Diane, Author at Cherokee Women's Health

Have you decided that it’s time to make your family of two an official family of three or more? The decision to start trying to get pregnant is exciting, but it’s easy for hopeful mamas to get discouraged after a few months without seeing those two little lines. Studies have shown the link between stress and a woman’s ability to conceive, so the first step in trying is an easy one—relax and enjoy the process. Preconception Counseling Visit Next, visit your doctor for a pre-pregnancy checkup. Also referred to as a preconception counseling visit, this appointment is your opportunity to discuss your current lifestyle, weight, medications and medical history with your doctor. Together, you discuss how all these factors affect your chances of getting pregnant. He or she can also recommend changes you can make to help you get pregnant faster. Here are some additional steps you can take to get pregnant sooner: Start taking a prenatal vitamin with folic acid. Start taking prenatal vitamins at least a month before you officially start trying to conceive. Most prenatals contain the 400 micrograms of recommended folic acid, but check the label just to make sure. Folic acid is also naturally found in leafy green veggies, citrus fruits, beans and whole grains, so doubling up is always a plus. Improve your diet. Healthy babies start with healthy moms. Try to avoid junk food and load up on fresh fruits and veggies, which will aid in both helping you maintain a healthy weight and give you the energy to maintain a baby-friendly exercise plan. Start limiting your caffeine intake. If you’re a 2-or-more-cup a day gal, it’s best to start cutting back, as the recommended daily intake of caffeine is 200 milligrams while pregnant. Have your teeth cleaned. A rise in hormones causes gums to bleed more often than usual during pregnancy, causing what’s known as pregnancy gingivitis. Get to know your cycle. Knowing when you ovulate will increase your chances of timing intercourse, which should be during the three to four days around your most fertile time of the month. There are lots of ways to track, including free apps for your phone or the good ‘ol fashioned way – with pen and paper. Quick Conception Numbers Overall, around 70% of couples will have conceived by 6 months, 85% by 12 months and 95% will be pregnant after 2 years of trying. Only about 8% to 10% of couples get pregnant within a one-month time frame, and the ‘per month’ rate for a normally fertile couple is around 20%. With all these facts and figures, it’s important not to stress out to give it time and try to relax and enjoy the time you have alone with your partner. By meeting with your physician during a preconception counseling appointment before you start the process of trying to conceive, you can ensure that every possible precaution is taken to prevent future problems throughout gestation, labor, delivery and even afterwards. Your peace of mind combined with our experience experience and expertise is our ultimate goal so that you may enjoy a safe and healthy pregnancy. Schedule an appointment online or call us today at 770-720-7733.

Nutrition and Weight Loss

Conquer Your Weight Loss Goals With An Individualized Plan

Diane /

Popular diets have two things in common: they tout rapid, dramatic results and they accommodate the masses with an ironic ‘one size fits all concept’. Many participants even experience significant weight loss in a short time —initially. Inevitably, however, that dreaded ‘plateau’ occurs. Then, despite all efforts, those last stubborn, morale-shattering pounds remain. Women come to us regularly, discouraged because yet another diet did not yield the desired, optimistic results it promised. Their frustration is understandable-even warranted- because most are simply unaware of the complexities involved in safe weight loss management. Fad diets usually fail because they are not individually customized. A myriad of factors can hinder successful weight loss. Medical history, genetics, hormonal issues, body mass index (BMI), basal metabolic rate (BMR), lifestyle, general health, medications-even state of mind must be considered. For instance, a sedentary lifestyle, diabetes, depression, or a sluggish thyroid can greatly impact the rate at which one sheds unwanted weight. So can lack of support and negativity from apathetic family and friends who are hearing optimistic, unrealistic blather about yet another quick loss trend for the umpteenth time. Additionally, some patients may require prescriptive intervention through safe and approved supplements, appetite suppressants and even injections if necessary. All of these influences and more are important considerations and contribute to dietary outcomes. So do regular weekly follow-ups, one-on-one consultations, and ongoing moral support-even long after the desired goal is reached. As specialists in female health, we realize that a woman’s chemistry and anatomy differ greatly from a man’s- and even from that of other females. This knowledge guides us to focus solely on each woman and her individual dietary needs. By combining our expertise, patient data, and continuing encouragement, all these elements help us create a customized medical weight loss program tailored for each woman and her unique requirements. Correct nutrition fuels the body and mind like curative medicine, providing more pronounced energy, lifelong physical health benefits, and cognitive clarity, the same way the proper additives keep a car running at peak performance. Adhering to a healthy diet and exercise regimen is never easy, but it doesn’t have to be an excruciating experience. With time, perseverance, nutritional insight, and safe medical intervention when necessary, any women can overcome the setbacks that would normally prevent her from reaching her dietary goals. With proper guidance, a harmonious balance between a comfortable self-image and a permanent, healthy lifestyle is achievable.

O-Shot Education, Vaginal Rejuvenation Patient Stories

Putting the “O” Back in an Overtired, Overworked Mom

Diane /

I am on my way to Cherokee Women’s Woodstock office to get an O-Shot, a procedure that offers women treatment for urinary incontinence and sexual dysfunction. I’m excited and a little nervous. However, I am hopeful after hearing other women’s success stories, and hope to have my own story add to the increasing number of women who have had remarkable results after getting the O-Shot. See if the O-Shot is right for you. Request more information now! When I heard that Cherokee Women’s was offering this procedure, I wanted to try it. I trust Dr. Michael Litrel and his team, so much so that I’ve been a patient for over eight years. The practice has delivered both of my children, and I refer them to anyone looking for a patient, kind team of physicians. Why Was I Interested in the O-Shot? I have suffered from sexual dysfunction for a number of years. While I know I am not alone in this (nearly half of women report suffering from some sort of sexual dysfunction in their life), this isn’t something most women are comfortable discussing with each other, their doctors, much less their husbands or anyone else. As a woman in my early 30s, the daily life of being a full-time working mother has pulled my libido to nearly nonexistent levels and has caused complications in my marriage. I’m happily married, but I feel guilt and shame surrounding my low libido and am curious to see if the O-Shot (in addition to careful communication with my husband) helps me at all. Learn more! Download our FREE O-Shot eBook. Getting Ready for the Procedure When I get to the office, the girl at the front desk smiles at me as I sign in. She has a very memorable face and kind eyes that I remember from previous visits. It puts me at ease while I try not to think about what I’ve signed myself up for. I’m called back to the exam room and told to undress from the waist down and wrap myself with the crinkly white cover. A few minutes later, Dr. Litrel comes in and explains that he’s going to apply a very thick layer of Lidocaine gel. It will need to sit for at least 20 minutes, and a nurse would be coming in shortly to take my blood so they can run it through the centrifuge. First, I needed two Lidocaine injections to make sure I didn’t feel the larger needles. This is the part that is different for every patient, Dr. Litrel tells me. “Some women feel absolutely nothing at all, and others feel the tiniest prick.” I was in the second category, but it was slight discomfort. (I mean, I’ve had two children—this was nothing I couldn’t handle.) The Lidocaine is cold, but welcome when I consider the alternative. A nurse comes in and gathers the tools she needs to take my blood. We make small talk and she says she’s heard lots of wonderful things about the procedure. She gets my blood ready for the centrifuge, and Dr. Litrel comes back in and places the blood in the centrifuge for 10 minutes. I continue to lay back on the exam table and wait for the Lidocaine to do its thing, scrolling through email and social media channels mindlessly. As a full-time working mom of two rowdy boys, I enjoy the quiet and stillness of the next few minutes. Once the centrifuge was done separating the blood, I was amazed when it I saw the tube pulled out and it was in three separate layers. I watched Dr. Litrel add calcium carbonate to the blood in two different syringes, one for my clitoris and the other for my vagina. It was time to start the procedure. I try to calm my nerves by making jokes, something I always do as a defense mechanism. “Well, I guess if you’re going to have a needle in your vagina, you want a female pelvic reconstructive surgeon in charge of it.” Dr. Litrel chuckles softly at my joke, reassuring me that the procedure will take just a few minutes and I’ll be out the door in no time. Dr. Litrel and his team were very warm, and so conscientious. Throughout the procedure, they asked, “Are you comfortable? Feeling okay? You’re doing a great job, we’re almost done.” In just a couple more minutes, the procedure was done. Dr. Litrel explained that I should wait 48 hours before any sexual activity, and that I may want to wear a panty liner for a day or two just in case I experienced any breakthrough bleeding. They gave me a few minutes to get dressed, and I walked out feeling a rush of excitement that I had done this for myself, and I couldn’t wait to test it out. All in all, the procedure only took about 45 minutes, and the longest part was waiting for the Lidocaine gel to take full effect. As I walked out of the office and down to my car, my satisfaction grew. I was glad I went through with it, and I couldn’t imagine doing this procedure with another physician’s group. That evening, I felt the tiniest bit of discomfort while sitting in a hard chair. I took some ibuprofen and didn’t have any more discomfort after that. The next morning, I had very mild swelling, but no pain. Giving the O-Shot a Try I’d kept the procedure a secret from my husband, wanting the first experience to be authentic and free from expectations. After “giving it a go,” I can say that I’m impressed. Frankly, I’m more than impressed. I haven’t felt a distinct change in my sexual desire like this, ever. Two weeks after receiving the O-Shot, my desire has increased considerably. And not just when the timing is right and the candles are lit and my mind is empty—even during the middle of the day—something many women don’t have the pleasure of thinking

Nutrition and Weight Loss

Why Sleep is Important for Maintaining a Healthy Weight

Diane /

As people become more sleep-deprived in our fast-paced world, scientists are learning that this deprivation is also a huge contributor to their difficulty in losing weight. It’s hard to imagine that the number of hours you sleep can have so much impact on your ability to shed pounds, but, thanks to two hormones and their role in weight control, those extra forty plus winks can mean the difference between slender and – well- not so slender. Just when women have had their fill of hormones like estrogen, testosterone, and progesterone raging inside and causing mood swings and feminine issues, along come two more that dictate whether or not they can successfully lose weight. These culprits are named ghrelin and leptin, and they have been at constant war with each other since Adam allegedly bit into that first apple and probably couldn’t sleep afterward. What are Leptin and Ghrelin, and What is Their Function? Both leptin and ghrelin regulate hunger. Leptin, which, under a microscope, looks like that pretty ribbon you’ve curled with scissors to add a special touch to your Christmas gift, decreases hunger. In ‘non-science’ talk, your fat (adipose tissue) creates leptin and, like a homing pigeon sends it on its way into your circulatory system. From there, it is set free to travel to the hypothalamus which controls such things as thirst, hunger, temperature, and your wake-sleep cycle (circadian cycle). It carries the message that your body has enough food and can stop eating. Ghrelin, on the other hand, is the dieter’s nemesis and saboteur. It works in a similar manner to leptin, but this ‘carrier pigeon’ brings the opposite news. It tells the hypothalamus you’re hungry, thus increasing your appetite. Unfortunately, insufficient sleep causes the body to make more ghrelin and lessens leptin production. So, the less you sleep, the more you want to eat. It follows that, unless you have the willpower of robot, you will eat. Of course, the more you eat, the more weight you’ll gain. Even if you adhere to the same dietary restrictions as your clone, exercise as much, and live the same lifestyle, one of you that is not getting enough sleep will have trouble losing weight. In fact, it may not be a coincidence that the Center for Disease Control (CDC) reports over 30% of the American population is sleep deprived. Roughly the same statistics are ascribed to obesity. A recent study found that participants who slept poorly or less than 7 hours a night lost 55% less fat than their counterparts who rested enough. Furthermore, they were hungrier, suffered from low energy, and didn’t feel satisfied with the amount they ate. How Much Sleep is Enough Sleep? It is recommended that you get at least 7-9 hours of sleep every night. Your body begins to rebel after a mere 4 days of getting less than 6 hours, not only by stimulating ghrelin production but also by causing: Interference with insulin production: Insulin, yet another hormone, is vital. It helps the body to transform starches, sugar, and other nutrients into energy. Mood swings Inattention, confusion, disorientation, and difficulty focusing Exhaustion and lack of will-power, leading to resistance to exercise and other physical exertion A rise in cortisol levels: Cortisol is a stress hormone that activates the brain’s reward center (amygdala), triggering food cravings. High levels of cortisol, when combined with ghrelin activate hunger by blocking brain messages telling you you’re full. Ghrelin and cortisol join forces like two little starving demons, demanding you feed them with anything that isn’t nailed down. Diminishment of mental clarity: Just like having too many shots of tequila, you begin to make poor choices, eating larger portions and selecting fatty, sweet, or otherwise high-caloric food. Onset of muscle loss (atrophy): Your body’s muscle building ability (protein synthesis) begins to fail, resulting in possible of physical injury. Slow wave or deep sleep depletion: Sleep deficit can rob your brain of the recuperation it needs after a busy day. Slow wave sleep is vital to physical growth and the body’s ability to repair and heal itself. What Can I do to get a Better Night’s Sleep? There are several things you can do to create better bedtime habits that enable you to get the proper rest you need. Some of these include: Turning your bedroom into your fortress of solitude: Treat it like hallowed grounds for the purposes of intimacy, relaxation, and sleep only. Avoid making it a bouncy house for the kids, a workstation, or an entertainment section complete with 70’ flat screen and enough woofers and tweeters to raise the dead. Adhering to a schedule: Try to go to bed and wake up at the same time every night and morning. No matter how tempting it might be to get those extra weekend zzzz’s, disrupting your routine can lead to even more sleep irregularities. Keeping it fresh: Grungy sheets and lingering human odors can be distracting. Change the linen as often as possible and air out the room regularly. You’ll rest better feeling clean sheets against your body and inhaling sweet-scented fabric softener. Establishing a routine: Wind down before bedtime by reading, soaking in a warm bath, taking a soothing shower or meditating. Leave budget worries or to-do lists for daytime. Turning off all electronics at least an hour before retiring. Studies show that these devices emit a short-wavelength bluish light that confuses your internal clock (circadian rhythm) and interfere with your body’s ability to produce melatonin, the hormone that helps encourage sleep. Watching your food and liquid intake: Avoid heavy food before bedtime, along with caffeine-laced beverages, alcohol, soft drinks, sugary snacks, and Sleeping in complete darkness: Even the glow from the alarm clock or a night light prevents melatonin output. If your job requires you to work at night, invest in blackout and/or soundproof Empty your bladder: Void before bedtime so that Mother Nature does not call during a delicious dream. Everyone goes through periods of insomnia. However, if you experience it

O-Shot Education, Urinary Incontinence Education, Vaginal Rejuvenation

A Holistic Approach to Sexual Dysfunction and UI with O-Shot

Diane /

The O-Shot, or Orgasm Shot, is a holistic solution for painful intercourse, urinary incontinence, vaginal dryness and low libido. Although our physicians at Cherokee Women’s Health Specialists are experienced in treating all pelvic issues unique to women, we do not concentrate solely on the physical aspects of your genitalia. We recognize that health issues can be comprised of overall physical, mental and social factors and take all that into account, offering holistic approaches to the many problems that have plagued women since the beginning of time. One of these holistic solutions is the O-Shot, also known as the Orgasm Shot. Learn more! Download our FREE O-Shot eBook. Women have always suffered from a plethora of physical ailments unique to their gender-so much so that an entire branch of medicine, Gynecology, has been devoted to their exclusive issues. Painful intercourse, urinary incontinence, vaginal dryness, and sexual disinterest are only a few of the problems we see on a daily basis. Though medicinal and surgical intervention is always available, many women today prefer a gentler and more natural approach. The O-Shot has been known to alleviate or entirely correct many of these problems in a less invasive, natural and extremely effective way. Below, Dr. Litrel offers more insight on the holistic approach to treatment urinary incontinence and sexual dysfunction with the O-Shot: What is the O-Shot? The O-Shot is a non-surgical injectable procedure administered in-office, using your own processed growth factor cells harvested from your blood. It is then re-injected into an area of the upper vagina and near the clitoris, resulting in healing regeneration of the orgasmic zone, triggering the power of your own body’s natural healing properties. Click here to see more videos of Dr. Litrel discussing how the O-Shot can help treat urinary incontinence and sexual dysfunction. How is This Done? After a vial of blood is taken from you, it is centrifuged, separating concentrated plasma and platelets from the rest of the blood. This process produces platelet-rich plasma (PRP), to which your physician applies an additive to boost the activation of your growth factors. Then, the platelet-rich serum is reintroduced into your body after swabbing the area with a numbing anesthetic. Platelets normally swim around in your blood vessels, always on guard for any disruption or damage. When they sense one, they rush to the injury site, join together in a chain to ‘hold down the fort’, by forming a clot or plug. Then, they send out a type of S.O.S.to healing stem cells to hurry over and start repairs in the form of collagen production. Request more O-Shot information. The O-Shot mimics this sequence by introducing a multitude of platelets into the body. The additive mixed in earlier sends that signal a false alarm of sorts- to lure the stem cells over. Stem cells, recognizing so many of your own platelets in one place are fooled into thinking there’s an injury and immediately respond, doing what they’re designed to do, which is to begin producing collagen and new tissue, replenishing vital elasticity, skin cells, moisture, plumpness, sensitivity, and strength to the area. PRP is not a not a novelty or fad. This technique has been used for many years to heal wounds, to treat sports and other injuries— has even proven effective in dentistry. What Can the O-Shot Do For Me? The O-Shot can benefit women a great deal. By spurring the area of the body where it has been injected into healing itself, the O-Shot immediately begins to work. It starts correcting different feminine issues that have developed over time due to aging, childbirth trauma, depleted collagen, tissue damage, skin cell death, etc., physical changes which can evolve into such problems as: Sexual dysfunction Sexual disinterest or low libido Vaginal Dryness Urinary Incontinence Failure to achieve orgasm Desensitization Painful intercourse Stress incontinence Urge incontinence The O-shot, in tandem with your own biological healing factors, can then ease or altogether eliminate these troubles, resulting in: Accelerated desire for sex More powerful orgasms Corrected or minimized urinary incontinence leakage More youthful and supple vaginal lip appearance Increased tautness to the vaginal opening Less or no need for artificial vaginal lubricant More frequent and regular orgasms Less or no pain during intercourse More sensitivity and arousal during clitoral stimulation More ease in attaining orgasm Possibility of reducing or stopping previous drug intervention Possibility of less frequent or complete cessation of pelvic-related infections How Long Do the Effects of the O-Shot Last? Individual results vary, but often noticeable change begins immediately and can last up to 18 months. Depending on how severe your issue is, we may recommend a booster procedure in about 4 to 8 weeks, and a maintenance shot in about a year so that there is no diminishment of ongoing benefit. There is also no recovery period necessary. You can resume all normal activities immediately after leaving our office. Furthermore, the whole process will cause you little or no discomfort. Who is a Good Candidate for the O-Shot? Almost every woman between the ages of 25 to 65 is a good candidate. There are virtually no exceptions, but we can only recommend this procedure 100% after you disclose your full medical history so we can be sure there are no foreseeable problems exempting you. Usually, however, most women prove to be excellent candidates. Why Should I Choose Cherokee Women’s Health Specialists for My O-Shot Treatment? At our establishment, we pride ourselves on our holistic approach to female wellness. We treat you as a whole, taking into account any metabolic or hormonal problems you may have. Even diet and lifestyle can compromise or your body’s ability to heal or regenerate tissue. We address any psychological or emotional issues as well so that we can help restore your overall health, head to toe and inside and out. We do not just focus on your pelvic area. We examine all your alternatives and only recommend the best one for your unique situation. Drs. Litrel and Haley have spent their entire medical

Cosmetic Services, Liposuction Education, Tummy Tuck Education

What to Consider Before Getting a Tummy Tuck

Diane /

You’ve done everything right! You dieted, exercised and finally lost all that extra weight you’ve been carting around. Or maybe you religiously followed all your doctor’s instructions to remain safely trim and as healthy as possible while pregnant. Yet, no matter how hard you worked at it, you’re stuck with that loose dewlap-looking fold of skin hanging around your tummy. It just won’t go away! You’ve researched and considered many available options, but realize your only remedy is probably a tummy tuck. You’re almost ready to commit to having one, but you still have questions. At Cherokee Women’s Health Specialists, we understand and are more than qualified and happy to answer all your concerns, both in this forum and during your free consultation. What is a Tummy Tuck? A tummy tuck, or abdominoplasty, is a procedure that surgically removes superfluous skin and fat around the abdominal area distended by pregnancy, former surgery, obesity, accelerated weight loss, age, or heredity. It also repairs the slackened or separated muscles (diastasis recti) caused by these factors. In some cases, depending on their location, some abdominal marring such as cesarean section scars and stretch mark can even be eliminated. The result of an abdominoplasty is a firm, flat stomach and a more appealing profile without those unwanted bulges or bumps. Are all Tummy Tucks the Same? No, there are several different types of tummy tucks. The one is best for you depends entirely on your individual needs and desired results. Our experts will advise you accordingly, but the following are the three most common abdominoplasty methods: Standard or Full Tummy Tuck: This procedure addresses the area both below and directly above the navel (umbilicus). Under sedation, a predetermined incision, based on the amount of excess skin to be removed, is made horizontally between the hips. Another is made around the umbilicus, which is carefully excised for repositioning afterward. The abdominal skin is then pulled back. Damaged muscles are tightened and tissue is removed. Liposuction, if required, is performed, Remaining skin is tightly pulled together and closed. The belly button is then replaced in a centered position. The standard tummy tuck is usually the method used when there is a large amount of surplus skin and/or muscle weakness. Mini Tummy Tuck: This method is less invasive and only concentrates on the area of the lower abdomen beneath the belly button. It is ideal for slimmer patients with a slight bulge. Muscles are tightened and extra skin is removed, but there is no need for navel extraction and consequent readjustment. Circumferential Lower Body Lift: This is the most invasive tummy tuck procedure and the one that yields the most dramatic results. It not only encompasses the entire abdomen but also targets the lower back and hips, resulting in a total upper body reshaping. It requires both vertical and horizontal incisions, allowing the surgeon better access to more compromised muscle and excess tissue. Then liposuction is used to draw out fat located around the hips and lower back for a more defined silhouette. The belly button is replaced as in a standard tummy tuck before closing. Because this is a more intense surgery requiring a longer period of recuperation, patients must be in extremely good physical health. Am I a Good Candidate for a Tummy Tuck? You are a good candidate if you: Are in good health Are a non-smoker Are between 25 and 60 years of age Have good skin elasticity and muscle tone Have a great deal of loose, flabby skin: There must be enough skin to perform a standard tummy tuck so that the resulting scar does not become stretched and unsightly after healing. If you only have a small pocket of skin, the preferred choice is usually a mini tummy tuck. Realize that abdominoplasty is not a weight loss procedure or miraculous overnight makeover. Are committed to weight and good nutrition maintenance, a healthy lifestyle, and regular exercise No longer plan to become pregnant: Unexpected pregnancy after a tummy tuck is not harmful to a baby, but additional surgery to correct subsequent loose skin may be needed. Are within 15 to 20 pounds of your ideal weight with no plans to lose more. Who Should Not Have a Tummy Tuck? An abdominoplasty is a low-risk elective plastic surgery, but surgery nonetheless. Full medical history disclosure is needed, including a list of all prescribed, over-the-counter medications, vitamins, herbs and supplements you use. Additional preoperative tests must be performed. Information from all sources is used to ensure that all precautions are taken to determine that you can safely tolerate the procedure. Possible reasons that make you a poor candidate are: An intolerance to the anesthesia Lung, heart, kidney, liver, or connective tissue issues A tendency to develop keloids or other thick scarring problems (hypertrophic scarring) Healing difficulties caused by certain medical conditions such as diabetes, coronary artery disease etc. A compromised immune system Obesity Poor circulation A tendency to form blood clots. What is the Recovery Time After a Tummy Tuck? Your surgeon is usually the best person to answer this question, based on individual factors and type of surgery, but typically the recovery time is 2 to 6 weeks. This is usually the time allotted before the patient can return to work unless the job involves heavy or rigorous activity. Otherwise, the recuperation may be longer. Will I Need to Stay Overnight After a Tummy Tuck? Most tummy tucks do not necessarily require an overnight hospital stay, but some physicians–and patients–prefer it. You are usually physically able to leave within two hours. I’m a Busy Mom. Can I Resume Care of Children After a Tummy Tuck? It is crucial that the repaired muscles heal after an abdominoplasty. Any undue stretching of can cause tearing and stitch separation. Not only can this cause complications, but the desired abdomen flattening will not occur, rendering the whole process ineffective. You are usually cautioned not to lift anything over 10-15 pounds, and then, carefully. A wiggling toddler

Well Woman

Ladies, Make Heart Health a Priority

Diane /

In honor of National Heart Health Month, we’d like to touch on a disease that affects an estimated 44-million of women every year. Cardiovascular disease is the #1 killer for women across America. You may be surprised to learn 1 in 3 deaths of women is caused by this deadly disease. Heart disease differs from woman to woman. Warning signs can be hard to spot and even non-existent. That’s why it’s important to take every possible measure to live a heart-healthy lifestyle especially if you have one or more risk factors. Cardiovascular disease can include diseased blood vessels, structural problems, or blood clots. Over time, heart disease can cause strokes, heart attacks, arrhythmia, and more. Who’s at Risk? The truth is cardiovascular disease can adversely affect anyone. However, there are several factors that can put you at a higher risk. A whopping 90% of women have at least one or more risk factors for heart disease. Today, we’ll go over several key risk factors women should be on the lookout for. While some factors cannot be controlled such as age, race, or genetics, there are steps you can take to lower your chances of getting heart disease. Women from all walks of life should get an annual well-woman exam and maintain an open dialog with their physician. If you have a family history of heart disease or any of the following risk factors, your doctor should be aware. Age Most women don’t start to think about heart disease until they’re older. And, while it’s true that age can play a major role in your heart health, it doesn’t always have to. Did you know, the combination of birth control and smoking increases young women’s risk for getting cardiovascular disease by 20%? Family History Family history plays a key role in your heart health. High blood pressure and cholesterol levels can pass from one generation to the next and can increase your risk. You may be at a higher risk for getting heart disease if: Race Yes, heart disease affects all women but your ethnicity can put you at a significantly higher risk. For example, Hispanic women are more likely to develop heart disease 10-years earlier than Caucasian women. Forty-eight percent of African-American women 20-years and older have cardiovascular disease. High Blood Pressure/Cholesterol Having high blood pressure for long periods of time puts added strain on your heart. After a while, it scars and damages the arteries leaving you vulnerable to heart attacks, stroke, kidney failure, and more. High cholesterol levels can potentially harden and line the artery walls over time causing unwanted blockages. These blockages can lead to blood clots, heart attacks, and stroke. Smoking We all know just how bad smoking is for us. It causes cancer, makes us gain weight, and increases irritability but did you know it affects your heart too? Take a look at how smoking puts you at greater risk for cardiovascular disease. Women who smoke are 25% more likely to get heart disease than men who smoke. Sedentary Lifestyle Physical inactivity can lead to blood clots, high blood pressure, heart attack, and strokes. People who don’t have regular to moderate physical activity are 30-40% more likely to be at risk for heart disease. Weight Even if you have no other health conditions, being 20% overweight can put you at a greater risk for cardiovascular problems. Carrying extra weight (especially in the waist area) puts extra strain on your heart. It can also increase your risk for other heart disease causing factors such as increased cholesterol and blood pressure levels, and induced diabetes. Diabetes Adults who have diabetes are 2-4 times more likely to have heart disease or a stroke. Over time, high glucose levels can damage blood vessels and the nerves that control the heart. The good news is, diabetes can be controlled through medication, as well as diet and exercise. Signs You’re Having a Heart Attack When it comes to actual warning signs, men and women differ a good deal. While men typically have very specific symptoms such as tightness or extreme pain in the chest, women have more subtle symptoms. Some signs you may be having a heart attack include (but are not limited to); Listen to your body. If you think you may be having a heart attack, stay calm and seek immediate medical attention. Steps to Take Towards a Heart-Healthy Lifestyle Okay, you may not be able to go back in a time machine and lower your age, but there are several steps you can take towards a healthier life. Implementing a healthier lifestyle through diet and exercise can add years to your life. Consider making small changes to your daily routine and keep heart disease at bay. Schedule an annual well-woman visit today to learn more about your risk factors for getting heart disease. Together, you and your doctor can create an action plan for preventing and maintaining healthy heart health.

O-Shot Education, Vaginal Rejuvenation

The O-Shot and Sexual Dysfunction

Diane /

Sexual dysfunction. Lack of sexual desire. The inability to become aroused or orgasm during intercourse. Painful or unpleasant sex. These are all symptoms of sexual dysfunction and if you’re experiencing any of them, you’re not alone. Nearly 43% of women report at least some degree of poor sexual function. Request more O-Shot information now! Sexual dysfunction affects women of all ages. However, it can be particularly brutal for women entering menopause thanks to hormonal imbalances. If you’re simply no longer interested in sex or have trouble staying lubricated before or during intercourse, you may want to consider the O-Shot. Aptly named, the O-Shot or ‘Orgasm Shot’ works to improve overall sexual health so you can take your life back. It’s a simple minimally-invasive procedure that safely and effectively restores your ability to climax by improving lubrication and sensation. Dr. Litrel shares how the O-Shot can help treat incontinence and sexual dysfunction. How Does It Work? Before your O-Shot treatment, you’ll undergo a simple blood draw. One of our specialists will then spin, clean, and process the blood into platelet-rich plasma (PRP) while you wait in-office. The PRP is then injected directly into the clitoris and inside the vagina. The process stimulates the growth of new cells and encourages the formation of new collagen, blood vessels, and nerves. In turn, the injection sites become more sensitive. A topical numbing agent is placed on the injection sites prior to your treatment to minimize discomfort. There is no downtime associated with the O-Shot and patients are free to go about their daily activities immediately following the procedure, including intercourse. Unlike other similar procedures, the O-Shot uses your own body’s natural healing process. Dermal fillers provide short-term results and are quickly absorbed and expelled from the body. Surgical methods are costly, time-consuming, and have longer recovery times. Learn more! Download our FREE O-Shot eBook. What To Expect Because the O-Shot uses a biologic process, some women may experience improvement almost immediately while it can take several weeks for other women to notice results. Once the O-Shot takes effect, you should experience better sexual function for up to a year or more. After your Orgasm Shot, you can expect improved sexual desire, better lubrication, and the ability to climax more often. Stronger, longer-lasting orgasms can also be accomplished with O-Shot injections. A series of two O-Shots are typically recommended to achieve maximum sexual benefits. No significant side effects have been reported with the O-Shot. Some patients expressed temporary spotting, swelling, and hypersensitivity after their vaginal rejuvenation procedure. Any adverse side effects should dissipate within 1-3 days. Am I A Good Candidate? The ideal candidate for the O-Shot include women who are seeking a non-surgical way to improve their sexual health. With a short, in-office appointment women can achieve long-lasting results without the downtime. You may be a good candidate if you have one or more of the following sexual concerns: Menopausal and post-menopausal women can especially benefit from the O-Shot. New collagen, blood vessels, and nerves that are formed help restore your sexual health to its previous good health. Women who go into the procedure with realistic expectations are more likely to be happy with the results of their O-Shot procedure. During your consultation, your doctor will be able to explain the procedure in detail so you can make an informed decision about what’s right for you. Ready to improve your sexual health with the O-Shot? Schedule a consultation with Cherokee Women’s Health today to inquire about getting the O-Shot for yourself. Call us today at 770.721.6060.

Well Woman

What is Melasma and How to Beat it

Diane /

Melasma is a skin issue that results in brown or brownish-gray blemishes, or inflamed, red patches (erythrosis pigmetosa faciei) that begin to appear in a typically recognizable configuration and hue that physicians can easily identify in areas such as: The jawline (mandibular pattern) The cheek (lateral cheek pattern) Nose, cheeks, upper lips and forehead (centrofacial pattern) Nose and cheeks (malar pattern) Upper arms and shoulders (acquired brachial cutaneous dyschromatosis) The sides of the neck, usually after the age of 50 (poikiloderma of civatte). What Causes Melasma? The cause is unclear, but there is speculation that hormonal factors, combined with heat, sun, and light exposure, may create an imbalance of cells in the body called melanocytes. These melanocytes normally create the skin pigmentation, melanin, which decides the uniform color and shade of your skin. When melasma occurs, it is thought that the confused melanocytes sense some sort of disruption and command the melanin to generate more pigment. This results in patches of off-color skin. Who Gets Melasma? Melasma is completely impartial. Anyone, male or female can get it, but it is more commonly found in: Pregnant women: This form of melasma is known as ‘chloasma’ or ‘the mask of pregnancy’. Women taking contraceptives: Because progestin and/or estrogen found in birth control pills fool the body into believing it is in a state of pregnancy, women taking these medications are also prone to chloasma. Women taking hormonal replacement drugs or steroids Women using intrauterine devices or other implants Women using certain medications for cancer and other problems that may make them more vulnerable to solar rays (photosensitivity) Women using essential oils or certain toiletries, hygiene, and cosmetic products such as soaps, deodorants etc. that may result in skin reactions (phototoxicity) when exposed to the sun’s rays. Darker skin-toned women such as females of Middle Eastern, North African, Latin, Mediterranean, Asian, and Indian descent Women whose backgrounds may include a family history of melasma Women between the ages of 40 to 60 and beyond who have been regularly exposed to the sun. Women suffering from hypothyroidism or other medical issues Women suffering from stress. How is Melasma Diagnosed? Melasma is easily identifiable and usually only requires a visual diagnosis, especially if you are obviously pregnant, or if any of the abovementioned criteria apply to you. However, if there is any doubt on the part of your doctor, certain tests can be performed. One is called a Wood’s lamp examination. This lamp emits a particular light that, when scanning a targeted mottled section, can enable your physician to evaluate the depth of skin affected by the suspected melasma. Treatment would then depend on those findings. Once the number of skin layers affected by melasma is determined, the Wood lamp results are usually categorized into one of these three classifications: Epidermal melasma which responds very well to treatment Dermal melasma which can be difficult to treat Mixed melasma which can be treated partially. If the doctor is still not positive that you are presenting with melasma, an additional procedure of removing a small skin sample for further analysis (biopsy) may be required. Is Melasma Dangerous? Not at all. Melasma poses no physical health risks whatsoever. It is purely a visual cosmetic issue. Its impact is more emotional and psychological due to the fact that it is predominantly a facial discoloration that is always noticeable. Women with severe melasma often suffer from low self-image, social discomfort and even depression depending on the severity of the condition. Is There Any Treatment For Melasma? Absolutely! With pregnancy-related melasma, the condition often disappears by itself after giving birth. Drug modification or complete cessation of medication containing steroids, hormones, or other melasma triggers can eliminate the problem as well. Minor cases can be addressed through home remedies made with items found in your pantry or spice rack that contain natural bleaching or exfoliating properties. Many recipes are available online and include such ingredients as: Turmeric Papaya Oatmeal Apple cider vinegar Almonds Onion juice Horseradish Lemon juice Sandalwood Aloe Vera gel Mulberry extract. Over the counter preparations can help too. Your doctor may prescribe oral medications or creams containing medicinal ingredients. For more stubborn or resistant melasma, there are other, more aggressive options that your doctor may discuss with you such as: Dermabrasion Microdermabrasion Topical glycolic or acid peels Fractional lasers Intense pulsed light (IPL). Does Melasma Always Go Away Completely? Unfortunately, not all the time. Usually, the gentler interventions mentioned are enough to eliminate the problem altogether or lighten it to a more acceptable level. Some cases of melasma, however, are difficult to correct. They may require several treatments, and even ongoing care to minimize large or extremely dark blemishes. Every case is different and only a specialist can determine your unique needs. Is There Anything I Can do to Make Sure I Don’t Get Melasma? There are definitely precautions you can take to lower your risk of getting melasma. You can: Wear SPF 30 or higher sunscreen daily, reapplying it every 2 hours Select make-up that also includes sunscreen Avoid extreme exposure to the sun Wear a wide-brimmed hat, and make sure your neck, shoulders, and arms are covered or protected outdoors Discuss all medications you are taking with your physician to see if any of them may make you more prone to developing melasma. Sometimes a simple adjustment can prevent the condition from occurring. Avoid rough or abrasive cleansers and soaps Apply moisturizer regularly if your skin is dry. If you have already been diagnosed with recurring melasma, or have been unable to eliminate all traces of it, there are now excellent camouflage cosmetics available that greatly reduce the appearance of darker discolorations. As well, if you are experiencing psychological repercussions that often accompany more severe cases. It may be to your benefit to join a support group that can help you share and possibly overcome these issues. Cherokee Women’s Health Specialists Can Help You if You Have Melasma At Cherokee Women’s Health Specialists, our doctors can

GYN Problems

Menstrual Pain

Diane /

Almost every woman has suffered from menstrual pain or heavy bleeding at least once since her first period. For many, a simple over the counter pain reliever, heat applications, or a soothing hot bath can alleviate the discomfort, but for others this can be a debilitating experience month after month, often interfering with enjoyment of daily living. Our experts at Cherokee Women’s Health Specialists encounter this problem on such a frequent, regular basis that our skills are honed to immediately recognize the symptoms and provide help. We know the physical limitations and psychological impact chronic pelvic pain and heavy bleeding have on your life. Our physicians take menstrual pain very seriously and are very aware of the limitations it may put on you if you suffer from its distressing effects. Menstrual pain is different from premenstrual syndrome (PMS) in that PMS usually occurs within 7 to 14 days before actual menses. Symptoms associated with PMS are bloating, irritability, weight gain, and fatigue, whereas menstrual pain occurs during your period. Symptoms include cramping and a throbbing dull ache or pressure low in your abdomen. It can radiate to your lower back, hips and inner thighs. Other more extreme symptoms may be nausea, vomiting, or diarrhea. It can be annoying, but tolerable for -or so severe that it limits functionality. Different Types of Menstrual Pain Menstrual pain is called dysmenorrhea, and there are two types—primary and secondary. Most women suffer from primary dysmenorrhea, which is usually linked directly to menstruation itself without any other underlying conditions. Contractions of the uterus push against neighboring blood vessels, briefly cutting off blood supply to the uterine tissue, thus resulting in menstrual pain. It generally lasts 2 to 4 days. Secondary dysmenorrhea is caused by a medical disorder of your reproductive system which may require testing to identify the source. It is typically treated with either medication or surgery. Some causes may include conditions such as pelvic inflammatory disease (PID), fibroids, adenomyosis, cervical stenosis, or endometriosis. There can also be diarrhea, nausea, fatigue or vomiting. Accompanying pain lasts longer and begins earlier than primary dysmenorrhea. Another menstrual disorder that can lessen the quality of life, interfere with regular activities, and is often cause to call into work to take the day off, is heavy bleeding or menorrhagia. It affects a whopping 10 million American women and is one of the complaints gynecologists hear most often. This excessive bleeding can last longer than a full week. Sanitary napkins or tampons need changing every hour or two and, often, throughout the night. There can be leakage, even with precautionary double padding. Some women with severe menorrhagia can pass large, quarter-sized clots. This condition can cause serious anemia if left untreated for too long. Causes of Menorrhagia May Include: If you suffer from menstrual pain that is not relieved by over the counter medicine, rest, heat application, or soothing hot baths- or if experience heavier than normal bleeding, you should seek the advice of an accredited practitioner familiar with women’s reproductive wellness, especially if your discomfort interferes drastically with day to day life. At Cherokee Women’s Health Specialists, we are familiar with every aspect regarding a woman’s exclusive health issues. Doubly accredited Dr. Haley and Dr. Litrel, our urogynecologists, hold certification in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) and OB/GYN. They were among the first to receive this special recognition by the American Board of Medical Specialties (ABMS) in recognition of their ability, proficiency, and training. This qualifies them to diagnose and treat any and all disorders pertaining to your feminine health. Furthermore, they are two of only a limited number of doubly accredited physicians in private practice in Atlanta. When you choose our facility for your care, your first consultation will probably consist of in-depth questions in order to determine what your possible complications might be. A pelvic examination may reveal the problem immediately. If not, our state-of-the-art facility and our close affiliation with Northside Hospital Cherokee, with access to all its amenities, enables us to perform all additional testing necessary such as: Laparoscopy: A tiny fibro-optic telescope can be inserted through a minuscule incision to examine internal reproductive organs, and take a small sample of tissue for biopsy. Hysteroscopy: A fibro optic telescope is introduced into the womb via the vagina to look for any abnormalities. Urine and blood tests: These pinpoint and accurately identify any medical disorders or diseases Pelvic ultrasound study: This detects physical irregularities painlessly via high-frequency sound waves. Pap smear: A quick swab rules out any cancer, infection, dysplasia or inflammation. Sonohysterogram: After the uterus is infused with fluid, ultrasound is used to find any anomalies. Dilation and curettage: Though this is usually a treatment, it can also be used to pinpoint any physical abnormalities. Normally, invasive intervention is unnecessary. We do our best to avoid any treatment that makes you more uncomfortable. We analyze results carefully, taking in all factors such as your age, general health, weight, etc., and use our combined expertise and decades of accumulated knowledge to decide on the most effective management for your dysmenorrhea or menorrhagia. Treatment Options for Severe Period Pain and Heavy Bleeding The first option we look into is oral hormonal or non-hormonal therapy such as contraception, non-steroidal anti-inflammatories (NSAIDs), or other medications that can reduce bleeding and pain. If you suffer from anemia as a result of your condition, folic acid or iron supplements might be prescribed. In some cases, a hormonal intrauterine device (IUD), patch, vaginal ring or injections can be helpful. Should you require a surgical alternative to alleviate your pain or bleeding, our FPMRS, OB/GYN specialists have the most current medical knowledge to do everything possible to treat your individual problem. Severe period pain and heavy bleeding do not have to keep you from living the life you want. With the proper help, you can get better. If period pain or prolonged, heavy bleeding is interfering with your life, call us today at 770.720.7733 or schedule an appointment online.

OB, Premature Birth Education

Premature Births on the Rise in Georgia

Diane /

Babies born before 37 full weeks of gestation are considered premature. Disturbing statistics show that, after previous years of decline, premature births are now on the rise in Georgia. Though this is partly due to lack of funding and, consequently, the shutting down of many medical facilities in Georgia, it is also happening nationwide. What Causes Premature Birth? Many maternal factors can contribute to preterm deliveries. Some of these include: Complications of Premature Birth Premature babies often suffer from both short and long-term health complications, neurological issues, and developmental delay concerns such as: Is Your Pregnancy High-Risk? If your pregnancy classifies as high-risk with a danger of premature birth, you should find a fully accredited physician who is both familiar with and can treat complications associated with these pregnancies, as you will probably need extra monitoring throughout gestation. Any medications, vitamins or supplements you are taking will be evaluated and possibly stopped or modified. Your diet might be adjusted to create a more nutritious and beneficial plan. Additionally, you will be provided with a list of any danger signs that may point towards a premature birth. Cherokee Women’s Health Offers Prenatal Care for All Pregnancies If you are not yet pregnant but may potentially give birth prematurely, prenatal counseling and testing are usually advised. At Cherokee Women’s Health Specialists, we offer you exceptional prenatal service. All of our professionals possess up-to-the-minute knowledge in their fields of obstetrics, gynecology, surgery, midwifery, cosmetic surgery, nutrition, medical assistance, nursing, holistic medicine and equipment technology. They are committed to putting your well-being and that of your child first. Unlike many OB/GYN facilities, we conveniently deliver multiple women’s health services to meet your needs under one roof. Our priority is to prevent as many premature births as possible by providing you with these broad amenities. Along with being voted “Best OB/GYN in Towne Lake, Woodstock, and Canton, we are affiliated with Northside Hospital Cherokee, the nation’s leader in maternity services. We have unlimited access to their state of the art equipment, test center, and birthing center. Their Neonatal and NICU facilities have the most advanced technology to ensure that your baby is given every possible opportunity to fight against the challenges it might face due to a premature birth. Not all premature births can be foreseen or prevented, but at Cherokee Women’s Health Specialists, we try to do everything within our scope of expertise to deliver one healthy baby at a time.

Contraception Education

IUDs May Have a Surprising Health Benefit

Diane /

An observational study conducted at the Keck School of Medicine of USC determined that intrauterine devices (IUDs) may have the surprising health benefit of lowering the instances of cervical cancer. Worldwide, cervical cancer is the third highest cancer among women. Projected statistics by the World Health Organization (WHO) estimate that, by 2035, the numbers in the United States alone will climb to 756,000. According to the information collected from 16 different epidemiological studies, (i.e. studies of disease in different populations), the results of 12,000 women from around the world who used IUDs were analyzed. Findings revealed that invasive cervical cancer among them was lowered by 30%. Though this revelation is both hopeful and promising, doctors urge you to remember that the statistics are currently based solely on observation and not clinical trials. A great deal more exhaustive research must be done in controlled settings before these conclusions are found to be of merit. Clinical trials require years of intense scrutiny, but if this correlation is proven, it can offer a beacon of hope for women everywhere. Until that time, it is recommended that you be vigilant, schedule regular cancer screening, and vaccinate against the HPV virus—the latter preferably before sexual activity begins. How Does an IUD Work? An IUD is a device formed like a letter T and is used as a method of birth control. A gynecologist inserts it into your uterus to prevent pregnancy. It is 99% effective and can last anywhere from 3 to 12 years, but can be removed at any time. To date, there are two kinds of IUDs: hormonal and non-hormonal IKUDs. Traditional non-hormonal IUDs prevent pregnancy by releasing copper which causes an inflammatory effect. This reaction inhibits sperm movement, stopping it from reaching the egg to achieve ovulation. More recently manufactured IUDs are hormonal. These devices release synthetic progestin. High progestin levels in the body form thick cervical mucus that is hostile to sperm, preventing it from reaching the egg and succeeding at fertilization. Since hormonal IUDs are a fairly new concept, it is assumed that the subjects used the copper-releasing types, but this information still needs to be clarified. Exactly why IUDs can lower cervical cancer rates is still a mystery. Speculation is that when the physician is making sure the device is placed correctly, this adjustment in the area known as the transformation zone results in an immune response, protecting the cervix from the pre-invasive lesions which lead to cervical cancer. It is also thought that IUDs may assist the body in repelling Human Papilloma Virus (HPV) infections, which carry the most danger of triggering cervical cancer. For many women, the benefits and convenience of an IUD far outweigh the possible risks. IUDs eliminate the worry of forgetting to take a daily pill or renewing a monthly oral contraceptive prescription. Periods are often lighter-even non-existent, so IUDs can also prevent anemia from excessive monthly blood loss. There is no need to interrupt ’the mood’ to insist on a condom to prevent conception–as long as you are in a trusted monogamous relationship. Last, but not least, the almost 100% effectiveness gives women complete peace of mind, allowing them to enjoy lovemaking without worrying about babies they’re not prepared to have. Though the recent findings and theories provide an optimistic outlook to both women and cancer research, specialists, including those of us at Cherokee Women’s Health Specialists, caution against pinning your hopes on these yet unproven hypotheses. Insisting on an IUD solely to prevent cervical cancer is both unwise and sometimes dangerous. IUDs Do Not Protect Against STIs or STDs IUDss ensure against pregnancy and can possibly lower your risk of a deadly disease based on this new discovery, but they do not guard against sexually transmitted diseases (STDs) or infections (STIs). It is recommended that a condom and/or spermicide always be used, especially if intimacy is with a new partner. IUDs can cause cramping, pain, and spotting between periods. You may also experience irregular periods. IUDs can also slip out of place, causing pregnancy-and possible ectopic pregnancy if you are unaware of your condition. An unknown allergy to copper, if you are given the non-hormonal IUD, can be life-threatening-possibly fatal. In rare cases, an IUD put in place incorrectly can push through the wall of the uterus, which may necessitate removal through surgery. Are You a Good Candidate for an IUD? Because every woman’s body is unique, an IUD may or may not be right for you. In order to make the right decision that benefits you the most, we take the time to study your medical history in depth. We evaluate any medications and supplements you may be using, run tests if necessary, establish that all is well with a pelvic examination, take into consideration any food or product sensitivities, inquire about allergies and much more. The smallest detail may be of utmost importance in establishing the proper course of birth control for your individual needs. Our extensive training and accumulated knowledge give us the tools we need to make sure your pelvic and reproductive health is guarded at all times. Alternative birth control methods to an IUD may be prescribed in your case, along with full disclosure of any risks, possible side effects, and percentage of effectiveness. Some of these additional methods are: If you no longer wish to have children, you may opt for tubal ligation, a procedure our surgeons are very capable of performing. If you prefer not to use any of these methods or are unable to tolerate them, we can, upon request, counsel or instruct you on the Fertility Awareness-Based methods (FAMS) and withdrawal methods. It remains to be seen if the surprising health benefits of IUDs observed in the above mentioned studies do indeed have potential merit before relying on the findings to prevent cervical cancer. If they do show irrefutable proof of prevention, Cherokee Women’s Health Specialists will most likely be among the first of the OB-GYN facilities in Atlanta to implement those

Author name: Diane

Trying to Conceive: Your “Get-Pregnant” Checklist

Conquer Your Weight Loss Goals With An Individualized Plan

Putting the “O” Back in an Overtired, Overworked Mom

Why Sleep is Important for Maintaining a Healthy Weight

A Holistic Approach to Sexual Dysfunction and UI with O-Shot

What to Consider Before Getting a Tummy Tuck

Ladies, Make Heart Health a Priority

The O-Shot and Sexual Dysfunction

What is Melasma and How to Beat it

Menstrual Pain

Premature Births on the Rise in Georgia

IUDs May Have a Surprising Health Benefit

Find us on

Locations

Patient Portal

Appointments

Credit Card Financing

Cherokee Women's Health

WARNING: Mature Content