar services. Also, maternity coverage and preventative services such as birth control were made available only with an extra fee.

What Should I Know About Sterilization Under Obamacare?

Under Obamacare, all birth control options and all preventative measures designed to safeguard women’s health are covered. This includes sterilization. The law requires all insurance plans to cover all FDA-approved birth control methods without co-pays.

It is now therefore much easier for all women who have ACA plans to consider sterilization as a possibility. No matter which state you’re in or what insurance company you’re with, you can undergo a sterilization procedure at no cost.

Conditions Which Need To Be Met

Most insurance carriers require informed, voluntary consent from a mentally competent woman in order for coverage to be assured. Also, Obamacare carries a religious exemption, so that women who are part of group plans sponsored by religious employers may not be covered, depending on the employer’s views. These conditions also apply to Medicaid, which provides medical services to lower-income families.

You should check with your personal insurance policy to make sure everything is in order. If you think that sterilization may be the birth control route you wish to take, cost will not be a hindrance under the ACA. As long as your OB/GYN takes your insurance, you will be covered.

Be sure to consult your doctor about whether or not either the surgical or non-surgical options are right for you. Obamacare’s mandate means that you can make a decision about sterilization based on your personal health issues, your living circumstances, and your desires rather than cost.

Alternatives to a Hysterectomy

October 29th, 2014

Picture this scenario. You are having issues with heavy bleeding at menstruation. You go to your gynecologist and are told you need a hysterectomy. This will require a major surgery, a prolonged recovery time and inability to get back to work and your daily life for quite a while. Is this the only solution? The answer is probably no. We now have many more alternatives to hysterectomy than ever before.

In the category of medical alternatives to hysterectomy there is the possibility of oral contraceptives and hormonal Depo-Provera infections. These medications are traditionally used for contraception but are safe for women to use until menopause if no medical health issues exist. They can decrease monthly bleeding substantially and even be manipulated so that there are fewer menstrual cycles, Oral contraceptives can also decrease acne and perimenopausal side effects as well.

Another new alternative to hysterectomy is the Mirena IUD. This device recently received FDA approval for use in managing heavy menses. It can easily be placed in an office visit without anesthesia. After the first few months most patients will have either no menses or very light menses. The device can be left in for 5 years and is very safe in all age groups.

If you prefer not to use a medication or are reluctant to use and IUD another alternative would be an endometrial ablation. This is a procedure that in some cases can be done in an office setting or as an outpatient at the hospital. The lining of the uterine cavity is treated so there is either no menses or very light menses each month.

The nice feature with this procedure is that recovery time is very quick. Most people are back to work within a 24-hour time period and the results last for years.

So the next time your doctor says you need a hysterectomy, be sure to discuss these options. While the need for hysterectomy still exists in some cases there are more alternatives than ever before.

– Written by Dr. Laura Tsakiris

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