Diane, Author at Cherokee Women's Health

HPV is the most common sexually transmitted infection. Nearly all sexually active people contract it. If fact, nearly 79 million people are estimated to be currently infected. Each year, another 18 million people will be diagnosed with it. So, what is it? HPV or human papillomavirus has over 100 unique types, many of which have no symptoms. These types are broken down into ‘low-risk’ and ‘high-risk.’ High-risk types of HPV usually have little to no signs and can cause serious health risks such as cancer. Signs and Symptoms of HPV Almost all sexually active people get HPV sometime in their lifetime. It is most commonly passed from partner to partner during vaginal or anal sex. However, it may be transferred during oral sex or intimate skin-to-skin conduct as well. In many cases, certain types of the human papillomavirus will go away on its own. Other high-risk types may show zero symptoms and can lead to serious health issues such as cancer. If you or your partner are experiencing any of the following symptoms for low-risk types of HPV, you should consider scheduling an appointment with your healthcare provider. You should be aware that HPV can be passed from one partner to another even when there are no signs of symptoms. If you suspect you or your partner have HPV, preventive measures are recommended. How is HPV Diagnosed? Most people that have a high-risk type of HPV don’t even know they have it. Depending on the type very little signs are shown in the beginning stages. The longer the virus stays in your body, the bigger the chance that you’ll be at risk of developing health problems. It is especially important to have regularly scheduled Pap smears before real damage to your health can be done. Pap smears do not directly test for HPV, however, they can detect abnormal cells in your cervix, that are often caused by HPV. If your doctor diagnoses you with HPV, they may request that you get tested more regularly to ensure you are healthy and cancer free. Having HPV and getting cancer don’t always go hand in hand but it does put you at a higher risk for getting cancer down the line. Being pro-active in treating an occurrence of HPV and regularly scheduling follow-up screenings and appointments with your OB/GYN can prevent serious health problems in your future. Preventive Measures for HPV The safest and most effective way of preventing HPV is a vaccine. Vaccines such as Gardasil can protect women from getting HPV by helping prevent the transmission of certain types of HPV. Vaccines are more effective when given prior to exposure of human papillomavirus or sexual activity. HPV vaccines are recommended for both boys and girls starting at around the age of 11 or 12. A second dosage approximately 6 months to a year later is ideal. Gardasil or other forms of HPV vaccination should be administered to young women throughout the age of 26 and in young men throughout the age of 21. Even if you aren’t vaccinated, there are ways that sexually active people can lower their risk for contracting HPV or passing it to their partner. Final Thoughts Women who are concerned they may have or be at risk for contracting HPV should consult their doctor. Regular pap smears are important in catching HPV early and preventing it from causing more serious health issues. If you’ve already been diagnosed with HPV, keep an open dialog with your health care provider. Together you can come up with a plan to be pro-active in treating it and screening for cancer in the future.

dr. cross at northside cherokee hospital

Dr. Cross: Northside Hospital’s “Original OB/GYN”

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Cherokee Women’s Health Specialists founder Dr. James Cross has made his mark in obstetrics history in metro Atlanta over the past half century. Dr. Cross was the first OB/GYN in Georgia to offer epidurals to women in labor. He was among the original 17 obstetricians who opened Atlanta’s Northside Hospital. And in 1993, he came out of retirement to single-handedly provide OB services for metro Atlanta’s Cherokee County, delivering babies in the facility that is now Northside Hospital Cherokee. His presence was credited for cutting in half the perinatal morbidity and mortality rate for the county’s babies, a rate which before his arrival had been among the highest in the state. As the glamorous new Northside Hospital Cherokee opens its doors, we thought it was a good time to interview the obstetrician whose memories span six decades, and who has delivered over 15,000 babies during his career in medicine. Introducing Epidurals To Atlanta’s Pregnant Women: From Texas Air Force Base to the South We met with Dr. Cross on the campus of the new Northside Hospital Cherokee, three weeks before the facility is to open. A utility truck outside the wing of the Women’s Center lifts a window washer high against the plate glass windows, while Dr. Cross — now in his early 90s — enters the soaring main atrium and marvels at the hanging chandelier. He shakes his head and laughs. “More like a hotel, don’t you think?” He is cheerful and spry, wearing his white doctor’s coat and remarking he is “happy to do anything” to spread the news about the new hospital. “A hospital makes all the difference in a community.” Dr. Cross says, with the air of someone who has said it hundreds of times. Born in a small Colorado mining town in 1931, James Cross (“Jim” to friends and family) graduated from college when he was 19. With a degree in Chemistry and the encouragement of his professors, he was in medical school four days later. After three years training in Emory University’s OB/GYN residency at Grady Memorial Hospital, the young doctor was stationed at the Amarillo Air Force base. There he delivered 2,600 babies in four years. More significantly, he learned the then-innovative practice of administering epidural analgesia. Previously, laboring women were given ether to dull the pain of childbirth, resulting in not only sleepy mothers, but also oxygen-deprived babies, who emerged in a ‘twilight sleep” with impaired breathing and a telltale blue skin color. Dr. Cross comments that mothers given ether often slept for hours, or even days, waking up “only when the hairdresser got there.” Spinal anesthesia, which was later used in place of ether, had equally undesirable complications such as headache, compromised blood pressure, spinal damage, infection etc. Upon Dr. Cross’s return to Georgia and a practice at Georgia Baptist Hospital, he immediately introduced the use of epidurals for laboring mothers, becoming, he believes, the first physician to employ the technique in Georgia. He says with a smile, “I’m happy to report that epidurals have been used now for decades all across the country.” He comments that the benefits were much reduced side effects over former pain treatments, a drop in the Caesarean rate down to about 5-6%. Furthermore, administering epidurals was delegated to anesthesiologists, freeing obstetricians to attend to critical matters that might arise during a delivery. Best of all, he says, babies came into the world a healthy pink, crying, alert and wide awake. “It was nice to see those babies finally come out squalling,” he exclaims. He went on to help establish an epidural training program for more than 30 residents over the next decade at Georgia Baptist Hospital. Northside Hospital Atlanta: Helping To Open the Country’s Largest Maternity Hospital In 1967 Dr. Cross joined the staff and building committee at Northside Hospital in Atlanta. Three years later, he watched proudly as Northside Hospital Labor and Delivery opened its doors. “There were 17 of us OB/GYNs when we started,” he relates. “I remember we were shortchanged one delivery room, but it all worked out,” he chuckles. With visible pride, he fondly points out that Northside Hospital Atlanta has today evolved into the largest maternity hospital in the country. In the interim, Dr. Cross helped found the OB/GYN practice Atlanta Women’s Specialists in 1968, a practice that eventually expanded into four offices, including a residency program with six doctors. Over the next two decades, he states, he strove to make sure that no physician at any of those clinics was overworked, overwhelmed, or otherwise “prevented from providing quality care.” “It was a growing process – one step at a time. If you give patients quality care and are hardworking, they respect you.” Dr. Cross on opening his first OB practices Dr. Cross speaks about his philosophy of care, that he considered every patient “family,” treating each one as such. He says, “you can be honest, but tactful,” to strengthen the resolve of pregnant women to change the way they treat their bodies. He encouraged healthy diets, smoke and drug cessation, careful vigilance of medicinal products, and weight loss. He felt that though women may sometimes be resistant to change, once they begin to take care of themselves — thus ensuring the additional health of their unborn children — they realize and appreciate the positive benefits. By approaching them the same way he would any female in his own family circle, they became receptive to his advice and genuine concern. Dr. Cross also developed a unique approach, whereby pregnancy was not a sole female issue, but a family one, involving fathers and children in the whole process. A post natal care appointment was not attended only by the woman. The partner was also involved, especially when the couple decided that their family was complete and they no longer wished to have children. It was then that Dr. Cross would explain to them both that modern reconstructive surgeries could transform the woman’s internal and external reproductive organs back to the

Instructions After Surgery

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The physicians at Cherokee Women’s Health Specialists are committed to ensuring that your experience after surgery is as comfortable as possible. The following information will help answer frequently asked questions and will help you understand some of the common experiences that may occur after your surgery. Please do not hesitate to call the office with any additional questions about your recovery. Call the office at 770.720.7733 right away if you experience: IF THE SYMPTOMS ARE SEVERE, GO TO THE EMERGENCY ROOM OR CALL 911 FOR AN AMBULANCE IF NECESSARY. How Much Activity Can I Do After Surgery? General – There are no standard limitations with regards to activity after gynecological surgery except for driving and sexual activity (see below). If you stayed in the hospital overnight, you should plan to rest with minimal activity for at least a week. If you were sent home the same day you should plan to rest with minimal activity for three days. If you had a procedure with no incisions (such as a D and C or endometrial ablation) then you probably only need to rest for a day. Use common sense and listen to your body. Every patient is different, and different patients will have differing degrees of recovery. Gradually advance your activity. If the activity you are doing increases your discomfort, then STOP. If you are feeling well during increased activity but have increased pain the next day you need to decrease your activity. Adequate rest and nutrition is required to heal from surgery. LISTEN TO YOUR BODY. Stairs – Apprehension about stairs or weakness in mobility may require help when climbing up and down stairs. You are allowed to use the stairs if you feel you are able. It’s a good idea to put both feet on each step to not lessen the strain on your body for a week or longer after surgery. Exercise – If you had incisions on your body wait until you get clearance from your surgeon. Use common sense when starting an exercise routine after surgery. Start out slowly and gradually increase time, distance and speed. Once you are cleared to exercise a general recommendation is to start out at 25% of what you were doing before surgery for a week or two and increase by 25% at each one or two week interval. Driving – Driving should only begin only after you have stopped taking narcotics, and if you feel strong enough to be able to stop the vehicle in an emergency. At this point you should be able to walk up and down stairs comfortably and sit down and stand up without experiencing discomfort. Have someone drive you if you are still experiencing discomfort. What Should I Eat After Surgery? After surgery, your body needs enough calories and nutrients to fully recover from the procedure. Eating the right foods after surgery can decrease risk of infection, speed healing of the incision and increase strength and energy. The best post-surgery foods to eat are packed full of vitamins and minerals. Here are some foods and nutrients you should focus on in your post-surgery diet: Fiber – A common complaint after surgery is constipation. To avoid this uncomfortable post-surgery complication, eat plenty of fiber. Some high-fiber foods include fresh fruit and vegetables. Whole grain breads and oatmeal are other great sources of fiber. To prevent constipation, avoid foods like dried or dehydrated foods, processed foods, cheese and dairy products, red meats and sweets. Protein – The amino acids in protein help with wound healing and tissue regeneration. Protein can also help with strength and energy following surgery. Lean meats such as chicken, turkey, pork and seafood are excellent sources of protein. You can also get protein from eggs, nuts, beans and tofu. Dairy also contains protein, but if you’re struggling with constipation, go for the other sources of protein instead of dairy options. If you have trouble getting enough protein in your diet after surgery, try adding protein powder to drinks or smoothies. Several Physicians at Cherokee Women’s recommend a Vegan diet which is absence of animal products including meat, dairy and eggs. Eat to Live by Joel Furman MD gives excellent recipes and recommendations for those inclined. Carbohydrates – Fatigue is common following any surgical procedure, but eating the right kinds of carbs can help restore your energy levels. Get carbs from high-fiber foods like whole grains, fruits and veggies, and beans and legumes. These foods will boost energy levels without causing constipation. Fat – Healthy fats from olive oil, avocados, coconut oil, nuts and seeds will improve immune response and aid the body’s absorption of vitamins. Fat will also help increase energy levels after surgery. Vitamins and Minerals – Perhaps the most important nutrients in your post-surgery diet are vitamins and minerals. Vitamin A (found in orange and dark green veggies like carrots, sweet potatoes, kale and spinach) and vitamin C (found in citrus fruits, berries, potatoes, tomatoes, melons, and sweet bell peppers) help with wound healing. Vitamin D (found in milk, fish, eggs, and fortified cereals) promotes bone health. Vitamin E (found in vegetable oils, nuts, beef liver, milk and eggs) protects the body from free radicals. Vitamin K (found in green leafy veggies, fish, liver and vegetable oils) is necessary for blood clotting. Zinc – (found in meat, seafood, dairy and beans) and Iron (found in meat and poultry, beans, apricots, eggs, whole grains and iron-fortified cereals) are also helpful for wound healing and energy following surgery. Water – In addition to eating foods that are rich in fiber, protein, healthy fats, carbohydrates, vitamins and minerals, you must stay hydrated after surgery. Proper hydration isn’t only necessary for healing, but may also be necessary to help your body absorb medications following surgery. Be sure to drink at least eight glasses of water every day after surgery to stay hydrated. The foods you should and shouldn’t eat can vary depending on the type of surgery and any medications you may be on so speak with your surgeon

Midwife Education, OB

What is Natural Childbirth?

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Natural childbirth is a labor and delivery that does not include the use of routine medical interventions, particularly anesthesia, the most common forms being epidurals and spinal blocks. It also attempts to minimize surgical interventions such as episiotomies, forceps, and caesarean sections. A natural childbirth may occur in a hospital while under the supervision of a physician or midwife, or at home assisted by a midwife. Natural Child Birth Options Pregnant women who are approaching their due date may often become anxious about the process of delivering a healthy baby and what it may entail. In order to relieve any unnecessary anxiety or concern, it is helpful to become informed about childbirth, which options are available and have a birth plan ready for when it is time for delivery. It is important to speak with your health care provider to explore both natural and medical options for you and your baby. This way you can be prepared and empowered to make a decision. Each birth is different, and the health of mother and baby is ultimately paramount. Alternative Options to Medical Interventions Some of the alternative options to medical interventions include: Massage Massage stimulates your body to release endorphins that can help ease the pain, reduce anxiety and make contractions feel less intense. Massage can be performed on the shoulders, back, feet/hands and the perineal area. Breathing and Relaxation Exercises This can include a variety of methods such as mindfulness and meditation, specific breathing techniques, vocalization, visualization, and progressive muscle relaxation. Acupressure A form of Traditional Chinese Medicine, acupressure can be used to apply pressure on specific points to provide pain relief, calm anxiety and encourage an efficient labor. This can be learned and practiced on yourself or by your partner. Positioning and Movement Certain birth positions have been favored in natural childbirth including squatting, and being on hands and knees versus the traditional lithotomy – laying on the back with hips and knees flexed – position. Walking, gentle stretching and the use of a birthing ball can also be helpful in the labor process. Hot and Cold Therapy Intermittent heat and cold in the form of warm and cold packs may be used on the lower back, lower abdomen and perineum during labor to help with pain and discomfort. Hypnotherapy This is an integrative mind-body technique which can aid women to replace fear and expectations of pain with expectations of a safe, gentle and comfortable birth. It can be self-performed or performed by a partner using deep breathing, vocabulary cues or visualization. Final Thoughts When it comes to childbirth today, women have a variety of options to explore and choose from. It is important that you feel as comfortable, prepared and relaxed as possible when preparing for your labor and delivery. Being educated about both natural and traditional medical birth options will allow you and your doctor to make an informed plan that best suits you and your baby’s needs. Please don’t hesitate to call with any further questions or concerns you may have regarding natural childbirth.

Are Prenatal Vitamins Really Necessary?

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Healthy nutrition is important throughout life, and especially during pregnancy. Even with a wide variety of whole foods, a mother and baby may require nutrients above and beyond what is contained in food. Think of prenatal vitamins as insurance to make sure you are getting all of the essential nutrients during pregnancy. Whether currently pregnant or planning to become pregnant, women can benefit from taking prenatal vitamin and mineral supplements as early as possible. It is particularly important if you meet any of the following criteria: Follow a vegetarian or vegan diet Are lactose intolerant or have other food intolerance Smoke or abuse other substances Have a blood disorder Have an eating disorder Experience chronic disease Have had gastric bypass surgery Are having twins or higher multiples Even if you do not fall into these categories, ensuring you get all of your nutrient requirements daily will help give you optimal strength and energy levels. It will also give your baby the best head start possible during all of the important stages of development in the womb. Important Vitamins and Minerals Before and During Pregnancy You may be wondering which nutrients are especially important when pregnant, and how to choose the best supplement. Consult with your health provider to discuss your individual needs and which prenatal vitamins you should take before, during and after pregnancy. Many pregnant women do not get enough of this mineral from their diet to meet the body’s increased need. This can lead to a deficiency called anemia, in which the blood has a low number of healthy red blood cells. Iron supports the baby’s growth and development and can cut your risk for preterm delivery, low birth weight and even infant mortality. Folic Acid. This B vitamin is important to take even if you are in the planning stages of conceiving. The body absorbs the synthetic version of folic acid better than the natural one typically found in food, so even with a balanced diet, a folic acid supplement is recommended. It can reduce your baby’s risk of neural tube, heart, and other defects. Iodine is important for healthy thyroid function during pregnancy. It can also lower the risk of miscarriage, stillbirth and stunted fetal growth and development. Calcium helps your baby grow a healthy heart, strong bones, and teeth, nerves, and muscles as well as develop a normal heart rhythm. It can also reduce your risk of hypertension and preeclampsia. This mineral is important even after you give birth and if you are breastfeeding. Vitamin D. This vitamin is necessary for the absorption and metabolism of Calcium and Phosphorus. It is beneficial for immune function, healthy cell division and bone health in both mother and baby. You may be wondering if you should be concerned about other nutrients. Not all prenatal vitamins include omega-3 fatty acids which may help promote your baby’s brain development. Your health care provider may recommend this or other supplements, particularly if you do not eat fish or other omega-3 rich foods. Which Prenatal Vitamin Should I Take? There are many prenatal vitamins available in pharmacies to purchase over-the-counter. Consult with your health care provider if you are unsure which specific brand best meets your needs. He or she may recommend a prenatal vitamin that has the proper doses of nutrients for your particular circumstance. Final Thoughts If you still have questions or concerns about prenatal vitamins, don’t hesitate to contact us. Our physicians at Northside Hospital Cherokee provide nutritional counseling and can quickly get you on the right path to the proper allotment of vitamins and supplements for you and your little one on the way.

GYN and Annual Exams Videos

Get to Know Dr. Litrel

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Dr. Michael Litrel, double board-certified OB/GYN and FPMRS surgeon, shares his unique practice philosophy that guides his care of patients from across the country. Read Dr. Litrel’s accompanying article. Watch more GYN and Annual Exams videos below.

Pap Smears, Well Woman

Health Screening by Age

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It is critical that women receive various health checks at different age ranges as recommended by your doctor. When you break down health screening by age, it can help you to stay on track and take preventative measures. There are many key reasons to receive regular health check-ups, and by screening for medical issues or assessing your risk for future medical problems, you can maintain a healthy lifestyle at every age. Women Ages 18-21 Women Ages 21-35 Women Ages 35-50 Women Ages 50 and older Final Thoughts By using these guidelines listed above for health screenings by age in combination with what your doctor recommends can help resolve and even prevent serious health issues. If you have not received certain tests as outlined for your age group, call for an appointment to consult with your OB-GYN about setting up additional health screenings.

Well Woman

Alternatives to Latex Condoms

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When used correctly and consistently, condoms can be an effective method of birth control and provide protection from STIs. If you or your partner has a latex allergy or sensitivity to latex, rest assured that there are easily available alternatives to latex condoms. Many are equally useful in the prevention of pregnancy and sexually transmitted infections. What is a Latex Allergy? Latex is natural rubber, a product made primarily from the rubber tree. Some people have a reaction to the rubber in latex, which can cause moderate, severe, or even life-threatening reactions. Allergy to latex is an increasing health problem. In some cases, repeated contact with products containing latex can increase your sensitivity and, with continued use, develop into an allergy. Symptoms of Latex Allergy The following are the most common identifiers that you may be sensitive to latex. You’ll find that latex can affect both your skin as well as cause internal respiratory problems. Below is a list of the most common skin reactions when it comes to latex allergies. These reactions most commonly occur on or near areas that come into direct contact with latex. You may have a latex allergy if you are experiencing any of the following respiratory issues during or after using a latex based condom. If you notice one or more of these symptoms after coming in close contact with latex, contact your doctor to get tested for a latex allergy. Furthermore, if you experience severe or life-threatening symptoms, seek immediate medical attention. Alternatives to Latex Condoms Condoms are one of the most common types of birth control and STI protection on the market. A condom is a thin sheath that fits over the erect penis. There are currently three types of male condoms available other than the latex variety. Let’s take a closer look at some of your options to help you determine which will work best for you. Each has advantages and drawbacks. Ultimately, it’s up to you and your partner to make the right choice for your lifestyle. Polyurethane Condoms Polyurethane is a plastic based product that contains no latex. Polyisoprene Condoms Polyisoprene is a newer product made of a non-latex material. Natural Condoms Made from the oldest material on the market—the intestinal membrane of a lamb, sometimes known as a lambskin condom. Female condoms are not as popular of choice as traditional condoms. However, you may find that they suit your needs better. A female condom is a thin plastic pouch that lines the vagina. It is held in place by a closed inner ring, or rim, at the cervix and an outer ring at the opening of the vagina. Final Thoughts There are numerous alternatives to latex condoms. All of the varieties we’ve mentioned require no prescription and can be purchased in pharmacies, stores or vending machines. Many family planning clinics, school nurses, or university health centers will provide condoms, including non-latex condoms, free of charge. For the best protection against unplanned pregnancy and STIs, use a condom even when using another method of birth control, such as pills or an IUD. Always use a condom when participating in vaginal, oral, or anal intercourse. If you have a latex allergy or sensitivity to latex, make an appointment to discuss your options with your OB/GYN.

OB Videos

Pregnant? Count Your Fetal Kicks

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Dr. Litrel discusses the importance of counting fetal kicks during your pregnancy. Watch more OB videos below.

Menopause and Hormone Therapy

4 Things to Know if You Are Entering Menopause

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Menopause is a turning point in a woman’s life that can have a significant impact on her health and overall well-being. Natural menopause is a gradual process that can bring about physical upheaval from hot flashes, night sweats, sleep issues and other symptoms. Let’s take a look at the different phases of menopause and the signs and symptoms to help determine if you are entering menopause. It will be much less stressful if you are informed and know what to expect. Perimenopause: An Overview The transition to menopause is known as perimenopause. It can range 4-7 years prior to actual menopause. The average woman experiences perimenopause at approximately 46 years of age. During this phase, a woman’s ovaries are beginning to produce less estrogen. Estrogen is the hormone that helps control the menstrual cycle. You will notice a difference in your periods which will vary from woman to woman. Although periods may become unpredictable, ovulation can still occur, so it is still possible to get pregnant. In fact, many of the signs and symptoms of perimenopause are similar to pregnancy or PMS including the following. Perimenopausal women will notice these symptoms appear at any time throughout their cycle instead of only 1-2 weeks before menstruation. Determining whether you’re experiencing perimenopause or may be pregnant can be confusing so consult with your OB-GYN right away if you think you might be pregnant. Menopause: An Overview Menopause is the permanent end of menstruation. It is the natural end of a woman’s potential childbearing years. At this point, the ovaries no longer function, menstrual periods have stopped, and it is not possible to become pregnant. According to the National Institute on Aging, on average, women are 51 years of age at natural menopause. However, a woman is considered to have reached menopause after she has missed her menstrual cycle for 12 consecutive months. There is no reliable way to predict menopause age. Women have been known to start menopause as young as 40 and as late as 60 years old. Women who smoke tend to begin menopause a few years sooner than non-smokers. Menopause can be induced, at any age, by certain surgeries and medical treatments. Chemotherapy, pelvic radiation therapy and surgical removal of the ovaries can lead to the sudden onset of menopause. What To Expect As Your Body Changes Beginning in your 30s and 40s, the amount of estrogen produced by the ovaries starts to fluctuate. It’s likely you will notice a change in your menstrual cycles. You may begin to skip periods. Flow may be heavier or lighter. Cycles may be shorter or longer in duration. You may have periods less often or more frequently. Menopause affects each woman differently. Some women reach natural menopause with little or no trouble. Others have severe symptoms that drastically affect their health and lifestyle. The length of time from perimenopause until menopause will also vary from woman to woman. When menopause begins suddenly as a result of radiation, chemotherapy or surgical removal of the ovaries, the symptoms and adjustments can be more extreme than with naturally occurring menopause. Signs and Symptoms of Menopause Numerous signs and symptoms will help you, and your doctor determine if you are entering menopause. Remember, every woman is different. You may experience none, some, or all of these symptoms during perimenopause and menopause. Hot Flashes and Night Sweats A hot flash is a sudden feeling of heat that rushes to the face and upper body. Some women have hot flashes several times a day while others only several times a week. A hot flash can last a few seconds or several minutes or longer. Hot flashes occurring at night are known as night sweats. They may wake you up or make sleep difficult causing you to feel tired and ill-rested the next day. A hot flash can cause temporary red blotches on the chest, back and arms. Both sweating and chills are possible. Sleep Issues Menopause can affect your body’s chemistry in other ways as well. Besides having problems associated with night sweats your normal sleep patterns may be disrupted. Because of the many changes your body is experiencing, you may have trouble falling asleep and staying asleep. You may wake up long before your usual time. Vaginal and Urinary Tract Changes The lining of the vagina may become thinner, dry, and less elastic as estrogen levels decrease. Vaginal dryness can make intercourse uncomfortable or painful. Vaginal infections may occur more frequently. The urethra can become dry, inflamed, or irritated causing more frequent urination and an increased risk of urinary tract infections. Changes In Libido Function During perimenopause and menopause, the libido may also change, for better or worse. But remember that many factors besides menopause can affect sex drive. Stress, medications, depression, poor sleep, and relationship problems can all have an immediate impact on your libido. Menopause Health Risks Along with menopause comes a greater chance of heart disease (the No. 1 cause of death for U.S. women) and osteoporosis (thinning of the bones). These are areas to be aware of even after other symptoms of menopause have subsided. Heart health and strong bones are important throughout life, but menopause is the time to get serious about it. Consult your doctor about any lifestyle changes that should be made during menopausal years to maintain a healthy heart. How Your Doctor Can Help Your doctor will help you monitor your transition through perimenopause into menopause and beyond. Some women experience only minor changes or discomfort. Others find the menopause years to be quite challenging both physically and mentally. It is possible that your symptoms will require appropriate treatment to help you navigate your way through menopause more comfortably. Your doctor will work closely with you to find a treatment that will see you through this normal phase of life. What To Tell Your Doctor About You know your body better than anyone. If you are experiencing any of the following symptoms or have any concerns about your

GYN Problems, STD/STI Screening

Gonorrhea: Know the Warning Signs

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Being sexually active is a decision that comes with responsibility. As a woman who is sexually active, it is important to be informed about the risks involved as well as how to protect yourself from sexually transmitted infections (STIs) such as gonorrhea. Since these infections can be treated effectively, it is also important to be able to recognize the signs and symptoms in order to get treated as early as possible for the best outcome. What Is Gonorrhea? Gonorrhea is a type of STI that is caused by a specific type of bacteria, Neisseria gonorrhoeae, which can infect the mucous membranes of the reproductive tract. In women this includes: Gonorrhea is transmitted through direct sexual contact with the penis, vagina, mouth, or anus of a person who is infected. It can also be transmitted from a mother to baby during childbirth. In infants, gonorrhea most commonly affects the eyes. You can be re-infected after treatment if you later come into contact with someone who is carrying the bacteria. If you’ve had gonorrhea in the past and suspect you have it again, you should schedule an appointment with your OB/GYN as soon as possible. Who is at Risk for Gonorrhea? Statistics show that approximately 820,000 new cases of gonococcal infections occur each year in the United States, well over half of these cases being in young people ages 15-24. Populations most at risk for contracting gonorrhea are sexually active teenagers, young adults, and African Americans. Signs and Symptoms of Gonorrhea While men may or may not experience symptoms such as urethral discharge, women are almost always asymptomatic. Initial symptoms for women can be mild but may include one or more of the following: Long-Term Problems Often these symptoms can be mistaken for other ailments such as bladder and vaginal infections. Many women are unaware they have gonorrhea until they visit their doctor for other reasons. If left untreated, gonorrhea can put you at a high-risk for developing permanent health complications such as pelvic inflammatory disease (PID), and disseminated gonococcal infection (DGI). These are of particular concerns that require immediate treatment in women as they can lead to infertility, pregnancy complications, and scarring of the fallopian tubes. Gonorrhea can also increase your risk of acquiring or transmitting the HIV virus. If you are experiencing any symptoms, it is important to have them examined by your doctor or another health care provider. Should You be Tested? If you experience any of the above symptoms, or if you are having sexual contact with anyone who has been recently diagnosed with an STI you should discuss testing with your health care provider. The CDC recommends that all sexually active women under the age of 25 and women with risk factors (a new sexual partner, multiple sexual partners or a partner who has an STI) be tested on a yearly basis. How is Gonorrhea Tested? Your health care provider will collect and analyze a sample of cells. Samples are typically collected in one of two ways: What is the Treatment for Gonorrhea? The good news is that gonorrhea can be cured with the right treatment. Treatment frequently involves dual therapy or the use of two antibiotic medications. The CDC recommends that one be taken orally, and one may be administered as a one-time intramuscular injection. It is important to complete the full course of the medication to ensure the bacteria is eradicated adequately. These medications can kill the infection. However, they cannot repair any permanent damage done by the disease. It is important to identify and treat symptoms as early as possible. Remember, your partner should also be treated for gonorrhea if you have been diagnosed to prevent re-infection. How Can You Prevent Gonorrhea? If you are sexually active, the first line of defense against gonorrhea is practicing safe sex. Whether having oral, vaginal, or anal sex, the proper use of condoms can reduce the risk of transmission. The only way to be sure there is no transmission risk of gonorrhea is to temporarily abstain from any type of sexual activity or be in a long-term monogamous relationship with a partner who has been tested and is not infected. Seek Help From Your OB/GYN If you are a woman who is currently sexually active with one or more partners, it is important to be aware of the signs and symptoms of gonorrhea infection and be examined by your OB/GYN if you have any concerns. Gonorrhea is a sexually transmitted infection that can have serious consequences if left untreated. However, when identified early and treated effectively with proper medication, it can be completely cured. Don’t hesitate to call confidentially at 770.720.7733 with any questions or concerns you may have regarding gonorrhea or other STIs. Or, you may schedule an appointment online.

Contraception Education

Birth Control No-Nos

Diane /

Birth control is offered in many varieties with different instructions, so it can be confusing for women to know that what they are doing is correct. By using birth control correctly, you can increase its effectiveness. Here are the different methods of birth control and the common errors or actions you should avoid to keep yourself protected. Hormonal Contraception Hormonal methods of birth control have a low chance of error if used correctly. The pill is a common choice, but the first mistake is selecting the wrong pill for your body and lifestyle. Call your doctor for an appointment today to explore options and make the right decision. Birth Control Pills Missing a pill or forgetting to take the pill for a couple of days can negatively affect the way it works. This common error can be helped with certain steps. If you forget your pill, take one as soon as you remember, even if that means you take 2 in one day. If you forget 2 days of pills, take 2 the day you remember and 2 the following day to get back on track. Use a backup method until your next period. A big “no, no” when using the pill is to avoid taking rifampin, a drug used to treat tuberculosis, as it interferes with the effectiveness of the pill. General antibiotics are fine; however, be sure to use another form of birth control if you need to take anti-seizure drugs, anti-HIV drugs, and some anti-fungal medications. The Patch The patch is less effective when you apply it at the wrong time of your cycle. To have high effectiveness, you must implement it on the first day of your menstrual cycle or the first Sunday following your period. Also, be cautious of the day you change your patch, and do not apply it to skin that is moisturized, has make-up, or is ultra dry. Vaginal Rings The vaginal ring releases hormones into the body the same way the pill does. A typical mistake is not inserting it within 5 days of the beginning of your period. You will also be at risk of getting pregnant while using the ring if you forget to remove it after 3 weeks and don’t replace it within 7 days. Condoms and Barrier Methods When using a female condom, common mistakes include not applying enough lubrication and not entering the penis directly into the condom. Make sure to remove the female condom carefully after sex to avoid leakage. With male condoms, effectiveness is decreased if you do not leave enough space at the tip or do not remove the air before intercourse. Never reuse condoms, and make sure to hold the base when withdrawing. Be sure to check the expiration date before use along with the size and fit. If a diaphragm is not the right size for you, then it will not be as effective. Be sure to consult your doctor with questions at any point when using contraception. A common mistake to avoid is leaving your diaphragm in for more than 30 hours. Plan to remove the diaphragm or sponge 6 hours after sex and no sooner. Intrauterine Devices (IUDs) With IUDs being almost mistake-proof, they are one of the most effective forms of birth control. However, as with the pill, the ring and the diaphragm, the IUD only protects users from pregnancy, not sexually transmitted infections. Error or lack of effectiveness can arise from not checking the placement of your IUD after insertion. Be sure to check for the string inside your vagina as directed by your physician. Do not use a copper IUD if you are allergic to copper. If you are not in a committed relationship and have multiple partners, the IUD may not be the right choice for you. Similarly, with other forms of birth control, do not use an IUD if you are pregnant. When taking contraception post-pregnancy, check with your OB for the best course of action. Final Thoughts If you are considering birth control or are currently unhappy with your contraception, call your doctor with questions or for an appointment to explore options. Birth control is primarily designed to protect you from an unwanted pregnancy. It does not provide STD protection, so always use condoms if you are not in a committed relationship or may be at risk for STD exposure. To increase the effectiveness of your birth control, make sure to educate yourself about the risks and follow the appropriate instructions.

Author name: Diane

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Birth Control No-Nos

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