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September 20, 2017

“When I started the program at Cherokee Women’s Health I had already lost 16 pounds but it had taken me over 5 months and then I plateaued in my weight loss journey.”

This part of Wendy’s story is not uncommon. Many people begin diet and weight loss programs and see early successes but have a difficult time reaching their goal. At Cherokee Women’s Health Specialists our doctors have formulated a plan specifically for women and their unique needs. The program includes personalized meal plans and nutritional education.

“One big thing that I learned from the program is the relation of calories in food to how many calories my body actually burns and that every calorie counts. I used to let food control me but now I control the food.  It really puts calories into perspective and this program has given me the tools I need to not only lose the weight but to keep it off!”

Each patient gets a personalized plan that can include supplements along with the nutritional counseling, and regular check-ins giving women the skills they need for long term success.

 Goal for the Bridesmaid: Pounds and Dress Size… Going Down!

“In the last 4 ½ months I have lost an additional 38 pounds with Cherokee Women’s Health Specialists. When I began the program, I was shopping for and being fitted for a dress for my sister’s wedding and initially I was going to be in a size 18-20 dress. By the time the wedding came around I had a size 14-16 and still had to have the dress taken in some before the wedding.

The program gave me a huge boost in my weight loss journey. I now have more confidence, I’m happier, I feel better, and best of all I have more energy to run around and play with my kids without feeling so tired.”

Our medical weight loss program is designed to be an effective life style change that puts the power in our patients’ hands. With nutrition counseling, exercise plans and accountability, the medical weight loss plan gets results for women.

Call 770-720-7733 to schedule your free consultation today.

September 6, 2017

by James Haley, MD, FACOG, FPMRS

Dr. Haley photo

Dr. Haley

As many as 86 million people in the United States have prediabetes, yet 90% of them don’t even know it. Prediabetes is the condition that exists when you have higher than normal blood sugar levels, but not high enough to classify as diabetes. Someone with prediabetes has a higher risk of developing Type 2 diabetes and other serious health issues, including stroke and heart disease.

Since this condition has no symptoms, it can easily go undiagnosed. However, there are risk factors to look for, and certainly ways you can decrease your risk of becoming a Type 2 diabetic. Type 2 diabetes is a major public health issue, and more people need to know they are at risk.

Know the Risk Factors for Prediabetes

The American Diabetes Association (ADA) has guidelines that list a total of 11 specific risk factors that determine if you should be screened for prediabetes. They include:

  • High Blood Pressure
  • High Cholesterol
  • Body Mass Index (BMI) over 25
  • History of Heart Disease
  • Physical Inactivity
  • 1st Degree Relative with Diabetes
  • Over 45 years old
  • Had Diabetes in Pregnancy (gestational diabetes)
  • African-American race
  • Latino ethnicity
  • Asian-American race

bmi-photo

If you’re over 45 and have any of the other risk factors, you should see your doctor. A simple blood test can let you know if you are prediabetic. Unfortunately, most Americans these days have a body mass index (BMI) over 25, not realizing the risks associated with it. If you have a calculator, you can easily figure your BMI. Below is the standard formula. If you are in good shape and have extra muscle, it may be a little off. Nevertheless, it is still a good method and will give you a close estimate.

How to Calculate Your BMI

  1. Figure out how many inches tall you are. (Example: if you are 5’4″ you are 64 inches).
  2. Multiply the number by itself. (Example: 64 x 64 = 4096)
  3. Write the total down and clear your calculator.
  4. Now, punch in your weight in pounds and divide by that saved 4-digit number (For a 125 woman, 125 divided by 4096 = .03051758)
  5. Multiply your result by 703. (.03051758 x 703=21.4538)
  6. Here, 21.45 is the BMI

If the result you get is less than 18.5, you are considered underweight. If your BMI is between 18.5-24.9, you are normal weight. But if your BMI is 25-29 you are considered overweight, and over 29 is considered obese.

No matter how undesirable you find your calculations, don’t despair. Make today the first day of positive changes. It’s never too late to start a sensible diet and exercise plan. Change begins with that first step. Get committed!! Get going!

For guidelines on nutrition and weight loss, discuss your concerns with your doctor at your next annual exam.

by James Haley, MD FACOG, FPMRS

Dr. Haley photo

Dr. Haley

As a physician and fitness enthusiast, I’ve read a plethora of articles, books, and journals on weight loss. My patients continually tell me their struggles with dieting, lamenting that the weight always returns, usually along with a few extra pounds. Personally, I can relate. It’s not a dilemma exclusive to women. Men struggle, too. As you age, you just can’t eat like you used to – even if you exercise regularly.

After reading numerous books and trying different diets myself, I finally discovered an author who not only pinpoints the problem of obesity, but also the answer to those last ten pounds.

In his book, ‘The Obesity Code’, Dr. Jason Fung, a nephrologist, states that the real culprit of weight gain isn’t overeating. It’s excessive insulin. He is emphatic that many of his patients would need less medical intervention if they lost weight. Since most of his patients are Type 2 Diabetics, a disease associated with too much insulin, he has been able to determine the common link – SNACKING.

In the past few decades, the number of times we eat daily has increased. People have gone from eating three meals a day to about six, counting snacks. Go on, admit it. It’s what you do – what I’ve done. it’s a cycle, and it makes sense once you understand the reason why. Every time you eat, you stimulate insulin, keeping it at a constant high level. This fools the body into thinking it’s always hungry. Your body is constantly thinking you are hungry because your insulin stays in a high range.

woman weighing on scaleObesity is a hormonal disease. Insulin, a hormone, tells you how much to eat and how much to burn. The body behaves as if the weight is set on a thermostat. So, obesity is not about caloric imbalance. Thus, it makes sense that the idea of cutting calories is totally wrong.

You may not be obese. Maybe you have a few obstinate pounds that won’t melt – a jiggle around the middle resistant to diet and exercise. ‘Fat’, ‘plump’, ‘chubby’ – whatever you call it, a surplus of insulin is causing it. The longer you have higher amounts of it, the more resistant your body becomes, which produces even more and causes that crazy, never-ending cycle.

So what’s the solution?

  • Avoid insulin-stimulating foods like sugar and refined grains. These are the enemy.
  • Eliminate between-meal snacks.
  • Designate mealtimes.

Meal timing and insulin levels work together to regulate our weight. We need periods of time when we aren’t eating, so insulin can go down, leaving our bodies in energy burning mode. If we leave more time between meals…. we burn energy.

And when we burn energy, we lose weight.

To learn more about the other secret to regulating insulin for weight loss, read here.

 

September 5, 2017
Dr. Haley photo

Dr. Haley

by James Haley, MD, FACOG, FPMRS

I have always had a personal interest in nutrition and fitness, and more so after I became a doctor and needed that knowledge to benefit my patients. After reading volumes of research on these subjects and hearing my patients’ struggles with weight gain, I came across nephrologist Dr. Jason Fung’s book, ‘The Obesity Code’.

Most of Dr. Fung’s patients are Type 2 diabetics, and he explains clearly how obesity is a problem due not to caloric intake, but to constant high levels of insulin in the body retained through frequent eating.

In short, Dr. Fung states that the more often you eat, refueling with snacks between meals, the longer your insulin levels remain elevated. Since insulin is a hormone that tells your body how much to eat and how much to burn, high insulin levels fool the body into thinking you are always hungry. Those messages cause you to eat more, and of course, gain weight.

How do you overcome this vicious circle?

1. Stop Snacking

This is the first step. Avoid especially the sugary and refined, processed foods which make your insulin levels spike and fall all day, perpetuating the cycle of hunger and sluggishness, making you think you’re hungry.

2. Stay Hydrated and Eat Well  

Drink plenty of water and eat healthy foods like vegetables, nuts, salads, fruit and protein-rich chicken and fish, which keep your insulin levels steady.

woman fasting fruit photo3. Fast

Fasting! The word may make you shudder. I’m not talking about a three-week, Gandhi-type fast. Dr. Fung suggests a “mini- fast”: going without breakfast. And yes, this goes against everything you’ve ever been told, that breakfast is the most important meal of the day. You don’t need to do it daily, but skipping breakfast gives your body about 14 hours of fasting from the night before. We need periods of time when we aren’t eating, when insulin can go down, leaving our bodies in energy burning mode. This one step will dramatically lower your insulin, which in turn acts to lower the body’s set weight. You’ll start to feel better, have more energy – and you may just get rid of that last, lingering ten pounds.

4. Consult Your Doctor

Fasting is never recommended for pregnant women, breastfeeding mothers, or people with certain diseases.

If you simply need a jump start to weight loss, try the mini-fasting route and let your body’s insulin levels drop to burn energy. You will be surprised at how much better you feel. Once you change your mindset about food, regulate your insulin, and time your meals, you will see many positive results. Whether you need to lose weight or not, you will definitely have more energy, and hopefully live a longer, healthier life.

To learn more about the other secret to regulating insulin for weight loss, read here.

Sherene Harati after the Teal Trot.If you go to our Canton office, there is a good chance you have met Sherene. Her bright smile and helpful attitude keeps her teammates and patients in high spirits.

What you may not know about Sherene is that she is an Ovarian Cancer Survivor. She was diagnosed in 2014 after getting a second opinion for her PCOS. She felt the doctor she was seeing at the time didn’t take her concerns about her symptoms seriously. When she saw a new doctor she mentioned her symptoms again. This time the doctor recommended an ultrasound.

During the ultrasound they identified a mass. Sherene had just graduated from college and didn’t fit the demographics of the women who usually develop Ovarian cancer, so her doctor wanted to keep an eye on the mass. It would have been easy for her to sweep it under the rug, but her doctor followed up, and Sherene kept all of her appointments.

Sherene lost one of her ovaries, but they caught the cancer early. After completing her treatment, including chemotherapy, Sherene is cancer free. It’s been almost three years and Sherene sticks to her follow-up appointments every few months to make sure she is still healthy.

Sherene’s Take Home Message

Sherene’s biggest message? Listen to your body! If you think something isn’t right, talk to your doctor. It’s okay to get a second opinion, especially if you think you aren’t being heard.

Now Sherene is dedicated to spreading the message about Ovarian cancer. Every year she participates in the Teal Trot 5k in Atlanta. She raises money and awareness and has fun in the park with her friends and family. Sounds like a great day!

 

Sherene kept a positive attitude during treatment.

Sherene kept a positive attitude during treatment.

Still smiling! Sherene participates in her first Teal Trot.

Still smiling! Sherene participates in her first Teal Trot.

Sherene gets the word out about Ovarian Cancer Awareness with teal hair.

Sherene gets the word out about Ovarian Cancer Awareness with teal hair.

August 9, 2017

It often takes longer for women to lose weight.While losing weight can be a challenging feat for both sexes, women have a few additional physiological hurdles from the start that men simply don’t. For women, it may take more of an initial lifestyle change to accomplish weight loss than it would for men.

Don’t worry though. All hope is not lost.

Staying focused on hitting your first health related goals can be empowering and keep you on the right track to shedding unwanted pounds down the line.

You may not come out of the gate dropping pounds left and right like your male counterparts, but in most cases weight loss will even out over time.

Physiological Reasons Initial Weight Loss is Harder for Women

Initially, it can be discouraging for women who decide to lose weight with male friends, family, or partners. It may seem as if you’re male weight loss partner is losing weight with little or no effort while you’re struggling to drop that first couple pounds.

Well, it turns out there’s a reason.

Let’s take a look at some of the biological reasons women have a tougher time getting rid of excess weight and looking slimmer at first.

  • Men have a height and weight advantage over women. Performing even simple tasks requires the body to burn more energy the larger the person is.
  • Men typically have a faster metabolism than women due to testosterone levels. Lean muscle tissue can burn more calories than fat even when resting.
  • Women’s fat stores are often spread throughout the body. It’s more difficult to lose weight when fat stores are spread over the entire body rather than held in one place such as the belly like it often is in men.
  • Women have larger fat stores to help during pregnancy. A perfectly fit woman will hold and extra 6-11% more body fat than a perfectly fit man simply due to biology.
  • Post-workout cravings. After a workout women’s ghrelin levels (the hormone that tells us we’re hungry) increase. Meanwhile, our leptin (the hormone that tells us we’re full) drop significantly. This hormonal fluctuation isn’t as prominent in men after exercise.

Don’t despair. Women have some advantages over men too. For example, women tend to burn more body fat when they exercise than men do.

Pushing Through Physiological Obstacles

Whether you want to commit to dropping a significant amount of weight, restore your optimal body weight after a pregnancy, or just live a healthier lifestyle overall, there are several things you can do to expedite the process.

  • Incorporate strength training exercises into your workout and benefit from more muscle mass too.
  • Focus on healthier post-workout snacks to tame cravings.
  • Banish negative thoughts and focus on the positive to nix emotional eating.
  • Have a balanced workout that includes plenty of cardio (at least 20 minutes a day).

Getting your mind in the right place can be helpful during your weight loss journey as well. One thing you can do immediately is to stop thinking of it as a competition. Celebrate and encourage both parties weight loss achievements equally.

Final Thoughts

Don’t be discouraged if you don’t lose weight as quickly as the men around you. Remember, weight loss isn’t a race. It’s a slow and steady process to regaining your optimal well-being and taking control of your life.

Although guys may have an initial head start, your partner’s weight loss will eventually plateau and you should be on the same page over time.

Losing weight doesn’t need to be daunting. Talk to your health care provider for guidance on how to accomplish weight loss and other health-related goals. Feel free to give us a call regarding any questions you may have through your weight loss journey. We’d be happy to schedule an appointment with your doctor for a consultation.

You’ll soon be on the road to feeling great!

Insecurities, Relationship Issues, and Pelvic Health
dr-litrel photo

If you’re considering vaginoplasty, labiaplasty, or other pelvic surgeries, you probably have a lot of questions – and you should! Dr. Litrel has been performing these types of procedures for twenty years and even has a board certification in Female Pelvic Medicine and Reproductive Surgery in addition to his OB-GYN certification. He believes that the best patients are well informed, and does his best to answer all the questions that come his way.

Here are 10 recent questions he answered on an online forum.

1. I am very insecure about my vagina and the color of it. Is it normal? I’m afraid to have sex.

Your appearance is perfectly normal and does not have any issues that require intervention from a cosmetic surgeon. Your insecurity is normal as well to some degree.  Everyone has some fear about social rejection, the feeling that others will not like or love us. This is really a spiritual issue, learning to love ourselves and love others, growing daily in our abilities in this arena. This is what makes life meaningful and fulfills our purpose in life: love.

When it comes to sexuality –  the sharing of our bodies with another in a pleasurable and intimate manner – the insecurity that one feels can prevent us from extending ourselves in this way.  This is painful because sex and intimacy and pleasure are so important to enjoy life.

But as a doctor who specializes solely in the care of woman, the common problem that women experience is not that they can’t find sexual partners, but rather that they choose the wrong sexual partner. Or too many. For men, in many and most cases sex is the end. Sex and orgasm itself is the goal.

Women like sex and orgasm, too. But for women, sex is really the beginning – the beginning of a powerful and important relationship – and the beginning of New Life (pregnancy). This is why so often women are broken hearted by the way they are treated by men. Men get sex – and eventually leave for someone else.

Thus it’s important for women to choose a partner who is committed to not just his own orgasm and his own pleasure – but one who is committed to you and the future of the relationship that God willing may someday include children.

Bottom line is this: if insecurity about the appearance of your genitals is holding you back from “sex” – when you find the partner who is not just attractive physically but spiritually as well – one who will be committed to you and the future, that person will love you so you will not be so afraid.

So it’s okay to wait to have sex and indeed it’s usually better. It builds a better long term relationship. When a woman waits to have sex not only does the guy think that she’s special, he also thinks that he’s special. And thus the relationship becomes special.

2. Is there any way to make my vagina look new again?

Women sacrifice a lot. Pregnancy and delivery is difficult enough as is raising children.  But the changes that women experience to their bodies are just another painful thing that women must confront. There are office procedures and surgeries that can help you with both sexual function and appearance of your genitalia. As far as specifics are concerned that is something that is tailored to each patients desires and anatomy.

3. Suffering from some mild incontinence and loss of muscle tone in my vagina. Does the Apex M pelvic floor exerciser work?

There are three good things about the apex devices. One is that they can help improve the muscle tone on your pelvic floor and can help with incontinence. Two is that they are done in the privacy of your own home. Three they are safe and won’t hurt you. It’s reasonable to try this before surgery. It’s reasonable to use this afterwards as well.

4. Can any board certified surgeon do a labiaplasty?

I would strongly advise you to wait until you find a specialist surgeon who focuses on labiaplasty. This can be a cosmetic gynecologist or a plastic surgeon. But don’t see someone who does not do a lot of these surgeries. Board certification is about education and passing examinations. But the key is experience and skill rather than diplomas on the walls and initials after your name.

5. Vaginoplasty: Can this surgery be personalized based on size of husband? Do all “holes” end up the same after this surgery regardless of requests?

Your surgery should be tailored to the size of your husband. Sexual issues are usually top-of-mind for women considering vaginoplasty. Thus your experience with your sexual partner is an essential part of the interview, the examination and the performance of the surgery.

6. I recently had vaginal tightening surgery. Is it normal to have a lot of pain afterward?

Everyone responds to the pain of surgery in a different way. Our bodies are different. It’s important to get an examination by your surgeon to make sure that there are not issues. But assuming a normal exam, be assured that everyone will have a different response. Typically by seven to fourteen days patients feel alright. If the pain continues, pelvic floor physical therapy can help. Muscle relaxers can also help if the examination demonstrates tenderness on your pelvic muscles.

7. Would a perineoplasty help with some feelings during sex?

The quick answer is that it will help – some.  Your question shows a sophisticated knowledge of your body and the problems you are having.  Pelvic reconstruction is likely required along with vaginoplasty to give you the tightness you desire. and to correct the anatomic deformities and changes your eloquently describe. There are non-surgical modalities such as ThermiVa that can help. But that may be a waste – it will depend upon your anatomy and the findings on physical examination. Good luck!

8. Can I enjoy sex after my clitoris is removed?

This should not be done for any reason other than the rare presence of cancer.  In some parts of the world there is “female circumcision” where young girls suffer genital mutilation. This is cultural and often the clitoris is not injured in the process. If you are considering a procedure make sure you understand what is being done and why.

9. Is a partial labiaplasty possible?

This is a good question. The truth is that every labiaplasty has to be tailored to a patient’s anatomy and also her desire. So really, you should just receive what it is that you desire rather than a “one size fits all.” Likely you have excess skin adjacent to your clitoral hood or the hood itself is more pronounced than you desire. This is a common problem that can be handled during an office procedure.

10. What are the adverse effects from an overly aggressive labiaplasty?

The Labia Minora come in all sizes and shapes. Our bodies differ. Consider how noses and ears are different sizes and shapes. The main thing that troubles patients with a “botched labiaplasty” is emotional upset with appearance. This can cause issues with sex because if we are not comfortable with how we look then it is more difficult to be intimate with another. There are less common instances when an over-aggressive labiaplasty can cause pain with sex but I would not worry about this. The most important things for sexuality to go well is to be in a loving relationship. This is a loving relationship with another – and also with yourself.

Were you questions among the ones Dr. Litrel answered here? If not, let us know! Ask during your next appointment, or call the office. And you can always check Dr. Litrel’s RealSelf profile where he answers questions about several types of vaginal reconstructive surgery and female pelvic health.

July 28, 2017

by James Haley, MD, FACOG, FPMRS

Dr. Haley photo

Dr. Haley

Below are the 7 FAQ’s about Hormone Replacement Therapy I’ve encountered in twenty-five years being an OB-GYN specializing in women’s health. The truth is, the real facts about Hormone Replacement Therapy (HRT) are hard to find! They are submerged in an ocean of misinformation surrounding women’s hormones, available hormone types, and ideas about what is “healthy” and “unhealthy” for women as they experience the sometimes confusing, uncomfortable and even painful symptoms of menopause.

Hormone Replacement Therapy (HRT) can help! Here’s what you need to know, summed up in 7 FAQs:

7 FAQ’s About Hormone Replacement Therapy (HRT)

What types of HRT are there?                                    

HRT is most often spoken of, and divided into, two categories:

Traditional

Sometimes referred to as “synthetic,” these FDA approved medications have in the past been the ones most commonly used for hormone replacement. A few of these could be classified as more “natural” rather than synthetic, as discussed below. Names brands can be very expensive, generics can be very inexpensive.

Bioidentical (sometimes referred to by people as “natural”)

These are compounded at special compounding pharmacies. There are some who claim that, because they are more “natural”, they mimic more of what ovaries produce on their own, and the body responds better, with less potential side effects, then with synthetic HRT. Is that true? See note below. Average cost of bioidentical HRT (BHRT) is approximately $30-$45, although it can cost a whole lot more at certain pharmacies. (Your doctor should help you stay away from those.) BHRT is often cheaper, however, then name brand traditional HRT.

Are Bioidentical hormones (BHRT) better?

I believe there are enough good studies that have now been done to be able to say, “Yes, it would appear BHRT is probably better than traditional HRT.”

This has been hard to prove with absolute certainty, and early on some of those involved with BHRT tried to make these claims without any supporting literature. Now there is much supportive literature out there to suggest it probably is the better way to go for hormone replacement. BHRT definitely allows for the greatest ability to create custom therapy best suited for you as an individual. It is very easy, and obviously better, to be able to add/subtract hormones or tweak doses according to individual needs, rather than having just a few doses of certain hormones to choose from in the traditional hormone route.

How do I know what hormones, and in what amounts, are right for me?

That is where the expertise of your Gynecologist comes in. Based on age, history, symptoms, whether you’ve had a hysterectomy, and other factors, one or more hormones will be suggested. On occasion, hormone levels (blood levels typically being the most accurate) will need to be checked, especially early on or after dose changes are made, but the MOST important factor is – how do you feel? Patient feedback is often a very reliable indication of how we are doing with the hormones chosen and the amounts of each.

If I have the following history, does that mean I can’t take hormone therapy?

  • Family history of Breast Cancer
  • Personal history of fibrocystic changes of the breasts
  • Prior breast cysts drained or benign lump removed
  • Smoker

NO, your history does NOT rule out hormone therapy. These are not contraindications.

Will hormone therapy help me with any of the above problems or symptoms?

HRT can certainly help with any of these, but be aware there are other health factors that can be, and often are, creating problems as well. These include underlying thyroid issues, adrenal gland stress or fatigue, food sensitivity/intolerance, gut immunity or imbalance issues, inflammatory issues, or autoimmune disorders.

What is the best way to receive HRT?

Usually through the skin (such as a roll-on gel), or else under the skin. For most women, oral hormone therapy tends to get broken down in the stomach so that less hormone absorbed, and in a less predictable amount. (On an individual basis, someone may find the oral route works better for them, and that is fine.)

How long should I stay on HRT?

Indefinitely! We know menopause starts an accelerated aging process, with all the potential day-to-day problems, as well as long term problems, that were described earlier. Knowing that, would it make sense to use HRT for just a short period of time? No, not at all.  All the benefits a woman gets from HRT will be lost over time once she quits. So, when you make the decision to start HRT, make it for life (unless your doctor gives you a specific reason you need to stop).

One final note, since a woman’s time in menopause and hormone therapy use are very important matters, it is critical that your gynecologist is current on HRT and it is of interest to them. At Cherokee Women’s Health Specialists, all of our physicians are all up-to-date on the most recent information on menopause, as well as all health matters.

Your quality of life is critical, and I urge you to take care of yourself to enjoy your menopausal years and make them the best you possibly can.

Have you read Part One of this series? Here it is: Menopause Part One: 6 Things Every Woman Should Know

by James Haley, MD, FACOG, FPMRS

Dr. Haley photo

Dr. Haley

Menopause facts can be hard to come by, considering that a third – or more – of a woman’s life will be spent in menopause. That is a long time!

They say that with age, comes wisdom, so it is my goal to empower you to make wise decisions about the quality of your life during that phase of your life. Hormone therapy is an important option to consider, a therapy that is becoming more critical for women as their average lifespan continues to increase. I have been helping care for menopausal women for more than 25 years. Over this time, I have seen misinformation or even completely wrong information affect women and keep them from achieving optimal health through hormone use.

To help make sense of this potentially confusing subject, I’ve compiled a list of 6 key menopause facts every woman should know to help you make the best decision possible for you.

  • Women begin to have a decrease in hormone levels starting in their 30’s – 40’s.
  • With decreases in estrogen and testosterone (and in small part progesterone), women start to prematurely age, and a multitude of symptoms and problems will often occur.
  • Most women are candidates for Hormone Replacement Therapy (HRT) and should be on it once they reach menopause.
  • Although there are many over the counter products, herbs, and supplements that claim they can help with the problems a menopausal women experiences, nothing takes the place of estrogen and what it does for a woman. There is nothing that even comes close. Nothing! HRT is it.
  • Many women think that menopause is just the stage during which they experience hot flashes, night sweats, etc. and when those symptoms disappear, they are “no longer in menopause”. Not true! A woman becomes menopausal when her ovaries quit working (or are surgically removed) and is then menopausal (or postmenopausal – same thing) until the day she dies.
  • Estrogen has NOT been shown to increase the risk of Breast Cancer for women. (The combination of estrogen and progesterone, for some women, has been shown to increase a woman’s breast cancer risk slightly. Knowing that, we strongly recommended women on HRT be very diligent about breast exams and mammograms)

What problems can menopausal women experience?

The problems women experience with menopause can be separated into two basic categories. Know that both types can be helped with HRT (Hormone Replacement Therapy).

Day-to-day Symptoms (affect quality of life)

  • Hot flashes
  • Night sweats
  • Fatigue/decrease energy
  • Brain fog
  • Memory loss
  • Loss of focus/concentration
  • Dryness of skin, nails, brittle hair or loss of hair
  • Irritability, anxiety
  • Mood changes, depressive symptoms
  • Bone or joint pain
  • Loss of libido
  • Weight gain
  • Vaginal dryness which can result in pain with intercourse

Long Term Health Issues (can significantly impact lifespan)

  • Protection for your heart (# 1 killer of women)
  • Protection for your bones
  • Decrease risk of colon cancer
  • Good evidence suggests it decreases the risk of Alzheimer’s/Dementia

All of these issues can potentially be helped by Hormone Replacement Therapy (HRT)! Learn all about it in Part Two!

July 27, 2017

Monitoring fetal kick counts can save your baby's life.It’s important for expectant mothers to keep track of their baby’s movements. Not only will it give you reassurance that your baby is healthy, but a lack of movement can be the first sign that something is seriously wrong. In fact, monitoring your baby’s fetal kick count has the potential to save your baby’s life.

Counting fetal movements is easy to do, and can be a relaxing time spent bonding with your little one.

When Should You Start Counting Fetal Movements

Some women can feel their baby’s first kicks anywhere from 16-25 weeks. However, the average for first-time mothers is between the 20-22 week range.

Your doctor will likely suggest beginning to track your baby’s fetal kick counts starting during the third trimester (week 26-27) onward.

Monitoring fetal kick counts are especially important for expectant mothers who have health conditions. If you have diabetes or high blood pressure, for example, your doctor will recommend closely keeping track of your baby’s movements.

How to Track and Count Fetal Kicks

Tracking your baby’s movements is somewhat easy. Following a few simple steps is an easy way to reassure yourself that your baby is okay.

Most babies move at least 10 times within any given 1 hour period.

When checking your baby’s fetal kick count, you’ll need the following tools:

  • A comfortable place to sit or lay
  • A journal
  • A timing device

Start by sitting or laying on your side. Begin your timer and count each movement that your baby makes. These movements could include anything from:

  • Rolls
  • Kicks
  • Jabs
  • Flutters

Once you’ve gotten to 5 of these movements, stop counting and record the length of time it took from the first to the last.

Here are a few additional tips you may want to follow to help you when you are tracking the fetal movement of your little one.

  • Try to count movements at the same time every day.
  • Try evening or after dinnertime. Some babies are more likely to be more active during this time.
  • Write down times in a daily journal for easy tracking. Your doctor may request to see your times during checkups as well.
  • If you choose to lie down while counting, try to lay on your left side. Circulation will be better for the baby.
  • Stop timing after 5 moves.

When To Call Your Doctor

Babies that do not move at least 5 times within thirty minutes should be checked by your doctor. Movement is an important barometer of your baby’s health.

Sudden increase or decrease in baby’s fetal kick count in the third trimester should also be reported to your doctor, especially if you have health concerns that put you at a high-risk pregnancy.

If your baby doesn’t move within the half hour, don’t panic. Your baby could simply be sleeping. Instead, get up and move around for a few minutes. Grab a bite to eat or drink. After half hour, if your baby still doesn’t seem to be moving, call your doctor immediately. Letting your doctor know that your baby is not moving enough can save their life.

 Other Indicators That Require a Call to Your Doctor 

  • Rupture of membranes (Water breaking)
  • Contractions every 2-5 minutes (more than 5 per hour)
  • Cramps in the lower abdomen with or without diarrhea
  • Temperature over 100 degrees
  • Vaginal spotting or bleeding

Final Thoughts

Monitoring your little one’s fetal kicks can potentially save your baby’s life. If you’ve got questions or concerns regarding your baby’s movements or would like to schedule an appointment to discuss these techniques with your doctor, feel free to give us a call. One of our helpful staff members would be happy to assist you with your needs.

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“Dr. Litrel was a fantastic doctor. I had my first exam with him, although at first I was skeptical about a male doctor for my GYN. But after I met him I’m glad I kept an open mind, and I couldn’t have dreamed up a better doctor. He cares about you as a person and not just a patient. The front desk ladies and nurses were very friendly and it’s a great office, very clean and not intimidating. I highly recommend Cherokee Women’s Health.”
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