Women’s Health
PAP Smears
Understanding Pap Smears
Used for screening, a Pap Smear is a tests for cervical cancer in women. During a Pap smear your women’s health provider collects cells from your cervix and sends them to a lab to be tested for abnormalities that could indicate the possibility of cancer developing in the future.
Healthcare providers recommend that every woman begins having pap smears by the age of 21. Typically, providers recommend having a Pap smear every three to five years, but if you have certain risk factors your health care provider may schedule more frequent testing.
What to Expect During a Pap Smear
While Pap smears can be somewhat uncomfortable, the test itself is very fast.
You lay on your back on an examination table while your health care provider inserts a speculum into your vagina to allow access to your cervix. Your healthcare provider then removes a sample of cells from your cervix to be sent off for testing.
You may feel some discomfort or cramping along with some light bleeding following your Pap smear. However, if you continue to have pain or bleeding following your test, be sure to let your healthcare provider know.
Mammograms
Understanding Mammograms
A mammogram consists of pictures of the breast taken by a low dose X-ray machine. A mammogram looks for signs of breast cancer that may not be found during a physical breast exam.
2 types of mammograms: Screening Mammograms and Diagnostic Mammograms
Screening Mammograms look for breast cancer in individuals who have not had any signs or symptoms that would indicate breast cancer. Screening mammograms typically include two or more x-rays of each breast. In particular, these images show tumors that may not be able to be detectable by a physical breast exam.
Diagnostic Mammograms are performed after a lump or other symptom has been found. Additionally, diagnostic mammograms help evaluate findings from a screening mammogram.
Signs of breast cancer include:
- Breast pain
- Skin thickening
- Discharge
- Change in breast size
- Change in breast shape
Benefits of Mammograms
A helpful diagnostic tool, mammograms screen for breast cancer and detect changes in the breast early.
Benefits of having a mammogram include:
- They save your life. Having an annual mammogram provides for early detection of breast cancer which lowers your risk of dying from breast cancer.
- They show small tumors and tumors that can’t be felt by a physical breast exam.
- They provide early detection. A mammogram can find abnormal tissue in the breast about 2 years before it turns in to cancer.
- They increase your likelihood of breast conservation. By finding the breast cancer early, the need for a full mastectomy lowers.
Risks of Mammograms
Some risks associated with mammograms include:
- False Positive Mammograms. False positive mammograms find an abnormality in the breast tissue that appears to be cancer, but is later determined to be normal. A false positive can lead to unnecessary worrying, as well as, additional testing.
- False Negative Mammograms. False negative mammograms fail to identify breast cancer during the screening. If the cancer is very small or in a spot that is hard to capture with the mammogram, it may be missed.
- Exposure to low-dose radiation. While there is some exposure, it remains very low and the benefits of being screened outweigh the risks for most people.
Irregular Menses Management
Understanding Irregular Menses
Irregular menses, also known as irregular periods, occur when the length of the menstrual cycle doesn’t follow the typical 28 days cycle. With an irregular period, your period comes earlier or later than the usual 28 days timeframe. While some irregularity is expected when you first begin getting your period, after having a baby, or when you are approaching menopause, irregularity outside of these stages of life can sometimes indicate an issue. If you are experiencing irregular menses, your women’s health provider can help determine the cause of the irregularity and help to manage it.
Causes of Irregular Menses
Irregular menses have numerous possible causes. It may be as simple as it’s just how your body works and irregular menses are normal for you or it could have another cause.
Some other causes of irregular periods include:
- Stress
- Significant weight gain or loss
- Change in exercise routine
- Illness
- Changes in normal routine (traveling, shift change)
- Medications (such as oral contraceptives, steroids, and blood thinners)
- Medical conditions (such as thyroid or pituitary disorders)
- Polycystic Ovary Syndrome
- Endometriosis
- Primary Ovarian Insufficiency (Early Menopause)
Treatment for Irregular Menses
Different treatment options exist for the regulating of irregular menses. The cause of the irregular periods determines which treatment to use. Therefore, your women’s health provider needs to determine what is causing your abnormal cycles and then select the best method of treatment for you.
Some of the treatment options include:
- Regulating the menstrual cycle thru the use of hormones like estrogen or progestin.
- Pain control to help reduce cramping and mild to moderate pain.
- Placing an IUD to help reduce heavy bleeding during your period.
- Surgery
Menopause
Understanding Menopause
Menopause marks the end of a woman’s reproductive years by the ending of her menstrual cycle. A woman is considered to be in menopause 12 months after having her last period. Menopause consists of 3 transitional periods (Perimenopause, Menopause, and Postmenopause) that can last up to 14 years.
The 3 Transitional Periods
Perimenopause begins in the years prior to actual menopause and continues until you reach menopause. During perimenopause the ovaries begin to make less estrogen leading to the symptoms of menopause.
Menopause starts when it has been a year since you have had a menstrual cycle. During menopause the ovaries no longer release eggs and have stopped making most of the estrogen for your body.
Postmenopause includes the years following menopause. While the symptoms from menopause usually get better, the risks associated with less estrogen rise.
Signs & Symptoms of Menopause
Early signs of menopause include:
- Abnormal periods
- Sore breasts
- Urinary incontinence
- Vaginal dryness
- Insomnia
- Dry skin
- Mood changes
Later symptoms include:
- Headaches
- Aches and Pains
- Weight gain
- Hair loss
- Libido changes
- Fatigue
- Depression
Diagnosis of Menopause
To help determine if menopause has begun, your women’s health provider will ask you for information about your symptoms and family history. Next, your provider may order a blood test to look at your FSH (Follicle-Stimulating Hormone) and Estradiol (E2) levels. They may also check your thyroid levels to make sure that your symptoms are not being caused by an issue with your thyroid gland.
Treatment for Menopause
While most menopause symptoms go away on their own, some options to help exist if the symptoms are causing problems.
Hormone Replacement Therapy (HRT)
Hormone replacement therapy replaces the hormones that your body is no longer making to help relieve symptoms like hot flashes. It also helps to strengthen your bones which can become weaker with the lack of estrogen. Unfortunately, hormone replacement therapy can increase your risk for heart disease and breast cancer, so it should only be used with a low dose for a short time.
Topical Hormone Therapy
Topical hormone therapy helps with vaginal dryness and comes in a cream, gel or insert.
Nonhormonal Medications
Some medications used to treat other conditions can also be used to treat the symptoms of menopause.
The following medications can be used to treat hot flashes:
- Selective Estrogen Receptor Modulators (SERMs) can also help with vaginal dryness
- Clonidine
- Gabapentin
- Paroxetine
Infertility
Understanding Infertility
Infertility is defined as the inability to get pregnant after trying (having frequent, unprotected sex) for at least 12 months. Women who are 35 years old or older may be treated by a women’s health provider for infertility after only 6 months of actively trying to conceive. The issues causing infertility may be caused by problems with the female’s reproductive system, the male’s reproductive system, or a combination of both.
The 2 types of infertility include: primary and secondary. Primary infertility occurs when the person has never been pregnant, and secondary infertility occurs after at least one prior pregnancy.
Causes of Infertility
Infertility can be caused by many different issues, and sometimes it isn’t possible to pinpoint the exact cause. Below you will find some of the possible causes for female and male infertility.
Some possible causes of female infertility include:
- Problems with or the complete lack of ovulation
- Issues with the fallopian tubes
- Abnormalities with the uterus
- Polycystic Ovary Syndrome (PCOS)
- Endometriosis
- Pituitary Gland, Thyroid or Hypothalamus issues
- Premature Menopause
Some potential causes of male infertility include:
- Blockage in the reproductive tract
- Pituitary gland, Hypothalamus, or Testicular issues
- Failure to produce sperm
- Abnormal function and quality of sperm
- Being exposed to different chemicals, such as pesticide and radiation
- Excessive use of alcohol, anabolic steroids or illicit drugs
Treatment for Infertility
Several different treatment options are available for those facing infertility. Healthcare providers may treat infertility with medication, surgery, intrauterine insemination, or through assisted reproductive technology. Specifically, the course of treatment depends largely on the cause of the infertility, how long the couple has been trying to conceive, and the age of the woman.
Medications
Certain medications are used to stimulate ovulation in women and can either be taken as a pill or through an injection. Men may also receive medication to help with erectile dysfunction or premature ejaculation.
Surgery
Surgery may be required to remove abnormalities or to repair any issues found in the reproductive tract. In addition, healthcare providers may use surgery to extract sperm that will then be injected into an egg.
Intrauterine insemination
Intrauterine insemination involves specially prepared sperm being inserted directly into a woman’s uterus. Furthermore, intrauterine insemination is sometimes done in conjunction with the use of ovulations stimulating medications.
Assisted reproductive technology
Assisted reproductive technology includes any fertility treatment where the egg or embryo is handled outside of the woman’s body. The most common form of assisted reproductive technology is in vitro fertilization (IVF), during which the eggs and sperm are both collected and sent to a lab. The eggs are then fertilized with the sperm to produce an embryo, and once fertilization is complete, the embryo is put directly into the uterus, or frozen for use later.
While infertility can be devastating, treatment options are available to aid you in your desire to have a child. Your women’s health provider will work with you and your partner to find out the cause of your infertility problems and to determine which treatment or treatments are right for you.
Contraception
Understanding Contraception
Contraception is used to try to prevent an unwanted pregnancy, either by preventing the egg and sperm from meeting, keeping eggs from being produced, or by keeping the fertilized egg from attaching to the lining of the uterus. Various forms of contraceptive methods are available to choose from and each person should select the contraceptive method that is best for them. However, if you are unsure about which method is right for you, our women’s health providers at Magnolia Family Medicine & Wellness would be happy to help you learn more about each contraception method and determine which would be the best fit for you.
Types of Contraception
These include:
- Abstinence (choosing to refrain from sexual activities)
- Intrauterine devices (IUD)
- Hormonal methods (such as oral contraceptive pills and the Patch)
- Barrier methods (including condoms and diaphragms)
- More permanent options (such as tubal ligation and vasectomy).
Types of Hormonal Contraceptive Methods
Several hormonal options are available for contraception.
The most commonly used include:
Oral Contraceptives
Oral Contraceptives are a pill that is taken at the same time every day to help prevent pregnancy. The two oral contraceptive options available are combined oral contraceptives and a progestin only pill.
- Combined oral contraceptives or typically referred to as “the pill” contain both estrogen and progestin hormones. It is not recommended for women who are over 35 and smoke, or have a history of breast cancer or blood clots.
- Progestin Only Pill, or “the mini pill” only has the progestin hormone and can be a good option if you can’t take estrogen.
Patch
The patch contains progestin and estrogen that it releases into your body through your skin. Placed on the upper body, buttocks or lower abdomen, the patch needs to be replaced every week for 3 weeks. However, the fourth week you do not wear a patch which allows you to have your menstrual period.
Implant
A hormonal implant involves placing a small rod into the skin of the upper arm. The implant then releases progestin into the body over a 3 year period.
Injection
A shot containing progestin is injected into the body every 3 months to help prevent pregnancy.
Hormonal Vaginal Contraceptive Ring
The ring is placed inside your vagina and releases progestin and estrogen into your body. The ring is worn for 3 weeks and then removed for a week to allow you to have a period.
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Whatever stage of life you are in, Magnolia Family Medicine & Wellness is here to help you with any issues or concerns that you may face.