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GYN Problems

Can Endometriosis Be Genetic?

Can endometriosis be genetic? We’ll explore the genetic links to endometriosis and how our board-certified OB/GYNs at Cherokee Women’s Health can help you manage your risks and symptoms. Endometriosis is a chronic and often painful condition affecting approximately 1 in 10 women of reproductive age. Characterized by the growth of tissue similar to the uterine lining outside the uterus, it can lead to severe pelvic pain, heavy periods, and infertility. While the exact cause of endometriosis remains unclear, researchers have increasingly pointed to genetics as a significant factor. The Genetic Connection: Is Endometriosis Hereditary? Mounting evidence suggests that endometriosis has a hereditary component. Studies show that women with a first-degree relative—such as a mother, sister, or daughter—diagnosed with endometriosis are up to 7-10 times more likely to develop the condition themselves. This increased risk points to a genetic predisposition, though the condition isn’t caused by a single gene. Instead, it’s considered polygenic, meaning multiple genetic variations, combined with environmental factors, contribute to its development. Research published in journals like Human Reproduction has identified specific genetic markers associated with endometriosis, particularly those linked to inflammation, hormone regulation, and tissue growth. For example, variations in genes like WNT4 and GREB1 have been implicated in altering how the body responds to estrogen, a key driver of endometrial tissue growth. While these findings don’t guarantee you’ll inherit endometriosis, they highlight why family history is a critical piece of the puzzle. At Cherokee Women’s Health, our OB/GYNs take your family history seriously. During your consultation, we’ll ask detailed questions about your relatives’ health to assess your risk and guide our diagnostic approach. How Family History Influences Endometriosis Risk Understanding your family history can be a powerful tool in predicting and managing endometriosis. If your mother or sister has experienced symptoms like chronic pelvic pain, painful periods, or fertility struggles, it could signal a shared genetic vulnerability. Twin studies further support this link: identical twins, who share nearly 100% of their DNA, are more likely to both have endometriosis compared to fraternal twins, who share about 50%. However, genetics isn’t the whole story. Environmental factors—such as exposure to endocrine-disrupting chemicals (e.g., BPA in plastics) or lifestyle habits—can interact with genetic predispositions to trigger or worsen the condition. This interplay explains why some women with a family history never develop endometriosis, while others without apparent genetic risk do. Recognizing Symptoms: Could It Run in Your Family? Endometriosis symptoms can vary widely, but they often overlap within families due to shared genetics. Common signs include: Severe menstrual cramps that worsen over time Chronic pelvic pain outside of periods Pain during intercourse Heavy or irregular bleeding Infertility or difficulty conceiving If these sound familiar—especially if a close relative has similar complaints—it’s worth exploring further. Early recognition is key, as endometriosis is often misdiagnosed or dismissed as “normal” period pain, delaying treatment by years. Managing Genetic Risks: Prevention and Treatment Options While you can’t change your DNA, understanding your genetic risk for endometriosis opens the door to proactive management. Modern medicine offers a range of strategies to reduce symptoms and prevent complications, tailored to your unique needs. Here’s how we approach it at Cherokee Women’s Health: Hormonal Therapies Since estrogen fuels endometrial growth, hormonal treatments like birth control pills, progestin IUDs, or GnRH antagonists (e.g., elagolix) can suppress symptoms and slow disease progression. These options are especially helpful for women with a family history who want to manage risk before symptoms escalate. Lifestyle Adjustments Research suggests that diet and exercise may influence endometriosis severity. Anti-inflammatory foods (e.g., fatty fish, leafy greens) and regular physical activity can help mitigate inflammation, a key factor in the condition. Our team provides guidance on lifestyle changes to complement medical treatment. Surgical Intervention For severe cases or fertility concerns, minimally invasive laparoscopic surgery can remove endometrial lesions while preserving reproductive health. Our physicians excel in these advanced techniques, offering shorter recovery times and better outcomes. Fertility Support If endometriosis runs in your family and you’re planning to conceive, we collaborate with fertility experts to optimize your chances, whether through surgery or assisted reproductive technologies like IVF. By addressing your genetic risk early, we aim to minimize the impact of endometriosis on your life. Call us at 770-720-7733 or schedule online for a free consultation to discuss your options. Take Control of Your Health Today So, can endometriosis be genetic? The answer is yes—family history plays a significant role in your risk, but it doesn’t have to define your future. At Cherokee Women’s Health Specialists, our board-certified OB/GYNs are here to help you uncover your risks, recognize symptoms, and access cutting-edge treatments to live better with or without endometriosis. Whether it runs in your family or you’re experiencing unexplained pain, we’re ready to support you with compassionate, expert care. Don’t let uncertainty hold you back. Contact us today at 770-720-7733 or schedule and appointment online. Together, we’ll explore your family history, assess your risks, and create a plan to protect your health—because you deserve answers and relief.

GYN Problems

Modern Advances in Treating Endometriosis

Cherokee Women’s Health is at the forefront of treating endometriosis, a chronic condition affecting millions of women worldwide, characterized by the growth of tissue similar to the uterine lining outside the uterus. This often leads to debilitating pain, heavy periods, and infertility, significantly impacting quality of life. For years, treatment options were limited, but recent advances in medical research and technology have opened new doors for managing this condition effectively. At Cherokee Women’s Health Specialists, our board-certified OB/GYNs offer personalized, cutting-edge care to women in Woodstock and Canton, Georgia. In this article, we’ll explore the latest breakthroughs in endometriosis treatment and how our team can help you reclaim your health and well-being. Understanding Endometriosis: A Growing Need for Better Solutions Endometriosis affects approximately 10% of women of reproductive age, yet it remains underdiagnosed and misunderstood. Symptoms like severe pelvic pain, painful periods, discomfort during intercourse, and fertility challenges often go unrecognized or dismissed, leaving women suffering in silence. Traditionally, treatments focused on symptom management through pain relief or hormonal therapies, with surgery reserved for severe cases. However, modern research has reframed endometriosis as a complex, multi-system disorder, driving the development of more targeted and effective solutions. Our OB/GYNs understand the unique challenges of endometriosis. With decades of combined experience, state-of-the-art diagnostic tools, and a patient-centered approach, we’re committed to helping women navigate this condition with confidence and compassion. Modern Advances in Endometriosis Treatment The past decade has brought remarkable progress in endometriosis care, from improved diagnostics to innovative therapies. Here’s a look at some of the most promising advancements: 1. Enhanced Diagnostic Techniques: One of the biggest hurdles in treating endometriosis has been delayed diagnosis, with women often waiting 7-10 years for answers. Today, advances in imaging technologies, such as high-resolution transvaginal ultrasound and 3.0 Tesla MRI, allow for earlier detection of endometriomas (ovarian cysts caused by endometriosis) and deep infiltrating lesions. While laparoscopy remains the gold standard for definitive diagnosis, these non-invasive tools help OB/GYNs identify the condition sooner, enabling faster intervention. 2. Hormonal Therapies: Beyond the Pill: Hormonal treatments have long been a cornerstone of endometriosis management, aiming to suppress estrogen production and reduce lesion growth. Recent developments have expanded these options, offering more flexibility and fewer side effects. For example, gonadotropin-releasing hormone (GnRH) antagonists, such as elagolix, provide rapid symptom relief without the harsh “menopause-like” effects of older GnRH agonists. Progestin-only therapies, including intrauterine devices (IUDs) like Mirena, also offer long-term pain control and menstrual suppression with minimal systemic impact. 3. Targeted Pain Management: Pain is the hallmark of endometriosis, and new approaches are revolutionizing how it’s addressed. Beyond traditional nonsteroidal anti-inflammatory drugs (NSAIDs), researchers are exploring therapies targeting inflammatory pathways specific to endometriosis. For instance, studies on the gut-brain axis suggest that inflammation driven by microbiome imbalances may worsen pain, paving the way for novel treatments like probiotics or anti-inflammatory drugs originally developed for other conditions. 4. Minimally Invasive Surgical Techniques: For women with severe endometriosis or those seeking fertility preservation, surgery remains a key option. Laparoscopic surgery, which uses small incisions and a camera to remove endometrial tissue, has evolved with robotic assistance and improved precision. These advancements reduce recovery time, minimize scarring, and enhance outcomes compared to traditional open surgery. 5. Fertility-Focused Innovations: Endometriosis is a leading cause of infertility, but modern reproductive technologies are offering hope. Assisted reproductive techniques like in vitro fertilization (IVF) have become more refined, with protocols tailored to endometriosis patients. Additionally, surgical excision of endometriomas or adhesions can improve natural conception rates, particularly in mild to moderate cases. 6. Emerging Drug Therapies: Perhaps the most exciting frontier is the development of non-hormonal drugs targeting endometriosis at its root. Clinical trials, such as the EPiC study, are testing compounds like dichloroacetate (DCA), which may reduce lesion growth and pain without affecting fertility. While still in early stages, these breakthroughs could transform endometriosis care, offering a non-contraceptive alternative for the first time. How Cherokee Women’s Health OB/GYNs Can Help Located in Woodstock and Canton, Cherokee Women’s Health Specialists is uniquely positioned to deliver world-class endometriosis care. Here’s how our team stands out: Expertise You Can Trust:  Our practice boasts a rare combination of board-certified OB/GYNs and three FPMRS specialists—experts in pelvic health and reconstructive surgery. This depth of knowledge allows us to address endometriosis comprehensively, from diagnosis to advanced treatment. Whether you’re dealing with mild discomfort or complex pelvic issues, our team has the skills to help. Personalized Treatment Plans: No two cases of endometriosis are alike, which is why we prioritize individualized care. During your consultation, we’ll discuss your symptoms, medical history, and future plans—whether that’s pain relief, fertility, or both. From there, we craft a tailored plan that may include hormonal therapy, surgery, or lifestyle support, all designed to fit your life. A Holistic Approach: We recognize that endometriosis affects more than just your physical health—it impacts your emotional and social well-being too. Our team offers compassionate support, connecting you with resources like counseling or nutritional guidance to address the full scope of your experience. Convenient Access: With locations in Woodstock and Canton, scheduling an appointment is easy. Schedule Your Appointment Today Call us today at 770-720-7733 or schedule an appointment online to start your journey toward relief.

O-Shot Education, Vaginal Rejuvenation Patient Stories

How Andrea Stopped Bladder Leaks—And Got a Bonus

Andrea started noticing mild bladder leaks that, while not severe, were just enough to become a disruption. Whether it was a small leak when she sneezed, a sudden urge that made her nervous during carpool duty, or the worry of finding a restroom quickly while running errands, it was starting to impact her daily life, which was very troublesome as she’d always been an active and confident woman. At 46, she was a busy mom to two kids, aged 12 and 10, juggling work, family, and everything in between. One evening, while scrolling through health articles online, Andrea stumbled upon something intriguing—the O-Shot. She had heard of it before, but only in the context of improving sexual function. What she didn’t know was that this treatment was also being used to help women with urinary incontinence. The article explained how the O-Shot, which uses Platelet-Rich Plasma (PRP) from a woman’s own blood, could help regenerate tissue and strengthen the pelvic floor, potentially reducing or even eliminating bladder leaks. Searching for a Female Pelvic Health Specialist Andrea was intrigued but cautious. She wanted to make sure she saw a true expert, someone with specialized training in female pelvic health. She quickly learned that urogynecologists—OB/GYNs with additional expertise in treating bladder and pelvic floor disorders—were the best specialists for this type of issue. A little more research led her to a surprising discovery: there were not one but two double board-certified urogynecologists right in her town at Cherokee Women’s Health Specialists.   Meeting Dr. James Haley Encouraged, Andrea scheduled a consultation with Dr. James Haley. From the moment she stepped into his office, she felt at ease. Dr. Haley took the time to listen to her concerns, explain the science behind the O-Shot, and discuss what she could realistically expect. After reviewing her medical history and answering all her questions, he assured her that she was a great candidate for the procedure.Andrea decided to go for it, and the procedure itself was quick and surprisingly comfortable. Within a few weeks, she began noticing subtle but significant improvements. The little leaks that had been causing her so much anxiety were happening less frequently, and before long, they stopped altogether. She felt a newfound sense of freedom—no longer worrying about restroom access, unexpected leaks, or planning her activities around her bladder. Increased Sensitivity—A Bonus! And while Andrea hadn’t sought out the O-Shot for its sexual benefits, she wasn’t upset about those results either. She and her husband noticed an increase in sensitivity and overall pleasure—an added bonus she happily embraced. Looking back, Andrea was grateful she took control of her health and found a solution that worked. Thanks to the expertise of her urogynecologist and the effectiveness of the O-Shot, she was able to regain confidence, comfort, and a better quality of life. For any woman dealing with mild incontinence, Andrea would say this: don’t wait. The right help is out there—and sometimes, the best solutions come with unexpected benefits. Contact Erica For More Information To learn if the O-Shot may be right for you contact Erica to schedule a confidential consultation: Text: 770.874.0937 Call: 770.721.6060 E-mail: erica.deese@cherokeewomenshealth.com

O-Shot Education, Vaginal Rejuvenation

The O-Shot: A Breakthrough for Bladder Control

The O-Shot is a natural, non-surgical procedure that can help restore bladder control and improve quality of life. If you’re struggling with bladder leaks, you’re not alone. Millions of women experience urinary incontinence, whether it’s occasional leaks when laughing or sneezing (stress incontinence) or the sudden, overwhelming urge to go (urge incontinence). While there are many treatment options available, one lesser-known but highly effective approach is the O-Shot. What is the O-Shot? The O-Shot, or Orgasm Shot, is an innovative treatment that uses Platelet-Rich Plasma (PRP) from your own blood to rejuvenate tissue and improve function in the vaginal and urethral area. While often associated with enhancing sexual pleasure, the O-Shot has shown remarkable benefits for urinary incontinence as well. How Does the O-Shot Help with Incontinence? The growth factors in PRP stimulate tissue repair and increase collagen production, which can strengthen the pelvic floor and improve bladder control. This can help women dealing with: Stress Incontinence: Leaking when sneezing, coughing, laughing, or exercising due to weakened pelvic muscles. Urge Incontinence: The sudden, frequent need to urinate, often leading to accidents before reaching the bathroom. Mixed Incontinence: A combination of both stress and urge incontinence. What to Expect from the Procedure The O-Shot is a quick, in-office treatment performed by our double board-certified urogynecologists at Cherokee Women’s Health. The process includes: Blood Draw: A small sample of your blood is taken and processed to extract PRP. Numbing Cream Application: A topical anesthetic is applied to ensure comfort. PRP Injection: The PRP is carefully injected into targeted areas near the urethra and vaginal tissue to stimulate healing and regeneration. The entire procedure takes less than an hour, and most women experience little to no downtime. Benefits of the O-Shot for Bladder Control Many women notice improvements in bladder function within a few weeks, with results continuing to improve over several months. Benefits include: Stronger pelvic support for better bladder control Reduced or eliminated leaks with everyday activities Fewer nighttime trips to the bathroom Increased confidence and freedom to enjoy life without fear of accidents Is the O-Shot Right for You? If you’re experiencing urinary incontinence and want a natural, non-surgical solution, the O-Shot may be an excellent option. At Cherokee Women’s Health, our urogynecology experts specialize in treating bladder health concerns and can help determine if this treatment is right for you. Contact Erica For More Information To learn if the O-Shot may be right for you contact Erica to schedule a confidential consultation: Text: 770.874.0937 Call: 770.721.6060 E-mail: erica.deese@cherokeewomenshealth.com

GYN Problems

Heavy Periods After Stopping Birth Control

One unexpected side effect that often catches people off guard is heavy periods after discontinuing birth control. For many women, stopping birth control is a big decision, whether it’s to try for a baby, switch methods, or simply take a break from hormonal contraception. If you’ve recently stopped taking the pill, patch, or another hormonal contraceptive and noticed your periods are heavier than before, you’re not alone. This article explores why heavy periods happen after stopping birth control, what’s normal, and when you might need to see a doctor. Understanding How Birth Control Affects Your Cycle To understand why your periods might get heavier after stopping birth control, it helps to know how these methods work. Hormonal contraceptives—like the pill, patch, ring, or hormonal IUD—rely on synthetic hormones (usually estrogen and progesterone) to regulate your menstrual cycle. They suppress ovulation, thin the uterine lining, and often lighten or even stop your periods altogether. When you’re on birth control, your body adjusts to this artificial hormonal balance. The “period” you experience while on the pill, for example, isn’t a true period—it’s withdrawal bleeding caused by the drop in hormones during the placebo week. Because the uterine lining doesn’t build up as much under hormonal influence, bleeding tends to be lighter and more predictable. Once you stop birth control, your body needs time to recalibrate. Your natural hormonal cycle kicks back in, and for some women, this transition leads to heavier, longer, or more painful periods than they’re used to. But why does this happen? Let’s dive into the reasons. Why Are My Periods Heavier After Stopping Birth Control? 1. Hormonal Rebalancing: When you discontinue hormonal birth control, your ovaries start producing estrogen and progesterone again on their own. This shift can take a few weeks to several months, depending on your body and the type of contraception you were using. During this adjustment period, hormone levels may fluctuate, causing the uterine lining to thicken more than it did on birth control. A thicker lining means more tissue to shed during your period, which can result in heavier bleeding. 2. Return to Your Natural Cycle: If you started birth control as a teenager or young adult, the periods you had while on it might not reflect your body’s natural menstrual cycle. After years of hormonal suppression, your “real” periods might naturally be heavier or more intense than the controlled withdrawal bleeding you experienced. For some, this is a rude awakening—especially if they assumed birth control “fixed” their periods permanently. 3. Underlying Conditions Resurfacing: Birth control is often prescribed to manage conditions like polycystic ovary syndrome (PCOS), endometriosis, or uterine fibroids, all of which can cause heavy periods. While on contraception, these issues might have been masked by lighter bleeding or skipped periods. Once you stop, the symptoms of these conditions can return, leading to heavier flows. If your periods become unmanageable, it could be a sign to investigate further with a healthcare provider. 4. Post-Birth Control Shedding: Some women experience what’s informally called a “detox” period after stopping birth control. This isn’t a medical term, but it reflects the idea that your body may shed an extra-thick uterine lining as it clears out the effects of synthetic hormones. This shedding can make your first few periods after discontinuation heavier than usual. 5. Type of Birth Control Matters: The type of birth control you were using can also influence what happens when you stop. For example, progestin-only methods (like the mini-pill or hormonal IUD) might lead to different post-discontinuation effects than combined estrogen-progestin methods (like the pill or patch). Women who stop using a hormonal IUD, such as Mirena, sometimes report heavy bleeding as their uterine lining adjusts to the absence of localized hormones. How Long Will Heavy Periods Last After Stopping Birth Control? The good news is that for most women, heavy periods after stopping birth control are temporary. Your cycle should stabilize within 3 to 6 months as your hormones find their natural rhythm. However, this timeline varies. Some women notice changes for just one or two cycles, while others take longer—especially if they were on birth control for many years. If you’ve been off birth control for more than six months and your periods are still unusually heavy, it’s worth checking in with a doctor. Persistent heavy bleeding (known as menorrhagia) could signal an underlying issue that needs attention. What’s Normal vs. What’s Not It’s normal to experience some changes in your period after stopping birth control, including: Heavier bleeding than you had on contraception Longer periods (up to 7 days is still considered normal) More intense cramps or clotting Irregular cycles for a few months However, there are red flags that warrant a trip to the doctor: Soaking through a pad or tampon every hour for several hours Periods lasting longer than 7 days consistently Large blood clots (bigger than a quarter) Severe pain that interferes with daily life Signs of anemia (fatigue, dizziness, pale skin) from excessive blood loss These symptoms could indicate conditions like endometriosis, fibroids, or a hormonal imbalance that birth control was previously managing. Tips to Manage Heavy Periods After Stopping Birth Control If your periods are heavier but still within the realm of normal, there are ways to cope while your body adjusts: 1. Track Your Cycle: Use an app or journal to monitor your period’s length, flow, and symptoms. This can help you spot patterns and feel more in control during the transition. 2. Stock Up on Supplies: Switch to high-absorbency pads, tampons, or a menstrual cup to handle heavier flows. Period underwear is another great option for added protection. 3. Support Your Body: Eat iron-rich foods (like spinach, red meat, or lentils) to replenish what’s lost during heavy bleeding. Pair them with vitamin C (think oranges or bell peppers) to boost absorption and combat fatigue. 4. Try Natural Remedies: Some women find relief from cramps and heavy flow with heat therapy (like a heating pad) or herbal teas (such as ginger

GYN Problems

Thyroid Disorders and Heavy Periods: The Hormonal Link

For many women, thyroid disorders can lead to a cascade of symptoms, one of the most disruptive being heavy menstrual bleeding. Regarding women’s health, hormones are often at the center of the conversation. They regulate everything from mood to metabolism and play a starring role in the menstrual cycle. But what happens when the delicate balance of hormones goes awry? Understanding the connection between the thyroid gland and menstruation can empower women to seek the right diagnosis and treatment. We’ll explore how thyroid disorders influence heavy periods, the hormonal mechanisms at play, and what can be done about it. The Thyroid: A Hormonal Powerhouse The thyroid is a small, butterfly-shaped gland located in the neck, just below the Adam’s apple. Despite its modest size, it wields enormous influence over the body by producing hormones—primarily thyroxine (T4) and triiodothyronine (T3)—that regulate metabolism, heart rate, body temperature, and even reproductive health. The thyroid itself is controlled by the pituitary gland, which releases thyroid-stimulating hormone (TSH) to signal when more thyroid hormones are needed. When the thyroid functions normally, it keeps the body’s systems humming along smoothly. But when it malfunctions—either producing too much hormone (hyperthyroidism) or too little (hypothyroidism)—the ripple effects can be profound, especially for women’s reproductive health. Heavy Menstrual Bleeding: What It Looks Like Heavy menstrual bleeding, or menorrhagia, is more than just an inconvenience. It’s defined as excessive blood loss during a period that interferes with a woman’s quality of life. This might mean soaking through a pad or tampon every hour for several hours, passing large blood clots, or having periods that last longer than seven days. For some, it’s accompanied by severe cramps, fatigue, or even anemia due to significant blood loss. While heavy periods can stem from various causes—such as uterine fibroids, polyps, or endometriosis—hormonal imbalances are a common culprit. And that’s where the thyroid comes into play. Hypothyroidism and Heavy Periods Hypothyroidism occurs when the thyroid doesn’t produce enough hormones. Common causes include Hashimoto’s thyroiditis (an autoimmune condition), iodine deficiency, or certain medications. Symptoms often include fatigue, weight gain, cold intolerance, and dry skin, but its impact on menstruation can be just as significant. Here’s how it works: Thyroid hormones influence the production and regulation of sex hormones like estrogen and progesterone, which orchestrate the menstrual cycle. In hypothyroidism, low thyroid hormone levels can disrupt the hypothalamic-pituitary-ovarian axis—the communication network between the brain and reproductive organs. This disruption often leads to irregular ovulation or anovulation (no ovulation at all). Without ovulation, progesterone levels drop because this hormone is primarily produced by the corpus luteum, a temporary structure formed in the ovary after an egg is released. Progesterone’s job is to stabilize the uterine lining (endometrium) during the second half of the menstrual cycle. When progesterone is low, the endometrium can grow excessively under the influence of unopposed estrogen, leading to a thicker, more vascular lining. When it’s time to shed this lining during menstruation, the result is heavier, prolonged bleeding. Additionally, hypothyroidism can impair blood clotting by reducing levels of clotting factors like factor VIII and von Willebrand factor. This means that even normal menstrual shedding can become excessive because the blood doesn’t clot as efficiently. Hyperthyroidism and Menstrual Chaos On the flip side, hyperthyroidism—when the thyroid produces too much hormone—can also wreak havoc on periods, though the effects differ. Conditions like Graves’ disease, an autoimmune disorder, are common causes. Symptoms include weight loss, anxiety, heat intolerance, and a racing heart, but menstrual irregularities are also frequent. In hyperthyroidism, the excess thyroid hormones can overstimulate the reproductive system, leading to increased estrogen production and metabolism. This can cause irregular cycles, lighter periods, or even amenorrhea (absence of periods) in some cases. However, for some women, the hormonal chaos can paradoxically result in heavy bleeding. The overstimulation can disrupt the balance between estrogen and progesterone, leading to an unstable uterine lining that sheds unpredictably and excessively. The Broader Hormonal Web The thyroid doesn’t operate in isolation—it’s part of a complex hormonal network. For instance, thyroid dysfunction can affect the adrenal glands, which produce cortisol, a stress hormone that also influences reproductive health. Chronic stress from untreated thyroid issues can further exacerbate hormonal imbalances, creating a vicious cycle. Moreover, thyroid disorders often coexist with other conditions that impact menstruation, such as polycystic ovary syndrome (PCOS). Both hypothyroidism and PCOS can involve insulin resistance and elevated estrogen, compounding the risk of heavy bleeding. This overlap highlights the importance of a thorough medical evaluation when symptoms arise. Diagnosing the Connection For women experiencing heavy periods, pinpointing the thyroid’s role requires detective work. Doctors typically start with a blood test to measure TSH levels. High TSH suggests hypothyroidism (the pituitary is working overtime to stimulate an underactive thyroid), while low TSH points to hyperthyroidism (the thyroid is overproducing, suppressing TSH). Follow-up tests for T3, T4, and thyroid antibodies (in cases of autoimmune disease) provide a fuller picture. Menstrual history is also key. A doctor might ask about cycle length, bleeding duration, and associated symptoms like fatigue or hair loss. Imaging, such as an ultrasound, may rule out structural causes like fibroids, while a biopsy could check for endometrial abnormalities. Treatment Options: Restoring Balance Treating thyroid-related heavy bleeding involves addressing the root cause—restoring thyroid function—and, if needed, managing menstrual symptoms directly. For hypothyroidism, levothyroxine, a synthetic thyroid hormone, is the gold standard. As thyroid levels normalize, many women find their periods become lighter and more regular. It can take weeks to months to see full effects, so patience is key. Iron supplements may also be prescribed if anemia develops from blood loss. In hyperthyroidism, treatment might involve antithyroid drugs (like methimazole), radioactive iodine, or surgery, depending on the severity. Beta-blockers can manage symptoms like rapid heart rate while the thyroid stabilizes. As hormone levels settle, menstrual patterns often improve. For persistent heavy bleeding, hormonal therapies like birth control pills, progesterone-releasing IUDs, or tranexamic acid (a clotting enhancer) can help, regardless of thyroid status. In severe cases, procedures like endometrial ablation

GYN Problems

Heavy Periods in Your 40s: Perimenopause or More?

Could your heavy periods be perimenopause, or something more? If you’re in your 40s and noticing that your periods are heavier than usual, you’re not alone. Many women experience changes in their menstrual cycles as they approach midlife, often chalking it up to “just getting older.” But when soaking through pads or tampons becomes a regular ordeal, or when bleeding disrupts your daily life, it’s natural to wonder: Is this perimenopause, or could it be something else? Let’s dive into what heavy menstrual bleeding in your 40s might mean, explore the role of perimenopause, and highlight other potential causes that deserve attention. What Counts as “Heavy” Bleeding? Before we get into causes, it’s worth defining what “heavy menstrual bleeding” actually means. Medically known as menorrhagia, it’s more than just a nuisance—it’s bleeding that’s excessive or prolonged. Signs include soaking through a pad or tampon every hour for several hours, passing large blood clots (think quarter-sized or bigger), needing to double up on protection, or bleeding for more than seven days. If you’re waking up at night to change pads or finding it hard to leave the house during your period, that’s a signal to take a closer look. In your 40s, your body is likely in a transitional phase, and heavy bleeding can stem from hormonal shifts or other underlying issues. Let’s break it down. Perimenopause: The Usual Suspect Perimenopause—the years leading up to menopause—typically begins in a woman’s 40s (though it can start earlier or later). It’s a time when your ovaries gradually produce less estrogen, and ovulation becomes less predictable. This hormonal rollercoaster can wreak havoc on your periods, making them irregular, heavier, or both. Why does this happen? In a normal cycle, estrogen builds up the uterine lining, and progesterone stabilizes it after ovulation. During perimenopause, ovulation might not occur every month. Without progesterone to balance things out, the lining can grow thicker than usual, leading to heavier shedding when your period finally arrives. It’s like the body’s saying, “Oops, time to clear out the backlog!” The result? Flood-like periods, sometimes with clots, that can feel overwhelming. Other perimenopause clues might accompany the bleeding: hot flashes, night sweats, mood swings, or sleep trouble. But not everyone gets the full symptom package, so heavy bleeding alone could still point to this phase. The average age of menopause (when periods stop for good) is 51, so if you’re in your early or mid-40s, perimenopause is a strong contender. Beyond Perimenopause: Other Possible Culprits While perimenopause is a common explanation, it’s not the only one. Heavy bleeding can signal other conditions, some benign and some more serious. Here’s what else might be at play: Uterine Fibroids These are noncancerous growths in or around the uterus, and they’re incredibly common—up to 80% of women develop them by age 50. Uterine fibroids can make periods heavier, longer, or more painful, especially if they distort the uterine cavity or press on the lining. They’re more likely in your 40s because estrogen fuels their growth, and perimenopause’s hormonal fluctuations can exacerbate them. Symptoms like pelvic pressure or frequent urination might hint at fibroids, though some women have no signs beyond heavy bleeding. Endometrial Polyps Think of these as little overgrowths of the uterine lining. They’re usually benign but can cause heavy or irregular bleeding by interfering with the uterus’s normal shedding process. Like fibroids, they’re linked to estrogen excess, making them more common in perimenopause. Adenomyosis This condition happens when the uterine lining grows into the muscular wall of the uterus. It can lead to intense cramps and heavy bleeding, often described as a “boggy” or enlarged uterus. Adenomyosis tends to peak in women in their 40s and 50s and can overlap with perimenopause, complicating the picture. Hormonal Imbalances Beyond perimenopause, other hormonal issues—like thyroid problems or polycystic ovary syndrome (PCOS)—can disrupt your cycle. Hypothyroidism (an underactive thyroid) is sneaky and more common with age, bringing heavy periods alongside fatigue and weight gain. PCOS, though often diagnosed earlier, can persist into the 40s, causing irregular, heavy bleeds due to erratic ovulation. Bleeding Disorders Less common but worth considering are conditions like von Willebrand disease, a genetic disorder affecting blood clotting. If you’ve always had heavy periods, bruise easily, or bleed excessively after surgery, this could be a factor. It’s often overlooked until adulthood. Endometrial Hyperplasia or Cancer In rare cases, heavy bleeding signals a thickened uterine lining (hyperplasia), which can be a precursor to endometrial cancer. This risk rises in your 40s and beyond, especially if you’re overweight, have diabetes, or rarely ovulate—all of which boost estrogen exposure. Bleeding between periods or after menopause is a red flag, but heavy flows alone warrant a check if they’re persistent. When to See an OB/GYN Heavy bleeding isn’t just inconvenient—it can lead to anemia (low iron levels), leaving you exhausted, dizzy, or short of breath. If your periods are disrupting your life, don’t brush it off as “normal aging.” Track your symptoms—how long you bleed, how many pads or tampons you use, and any clots or pain—and bring that info to a healthcare provider. They might recommend: Blood tests to check for anemia, thyroid issues, or clotting problems. Ultrasound to spot fibroids, polyps, or adenomyosis. Endometrial biopsy to rule out hyperplasia or cancer, especially if you have risk factors. Hysteroscopy to peek inside the uterus for abnormalities. Managing Heavy Bleeding Treatment depends on the cause and your plans (like whether you want kids). For perimenopause-related bleeding, hormonal options—like birth control pills, a progesterone IUD (e.g., Mirena), or cyclic progesterone—can lighten periods by regulating the lining. Non-hormonal choices, like tranexamic acid, reduce bleeding during your period without affecting hormones. If fibroids or polyps are the issue, they might be removed surgically. Adenomyosis might call for similar approaches or, in severe cases, a hysterectomy (uterus removal). For hyperplasia or cancer, treatment escalates based on severity, from hormones to surgery. Lifestyle tweaks—managing stress, maintaining a healthy weight—can also help, especially if hormones are out of whack. We Can

OB, OB Education

Pelvic Pain During Pregnancy

Pelvic pain during pregnancy can make a significant difference in your pregnancy experience. While pregnancy is a beautiful journey, it does come with its fair share of discomfort, one of the most common being pelvic pain. While some degree of pelvic discomfort is expected as your body adapts to support a growing baby, persistent or severe pain can be concerning. Understanding the causes and knowing how to manage pelvic pain can help you navigate your pregnancy journey. What Causes Pelvic Pain During Pregnancy? Pelvic pain during pregnancy can stem from several factors, including: Round Ligament Pain – As the uterus expands, the round ligaments stretch and thicken, which can cause sharp or aching pain on the sides of the lower abdomen or pelvis. Symphysis Pubis Dysfunction (SPD) – The pregnancy hormone relaxin loosens the ligaments in the pelvis to prepare for childbirth, sometimes leading to instability and pain in the pubic bone area. Pelvic Girdle Pain (PGP) – This condition involves pain in the joints of the pelvis, including the sacroiliac joints and the pubic symphysis. It can be worsened by movement, such as walking, climbing stairs, or changing positions in bed. Pressure from Baby’s Growth – As your baby grows, the added weight and pressure on the pelvic floor muscles can lead to discomfort or pain. Braxton Hicks Contractions – These “practice” contractions can sometimes cause cramping and pelvic discomfort. Urinary Tract Infections (UTIs) – Sometimes, pelvic pain can be a sign of a UTI, which requires medical treatment to prevent complications. Preterm Labor – If pelvic pain is accompanied by regular contractions, lower back pain, or pressure, it may indicate preterm labor, which requires immediate medical attention. IMPORTANT: If any symptoms seem abnormal, uncomfortable or unusual, or if you have any doubts or questions, seek immediate medical attention. We have physicians on call 24/7 to answer any questions or concerns. If your medical condition is urgent, call 911 or go to the emergency room. You can never be too careful. How to Relieve Pelvic Pain During Pregnancy While pelvic pain can be frustrating, there are several ways to manage and alleviate discomfort: Prenatal Support Belts – A maternity support belt can help relieve pelvic pressure and provide stability. Exercise and Stretching – Gentle exercises, such as prenatal yoga, Kegels, and pelvic tilts, can strengthen the pelvic muscles and improve flexibility. Warm Baths or Heat Therapy – Applying a warm compress to the affected area or soaking in a warm bath may help relax tense muscles. Rest and Proper Posture – Avoid standing for long periods and practice good posture to reduce strain on the pelvis. Use a Pregnancy Pillow – Sleeping with a pregnancy pillow between your knees can help keep your hips aligned and reduce discomfort at night. When to Seek Medical Attention While mild to moderate pelvic pain is common, certain symptoms require prompt medical evaluation: Severe or sudden pelvic pain that does not improve with rest. Pain accompanied by vaginal bleeding, fever, or chills (which may indicate an infection or miscarriage risk). Difficulty walking or moving due to intense pain. Regular contractions before 37 weeks, as this may signal preterm labor. Pain with urination or foul-smelling discharge, which may indicate a UTI or other infection. Pelvic pain is a common pregnancy symptom, but you don’t have to suffer in silence. If you are experiencing discomfort, talk to one of our OB/GYNs or certified nurse midwives about ways to manage your symptoms safely. With the right strategies and support, you can have a more comfortable pregnancy experience. At Cherokee Women’s Health, we’re here to guide you through every stage of pregnancy. If you have concerns about pelvic pain or any other symptoms, don’t hesitate to reach out for expert care and support at 770.720.7333. Or, simply schedule an appointment online.

OB, OB Education

Pelvic Prolapse During Pregnancy

Pelvic organ prolapse (POP) during pregnancy can lead to discomfort and potential complications. POP is a condition where the pelvic organs—such as the bladder, uterus, or rectum—descend into or beyond the vaginal canal due to weakened pelvic floor muscles and ligaments. It is most commonly associated with postpartum and menopausal women, but can occur during pregnancy. Causes of Pelvic Prolapse During Pregnancy Several factors contribute to the development or worsening of pelvic prolapse during pregnancy, including: Increased Uterine Pressure – As the uterus grows, it puts additional pressure on the pelvic floor muscles and ligaments, potentially weakening them and allowing organs to shift. Hormonal Changes – Pregnancy hormones, particularly relaxin and progesterone, loosen the ligaments and tissues that support the pelvic organs, increasing the risk of prolapse. Multiple Pregnancies or Large Baby – Women who have had multiple pregnancies, especially those carrying large babies, may experience excessive strain on their pelvic muscles. Previous Vaginal Deliveries – A history of vaginal births, particularly with prolonged labor or forceps-assisted deliveries, can weaken the pelvic floor and contribute to prolapse. Chronic Straining – Conditions like constipation or chronic coughing can exert extra stress on the pelvic muscles, worsening prolapse. Genetic Predisposition – Some women may have naturally weaker connective tissues, making them more prone to prolapse. Symptoms of Pelvic Prolapse During Pregnancy Pelvic prolapse symptoms can vary in severity, but common signs include: A sensation of heaviness or pressure in the pelvis A visible or palpable bulge in the vaginal area Difficulty with urination, including urinary retention or incontinence Bowel movement difficulties, such as constipation or incomplete emptying Lower back pain or discomfort Increased vaginal discharge A feeling of something “falling out” from the vagina IMPORTANT: If any symptoms seem abnormal, uncomfortable or unusual, or if you have any doubts or questions, seek immediate medical attention. We have physicians on call 24/7 to answer any questions or concerns. If your medical condition is urgent, call 911 or go to the emergency room. You can never be too careful.   Diagnosis and Evaluation A thorough examination by one of our OB/GYNs or certified nurse midwives is necessary to confirm pelvic prolapse. Diagnosis typically involves: Pelvic Exam – A physical assessment to evaluate the extent of prolapse. Ultrasound or MRI – Imaging may be used in severe cases to assess the pelvic organs. Patient History – Understanding previous pregnancies, deliveries, and symptoms to determine risk factors. Management and Treatment Options While pelvic prolapse during pregnancy can be concerning, several management strategies can help alleviate symptoms and prevent further complications: Lifestyle and Physical Therapy Pelvic Floor Exercises (Kegels) – Strengthening the pelvic muscles can provide better support for the organs. Avoid Heavy Lifting – Reducing strain on the pelvic floor can prevent worsening symptoms. Managing Constipation – Eating a fiber-rich diet and staying hydrated can reduce straining during bowel movements. Proper Posture and Supportive Garments – Using maternity support belts may help distribute weight more evenly and relieve pressure on the pelvic floor. Medical Interventions Pessary Use – A pessary, a removable device inserted into the vagina, can help support the prolapsed organ and alleviate symptoms. Regular Monitoring – Close follow-up with an OB/GYN ensures that symptoms do not worsen or lead to complications such as urinary retention or infections. Delivery Considerations Women with significant pelvic prolapse may need a tailored birth plan. In some cases, a cesarean section may be recommended if vaginal delivery poses a high risk of worsening the condition. Postpartum Outlook Pelvic prolapse symptoms may improve after delivery as hormone levels stabilize and the uterus returns to its normal size. However, some women may require continued pelvic floor therapy or, in severe cases, surgical intervention. When to Seek Medical Help If you experience severe discomfort, difficulty urinating or having bowel movements, or notice a significant bulge, consult your OB/GYN immediately. Early intervention can help manage symptoms and prevent complications. Pelvic prolapse during pregnancy can be distressing, but with proper management, many women can have a healthy pregnancy and delivery. If you suspect prolapse or have concerns about your pelvic health, our team at Cherokee Women’s Health is here to help. Contact us today at 770.720.7733 or schedule an appointment online to learn more about maintaining pelvic health during pregnancy.

midwife with mom and baby
OB Patient Stories

A Redemptive Delivery: My VBAC Story

As Abby prepared to welcome her second child, she knew one thing for certain, she wanted to try for a VBAC (vaginal birth after cesarean). When her son Hudson was born via C-section 21 months ago, Abby carried the joy of his arrival but also the weight of a difficult delivery and a long recovery. Her decision was driven not only by her desire for a smoother recovery but also by a simple, heartfelt wish: to be able to lift and care for her toddler without limitations. “I wanted to have a VBAC so I could pick up Hudson,” Abby explained. “That was my number one reason. It’s so important to be able to lift your toddler when you’ve got two little ones to take care of.”  Collaboration Between Doctor and Midwife Made It Possible  From the start of her pregnancy, Abby found unwavering support from the team at Cherokee Women’s Health. Although she initially connected with midwife Susan Fischels for her first appointment, her primary care during the pregnancy was provided by Dr. Robert Barrett. Both agreed that if she went into labor naturally, she could try for a VBAC, but they would proceed with a repeat C-section if she didn’t.  A Natural Start: Going Into Labor at 38 Weeks  At 38 weeks and 5 days, labor began, and as fate would have it, Susan was on call. From the moment they reconnected in the delivery room, Susan became Abby’s steadfast coach, guide, and cheerleader. “If you want this VBAC, we can do it,” Susan assured her, and she meant it.  “Susan was amazing,” Abby said. “She is very to the point, and I love that. She’s the best coach. She gave me clear instructions on what to do during pushing, and I could understand and follow them. I felt like she had my best interests at heart every step of the way.”  Overcoming Fear: Addressing Concerns About Pitocin  Throughout labor, Susan listened carefully to Abby’s concerns. One of her biggest fears was the use of Pitocin, given the risks of uterine rupture. Abby’s labor team used the lowest possible dose, allowing her labor to progress naturally and without rushing her body.  “They were so great about it,” Abby said. “I was really scared of Pitocin because you hear all these stories about what can go wrong, like uterine rupture. They barely used it on me, just enough to get my labor going. When I told them I was worried, they listened. They kept me on a small dose, just a 5, for hours because my labor was progressing. They didn’t try to speed things up, they just let my body do the work.”  A Dream Birth: Welcoming Baby Charlee  With Susan coaching her every step of the way and Dr. Lisa McLeod, another OB/GYN of Cherokee Women’s Health, providing seamless support, the moment finally came. After just 30 minutes of pushing, little Charlee entered the world a healthy, beautiful baby girl.  “It was such a dream,” Abby reflected. “We only pushed for 30 minutes, and then Charlee was here. I felt so proud of myself. It was like my redemption story. After my first delivery, I had a lot of trauma and a really tough recovery. This time, I felt strong and empowered.”  For Abby, this birth wasn’t just about the method of delivery, it was about being heard, supported, and empowered. “When I got tired, there were moments I thought, ‘I can’t do this.’ But Susan kept telling me, ‘Yes, you can. You’re doing this.’ I believed her. She didn’t give up on me.”  Dr. Barrett, too, proved to be an advocate for Abby’s wishes. “People think doctors push to do C-sections, but he was so supportive of my VBAC,” Abby said. “He told me, ‘Whatever you want to do, I’ll make it happen.’ He just wants healthy moms and healthy babies, and that’s what I got.” As Abby reflects on her journey, she’s open about the challenges and triumphs of both types of birth. “There’s no easy way to birth a baby,” she admitted. “They’re both hard in their own way. But with a vaginal birth, when it’s over, it’s over. With a C-section, the recovery lingers. I was so happy to avoid that this time.”  A Message to Other Moms  Now a proud mom of two, Abby wants to share her story with others who might be considering a VBAC or feeling nervous about their options. “I tell all my friends now that this was my redemptive birth,” she said. “It gave me so much confidence and healed a lot of the fear I had from my first delivery. If you’re thinking about a VBAC, surround yourself with a team that listens to you and believes in you. That made all the difference for me.”  Today, Abby cherishes the joy of holding baby Charlee and Hudson in her arms. A proud, empowered mother who found healing and hope in her redemptive birth story.    

Sabrina and her family
OB Patient Stories

An Unmedicated VBAC: Sabrina’s Story

After three previous deliveries with another practice, Sabrina wanted a VBAC (vaginal birth after cesarean) for her fourth delivery and, if possible, to do it unmedicated. She had felt disempowered after her history of childbirth experiences and longed for a different approach. The Beginning: Emergency C-Section and Limited Choices “My first pregnancy ended in an emergency C-section. My daughter was a week overdue, and the practice I was with wouldn’t let me go past that. They induced me, gave me Cervidil, and things progressed too quickly. Her heart rate was dropping with my contractions, so they gave me an epidural, and it ended in surgery. I didn’t know to ask certain questions; I thought it was unique to me or just how things were supposed to be.” Sabrina stayed with the same practice for her next two pregnancies and attempted VBACs. However, she found their policies restrictive. “I didn’t realize at the time that it wasn’t hospital policy but their practice’s policy. They said I could have a VBAC, but I had to get an epidural because I was considered high-risk. I just went along with it because I didn’t know I could have a choice.” A New Chapter: Finding Cherokee Women’s Health Specialists Her fourth pregnancy was a turning point. “This one was a surprise. My youngest was almost four, and I was older, with more time to reflect. I started asking questions, and that’s what led me to Cherokee Women’s Health Specialists. From my very first visit, the experience was completely different. Truly night and day compared to any other practice I’d been to.” Sabrina explained how the midwives at Cherokee Women’s Health stood out. “The midwives were my cheerleaders. They didn’t just give me their opinions; they gave me resources that were truly helpful. Every appointment left me feeling supported, encouraged, and excited about my delivery. They were passionate, knowledgeable, and honestly listened to me. The other practices I went to had midwives as well, but at Cherokee Women’s Health, the midwives genuinely stand out. They are truly passionate about the care and support you would hope for from a midwife.” A Beautiful VBAC Experience Her delivery was everything she had hoped for. “For the first time, I was able to deliver unmedicated. All my requests and everything on my birth plan were honored. It was such a beautiful and empowering experience.” Her labor process reflected the calm and supportive environment she had been seeking. “I labored at home until I was six centimeters, then went to the hospital. As they were drawing me a bath, my body finally relaxed, and my water broke. Two and a half hours later, my baby was born healthy, without complications, and everything had gone smoothly.” Laboring Naturally Sabrina described the difference in laboring naturally. “The pain of an unmedicated childbirth is real, but it felt much more bearable knowing it was natural, the way God designed it. I meditated on scripture and trusted the Lord through the process. That made the experience so much more meaningful and beautiful. After having an emergency C-section, medicated VBACs, and now an unmedicated VBAC, I can confidently say that if it’s at all possible, I’d encourage everyone to try for a VBAC. Ten times out of ten, I’d choose unmedicated. It was life changing.” A Special Connection with Susan Fischels and the Midwives Sabrina’s connection with the midwives was especially meaningful. “Susan was amazing. She’s real, she’ll tell you what you need to hear without sugarcoating it, but she makes you feel like you’re talking to a friend. When I told Becca, CNM, I wanted an unmedicated VBAC, she literally rolled up her sleeves and said, ‘Let’s do this!’ That level of enthusiasm and support meant everything to me.” Now, Sabrina eagerly shares her story with others. “Every time I hear of a friend who’s pregnant, I ask, ‘Do you live nearby? You have to check out Cherokee Women’s Health Specialists.’ This practice is completely unique, nothing like any other OB/GYN I’ve ever been to. They truly make you feel supported and empowered.” For Sabrina, the experience was not just about having a successful VBAC. It was about feeling heard, supported, and empowered throughout her journey.

OB Patient Stories

Rachel’s OB Story at Cherokee Women’s Health

Rachel and her husband moved to Atlanta when she was already five months pregnant with her first baby, Daniel. “At my age, with this being my first pregnancy and with IVF, my previous OB warned me to find an OB/GYN quickly since not all providers accept patients so late in pregnancy,” Rachel said. Amid the whirlwind of finding a new home and adjusting to life in a new city, Rachel began her search for an OB/GYN. “I Googled nearby OBs and found Cherokee Women’s Health. Their website was so helpful, and when I saw Dr. Stone’s photo, I thought, ‘She seems so kind and approachable.’ I asked around at my new church community, and a few moms there also recommended Cherokee Women’s Health. So, I decided to schedule an appointment and I’m so glad I did.” From her very first visit, Rachel felt reassured by the level of care she received. “Dr. Stone listened to all my concerns and really put me at ease. Everyone at the office was so kind and inviting.” An Early Arrival Rachel’s delivery was scheduled for a C-section at Northside Hospital Cherokee, but baby Daniel had other plans. “At 3:05 a.m., while I was brushing my teeth, my water broke! My husband and I rushed to the hospital. Even though we were a bit ahead of schedule, the staff made everything so smooth.” Rachel had her epidural at 6:30 a.m., and by 7:07 a.m., baby Daniel was born. “I was so nervous about the procedure, but the team was amazing. They walked me through everything step by step, and the process couldn’t have gone better.” A Grateful Heart Rachel was overwhelmed by the kindness and professionalism of everyone at Northside Hospital Cherokee. “The nurses were so sweet and attentive, even offering to help with Daniel at night so I could rest. They treated me like family. The care I received was truly incredible.” She added, “I even joked that the food was so good it felt like I was staying at a 5-star hotel! Everything about the experience exceeded my expectations.” Advice for New Moms Reflecting on her experience, Rachel offered advice to other first-time moms. “Do your homework. Research your provider and the hospital. Once you find someone you trust, relax and trust the process. You’re in good hands, you’ll be just fine.” Now home and recovering well, Rachel shared her gratitude. “I’m so thankful for Dr. Stone and the entire team at Cherokee Women’s Health. I couldn’t have asked for a better experience, and I’m so grateful they helped bring Daniel into the world safely.”

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