Voted "Best OB-GYN" in Towne Lake, Woodstock and Canton Voted "Mom-Approved OBs" by Atlanta Parent magazine readers
July 25, 2018

Vaginal dryness is a common problem that affects millions of women. Thankfully, lubricants are available to help provide relief from painful sex and irritation. To help you make an informed decision on which lubricant is right for you, it’s first important to learn why you’re experiencing vaginal dryness.

What Causes Vaginal Dryness?

Woman with lubricantsThe most common reason for vaginal dryness is perimenopause, menopause, and post-menopause. Hormones, such as progesterone, estrogen, DHEA (dehydroepiandrosterone) and testosterone begin to plummet with age and can result in dryness.

Several other causes include:

  • Medications that have an overall dehydrating effect
  • Minimal moisture due to inadequate foreplay
  • Certain autoimmune diseases
  • Allergies
  • Stress and prolonged periods of anxiety
  • Alcohol
  • Smoking
  • Cancer treatments
  • Breastfeeding
  • Childbirth
  • Ovarian surgery
  • Hysterectomy
  • Beauty products such as soaps, bath products, scented hygiene products and douches
  • Foods that contain hormones

What Other Conditions Can Accompany Vaginal Dryness?

Lack of vaginal lubrication can affect you in many different ways, resulting in:

  • Pain: When genitals lack sufficient moisture, penetration and other everyday activities can become unbearable.
  • Weakened vaginal elasticity and tissue lining: As vital hormones deplete, skin and tissue thin, sag and lose their ability to stretch. This is why we become reliant on oils, creams, moisturizers, hormonal therapy and lubricants.
  • Psychological issues: Vaginal dryness and the many conditions that cause or accompany it can lead to depression, anxiety and even relationship deterioration.
  • Skin and internal problems: Without vital lubrication, irritation, itching, foul odor, urinary tract infections, and many other pelvic problems can occur. You can even suffer from prolapse, bladder deficiencies, leakage, pressure, chronic pain (vulvodynia) and inflammation (vestibulitis).

Choosing the Right Lubricant for You

Now let’s look at how to select the correct lubricant. There are many types and they range from pleasure-enhancing, non-staining, odorless, perfumed, and even flavored options. And many contain a myriad of unpronounceable ingredients so choosing the right one can be a challenge. Before deciding on the best one for you, you should consider the following:

  •  Safety: You want something that’s natural and safe as certain ingredients contained in over-the-counter lubricants can be unnecessary or harmful. As such, you’ll want to avoid the following:
  1. Chlorhexidine gluconate
  2. Parabens
  3. Benzocaine
  4. Petroleum-based
  5. Propylene glycol
  6. Glycerin
  7. Nonoxynol-9
  8. Phenoxyethanol
  9. Aspartame
  • Multi-purpose usage: Consider buying a lubricant that addresses additional problems such as thinning, skin sensitivity, urine leakage, etc.
  • Compatibility: Will you be using the product in combination with adult pleasure items or condoms?
  • Sensory enhancers: Are taste, smell and texture important? You may prefer something more neutral. Today’s lubricants may also contain menthol or capsaicin, a compound of chili peppers, which tout additional stimulation. While they might enhance your sexual experience, they can also cause uncomfortable stinging or burning to more sensitive skin and tissue.
  • Can any of the ingredients clash with medications you are presently using or any disorder you might currently have?
  • Do you plan to use the lubricant on a daily basis for general dryness, or only when considering intercourse?

Once you have established all safety factors and your personal needs, deciding if you actually need a lubricant, moisturizer, or more aggressive therapies is your next step. Knowing their function and the results they provide will enable you to make the right selection.

What is a Lubricant and What Does it Do?

Most lubricants are designed for mild to moderate dryness and immediate use. They alleviate uncomfortable friction during intercourse and provide short-term relief.

They come in gel or liquid form and the following types are available:

  • Water-based lubricants: These are topical and are not absorbed by the skin. They can be used safely for self-gratification, foreplay stimulation and intercourse. Easy to wash off, they pose no damaging danger to condoms. If you are currently suffering from a yeast infection, make sure your product does not contain glycerin, as it may further aggravate the situation. Water-based lubricants are applied immediately before sex. They do not provide long-term relief for dryness, require no prescription, and are available over the counter.
  • Oil-based lubricants: These may contain petroleum jelly and other harmful additives, so read the labels carefully. Vaginal tissue is highly absorbent, and these lubricants can disrupt your already delicate hormonal balance. Their greasy texture makes them difficult to wash off, exposing you to infectious bacteria and skin disorders. Oil-based lubricants can disintegrate latex condoms that protect you from pregnancy or sexually transmitted diseases (STDs). Polyurethane condoms are recommended. Oil-based lubricants are not intended for long-term relief and available over the counter.
  • Silicone-based lubricants: Silicone lubricants consist of safe, non-toxic ingredients and fall somewhere between the oil- and water- based lubricants. They cannot be absorbed through skin, can be used in water, and pose no danger to latex condoms. Their downside is their disagreeable taste and difficulty to rinse off. Residue can invite bacteria. They should never be used with silicone adult toys because they can stick and cause discomfort. Not everyone feels comfortable with their unusual slipperiness. They are available over the counter and are usually hypoallergenic.
  • Moisturizers: Vaginal moisturizers have been found to be beneficial for women’s menopausal dryness issues. They don’t only soothe friction discomfort, but can be used regularly to minimize daily dryness. Moisturizers continue to work up to four days by adhering to the vaginal walls in the same manner as your natural secretions do. They often come with an applicator for internal use. You may still have to rely on a lubricant for additional help. Moisturizers can be bought without a prescription.
  • Natural, homemade lubricants: Many women make chemical-free lubricants from home ingredients with their own preferred scent and flavor. Some safe ingredients include organic coconut oil, sea buckthorn oil, ghee (purified butter), olive oil or aloe vera. Herbal extracts and essential oils may also be added. Always research if these can be used in tandem with your partner’s condom type to avoid breakage.

Symptoms That May Not be Helped by Lubricants

Store-bought lubricants or other dryness aids may not help some of your symptoms. In that case, you may need to talk to your gynecologist about trying something more effective, such as:

  • Estrogen therapy: Low-dose estrogen therapy requires a prescription. It comes in cream form, tablets with applicators to insert them, or as vaginal rings that must be replaced every three months. The cream should never be used immediately before sex, as hormonal transference is possible. Vaginal estrogen therapy is never recommended for women with breast cancer.
  • Androgen therapy: If you are also experiencing low libido, prolapse, vaginal thinning, or incontinence issues, androgen therapy may be right for you. Available over the counter, this topical vulvar cream contains the hormones testosterone and DHEA (dehydroepiandrosterone). This combination has proven to work wonders for dryness, vaginal irritation, sexual disinterest, urinary leakage, incontinence, thinning and failure to achieve orgasm.

We’re Here to Help You

Dr. Litrel addresses menopause in this informative video as he explains the effects of hormones in various areas of a woman’s life. If you have any questions about vaginal lubricants, moisturizers, or related therapies, our experts at Cherokee Women’s Health Specialists are here to help you. Their skill and training in the most up-to-date technology enable them to diagnose and treat all of your unique feminine issues.

To book an appointment, call 770.720.7733.

February 28, 2018

Hormone replacement therapy (HRT) has been used for decades to correct age-related hormonal imbalances in women. HRT treatments are comprised of both estrogen and progesterone. Depending on your individual needs, hormone replacement therapy can be administered in many ways including; oral, patch, topical, or vaginal treatments.

Hormone replacement therapy is commonly used to treat side effects associated with menopause such as hot flashes, irritability, and even vaginal dryness. Although more research needs to be done, HRT has been shown to be safe and effective when used for short periods of time.

The long-term benefits of hormone replacement therapy are not yet fully known but can include the prevention of bone loss leading to osteoporosis and lower cholesterol levels. However, the risks may outweigh the benefits for many women. There is still much to learn about the different variations of hormone replacement.

HRT Risks Heart health is important for women

It was previously thought that HRT could actually reduce the risk of heart disease but, it may not be as good for our heart health as was once thought. Long-term use of HRT can cause potentially deadly blood clots which can lead to stroke or heart attacks.

After mixed clinical trials, the American Heart Association has recommended that cardiovascular hormone replacement therapy not be given to women solely with the intent to prevent heart disease. Women who have previously had a stroke or a heart attack should not begin taking hormone replacement therapy.

Other Risks associated with hormone replacement therapy may include (but not limited to);

  • Certain Types of Cancers
  • Gallbladder Issues
  • Negative Effects on Mood

Continued research is necessary to fully understand the relationship between hormone replacement therapy and the possible benefits and risks.

Who Should Not Take HRT

Even when used short-term HRT can have an adverse effect on some women. Women with any of the following conditions should seek medical advice before starting hormone replacement therapy to ensure their overall well-being:

  • A history of breast cancer
  • A history of cancer of the uterus
  • Liver disease
  • Blood clots in the veins or legs, or in the lungs (Including blood clots during pregnancy or when taking birth control pills)
  • Cardiovascular disease

Alternative Treatments

Nobody should have to live with painful menopause symptoms. If you’re having bothersome menopausal symptoms but are worried about hormone replacement therapy, talk to your healthcare provider about your options.

Hormone replacement therapy is a widely available option for women seeking to get relief from menopausal-related symptoms but there are alternatives. Here are some of our favorites.

Bioidentical Hormone Replacement

Bioidentical hormones are chemically identical to those found within the human body. They are often used as an alternative to traditional hormone replacement therapy to correct hormonal imbalances. Bioidentical hormone therapy is said to treat such menopausal symptoms as fatigue, bloating, and low sex drive.

Natural Alternatives

Fruits and vegetables with high levels of phytoestrogen (yep, that’s plant-based estrogen), such as soy, red clover, and flaxseed can be used to treat mild to moderate menopausal symptoms.

Additionally, there are many herbal remedies that can help treat side effects associated with hormone deficiencies. One herb, in particular, black cohosh, has shown promising results when it comes to treating hot flashes, insomnia, and vaginal dryness.

Healthy Lifestyle

Maintaining a healthy lifestyle through proper diet and exercise is one of the best ways to manage many menopausal symptoms. Energy levels, mood, mild pain can all be managed through exercise. And, it’s good for your bone and heart health too!

Of course, diet and exercise may not be enough for everyone. You’re encouraged to talk to your doctor about additional treatment options are right for you.

Schedule an appointment with one of our physicians to determine what may be right for you. A friendly member of our staff will be more than happy to answer any questions or address any concerns you have about hormone replacement therapy and your heart.

February 20, 2018

As National Heart Health Month comes to a close, we’d like to touch on a disease that affects an estimated 44-million of women every year. Cardiovascular disease is the number-one killer for women across America. You may be surprised to learn 1-in-3 deaths of women is caused by this deadly disease.

Heart disease differs from woman to woman. Warning signs can be hard to spot and even non-existent. That’s why it’s important to take every possible measure to live a heart-healthy lifestyle especially if you have one or more risk factors.

Cardiovascular disease can include diseased blood vessels, structural problems, or blood clots. Over time, heart disease can cause strokes, heart attacks, arrhythmia, and more.

Who’s at Risk? 

The truth is cardiovascular disease can adversely affect anyone. However, there are several factors that can put you at a higher risk. A whopping 90% of women have at least one or more risk factors for heart disease.

Today, we’ll go over several key risk factors women should be on the lookout for. While some factors cannot be controlled such as age, race, or genetics, there are steps you can take to lower your chances of getting heart disease.

Women from all walks of life should get an annual well-woman exam and maintain an open dialog with their physician. If you have a family history of heart disease or any of the following risk factors, your doctor should be aware.


Most women don’t start to think about heart disease until they’re older. And, while it’s true that age can play a major role in your heart health, it doesn’t always have to. Did you know, the combination of birth control and smoking increases young women’s risk for getting cardiovascular disease by 20%?

Family History

Family history plays a key role in your heart health. High blood pressure and cholesterol levels can pass from one generation to the next and can increase your risk.

You may be at a higher risk for getting heart disease if:

  • Your father had a heart attack before the age of 55.
  • Your mother had a heart attack before the age of 65.
  • Your mother, father, sister, brother or grandparent had a stroke.


Yes, heart disease affects all women but your ethnicity can put you at a significantly higher risk. For example, Hispanic women are more likely to develop heart disease 10-years earlier than Caucasian women. Forty-eight percent of African-American women 20-years and older have cardiovascular disease.

High Blood Pressure/Cholesterol

Having high blood pressure for long periods of time puts added strain on your heart. After a while, it scars and damages the arteries leaving you vulnerable to heart attacks, stroke, kidney failure, and more.

High cholesterol levels can potentially harden and line the artery walls over time causing unwanted blockages. These blockages can lead to blood clots, heart attacks, and stroke.


We all know just how bad smoking is for us. It causes cancer, makes us gain weight, and increases irritability but did you know it affects your heart too? Take a look at how smoking puts you at greater risk for cardiovascular disease.

  • Nicotine makes your heart rate and blood pressure levels skyrocket.
  • Carbon monoxide in tobacco rob your heart, brain, and arteries of oxygen.
  • It damages your blood vessels and makes your blood sticky, making blood clots more likely.
  • It lowers your tolerance for physical activity and decreases HDL (good) cholesterol.

Women who smoke are 25% more likely to get heart disease than men who smoke.

Sedentary Lifestyle

Physical inactivity can lead to blood clots, high blood pressure, heart attack, and strokes. People who don’t have regular to moderate physical activity are 30-40% more likely to be at risk for heart disease.


Even if you have no other health conditions, being 20% overweight can put you at a greater risk for cardiovascular problems. Carrying extra weight (especially in the waist area) puts extra strain on your heart. It can also increase your risk for other heart disease causing factors such as increased cholesterol and blood pressure levels, and induced diabetes.


Adults who have diabetes are 2-4 times more likely to have heart disease or a stroke. Over time, high glucose levels can damage blood vessels and the nerves that control the heart. The good news is, diabetes can be controlled through medication, as well as diet and exercise.

Signs You’re Having a Heart Attack

When it comes to actual warning signs, men and women differ a good deal. While men typically have very specific symptoms such as tightness or extreme pain in the chest, women have more subtle symptoms.

Some signs you may be having a heart attack include (but are not limited to);

  • Indigestion
  • Shortness of breath
  • Nausea/vomiting
  • Dizziness/ lightheaded
  • Discomfort in the jaw, upper back, or arms
  • Prolonged excessive fatigue

Listen to your body. If you think you may be having a heart attack, stay calm and seek immediate medical attention.

Steps to Take Towards a Heart-Healthy Lifestyle

Okay, you may not be able to go back in a time machine and lower your age, but there are several steps you can take towards a healthier life.

  • Be more active. For every hour of regular exercise you get, you keep heart disease at bay and gain approximately two hours of additional life.
  • Lose Weight. Losing as few as 10-pounds can decrease your risk for getting heart disease.
  • Avoid Smoking. After only one year of non-smoking, your risk for cardiovascular disease is cut in half.
  • Lower Cholesterol Levels. Lowering your cholesterol by 1 point decreases your risk for heart disease by 2%.
  • Reduce Blood Pressure. About 7 of every 10 people having their first heart attack have high blood pressure.

Implementing a healthier lifestyle through diet and exercise can add years to your life. Consider making small changes to your daily routine and keep heart disease at bay.

Schedule an annual well-woman visit today to learn more about your risk factors for getting heart disease. Together, you and your doctor can create an action plan for preventing and maintaining healthy heart health.

January 24, 2018

If your doctor looked at your face discoloration that has been worrying you and quickly murmured the word, ‘melasma’, you have nothing to fear. It is not only treatable but oftentimes, it is temporary and in no way a health risk.

What is Melasma?

Melasma is a skin issue that most often affects women, but men can experience it too. Brown or brownish-gray blemishes, or inflamed, red patches (erythrosis pigmetosa faciei) begin to appear in a typically recognizable configuration and hue that physicians can easily identify in areas such as:

  • The jawline (mandibular pattern)
  • The cheek (lateral cheek pattern)
  • Nose, cheeks, upper lips and forehead (centrofacial pattern)
  • Nose and cheeks (malar pattern)
  • Upper arms and shoulders (acquired brachial cutaneous dyschromatosis)
  • The sides of the neck, usually after the age of 50 (poikiloderma of civatte)

What Causes Melasma? Melasma is a common skin condition during pregnancy

The cause is unclear, but there is speculation that hormonal factors, combined with heat, sun, and light exposure, may create an imbalance of cells in the body called melanocytes. These melanocytes normally create the skin pigmentation, melanin, which decides the uniform color and shade of your skin. When melasma occurs, it is thought that the confused melanocytes sense some sort of disruption and command the melanin to generate more pigment. This results in patches of off-color skin.

Who Gets Melasma?

Melasma is completely impartial. Anyone, male or female can get it, but it is more commonly found in:

  • Pregnant women: This form of melasma is known as ‘chloasma’ or ‘the mask of pregnancy’.
  • Women taking contraceptives: Because progestin and/or estrogen found in birth control pills fool the body into believing it is in a state of pregnancy, women taking these medications are also prone to chloasma.
  • Women taking hormonal replacement drugs or steroids
  • Women using intrauterine devices or other implants
  • Women using certain medications for cancer and other problems that may make them more vulnerable to solar rays (photosensitivity)
  • Women using essential oils or certain toiletries, hygiene, and cosmetic products such as soaps, deodorants etc. that may result in skin reactions (phototoxicity) when exposed to the sun’s rays.
  • Darker skin-toned women such as females of Middle Eastern, North African, Latin, Mediterranean, Asian, and Indian descent
  • Women whose backgrounds may include a family history of melasma
  • Women between the ages of 40 to 60 and beyond who have been regularly exposed to the sun.
  • Women suffering from hypothyroidism or other medical issues
  • Women suffering from stress.

How is Melasma Diagnosed?

Melasma is easily identifiable and usually only requires a visual diagnosis, especially if you are obviously pregnant, or if any of the abovementioned criteria apply to you. However, if there is any doubt on the part of your doctor, certain tests can be performed.

One is called a Wood’s lamp examination. This lamp emits a particular light that, when scanning a targeted mottled section, can enable your physician to evaluate the depth of skin affected by the suspected melasma. Treatment would then depend on those findings.

Once the number of skin layers affected by melasma is determined, the Wood lamp results are usually categorized into one of these three classifications:

  • Epidermal melasma which responds very well to treatment
  • Dermal melasma which can be difficult to treat
  • Mixed melasma which can be treated partially.

If the doctor is still not positive that you are presenting with melasma, an additional procedure of removing a small skin sample for further analysis (biopsy) may be required.

Is Melasma Dangerous?

Not at all. Melasma poses no physical health risks whatsoever. It is purely a visual cosmetic issue. Its impact is more emotional and psychological due to the fact that it is predominantly a facial discoloration that is always noticeable. Women with severe melasma often suffer from low self-image, social discomfort and even depression depending on the severity of the condition.

Is There Any Treatment For Melasma?

Absolutely! With pregnancy-related melasma, the condition often disappears by itself after giving birth. Drug modification or complete cessation of medication containing steroids, hormones, or other melasma triggers can eliminate the problem as well.

Minor cases can be addressed through home remedies made with items found in your pantry or spice rack that contain natural bleaching or exfoliating properties. Many recipes are available online and include such ingredients as:

  • Turmeric
  • Papaya
  • Oatmeal
  • Apple cider vinegar
  • Almonds
  • Onion juice
  • Horseradish
  • Lemon juice
  • Sandalwood
  • Aloe Vera gel
  • Mulberry extract

Over the counter preparations can help too. Your doctor may prescribe oral medications or creams containing medicinal ingredients.

For more stubborn or resistant melasma, there are other, more aggressive options that your doctor may discuss with you such as:

  • Dermabrasion
  • Microdermabrasion
  • Topical glycolic or acid peels
  • Fractional lasers
  • Intense pulsed light (IPL)

Does Melasma Always Go Away Completely?

Unfortunately, not all the time. Usually, the gentler interventions mentioned are enough to eliminate the problem altogether or lighten it to a more acceptable level. Some cases of melasma, however, are difficult to correct. They may require several treatments, and even ongoing care to minimize large or extremely dark blemishes. Every case is different and only a specialist can determine your unique needs.

Is There Anything I Can do to Make Sure I Don’t Get Melasma?

There are definitely precautions you can take to lower your risk of getting melasma. You can:

  • Wear SPF 30 or higher sunscreen daily, reapplying it every 2 hours
  • Select make-up that also includes sunscreen
  • Avoid extreme exposure to the sun
  • Wear a wide-brimmed hat, and make sure your neck, shoulders, and arms are covered or protected outdoors
  • Discuss all medications you are taking with your physician to see if any of them may make you more prone to developing melasma. Sometimes a simple adjustment can prevent the condition from occurring.
  • Avoid rough or abrasive cleansers and soaps
  • Apply moisturizer regularly if your skin is dry


If you have already been diagnosed with recurring melasma, or have been unable to eliminate all traces of it, there are now excellent camouflage cosmetics available that greatly reduce the appearance of darker discolorations. As well, if you are experiencing psychological repercussions that often accompany more severe cases. It may be to your benefit to join a support group that can help you share and possibly overcome these issues.

Cherokee Women’s Health Specialists Can Help You if You Have Melasma

At Cherokee Women’s Health Specialists, our doctors can diagnose most cases of melasma. Honest, open, confidential dialogue regarding all your concerns allows us to give you the best possible attention and discuss treatment options you deserve.  We can help you. Melasma can be treated and controlled, and we are available to make that happen.

To book an appointment to discuss melasma with one of our doctors, call (770) 721-6060.

January 15, 2018

An observational study conducted at the Keck School of Medicine of USC determined that intrauterine devices (IUDs) may have the surprising health benefit of lowering the instances of cervical cancer.

Worldwide, cervical cancer is the third highest cancer among women. Projected statistics by the World Health Organization (WHO) estimate that, by 2035, the numbers in the United States alone will climb to 756,000.

According to the information collected from 16 different epidemiological studies, (i.e. studies of disease in different populations), the results of 12,000 women from around the world who used IUDs were analyzed. Findings revealed that invasive cervical cancer among them was lowered by 30%.

Though this revelation is both hopeful and promising, doctors urge you to remember that the statistics are currently based solely on observation and not clinical trials. A great deal more exhaustive research must be done in controlled settings before these conclusions are found to be of merit. Clinical trials require years of intense scrutiny, but if this correlation is proven, it can offer a beacon of hope for women everywhere. Until that time, it is recommended that you be vigilant, schedule regular cancer screening, and vaccinate against the HPV virus—the latter preferably before sexual activity begins.

How does an IUD Work?

An IUD is a device formed like a letter T and is used as a method of birth control. A gynecologist inserts it into your uterus to prevent pregnancy. It is 99% effective and can last anywhere from 3 to 12 years, but can be removed at any time.

To date, there are two kinds of IUDs: hormonal and non-hormonal IKUDs.  Traditional non-hormonal IUDs prevent pregnancy by releasing copper which causes an inflammatory effect. This reaction inhibits sperm movement, stopping it from reaching the egg to achieve ovulation. More recently manufactured IUDs are hormonal. These devices release synthetic progestin. High progestin levels in the body form thick cervical mucus that is hostile to sperm, preventing it from reaching the egg and succeeding at fertilization.

Since hormonal IUDs are a fairly new concept, it is assumed that the subjects used the copper-releasing types, but this information still needs to be clarified.

Exactly why IUDs can lower cervical cancer rates is still a mystery. Speculation is that when the physician is making sure the device is placed correctly, this adjustment in the area known as the transformation zone results in an immune response, protecting the cervix from the pre-invasive lesions which lead to cervical cancer. It is also thought that IUD’s may assist the body in repelling Human Papilloma Virus (HPV) infections, which carry the most danger of triggering cervical cancer.

For many women, the benefits and convenience of an IUD far outweigh the possible risks. IUDs eliminate the worry of forgetting to take a daily pill or renewing a monthly oral contraceptive prescription. Periods are often lighter-even non-existent, so IUDs can also prevent anemia from excessive monthly blood loss. There is no need to interrupt ’the mood’ to insist on a condom to prevent conception–as long as you are in a trusted monogamous relationship. Last, but not least, the almost 100% effectiveness gives women complete peace of mind, allowing them to enjoy lovemaking without worrying about babies they’re not prepared to have.

Though the recent findings and theories provide an optimistic outlook to both women and cancer research, specialists, including those of us at Cherokee Women’s Health Specialists, caution against pinning your hopes on these yet unproven hypotheses. Insisting on an IUD solely to prevent cervical cancer is both unwise and sometimes dangerous.

IUD’s ensure against pregnancy and can possibly lower your risk of a deadly disease based on this new discovery, but they do not guard against sexually transmitted diseases (STDs) or infections (STIs). It is recommended that a condom and/or spermicide always be used, especially if intimacy is with a new partner.

IUD’s can cause cramping, pain, and spotting between periods. You may also experience irregular periods. IUDs can also slip out of place, causing pregnancy-and possible ectopic pregnancy if you are unaware of your condition.

An unknown allergy to copper, if you are given the non-hormonal IUD, can be life-threatening-possibly fatal. In rare cases, an IUD put in place incorrectly can push through the wall of the uterus, which may necessitate removal through surgery.

Are You a Good Candidate for an IUD? Smiling young woman

Because every woman’s body is unique, an IUD may or may not be right for you.  In order to make the right decision that benefits you the most, we take the time to study your medical history in depth. We evaluate any medications and supplements you may be using, run tests if necessary, establish that all is well with a pelvic examination, take into consideration any food or product sensitivities, inquire about allergies and much more. The smallest detail may be of utmost importance in establishing the proper course of birth control for your individual needs.

Our extensive training and accumulated knowledge give us the tools we need to make sure your pelvic and reproductive health is guarded at all times. Alternative birth control methods to an IUD may be prescribed in your case, along with full disclosure of any risks, possible side effects, and percentage of effectiveness. Some of these additional methods are:

  • Vaginal ring (Nuvaring)
  • Birth control patch
  • Birth control pills
  • Copper non-hormonal IUD
  • Hormonal IUD
  • Female condom
  • Male condom
  • Spermicides
  • Cervical cap
  • Depo-Provera injection
  • Diaphragm
  • Sponge
  • Birth control implant

If you no longer wish to have children, you may opt for tubal ligation, a procedure our surgeons are very capable of performing.

If you prefer not to use any of these methods or are unable to tolerate them, we can, upon request, counsel or instruct you on the Fertility Awareness-Based methods (FAMS) and withdrawal methods.

It remains to be seen if the surprising health benefits of IUDs observed in the above mentioned studies do indeed have potential merit before relying on the findings to prevent cervical cancer. If they do show irrefutable proof of prevention, Cherokee Women’s Health Specialists will most likely be among the first of the OB-GYN facilities in Atlanta to implement those findings in the daily care we provide to our patients.

Why Choose Cherokee Women’s for Your Birth Control Options

All methods of birth control carry risks. This is why it’s important that you choose an accredited physician to determine the best option for you if you are trying to prevent pregnancy.

At Cherokee Women’s Health Specialists, we have three doubly accredited urogynecologists- Drs. Litrel, Haley, and Gandhi. All three hold certification in Obstetrics-Gynecology and in Female Pelvic Medicine and Reconstructive Surgery (FPMRS), the latter being an enviable recognition requiring years of training and experience before receiving approval and acceptance by the American Board of Medical Specialists. Furthermore, all three are only among very small, select group of physicians who hold these degrees and practice privately in Atlanta.

Together, along with an additional stellar staff that makes us a broad-based practice offering multiple services, Cherokee Women’s Health Specialists was voted “Best OB-Gyn in Towne Lake, Canton and Woodstock, making us a wise choice for not only your birth control necessities, but also for all your other feminine health and wellness needs.

Call today to schedule an appointment to discuss what birth control options are safest and most beneficial for you at 770.720.7733.

January 9, 2018

As women approach mid-life and start to experience menopause, many often wonder if hormone therapy is the right choice for them. Hormone Therapy is an important consideration for women, and for many, the choice as to which type to use, can be quite confusing. There are basically two types of hormone therapy: traditional, or the more natural approach, which is called bioidentical hormone replacement therapy (BHRT).

Traditional hormone therapy, sometimes referred to as “synthetic,” are FDA approved medications that have been most commonly prescribed for hormone replacement. Bioidentical hormone therapy, or sometimes referred to as “natural”, are compounded at special pharmacies. With natural bioidentical hormones, there is good evidence that women can find relief from symptoms of hormonal imbalance without the risks that come along with synthetic hormones.

What are Bioidentical Hormones? 

Bioidentical hormones are derived from naturally occurring sources, such as soy or yams, and are designed to replicate the same chemical structure as the hormones that are produced naturally by our bodies. Based on your hormone levels, a compounding pharmacy can individually tailor a bioidentical hormone regimen specifically designed for you by your physician. BHRT allows for the greatest ability to create custom therapy best suited for you as an individual. Typical cost should be $40-$45 per month.

Are Bioidentical Hormones Safer, More Effective than Synthetic Hormones?

Bioidentical hormones are more suitable to most when dealing with menopause because they are derived naturally and our bodies can metabolize them properly. Another advantage of using bioidentical hormones is that they are specifically designed to match your individual hormonal needs – unlike synthetic hormones, which often uses a one-size-fits-all approach to symptom relief.

There is much supportive literature that suggests bioidentical hormone therapy is safer and more effective than synthetic hormone replacement. However, it’s important to remember that no drug or supplement is completely safe – that is where the expertise of a women’s specialist is needed to decide the best approach for you and your specific medical needs. At Cherokee Women’s Health Specialists, our physicians are board certified in Obstetrics and Gynecology and are experts in menopausal management.

What are the Benefits of Bioidentical Hormone Therapy? 

Some of the day-to-day benefits are as follows:

  • Stops hot flashes
  • Diminishes night sweats
  • Increases energy
  • Helps control anxiety and irritability
  • Decreases brain fog
  • Controls loss of hair, brittle nails and dry skin
  • Helps lift mood or depression symptoms
  • Helps manage weight
  • Increases libido
  • Reduces vaginal dryness

Hormone therapy also has long-term benefits that significantly impact life:

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

How Do I Know What Hormones and What Amounts are Right for me?

Based on your age, history, symptoms, whether you’ve had a hysterectomy, and other factors, one or more hormones will be suggested. On occasion, a blood test will be performed to check the hormone levels. Again, it is very important that you choose an OB/GYN that is an expert in menopause management and is up-to-date on the latest medical information.

What is the Best Way to take Bioidentical Hormones and How Long?

Usually the best route to take bioidenticals is through the skin, such as a roll-on gel or cream. Occasionally, oral medication or pills will be given. We know that menopause accelerates the aging process and causes challenging daily symptoms. Additionally, there are known health benefits of being on hormone therapy, so for most, it is recommended to be on HRT for the rest of your life.

Why Should You Choose Cherokee Women’s Health to Manage Bioidenticals?

Our method of managing your hormone therapy has your best interest in mind. We limit visits and lab tests to only what’s needed, using symptoms to monitor most of your progress. In an office visit and possibly a basic blood test, you can be given a prescription for bioidentical hormone therapy and be on your way to feeling your best. If your symptoms remain, we can tweak the dosage until your are at your optimal health.

At Cherokee Women’s Health Specialists, our goal is to help women live the best life possible. When you give your body the attention and support it needs, you’ll look better and feel better because of it.

With bioidentical hormones and the help of our highly trained physicians, you can be on your way to feeling your best in no time.

Call our office at (770) 720-7733 for an appointment with one of our menopause management expert physicians.

November 22, 2017

Many people are afraid to ask important questions when it comes to their sexual health. But it’s better to be safe than sorry.

Separate fact from fiction when it comes to STDs and STIs.

Today, we’ll walk you through how STDs are spread so you can learn the best ways to treat and prevent them. Ask your doctor to clarify facts on any questions you might have regarding STDs and STIs.

Who Can Get STDs?

Anyone who is sexually active can get an STD or an STI. You are considered sexually active if you have vaginal, anal, or oral sex.

More young people have an STD than older adults. Nearly half of everyone under the age of 25 has an STD or STI. This is especially alarming considering this age bracket only makes up for one-quarter of people having sex.

Many STDs and STIs do not have any symptoms. Talk with your partner and get tested together before becoming sexually active.

How to Prevent STD/STIs?

The only way to 100% prevent STDs and STIs is to abstain from sexual activity.

However, you can reduce the risk of contracting a sexual disease by using a condom.

Even if you are on birth control, you should consider STD protection. While birth control can prevent you from becoming pregnant, it will not aid in the prevention of STDs.

How Are STDs and STIs Diagnosed? 

If you think you might have been exposed to an STD, get tested right away. The only way to know for sure is to get tested.

Remember, STD and HIV testing is not always a part of your regular doctor visit. If you’re sexually active, don’t assume you are STD-free without getting tested.

Testing for STDs is confidential, quick, and easy. For example, you can get tested for HIV with a simple oral cotton swab and know your results in as little as 20-minutes. Other STDs can be tested by a urine test, vaginal swab, or a quick blood test.

What if I have an STD?

Having an STD isn’t the end of the world. All STDs including HIV are treatable. Most are even curable.

It’s important to be open with your sexual partner. Having an honest conversation before sex (whether it be vaginal, anal, or oral) can help stop the spread of STDs.

While these conversations may seem hard, it’s better to have a responsible talk sooner than later. This way, you can both be vigilant in protecting against STD transfer to an uninfected partner.

Concerns About Sexual Health

When it comes to sexual health, it’s better to be safe than sorry. If you think you may have been exposed to an STD or STI, see your doctor right away.

Untreated, STDs can lead to serious health problems down the road. Don’t be afraid to talk to your doctor about symptoms you may be having.

Still have questions? Don’t hesitate to contact us with concerns regarding your symptoms. A member of our trained staff can answer questions about your sexual health or schedule a confidential appointment.

‘Tis the season to maximize your annual insurance benefits. Get the most out of your medical benefits before the year comes to a close. In many instances, preventative care treatments are available to you with no co-pay or co-insurance.

Plus, if you’ve already satisfied your health insurance deductible, it’s the perfect time to get last minute screenings. Your deductible will automatically restart at the beginning of the year, meaning you’ll likely be paying out-of-pocket for those same procedures.

Here are a few tips and tricks that you can do to maximize your annual check-up.

#1 Come Prepared Make the most of your annual exam

From the moment you schedule your appointment (or even before), keep a list of questions and concerns you’d like to speak to your physician about. Going through your checklist at the start of your visit will ensure you get the most out of your exam and that all of your concerns are addressed.

#2 Review Your Medical History – And, Your Family’s

Filling out medical forms 5 minutes before your visit can potentially leave vital information missing. Doing your homework beforehand can give your doctor the information they need to properly treat you. Include: family members who have had cancer, heart disease, diabetes, or other conditions that run in your family.

#3 Remember: Your Doctor’s Office is a Judgement-Free Zone

Don’t be afraid to bring up uncomfortable topics such as weight, fertility, or sexual health – even if it’s something small. You may not realize it but your doctor could recognize your problem as a sign or symptom of something bigger. Small problems, like being slightly overweight can also increase your risk for illnesses such as heart disease and certain cancers. Being open and honest with your doctor could help you set a plan for a better overall well-being.

#4 Talk About Vaccines

Just because you’re not in grade-school anymore doesn’t mean you get to escape the dreaded needle. When you get your flu shot, ask your doctor what other vaccines you’re due for. Adults still require a tetanus shot every 10-years for example. Your doctor may also suggest a pertussis vaccine for whooping cough – especially if you come in close contact with infants or small children.

#5 Bring Up Age-Related Issues

Even if you don’t have a family history of breast cancer, you should get a mammogram annually starting at the age of 40. Starting between 35-40 you should also have annual blood tests done to check cholesterol and blood-sugar levels. After menopause, women should have thyroid tests done every 5 years as well.

#6 It’s Not Just Physical

Your emotional health is just as important as your physical well-being. Let your physician know if you’re not sleeping properly, you’re extra stressed, or are feeling down in the dumps. Your doctor might be able to suggest simple lifestyle changes that can benefit your emotional well-being.

Final Thoughts

Now is the time to start seriously thinking about last-minute preventative care. Use this opportunity to maximize your annual health insurance benefits. You’ll have your health care provider’s undivided attention–make the most of it.

Call our offices to schedule your annual exam today. If you have any questions or concerns regarding your well-being, don’t hesitate to call. A trained member of our staff will be happy to help.

Self-breast exams are important for adult women. Approximately 1-in-8 US women will develop invasive breast cancer during her lifetime. Regular breast exams can help familiarize yourself with your body and provide early detection for breast cancer in many women.

How Often to Do a Self-Breast Exam

Feel free to do a self-breast exam as often as you like. The more familiar you are with your breasts, the easier it is to recognize noticeable changes. Typically, adult women should complete a self-exam at least once a month.

Breast cancer cannot be prevented but it can be detected early and caught before it spreads. If you discover changes in your breasts, seek medical attention as soon as possible for a professional evaluation.

What to Look for During a Self-Exam Breast exams are an important part of a woman's health and wellness.

Breast cancer can look different for many women. However, some of the things you should be looking for when doing a self-exam are the following;

  • A lump or hardened knot
  • Thickening or discoloration of the skin
  • Redness, soreness, or swelling
  • Changes in the contour of the breast
  • Changes in nipple color or inverted nipple
  • Unusual discharge from nipple

Keep in mind, not all symptoms of breast cancer are the same. If you suspect anything out of the norm when completing a breast exam, schedule a consult and mammogram with your physician immediately.

Self-Breast Exam Techniques

Some women prefer to do a circular motion using the pads of their fingers. Start at the center of your breast using a medium-firm pressure. Be sure to cover the entire area of the breast from armpit to cleavage.

Another way to evaluate your breasts is using a top to bottom method. Again, use a medium-firm pressure to run your fingers up and down your entire breast region. Start at your collarbone and glide your fingers down to your abdomen.

Where to Complete a Self-Breast Exam

An accurate self-breast exam will require three simple steps in 2-3 positions. When done correctly a self-exam shouldn’t take more than 10 minutes of your time.

In of the Mirror

Standing in front of a mirror allows you to visually inspect your breasts. Start with your arms at your sides and look at your breasts from the left, right, and frontal positions. After you’ve completed this portion of your exam, repeat the process with your arms high above your head.

Lying Down

For the second portion of your breast exam, you’ll need to be in a lying position. Lying down is advantageous because your breast tissue is flat against your chest cavity making it easier to spot something unusual.

Once you’re lying on your back, place a pillow under your right shoulder (or whichever side you’d like to examine first). Then, fold the same arm behind your head. Take the opposite hand and begin to use your preferred examination technique.

After you’ve covered the entire breast area, repeat the process with your other side.

In the Shower

During the final step of your exam, you’ll need to be standing upright. Many women find it easier to complete this stage of the self-examination in the shower where the skin is wet and slippery. Once again, use a medium-firm pressure to feel for anything out of the norm on both breasts.

At this time, lightly squeeze your nipple feeling for lumps and looking for any time of discharge.

Final Thoughts

Don’t hesitate to give us a call for further guidance regarding your self-breast exam. If you’ve discovered something unusual that you want a professional to evaluate, call to schedule a consultation immediately.

November 21, 2017

Your diet impacts every aspect of your body. And, yes, that includes your vagina as well. Making healthier choices can boost your sexual health, reproductive health and even help women navigate menopause with less severe symptoms.

A healthy vagina has naturally healthy acidic pH levels. A vagina that’s in good health has a host of healthy bacteria known as probiotics. These good bacteria ward off infections and keep your reproductive system working smoothly.

Today, we’ll take a look at several simple dietary adjustments you can make to maintain optimal vaginal and sexual health.

Alleviate Painful Cramps

Foods rich in omega-3 fatty acids can help ease your period pain. Omega-3 fatty acids have anti-inflammatory properties that reduce period symptoms such as cramps. Some omega-3 rich foods to add to your diet include:

  • Tuna
  • Salmon
  • Avocado
  • walnuts

If you’re craving something on the sweet side, try fresh fruit like strawberries or raspberries.

If you’re experiencing cramps related to your period, you may want to avoid these foods; fatty foods, alcohol, caffeine, and salt.

Ward Off Yeast Infections

Probiotic-rich foods have been shown to promote a good pH balance within the vagina. The good bacteria Lactobacillus improves overall vaginal health and can help prevent yeast infections.

The best probiotic-rich foods to try for the prevention of yeast infections are:

  • Greek yogurt
  • Kimchi
  • Sauerkraut
  • Kefir

While you’ve probably heard about the benefits of cranberry juice in the treatment of yeast infections, it’s also packed with unhealthy amounts of sugar.

Put an End to UTIs

Urinary tract infections (UTIs) can cause annoyingly frequent bathroom breaks and a painful burning sensation. About half the women in the US have (or will have) a UTI at some point in their life.

Keeping your body hydrated by drinking lots of water is a great way to flush bad bacteria from your kidneys, bladder, and uterus. Another great way to keep UTIs at bay is to consume plenty of antimicrobial-rich foods such as green tea and ginger.

Avoid acidic foods such as tomatoes, oranges, limes, and lemons.

Counteract Menopause Symptoms

There are even foods that can help you navigate menopause with less severe symptoms. Vaginal dryness, for example, is caused by reduced estrogen levels. Phytoestrogens (a natural plant-based estrogen replacement) can help reduce irritating vaginal dryness.

Some good phytoestrogen-rich foods include soy products such as:

  • Edamame
  • Tofu
  • Miso
  • Tempeh

These soy-based products are also hydrophilic, or natural lubricants, that attract moisture to your tissue.

Final Thoughts

Healthy foods equal a happy, healthy vagina. But keep in mind, the foods you eat only affect your body for 2-3 days after consuming them. It’s important to maintain a healthy diet for optimal sexual and vaginal health.

To learn more about your sexual health, give us a call. We’ll be happy to answer any questions you may have or schedule a nutritional consultation.

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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.”
– Vicki

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