Author name: Diane

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Hysterectomy

A hysterectomy is the surgical removal of a woman’s uterus, the womb. After hysterectomy, you will not be able to have children. Your hormones are generally not affected unless your ovaries are also removed. Who Should Have a Hysterectomy? A woman may have a hysterectomy to treat common conditions, such as: pelvic pain, bleeding, prolapse, endometriosis, fibroids, painful periods, and pain with sex. How is a Hysterectomy Performed? A hysterectomy can be performed in different ways depending on the reason for the hysterectomy and other factors. You and your doctor can discuss the different ways of performing a hysterectomy to decide which route is safest and most appropriate for your specific situation. The three main hysterectomy procedures are laparoscopic, vaginal, and abdominal. Laparoscopic Hysterectomy – A thin, lighted tube attached to a camera is inserted into the abdomen through a small incision. Additional small incisions are made to insert surgical instruments. A laparoscopic hysterectomy results in shorter hospital stays, an easier recovery and a decreased risk for infection than an abdominal hysterectomy. Vaginal Hysterectomy – The uterus is removed through the vagina. The only incision is inside the vagina. However, your internal anatomy cannot be visualized by the surgeon. Abdominal Hysterectomy – A larger incision is made on the abdomen to remove the uterus. An abdominal hysterectomy may be suggested if a patient has a large uterus, adhesions or other anatomical challenges. This kind of hysterectomy requires a longer hospital stay and healing time. What are the Risks? A hysterectomy is a commonly performed surgery. However, there are always some risks associated with having a surgical procedure. Your surgeon will discuss the risks and benefits so you can be informed to make the best decision. What to expect after the surgery. If you have any additional questions, please contact Cherokee Women’s Health Specialists at 770.720.7733 or schedule an appointment online.

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Menopause and Depression

It’s estimated that 20% of women suffer from depression during the time leading up to menopause (perimenopause) and throughout menopause itself. That means for every five women aged approximately 40 to 65, one may be suffering from menopausal depression. What are the Signs of Menopausal Depression? Everyone goes through extended periods of stress, which can often lead to temporary mild depression. When those emotions continue past a reasonable time frame, however, intervention may be necessary. If you find some of the following signs have remained for prolonged periods during menopause, they may indicate depression. These are: Sometimes I Feel Like I’m Going Insane! Why is This Happening? Rest assured that you’re not alone. Menopausal depression is only partially, but not completely linked to hormonal changes within the body. As your ovaries age, they get tired and stop producing estrogen and progesterone, which are responsible for enabling fertility, menstruation and good reproductive health. Other parts of the body go into overdrive to try and make up for the loss. Fat cells, adrenal glands, and the hypothalamus struggle to make up the difference, but aren’t very efficient, causing internal balance disruptions. The situation is similar to a substitute teacher taking over a class for a week while the regular one is off sick. She does her best but lacks familiarity with both the students and their curriculum. Though the class survives the temporary disruption, it does not function at an optimal level. The Scientific Whys of Depression In your body’s case, the hypothalamus and pituitary glands produce more luteinizing hormone (LH) and follicle stimulating hormone (FSH) than normal to nudge additional estrogen production, but can’t quite pump out enough to maintain normal levels. Thus, serotonin and norepinephrine, which affect mood don’t get their regular dose of estrogen. Additionally, plummeting progesterone can cause sleep disturbances and erratic mood swings. Most women can get through menopause with minimal discomfort, but for others whose side effects are much more dramatic, menopausal depression can have a psychological ripple effect when combined with the following occurrences: Who is More Likely to Suffer From Menopausal Depression Any woman can experience depression during menopause, but some are more predisposed. Extreme menopausal depression can lead to social isolation, relationship breakdowns, and even thoughts or attempts of suicide, especially for women who: What Can I Do to Feel Better? There are many lifestyle changes you can make to find relief. Some are: Are There Any Natural Remedies That Can Help? Eastern cultures rely heavily on diet and herbal and holistic medicine for many ailments, including menopausal depression. In China, for instance, only 10% of women suffer from different menopausal discomforts compared to 85% of American women. Western medicine recognizes the value of many of these time-honored and effective remedies. Today, many doctors work in tandem with these ideas, incorporating them into their modern day treatments, and recommending different formula combinations which may contain the following: A healthy diet rich in protein, vegetables, fiber, and whole carbohydrates is also essential in warding off depression during menopause. Other Natural Herbs and Supplements Include: Depression is Treatable Depression is treatable. It is also encouraging to note that, though many women suffer from depression before and during menopause, once the transition is complete, with proper care, the depressive symptoms decrease and often disappear. Your depression could be menopause-related, but there can also be other reasons for your symptom. As stated earlier, menopause itself does not cause depression, but it can contribute to it hormonally. You should always discuss your issues with your doctor to rule out any other physical or psychiatric disorders. What if Nothing I Do Helps? If your depression continues despite all your attempts, you may need medical intervention in the form of short or long-term antidepressants, estrogen replacement therapy, or the additional help of a therapist to discuss your problems. How Can Cherokee Women’s Health Specialists Help Me? Cherokee Women’s Health Specialists is a broad-based OB practice consisting first and foremost of three doubly accredited urogynecologists holding certification in OB/GYN and Female Pelvic Medicine and Reconstructive Surgery (FPMRS), a highly coveted credential approved only under the most stringent criteria set forth by the American Board of Medicine (ABM). Along with these specialists, additional gynecologists, urogynecologists, obstetricians, nutritionists, and experts in holistic medicine and diet, are available for any and all female health-related disorders, concerns, and problems, providing you with the best possible care. For a consult with one of our gynecologists to discuss depression during menopause, call 770-720-7733.

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Vaginal Dryness — Which Lubricant is Right for You?

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? The 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: What Other Conditions Can Accompany Vaginal Dryness? Lack of vaginal lubrication can affect you in many different ways, resulting in: 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: 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: 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: We’re Here to Help You Dr. Michael 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. Schedule an appointment online or call us today at 770.720.7733.

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Life Lessons: A Veteran Mom of 3 Starts Over

An interview with Air Force veteran Dianna Hornes, third-time mom and our OB “Cover model” for this spring’s AroundAbout magazines. “I joined the Air Force after high school to get as far away from home as possible,” Dianna opens her story. “And they sent me from Phoenix to Las Vegas!” She laughs. “My friend and I joined at the same time. She wanted to be as close to home as possible – and they sent her to Guam! Go figure.” Dianna’s new baby Matthew is the first child of her second marriage to Dennis, a Woodstock policeman. As she already had two daughters from her first, we suspect that her journey from military through family life may not have been smooth. Q: So, first off, you’re married to a Woodstock policeman and fellow veteran, you have two little girls from your first marriage and now a newborn, Matthew. Would you mind just telling us a little bit about your story? I was born and raised in Phoenix, AZ. I am the oldest and have 4 sisters and 2 brothers. As I said, I joined the Air Force after high school to get as far away from home as possible… But the military experience was wonderful, in fact, one of the best experiences ever! I got to travel the world and see everything. I experienced life on a different level, and it made me more appreciative. From my first marriage I have Madison and Kayla … and now with Dennis I have little Matthew, as you know. Q: How did you meet Dennis? We are one of those Match.com success stories. It’s funny too, because I reached out to him first. After I divorced, I waited a year before I considered dating again. I had two daughters, Kayla and Madison, from my first marriage. At around a year, I created a Match.com profile. One day I was scrolling through all the profiles, specifically looking for matches who were interested in someone with kids. I came to Dennis’ profile, and his just happened to say “no”. But I was looking at pictures and I thought, “’He’s a good-looking dude, you know what, screw it. I’m just going to send the message.’” I’m very straightforward, and I believe you don’t need to sugar coat things or hide things from folks. So, I sent him a message saying, “Hey, you seem like a good-looking, nice guy. I have two daughters, I know you said you’re not interested in someone with kids, but if you change your mind, message me. If not, have a nice life.” And it took a couple of weeks, but he responded, and we went on our first date to Starbucks. Starbucks seemed like a safe bet in case things didn’t work out. Surprisingly, our first date was nine hours long. We met for coffee and stayed there for a few hours. Then we went to a restaurant, and we closed the restaurant down. After that, we drove home and continued to talk on the phone for like, 2 hours. We had a lot in common—he was in the Army, I was in the Air Force, and we connected and teased each other about which branch was better. The Air Force, of course! Q: What made you decide to marry Dennis? He makes me want to be a better person for me and for everybody else. I couldn’t believe people when they said they met their true love or that they were in love with their best friend. It just didn’t seem real to me. I suppose I was a bit jaded from my divorce. Then I met Dennis. He makes me laugh, he’s someone who appreciates me, loves me and makes me feel good, and I realized, this is how it’s supposed to feel. I’m very much in love with him. He’s my best friend. “I couldn’t believe people when they said they met their true love… It just didn’t seem real to me.” Q: Did you have any concerns about starting over or creating a blended family? Yes, I was very much against starting over and starting another family. My husband was also married before, but he didn’t have children with his ex.  It took me dating him for 4 months before I introduced him to the girls. I didn’t want them to meet this random person, and I didn’t know how dating would be for me. When we first started dating, and the first few months after being married, I wasn’t sure if I wanted more children. He was okay with that. He loves them very much, and he is very much their parent. People find it hard to believe that they aren’t his biological girls. He’s a natural with them. Though, I could see how happy he was with being a father to the girls I knew he wanted to have a baby of his own. And that’s when I realized that when you love someone, their wants and needs become your wants and needs. I wrapped my head around that and am very much in love with him. I realized I wanted to have that connection with him forever, so that’s when we started trying to have a baby. I had a Mirena and decided, “it’s time we took this bad boy out.” When I told him that I was ready to start a family with him, the look on his face was just love and excitement and joy. And then when we were pregnant the first time it was, oh my gosh, it was the most amazing feeling in the world to have created a life with him. But the last two pregnancies (and miscarriages) were just horrible to go through. But they made us stronger as a couple, and we also appreciate every moment that we have with Matthew. I want my husband to experience every little moment with his son and have all the input he wants on what we do day-to-day.

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Trying to Conceive: Your “Get-Pregnant” Checklist

Have you decided that it’s time to make your family of two an official family of three or more? The decision to start trying to get pregnant is exciting, but it’s easy for hopeful mamas to get discouraged after a few months without seeing those two little lines. Studies have shown the link between stress and a woman’s ability to conceive, so the first step in trying is an easy one—relax and enjoy the process. Preconception Counseling Visit Next, visit your doctor for a pre-pregnancy checkup. Also referred to as a preconception counseling visit, this appointment is your opportunity to discuss your current lifestyle, weight, medications and medical history with your doctor. Together, you discuss how all these factors affect your chances of getting pregnant. He or she can also recommend changes you can make to help you get pregnant faster. Here are some additional steps you can take to get pregnant sooner: Start taking a prenatal vitamin with folic acid. Start taking prenatal vitamins at least a month before you officially start trying to conceive. Most prenatals contain the 400 micrograms of recommended folic acid, but check the label just to make sure. Folic acid is also naturally found in leafy green veggies, citrus fruits, beans and whole grains, so doubling up is always a plus. Improve your diet. Healthy babies start with healthy moms. Try to avoid junk food and load up on fresh fruits and veggies, which will aid in both helping you maintain a healthy weight and give you the energy to maintain a baby-friendly exercise plan. Start limiting your caffeine intake. If you’re a 2-or-more-cup a day gal, it’s best to start cutting back, as the recommended daily intake of caffeine is 200 milligrams while pregnant. Have your teeth cleaned. A rise in hormones causes gums to bleed more often than usual during pregnancy, causing what’s known as pregnancy gingivitis. Get to know your cycle. Knowing when you ovulate will increase your chances of timing intercourse, which should be during the three to four days around your most fertile time of the month. There are lots of ways to track, including free apps for your phone or the good ‘ol fashioned way – with pen and paper. Quick Conception Numbers Overall, around 70% of couples will have conceived by 6 months, 85% by 12 months and 95% will be pregnant after 2 years of trying. Only about 8% to 10% of couples get pregnant within a one-month time frame, and the ‘per month’ rate for a normally fertile couple is around 20%. With all these facts and figures, it’s important not to stress out to give it time and try to relax and enjoy the time you have alone with your partner. By meeting with your physician during a preconception counseling appointment before you start the process of trying to conceive, you can ensure that every possible precaution is taken to prevent future problems throughout gestation, labor, delivery and even afterwards. Your peace of mind combined with our experience experience and expertise is our ultimate goal so that you may enjoy a safe and healthy pregnancy. Schedule an appointment online or call us today at 770-720-7733.    

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Why Sleep is Important for Maintaining a Healthy Weight

As people become more sleep-deprived in our fast-paced world, scientists are learning that this deprivation is also a huge contributor to their difficulty in losing weight. It’s hard to imagine that the number of hours you sleep can have so much impact on your ability to shed pounds, but, thanks to two hormones and their role in weight control, those extra forty plus winks can mean the difference between slender and – well- not so slender. Just when women have had their fill of hormones like estrogen, testosterone, and progesterone raging inside and causing mood swings and feminine issues, along come two more that dictate whether or not they can successfully lose weight. These culprits are named ghrelin and leptin, and they have been at constant war with each other since Adam allegedly bit into that first apple and probably couldn’t sleep afterward. What are Leptin and Ghrelin, and What is Their Function? Both leptin and ghrelin regulate hunger. Leptin, which, under a microscope, looks like that pretty ribbon you’ve curled with scissors to add a special touch to your Christmas gift, decreases hunger. In ‘non-science’ talk, your fat (adipose tissue) creates leptin and, like a homing pigeon sends it on its way into your circulatory system. From there, it is set free to travel to the hypothalamus which controls such things as thirst, hunger, temperature, and your wake-sleep cycle (circadian cycle). It carries the message that your body has enough food and can stop eating. Ghrelin, on the other hand, is the dieter’s nemesis and saboteur. It works in a similar manner to leptin, but this ‘carrier pigeon’ brings the opposite news. It tells the hypothalamus you’re hungry, thus increasing your appetite. Unfortunately, insufficient sleep causes the body to make more ghrelin and lessens leptin production. So, the less you sleep, the more you want to eat. It follows that, unless you have the willpower of robot, you will eat. Of course, the more you eat, the more weight you’ll gain. Even if you adhere to the same dietary restrictions as your clone, exercise as much, and live the same lifestyle, one of you that is not getting enough sleep will have trouble losing weight. In fact, it may not be a coincidence that the Center for Disease Control (CDC) reports over 30% of the American population is sleep deprived. Roughly the same statistics are ascribed to obesity. A recent study found that participants who slept poorly or less than 7 hours a night lost 55% less fat than their counterparts who rested enough. Furthermore, they were hungrier, suffered from low energy, and didn’t feel satisfied with the amount they ate. How Much Sleep is Enough Sleep?  It is recommended that you get at least 7-9 hours of sleep every night. Your body begins to rebel after a mere 4 days of getting less than 6 hours, not only by stimulating ghrelin production but also by causing: Interference with insulin production: Insulin, yet another hormone, is vital. It helps the body to transform starches, sugar, and other nutrients into energy. Mood swings Inattention, confusion, disorientation, and difficulty focusing Exhaustion and lack of will-power, leading to resistance to exercise and other physical exertion A rise in cortisol levels: Cortisol is a stress hormone that activates the brain’s reward center (amygdala), triggering food cravings. High levels of cortisol, when combined with ghrelin activate hunger by blocking brain messages telling you you’re full. Ghrelin and cortisol join forces like two little starving demons, demanding you feed them with anything that isn’t nailed down. Diminishment of mental clarity: Just like having too many shots of tequila, you begin to make poor choices, eating larger portions and selecting fatty, sweet, or otherwise high-caloric food. Onset of muscle loss (atrophy): Your body’s muscle building ability (protein synthesis) begins to fail, resulting in possible of physical injury. Slow wave or deep sleep depletion: Sleep deficit can rob your brain of the recuperation it needs after a busy day. Slow wave sleep is vital to physical growth and the body’s ability to repair and heal itself. What Can I do to get a Better Night’s Sleep? There are several things you can do to create better bedtime habits that enable you to get the proper rest you need. Some of these include: Turning your bedroom into your fortress of solitude: Treat it like hallowed grounds for the purposes of intimacy, relaxation, and sleep only. Avoid making it a bouncy house for the kids, a workstation, or an entertainment section complete with 70’ flat screen and enough woofers and tweeters to raise the dead. Adhering to a schedule: Try to go to bed and wake up at the same time every night and morning. No matter how tempting it might be to get those extra weekend zzzz’s, disrupting your routine can lead to even more sleep irregularities. Keeping it fresh: Grungy sheets and lingering human odors can be distracting. Change the linen as often as possible and air out the room regularly. You’ll rest better feeling clean sheets against your body and inhaling sweet-scented fabric softener. Establishing a routine: Wind down before bedtime by reading, soaking in a warm bath, taking a soothing shower or meditating. Leave budget worries or to-do lists for daytime. Turning off all electronics at least an hour before retiring. Studies show that these devices emit a short-wavelength bluish light that confuses your internal clock (circadian rhythm) and interfere with your body’s ability to produce melatonin, the hormone that helps encourage sleep. Watching your food and liquid intake: Avoid heavy food before bedtime, along with caffeine-laced beverages, alcohol, soft drinks, sugary snacks, and Sleeping in complete darkness: Even the glow from the alarm clock or a night light prevents melatonin output. If your job requires you to work at night, invest in blackout and/or soundproof Empty your bladder: Void before bedtime so that Mother Nature does not call during a delicious dream. Everyone goes through periods of insomnia. However, if you experience it

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Ladies, Make Heart Health a Priority

In honor of National Heart Health Month, we’d like to touch on a disease that affects an estimated 44-million of women every year. Cardiovascular disease is the #1 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. Age 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: Race 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. Smoking 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. 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. Weight 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. 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); 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. 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.

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What is Melasma and How to Beat it

Melasma is a skin issue that results in brown or brownish-gray blemishes, or inflamed, red patches (erythrosis pigmetosa faciei) that 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?  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

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Menstrual Pain

Almost every woman has suffered from menstrual pain or heavy bleeding at least once since her first period. For many, a simple over the counter pain reliever, heat applications, or a soothing hot bath can alleviate the discomfort, but for others this can be a debilitating experience month after month, often interfering with enjoyment of daily living. Our experts at Cherokee Women’s Health Specialists encounter this problem on such a frequent, regular basis that our skills are honed to immediately recognize the symptoms and provide help. We know the physical limitations and psychological impact chronic pelvic pain and heavy bleeding have on your life. Our physicians take menstrual pain very seriously and are very aware of the limitations it may put on you if you suffer from its distressing effects. Menstrual pain is different from premenstrual syndrome (PMS) in that PMS usually occurs within 7 to 14 days before actual menses. Symptoms associated with PMS are bloating, irritability, weight gain, and fatigue, whereas menstrual pain occurs during your period. Symptoms include cramping and a throbbing dull ache or pressure low in your abdomen. It can radiate to your lower back, hips and inner thighs. Other more extreme symptoms may be nausea, vomiting, or diarrhea. It can be annoying, but tolerable for -or so severe that it limits functionality. Different Types of Menstrual Pain  Menstrual pain is called dysmenorrhea, and there are two types—primary and secondary. Most women suffer from primary dysmenorrhea, which is usually linked directly to menstruation itself without any other underlying conditions. Contractions of the uterus push against neighboring blood vessels, briefly cutting off blood supply to the uterine tissue, thus resulting in menstrual pain. It generally lasts 2 to 4 days. Secondary dysmenorrhea is caused by a medical disorder of your reproductive system which may require testing to identify the source. It is typically treated with either medication or surgery. Some causes may include conditions such as pelvic inflammatory disease (PID), fibroids, adenomyosis, cervical stenosis, or endometriosis. There can also be diarrhea, nausea, fatigue or vomiting. Accompanying pain lasts longer and begins earlier than primary dysmenorrhea. Another menstrual disorder that can lessen the quality of life, interfere with regular activities, and is often cause to call into work to take the day off, is heavy bleeding or menorrhagia. It affects a whopping 10 million American women and is one of the complaints gynecologists hear most often. This excessive bleeding can last longer than a full week. Sanitary napkins or tampons need changing every hour or two and, often, throughout the night. There can be leakage, even with precautionary double padding. Some women with severe menorrhagia can pass large, quarter-sized clots. This condition can cause serious anemia if left untreated for too long. Causes of Menorrhagia May Include: If you suffer from menstrual pain that is not relieved by over the counter medicine, rest, heat application, or soothing hot baths- or if experience heavier than normal bleeding, you should seek the advice of an accredited practitioner familiar with women’s reproductive wellness, especially if your discomfort interferes drastically with day to day life. At Cherokee Women’s Health Specialists, we are familiar with every aspect regarding a woman’s exclusive health issues. Doubly accredited Dr. Haley and Dr. Litrel, our urogynecologists, hold certification in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) and OB/GYN. They were among the first to receive this special recognition by the American Board of Medical Specialties (ABMS) in recognition of their ability, proficiency, and training. This qualifies them to diagnose and treat any and all disorders pertaining to your feminine health. Furthermore, they are two of only a limited number of doubly accredited physicians in private practice in Atlanta. When you choose our facility for your care, your first consultation will probably consist of in-depth questions in order to determine what your possible complications might be. A pelvic examination may reveal the problem immediately. If not, our state-of-the-art facility and our close affiliation with Northside Hospital Cherokee, with access to all its amenities, enables us to perform all additional testing necessary such as: Laparoscopy: A tiny fibro-optic telescope can be inserted through a minuscule incision to examine internal reproductive organs, and take a small sample of tissue for biopsy. Hysteroscopy: A fibro optic telescope is introduced into the womb via the vagina to look for any abnormalities. Urine and blood tests: These pinpoint and accurately identify any medical disorders or diseases Pelvic ultrasound study: This detects physical irregularities painlessly via high-frequency sound waves. Pap smear: A quick swab rules out any cancer, infection, dysplasia or inflammation. Sonohysterogram: After the uterus is infused with fluid, ultrasound is used to find any anomalies. Dilation and curettage: Though this is usually a treatment, it can also be used to pinpoint any physical abnormalities. Normally, invasive intervention is unnecessary. We do our best to avoid any treatment that makes you more uncomfortable. We analyze results carefully, taking in all factors such as your age, general health, weight, etc., and use our combined expertise and decades of accumulated knowledge to decide on the most effective management for your dysmenorrhea or menorrhagia. Treatment Options for Severe Period Pain and Heavy Bleeding The first option we look into is oral hormonal or non-hormonal therapy such as contraception, non-steroidal anti-inflammatories (NSAIDs), or other medications that can reduce bleeding and pain. If you suffer from anemia as a result of your condition, folic acid or iron supplements might be prescribed. In some cases, a hormonal intrauterine device (IUD), patch, vaginal ring or injections can be helpful. Should you require a surgical alternative to alleviate your pain or bleeding, our FPMRS, OB/GYN specialists have the most current medical knowledge to do everything possible to treat your individual problem. Severe period pain and heavy bleeding do not have to keep you from living the life you want. With the proper help, you can get better. If period pain or prolonged, heavy bleeding is interfering with your life, call us today at 770.720.7733 or schedule an appointment online.

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Premature Births on the Rise in Georgia

Babies born before 37 full weeks of gestation are considered premature. Disturbing statistics show that, after previous years of decline, premature births are now on the rise in Georgia. Though this is partly due to lack of funding and, consequently, the shutting down of many medical facilities in Georgia, it is also happening nationwide. What Causes Premature Birth? Many maternal factors can contribute to preterm deliveries. Some of these include: Complications of Premature Birth Premature babies often suffer from both short and long-term health complications, neurological issues, and developmental delay concerns such as: Is Your Pregnancy High-Risk? If your pregnancy classifies as high-risk with a danger of premature birth, you should find a fully accredited physician who is both familiar with and can treat complications associated with these pregnancies, as you will probably need extra monitoring throughout gestation. Any medications, vitamins or supplements you are taking will be evaluated and possibly stopped or modified. Your diet might be adjusted to create a more nutritious and beneficial plan. Additionally, you will be provided with a list of any danger signs that may point towards a premature birth. Cherokee Women’s Health Offers Prenatal Care for All Pregnancies  If you are not yet pregnant but may potentially give birth prematurely, prenatal counseling and testing are usually advised. At Cherokee Women’s Health Specialists, we offer you exceptional prenatal service. All of our professionals possess up-to-the-minute knowledge in their fields of obstetrics, gynecology, surgery, midwifery, nutrition, medical assistance, nursing, holistic medicine and equipment technology. They are committed to putting your well-being and that of your child first. Unlike many OB/GYN facilities, we conveniently deliver multiple women’s health services to meet your needs under one roof. Our priority is to prevent as many premature births as possible by providing you with these broad amenities. Along with being voted “Best OB/GYN in Towne Lake, Woodstock, and Canton, we are affiliated with Northside Hospital Cherokee, the nation’s leader in maternity services. We have unlimited access to their state of the art equipment, test center, and birthing center. Their Neonatal and NICU facilities have the most advanced technology to ensure that your baby is given every possible opportunity to fight against the challenges it might face due to a premature birth. Not all premature births can be foreseen or prevented, but at Cherokee Women’s Health Specialists, we try to do everything within our scope of expertise to deliver one healthy baby at a time.

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IUDs May Have a Surprising Health Benefit

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 IUDs 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. IUDs Do Not Protect Against STIs or STDs IUDss 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. IUDs 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?  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: 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

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Getting Pregnant After 50: What You Need to Know

Whether naturally or through in vitro fertilization, the number of women who are getting pregnant after 50 is increasing. Celebrities such as Gwen Stefani, Sophie Hawkins, Kelly Preston, Geena Davis, Janet Jackson, and Halle Berry were well into their 40s and early 50s before giving birth. As more women wait to secure careers and stablize incomes before starting a family, their decision can come with the following drawbacks to both mother and child: Because of these possible complications, pregnancies occurring later in life are considered high risk and therefore should be monitored more carefully. If you are considering getting pregnant after 50, you owe it to yourself and to your baby to choose an accredited OB/GYN whose experience, training and credentials encompass the entire spectrum of requirements and problems that could arise. You need a provider who will closely follow your progress throughout your entire nine-month gestational period. Prompt recognition and treatment of any complications that may occur from their onset are vital to both your health and that of your baby.  Getting Pregnant After 50 Unless you conceive naturally, which is rare for women over the age of 50, you would probably have to become pregnant via in vitro fertilization, using either your own stored eggs or those of a donor. Preconception and fertility counseling might be recommended to inform you of both the risks and benefits that may arise with starting a family later in life. Your entire pregnancy should be monitored from beginning to end with regular ultrasounds, checkups, and prenatal testing. If you are overweight, wish to maintain an already healthy weight, or want additional advice regarding the best food and exercise plan during your pregnancy, it may be wise to consult a dietitian. Finally, if you prefer a more holistic approach and opt for a midwife, finding one that is familiar with pregnancies occurring after 50 is as important as any physician you would choose. Preconception Counseling Cherokee Women’s Health Services not only offers all these amenities under one roof, but we offer them with a superlative degree of excellence. Our physicians and staff are trained to meet all your needs. Dr. Haley and Dr. Litrel possess double accreditation in the field of Female Pelvic Medicine and Reconstructive Surgery (FPMRS). Receiving this credential requires years of additional education, skill, and training, not to mention meeting the strictest guidelines set forth by the American Board of Urology. Their 40 combined years of knowledge and proficiency ensure you will have optimum care during your mid-life pregnancy. Our entire staff of OB/GYNs, counselors, and board-certified midwives possess stellar credentials. They diligently remain abreast of the most advanced scientific breakthroughs in women’s health, thus offering you the finest obstetric care modern medicine has to offer. They work as a team, making sure you receive every advantage to make your prenatal experience as safe as possible. Practitioners at Cherokee Women’s Health Services are affiliated with Northside Hospital-Cherokee and all babies are now delivered at its new location which opened earlier this year. Their birthing center provides a comfortable and modern environment with access to the latest technology only steps away should any last minute problems arise. Our Patient Philosophy at Cherokee Women’s Health Our basic philosophy at Cherokee Women’s Health Specialists is a simple one — to treat every woman who walks through our doors with no less than the same consideration, understanding, and respect we would expect for any woman in our lives. This tenet is one of the many reasons that our full-service facilities were voted both “Best OB/GYN in Towne Lake, Woodstock, and Canton” and “Mom-Approved OBs” by Atlanta Parent Magazine readers. We take pride in these recognitions and make sure to pass the expertise that earned them on to you, the patient. As we see more and more women get pregnant after the age of 50, we strive to keep ahead of all the improvements in medicine in regard to your special needs so that you and your baby can have a trouble-free pregnancy, safe delivery and can go on to enjoy the wonderful rewarding pleasures motherhood has to offer. Call today to schedule an appointment with one of our OBs at 770.720.7733.

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