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Author: Greenville Womans Care

21 Reasons to Visit Greenville Women’s Clinic Before Age 21

Although most young women don’t need to have a pap test until they are about 21 years old, there many reason why you should see a gynecologist before you reach that age.

  1. Get advice on maintaining a healthy body weight and feel good about your body.
  2. Start habits for keeping your bones healthy and strong.
  3. Learn how to recognize, prevent and treat urinary tract infections.
  4. Get treatment for any vaginal itching, odor and discharge.
  5. Learn about what a normal period is supposed to look and feel like.
  6. Get advice and relief if your periods are painful.
  7. Find out why your periods may be heavy.
  8. Find out why your periods are too close or too far apart and why bleeding may happen between them.
  9. Discover ways to deal with premenstrual syndrome, commonly referred to as PMS.
  10. Learn how to have a healthy relationship with romantic partners.
  11. Know when a relationship may be threatening, abusive or harmful.
  12. Talk about and think things through if you are considering sex for the first time.
  13. Learn about how to have safe sex.
  14. Discover the right birth control option, so you can choose to become pregnant when the time is right for you.
  15. Plan ahead for a safe and healthy pregnancy.
  16. Get tested for pregnancy.
  17. Learn about your options if you become pregnant.
  18. Protect yourself from sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) by learning steps you can take to lower the risk of becoming infected.
  19. Receive the human papillomavirus (HPV) vaccine.
  20. Get tested for STDs of HIV if you are sexually active.
  21. Have open and honest conversations about any body changes you may be experiencing.

Teenage years are the perfect time to find the right gynecologist. This healthcare provider will be there with you through some pretty important moments in your life. Greenville Women’s Clinic is committed to providing young women with the best care possible so they can live healthy, educated and safe – even before they turn 21. We encourage every young women to take charge of their health and body, and make an appointment at Greenville Women’s Clinic – even if it is just to ask questions.

How To Get A Better Night’s Sleep

Your quality of sleep directly affects your physical and mental health. Fall short of the amount of sleep you need and it can take a serious toll on your daytime energy, productivity, emotional balance and even your weight! There are steps you can take to have a better night’s sleep. The tossing and turning and struggling to fall asleep can become a thing of the past. Simple but important changes to both your daytime routine and nighttime habits can have a profound impact on how you sleep.

1. Try to go to sleep at the same time every night.

By going to sleep at a consistent time every night you help to set your internal clock and optimize the quality of your sleep. Choose a bedtime around the time you normally feel tired, so that you won’t lie awake for hours. If you are getting enough sleep, your body should wake up naturally without an alarm. If you find you need an alarm, you may want to consider setting an earlier bedtime.

2. Avoid sleeping in late – even on weekends.

The more your weekday and weekend sleep habits differ, the worse the “jetlag-like” symptoms will be. If you need to make up for a late night, opt for a daytime nap rather than sleeping in. This will allow you to pay off your sleep debt without interfering with your natural wake-sleep rhythm.

3. When it is time to go to bed, make sure the room is dark.

The blue light emitted from your phone, computer and TV all make it harder for you to fall asleep. Use heavy curtains or shades to block light from windows or try a sleep mask. Your brain secrets more melatonin when it is dark – making you sleepy!

4. Exercise during the day.

People who exercise regularly tend to sleep better at night and feel less fatigued during the day. Regular exercise also helps to improve the symptoms of insomnia and increases the amount of time one spends in the deep, restorative stages of sleep. Even if you are unable to exercise vigorously, just walking for 10 minutes a day can improve your overall sleep quality.

5. Limit caffeine.

Did you know that caffeine can cause sleep problems up to twelve hours after drinking it! Limit your caffeine intake throughout the day and especially at bedtime.

6. Wind down and clear your head.

Many people note that their sleeping problems are the result of residual stress, worry or anger from the day. Practice relaxation techniques before going to bed at night to wind down and prepare for sleep. Deep breathing, muscle relaxation and warm baths are all ways to unwind from the stress of the day. Take the time to discover the bedtime relaxation routine that works best for you.

7. Improve the comfort of your sleep environment.

Making sure you are completely comfortable in your sleep environment is important in achieving a quality night’s sleep. Make sure the room is quite and cool. Most people sleep best in a slightly cool room (65°F). A bedroom that is too cold or too hot can interfere with your quality of sleep.

8. Learn ways to fall back asleep.

It is normal to wake up briefly during the night, but if you are having trouble falling back asleep, avoid looking at your phone or turning on your TV. Keep the lights dim and focus on relaxing.

If you are having difficulty falling or staying asleep at night, do not hesitate to talk with your doctor at Greenville Women’s Clinic. Healthy sleep habits are the foundation of healthy lives.

Sexually Transmitted Diseases – What You Need To Know

If you’re sexually active, including oral, anal or vaginal intercourse and genital touching, you can get a Sexually Transmitted Disease (STD).

STDs often have no signs or symptoms, and even with no symptoms, you can pass the infection onto your partners. It’s important to use a condom during sex, and visit your doctor regularly for STD screenings, so you can identify and treat infections before passing it along.

If you are diagnosed with a STD, it’s important to get treated and inform your partner or partners so they can be evaluated and treated as well.

Left untreated, STDs can increase your risk of infertility or of acquiring another STD such as HIV. A STD can stimulate an immune response in the genital area which might raise the risk of HIV transmission.

Some of the following diseases can be transmitted without sexual contact, like hepatitis which can be transmitted by coming into contact with an infected person’s blood. Others, such as gonorrhea, can only be transmitted through sexual contact.

Common STD’s, their signs and symptoms

Chlamydia is a bacterial infection of your genital tract. It usually starts one to three weeks after being exposed. Signs and symptoms can often be mild and passing which makes them easy to overlook. Those may be:

  • Painful urination
  • Lower abdominal pain
  • Vaginal discharge in women
  • Discharge from the penis in men
  • Pain during sexual intercourse in women
  • Bleeding between periods in women
  • Testicular pain in men

Gonorrhea is a bacterial infection of your genital tract. It can also grow in your mouth, throat, eyes and anus. The first gonorrhea symptoms usually appear within 10 days after exposure. However, it’s not uncommon for people to be infected for months before signs or symptoms occur. Signs and symptoms of gonorrhea may include:

  • Thick, cloudy or bloody discharge from the penis or vagina
  • Pain or burning sensation when urinating
  • Heavy menstrual bleeding or bleeding between periods
  • Painful, swollen testicles in men
  • Painful bowel movements
  • Anal itching

Genital herpes is highly contagious and caused by a type of the herpes simplex virus (HSV) that enters your body through small breaks in your skin or mucous membranes. Most people never know they have it, because they have no symptoms or the symptoms are so mild they go unnoticed.

When present, genital herpes signs and symptoms may include:

  • Small red bumps, blisters (vesicles) or open sores (ulcers) in the genital, anal and nearby areas
  • Pain or itching around the genital area, buttocks and inner thighs

The initial symptom of genital herpes is usually pain or itching, which begins within a few weeks of exposure. After several days small red bumps may appear. They then rupture, becoming ulcers which ooze or bleed, and eventually, scabs form and the ulcers heal.

In women, sores can erupt in the vaginal area, external genitals, buttocks, anus or cervix.

Ulcers can make urination painful. You may also have pain and tenderness in your genital area until the infection clears. During an initial episode, you may have flu-like signs and symptoms, such as headache, muscle aches and fever, as well as swollen lymph nodes in your groin.

In some cases, the infection can be active and contagious even when sores aren’t present.

Human Papillomavirus (HPV) infection is one of the most common types of STDs. Some forms put women at high risk of cervical cancer, and other forms can cause genital warts. HPV usually has no signs or symptoms, however the signs and symptoms of genital warts include:

  • Small, flesh-colored or gray swellings in your genital area
  • Several warts close together which take on a cauliflower shape
  • Itching or discomfort in your genital area
  • Bleeding during intercourse

Sometimes genital warts cause no symptoms. Genital warts may be as small as 1 millimeter in diameter or may multiply into clusters. In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or the anus. Genital warts can also develop in the mouth or throat of a person who has had oral sex with an infected person.

Hepatitis A, hepatitis B and hepatitis C are all contagious viral infections that affect your liver. Hepatitis B and C are the most serious of the three, but each can cause your liver to become inflamed. Some people never develop signs or symptoms. But for those who do, signs and symptoms may occur after several weeks and may include:

  • Fatigue
  • Nausea and vomiting
  • Abdominal pain or discomfort, especially in the area of your liver on your right side beneath your lower ribs
  • Loss of appetite
  • Fever
  • Dark urine
  • Muscle or joint pain
  • Itching
  • Yellowing of your skin and the whites of your eyes (jaundice)

HIV is an infection of the human immunodeficiency virus. HIV interferes with your body’s ability to fight off viruses, bacteria and fungi that cause illness and lead to AIDS, a chronic, life-threatening disease. When first infected, you may have no symptoms. Some people develop a flu-like illness, usually two to six weeks after being infected. Still, the only way you know to know for sure is to be HIV tested. Some early HIV signs and symptoms may be:

  • Fever
  • Headache
  • Sore throat
  • Swollen lymph glands
  • Rash
  • Fatigue

These early signs and symptoms usually disappear within a week to a month and are often mistaken for those of another viral infection. During this period, you’re highly infectious. More-persistent or severe symptoms of HIV infection may not appear for 10 years or more after the initial infection.

As the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic signs and symptoms such as:

  • Swollen lymph nodes — often one of the first signs of HIV infection
  • Diarrhea
  • Weight loss
  • Fever
  • Cough and shortness of breath

Signs and symptoms of late-stage HIV infection include:

  • Persistent, unexplained fatigue
  • Soaking night sweats
  • Shaking chills or fever higher than 100.4 F (38 C) for several weeks
  • Swelling of lymph nodes for more than three months
  • Chronic diarrhea
  • Persistent headaches
  • Unusual, opportunistic infections

If you suspect you have any of these or other STDs, or have been exposed to one, see your doctor for testing. Timely diagnosis and treatment are important to avoid or delay more-severe health problems and to avoid infecting others.

Postpartum Depression – What You Need To Know

Having a baby is a big deal, and the birth of a baby can trigger many powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something unexpected — depression.

Mothers often have a lot of different feelings and emotions in the weeks and months after they give birth. These feelings can change often, going from happy to sad to worried to scared and back again. These emotional changes are commonly known as the “baby blues.”

Many new moms experience the “baby blues” after childbirth. Baby blues can begin within the first two or three days after delivery, and could last up to two weeks. Common symptoms of the baby blues may include:

  • Mood swings
  • Crying spells
  • Anxiety
  • Difficulty sleeping
  • Sadness
  • Irritability
  • Feeling overwhelmed
  • Reduced concentration
  • Appetite problems

However, some new moms may experience something more severe and longer-lasting, a form of depression commonly known as postpartum depression. Postpartum depression isn’t a flaw or a weakness; sometimes it’s simply a complication of giving birth.

Postpartum depression may be mistaken for the “baby blues” at first, but the symptoms are more intense, last longer and eventually interfere with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin later — up to six months after birth.

Signs and symptoms of depression after childbirth vary, and they can range from mild to severe; some symptoms may include:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawing from 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 make decisions
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

Contact your doctor immediately if your signs and symptoms of depression have any of these features:

  • Don’t fade after two weeks
  • Are getting worse
  • Make it hard for you to care for your baby
  • Make it hard to complete everyday tasks
  • Include thoughts of harming yourself or your baby

If you’re feeling depressed after giving birth, you may be reluctant or embarrassed to admit it. But, it is important to talk with your doctor about all of your postpartum symptoms. If you have postpartum depression, prompt treatment can help you manage your symptoms — and enjoy your baby.

If you’re experiencing any of the symptoms of “baby blues” or postpartum depression, you should call Greenville Women’s Clinic and schedule an appointment with your doctor today. We are here to listen to any of your concerns or worries after giving birth.

Heart Health Tips For Women

Did you know that heart disease is the number one killer of women, causing one in three deaths each year? That’s about one women every minute! The latest findings from the American Heart Association also report that:

  • around 44 million women in the U.S. are affected by cardiovascular diseases
  • 90% of women have one or more risk factors for heart disease
  • fewer women than men survive their first heart attack
  • the symptoms of heart attack can be different in women vs. men
  • 80% of heart disease events may be prevented by lifestyle changes and education

These finding are alarming which is why it is important for women to live a healthy lifestyle that positively influences their heart. Heart disease doesn’t appear overnight; it is the result of many years of heart-unhealthy choices. Here are a few tips that can help you live a more heart-healthy lifestyle.

1. Eat More Fruits and Vegetable

To give your heart the nutrients it needs to function optimally, it is important to eat a diet full of fruits and vegetables. Beans and legumes are a smart choice for a heart-healthy diet.

2. Get Active

Daily physical activity is a great way to live a healthier life. Just 30 minutes of exercise, five times per week can lower your risk of heart disease, stroke and diabetes.

3. Control Your Cholesterol

It is important to control your cholesterol to give your arteries the best chance to remain clear of blockages. Cholesterol is a waxy substance that our bodies use to make cell membranes and some hormones. But, when you have bad cholesterol it combines with white blood cells to form plaque in your veins and arteries. This plaque causes blockages that lead to heart disease. Ask your doctor for tips and diet ideas to help lower or maintain your cholesterol.

4. Manage Your Blood Pressure

High blood pressure is another major risk factor for heart disease, along with bad cholesterol. When you maintain a blood pressure within healthy ranges, you reduce the strain on your heart and arteries. If you have high blood pressure, also known as hypertension, it means that blood flows with too much force and puts pressure on your arteries, stretching them past their healthy limit and causing microscopic tears. To repair these tears, our bodies form scar tissue which can trap plaque and form blockages, blood clots and hardened arteries. If you have or are at risk of high blood pressure, ask your doctor about measures you can take to reduce it.

5. Stop Smoking

Those who use tobacco products have a higher risk of developing cardiovascular diseases. If you smoke, the best thing you can do for your heart is to quit. Smoking damages your entire circulatory system and increases your risk for hardened arteries and blood clots. Whatever it takes for you to stop smoking is worth it. Ask your physician for tips and advice on how to kick this unhealthy habit.

There are many other ways to live a heart-healthy lifestyle. We encourage you to ask your doctor at Greenville Women Clinic’s for advice on how to reduce your risk of cardiovascular diseases. As we mentioned previously, education is also important in preventing the disease. Share the information and tips you have learned with your friends and family and let’s all have healthier hearts!

What Does Motherhood Mean to You?

Motherhood, I invite you to think about what this word means to you?  As an Obstetrician, I am blessed to witness the miracle of pregnancy and childbirth where every delivery is like I am in awe for the first time.  But I would be remiss in not talking about my Patients who become a Mother in other ways.  Mothers who foster or adopt their children, human and furry alike.  Mothers who provide their own eggs or body for surrogacy so that someone else can become a mother.  Mothers who are working hard to overcome their infertility challenges to meet the child they know is out there.  Lastly there are the silent mothers who experienced the joy of a positive pregnancy test that sadly ends in miscarriage.  She did not get to see or hold this baby that entered her heart the moment she saw those two lines, but now has an angel above.  Every day thereafter is bittersweet for anyone who loses a pregnancy, a baby or a child.  Even with loss however I am sure you would agree that no matter how one comes to know motherhood, it is a leap of faith worth making.   

The road to motherhood is unique to everyone.  There was a time in my young life where the thought of becoming a mother or being around children effectively sent my heart racing with sense of angst and uncertainty.  I had a defined plan for my life.  Starting in the 7th grade, I knew I wanted to be in Medicine.  I was blessed by several influences and thankful to those who mothered me.  It was my teachers who nurtured me, and opened my eyes to the power of education and all its possibilities.  It was listening to the intriguing stories that my late Grandmother Joyce told of her life as a Registered Nurse in the ER.  She would share medical stories that sparked my interest, but her accounts went much deeper than story telling.  I saw the passion she had in helping others and the curious navigation through humanity that she made.  A journey of this kind could not be made without knowing the love, devotion and tireless work I saw in my Mother.  She also empowered me to pursue my dreams.  I had a defined plan for my life.  I vowed to let nothing stand in my way.  How and when would I insert having children into this equation did not seem possible should I pursue this dream? 

It was at the age of 21 however that my world was forever changed.  I fell in love with my husband and in our new life together also came a precious 4-year old little girl.  At the time I thought to myself, “Oh no!  Will I be Cruella de Vil to her?! How will I relate to her and better yet will she like me?”  Our story together evolved into the birth of something quite the opposite of that which I feared, I found the beauty in motherhood.  Life was no longer just about me; it was what was best for her and our family.  I was blessed to later officially adopt her.  The day she called me “Mom” for the first time, the day I saw my name on her birth certificate and the day she became a big sister to her two brothers are by far the best and proudest moments in my life.  I am so glad that the defined plan for my life was altered and my journey to Motherhood lead me to my beautiful miracles.   Thankfully the equation for my life allowed me to not only be blessed with family, but they joined me on my journey in Medicine. 

Don’t get me wrong and I am sure you would agree that this wonderful world called Motherhood comes with as much joy as there are and tears.  I struggle daily to balance my life as a Mother, Wife and a Physician.  Every minute you fret and question what will happen if I am not here?  Am I doing the best I can?  Did I make the right decision?  For my children, how can I best teach them to live and love in this good life?  How can I protect them from the world?  I have resolved to believe that I am human.  I try to do the best I can with what I have, and accept that this must be right for me, my family and my patients.  I find the humor in my crazy life and call it controlled chaos.   My Grandmother Joyce used to sing us a song by Doris Day “I love you a bushel and a peck.”  I always loved to hear her sing it, but there is one verse I never understood until now.  After she passed I wanted to find those words and know them exactly by heart,  I wanted my children to come to know and love this song just as I had.  I found the words and I especially love the verse and it goes…

I love you a bushel and a peck

A bushel and a peck though you make my heart a wreck

Make my heart a wreck and you make my life a mess

Make my life a mess, yes a mess of happiness

So, take the time to reflect on what motherhood means to you.  It is important to remember and cherish those who affected your past, your present and future with who you may call, or may call you, Mother. 

Heart Disease – Where do you stand?

Don’t become a statistic.  Know your numbers.  As we enter the month of February, it is time to put your best red dress on to help raise awareness and celebrate all the efforts to stomp out heart disease in women.  Please pay attention as what I am about to share with you can and will save lives, a life that could be your own.  Heart disease is the #1 killer for women, next to cancer however in recent studies they are now racing in a dead heat.  Do you know where you stand in this race?  It is a race you can hopefully sit out, so please read on. 

Heart disease represents just one of the 3 forms of cardiovascular disease that can adversely affect women.  In fact, the same process that causes a heart attack can also lead to stroke in the brain or body with serious lifelong disability and death.  We know women are different than men when it comes to cardiovascular disease.  It is a fact that women are not as easy to diagnose as men.  It is imperative to know your body well and to be your own advocate to evade the misdiagnoses that can occur due to our gender differences.  Are you at risk or ever experienced a heart attack?  Do you know for sure?  The fact is that about 35% of all heart attacks that occur in women go unnoticed or unreported.  It is not that we are oblivious or too busy; it is that we do not have the same symptoms as men.  We do not get that vice grip or elephant on your chest pain like our male counterparts.   We may instead experience extreme nausea with mild chest discomfort often mistaken as heartburn or a terrible stomach bug.  A woman will more often have pain in her neck, jaw or arms when a heart attack is happening.  A heart attack may even be as subtle as new onset of extreme fatigue, where family, work or stress may mistakenly be rationalized as to why one feels so badly.  Bottom line, unless you keep up with your well women’s health and numbers you may not ever know until it is too late.    

As women, our ovaries protect our cardiovascular health when it comes to that golden hormone produced called estrogen.  Up until about the age of 50 to 55, we have our angel wings, and estrogen helps promote the good cholesterol, called HDL that fights off the bad.  Bad cholesterol, being LDL, is what can block the vital vessels in our brain, heart or body resulting in a stroke or heart attack.  After age 50 to 55, when we officially enter menopause, the change of life, we are then a sitting duck!  Careful ladies, this is not just about menopause, as we know issues in our youth can lead to what happens later.  We know women who experience complications in pregnancy like high blood pressure or diabetes are certainly at risk for heart disease when they are older.  Further, medical conditions like obesity, high blood pressure, diabetes, polycystic ovarian disease, autoimmune disorders and even improper use of birth control or hormone replacement therapy can be a risk factor for a heart attack or stroke.  It is time that we take a stand, as we know the path it takes to fight and overcome this battle.   

Let’s talk numbers.  The American Heart Association has identified 7 areas that you should know and keep track to decrease your risk of heart disease or stroke. 

Absolutely no smoking!  I tell my patients to choose another bad habit!  I would rather you have that dark chocolate or glass of wine than a cigarette.  We know smoking accelerates the fatal process leading to heart attack or stroke. 

Get your physical activity.  Exercise can be wherever you choose as long as you get that heart pumping! I advise my Patients you can do whatever you want as long as you can sing a song and break a sweat – it is that great aerobic zone that trains your heart. 

Follow a heart healthy diet.  You should eat as much fresh fruit, vegetables and lean protein you can.  If it is in a box or doesn’t expire, then you don’t want it!  Processed foods are terrible for our health when it comes to heart disease and cancer prevention.    

Maintain a normal body weight.  Talk to your health care Provider to know where you stand. 

Control of cholesterol.  Have your levels checked now. 

Monitor your blood pressure.  High blood pressure damages your heart and body as it places undue stress on the blood flow and creates havoc on its way. 

Control your blood sugar.  High blood sugar and diabetes is known to damage every cell in our body.  Ask to be screened to know where you stand. 

Sounds easy enough?  In our present American culture, it has not proven to be so easy.  The fact is over 86-million Americans are affected by heart disease in some way and as a result, one person dies every 40-seconds in the United States.  We know what we need to do so save ourselves, but we somehow continue to fall prey to this disease. 

Get to your health care provider now and start the conversation.  Get your well women’s exam.  Ask to know your numbers and take this quiz as the life you save could be your own.  Go to https://www.goredforwomen.org/ for more information.  If you know your numbers, please plug them into this calculator and bring to your health care provider today.    http://www.cvriskcalculator.com/

Birth Control – Know Your Options

Do you know your birth control options?  Contraception is currently a hot topic in our political and social media world.  With the election of President-elect Donald Trump, the threat of an appeal to Obamacare immediately brings focus whether access to contraception will remain.  Would access to contraception be a target of the appeal or would it be inadvertently taken away in the aftermath of a repeal of Obamacare as a whole?  There are many unanswered questions and this uncertainty is driving this heated discussion across the country.  We as Obstetrician Gynecologists support access to contraception for any person who desires this measure in their life.  Access should be open to all persons regardless of health insurance status.  You may be thinking, “Why would anyone want to argue about birth control?  If someone wants to avoid pregnancy, it is their own prerogative, right?”  Well, since the late 1800s, birth control and politics have had nothing less than an inflammatory relationship.  No matter your stance or political or religious beliefs, be informed and be a part of the conversation. 

Obamacare has opened the door to well woman’s visits and access, to what I call a buffet of contraceptive options. Under the Affordable Care Act, a physical exam and birth control consultation is considered a preventative service.  It is therefore offered without having to pay a copay for these services.  Mind you, there are grandfathered, religious and short-term health insurance plans that are exempt and result in out of pocket costs.  For the majority, it is estimated that Obamacare has afforded women nearly 50% savings in their birth control expense and has been said to equate to 1.4 billion dollars.  There are officially as follows:

• Sterilization surgery

• Surgical sterilization implant

• Implantable rod

• Copper intrauterine device

• IUDs with progestin (a hormone)

• Shot/injection

• Oral contraceptives (the pill), with estrogen and progestin

• Oral contraceptives with only progestin

• Oral contraceptives, known as extended or continuous use that delay menstruation

• The patch

• Vaginal contraceptive ring

• Diaphragm

• Sponge

• Cervical cap

• Female condom

• Spermicide

• Emergency contraception (Plan B/morning after pill)

• Emergency contraception (a different oral medication named Ella)

Thanks to Obamacare, we now have a buffet of options to discuss with women and have been able to take cost concerns off the table.  When exploring a Patient’s contraceptive needs, I advise them that choice depends on personality and lifestyle.  I often say, “You may find that you try one, but you may try them all until you decide which option works best for you.” 

With Obamacare, the category of “implantable” birth control has lifted barriers to this more effective option.  The intrauterine device and implantable rod placed in the arm are known as LARCs – long-acting reversible contraception.  They are proven to be 99% effective in preventing pregnancy.  Compare this to pills and condoms which prevent pregnancy only 92% of the time.  The use of LARC has increased from 2.4% to 11.6% of all women using contraception from 2002 to most recent studies as of 2013.  Once placed, the rod and IUD can provide effective birth control for 3-5 years depending on the device chosen.  The cost of the device is well over $1000 and with Obamacare is now completely free.  If and when it is time to remove the device, it may be replaced with a new one or removed at any time to become pregnant right away.  Why wouldn’t every woman choose such a reliable and modern device?  It is a “set it and forget it,” until one is ready to pursue a pregnancy.  Prior to Obamacare, cost was a major barrier, but now it is lack of awareness and a historical bias that has hindered the rise in women choosing a LARC.  The implantable devices of decades past resulted in serious side effects and consequences and were removed from the market.  The LARC devices we have at present have proven safety but the reputation of devices past have left distaste among older generations who may be influencing the present. 

With the current political climate and uncertainty of contraceptive coverage, however calls to question what happens if contraceptive coverage is eliminated or the cost increases?  Social media has seen thousands discussing this topic.  Some are asking, “Should I hurry and obtain a LARC to have long term contraception before Obamacare is repealed?  But if I do, what happens when I want or need it taken out?  What would be the cost to me?”  We cannot answer many questions as it stands now, but in my present knowledge, I counsel Patients that a LARC is a great choice per its effectiveness to prevent pregnancy and from a cost perspective long term if even Obamacare was lost.  The removal of a LARC device without insurance coverage averages around $300.  If you keep the device in place for more than one year, it averages to equal the cost of birth control pills that one would have paid for that year.  If you keep the LARC in place even longer, then costs are clearly in favor of choosing a LARC at this time. 

When it comes to contraception, I counsel Patients on a daily basis that no choice is a wrong choice.  It is what is best for you, your situation and fertility plans.  With Obamacare, there is a buffet of contraceptive options, however if access if called into question over the coming years, it may be wise to consider your long-term goals and options.  When choosing a LARC, it is ideal if there are no immediate plans for fertility.  No matter your current life stage, stay tuned and be informed to support all women.  We pray the landscape of the future maintains contraceptive access for all. 

Tips to Avoid the Holiday Blues

The holidays provide joy and happiness for many. Time off from work, quality time with family and annual traditions generate feelings of warmth and love. But it also can activate many negative emotions for some people. There are many causes for this collection of symptoms that has come to be known as the “Holiday Blues.”

Causes

Decreased exercise

People tend to not exercise as much during the holidays, which can contribute to depression.

Having trouble sleeping

Due to the increase in traveling, scheduling and time spent with family and friends, some people get less sleep than normal. This could lead to a decrease in positive emotion and motivation.

Emotions of lost loved ones

While spending time with family can be very enjoyable, sometimes it can produce the opposite effects. Being around close friends and family can lead to remembering a loved one that has passed away.

Overeating and overdrinking

The holiday festivities can involve indulging in food and alcohol. When either one of these things is consumed at a high rate, it can have adverse effects on one’s physical and mental health.

Stress

Examples of this can be financial,  dealing with schedules, planning and

returning to one’s hometown.

Unrealistic Expectations

It’s easy to get excited about the holidays, but when reality sets in, you can find yourself feeling disappointed. Whether it’s someone not getting as excited about their gifts as they were, or a party not going as expected, it’s possible the holidays won’t live up to what your idea of a perfect holiday was supposed to be.

Seasonal Affective Disorder (SAD)

This can be related to shorter days and a lack of sunlight.

Symptoms

Negative feelings

This could be in the form of depression, sadness and discouragement feeling of hopelessness

Loss of interest

This could be a decrease of interest in things once found pleasurable.

Eating more or less than usual

Negative emotions can lead to binge eating or a suppression of appetite.

Weight gain or loss

Because of the possibility of an increase or decrease in appetite, weight fluctuation could follow.

Sleep deprivation

Because of the effects depression can have on falling asleep, sleep deprivation can be a resulting symptom.

Lack of energy

This could be the result of a lack of sleep and a change in daily habits and nutrition intake.

Withdrawal from others

There could be many causes for this. It could be the loss of a loved one or the recoil of proximity due to emotional comfort.

Difficulty thinking clearly

A decrease in sleep and straying from a normal routine can lead to a difficulty focusing and thinking clearly.

Treatment

Spend time outdoors

Studies have shown that being outside can help with depressive traits. The natural air, the sun and the calming natural beauty of the great outdoors can ease the mind and help fight causes of depression.

Limit eating out of boredom or downtime

This will help with overeating. Find something else to do during this time.

Keep healthy sleep habits

Stay on track with normal routines and habits. This will keep your physical and mental health by staying on a normal rhythm.

Plan accordingly

By planning your travel and other holiday logistics, it takes some of the stress away from what should be an enjoyable time of the year.

Exercise

Exercise releases brain chemicals that calm the mind. It also reduces immune system chemicals that can worsen depression.

Find proximity balance

Finding the right amount of time to spend alone will help you relax your mind and body.

Sometimes people can confuse the Holiday Blues with SAD. While both can exist at the same time, it is important to talk to your doctor if symptoms persist. He or she can help you find a treatment that is appropriate for you.

How do you V-care?

This month I wish to share with you a book that every woman should have in their library, as it carries a mission near and dear to me – The V Book by Dr. Elizabeth Gunther Stewart. Can you guess the topic? You got it…our lady parts. Dr. Stewart provides an owner’s manual, of sorts, teaching women about their vulva and vagina. Page 1 of the book says it all, “Your private parts shouldn’t be private to you.” She is very clear that this is not a “cocktail party conversation,” but a topic you should feel very comfortable to explore and communicate. You should be able to talk about your vulva and vagina just as you freely speak about your blood pressure and heart rate. It is no argument that our culture, family dynamics and life experiences do certainly dictate the relationship we have, or lack thereof, with our body. As a female, we all know each of us have a vulva and a vagina but history and evolving cultures have either photo shopped it out or sent it mainstream. There seems to be no happy medium. I, join Dr. Stewart’s mission and goal, to empower women to know their bodies, to be informed and to speak the language of our intricate anatomy with utmost certainty and confidence. The vulva and vagina have a topographic landscape just as any map. It is vital that one learns the changes that take place with each stage of life, the appropriate vulvovaginal care and when and how to communicate any concerns, needs or uncertainties. The vulva and vagina are very important to our overall health and wellness. So listen up my Sisters…

First let’s talk about anatomy. Do you know your vestibule from your fourchette or your labia majora from your minora? The vulva and vagina are complex organs, with orchestrated form and function. This V-organ and its individual components function as a living biosphere, swirling with hormones, functional glands and transitory passengers of various bacteria and yeast. The interplay of this community is certainly influenced by one’s age and stage in life, just as we are influenced by the time of year and our weather pattern. It is a dynamic environment and must be monitored. This is no different than the way we currently promote self-breast awareness and performing our own breast exams. I challenge you to go to the mirror and practice your V-awareness. Learn what your vulva looks like, as no two vulvae are created alike. As you transition through each life stage, be aware of the changes that occur. The vulva and vagina are very different when compared across puberty, pregnancy and menopause. Take heed of each life stage, its needs and that which keeps the vulvovaginal environment in balance. Appropriate daily V-care depends on this knowledge to promote vulvovaginal health.

I receive numerous calls daily regarding discharge, pain and irritation. Depending on your age as well as style of V-care, the etiology can vary widely. Many women perceive vaginal discharge as abnormal. Unless it is malodorous or causing irritation, it can be entirely normal with respect to age, day of the menstrual cycle or even pregnancy status. Bottom line, no matter the condition, the treatment varies and not always easily treated over the counter, over the phone or without a pelvic exam. When it comes to the vulva and vagina, when she is angry, she stalks. When she is ignored, she persists. We all know that she will NOT be ignored! Pain or irritation can be a warning sign of infection or even cancer. If symptoms persist or do not improve with initial treatment, please seek medical evaluation to determine the source of your symptoms.

No matter your age or life circumstance, it is important to know how to best care for your vulva and vagina. This is a buzzing industry, whether it be at the drug store, on-line or provided by aesthetic services. You can spend a small fortune. Although the pleasant scents, frills and treatments seem like a perfectly relaxing way to indulge, the regret comes in the aftermath! The vulva and vagina thrive with specific requirements. There is a balance of tissue integrity, environmental demands, and hormones, bacteria and yeast. Depending on the treatment, this balance may be upset and sends such symbiotic relationships into raging conflict. This conflict brings about opportunistic infection, irritation and pain. Daily V-care can be as simple as using water, wearing cotton, avoiding perfumes, dyes or soaps and listening to the changing needs of your vulva and vagina.
I challenge you to consider your vulvovaginal health. It is a matter of good health, wellness and ensuring a danger sign does not go unnoticed. Please seek out the references I have offered below. As always, you are welcome to come see me as your Vulvovaginal Healthcare Advocate!

Reference:
“The V Book “– A Doctor’s Guide To Complete Vulvovaginal Health. Elizabeth Gunther Stewart, M.D. and Paula Spencer.
Vulvovaginal Health. The American College of Obstetricians and Gynecologists.