Diane, Author at Cherokee Women's Health - Page 42 of 59

Author name: Diane

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GYN Problems

What to Do if You Have a Urinary Tract Infection

The risk of getting a urinary tract infection, or UTI, is high when you are a woman. Some experts say there is 50% chance to get it at least once in your life, with many women experiencing UTIs multiple times. Symptoms of Urinary Tract Infections First, it is important that you recognize the symptoms associated with the infection that can be located in different parts of the urinary tract. Symptoms of Lower UTIs Lower symptoms of UTIs are in the urethra or bladder, and include: Symptoms of Upper UTIs Upper UTIs are in the kidneys. These are vital to have immediately treated, due to the risk of having the bacteria moving from the kidney to the blood. This last condition is called sepsis and can cause low blood pressure, shock, and even death. Symptoms include: Diagnosis and Treatment for UTIs If you think you may have a urinary tract infection, get assessed by your OB/GYN. You will be asked to give a urine sample, which will be used to detect the bacteria that is causing the UTI. The treatment for lower UTI is oral antibiotics. Be sure to finish all the prescribed number of pills completely. Otherwise, you risk suffering the infection again with stronger bacteria. Upper UTIs may involve intravenous antibiotics. If your doctor suspects of an upper UTI, he may ask you for blood cultures and a complete blood count (CBC). This is to discard the possibility of having the infection moved to the blood. Some women have a bigger risk of being affected by a UTI. These factors contribute to a high-risk: If you have any of these conditions, it is especially important that you check with your OB/GYN right away when you experience the symptoms previously described. Recurrent UTIs Approximately 20% of women suffer a second urinary tract infection, and some undergo this continually. When this is the case, usually there is a different type of culprit or strain of bacteria. Some types can grow a community resistant to antibiotics and the body’s immune system. They travel out of the cells and re-attack. When the UTIs are recurrent, you should also check if there are any obstructions causing them. The tests used for this are: It is possible that during a cystoscopy, your doctor removes a small piece of bladder tissue to have a biopsy and rule out bladder cancer. Preventing Urinary Tract Infections You should also talk to your OB/GYN about how to prevent or minimize the urinary tract infections. The recommendations may include: Don’t Wait to Seek Help Don’t take too long to check with your doctor after recognizing the symptoms of a UTI. Kits designed for at-home tests can help detect a UTI but are not 100% accurate. You can observe the results, prevent complications and ensure a full recovery when you analyze the causes behind the UTI with your OB/GYN. If you suspect you have a UTI, call us today at 770.720.7733 or schedule an appointment online.

urodynamic testing urogynecology
GYN Problems

Urodynamic Testing

Since you were a teenager, or maybe even younger, you were probably aware that gynecologists existed. You knew that, as you matured, they were there for your basic women’s health issues, annual checkups, Pap smears and other feminine physical needs. It probably wasn’t until you began experiencing problems that you learned about different specialists and subspecialists. Words like ‘female pelvic medicine reconstructive surgeon’ (FPMRS), urogynecologist and urodynamic testing may have begun to litter your doctor’s vocabulary, and though they may sound daunting, they’re very simply explained. From the time you were potty trained, the exercise of urinating was something you did automatically. Your body told you when it was time to go and, depending on the intensity of the message your bladder was sending you, you either strolled, trotted, or ran to the bathroom to take care of business. However, as you age, you may have noticed some changes – unexpected involuntary leaks when you laugh or cough, sudden urges that leave you very little time to make it to the toilet, recurring infections, discomfort and maybe even the need to rush right back into the bathroom. When your quality of life becomes compromised, our experts are here to step in. Our FPMRS accredited specialists are intensely educated urogynecologists and experts in the field of women’s pelvic health issues. One of the many things we do is recommend and administer urodynamic testing to study, and subsequently, correct your urinary problems or disorders. What is Urodynamic Testing? Urodynamic testing is a series of tests that are run in order to evaluate exactly how well the bladder, sphincter and urethra are functioning in their job of storing and emptying the urine in your body. These tests can accurately pinpoint the reason for your particular problem. Why Might You Need Urodynamic Testing? You may need one or several different urodynamic tests if a routine pelvic examination does not reveal a visible reason for your problem. Your doctor may then recommend further testing if you have experienced any of the following: A pressing need to urinate without any flow Difficulty in starting urine flow Difficulty emptying your bladder completely Recurring urinary tract infections Burning or painful urination Unexpected and sudden urge to urinate Slow urine flow A need to urinate immediately after voiding Frequent urination (polyuria): You suddenly need to void more often than is normal for you, or find that you need to use the bathroom two times or more nightly (nocturia). Urge incontinence or overactive bladder (OAB): This is an uncontrollable leakage resulting from the inability to reach a restroom in time. Stress incontinence: You experience bladder leakage while lifting, exercising, laughing, coughing or sneezing. How Can You Prepare For These Tests? You will probably be asked to stop any bladder medications you are currently taking. Some tests may require that you arrive with a full bladder, while in other cases, you will be asked to arrive earlier and drinks at the testing site. Your doctor will give you this information. Complete testing should take approximately 2 to 3 hours, but again, this depends entirely on what tests are required for your particular issue. What Will Happen During the Test? The first part of urodynamic testing deals with emptying your full bladder, checking for any residual urine, and monitoring your urine flow. The second part examines how your bladder behaves as it fills up. Catheters are used for this and may cause some discomfort or pinching, but the experience is not intolerable. Leakage is common and expected, so there is absolutely no need to be embarrassed by this. It is an important part of the testing. Your input as you answer questions throughout the process is also important. You will be asked to shift positions, stand and cough. Again, your body’s reaction is important to your diagnosis and subsequent treatment. When testing is complete, you will be required to void again while the catheters are still attached, after which they will be removed and the testing will be complete. What Tests are Performed During Urodynamic Testing? There are several tests. Depending on your particular case, you may need one or more of the following: Video urodynamic test: While your bladder is filling and emptying, a technician will take pictures of the process, either through X-rays or via ultrasound. These are then studied, enabling your physician to make a diagnosis of your bladder function. Uroflowmetry: This test measure both how quickly you empty your bladder (free uroflowmetry) and the amount of pressure exerted (pressure uroflowmetry) while doing so. The purpose is to assess why there may be a problem voiding, and to check for any possible blockages or muscle weakness. Postvoid residual measurement: This measures any urine that is left in the bladder after you’ve finished urinating. Measurement can be obtained through either catheter tube drainage directly from the bladder or through an ultrasound scan. Depending on how much urine is extracted or scanned, anything over 100 milliliters may indicate inefficient bladder evacuation. Multichannel Cystometry: Under local anesthesia, two pressure catheters are placed in the rectum and the bladder to gauge bladder capacity, and to determine the amount of pressure buildup as the bladder fills with warm water. You will be required to indicate when the urge to urinate begins. This procedure can also determine if there are contractions while the bladder fills, or it can pinpoint the bladder muscle (detrusor) that may not be contracting as it should. Leak Point Pressure Measurement: During the cystometric test, while the bladder is filling, a sudden contraction may occur resulting in some of the water squirting out. This test, where one of the previously mentioned catheters is equipped with a pressure sensor called a manometer, measures the pressure at that leak point moment. You may also be asked to cough, or hold your nose and mouth while trying to exhale (Valsalva maneuver) at this time to check for any urine leakage that may indicate stress incontinence, and for any sphincter deficiency. Electromyography: This test

vaginal rejuvenation
GYN Problems, Vaginal Rejuvenation Education

Vaginal Obliteration

You’ve just been informed that you need a procedure called vaginal obliteration. If anything your doctor said after that became a buzzing jumble of words in your head, you’re not alone. The word ‘obliteration’ probably conjured up images of a bad war or alien invasion movie that left the earth a wasteland, and you may be picturing a similar, raw gaping devastation somewhere in the lower region of your body. This is not the case at all. What is Vaginal Obliteration? Simply explained, vaginal obliteration is closure of the vagina. It is all done internally and leaves no visual evidence on a woman’s outer body. It is a quick, safe and fairly simple surgery that our Female Pelvic Medicine and Reconstructive Surgeons (FPMRS) are highly qualified to perform due to their combined decades of experience here at Cherokee Women’s Health Specialists. The female body is capable of many miracles. Not only can you reproduce human life in approximately 280 days, but you are capable of sustaining and nourishing that life from the moment of its conception, and for long after its entrance into the world. Though they can be unusually resilient, and capable of performing this process over and over again, your reproductive organs are still only made of tissue, muscle, fiber, cartilage and bone, all of which is vulnerable to wear and tear over time. The same way the framework and internal parts of a car become dented, sluggish, loose, leaky, and damaged from years of constant use, the complicated parts of your pelvic structure may eventually become compromised. They are exposed to various traumas throughout your childbearing years, into menopause and beyond, especially if you have given birth several times or have had multiple births. Just like that vehicle, your body may begin to need regular maintenance, and may also need repair if the damage becomes severe. In cases where the internal organs of the reproductive system begin to shift or droop drastically, and all other measures have failed or are deemed ineffective, vaginal obliteration may help you. Who is a Candidate for Correction of Vaginal Obliteration? This procedure is usually reserved for women who are older, who are no longer engaged in sexual activity, and who suffer from: Because this is a brief and safe procedure, it is ideal for women who suffer from chronic conditions such as heart disease or asthma, and are unable to undergo prolonged surgery due to possible risk factors. Your doctor may also perform a pap smear before your surgery date to insure that all is well. Afterwards, ultrasonic assessment will be done in place of a routine smear. If you have had abnormal pap smear results in the past, it is important that you discuss this with your doctor. How is a Vaginal Obliteration Procedure Performed? You will be given either a regional, general or local anesthetic depending on the complexity of the procedure. After numbing has taken place, the surgeon will then remove the entire vaginal lining (vaginal epithelium) leaving approximately 1 to 1 ½ inches. When this is completed, the vagina will be sutured shut (total colpocleisis). If your uterus is still intact, a small opening will be left to accommodate drainage of any fluids from the uterus (Le Fort procedure). Sometimes, women who require vaginal obliteration surgery suffer from urinary incontinence as well, and this problem can be corrected at the same time. Immediately after surgery, you will be on intravenous fluids and a catheter. The catheter will be removed after 24 to 48 hours and you will be able to urinate on your own from then on. This surgery does not affect your ability to pass urine, since entry to the bladder is located above the vaginal opening. You will also be given compression stockings to avoid any risk of clots in your blood vessels that could travel to your heart or lungs. This is a precaution that is taken with most surgeries. What About Having Sex After the Surgery? No. Because the vagina will be closed permanently, this surgery is only usually recommended for older women who are no longer engaged in sexual activity, or for those who don’t foresee having intercourse in the future. What is the Recovery Time? Recovery times vary from patient to patient, but usually, vaginal obliteration requires one or two days of hospitalization. It is recommended that you avoid strenuous activity or exercise for one or two weeks after the procedure, increasing both very gradually afterwards until about 4 to 6 weeks have passed, after which you can usually resume your regular lifestyle. You should try to drink plenty of water and eat a diet high in fiber to avoid constipation. Are There Any Risks With Vaginal Obliteration? As you’ve probably heard, there are risks involved with any surgery, but vaginal obliteration is a quick, safe and effective procedure and complications are uncommon, with a high 90 to 95 % success rate. You may notice a white or creamy discharge for up to six weeks after surgery. This is nothing to worry about. This occurs because there are stitches in the vagina. As these stitches dissolve, the discharge will become more minimal until it disappears altogether. Discharge stained with some brownish blood may also appear immediately, or even a week after the procedure. There is no need for concern as this is the body’s natural way of breaking down any blood trapped under the skin. However, you should contact your doctor if you experience any of the following: Cherokee Women’s Health Can Help There is no need for postmenopausal or older women to suffer with the pain and discomfort associated with the above mentioned symptoms. Our double board-certified urogynecologists are experts in female pelvic health and can help you. If you have questions about vaginal obliteration or would like to make an appointment with one of our specialists, call 770.720.7733 or schedule an appointment online.

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Anterior and Posterior Repair Education, Hymen Repair Education, Labiaplasty Education, Perineoplasty Education, Robotic Surgery Education, Urinary Incontinence Treatments Education, Vaginal Rejuvenation, Vaginal Rejuvenation Education

Cosmetic and Reconstructive Surgery – Repair vs. Aesthetics

At Cherokee Women’s Health Specialists, we offer women the most modern, up-to-date solutions to gynecological problems that were formerly considered almost impossible to treat. Our OB/GYNs, urogynecologists, and Female Pelvic Medicine and Reproductive Surgeons are trained and credentialed to perform the many highly specialized cosmetic GYN and reconstructive procedures that can dramatically change women’s lives and boost their psychological outlook. Since the beginning of time, women have strived for ultimate beauty, perfect body symmetry and feminine wellness. Similarly, the world of medicine has dedicated itself to studying and repairing human anatomy, and to provide and maintain optimum overall health. It was inevitable that this combination would ultimately lead to a branch of medicine focused solely on women’s unique medical and cosmetic pelvic health issues. From the time of the misguided, but well-intentioned Hippocrates, who believed in using a pomegranate as a pessary to cure prolapse, doctors have dissected, analyzed, and tried to understand the all-important female reproductive system, not just to insure the future of mankind, but to alleviate and correct those gender-specific disorders. Eventually, as medical knowledge evolved, specialties such as gynecology, obstetrics, and urogynecology emerged. However, it wasn’t until 2014 that cosmetic and reconstructive surgery combined into a recognized and accredited field called Female Pelvic Medicine and Reconstructive Surgery (FPMRS). This subspecialty satisfied women’s dual concerns of both repair and cosmetically improved genital appearance without the need to see several different doctors for each individual requirement. Today, complete hysterectomies and other radical surgeries are no longer the all-in-one solution to many of the pelvic health problems women encounter throughout their lifetimes. The days of dangerous, invasive surgeries that resulted in disfiguring scars and months of recuperation and rehabilitation are slowly being left behind in the last century where they belong. Yet many women, especially older ones, are unaware of the many options available to them today. They suffer needlessly, assuming their disorders are simply something they must learn to live with. They shyly excuse themselves to leave a room to change an adult diaper, or to push back something that might be peeking out from their private areas, not realizing that a simple surgery with minimal scarring and recovery time is available and can easily correct the problem. Others are hesitant to indulge in sexual intimacy because they’re concerned their partner may find a particular irregularity distasteful. What is the Difference Between Pelvic Cosmetic and Pelvic Reconstructive Surgery? Cosmetic surgery is usually an elective procedure to correct physical flaws, irregularities or deformities, and is not typically done out of necessity, but more to improve appearance and elevate self-confidence. It can also reverse many physical age-related effects, providing a more youthful rejuvenation to the area. Reconstructive surgery is done for medical, and sometimes life threatening issues. It corrects damage to the pelvic area, and usually restores function, stability, sensation, and position, reverting the reproductive system to its pre-trauma state. Learn more! Download our FREE Vaginal Rejuvenation eBook. Cosmetic and Reconstructive Surgeries There are a number of different procedures available to you for both physical wellness and aesthetic benefits. Cosmetic Surgeries include: Reconstructive surgeries include: Midurethral slings: This procedure quickly, easily and effectively corrects the problem of stress urinary incontinence, which is involuntary urine leakage when you cough, sneeze or laugh. Urinary incontinence may also occur during different activities. This is an outpatient procedure that can be completed in approximately 30 minutes. Colposuspension: Used to treat stress urinary incontinence as well, colposuspension is a surgical procedure that requires restoring the shifted or fallen vagina to its original location. This can either be done by laparoscopic technique or via abdominal incision. Posterior/anterior colporrhaphy: This vaginal wall defect repair corrects any protrusion of the bladder into the vagina (cystocele) or the rectum into the anus (rectocele). Both these problems are known as pelvic organ prolapse (POP), meaning organs are drooping from their regular place in the pelvic vault. POP can cause pelvic pain and pressure, vaginal bleeding, painful intercourse, back pain, bowel movement problems and incontinence. Perineoplasty: Though usually considered a reconstructive procedure, perineoplasty can also be cosmetic in the case of a deformed perineum. Perineoplasty corrects damage and defect in the perineum, the triangular section located between the anus and vagina, and serves an important role as a structural support for several reproductive organs. Typically, it can become impaired through childbirth, episiotomy, obesity or excess weight loss. Perineoplasty can correct issues such as scarring, excess skin, reduction in sexual pleasure, and can restore support to internal organs. Hymenoplasty: Though this usually involves cosmetic restoration or creation of the tissue that may have been non-existent from birth, lost through trauma, sexual intercourse or other forms of rupture, hymenoplasty can also correct conditions such as imperforate, septate or microperforate hymen that can make intercourse, menstruation or tampon insertion difficult or impossible without surgical intervention. Monsplasty (pubic lift): Reduces, tightens or lifts the pubic mound located just under your abdomen for a more feminine look. Clitoral hood reduction: A thick or prominent clitoral hood may inhibit sensation and diminish sexual pleasure. A clitoral hood reduction can alleviate extreme discomfort, redness or irritation that can possibly lead to infection from constant chafing against clothing. Often, this procedure is accompanied by labiaplasty to shorten the vagina. Can Pelvic Reconstructive Surgery Also be Cosmetically Beneficial? It certainly can! While repairing damage that requires necessary tightening or trimming, reconstructive surgery can also automatically provide a more visually appealing and youthful look. Also, in many cases, as reconstructive surgery is being performed, an elective cosmetic procedure can be done simultaneously as well. Non-Surgical Treatments O-shot: The Orgasm Shot® (O-Shot®) is a treatment to enhance sexual pleasure, thus making it beneficial physically. The O-shot can be administered by our pelvic health physicians. ThermiVa: ThermiVa is a completely non-invasive, nonsurgical, drug and hormone- free vaginal rejuvenation treatment that restores vaginal health in many beneficial ways. Though it cannot actually be classified as ‘reconstructive’ in a surgical sense, temperature controlled heat administered via radio frequency energy rejuvenates interior and exterior vaginal tissue by stimulating

uterine fibroids
GYN Problems

Uterine Fibroids: What You Should Know

Uterine fibroids are a benign growth that appears on your uterus, uterine wall, or on the surface. These growths can be so small your doctor won’t notice them during an exam or significant enough to change the shape of your uterus, giving you severe discomfort. Statistics show that a whopping 25 percent of women suffer from uterine fibroids. As many as one-third of those women will experience pain or abnormal bleeding due to their fibroids. While uterine fibroids don’t cause pain in every woman, they have been known to create complications for some. Depending on the location of your fibroids, you may experience symptoms that can affect your daily life. You should consult your doctor about any symptoms you may be experiencing, especially if you have been trying to conceive. Symptoms Caused by Fibroids Uterine fibroids affect each woman differently. Women who suffer from uterine fibroids can have varying degrees of pain, especially during menstruation. Women who are at high risk for uterine fibroids are between the ages of 25-45. African-American women also are more likely to suffer from uterine fibroids. Research is still unclear as to why this may be. Women who are considerably overweight are 2-3 times more likely to get uterine fibroids. If you suffer from one or more of the following symptoms, you may have uterine fibroids. Changes in Menstruation – A typical menstrual cycle will last seven days. It should be heavier in the first several days and become lighter. Women who have fibroids can experience longer, more frequent or heavier periods. Bleeding or spotting at times other than your period are more likely to occur as well. Difficulty or Frequent Urinating – You may feel the need to use the restroom more often if you have uterine fibroids. Urinary leakage can be another side effect of having fibroids. Abdominal or Lower Back Pain – Generally, this pain will be a dull, heavy ache. However, you may experience a sharp pain as well. Pain or Pressure During Sex – Sex can be uncomfortable when you have fibroids, depending on the size and location of them. Infertility – Although there are many reasons you may be unable to conceive, your doctor will want to check to see if you have uterine fibroids. If you believe that you have uterine fibroids, you might want to consider speaking with your doctor about diagnosing them. Once diagnosed there are many treatment options available. Relieving Uterine Fibroid Symptoms There are several non-surgical options your doctor will suggest to help relieve the symptoms you may be feeling. If you are near menopause, your OB/GYN may recommend waiting out the fibroid symptoms if you can. Fibroids are linked to high estrogen levels, so they are likely to disappear with menopause. Use some of the following techniques to alleviate they symptoms of your uterine fibroids: Over-the-Counter Pain Medicine – If you suffer from painful, long lasting periods, drugs such as ibuprofen may help alleviate some of your pain. Birth Control – These pills can be prescribed to help control heavy bleeding during your period. Relax – Some research has determined a link between high-stress levels and your fibroids. Try relaxation techniques such as yoga, medication, and exercise to manage stress. Manage Your Blood Pressure – High blood pressure has been linked to fibroids. Talk to your doctor about lowering your blood pressure through diet, exercise or medication. Steer Clear of Smoking – Cigarette smoking can reduce the amount of oxygen that can reach your pelvic area and can worsen your menstrual pain. Be sure to contact your OB/GYN before taking any supplements or medicines that could affect your estrogen levels. We Can Help If you think you may have uterine fibroids, schedule an appointment today or call us at 770.720.7733 and ask your doctor about the various non-surgical treatment options available for uterine fibroids.

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Vaginal Rejuvenation

G-Spot

For many women, the genital area and its many complicated parts still remain a mystery, often depriving them of the many delightful sensations they are capable of enjoying. Our doctors at Cherokee Women’s Health are aware of the possible inhibitions you may have when it comes to asking what you might consider embarrassing questions. Simply admitting to exploring your own body may seem like a taboo subject, but to us, it’s a very natural and healthy practice, so we welcome any questions you may have regarding erogenous areas of your body such as the G-Spot. Learn more! Download our FREE Vaginal Rejuvenation eBook. What is the G-Spot and Where is It? The G-Spot, or Gräfenberg spot, is an internal area located inside the entrance of a woman’s vagina. Named for a German gynecologist, Ernst Gräfenberg, who also invented the intrauterine device (IUD), the G-Spot is believed to be an extremely sensitive nerve bundle that, when aroused, can result in a profound, thrilling orgasm, sometimes culminating in female ejaculation. Although the G-Spot varies slightly in location from one woman to the next, it is usually situated 2 to 3 inches upwards on the front wall inside the vagina. Some theorize that it is part of the prostate, while others believe it to be an extension of the clitoris, which extends up to four inches into the vagina. Does Every Woman Have a G-Spot? There is some controversy on the subject. Some sexologists and doctors say no, while others say with absolute certainly that, yes, it is present in all woman. If you’ve ever achieved G-Spot orgasm, you know it exists. It is likely that the reason for any doubt may be because of the G-Spot’s location in your body, which varies a little from woman to woman, making it tricky to pinpoint sometimes. As well, it cannot always be accessed and stimulated with normal penile penetration in the traditional missionary position. Rear entry vaginal penetration, or the woman on top, (‘cowgirl’) position are two examples you may wish to try. Sometimes, it just requires a little imagination, practice, and/or the introduction of oral, manual or artificial methods to achieve G-Spot gratification. You Mentioned Female Ejaculation. Isn’t That Something Only Men Do? No, some women are capable of ejaculating fluid during a G-Spot climax, and there is nothing harmful or unusual about it. It’s not known for certain if this happens because the G-Spot is an extension of the clitoris, which becomes engorged during sexual activity, or if the fluid is expelled by the woman’s prostatic-like glands that are situated in the urethral sponge, a part of the inner clitoral structure. Request more information now! Am I Abnormal if I’ve Never Experienced This? Absolutely not! It is still difficult for many women to achieve orgasm, whether it be through clitoral, vaginal or G-Spot stimulation. There are many factors that can prevent a woman from enjoying full and satisfying intimacy, and these can be both psychological and/or physical. It’s our job to determine which might be preventing you from doing so, and to help you in any way we can. If a pelvic examination shows no abnormalities, then some of the following reasons may be preventing you from enjoying the full, stirring benefits of G-Spot orgasm. Inhibitions such as nervousness or sexual taboo beliefs Insufficient lubrication Improper positioning Minimal or no foreplay Rough manipulation Lack of pressure during stimulation Lack of candid verbal or manual guidance between partners. Is There Anything Else You Can Do to Help Me Experience G-Spot Pleasure Regularly? Yes, we can. If we find there are no physical or psychological reasons preventing you from achieving G-Spot satisfaction, a procedure called G-Spot amplification (also known as G-Shot or GSA) enhances sexual arousal and gratification. Our experts are fully qualified to administer this quick, safe, and painless procedure which injects a harmless filler that allows the G-Spot to extend lower into the vagina, making it more accessible and easier to stimulate. The effects have proven to be highly successful, and can last anywhere from three to five months, allowing women to enjoy the delightful benefits and gratification of G-Spot orgasms. Sexual pleasure is a personal experience with individual preferences. What impassions one woman may not necessarily excite another, and that includes attaining climax through G-Spot stimulation. We are always here to help you and to discuss your concerns regarding intimacy and other feminine health issues that you may be dealing with. If you have any questions about your sexual health, call us today for an appointment at 770.721.6060.

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OB

In Vitro Fertilization

In vitro fertilization has become a wonderful option for many women who suffer from fertility issues. At Cherokee Women’s Health Specialists, our OB/GYNs and Female Pelvic Medicine Specialists are not only qualified to diagnose and treat these issues, but have the accreditations and combined decades of experience to effectively change lives child-free lives with their accumulated wisdom, experience, and access to the most cutting edge, up-to-date medical technology. What is In Vitro Fertilization? In vitro fertilization (IVF) is the most successful of several fertility treatments known as assisted reproductive technology (ART). Both the female egg and sperm are fertilized outside of the body, processed, and then reintroduced into a woman’s uterus to achieve conception. Is In Vitro Fertilization My Only Recourse If I Suffer From Infertility? There are several assisted reproductive technologies. In vitro fertilization may be necessary if other methods cannot help you achieve conception. Our OB/GYNs and FPMRS specialists are skilled in all aspects of Women’s Health, including fertility issues. We examine, diagnose and treat each patient with the same intense scrutiny and care we would a member of our own family. You will be assessed on an individual basis. We will recommend the best options based on your unique case, providing you with any available resources and referrals that meet your specific requirements. Am I a Good Candidate for In Vitro Fertilization? When other options have failed, or if we consider IVF the best course of action based on our expertise and knowledge, then this procedure will be recommended, if you: How Does In Vitro Fertilization Work? In vitro fertilization is done in stages beginning with hormonal treatments to stimulate the growth of multiple eggs needed in the event that one or more may not develop or fertilize during the later process. These eggs are subsequently retrieved through a simple surgical procedure, and inseminated with the prepared, furnished sperm. Eggs are then monitored carefully to insure that fertilization and cell division are occurring. If success is achieved, the egg officially becomes an embryo and is ready for transfer into the uterus, where implantation will hopefully take place. The entire process from retrieval to implantation takes approximately a week. Close monitoring is done at every stage of this process to insure optimal results. What if My Eggs or My Partner’s Sperm Are Deemed Weak or Unhealthy, or if There Are Dangerous Genetic Factors in My Family Tree? From the moment of your first appointment, we will study and assess any problems that may be preventing you from conceiving, after which we will outline your best options. In the case of a low sperm count, intracytoplasmic injection can be used to infuse a single strong and healthy sperm directly into the egg. If healthy sperm cannot be provided by your partner, if your own eggs are not viable for this procedure, or if you are a female in a same sex relationship, you may opt to use donor sperm or eggs. If genetic abnormalities are a concern, we will thoroughly study your family history, along with your own medical information. After careful analysis and testing, if we concur that your child may be at risk for inheriting a genetic or infectious disease, the above mentioned donor option is, again, available to you. Today’s technology also allows us to screen an IVF embryo for certain diseases or conditions before implantation. What About Multiple Births? During the in vitro fertilization process, several fertilized eggs are reintroduced into your uterus to insure a better chance of successful pregnancy. However, if you prefer not to have more than one baby and wish to avoid a multiple birth, today’s technology makes it possible to limit the number of fertilized eggs implanted to one in order to insure a single birth. What Happens to Perfectly Good Eggs, Sperm or Embryos That Are Not Used? Both fertilized and unfertilized eggs and sperm can be frozen (cryopreservation) for use at a later date. If you no longer wish to have another baby, you are free to donate them for use by someone else. Freezing for later use is an excellent option if, for some reason, it is inconvenient to become pregnant immediately due to health or other concerns such as cancer treatment, a medical condition that can compromise fertility, etc. How Successful is In Vitro Fertilization and How Can I Improve My Chances of Getting Pregnant? As with every assisted reproductive technology, there is never a 100% guarantee, but IVF is one of the most effective methods to insure pregnancy. You can help guarantee even better results with the following lifestyle changes: Today’s technology gives more women than ever the opportunity to conceive in cases where there was little hope only a few decades ago. For a consult with one of our OB/GYNs, call us at 770.720.7733 or schedule an appointment online.

cosmetic gyn
Ablation Education, Anterior and Posterior Repair Education, Hymen Repair Education, Labiaplasty Education, Perineoplasty Education, Robotic Surgery Education, Sterilization, Vaginal Rejuvenation, Vaginal Rejuvenation Education

The Top GYN Procedures: Dr. Litrel Explains Cosmetic GYN & GYN Terms

Have you ever wondered what the difference between vaginoplasty and labiaplasty is but have been to embarrassed to ask? Never fear, here’s a list of cosmetic and GYN glossary terms in plain English, broken down by surgery type. Vaginoplasty: Tightening of the entire vaginal canal from the opening to the cervix (or the apex of the vagina, if hysterectomy was performed). Hymenoplasty: Restoration of the hymen to restore anatomic state, which can be done at the time of vaginoplasty, if patient desires. Cosmetic GYN Surgery on the External Genitalia Labiaplasty: Reshaping the labia minora or inner lips for improvement in appearance and to diminish labial irritation with clothing and during sex. Clitoral Hoodectomy: Removal of excess skin covering the clitoris to create a better appearance and to help with clitoral orgasm. Perineoplasty: Reshaping the external opening to the vagina for a smaller, more youthful appearance. This is performed during vaginoplasty or can be done without vaginoplasty, if vaginal tightening is not desired. Labia Majora Reduction: Reshaping the labia majora or outer lips for a better appearance. Learn more! Download our FREE Vaginal Rejuvenation eBook. Female Reconstructive And Reparative Surgery (Usually Covered By Medical Insurance) Anterior Repair: Repair of cystocele or bulging of bladder using natural tissue or biological graft or synthetic material. Posterior Repair: Repair of rectocele or bulging of rectum using natural tissue or biological graft. Enterocele Repair: Repair of enterocele or the sagging of the top of the vagina using natural tissue or biological graft or synthetic material. Incontinence Repair: Repair of leakage of urine using native tissue, biological graft or synthetic material. Endometrial Ablation: Outpatient or in-office procedure to diminish or eliminate menstrual bleeding without changing hormone status. Hysterectomy: Removal of uterus to stop periods and pelvic pain associated with menses and sexual intercourse (pelvic pain with thrusting motions). Or, to remove tumors or pathology once childbearing is complete. During this procedure, removal of fallopian tubes (or salpingectomy) is strongly recommended to decrease the risk of future cancer. Oophorectomy: Removal of ovary or ovaries for pelvic pain associated with sex or menses or is chronic or for cyst or mass. These are the organs that secrete hormones so removal of both will result in surgical menopause. Removal of one ovary will not affect hormones. Removal of one ovary is recommended once a woman is in menopause if hysterectomy is performed to decrease risk of cancer. If a woman has significant chronic pain on one side of her pelvis during her cycles or sex or chronic, removal of that ovary is considered. Enterolysis: Minimally invasive (laparascopic or robotic) removal of internal adhesions of bowel to pelvic organs that cause pelvic pain with sex, menses, bowel movements or is chronic in nature. Removal/Fulgurtion of Endometriosis: Minimally invasive (laparoscopic or robotic) removal and destruction of endometriosis lesions that cause painful menses or pain with sex or is chronic. Salpingectomy: Removal of tubes for sterilization. Note: Tubal ligation without removal of tubes is not recommended because tubal removal will decrease future cancer risks but tubal ligation will not. Make an Appointment Today Still have questions? schedule an appointment online or call us at 770.721.6060.

low-sex-drive
GYN Problems, O-Shot Education, ThermiVa Education, Vaginal Rejuvenation Education

Why Is My Sex Drive So Low?

by Michael Litrel, MD, FACOG, FPMRS Every week women ask me why their sex drive is so low. “Help me so I can enjoy sex more and want it more often,” they say. Then they ask me to check their hormones and to give them a physical examination. This is a popular topic among women and it’s everywhere in the media. Patients ask me about the latest fads they’d seen touted as the latest, greatest best thing. They ask about bioidentical hormones. Vaginal rejuvenation. Sexual vitamins. G-spot enhancement. clitoral hood reduction. The list goes on. Treatments of all sorts are advertised to women of all ages to solve a low sex drive. And it’s true that some solutions, when chosen for the right person, can transform a woman’s sexual responsiveness. Sometimes a woman’s sex drive is low for a good reason. But something that’s not broken can’t be fixed. Other times there is something that can be done. Asking the right questions is the key to understanding how to help them. Five Key Questions for Women With a Low Sex Drive 1) Has your sex drive dropped or has it stayed more or less the same? Many women are convinced they have a low sex drive because they compare their desire for sexual contact with their male partner’s. However, men and women typically have vastly different desires for sexual intercourse. The typical woman’s sexual desire usually ranges from once or twice a week to once or twice a month. The typical man’s is once or twice a day. This discrepancy accounts for the feeling many women have that there is something wrong with them. That said, if a woman’s sex drive has suddenly dropped, a woman should consult with her doctor to determine the reason. If it’s always been low, chances are that’s the way you are. 2) What is your childbearing history? There is a myth that women reach their sexual peak in their forties. This is the idea that women in this age range finally becoming sexually liberated from natural inhibitions. The idea is that the forty-year-old woman now has a sexual desire and ability to orgasm that has reached new heights. There are specific circumstances in which this occurs, but it is the exception rather than the rule. Women in their forties who have not yet had children can have a very high sex drive. But oftentimes, there’s a reason for this. Women who have small children will often see their sex drive plummet. When toddlers and grade school children require constant mothering, there is often little left for the woman’s partner. And women who are breastfeeding often have the lowest sex drive of all women. After all, she has a baby feeding off her body all day long and when she puts her head on her pillow at night, the last thing she wants is for more physical contact. Men will often say, “You used to want to have sex, I think there is something wrong with you.” It’s at this point that she’ll seek my help. Or, her partner will send her in to see me. 3) Does sex hurt or do you have pain with your cycles? There are two main reasons why sex hurts. One has to do with vaginal dryness. This is pain with entry, which commonly occurs with menopause. The ovaries stop producing estrogen which leads to thinning of the vaginal lining, which exposes nerves and decreases lubrication. There is more pain and less pleasure and a reduced desire for sex. This can be treated with topical estrogen cream or even more advanced office procedures, such as ThermiVa. Other women commonly hurt with sex because they experience pelvic pain with their menstrual cycles. This is painful sex from the actual thrusting motion. If a woman missed school during her adolescence because of discomfort during her cycle or if her mother needed a hysterectomy for pelvic pain, it’s very likely she has endometriosis or internal scarring of her internal reproductive anatomy. This patient needs a gynecological evaluation, particularly if she has not had children, is experiencing infertility or if she experiences pain more than a couple of days a month. Women with back pain during their cycles often have a tilted uterus that can be corrected by an experienced surgeon during an outpatient laparoscopy. 4) How is your general health? In the same way that a person’s appetite for food drops when they’re not feeling well, so does their appetite for sex. When you are in bed with the flu you don’t want to eat and you don’t want to be sexually active. But if you are chronically unhealthy, your desire for sex will be low as well. The most common reason for poor health in America is lifestyle. As a society, we are sedentary and we eat addictive, poorly nutritious food. Patients with cancer and heart disease don’t come to my office complaining of low sex drives. But overweight patients who consume a steady diet of unhealthy foods and don’t exercise often complain of a lack of sexual desire. Exercise and nutritious plant-based diets raise testosterone levels and other important hormones responsible for not only sex drive but also an overall sense of youth and vigor. 5) Do you have orgasms? Many women cannot have orgasms with sexual intercourse. Clitoral stimulation is the main way for a woman to achieve sexual climax. Unlike a man’s sex drive that ends with ejaculation, many women don’t focus on the biological climax but rather the emotional and physical intimacy. But a woman who does not orgasm can see her sex drive eventually plummet. It’s important to understand your body and to know how you achieve physical gratification from sexual activity. Many women need vibrators applied directly to their clitoral region to achieve climax. The first step is masturbation alone when you can discover for yourself what causes you to climax. This can then be incorporated into sexual activity with your partner. Good communication

Woman Healing From Surgery
GYN Problems

Eight Things to Do to Speed Up Your Recovery from Surgery

The length of time it takes to recover from surgery is different for everyone. Following are things you can do to lessen your recovery time after surgery. Things You Can Do to Shorten Your Recovery Time 1) Adequate Rest – Most women are sleep deprived even without surgery because they typically take care of everyone around them. 12 to 14 hours of sleep each day is recommended the first week after surgery. For the next three weeks, an extra two hours of sleep a day is recommended. 2) Adequate Calories – After surgery is not the time for weight loss. Your body needs good nutrition to allow for healing of injured tissue. 15 to 20 calories per pound of current body weight is a good guideline. 3) Adequate Protein – Healing from surgery requires increased protein intake. Protein is required for your tissue to rebuild and for antibodies and white blood cells to fight off infection. This is sometimes difficult to do in the first week after surgery when you are more sedentary and may not be as hungry. But target one half to one gram of protein per pound of body weight a day. A hundred grams of protein a day is an excellent target. Consider supplementing your diet with protein shakes or protein bars. 4) Adequate Iron – If you had any blood loss during surgery, then you should take 15 to 30mg of iron a day for the first month after surgery. There are iron supplements available over the counter. These can cause constipation, particularly when taken with narcotics for pain relief. Iron rich foods include spinach, beans, whole grain oats, greens, lentils, shell fish like clams or oysters. Dietary iron is better than supplements if you can get enough this way. Eat a spinach salad with beans and drink a green smoothie to build up your iron and get rich healing nutrients every single day. 5) Water and Fluids – Water is necessary for carrying nutrients to your cells and to flush bacteria and waste from your body. The classic recommendation for water intake is eight 8 oz. glasses of water a day or about one half gallon. This is a fine target for most people. You want to drink about one half to one ounce of fluid per pound of body weight. Gatorade or a drink with electrolytes can help replace lost salts and minerals and help you get additional calories. You can tell you are getting enough fluids if you must urinate frequently. 6) Decreased Activity – After surgery everyone decreases their activity because of the pain. People have different abilities to tolerate physical discomfort so some increase activity faster than others. A good rule of thumb after a major surgery is to minimize your activity for at least two weeks. It’s fine to walk to the mailbox when you feel up to it but don’t go shopping or clean or vacuum. I took my wife to the movies four days after her c-section because she absolutely insisted, but I parked in the handicapped spot. After two weeks of relative inactivity, try increasing your activity to about 25% of your activity before surgery. After four weeks increase to 50%. After six weeks, 75%. Expect to get to 100 percent after 8 weeks. This will vary of course based upon the surgery and the individual. Bottom line: Get adequate rest and allow your body to heal. 7) Fresh Air and Sunshine – It is well known that sunlight helps with the synthesis of Vitamin D. This is certainly necessary for healing. But many holistic doctors also promote sunshine as necessary for the healing process in general. There are different theories about this but nothing definitive. From my experience as a clinician and at times in my life as a patient, I have noticed that people heal faster when they get sunshine and fresh air on a daily basis. This doesn’t mean you should lay out in the sun but an open window or sitting on the porch each day for twenty minutes or longer is a good idea. I suspect so much of the poor health that we see in the developed world is that too many of us are cooped up inside all day. 8) Inner Peace – We all weaken and become ill at times and this can be very frightening. As you heal from surgery, it’s important to focus on whatever it is that brings you peace and comfort. For some, it’s prayer. For others, it may be meditation. But at the core of these things, it’s the ability to feel gratitude for all the blessings we’ve been given. It’s a blessing to be able to walk around pain-free, to have plenty to eat and drink, to have a warm bed, to have people to love and laugh with – and yes, even to be able to go to work. So while it’s easy to get down while your body heals, it helps to focus on the big picture and be grateful for all you have, including the surgery you just had. After all, there was a time not so long ago when that surgery may not have even been available.

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