Voted "Best OB-GYN" in Towne Lake, Woodstock and Canton Voted "Mom-Approved OBs" by Atlanta Parent magazine readers


August 9, 2017

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:


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.

July 26, 2017

Stock up on healthy must have products for summer.Choosing safer sunscreens, bug repellents and hydration products can be a daunting task with aisle after isle of options.  Of course, you want your friends and family to enjoy the great outdoors this summer, but worrying about sun exposure, bug bites, and possible mosquito and tick spread diseases can put a damper on the day faster than a black cloud.

Many products on the shelves these days are chemical ridden and loaded with synthetic ingredients that can be harmful to your body.

Let’s take a look at a few key ingredients to avoid when shopping for summer necessities such as sunscreen, bug repellent, and hydration products. Opt for a few of the safer environmentally-friendly alternatives on our list for a worry-free day of fun in the sun.


Sunscreens are designed to protect your family from harmful radiation from the sun’s UV rays. However, not all sunscreens are created equal, so we’ve created this list of what to avoid and what to seek out when keeping your family protected this summer.

Ingredients to Avoid in Sunscreen

Most sunscreens use the help of synthetic ingredients that are designed to absorb into your skin and block UV rays. However, occasionally these chemicals can lead to adverse reactions ranging from minor skin irritation to tumors.

When shopping for sunscreens, try to avoid anything that has the following chemicals.

  • Vitamin A (Retinyl palmitate/ retinol). Vitamin A can be helpful when ingested, however, when applied to the skin, it has been known to produce tumors and lesions sooner than products without.
  • Oxybenzone. You’ll find this ingredient in many sunscreens on the market. This chemical helps other active ingredients penetrate the skin and can disrupt the hormone system.
  • Octinoxate. This chemical can produce free radicals that can damage the skin.

Sunscreens with bug repellents should also be avoided. Instead, use separate products and apply bug repellent beforehand.

Sprays should be avoided whenever possible. They may seem like a good idea for easy application but they can release harmful-to-breathe chemicals in the air.

Family Friendly Ingredients in Sunscreen

When sourcing sunscreen for your entire family, there are several things you should take into consideration before you buy.

Typically, SPF 15 is recommended for families that plan to spend a good amount of time in the sun. If you or your loved one has especially fair skin, you might want to think about SPF 30 or higher.

UVA protection is also important when it comes to sunscreen. Unfortunately, sunscreens don’t label their bottles based on UVA protection. Instead, you’ll have to take a look at the active ingredients list. Look for one or more of the following active ingredients to determine if your sunscreen will give you adequate UVA protection.

  • Zinc oxide
  • 3% Avobenzone
  • Mexoryl SX
  • Ecamsule

Keep in mind, choosing the correct sunscreen is only half the battle. Using it correctly is also vital for protecting your skin. Re-apply sunscreen often, especially if you’ve been in the water longer than 20-30 minutes.

Bug Repellent

Bug repellent has become a summer necessity, especially with all the mosquito and tick diseases floating around. Choosing to protect your family from itchy bug bites may seem like an easy decision, but before you go out and spray down, you should learn about what you’re putting on your skin.

Ingredients to Avoid in Bug Repellent

Always remember that bug repellents are harmful chemicals and should be used with caution. Spray repellents on clothing rather than directly on the skin when possible.

Keep bug sprays and chemicals out of reach of young children.

Avoid using outdoor ‘foggers,’ candles, or aerosol sprays that can release chemicals into the air. These chemicals often get the job done, however, they can be harmful to you and your family to breathe in, as well as for the environment.

While DEET is an effective bug repellent, anything over 30% is considered excess unless in extreme circumstances.

Safe and Effective Ingredients in Bug Repellents

Instead of looking for a name brand bug repellent, there are certain active ingredients you should be aware of. Take a look at some of the safe and effective ingredients below and experiment to find your favorite.

  • Picaridin
  • IR3535
  • DEET (30% or below preferred)
  • Oil of Eucalyptus (Or Synthetic version PMD)

Each of the above ingredients has been shown to be effective at keeping bugs at bay while remaining safe for your family.

Hydration Products

Everyone knows the importance of staying hydrated throughout the hot summer months. Many people don’t realize just how much sun they’re getting or how much water they lose through sweat which can make the risk of dehydration all the more dangerous. However, there are right and wrong ways to beat the heat.

Ingredients to Avoid in Hydration Products

The first thing many people go to when quenching their thirst on a hot summer day is a sports drink. The common misconception is how healthy sports drinks are. The truth is, they are often loaded with sugars, high fructose corn syrup, and artificial dyes.

While electrolytes are great for replenishing water after a long day of sweating and expending energy, the majority of people don’t workout hard enough to need electrolytes replenished. Instead, you wind up consuming an overabundance of sodium.

If you’re going to use a sports drink to re-hydrate, be aware of what you and your family are consuming. Read the labels and choose accordingly.

Alternatives to Hydration Products

The best alternative to sports drinks and sugary sodas is plain water. However, if water doesn’t get you excited, you can supplement yourself in other ways.

Fruits and vegetables are an excellent source for hydration for adults and children alike. Try some of the following fruits and veggies that have high water content for a happy, healthy summer.

  • Coconut Water
  • Oranges
  • Mango
  • Celery
  • Cucumber
  • Carrots

Final Thoughts

Many summer products you’ll find can contain harmful ingredients to either your family or the environment. We hope with the help of this guide you’ll be able to make healthier decisions about the products you choose for your family this summer.

With a little research, sourcing sunscreen, bug repellent, and hydration products that will suit your family’s needs should be relatively easy. If you’d like to learn more about healthier options for your loved ones, feel free to give us a call.

Our friendly staff is always happy to answer any questions you may have or schedule an appointment to discuss your summer health goals.

July 12, 2017

Menstrual cramps have many treatments and potential remedies.Women have been debating for centuries on the best ways to treat their period cramps. Fortunately, you no longer have to rely on ‘old-wives-tales’ for dealing with pain associated with cramps. Instead, you can make informed decisions based on medical evidence.

While every woman’s body responds differently to each of the methods below, you’re certain to find at least one that works for you. Once you do, stick with it and take control over your life again.

Dull throbbing pain, sharp pains that take your breath away or even nausea and radiating lower back pain can be resolved by simple changes to your routine.

Lifestyle Changes to Treat Period Cramps

Making proper lifestyle changes can help lessen the pain associated with menstrual cramps. Adding diet and exercise to your daily routine is one of the best ways to alleviate pain and stress that comes with your monthly cycle.

Let’s take a look at some of the best ways to incorporate lifestyle changes into your routine so that you’ll be able to get through your period with reduced cramping.

Foods for Cramps

Some of the best foods to help treat cramps due to PMS are loaded with healthy fats and lots of water. Before and during your period, your uterus begins to contract and prepare to dispel its lining. During this time you’ll experience cramping but there are certain dietary changes you can determine the level of pain you feel.

When shopping for foods that will lessen the severity of your menstrual cramps, try some that contain higher levels of the following:

  • Vitamin E
  • Omega-3 Fatty Acids
  • Vitamin B-1 (thiamine)
  • Vitamin B-6
  • Magnesium

Let’s go over a few specific foods that are ideal for eating during PMS and throughout your menstruation that keeps you feeling as good as possible. Foods that are low-fat and high-fiber are going to be your best bet.

  • Whole grains
  • Lentils and beans
  • Fruits
  • Nuts
  • Dark leafy vegetables
  • And of course, don’t forget to load up on lots of water!

Remember, avoiding alcohol and tobacco during your period is another great way to reduce hurting from cramps. Comfort foods that contain high levels of salt or fat can also have adverse effects on cramps.

Exercises for Cramps

Some studies have shown that physical activity can combat hormone-like substances that can cause cramps. Many exercises can also help alleviate muscle tension and reduce inflammation which can lessen the severity of your period cramps.

Any exercises that deal specifically with your ‘core’ are ideal for stretching and relieving painful cramps. For example, there are many yoga poses that don’t have to be strenuous to be effective.

Physical activity also releases endorphins that make you feel good overall. So, why not? Take a spin class or walk to work during your period.

Other Home Remedies for Menstrual Cramps

There are several things you can do at home before seeing a doctor to get your menstrual cramps under control and take your life back. Today we’ll go over a few traditional methods, along with a couple alternative ways to reduce pain associated with cramps.

  • Over the counter medicine. Taking anti-inflammatory pills or medication designed to reduce pain such as Ibuprofen (Advil/Motrin), Aspirin (Tylenol), or Naproxen (Aleve) can combat your PMS symptoms.
  • Apply heat. Heat works in several ways to reduce your pain. It relieves muscle tension and relaxes your entire body. Take a long, hot bath, or apply a heating pad/patch to your lower abdomen for optimal results. Many experts agree that heat may be just as effective for treatment of cramps as over the counter medication.
  • Elevate legs. Lay on your back or side with a pillow supporting and elevating your legs from the knee up.
  • Try pads instead of tampons. During the most painful times of your menstrual period, you may want to consider using a pad as opposed to a tampon to prevent additional pressure.
  • Acupuncture or acupressure. Many women swear by these treatments for their period cramps. Always, consult an expert when attempting alternative treatments for cramps such as these.

It’s important to remember, there’s no one way to treat cramps for every woman. Find the treatment that works for you and stick to it!

When to See a Doctor for Your Cramps

While most women won’t need to see a doctor for their cramps, there are several instances that require attention. For example, if your period cramps are so unbearable that they are affecting your daily life, it may be time to speak with your doctor.

Generally, lifestyle changes such as diet and exercise or over the counter medicine provide enough relief that you will never need to see your OB/GYN. However, you should seek medical attention as soon as possible if you’re experiencing any of the following issues.

  • Cramps that last longer than your period.
  • Menstrual cramps that take over your life.
  • Cramps that become progressively worse.
  • Home remedies are having no effect on the severity of cramps.
  • Women over the age of 25 who recently started to have severe cramps due to period.

Your doctor may find that the cramps you have are related to an underlying disorder. In most cases, they will offer you a prescription drug for pain, or a hormonal birth control to reduce symptoms. However, for severe problems, surgery may even be required to correct the issue.

Final Thoughts

Experiencing monthly cramps that take over your life isn’t something that you should have to deal with. Use some of the above home remedies to alleviate stress and pain due to cramps and take back your life.

If you’re concerned about the severity of your cramps before or during your period, don’t hesitate to give us a call. Our staff is more than happy to answer any questions you may have and schedule an appointment with your OB-GYN.

July 11, 2017

It is usually safe for a couple to have sex during pregnancy.It’s completely normal to be worried about protecting the health and safety of your developing baby. Many couples, especially first-time parents, worry about how pursuing intimacy in their relationship will affect the little one growing inside mama.

Which brings us to the age-old question. Is sex safe during pregnancy?

The simple answer is yes, for normal pregnancies sex while your pregnant is fine. However, there are a few things you should be aware of before jumping into the sack.

Change in Your Libido

While some women crave sex during pregnancy, it’s the last thing on other women’s minds. Pregnancy can affect your body in ways you’d never expect. So, based on your hormonal functions, you may not be in the mood.

Some things that can have an effect on your libido early on during pregnancy include:

  • Fatigue
  • Nausea
  • Breast tendency

Later in your pregnancy, things such as weight gain, and back pain can dampen your enthusiasm for sexual intercourse.

Keep in mind, your partner can be affected by your pregnancy as well. Their desires may be toned down to fatigue, or simply anxious about hurting the baby during intercourse.

When is Sex Safe During Pregnancy?

For the most part, sex during pregnancy is completely safe for everyone involved. Your developing baby is protected by both the amniotic fluid in your uterus and the strong muscles of the uterus itself.

Sexual activity won’t affect the baby in the least.

You may be wondering about alternative forms of sex as well. While some alternative sexual activities are completely safe for both you and baby, others might be more detrimental to your health.

  • Oral Sex. When receiving oral, make sure your partner doesn’t blow air into your vagina. In some rare instances, doing so can block a blood vessel (air embolism) which can be harmful to both mother and baby.
  • Anal Sex. Vaginal sex should be avoided directly after anal sex to prevent infection-causing bacteria from spreading from the rectum to the vagina. Occasionally, pregnant women may find anal sex uncomfortable due to pregnancy-related hemorrhoids.

If you are pregnant and plan to have sex with someone you are not in a monogamous relationship with, using condoms is recommended to protect against possible transmission of STDs.

Any sexual position that you feel comfortable is completely safe. However, towards the second trimester, you’ll likely feel more comfortable in positions that are not directly putting pressure on your back.

When is Abstinence Recommended?

During your final weeks of pregnancy, your doctor may suggest abstaining from sex. Both female orgasms and semen can stimulate contractions. This is due to the release of a chemical called prostaglandins which is said to trigger contractions when you’re close to your due date late in the third trimester.

If you have a history of pre-term labor or have any of the following conditions your doctor will likely recommend practicing abstinence during the remainder of your pregnancy.

  • Vaginal bleeding
  • Leaking amniotic fluid
  • Carrying multiples
  • Placenta is covering (partially or completely) the cervical opening

Sex with a partner that has been diagnosed with an STD or STI should be avoided due to possible risk of your or your baby contracting the STD. At the very least, it’s important to use protection as always when any sexual activity with a person that has been diagnosed with any STD.

Final Thoughts

While usually, sex is safe during pregnancy. However, there are certain conditions that may require abstinence. Experiment with a mixture of positions throughout your pregnancy that offer the most support and comfort during sexual activities.

Don’t hesitate to give us a call to schedule an appointment with your doctor. Our caring staff is always available to answer any questions or concerns via phone regarding sexual intercourse during your pregnancy as well.

July 10, 2017

The first gynecology appointment is important for teenage girls.Visiting the gynecologist is an important part of the aging process for young women. Your doctor will give you vital information on how to stay as healthy as possible as well as giving you an overall checkup.

There are three main reasons that parents should take their young girls to a gynecologist.

  • Information: During your visit, you’ll learn about your body and how to maintain a healthy lifestyle whether you’re sexually active or not.
  • Prevention: Your doctor will look for signs of underlying issues that could affect you later in life.
  • Treatment: If you’re experiencing problems with your menstrual cycle, pain, or reproductive problems, your OB-GYN can look into why the problem is occurring and find a treatment.

A gynecology appointment can be nerve-racking for young girls who don’t know exactly what to expect. Being nervous is completely normal. However, once your exam is over, you’ll likely be wondering what all the fuss was about.

When Should You Schedule Your First Appointment?

Typically, a first appointment is recommended by OB-GYNs for girls between the ages of 13 and 15. This gives the doctor plenty of time to answer questions regarding sexual health, menstruation, and other concerns confidentially.

What to Expect

Doctor explaining to a teen what to expect from her first GYN appointment.At the beginning of your first gynecology exam, your doctor will sit down with you and just talk. It’s important to be open and honest when speaking to your OB-GYN so that they can give you the best medical care possible.

They will ask you questions regarding your health. Among others, some items you can expect to be brought up include:

  • Your menstrual cycle
  • Sexual activity (Including oral, vaginal, and anal sex)
  • Acne
  • Weight
  • Sexuality
  • Birth control
  • STIs (Sexually transmitted infections)
  • Emotional ups and downs

If you’re concerned about confidentiality, ask your doctor beforehand. In most cases, everything you disclose can be kept between you and your doctor.

Your first gynecology appointment will consist primarily of two exams. Both are important to your overall health.

Unless your OB-GYN feels it is vital, a pelvic exam will not be part of your first gynecology exam. Generally, pelvic exams are recommended starting at the age of 21.

Remember, if you feel uncomfortable during any portion of your gynecological visit, you can ask for a nurse or family member to be present as well.

General Physical Exam

During the general physical portion of your visit, your OB-GYN will give you a routine checkup-similar to what any doctor would. This part of the exam is designed to catch any general health problems that can easily be corrected. Doing so, some of the things your doctor will record include:

  • height
  • weight
  • blood pressure

The general physical exam is usually performed before the external genital exam. It allows the patient to become more comfortable with the doctor so they can be prepared for the next portion.

External Genital Exam

Although many young women stress about this part of the exam, it usually only lasts a few minutes. Not only does this part your first gynecology appointment let your doctor know how you’re physically doing, but it gives you much-needed knowledge about your own body.

Your OB-GYN will examine your vulva to ensure your overall health is in order. They may offer you a mirror so you can see it as well. You’ll learn the names of different parts of your body and where they are located.

Again, if you don’t feel comfortable doing this portion of the exam alone, you’re free to ask for a nurse or family member to be present.

Vaccinations You May Receive

Your doctor may ask you (or your parents) if you’ve been vaccinated or immunized to protect against certain diseases.

The following vaccinations are given on a routine basis to young women ranging in age from 11-18 and may be administered during your gynecologic exam.

  • Tetanus–diphtheria–pertussis (Tdap) booster
  • Human papillomavirus vaccine
  • Meningococcal vaccine
  • Influenza vaccine (yearly)

In addition to routine vaccines, special vaccines may be given to young women who are at an increased risk for certain diseases. These include:

  • Hepatitis A virus vaccine
  • Pneumococcal vaccine

What to Talk About During Your Appointment

Remember that your appointment gives you a  safe place to talk about anything and everything regarding both your physical and emotional state. Use this opportunity to speak confidentially to your OB-GYN for accurate answers.

Before going to your appointment, think of a list of questions you’d like to ask. Your doctor has heard it all, so if something is concerning you, don’t let your embarrassment or nervousness get in the way of your well-being.

Final Thoughts

Parents and young women should go into appointments with as much knowledge as possible. Your first gynecology appointment doesn’t have to be scary if you know what to expect.

The thought of a gynecologic exam can seem weird or uncomfortable at first but it’s a normal part of taking care of yourself as a woman.

Call to schedule an appointment with an OB-GYN today and one of our helpful staff members will be happy to assist you. Feel free to ask any questions regarding your first visitation beforehand so you can be as prepared as possible.

June 22, 2017

cwhs officePatients travel from across the country to Canton, GA, in north metro Atlanta to have surgery with Dr. Michael Litrel at Cherokee Women’s Health Specialists.

We are committed to ensuring your experience with us is safe, comfortable and convenient so we have provided the following information to assist out of town patients with transportation, accommodation and what you can expect before and after your surgery. And because you may have some downtime between your pre-op appointment and your surgery, we’ve also included links to stores and activities in the Canton area.

Please follow the instructions to prepare for your surgery with Dr. Litrel if you live outside the Canton/Atlanta area.

Contact Our Office
The first step for out of town patients is to contact our office to schedule a phone consultation with Dr. Litrel. If you have photos to provide for the consultation, you’ll be given a secure designated e-mail address to send the photos so that Dr. Litrel can review and understand your surgical needs.

Following your consultation, you’ll be contacted by our scheduling team to set up a preoperative examination appointment and your surgical date. 

Traveling to Canton
If you are flying to Atlanta, we recommend that you fly into Hartsfield Jackson International Airport, located about one hour from our Canton office. Once you arrive, you may choose from several transportation options. We have provided helpful links for you below.

Car Rental
Shuttle / Limo Services
Uber / Lyft

hampton-inn-and-holiday-inn-photosYour Accommodations
While staying in Canton, we recommend Hampton Inn or the Holiday Express Inn, where you will receive a reduced rate on your room during your stay, as a patient of Cherokee Women’s Health. It’s conveniently located off I-575 and within just three miles of our office, Northside Hospital Cherokee, several restaurants, shopping areas and more.

Hampton Inn
710 Transit Avenue
Canton, GA 30114

Holiday Inn Express
713 Transit Ave
Canton, GA 30114

Your Pre-Op Appointment
Your pre-op appointment will typically take place the day before your surgery. During this appointment, Dr. Litrel will examine you, explain again what to expect during your surgery, discuss what your recovery will be like, and answer any questions you may have. Rest assured, you will be able to contact Dr. Litrel with any issues or questions before you arrive – and after you depart.

Checking Into Your Hotel After Your Pre-Op Appointment
The check-in time at both Hampton Inn and Holiday Inn Express is 3 pm. However, as a patient of Cherokee Women’s, they may be able to accommodate an earlier check-in. If desired, please give them a call.

When checking in, be sure to tell them that you are a patient of Cherokee Women’s and that you will be receiving surgery at either our office or at Northside Hospital Cherokee to ensure you receive the reduced rate.

If you’re unable to check-in immediately after your pre-op appointment, we’ve provided several links to restaurants, shopping and other nearby activities below.

After Your Surgery
We want you to be as comfortable as possible so after your surgery, you will return to your room where you can rest in private. If you have arrived for your surgery alone, a Medical Assistant will provide transport from our office to the hotel. That evening, our nurse will come by to check on you. The following morning, Dr. Litrel and his medical assistant will do a post-op visit to ensure everything is going well and answer any additional questions or concerns you might have.

Canton Restaurants, Shops and Activities
You may want to get out and explore during your downtime so we’ve provided the following list for your convenience.

A wide range of restaurants are located within a mile or two of your hotel. For upscale dining, Downtown Woodstock is just ten minutes away, featuring award winning restaurants such as Century House, Vingenzo’s and Salt Factory Pub. If you prefer to stay even closer to your home away from home, Cracker Barrel is a one-minute walk from the hotel.

outlet-shoppes at atlanta photoShopping – Target, Kohl’s, Belk and Publix are just a few of the stores that are minutes away from Hampton Inn. The Outlet Shoppes at Atlanta is a short 10-minute drive south on I-575, and Downtown Woodstock just beyond offers a pedestrian-friendly downtown district. There you’ll find unique galleries and shops nestled among outstanding restaurants, bars and eateries.

Parks and Attractions
Greenprints Trail in downtown Woodstock begins in Woodstock’s Sculpture Garden at Elm Street and takes you through tree-lined green space through “Woofstock” Dog Park and beyond to the scenic local Noonday Creek. Elm Street Cultural Arts Village offers award-winning musicals, concerts and local improv talent.

Heritage Park has beautiful, open walking trails and is located just past our office, next to the YMCA.

Tanglewood Farm is a 10-acre petting zoo with more than 150 rare, miniature and heritage breed farm animals in a Wild West Town setting.

Gibbs Garden is 220 acres of beautifully landscaped gardens surrounded by forest, ponds, streams, waterfalls and bridge crossings. It is located about 30 minutes from Hampton Inn in nearby Ball Ground.gibbs-gardens photo

For more activities and information about Canton and the surrounding areas, visit Georgia Tourism and Travel.

Thank you again for choosing Cherokee Women’s Health Specialists. Please call us at 770.720.7733 to let us know if there is anything further that we can assist you with.

woman eating healthy before getting pregnantYou’re considering getting pregnant! Mentally, you’re beginning to commit to the idea, so one of the first few questions you might ask yourself is, “What can I do before getting pregnant? How can I be sure my baby will be healthy? Is there anything I can do ahead of time to make sure everything goes right?”

While the physical part of creating new life is pretty simple to comprehend, but many women don’t actually consider that there are ways to prepare their bodies for reproduction well ahead of time. Even if you’re not ready to conceive right away, there’s lots you can do before getting pregnant, and most of it is pretty basic.

When you leased your very first apartment, you wanted everything to be just right. Before you even moved in, you eagerly imagined how you would decorate it. You carefully selected the best furniture and matching accessories you could afford. You thought of where you would put your bed and bought food for the refrigerator and pantry. Everything was positioned just right for the new home you were to live in.

When you get pregnant, your body is going to be your baby’s ’apartment’ for approximately the next 280 days. Your womb (uterus) will be its bedroom, the amniotic sac will be its bed and the umbilical cord will be its fridge and pantry. Why not prepare your body to give your child the best possible home until its first ‘lease’ is up? There are steps you can take to make that happen.

Long before the actual union of sperm with egg, there are numerous measures you can take to optimally prepare your body. You can make gradual, positive lifestyle changes in the months preceding pregnancy. Some of these include:

Diet: If you haven’t done so yet, begin incorporating more fruits, fiber, and vegetables into your daily meals. Cut out excess fat, sugar, and caffeine. Eat junk food in moderation. Eliminate as many additives and preservatives as possible from your food by carefully reading labels and avoiding those with a long list of ingredients that you need a Hubble telescope to read or a scientific dictionary to translate.

• Exercise: Getting into the habit of walking even a block or two regularly can strengthen bone, muscle, circulation, tissue, blood and organ function, benefiting not only your own overall health but that of your future baby as well.

• Lose weight: If you are overweight, slowly shedding those extra pounds and achieving your ideal weight during the months before conceiving ensures a much better chance of becoming pregnant and carrying full term. The same holds true if you are underweight and need to bulk up a little. A healthier weight will also allow for an easier labor and delivery.

• Eliminate toxins: It’s no secret that smoking is dangerous to both you and those around you, so it stands to reason that it can be disastrous to the fetus growing inside you as well, Smoking while pregnant can deprive the fetus of oxygen, compromise heart rate, and result in premature birth or low birth weight. It can also increase the chances of miscarriage, birth defects, and stillbirth. Studies show there is a higher risk of Sudden Infant Death Syndrome (SIDS) in babies whose mothers smoked. Even exposure to secondhand smoke can have an adverse effect on your baby. Quitting before conception should be one of your top priorities. This also applies to excessive alcohol intake and any recreational drug use. Prescribed or over the counter medications should be discussed with our doctors before you become pregnant.

• Birth control: Ovulation can be calculated easier when you have had at least one normal menstrual cycle before getting pregnant. Though it’s not absolutely necessary to stop taking birth control months before you plan to get pregnant, this is something that should be discussed at your preconception counseling session with us, especially if you are currently using a long-lasting form of birth control, such as progestin, which may inhibit fertility for several months.

• Preconception counseling: Preconception counseling can evaluate, test for, diagnose, and determine any problems that may be a setback to a full, healthy and safe pregnancy for both mother and child. Your preconception counseling session with us will delve into a much more thorough list of steps you can take to make your future pregnancy as safe, smooth and healthy as possible. Ideally, it is best to book an appointment with us to discuss your plans approximately three months before you wish to conceive. At Cherokee Women’s Health Specialists, we are committed to giving you the best possible preconception care available to women today in order to ensure the optimum health of both you and the baby you are planning to have.

These are only several of the many things you can do before you decide to get pregnant. Our comprehensive staff includes Female Pelvic Medicine and Reconstructive Surgeons (FPMRS), urologists, nutritionists, OB-GYNs, physical therapists and midwives. Their combined decades of experience and expertise can guide you through the preconception process, pinpointing any problems that may inhibit or be detrimental to your pregnancy. They can correct any physical abnormalities that may be hindering the process as well. Your reproductive health and the wellness of your future baby is our primary concern. No question is too trivial or embarrassing, and you will be treated with the utmost respect and confidentiality.

To book an appointment, please call our clinic at 770.720.7733.

Request a Consultation

Recent Posts



“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.”
– Vicki