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May 3, 2018

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 preconception appointment

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. For any additional questions or concerns, or to schedule your preconception counseling appointment, call us at 770-720-7733.

 

 

September 26, 2017

Can post pregnancy exercise help a woman get back to her post-pregnancy weight.If you’re like many new moms, you’re ready to shed that extra baby weight… and now! It’s a perfectly natural feeling but if you’re not careful it can lead to a never-ending cycle of harmful weight loss that doesn’t last.

There is hope, however.

A healthy combination of nutrition and exercise can get you back to pre-baby weight in a matter of mere months. Be sure not to rush it though. Remember, it took 9-months to get to where you are now. Don’t expect lasting weight loss to happen overnight.

Incorporate Exercise into Your Daily Routine

Exercise can be a wonderful tool for new moms for many reasons. Physical activity can help reduce stress and help you sleep while keeping your muscles and bones strong.

Before starting a new routine, take care to get proper guidance on what to you can expect from your post-baby body. Heading to the gym for a workout right away can be harmful to your body, especially if you’ve had a c-section.

So what can you do?

  • Start slow. Having a newborn doesn’t leave you much time for anything, much less exercise. Try incorporating 30 minutes of walking into your daily routine broken into short 10 minute breaks as you can.
  • Incorporate strength training into your routine. Strength training with medium to light weights can help increase bone density as well as building muscle.
  • Don’t go it alone. You’re more likely to stick to an exercise program if you’ve got support from friends, family, or other new moms. Try joining a gym that has classes dedicated to new mothers.
  • Avoid jumping into old routines. Instead of worrying about what you could do before your pregnancy, focus on what your body can handle now. While you’re pregnant your body releases hormones that loosen your ligaments, making giving birth easier. It can take time for them to get back to normal.

Remember, don’t start any exercise until you feel ready. Women that have had c-sections or complicated births should consult a medical professional before starting any exercise programs.

Create A Healthy Diet Plan

Although exercise plays a strong role in meeting your weight loss goals, healthy nutrition is a primary factor for lasting weight loss. No matter how much you workout, exercise does not counteract an unhealthy diet.

It’s often hard to eat right when balancing life with a newborn. But it doesn’t have to be.

Try some of the following tips to get on the right track for reclaiming your body through healthy eating.

  • Eat at least 1,800 calories a day, especially if breastfeeding. Avoid crash diets. Pushing yourself to the max can leave you stressed which actually promotes weight gain.
  • Stock up on healthy snacks. Noshing on foods like sliced fruits, veggies or wheat crackers throughout the day is a healthy way to keep cravings at bay.
  • Choose a well-balanced variety of foods. Stick to foods high in the nutrients you need while low in calories and fats. Try a variety of lean meat, chicken, and fish as your primary source of protein to keep your energy levels up.
  • Drink lots of water. Not only does water keep you feeling full but some studies have shown that water can also aid in speeding up your metabolism.

When you were pregnant you likely changed your eating habits to support your baby’s growth and development. Making the change back to your old routine can seem daunting. Seek support from friends, family, or other new moms when necessary.

Final Thoughts

Don’t be afraid to ask for help with your post-baby weight loss. Every woman and every situation are unique. Here at Cherokee Women’s Health, we have a medically supervised weight loss program designed especially for women.

We can help nursing moms like you find a sustainable diet plan. Feel free to give us a call to learn more about our weight loss programs tailored just for you.

October 12, 2016

If your pregnancy has been defined as high risk, there is no need to panic. The truth is, all pregnancies on some level are high risk; to grow another human being inside your body is a significant event! A high risk pregnancy status is a precautionary determination to make sure that any pre-existing risk factors you have, along with any you may develop during your pregnancy, are monitored closely to ensure both your baby’s safety and yours.

Our obstetrics team has successfully delivered over 10,000 babies, many of those deemed high risk. We’re trained to detect and evaluate situations hazardous throughout gestation, and equipped with the technology to do so.

Most of all, our tenet is to treat every pregnant patient the way we would want our loved ones treated.

What Is Considered a High Risk Pregnancy?
There are many factors that can designate a pregnancy as high risk. Some medical, physical or genetic influences may predispose you to being susceptible to certain problems. These are:

    • High blood pressure
    • Being overweight or underweight
    • Diabetes
    • Cancer
    • High blood pressure
    • Heart, lung, or kidney disease
    • Epilepsy
    • Alcohol or illegal drug usage
    • Age (under 17 or over 35)
    • Multiple births
    • History of miscarriage
    • Family member or previous child with Down syndrome
    • Infections such as HIV, chicken pox, rubella, toxoplasmosis, hepatitis C, syphilis
    • Certain medications
    • Chronic health issues such a lupus, asthma, rheumatoid arthritis, heart valve abnormalities or sickle cell disease
    • History of preterm labor or preeclampsia.

What Can You Do For Me If I Have Any of These High Risk Pregnancy Markers?
The first step is to establish a trusting relationship with you, taking the time to answer all your questions and concerns.

In many cases, just a few lifestyle modifications can ensure a safe, healthy pregnancy. Some of these changes can be as simple as speaking to our diet and nutrition experts, who will counsel you on a food and supplement regimen appropriate for your specific needs. We may schedule more frequent prenatal visits so that we can carefully monitor your progress, taking immediate steps to treat whatever problems might occur.

high risk pregnancy photoYour blood pressure will be watched closely. Blood and urine tests will be taken during every prenatal visit, along with any physical examinations or scans that may be indicated.

Our high risk obstetric specialists will evaluate any medications you might be taking, making adjustments as necessary to protect you and your child. If you suffer from pre-existing chronic conditions, we will work with you to minimize any arising difficulties.

We may monitor your pregnancy more frequently with ultrasounds and fetal monitoring.

Finally, we screen for genetic abnormalities, providing information, counsel, and advice if required.

If My Pregnancy is Normal, With No Pre-Existing Conditions, Will it Stay That Way?
Usually, but not always. This is why prenatal care appointments are so important for both you and your baby. You can develop complications at any time, placing you into a high risk pregnancy category. Again, don’t become alarmed. Our specialists have combined decades of experience and training to deal with that if it happens, and the earlier we detect something, the better. Here are some of the things we look for:

  • Gestational diabetes mellitus (GDM or gestational diabetes): High blood sugar sometimes develops during pregnancy, causing headaches, depression, high blood pressure, hydramnios (increased amniotic sac fluid), and birth defects. It can also increase the danger of preeclampsia and premature labor. Babies can grow too large, resulting in a need for a caesarean, and they may suffer from jaundice and low blood sugar after birth. We screen for this between your 24th and 28th week- earlier if your history warrants it.
  • Preeclampsia: Preeclampsia causes persistent high blood pressure which can lead to organ damage and seizures, possibly requiring medication and/or early delivery. Routine urine testing at every prenatal visit can detect this, alerting us to rigidly monitor your progress.
  • Rh factor: Rh is an inherited protein found in some blood. If yours differs from your baby’s, difficulties may arise. We routinely test for this incompatibility to safeguard the well-being of the fetus.
  • Bleeding: Though not all bleeding is dangerous, if you’re deemed a high risk pregnancy, we follow up to make sure there is no jeopardy to you or your baby.
  • hCG: (human chorionic gonadotropin): This substance not only confirms pregnancy, but analyzing levels regularly can indicate if you are at high risk for ectopic pregnancy, possible miscarriage, or a Down syndrome baby.
  • Placenta previa: Sometimes the placenta covers the cervix, causing bleeding during delivery. Transvaginal ultrasound tests warn us beforehand if a caesarian is necessary.
  • Fetal problems: Our 4D ultrasound and other equipment can detect complications or abnormalities before they become a problem.
  • Premature labor: We can’t always predict if your baby will thumb its little nose at our calculated due date, but a previous history of early labor, a shortened cervix, or certain infections alert us to be vigilant of that possibility.
  • Placental abruption: When the placenta separates or peels away from the uterine wall, the situation may become detrimental to both mother and baby. We always look out for this and other potential dangers.

Our hospital partner, Northside Hospital Cherokee, opens its new facility in early 2017, continuing to handle a full range of services for our patients with high risk pregnancies. Since 1993, Cherokee Women’s Health has delivered more babies at Northside Hospital Cherokee than all other OB practices combined.

Whether yours is a routine or high risk pregnancy, our highly qualified, expert providers pride themselves on giving you the best individual prenatal care necessary to ensure a safe and healthy pregnancy.

For an appointment, call us at 770.720.7733.

September 1, 2016

Vulvodynia is persistent, inexplicable pain anywhere in the vulva. The discomfort associated with this condition can be so severe that any sexual activity may be impossible. Even sitting can become intolerable.

Vestibulodynia (Vulvar vestibulitis syndrome or vestibulitis) is another condition which is very similar to Vulvodynia except that pain is situated at the entryway just outside the vagina inside the labia (vestibule).

Though it is not known exactly what causes Vulvodynia, doctors speculate that there may be several triggers:

  • Allergies or sensitive skin that can be easily irritated
  • Hormonal changes or hormonal contraception
  • Injures to the vulvar area’s surrounding nerves
  • Sexual abuse
  • A predisposition to yeast infections
  • Pelvic floor dysfunction
  • Past history of anxiety and/or depression
  • Muscle spasms
  • Frequent antibiotic use.

Vulvodynia has also been associated with several other chronic pain-related conditions, meaning that there is a higher likelihood of Vulvodynia if a woman has any of the following:

  • Interstitial cystitis: (An inflammatory condition that causes moderate to severe pain or pressure of the bladder and surrounding pelvic area).
  • Fibromyalgia: (A chronic disorder causing widespread muscular, joint and tendon pain).
  • Irritable bowel syndrome: (Recurrent abdominal pain, diarrhea and constipation).
  • Endometriosis: (A painful disorder where tissue that is similar to the kind growing in the lining of the uterus (endometrium) grows outside of the uterus instead).
  • Chronic fatigue syndrome: (An unexplained ailment with symptoms of fatigue, fever, tenderness and depression, usually following a virus).

In most cases, however, there is no absolute known cause, and the reasons for Vulvodynia remain a mystery. Investigation of this disorder is still in its medicinal infancy because it was previously thought to be a purely psychological issue.

What are the Symptoms?

  • Itching
  • Throbbing
  • Burning
  • Stinging
  • Painful intercourse (dyspareunia)
  • Soreness
  • Rawness
  • Redness
  • Irritation.

These symptoms can be sporadic or constant. They can last for weeks, months or even years. They may also appear suddenly, and disappear just as abruptly. This discomfort can be centralized in one area such as the vaginal opening, or spread throughout the entire vulvar zone. This area may appear swollen or irritated, but often looks completely normal.

Vulvodynia can seriously impact a woman both physically and mentally. Inability to engage in sexual activity may jeopardize relationships. Chronic pain can also lead to irritability, anxiety, sleeping difficulties, social withdrawal, and low self-esteem. Vulvodynia, and the negative emotions that ripple from the condition, can disrupt quality of life and eventually activate full-blown depression.

How Is Vulvodynia Diagnosed?
There is no actual test for vulvodynia. Diagnosis is made by ruling out any other possible ailments that might mimic the symptoms of this disorder, such as:

  • Skin conditions
  • Diabetes
  • Yeast or bacterial infections
  • Cervicitis or inflammation of the cervix
  • Endometriosis.

A medical history will need to be provided, especially past infections in the pelvic region. Any current drugs you are using, specifically hormonal replacement or contraception should be mentioned.

Female pain photoYou will be asked pertinent questions in order to determine the problem. A pelvic exam will be done, both internally and externally to see if there is a possibility of a present infection. Even if the genitals show no visual signs of any infection, a cell sample may be taken to rule out bacterial vaginosis or yeast infection. Finally, to check for vulvodynia, a swab that has been moistened will be used to gently dab at and probe the vulva and surrounding area to determine the exact locations of your pain.

What Happens if I Have Vulvodynia? Can I Be Helped?
Yes. There are several treatments that can minimize pain or discomfort:

  • Antihistamines can calm itching, steroids, anticonvulsants, and antidepressants can subdue chronic pain.
  • Numbing creams or ointments containing a local anesthetic applied before initiating sex may provide temporary help, but may also cause your partner to experience numbing upon physical contact with these creams.
  • Biofeedback therapy can train you to relax, in turn decreasing suffering. You can be taught how to control your body’s responses to vulvodynia symptoms. If the human body anticipates pain, it involuntary contracts to avoid it, causing the very pain it tries to ward off. In time, this pain becomes chronic. Biofeedback can help with this vicious circle, allowing the pelvic muscles to relax and minimize this innate tightening and the subsequent discomfort.
  • Nerve blocks that are injected can help with chronic pain.
  • Pelvic floor therapy reduces muscle tension in the pelvic floor muscles. These muscles are a support for the bladder, uterus and bowel, and relaxing them can provide vulvodynia relief.
  • Surgery that removes tissue and skin affected by vulvodynia or vestibulodynia (vestibulectomy) can effectively relieve pain in many women.

Is There Anything I Can Do At Home in the Way of Self-Help?
There are some simple measures you can take to decrease some of the uncomfortable symptoms:

  • Sitz bath soaking, which is sitting in cool or lukewarm water for 5 to 10 minutes two or three times a day can soothe symptoms.
  • Avoid those hot tubs and long soaks in scalding water. They contribute to discomfort and itching. Chlorine pools exacerbate the problem as well.
  • Save the control top pantyhose and sexy synthetic panties for special occasions. They restrict airflow to the genitals, causing the temperature down there to rise and trap moisture that can cause irritation. Try to find cotton substitutes that promote dryness through absorption, and that encourage healthy, necessary ventilation to the delicate genital area. If you’re comfortable with it, go ‘commando’ at night and skip underwear altogether.
  • Cold compresses placed directly on the affected area can help itching and pain—especially after sex.
  • Whenever possible, try to avoid any activity that may put pressure on your vulva, such as horseback riding or biking.
  • Treat your lady parts gently. Avoid douches. Wash the area with plain water using your hand, then lightly pat it dry. Avoid soap when possible. Even residue scented laundry detergent and fabric softener in clean towels or facecloths can irritate sensitive tissue. You might even wish to put on a natural emollient without additives or preservatives after washing. Petroleum jelly creates a soothing barrier.
  • If you’re able to tolerate intercourse, a lubricant can greatly help, preferably a water soluble one.
  • Antihistamines before bed can stop itching and provide a restful sleep.
  • Unscented white toilet paper can make a difference. So can tampons and sanitary napkins that don’t smell like they’ve been dragged through a perfume factory. Contraceptive creams and spermicides can also irritate vulvodynia.
  • Harsh, irritating urine caused by certain foods and drinks like citrus beverages, beans, nuts, chocolate, berries, etc. may cause burning upon voiding. Rinsing the vulvar area after urination with cool water helps.

It is important to note that vulvodynia is NOT a sexually transmitted disease. It is not contagious, and is in no way an indication of any kind of cancer.

There is no cure for vulvodynia, but different remedies can ease the symptoms for different women. It may take time to find the combination that works best for you, but our doctors will work with you to help provide a comfortable, better quality of life. To schedule an appointment, call 770.720.7733.

August 30, 2016

What is Vaginal Shortening and is Vaginal Lengthening a Solution?
Vaginal shortening, or iatrogenic vaginal constriction, is a condition that occurs in women usually as a result of undergoing gynecological surgery. After removal or correction of organs within the pelvic area, post-surgical tweaks are always necessary to close any internal incisions, suture tissue together, and to restore the vagina back to its previous corridor-like shape.

Depending on the extent of the surgery, sometimes it’s necessary to stitch together a great deal of a woman’s remaining tissue, leaving the vagina shorter—the same way gathering fabric to repair a hole in the toe of a sock would alter its size. Subsequent scarring in the area over time may also contribute to narrowing and reduction. Unfortunately, though vaginal tissue is extremely elastic and stretchable, a substantial shortening may result in uncomfortable and even painful intercourse, especially during the natural penile thrusting stage of a sexual encounter.

What Conditions and Their Aftermath Cause Vaginal Shortening to Occur?
Most surgeries that involve the removal or correction of vaginal organs may contribute to this problem. Some of these include:

Vaginal mesh surgery – A transvaginal surgical mesh that may have been used to repair a woman’s urinary stress incontinence or pelvic organ prolapse (POP) can cause future problems. Mesh is sometimes used to support ligaments and organs that have slipped out of place. Its purpose is to reinforce the pelvic floor or weakened vaginal wall. Sometimes the mesh can cause infection, fuse with organs and tissue, or perforate its surrounding structures, making removal necessary. Much like cement sticking to the webbing used to adhere stucco to walls in home construction projects, tissue and organs may have stuck to the transvaginal mesh, making is difficult to remove without causing damage. When this damage is extensive, additional tissue is needed to repair the vagina, thus shortening it even more.

Bladder tack surgery/bladder suspension surgery – This procedure is used to minimize or correct stress incontinence in women by creating a hammock shaped sling made of a mesh tape. The material is different from transvaginal mesh, but with similar complications. If rejection, fusion, or infection arise, the methods used to correct these post-surgical problems may result in vaginal shortening.

Anterior repair/posterior repair (colporrhaphy) – Anterior repair surgery tightens the front wall of the vagina when the bladder has drooped or fallen out of place (cystocele or dropped bladder). Posterior repair surgery tautens a rectum that has sagged or dropped (rectocele or rectal prolapse). Though both procedures are minimally invasive, complications may occur that require surgical attention and subsequent suturing, in turn shortening the vagina.

Enterocele repair – This reparation is necessary when intestines (small bowel) bulge through the weakened tissue at the top of the vagina. As with anterior or posterior repair, risks are uncommon but may occur, needing attention that might impact vaginal proportion.

Sacrospinous ligament/vault suspension – This procedure lifts the top of the vagina and holds it in place after complete vaginal prolapse. As with several of the previous surgeries mentioned here, postoperative stitches are necessary using a woman’s available tissue. This can minimize the original size of the vagina.

Hysterectomy – In a hysterectomy, all or part of the uterus is removed. In some cases, it may also be necessary to extract the ovaries, cervix and/or fallopian tubes. The more radical the procedure, the more internal trimming and stitching may be necessary. Hysterectomy is possibly one of the biggest causes of vaginal shortening.
Cervical or uterine cancer: Due to removal of cancerous organs, and scarring that can occur as a result of follow up radiation, both vaginal capacity is usually reduced.

Can Vaginal Shortening Be Repaired?

Often, following surgery, the vagina may simply feel shorter due to swelling, inflammation, tenderness, bruising, and the presence of stitches. Vaginal tissue is very elastic, and though it may feel tight immediately after your operation, size often returns to normal after a short recovery time.

If actual shortening has occurred, repair can sometimes be complicated, depending on the extent of the surgery or cause of the diminishment.

Though it is possible to approach correction by using more drastic measures such as muscle flaps, biological animal grafts, skin grafts, or even a woman’s own bowel tissue, these methods can cause further complications and we prefer to avoid them. Instead, we opt for the least physically intrusive methods first. Several of these options are:

Pelvic floor massage – Internal and external massage can relax tenderness, muscle tightness and trigger points that cause pain, gently stretching or tightening the pelvic floor muscles and connective tissue.

Pelvic floor physiotherapy – These exercises stretch and strengthen the pelvic floor muscles.

Vaginal dilators – Plastic tubes that gradually increase in size are inserted to gently stretch the vagina over time.

If these procedures prove to be ineffective, laparoscopic surgery, which is minimally invasive and generates less blood loss, scarring, and a quicker postoperative recovery time may be beneficial.

Whatever the reason for vaginal shortening, we can recommend the safest and most effective approach to try and correct the problem. To make an appointment, call us at 770.720.7733.

What is Libido?
Libido, very simply put, is sexual desire or sex drive. Just as there are multiple shades in a color spectrum, levels of libido are unique to each woman, and these levels can rise and fall monthly throughout a woman’s lifetime depending on many biological and psychological factors.

What are the Different Levels of Sexual Desire?
Intensity can vary. Sexual desire may range from heightened – where a woman may want sex one or more times a day (hypersexuality), to several times a week, once a month, once every few months or year, (hyposexuality) or not at all (asexuality).

What is Considered ‘Normal Libido’?
There are no standards for ‘normal’ libido, especially if a couple is sexually compatible and comfortable in their mutual need for intimacy. Often, however, this is not the case. Women frequently tend to have a lower libido than men. In fact, it is estimated that 1 in 10 women suffer from low sexual desire in the United States, meaning that 16 million women have what is referred to as hypoactive sexual desire disorder (HSDD).

A female’s low libido can have a huge negative impact on a relationship. Once the brilliant shine of newly-found lustful love wears off, couples may find their physical needs are drastically different. The apathy of the less ardent woman may lead to conflict, suspicion, hurt, infidelity and even complete collapse of the relationship. The woman herself may also suffer feelings of inadequacy, self-doubt, and frustration, emotions that might send her into an emotional depression, worsening the situation.

Mass media today slants sex to appear as if anything less than constant bedroom activity is abnormal, often convincing a woman with a perfectly healthy sexual appetite that she is some kind of freak if she doesn’t engage in a passionate encounter at every opportunity. For one who suffers from a lower sex drive, the impact may be even more devastating. The inner turmoil of a dwindling self-image and shattered self-esteem can compound the problems already complicated by sexual dysfunction.

low libido photoWhat are the Causes of Low or Waning Libido?
There can many causes for low sexual desire, and they can be either physical or psychological.

The following are some of the physical reasons for a low libido:

  • Hormonal imbalances: The three hormones that impact a woman’s sexual function, desire and reproductive organs are estrogen, progesterone and testosterone.
  • Testosterone is the primary hormone responsible for a healthy libido in women. Yes, ladies, we all have testosterone, just as all males produce estrogen! The amounts just vary for each gender. Testosterone is what enables a woman to fantasize, piques her interest in sex, and aids in lubricating the vagina to prepare for comfortable, pleasurable intercourse. A woman’s testosterone levels begin to rise just before she ovulates, piquing a day or two before, and reaching maximum strength at ovulation. This is Mother Nature’s way of preparing the body for reproduction by plumping the uterine wall, which in turn stimulates sensitive nerve endings, encourages lubrication and heightens sexual motivation. Immediately afterwards, the amount of this hormone in her body diminishes. A low testosterone count hampers the possibility of a satisfying sexual experience by minimizing enthusiasm, sensitivity and arousal.
  • Estrogen is the main hormone responsible for the development of the female sex organs. It regulates the menstrual cycle and is crucial in thickening the uterine lining in preparation for pregnancy. As women age and enter the premenopausal stage (perimenopause), estrogen begins to significantly decrease until the levels are so low that menopause occurs. Vaginal tissue becomes thinner, less elastic, drier and more fragile. As with testosterone, natural lubrication diminishes with less estrogen, and this decrease affects sexual desire.
  • Progesterone is another female hormone that is vital in thickening both the uterine wall and endometrium to protect the egg during the process of fertilization, conception and pregnancy. Levels normally rise immediately after ovulation. If fertilization does not occur, levels drop, and the uterine walls become thin again, allowing the unfertilized monthly egg to pass as menstruation. Progesterone also regulates a woman’s menstrual cycle. As with estrogen, levels decline with age. Research is still being done, but it is believed that progesterone’s role in waning libido is just as important as those of testosterone and estrogen.
  • Menstrual cycle: Irregular or absent menstruation (secondary amenorrhea) can wreak havoc on natural hormonal processes, causing libido to become equally sporadic.
  • Age: Testosterone, progesterone and estrogen levels diminish as women age and enter menopause, causing lowered sexual interest, loss of muscle mass, compromised skeletal health, and vaginal dryness that can lead to painful intercourse. As these hormone levels decrease, so does libido.
  • Antidepressants: Sexual dysfunction, low lido and even genital numbness may be attributed to some currently prescribed antidepressants which are referred to as selective serotonin reuptake inhibitors (SSRI’S).
  • Drugs: All recreational or prescription drugs have side effects. They can inhibit hormonal functions, dull physical and mental sensations, dehydrate the body’s natural secretions and lubrications, or interfere with sexual desire. Blood pressure medications, tranquilizers and antihistamines are just a few. Always give your doctor a complete list of medications you are currently using.
  • Lack of restful sleep: Drowsiness, irritability and fatigue can dampen anyone’s mood for lovemaking.
  • Birth control: Some patches and oral contraceptives fool the body into believing it is pregnant by neutralizing the very hormones that enhance libido. If you notice a sudden disinterest in sex after beginning birth control, speak to your doctor.
  • Alcohol, smoking or drug abuse: Smoking restricts blood flow to the body. The clitoris, labia and vagina become engorged with blood during sexual arousal, just like a man’s penis, so restricting this flow also restricts sensation and response to physical stimulation. Alcohol is a depressant. It dehydrates the body, dulls sensitivity, and causes loss of vaginal lubrication.
  • Giving birth: Immediately after giving birth, a woman’s hormones are causing an uproar inside her body. Physical trauma to the vaginal area, possible postpartum syndrome, and the exhaustion and stress of caring for a newborn amplify sexual indifference. Luckily, these issues usually only last a few weeks, but if libido remains low or non-existent for longer, consult your doctor.
  • Genital abnormalities or problems: Pelvic organ prolapse(POP), muscle mass and tissue deterioration due to aging (urogenital atrophy), fecal incontinence, urinary problems, dryness, atrophy, and a small vaginal opening are only a few of the physical problems that can decrease libido.
  • Surgery: A hysterectomy with or without compete removal of the entire reproductive system (Oophorectomy) decreases or completely eliminates the hormones necessary for sexual gratification.
  • Major health conditions: Cancer, high blood pressure, neurological disorders, hypothyroidism, diabetes, arthritis, infertility, and coronary artery disease, along with the medications and procedures necessary to correct these issues are just a few disorders that can weaken female libido.
  • Anemia: Low iron levels caused by heavy periods can result in anemia. Anemia reduces red blood cells and compromises a protein called hemoglobin whose job is to push oxygen from your lungs to all your body parts, including the pelvic area. Since blood is vital to the labia, clitoris and vagina to enhance erotic sensitivity, anemia can greatly subdue bedroom pleasure and cause fatigue, weakness, and sexual apathy.

Psychological factors that can cause low libido are:

  • Low self-esteem or body image: If a woman is overweight, underweight, lacks self-confidence, or feels inferior in other ways, she may shy away from physical contact, robbing herself of the gratification of a healthy sex life.
  • History of sexual abuse: Rape, assault, and molestation can have a devastating effect on the psyche. Without counselling, the aftermath of these experiences can leave lifelong psychological scars, and it is understandable that a woman may avoid any future sexual encounters.
  • Religious and moral issues: Deep rooted personal beliefs can sometimes be detrimental to a healthy libido. Entrenched convictions about sex, religion, moral taboos and behavior can prevent a woman from truly enjoying an intimate relationship, causing her to view a physical union as repulsive or simply a ‘duty’ to get out of the way.
  • Trauma: Psychological trauma such as post-traumatic stress disorder (PTSD) can follow any highly disturbing event. Just as with sexual abuse, the repercussive emotions following the death of a loved one, a divorce, violence, being the victim of a crime, etc. may lead to sexual dysfunction and a damaged libido.
  • Relationship problems: Constant tension and conflict with a loved one can slowly chip away at even the strongest relationships. Anger, disillusionment and unresolved issues ultimately make their way into the bedroom, negatively impacting any activity that is still, or no longer, going on there.
  • Depression or anxiety: Either of these emotional conditions can affect performance or pleasure by causing disinterest, especially if medication is being used to control the issue.
  • Lifestyle: As the world becomes more and more fast paced, a busy lifestyle and the responsibilities that come with it can succeed in putting any romance on the back burner, lowering the flames of passion and eventually putting them out altogether.
  • Stress: Worries about health, finances, or other everyday problems cause physical and mental tension. If a woman is unable to relax and enjoy sex, orgasm is impossible and frustration inevitable, causing her to lose interest altogether.
  • Anxiety: Anticipation of sex is not always viewed favorably. Many women dread intercourse when they feel it’s expected or demanded of them. Some worry that they may not fulfill their partner’s expectations, or that they might be urged to perform acts that they’re not comfortable with to please their mate, especially in a new relationship.
  • Environmental stress: Distractions such as bright lights, lack of privacy and extreme noise can hinder a woman’s ability to relax and enjoy intimacy. For instance, visiting or living in a mother-in-law’s home, or listening to a neighbor’s loud, thumping music can impede full enjoyment of sex or orgasmic achievement.
  • Poor communication: Optimal sexual performance does not come naturally. It’s a learning process for both partners. Many couples avoid telling each other what pleases them in the bedroom. Whether it is because if shyness, fear of shock, or ridicule, women sometimes avoid telling their mates what they prefer and, in time, come to dread intimacy altogether.
  • Latent sexual orientation: Denial of gender preference can raise feelings of guilt and suppress the pleasure that comes with an open, honest, relationship.

Is Help Available?
YES!!!! There is no reason to go through life with lowered libido. Women can enjoy a satisfying sex life at any age, and with today’s resources and modern technology, we are usually able to effectively treat the problem.

Diagnosis and Treatment
In order to pinpoint the root of this dysfunction, frank honest discussion is necessary, as well as a list of any medications you are currently taking. Your doctor will ask pertinent questions to find out whether the problem is physical or emotional.

After an examination of the genital area, blood tests may be required to determine hormonal levels.

Once a diagnosis is made, your doctor will move forward to correct the problem. It may be as simple as a change or alteration in medication or a new prescription. If surgery is indicated, most physical corrections are minimally invasive, can be done in our clinic, and the recovery time is usually short.

If the problem is psychological, resources to help are available. For an appointment, call us at 770.720.7733.

August 16, 2016

Symptoms to bring to your doctor photoOftentimes women accept minor gynecological or urinary symptoms as a normal part of being a woman. The truth is those minor symptoms may be indicative of a more serious condition.

It is important to take charge of one’s health, stay up to date on annual visits, and make sure to speak with a doctor about any concerns, no matter how minor they may be. By recognizing and disclosing these symptoms early, doctors may be able to diagnose and treat underlying pelvic or urinary conditions.

If a woman is unsure whether to call her doctor, here are some symptoms that may go unnoticed but can be cause for concern:

  • Urinary Incontinence – Leaking urine is commonly seen in women who have had multiple pregnancies, or who are advancing in the aging process. However, urinary incontinence is not something a woman should take lightly. Leaking any amount of urine while laughing, sneezing, coughing, or exercising can be a sign of several urinary conditions, including bladder prolapse. Don’t wait until an annual exam to bring this to a doctor’s attention. There are treatments and lifestyle changes one can make to minimize the symptoms of incontinence.
  • Unexplained Bleeding Bleeding that is not associated with a monthly cycle should be brought to a doctor’s attention immediately. While one shouldn’t stress about the worst case scenario, possible conditions that could cause the bleeding range from fibroids and cysts, to ectopic pregnancies, anemia, or even cancer.
  • Pelvic Pain – Any pelvic pain whether it is during sex, or any other time should be mentioned to a doctor. There could be underlying causes that may need to be examined further and/or treated such as a sexually transmitted disease, endometriosis, or uterine fibroids.
  • Changes Anything seem out of the range of normal, lately? A change in discharge, itching, visible bumps or bulges, or burning while peeing are definite reasons to call your gynecologist immediately. These unpleasant symptoms may be signs of vaginal infections, sexually transmitted diseases, urinary tract infections, or other vaginal conditions that require a doctor’s diagnosis and treatment.

At Cherokee Women’s Health, we are here for any concerns you may have about your gynecological health. Make an appointment at one of our two locations where our highly specialized doctors can diagnose and treat any worrisome symptoms.

Pelvic Organ Prolapse (POP) refers to the sagging or drooping of any pelvic organs due to damage, trauma, childbirth or injury.

The pelvic floor consists of a group of cradle-shaped muscles that hold pelvic organs in place. The pelvic organs include the uterus, bladder, cervix, vagina, rectum and intestines. Like any other part of the body, these muscles, with their surrounding tissues (fascia), can develop problems.

If you fill a small plastic bag with grocery items, say for instance, a box of cereal, a few cans of vegetables, some jars and a package of rice —the bag should hold the items with no problem. But if you hang that full bag on a wall hook and leave it suspended, you’ll start to notice the items in it begin to bulge against the membrane of the bag as it takes on the shape of its contents.

After a while, depending on how heavy the items are, the corner of the cereal box or rim of a can may start to bulge and even poke through as the bag stretches, weakens and eventually tears from the weight of the items in it. The groceries may even begin to protrude and dangle outside of the bag as the tears get larger.

Pelvic pain photoPelvic prolapse happens much the same way. As the muscles and tissues holding the pelvic organs weaken, degrade or tear, the pelvic organs slip or drop through, sometimes forming a small hanging internal bulge. At other times, depending on the damage, they may actually dangle externally from the vagina or anus, causing problems and inhibiting their function. This is called prolapse.

Who is at Risk for Pelvic Organ Prolapse?

One in three women suffer from POP. Any activity that puts undue pressure on the abdomen can cause pelvic floor disorders. Typically, labor and childbirth are the leading causes of prolapse, especially when a woman has had several children, a long, difficult labor, or has given birth to a larger child.
Pelvic organ prolapse becomes more common with age, usually around menopause when tissues damaged during a woman’s childbearing years begin to lose strength. Other causes are:

  • Obesity: Excess weight places increased pressure on the abdomen.
  • Pelvic organ cancers: Tumors can also put additional pressure on the abdomen.
  • Constipation: The bowel puts increased pressure on the vaginal wall when constipation is a chronic problem.
  • Uterus removal (hysterectomy): During surgery, there is always a possibility of inflicting damage on pelvic organ support, resulting in dislocation of any organ within the pelvis.
  • Smoking and respiratory problems: Excessive coughing, especially if chronic, can put extra strain on the abdomen.
  • Genetics: Pelvic connective tissue weakness may be hereditary. Often, if immediate female family members have suffered from prolapse, there is a greater possibility that you will too.
  • Heavy lifting: Excess abdominal pressure from heavy lifting may cause POP.
  • Diseases of the nervous system: There is a greater risk of developing pelvic organ prolapse for women who suffer from multiple sclerosis, spinal cord injury or muscular dystrophy.

What are the Symptoms of Pelvic Organ Prolapse?

It is entirely possible not to have any symptoms at all. Sometimes pelvic organ prolapse is only discovered during a routine gynecological examination. Minor symptoms are a feeling of annoying pressure of the uterus or other pelvic organs against the vaginal wall, minimal malfunction of those organs, and mild discomfort. Other symptoms are:

    • Painful intercourse
    • Vaginal bleeding or spotting
    • A sensation of pelvic pressure
    • Feeling as if something is falling out of the vaginal opening.
    • Bowel movement problems such as constipation.
    • Urinary problems such as needing to void frequently, especially if this interrupts sleep (overactive bladder) or involuntary urine release (incontinence).
    • Stretching or pulling sensations in the groin or pain in the lower back.

Symptoms may be aggravated by jumping, lifting or standing. Relief is usually found after lying down for a while.

When Should You See Your Doctor?

If you have increased sensations of pelvic pressure or pulling which is exacerbated by lifting or straining, but relieved when you lie down.

  • If sexual intercourse has become painful or difficult.
  • If lower back pain or pelvic pain interferes with daily living.
  • If you can feel a bulge inside your vagina or see one protruding.
  • If you have irregular spotting or bleeding.
  • If urinary problems have developed, such as leakage, an urgent need to void, or more frequent urination, including two or more times a night.
  • If you suddenly develop bowel movement problems.

Diagnosis

At times, pelvic organ prolapse may be hard to diagnose, especially if a patient does not complain of any symptoms. Patients might be aware there’s a problem but cannot actually pinpoint its location.After asking questions regarding symptoms, medical history, past pregnancies, and other health problems, your doctor will perform a physical examination. Then, if organ prolapse is suspected or discovered, the following additional tests may be ordered:

    • Urodynamics test: Results will indicate how your body stores and releases urine.
    • Intravenous Pyelogram (IPV): An x-ray that reveals position, size and shape of the bladder, kidneys, ureters and urethra.
    • Cystoscopy: This lets your doctor see the interior lining of your bladder and urethra.
    • Computed Tomography Scan (CT scan): X-rays showing details of interior pelvic area structures.

The doctor will then use a classification system to decide the organ prolapse level so he can best decide treatment options. Often, only simple non-invasive treatments and lifestyle changes are recommended for minor prolapse. If surgery is warranted, the following may be suggested:

  • Cystocele repair: Repair of the bladder
  • Urethrocele repair: Repair of the urethra
  • Hysterectomy: Removal of the uterus
  • Rectocele repair: Repair of the rectum
  • Enterocele repair: Repair of the small bowel
  • Vaginal vault suspension: Repair of the vaginal wall
  • Vaginal obliteration: Closure of the vagina.

What Can You Do?

  • Eat fiber: Try to get at least 20mg daily to prevent constipation. Regular elimination is essential to good pelvic health.
  • Kegel exercises: These strengthen and tighten pelvic floor muscles and can be done anywhere, any time—on the sly.
  • Maintain a healthy weight: Your abdominal muscles will thank you.
  • Avoid heavy lifting: If you have to grunt to lift, it’s too heavy.
  • Gentle exercise: Walking is great. Put on those sneakers and try to gradually work up to 20 minutes a day.
  • Drink plenty of water: Not gallons, but about 8 cups a day. This also helps with constipation.
  • Bowel training: Try to schedule bowel movements at the same time every day. It may take time, but eventually your body will cooperate.
  • Don’t smoke.

Pelvic prolapse often sounds worse than it is. For many women, there are hardly any symptoms. For those who DO suffer, there is help available, whether it is a simple lifestyle change, surgical repair, cosmetic enhancement or reconstruction.

If you have questions about your gynecological health or would like to consult with one of our pelvic reconstructive surgeons, please call 770.720.7733 or contact us here.

August 10, 2016

What is Hymenoplasty?
Simply explained, hymenoplasty, also known as hymenorrhaphy, is the cosmetic repair, restoration, or construction of a woman’s hymen. Restoration of the hymen is also referred to as revirginization.

What is a Hymen?
In order to explain hymenoplasty surgery, a description, along with some information about the hymen might be beneficial.

The hymen consists of human tissue which resembles an oval rubber washer that partially or completely covers the vaginal opening. This ring-shaped membrane can be thin and flexible or thick and rigid. It begins to form while the female is still in the womb, usually beginning in about the fourth month of pregnancy.

Contrary to what many believe, except in rare cases, the hymen is NOT an impenetrable seal. If this were the case, there would be no portal for menstrual flow or healthy, normal vaginal discharge to leave the body.

Historical romance writers often describe the heroine in their bodice ripper books as having a Teflon hymen that causes her to wince or cry out painfully while in the throes of that first sexual encounter. Her lost virginity is also typically evidenced by vivid, crime scene-like blood splatter on pristine white sheets. However, in reality, that first rupture, regardless of the method, doesn’t always draw blood, and is not always painful.

Hymenoplasty photoLike the appendix, a hymen serves no real purpose. Yet, throughout history, this nondescript sheath of skin traditionally and very mistakenly has served as undeniable, positive proof of a woman’s purity and innocence. Even to this day, in many cultures, an intact hymen still indicates virginity, especially if there is the presence of blood upon first penile penetration.

Clinically speaking, however, a torn or damaged hymen is not irrefutable confirmation of virginity loss by sexual hanky panky. Depending on its rigidity, perforation of the hymen can be caused by normal everyday activities such as strenuous athletics, horseback or bicycle riding, a simple gynecological examination with speculum or gloved finger insertion or masturbation. Even placing a tampon into the vagina may rupture it.

In some cases, a hymen may not be present at all, as approximately 1 in 1,000 women are born without one.

What Are Some of the Reasons for Hymenoplasty?
Hymenoplasty is a cosmetic fix for women who may wish to repair or reconstruct their hymen. Their reasons for seeking this procedure are varied, and may be physical or psychological.

  • Reclaiming control: In the case of sexual assault, a woman is understandably left with traumatic psychological issues. She may feel that she was robbed of not only her innocence, but the opportunity to present the virginal gift of an intact hymen to the person of her choice. Hymenoplasty may not only offer the physical restoration she seeks, but may also supply some psychological comfort and healing as well.
  • Burying the past: Sexual curiosity and experimentation are a natural part of the growing process, especially during adolescence when hormonal changes and surges occur. Peer pressure may often compel a young girl to succumb to sexual activity before she’s mentally prepared for the emotional impact associated with such physical intimacy. As she matures, she may feel regretful that she indulged in that curiosity too early or too often, and may seek to bury evidence of what she might, in retrospect, view as promiscuity or bad judgment. Revirginization may psychologically allow her to turn back the clock and start over.
  • Cultural beliefs: Because the presence of an intact hymen is still important in many cultures, a woman may want to provide this indication of purity to her spouse for their upcoming nuptials.
  • A gift: Many women who have already been sexually active may wish to give their partner a virginal experience, whether it be as a surprise, for a special occasion, or on their wedding night.
  • Accidental rupture or tearing: For some women, penetration of the hymen via bicycle or horseback rides, slipping on ice, or tampon insertion is simply not acceptable and they opt for hymenoplasty to restore what was damaged unintentionally.
  • Enhancement of sexual pleasure: After childbirth, the vaginal muscles may weaken. Flaccidity also occurs over time with age. Hymenoplasty also tightens these muscles, giving the added benefit of a more sensually stimulating sexual experience.
  • Imperforate hymen: This is a condition where the entire vaginal opening is covered by the hymen. It is not usually discovered until a young girl enters into puberty and her menstrual flow is blocked. The hymenoplastic procedure to correct this is called hymenotomy, and a small hole is made in the membrane to allow blood flow.
  • Septate hymen: The hymenal tissue is split into what looks like rope-like bands. They resemble tonsils that are connected at both ends, and may impede tampon use or penile penetration. This is also corrected by hymenotomy. A septate hymen can also refer to a very thick or rigid hymen, like the almost bulletproof one of romantic lore mentioned earlier, and may require surgical penetration.
  • Microperforate hymen: This is similar to an imperforate hymen and is corrected in the same manner. A microperforate hymen has a small opening only adequate enough to permit menstrual flow. It does not usually present a problem or require enlargement unless a female wishes to use tampons.

What Happens During Hymenoplasty?
Hymenoplasty is usually a simple out-patient procedure that can be done in our clinic under local anesthesia. Any torn skin around the edges of the hymen is gently and neatly cut away, after which the remaining tissue is stitched together, leaving a small opening. This restores the hymenal ring to a normal size and shape.

If there is not enough skin to restore the hymen, or if a hymen is nonexistent, the surgeon may create one, using either some of the body’s own thin vaginal skin (vaginal mucosa) or a synthetic tissue. A small blood supply may be added, either artificial or the patient’s own taken from a piece of vaginal flap, thus simulating the traditional bleeding upon subsequent penetration.

What is the Recovery Time?
The surgery can be expected to take anywhere from one to two hours depending on the amount of repair needed. Though this is a clinical procedure with no hospital stay necessary, and women may return to work the next day, strenuous activity and heavy lifting should be avoided. During the first 48 to 72 hours, there may be some slight bleeding, but this is perfectly normal.

Full healing takes approximately six weeks. There will be no visible signs of surgery and it will be impossible to tell the difference between a natural hymen and a reconstructed one. At this time, the reconstruction process will be complete and all the sensations associated with virginal, first time sex may be experienced.

Complications
There are rarely complications. However, the doctor should be contacted if the patient experiences any of the following symptoms:

  • Dizziness
  • Pain beyond moderate discomfort after three days
  • Unusual or foul smelling discharge
  • Intense itching
  • Abnormal bleeding
  • Inflammation.

Depending on why you might request hymenoplasty, this may be a delicate subject to discuss. Rest assured that our doctors are familiar with the many reasons patients ask for this procedure, and fully understand your discomfort and shyness in regard to this subject. It’s your body. We want to help make you as comfortable and confident with it as possible.

To learn more about hymenoplasty or to schedule an an appointment with one of our doctors, please call 770.720.7733.

What is Clitoral Hood Reduction?
Clitoral hood reduction, also known as clitoral unhooding, clitoral hoodectomy, or clitoridotomy is a cosmetic surgical procedure which reduces the excess skin (prepuce) that covers the clitoris. The technique not only
enhances the visual appearance of a woman’s pubic area, but it also serves to improve sexual pleasure by making the clitoris more accessible. As the name implies, the clitoral hood conceals the clitoris nestled inside, similar to an uncircumcised penis where the foreskin sheathes the head in its non-erect state.

What is a Clitoris?
Before launching into a description of the surgery itself, it may be of interest to understand the function, location, and description of the female clitoris.

The clitoris is a woman’s primary and most complex erogenous zone. The head (glans) of this tiny body part is estimated to have more than eight thousand sensory nerve endings twice as many as the glans of a penis. Though its sensitivity and size can differ from female to female, it normally resembles a pea or small pearl. When aroused by oral or manual stimulation, the clitoris becomes engorged much the same way the male penis does, thus enabling a woman to achieve orgasm.

In order to more easily picture the location of the clitoris, simply imagine the nude frontal view of your pubic area. What you are looking at in your lower region is called the vulva. The cushioned ridge you feel beginning halfway down from your navel is the mons veneris. As you continue to move downwards, it separates into two cheek-like mounds that are separated by a vertical opening with lip-like tissue. Those lips are called the labia majora.

By gently pulling apart the labia majora, you will expose two more inner lip-like flaps of tissue on the left and right. These are labia minora. At the base of the labia minora, leading up to the anal opening, there is a small bony ridge called a perineum. At the upper tip of the labia minora, that small tube-like protrusion is the clitoral hood. Peeking out through, or hiding inside the opening of that hood is the tip of the clitoris.

The entire clitoris itself is about 4 inches long, but, as explained earlier, the head or glans, is small, roughly the size of an eraser on the end of a pencil, and it is extremely sensitive to touch.

Clitoral Hood Reduction photoWhy Would a Woman Need a Clitoral Hood Reduction?
Because the size, shape and thickness of the clitoral hood differs from woman to woman, this procedure is not always done for medical reasons alone. It can also be done for aesthetic purposes to give the vulva a neater, trimmer look.

In some cases, the clitoral hood may be extremely large, inhibiting access to the clitoris, thereby preventing the achievement of sexual gratification. A thick or large hood may also cause friction against clothing which can lead to soreness, redness or inflammation.

Often, a woman with an enlarged hood may also have large labial lips that protrude in a manner she may find unsightly. Both the clitoral hood and the labia, if quite prominent, can sometimes create obvious bulges that can be seen outlined against close-fitting outerwear. Women may opt to cosmetically correct prominent labia through a procedure called labiaplasty at the same time as they undergo a clitoral hood reduction.

What Can be Expected During and After the Procedure?
Clitoral hood reduction surgery is normally done as an outpatient procedure under local or general anesthesia. A specialized laser and surgical instruments remove a predetermined amount of superfluous hood tissue, insuring that accessibility and stimulation to the clitoris is no longer restricted. The clitoral head is not modified in any way. Only the hood is altered. At this time, if the patient so chooses, the surgeon may perform additional procedures to the genitalia, such as vaginal tightening, hymenoplasty or vaginoplasty.

Clitoral hood reduction is microsurgery. The procedure, after complete healing, will leave no scars. Tiny, barely visible incisions will be concealed in the folds of tissue around the surgical area.

There will be some numbness experienced after surgery, but this will subside. The numbness is in no way indicative of nerve or any other damage. In fact, after the effect wears off, sensitivity to the clitoris will be heightened due to easier access to it.

The entire procedure will take approximately an hour depending on what needs to be done.

Aftercare and Recovery
The area will be tender and inflamed, but rest and application of ice will help, along with over-the-counter pain relievers. After about two or three days, the patient will be able to return to work. Complete recovery will take approximately six weeks, and the patient will be cautioned not to engage in sexual intercourse during that time in order to avoid complications. Strenuous activities such as horseback or bicycle riding, running, and heavy lifting should also be avoided during this time. Special care to keep the area clean is important in order to avoid any possibility of infection.

What Are the Complications?
Complications are rare. However, your doctor should be contacted if there are any of the following problems:

  • Intense pain or discomfort
  • Inflammation or numbness after several days
  • Any foul odor or unusual discharge
  • Excessive bleeding.

Interesting Facts Regarding the Clitoris
The size and shape of the full clitoris was not revealed until 1998. Until that time, even though physicians knew of its existence, it was either eliminated from anatomy publications that previously mentioned it briefly, or it was ignored altogether. A 3D sonography image was not available until 2009. Throughout history, the importance of the clitoris to a woman’s sexual pleasure has either been disputed or dismissed altogether. In fact, in the 1500’s, the presence of the clitoris in women was used as irrefutable proof of witchcraft, and was referred to as the ‘devil’s teat’. Perhaps the clitoris snuggled deep within the camouflage of a thick clitoral hood back then saved many a woman from imminent death.

We’re Here to Help
Our highly qualified doctors are here to frankly and openly discuss whether this procedure is right for you. Genital surgery, whether for physical, aesthetic or psychological reasons, is an intimate and important decision. We are here to guide and advise you without judgement, bias or preconception. The more confident and comfortable a woman is with her body, the more pleasurable and satisfying her intimate life will be. We are here to provide the help and advice to make that happen.

To make an appointment with one of our doctors, call 770.720.7733.

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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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