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November 21, 2018

Young woman having abdominal painEndometriosis is the third leading cause of infertility in women of childbearing age. This disease affects 1 in 10 females from the ages of 15 to 44. It impacts more than 11% of women in the U.S. alone and is often times not diagnosed until a woman is in her 30’s or 40’s, so they may have it and not even know.

What is Endometriosis?

The inside of your uterus (womb) has a lining of tissue called the endometrium. This is similar to that thin layer of skin-type material attached to the shell you sometimes see when you peel a hard-boiled egg.

When you have a normal menstrual cycle, this uterine lining thickens to get your uterus ready to house a baby. Its purpose, if fertilization occurs, is to keep an embryo latched on to itself for nine weeks, providing nourishment until the mother’s blood supply through the placenta can take over the job.

If pregnancy doesn’t happen that month, menstrual blood sloughs away that barrier and your body begins to rebuild a new one in preparation for the possibility of pregnancy the next time.

With endometriosis, endometrial tissue grows and attaches itself in different places outside of your uterus where it doesn’t belong. Like the one in your womb, this tissue is stimulated during the menstrual cycle, but it doesn’t break down. Instead, it remains, causing pain, irritation, and possible scarring which can eventually lead to adhesions, a type of scarring that can cause different organs to fuse together.

Endometrial tissue can be found in:

  • The pelvic cavity lining
  • Ovaries
  • Fallopian tubes
  • Uterine support structures
  • Outer uterine surface
  • Rectum
  • Bladder
  • Bowels
  • Cul-de-sac (a space that is located behind the uterus)
  • Outer uterine surface
  • Peritoneum

In very rare cases, it has even been found on skin, and in the lungs and brain.

What are the Symptoms of Endometriosis?

Many women have none. Others may suffer a little discomfort, while yet others may experience extreme, debilitating effects. Symptoms include:

  • Moderate to crippling pain during menstrual cycles that worsens over time
  • Bloating
  • Sexual discomfort felt deep in the pelvic area both during and after intercourse
  • Constipation
  • Lasting, chronic pain in pelvis and lower back
  • Intestinal pain
  • Digestive problems, especially during menstruation
  • Nausea
  • Diarrhea
  • Infertility

What Are the Heath Risks of Endometriosis?

Although endometriosis is neither contagious nor cancerous, left alone it can continue to expand in places where growths should not appear. Unchecked, this may lead to the following problems:

  • Swelling and pain: Because these implants of endometriosis are appearing internally where they don’t belong they cannot be expelled from the body. They can cause tenderness, inflammation, swelling, irritation, and even excruciating pain depending on their location.
  • Infertility: Adhesions or scar tissue involving the fallopian tubes may block access to eggs, or damage both the sperm and egg during ovulation. Adhesions that have formed may also make pregnancy difficult or impossible.
  • Cysts: If endometrial tissue grows in the ovaries and traps blood, painful, blood filled sacs called cysts may develop.
  • Intestinal and bladder problems: Continual, unchecked growths in these areas can result in major health issues.

Who Can Get Endometriosis?

Any female who has begun to menstruate can get endometriosis. In the past, women were often not diagnosed until 30 or 40 years old. Now, doctors know to be on the lookout much earlier, starting in the teens to 20’s. Although endometriosis is not overly picky about which woman’s body it chooses to inhabit, you have a greater likelihood of suffering from it if you have:

  • Had short menstrual cycles of 27 days or less
  • Breast or ovarian cancer
  • Never had children
  • Difficulties or health problems preventing you from expelling regular menstrual flow
  • Allergies
  • Sensitivity to certain chemicals
  • A female relative diagnosed with endometriosis
  • Prolonged periods that exceed one week.
  • An autoimmune disease like lupus, multiple sclerosis, hypothyroidism etc.
  • Fibromyalgia
  • Chronic fatigue syndrome
  • Asthma

 What Causes Endometriosis?

No one really knows although research is intense and ongoing. Some theories include:

  • Genetics: Women in the same family are often diagnosed with the disease, so it is assumed that genetics play a role.
  • Hormones: Estrogen spurs endometrial tissue production, so there is a hormonal link.
  • Menstrual flow problems: Referred to as ‘retrograde menstrual flow’, this means that, since tissue is expelled through the fallopian tubes into the pelvis, it can end up in other parts of the body. This is the most popular theory
  • Compromised immune systems: A weakened immune system may not be able to perceive or fight off the growth of endometrial tissue. Endometriosis has been found in that many women with certain cancers and lowered immunities.
  • Invasive surgery: Transfer of endometrial tissue during certain abdominal surgeries is a possibility.
  • Transportation of cells: Some experts think that endometrial cells ‘hitchhike’ with tissue fluids and blood cells to other parts of the body.

How is Endometriosis Diagnosed?

The only way endometriosis is diagnosed is that it must be seen at the time of surgery. When someone presents with symptoms of endometriosis, initial workup may entail:

  • Complaints you are experiencing
  • Family and your own medical history
  • Evaluating all medications, herbs and supplements you are taking
  • Blood and urine tests if needed
  • A pelvic exam
  • Ultrasound

Surgery is then performed as necessary.

Is There a Cure for Endometriosis?

There is no cure, but endometriosis can be treated and managed. Options depend on your particular issues and symptoms, and whether you still want to become pregnant. They range from medication to surgery.

What Are the Treatments?

Your doctor will most likely try the following:

  • If pain is your major complaint, over the counter anti-inflammatory medications might work, or stronger prescriptive medication may be dispensed if needed. If you are averse to those, meditation, acupuncture, chiropractic help, and certain supplements may be beneficial.
  • If you are not trying to get pregnant, you may be prescribed a birth control pill minimizing menstrual occurrence or eliminating periods altogether. Another option is insertion of a long-term intrauterine device (IUD) to prevent pregnancy for up to five years. It may not, however, reduce bleeding and endometrial pain for its complete duration.
  • If you want to get pregnant, there are medications that may help. They stop the hormones that prod the body into ovulating, putting your body into a temporary state of menopause for a few months to control endometriosis growth. When this medication is stopped, menstruation resumes, allowing you a better chance of success for pregnancy.
  • If a possible fallopian tube blockage is suspected, a test called a hysterosalpingogram (HSG) may be performed to confirm obstruction. Surgery may follow to correct the problem, or another bypass method to achieve pregnancy, such as insemination or in vitro fertilization (IVF) may be recommended.
  • Laparoscopy is the mainstay of treatment. When the implants of endometriosis are found, they are treated or removed so that they no longer are active.
  • As a last resort for unbearable pain and extensive growth, a hysterectomy may be performed, removing the uterus and ovaries entirely, along with all visible endometrial tissue. Hormone therapy is then started immediately to stave off additional formation. There is still a chance that endometrial development may continue, but this usually solves the problem.

How Can I Make Sure I Don’t Get Endometriosis?

There is no way to prevent endometriosis, but there is a possibility of reducing your odds by using estrogen-lowering birth control, limiting caffeine and alcohol which raise estrogen, exercising regularly, and maintaining ideal body weight.

How Can Cherokee Women’s Health Specialists Help Me?

Our entire practice focuses solely on women and their unique biology. We are trained in every aspect of women’s health care and have three board–certified, doubly accredited urogynecologists holding certification in Female Pelvic Medicine and Reconstructive Surgery (FPMRS). This means that we can diagnose, understand, and treat all feminine problems with the most up-to-date knowledge and innovations known to modern medicine.

To book an appointment to further discuss endometriosis, call 770.720.7733.

November 14, 2018

By James P. Haley, MD, FACOG, FPMRS

Overweight woman in pain PCOS photoCan Your Weight Be a Factor?

Polycystic Ovary Syndrome, or PCOS, has recently received a great deal of exposure in the media. 5 to 10% of women in the United States suffer from this condition. It is one of the leading causes of infertility, yet fewer than 50% of those women are diagnosed correctly. That amounts to a staggering 5 million women!

What is PCOS?

Polycystic Ovary Syndrome is a genetic hormonal endocrine disorder that disrupts the menstrual cycle often resulting in anovulation (not ovulating) during a women’s childbearing years. Women suffering from PCOS will have disruption of normal female hormones and produce higher than normal levels of the male hormone, testosterone, (hyperandrogenism). This imbalance can cause a growth of numerous small cysts filled inside the ovaries, (hence the name “polycystic.”) The ovaries are often enlarged. These cysts are follicles that house eggs that have never matured due to the glut of male hormones inhibiting ovulation.

Most PCOS sufferers (possibly all) are also more resistant to insulin. This leads to further problems, including weight gain and susceptibility to developing diabetes.

Dr. Gandhi Discusses Polycystic Ovary Syndrome: “PCOS is often missed as a diagnosis.”

What are the Symptoms?

Because it is a genetic condition, Polycystic Ovary Syndrome can begin in utero, but symptoms only usually begin to occur when a female begins puberty. These include:

  • Obesity or undesirable weight gain
  • Absence of, or irregular periods
  • Heavy, prolonged menstruation
  • Excessive hair growth on face, neck, buttocks, and chest
  • Skin issues such as acne, psoriasis, skin tags, etc.
  • Male pattern baldness
  • Hair loss (alopecia)
  • Mood swings
  • Inflammation which may cause brain fog, joint pain, aches and fatigue.
  • Depression
  • Glucose intolerance
  • Patched, dark skin in creased body areas such as thighs, underarms, nape etc.
  • Difficulty becoming pregnant
  • Abdominal pressure and pain
  • Pregnancy complications- i.e. miscarriage, premature birth etc.

What Causes PCOS?

There are varying theories as to what causes PCOS. Because it is believed to be genetic, daughters of women with a history of it are very likely to suffer from the condition too. This may start as early as in the womb when they are exposed to the same oversupply of androgens as their mothers.

Insulin is produced by the pancreas to extract food sugars for energy. PCOS causes women to produce too much insulin. As a result of insulin resistance which, in turn, stimulates more over-production of androgens. These male hormones interfere with ovulation, impacting fertility. Male hormones then dominate female ones, resulting in some of the masculine characteristics mentioned earlier.

Since other factors can also contribute to surplus androgen development, medical science is still trying to pinpoint the exact cause of PCOS.

How is PCOS Diagnosed?

There is no actual test to diagnose PCOS. It is a matter of eliminating other disorder possibilities until the diagnosis of PCOS is reached.

Two primary symptoms of PCOS:

1) A history of skipping periods

2) Elevated androgen hormone levels (hyperandrogenic effect) alert physicians to suspect that a woman may have PCOS. Being overweight or obese strengthens the possibility, especially in females with more upper body fat. Weight gain in this area is more male-related, thus indicating the existence of higher testosterone levels.

This diagnosis is derived through:

  • Menstrual history
  • Blood tests
  • Gynecologic examination
  • Pelvic ultrasound
  • Evaluation of family medical history
  • Visual and reported confirmation of other common PCOS symptoms.

Does PCOS Cause Weight Gain and Obesity, Or Is It the Other Way Around?

Not every woman diagnosed with Polycystic Ovary Syndrome is overweight, but approximately 80% are. Other female family members tend to be overweight or obese as well. Realize, however, that PCOS causes weight gain for most patients, but being overweight or obese does not “cause” PCOS.

What are the Risks of PCOS?

Overweight and obesity alone can cause severe health problems. Compounded with PCOS, the following risks are elevated:

  • Diabetes or pre-diabetes: It is estimated that more than half of women suffering from PCOS will develop the disease by the age of 40. Diabetes is so serious that it aversely affects health more than almost anything else.
  • Cardiovascular disease and heart attack: Carrying around unhealthy weight can raise anyone’s risk of cardiovascular disease. However, compounded with other PCOS-related problems, women with Polycystic Ovary Syndrome have a 4 to 7 time higher chance of having a heart attack.
  • Endometrial cancer: A natural buildup occurs monthly on the uterus lining (endometrium) which is sloughed off during menstruation. Infrequent periods can result in an accumulation, leaving PCOS sufferers three times more likely to develop endometrial cancer that can occur as a result of this surplus.
  • Abnormal lipids: Insulin resistance, too much body fat, and the production of excessive androgens can wreak havoc on the delicate balance between good and bad cholesterol.
  • Obstructive sleep apnea: This is a dangerous condition of abrupt breathing cessation during sleep, characterized by snoring, gasping, choking or continual awakening. It can lead to serious issues such as hypertension, cardiovascular problems, sleep deprivation, etc. Overweight and additional male hormones contribute to the condition.
  • Hypertension: PCOS-related symptoms like obesity and hormonal imbalance may raise blood pressure.
  • Metabolic syndrome: Women with PCOS are at higher risk for having two or more of the above risks.
  • Breast cancer: Though it is not proven that PCOS causes breast cancer, PCOS sufferers with a family history of it are more susceptible to the disease than those without.

Can PCOS be Controlled?

Though it is a lifelong condition and a leading cause of infertility in women, PCOS can be controlled, especially if treated early.

What are the Treatments?

Once it is established that you have PCOS, your doctor may recommend some or all of the following:

  • Lifestyle changes: You will be encouraged to follow a healthy diet and to exercise regularly if you need to lose weight. Even less than 10% loss can have a tremendously positive impact on ovulation and fertility problems. If you smoke, you will be told to stop. Smoking elevates androgen levels.
  • Medications: Birth control, other hormone-controlling drugs, and diabetes medication may be prescribed.
  • Electrolysis or other hair removal options may be recommended.
  • Surgery when warranted may be considered.
  • In vitro fertilization (IVF): If all other interventions are unsuccessful, your physician may propose IVF, providing you are deemed healthy enough to undergo treatments.

PCOS -prescribed medications may have strong side effects, or become more potent with steady, consistent weight loss. You will have to be monitored and tested regularly to insure proper dosage for your continuing good health.

How Can Cherokee Women’s Health Specialists Help Me?

Our broad-based establishment has specialists at your disposal to deal with all PCOS irregularities. Doubly accredited, board-certified urogynecologists holding enviable degrees in OB/GYN and Female Pelvic Medicine and Reconstructive Surgery (FPMRS), nutritionists, specialists in holistic medicine, and more professionals are available. We are trained to diagnose, treat, and encourage you throughout your struggles with Polycystic Ovary Syndrome until and after a healthy and manageable level is reached.

You are the best judge of any bodily changes that might be of concern. By seeing a physician immediately when you suspect something is wrong, you stand an excellent chance of correcting troublesome symptoms of PCOS before they become detrimental to your reproductive health.

To book an appointment to further discuss PCOS, call 770.720.7333.


October 19, 2018

How One Patient Got “the Fireworks” Back in Her Marriage

The O-Shot is a treatment available for women which can have a positive effect on her relationships and desire to be intimate.

In the video, Dr. Litrel explains how the O-Shot works, and shares the stories of patients who have experienced changes in their relationships with the O-shot treatment. “I have one patient in her early 30’s with two children, ages 2 and 5, who experienced such a drop in her sex drive that she said it was affecting her marriage,” Dr. Litrel explains.

Dr. Litrel Shares What He Has Seen In Patients Receiving the O-Shot

“It’s quite common for women to have decreased sexual desire after having children! After meeting with my patient several times and trying different hormone approaches, and noting a normal exam, I recommended she consider the O-Shot. This is a treatment that injects platelet-rich plasma from a woman’s own blood into her genitalia to help with sexual satisfaction. It takes about five minutes for the procedure, performed right in the office, and only about 30 minutes total.

“When she returned five or six months later to my office,  she let me know she was delighted with the changes she had experienced. She had the fireworks back in her marriage. She told me she “felt hope” that her children didn’t destroy her desire to be intimate with her husband.”

Dr. Litrel concludes, “This is technology that was not available a few years ago. With such an easy procedure to perform, it’s very rewarding to be able to provide this now for our patients.”

The O-Shot can also help treat urinary incontinence, as Dr. Litrel discusses in this video.

oshot-graphic free ebook link

To schedule an appointment, call our Canton or Woodstock offices at 770.720.7733.

October 9, 2018

By James Haley, MD, FACOG, FPMRS

woman with prolapsed bladderLiving with a Prolapsed Bladder

As GYNs, we address bladder issues on a daily basis, so when we discovered that our longtime patient suffered from a prolapsed bladder, we asked her to share her story of life before — and after — bladder surgery.

“I knew every bathroom in town,” recalls Gabrielle, a vibrant woman in her mid-50s, a common age for women to experience bladder problems. “I never leaked – but I had to use the bathroom ALL the time,” she explained. “My husband used to complain, ‘I hate running errands with you because you have to go to the bathroom at every stop.’

“It started in my late 40s, when I began getting this weird feeling that my bladder had ‘fallen’. It got worse and worse, and it just became this constant pressure. It affected everything. When I exercised it was never painful, but I felt this constant sensation of pressure.

“I finally talked to my GYN, and he said it was caused by a prolapsed bladder.”

What is Prolapsed Bladder?

Prolapsed bladder, also known as Fallen Bladder or Cystocele, is a condition where the bladder drops down from lack of support. Pelvic floor muscles and tissues hold the bladder and other organs in place, but they can weaken over time. This causes the bladder to descend from its fixed position and slip downwards into the vagina. In more severe cases, the bladder may dangle completely outside of the vagina.

What Causes Prolapsed Bladder?

There are four main reasons a woman may develop a prolapsed bladder:

  • Childbirth: A difficult delivery, long labor, a large baby or multiple births
  • Strain: Heavy lifting, strained bowel movements, excessive coughing
  • Menopause: Lack of estrogen, which is vital in maintaining the health of vaginal tissue
  • Obesity: Excess weight, which puts undue strain on pelvic muscles and tissues

What are the Symptoms?

  • Sensation of pressure in the bladder or vagina
  • Leakage of urine when coughing, sneezing, laughing, etc.
  • Protrusion of tissue from the vagina
  • A sensation that the bladder is not completely empty right after urinating
  • Difficulty urinating
  • Pelvic pain or discomfort
  • Painful intercourse

Life After Treatment

Gabrielle relates that she was given multiple treatment options but ultimately chose a permanent treatment solution called a surgical bladder lift. “That surgery literally changed my life. It’s been five years, and I’ve never had a problem. AND no more crazy bathroom trips!”

When Should You See Your Doctor?

If you notice that you have any of these symptoms and you suspect a prolapsed bladder, you should see your doctor immediately. This is not a condition that repairs itself. It usually worsens over time. However, it can be fixed, thanks to many modern methods available today.

Why Our FPMRS Specialists are Experts in Bladder Prolapse

Our board-certified OB/GYNs Dr. Michael Litrel, Dr. Peahen Gandhi, and Dr. James Haley have earned board certification in Female Pelvic Medicine and Reconstructive Surgery. FPMRS is a surgical sub-specialty addressing the problems women experience with the changes to their anatomy from having children and pelvic prolapse. FPMRS surgeons are also known as ‘board-certified urogynecologists.’ Cherokee Women’s Health Specialists, PC, has unique surgical expertise in the Southeast United States as an OB/GYN practice with three board-certified urogynecologists.

To schedule an appointment, call our office today at 770-720-7733.

o-shot photoA Real Patient’s O-Shot Experience, by Lauren Barnes.

As I sat in the stirrups waiting for my doctor to come in and give me an O-Shot, in other words, to inject my vagina with a shot of my own blood (PRP), I had to remind myself of why I was there in the first place. I was a bit nervous, but confident that what I was about to endure was the right decision for me.

How it All Started

Last February, I was having one of those days where I just wanted to cuddle up in bed and watch old movies all day. It was rainy, cold, it had been an exhausting week at work, and my kids and husband were getting on my last nerve. I just wanted some “me” time, and quite frankly, I was long overdue for a day to myself.

Cuddling up in my spot in bed, I began flipping the channels. Much to my amazement, I came across one of my all-time faves from the 80s, “When Harry Met Sally.” Classic love stories never get old and I smiled to myself as I started watching, knowing that it was just what I needed.

Even if you haven’t seen the movie, you’ve probably heard of the famous scene where Sally (played by Meg Ryan) graphically acts out a fake orgasm in a restaurant. The room gets deathly quiet as all eyes are on Sally, then another woman promptly tells her waiter, “I’ll have what she’s having!”

The movie came out in the late 80s, and at that time, acting out an orgasm was a bit progressive. Boy have times changed. But after thinking about it for a few minutes, I found myself feeling sad. I realized that I used to have real orgasms just like that. Really. No acting required. What’s happened to me? Why has it changed over the years? This isn’t fair!

Time for a Change

Suddenly my afternoon of movie bingeing became an afternoon of self-reflection. As I’ve gotten older, it’s been rough facing all the shocking truths about my aging body. Health problems here and there, loss of eyesight, aging face, gray hair, menopause, and the ever-increasing weight gain. None of it is easy to face, and aging is not for sissies. It really sucks. But I haven’t really stopped to think about how sex has changed over the years, how it once was, and what it has become for me.

I have a fantastic marriage and husband, so it’s not really about that. It’s more about the feeling during sex — at one time, being practically “earth-shattering,” and then progressing to just being okay or ho-hum. It’s been a slow, gradual decline in pleasure. I can read about it and explain all the medical reasons why, but it’s sad to think that it will most likely continue to get even worse.

I Decided: “I’ll Have what She’s Having!”

The facts are that I’m over 50 and I’ve had three children. I love where I’m at in life and am honestly very grateful. But wouldn’t it be nice if something could bring back that feeling that was once there?

I heard about the O-Shot procedure from a friend who had great results and recommended her doctor to me. I read up on the procedure and scheduled an appointment with Dr. James Haley at Cherokee Women’s Health in Woodstock, GA. Three of the MDs at their office, including Dr. Haley, are double board-certified in OB-GYN and Female Pelvic Medicine and Reconstructive Surgery. I knew if I was going to get a shot in the vagina, I was going to a vagina expert!

In and Out in 35 Minutes

When I first went in the exam room, the nurse drew my blood, and then my doctor placed numbing cream inside my vagina. This cream was left in place for 20-25 minutes, while they spun my blood in a centrifuge. They then injected my platelet-rich plasma into my clitoris and vaginal wall. Although I slightly felt the shot, it was not painful. I was in and out of the office in 35 minutes. It wasn’t a big ordeal at all, and I had no problem driving myself back to work.

Amazing Results

I could hardly wait to test it. The next day, I positively noticed more feeling in my vagina. It was a warm feeling, as if more blood was circulating, a feeling I recognized from ages ago, but had been reduced over time. When we were finally alone, I practically jumped on my husband. I can honestly say that it was incredible. I hadn’t felt that intense of a feeling during sex for a very long time. And the orgasm was much stronger and longer lasting than it had been in decades. I was blown away, literally, and so thankful to get that feeling back.

5 Months Later

Does it stand the test of time? So far so good. It’s been five months, and it’s still doing the trick. It was a bit more intense the first couple of weeks, but it’s still incredibly better than it was before the shot. Dr. Haley has told me that I can expect it to typically last for a year and possibly longer. As soon as it starts to wear off, I will absolutely be getting another one. It is completely worth it to me.

Highly Recommend

Would I recommend the O-Shot to my friends? Definitely. I know some women who have had the procedure and all have reported positive results. A couple of women have told me they have more intense orgasms, and one has told me her urinary incontinence is much improved.

For me, I think I could do my own personal restaurant scene from “When Harry Met Sally” now, but just for my husband — who by the way, is one very happy guy.

O-Shot To Help Treat Sexual Dysfunction and Urinary Incontinence

Dr. Litrel discusses how the O-Shot can help treat both sexual dysfunction and urinary incontinence so you can help get your life back on track.

oshot-graphic free ebook link

For more information or to make an appointment, please call 770.720.7733.

September 5, 2018

Sherene Harati after the Teal Trot.If you go to our Canton office, there is a good chance you have met Sherene. Her bright smile and helpful attitude keeps her teammates and patients in high spirits.

What you may not know about Sherene is that she is an Ovarian Cancer Survivor. She was diagnosed in 2014 after getting a second opinion for her PCOS. She felt the doctor she was seeing at the time didn’t take her concerns about her symptoms seriously. When she saw a new doctor she mentioned her symptoms again. This time the doctor recommended an ultrasound.

During the ultrasound they identified a mass. Sherene had just graduated from college and didn’t fit the demographics of the women who usually develop Ovarian cancer, so her doctor wanted to keep an eye on the mass. It would have been easy for her to sweep it under the rug, but her doctor followed up, and Sherene kept all of her appointments.

Sherene lost one of her ovaries, but they caught the cancer early. After completing her treatment, including chemotherapy, Sherene is cancer free. It’s been almost three years and Sherene sticks to her follow-up appointments every few months to make sure she is still healthy.

Sherene’s Take Home Message

Sherene’s biggest message? Listen to your body! If you think something isn’t right, talk to your doctor. It’s okay to get a second opinion, especially if you think you aren’t being heard.

Now Sherene is dedicated to spreading the message about Ovarian cancer. Every year she participates in the Teal Trot 5k in Atlanta. She raises money and awareness and has fun in the park with her friends and family. Sounds like a great day!

Learn more or help Sherene on her mission to spread awareness by visiting the Georgia Ovarian Cancer Alliance site. The next Teal Trot will be September 15, 2018; to sponsor Sherene, visit her campaign page!

Sherene kept a positive attitude during treatment.

Sherene kept a positive attitude during treatment.

Still smiling! Sherene participates in her first Teal Trot.

Still smiling! Sherene participates in her first Teal Trot.

Sherene gets the word out about Ovarian Cancer Awareness with teal hair.

Sherene gets the word out about Ovarian Cancer Awareness with teal hair.

August 23, 2018

Hysteroscopy diagramWhat is a Hysteroscopy?

A hysteroscopy is used to diagnose and treat problems of the uterus. A hysteroscopy is performed by inserting a speculum to open the walls of the vagina. The hysteroscope is gently placed into the uterus through the cervix and sterile salt water is used to dilate the uterus so the surgeon can visualize your anatomy. Small instruments are used to take biopsies when indicated.

Why is it Used?

A hysteroscopy is used to find the cause of abnormal uterine bleeding, changes in bleeding or an abnormal ultrasound finding. A hysteroscopy is performed to determine the best treatment plan.
Hysteroscopy are also used to:

  • remove scarring in the uterus
  • diagnose the cause of repeated miscarriages
  • locate an intrauterine device (IUD)
  • perform a method of permanent birth control

What Can I Expect?

Hysteroscopy is performed in our Canton office under IV sedation. You will not experience discomfort during the procedure, but you will need someone to drive you from our office.

You will go home shortly after the procedure. It is normal to have some mild cramping or a little bloody discharge for a few days. You can take Ibuprofen or Tylenol for any discomfort. If you have a fever, chills, or heavy bleeding, call your healthcare provider right away.

If you have any additional questions, please contact Cherokee Women’s Health Specialists at 770.720.7733.

hysterectomy diagramWhat is a Hysterectomy?

A hysterectomy is the surgical removal of a woman’s uterus, the womb. After hysterectomy, you will not be able to have children. Your hormones are generally not affected unless your ovaries are also removed.

Why Should I Have a Hysterectomy?

A woman may have a hysterectomy to treat common conditions, such as: pelvic pain, bleeding, prolapse, endometriosis, fibroids, painful periods, and pain with sex.

How is a Hysterectomy Performed?

A hysterectomy can be performed in different ways depending on the reason for the hysterectomy and other factors. You and your doctor can discuss the different ways of performing a hysterectomy to decide which route is safest and most appropriate for your specific situation. The three main hysterectomy procedures are laparoscopic, vaginal, and abdominal.

lap hysterectomy diagram

  • Laparoscopic Hysterectomy – A thin, lighted tube attached to a camera is inserted into the abdomen through a small incision. Additional small incisions are made to insert surgical instruments. A laparoscopic hysterectomy results in shorter hospital stays, an easier recovery and a decreased risk for infection than an abdominal hysterectomy.
  • Vaginal Hysterectomy – The uterus is removed through the vagina. The only incision is inside the vagina. However, your internal anatomy cannot be visualized by the surgeon.
  • Abdominal Hysterectomy – A larger incision is made on the abdomen to remove the uterus. An abdominal hysterectomy may be suggested if a patient has a large uterus, adhesions or other anatomical challenges. This kind of hysterectomy requires a longer hospital stay and healing time.

What are the Risks?

A hysterectomy is a commonly performed surgery. However, there are always some risks associated with having a surgical procedure. Your surgeon will discuss the risks and benefits so you can be informed to make the best decision.

What to expect after the surgery.

If you have any additional questions, please contact Cherokee Women’s Health Specialists at 770.720.7733.

March 29, 2018

The following is a true account from one of our patients who recently received the O-Shot. Please note that names and details have been changed for confidentiality. 

It’s a gorgeous spring day in early March, and I am en route to Cherokee Women’s Woodstock office to get an O-Shot, a procedure that offers women treatment for urinary incontinence and sexual dysfunction. I am excited and a little nervous at the idea of this new procedure. However, I am hopeful after hearing other women’s success stories, and hope to have my own story add to the increasing number of women who have had remarkable results after getting the O-Shot.

When I heard that Cherokee Women’s was offering this procedure, I wanted to try it. I trust Dr. Litrel and his team, so much so that I’ve been a patient for over eight years. The practice has delivered both of my children, and I refer them to anyone looking for a patient, kind team of physicians.

Why am I particularly interested in the O-Shot? I have suffered from sexual dysfunction for a number of years.

While I know I am not alone in this (nearly half of women report suffering from some sort of sexual dysfunction in their life), this isn’t something most women are comfortable discussing with each other, their doctors, much less their husbands or anyone else.

As a woman in my early 30’s, the daily life of being a full-time working mother has pulled my libido to nearly nonexistent levels and has caused complications in my marriage. I’m happily married, but I feel guilt and shame surrounding my low libido and am curious to see if the O-Shot (in addition to careful communication with my husband) helps me at all.

When I get to the office, the girl at the front desk smiles at me as I sign in. She has a very memorable face and kind eyes that I remember from previous visits. It puts me at ease while I try not to think about what I’ve signed myself up for.

Getting Ready for the Procedure

I’m called back to the exam room and told to undress from the waist down and wrap myself with the crinkly white cover. A few minutes later, Dr. Litrel comes in and explains that he’s going to apply a very thick layer of Lidocaine gel. It will need to sit for at least 20 minutes, and a nurse would be coming in shortly to take my blood so they can run it through the centrifuge.

The Lidocaine is cold, but welcome when I consider the alternative. A nurse comes in and gathers the tools she needs to take my blood. We make small talk and she says she’s heard lots of wonderful things about the procedure. She gets my blood ready for the centrifuge, and Dr. Litrel comes back in and places the blood in the centrifuge for 10 minutes.

I continue to lay back on the exam table and wait for the Lidocaine to do its thing, scrolling through email and social media channels mindlessly. As a full-time working mom of two rowdy boys, I enjoy the quiet and stillness of the next few minutes.

Once the centrifuge was done separating the blood, I was amazed when it I saw the tube pulled out and it was in three separate layers.

I watched Dr. Litrel add calcium carbonate to the blood in two different syringes, one for my clitoris and the other for my vagina. It was time to start the procedure. I try to calm my nerves by making jokes, something I always do as a defense mechanism. “Well, I guess if you’re going to have a needle in your vagina, you want a female pelvic reconstructive surgeon in charge of it.” Dr. Litrel chuckles softly at my joke, reassuring me that the procedure will take just a few minutes and I’ll be out the door in no time.

First, I needed two Lidocaine injections to make sure I didn’t feel the larger needles. This is the part that is different for every patient, Dr. Litrel tells me. “Some women feel absolutely nothing at all, and others feel the tiniest prick.” I was in the second category, but it was slight discomfort. (I mean, I’ve had two children—this was nothing I couldn’t handle.)

After the Lidocaine injections, I felt nothing. I can feel pressure, but absolutely no pain. Wondering what was happening, I ask, “What are you doing now, exactly? And he responds, “We’re doing the first PLP (platelet-rich plasma) injection as we speak.”

Dr. Litrel and his team were very warm, and so conscientious. Throughout the procedure, they asked, “Are you comfortable? Feeling okay? You’re doing a great job, we’re almost done.”

In just a couple more minutes, the procedure was done. Dr. Litrel explained that I should wait 48 hours before any sexual activity, and that I may want to wear a panty liner for a day or two just in case I experienced any breakthrough bleeding.

They gave me a few minutes to get cleaned up and dressed, and I walked out feeling a rush of excitement that I had done this for myself, and I couldn’t wait to test it out. All in all, the procedure only took about 45 minutes, and the longest part was waiting for the Lidocaine gel to take full effect.

As I walked out of the office and down to my car, my satisfaction grew. I was glad I went through with it, and I couldn’t imagine doing this procedure with another physician’s group.

That evening, I felt the tiniest bit of discomfort while sitting in a hard chair. I took some ibuprofen and didn’t have any more discomfort after that. The next morning, I had very mild swelling, but no pain.

Giving the O-Shot a Try

I’d kept the procedure a secret from my husband, wanting the first experience to be authentic and free from expectations. After “giving it a go,” I can say that I’m impressed. Frankly, I’m more than impressed. I haven’t felt a distinct change in my sexual desire like this, ever. Two weeks after receiving the O-Shot, my desire has increased considerably. And not just when the timing is right and the candles are lit and my mind is empty—even during the middle of the day—something many women don’t have the pleasure of thinking about with small children.

And it is a pleasure. Women often come second when it comes to the importance of a healthy sex life (pun intended). But the truth is, physical enjoyment of sex matters greatly to most women, and we want to be sexually intimate with our partners. Women are challenged by a myriad of burdens every day, and so often trying to balance work and life can take a huge toll on a woman’s libido.

Would I recommend the O-Shot? Absolutely. So far, I know a couple of women who have gotten the procedure, and we’ve all had positive results. One has had her urinary incontinence issue treated completely. One has stronger, longer-lasting orgasms as a result. And me? I’m just an overtired, overworked mom who can now get excited about sexual intercourse with her husband. And that is worth a thousand O-Shots.

oshot-graphic free ebook link

For an O-Shot consultation, please email oshot@cherokeewomenshealth.com or call us at 770-720-7733.

March 13, 2018

Although our physicians at Cherokee Women’s Health Specialists are experienced in treating all pelvic issues unique to women, we do not concentrate solely on the physical aspects of your genitalia. We recognize that health issues can be comprised of overall physical, mental and social factors and take all that into account, offering holistic approaches to the many problems that have plagued women since the beginning of time. One of these holistic solutions is the O-Shot, also known as the Orgasm Shot.

Women have always suffered from a plethora of physical ailments unique to their gender-so much so that an entire branch of medicine, Gynecology, has been devoted to their exclusive issues. Painful intercourse, urinary incontinence, vaginal dryness, and sexual disinterest are only a few of the problems we see on a daily basis. Though medicinal and surgical intervention is always available, many women today prefer a gentler and more natural approach. The O-Shot has been known to alleviate or entirely correct many of these problems in a less invasive, natural and extremely effective way.

Below, Dr. Litrel offers more insight on the holistic approach to treatment urinary incontinence and sexual dysfunction with the O-Shot:

What is the O-Shot?

The O-Shot is a non-surgical injectable procedure administered in-office, using your own processed growth factor cells harvested from your blood. It is then re-injected into an area of the upper vagina and near the clitoris, resulting in healing regeneration of the orgasmic zone, triggering the power of your own body’s natural healing properties.

Click here to see more videos of Dr. Litrel discussing how the O-Shot can help treat urinary incontinence and sexual dysfunction.

How is This Done? 

After a vial of blood is taken from you, it is centrifuged, separating concentrated plasma and platelets from the rest of the blood. This process produces platelet-rich plasma (PRP), to which your physician applies an additive to boost the activation of your growth factors. Then, the platelet-rich serum is reintroduced into your body after swabbing the area with a numbing anesthetic.

Platelets normally swim around in your blood vessels, always on guard for any disruption or damage. When they sense one, they rush to the injury site, join together in a chain to ‘hold down the fort’, by forming a clot or plug. Then, they send out a type of S.O.S.to healing stem cells to hurry over and start repairs in the form of collagen production.

The O-Shot mimics this sequence by introducing a multitude of platelets into the body. The additive mixed in earlier sends that signal a false alarm of sorts- to lure the stem cells over. Stem cells, recognizing so many of your own platelets in one place are fooled into thinking there’s an injury and immediately respond, doing what they’re designed to do, which is to begin producing collagen and new tissue, replenishing vital elasticity, skin cells, moisture, plumpness, sensitivity, and strength to the area. 

PRP is not a not a novelty or fad. This technique has been used for many years to heal wounds, to treat sports and other injuries— has even proven effective in dentistry.

What Can the O-Shot Do For Me?

The O-Shot can benefit women a great deal. By spurring the area of the body where it has been injected into healing itself, the O-Shot immediately begins to work. It starts correcting different feminine issues that have developed over time due to aging, childbirth trauma, depleted collagen, tissue damage, skin cell death, etc., physical changes which can evolve into such problems as:

  • Sexual dysfunction
  • Sexual disinterest or low libido
  • Vaginal Dryness
  • Urinary Incontinence
  • Failure to achieve orgasm
  • Desensitization
  • Painful intercourse
  • Stress incontinence
  • Urge incontinence

The O-shot, in tandem with your own biological healing factors, can then ease or altogether eliminate these troubles, resulting in:

  • Accelerated desire for sex
  • More powerful orgasms
  • Corrected or minimized urinary incontinence leakage
  • More youthful and supple vaginal lip appearance
  • Increased tautness to the vaginal opening
  • Less or no need for artificial vaginal lubricant
  • More frequent and regular orgasms
  • Less or no pain during intercourse
  • More sensitivity and arousal during clitoral stimulation
  • More ease in attaining orgasm
  • Possibility of reducing or stopping previous drug intervention
  • Possibility of less frequent or complete cessation of pelvic-related infections

How Long Do the Effects of the O-Shot Last?

Individual results vary, but often noticeable change begins immediately and can last up to 18 months. Depending on how severe your issue is, we may recommend a booster procedure in about 4 to 8 weeks, and a maintenance shot in about a year so that there is no diminishment of ongoing benefit. There is also no recovery period necessary. You can resume all normal activities immediately after leaving our office. Furthermore, the whole process will cause you little or no discomfort.

Who is a Good Candidate for the O-Shot?

Almost every woman between the ages of 25 to 65 is a good candidate. There are virtually no exceptions, but we can only recommend this procedure 100% after you disclose your full medical history so we can be sure there are no foreseeable problems exempting you. Usually, however, most women prove to be excellent candidates.

Why Should I Choose Cherokee Women’s Health Specialists for My O-Shot Treatment?

At our establishment, we pride ourselves on our holistic approach to female wellness. We treat you as a whole, taking into account any metabolic or hormonal problems you may have. Even diet and lifestyle can compromise or your body’s ability to heal or regenerate tissue. We address any psychological or emotional issues as well so that we can help restore your overall health, head to toe and inside and out. We do not just focus on your pelvic area. We examine all your alternatives and only recommend the best one for your unique situation.

Drs. Litrel and Haley have spent their entire medical careers striving to learn all there is to know about a woman’s anatomy and the myriad of factors that can affect its performance and functions. They are board certified, double accredited urologists with certification in OB-GYN and Female Pelvic Medicine and Reconstructive Surgery (FPMRS), the latter requiring years of study, training, hands-on experience, and meeting rigid proficiency demands specified by the American Board of Medicine (ABMS). Dr. Haley has been trained and licensed in Aesthetic Injectables for over a decade. Together and separately, these professionals are knowledgeable in every aspect of the problems exclusive to women throughout their lifetimes.

oshot-graphic free ebook link

Administration of the O-Shot requires focused expertise, strict adherence to FDA guidelines, and astute knowledge of anatomy for optimum results. Our accomplished practitioners offer this skill on a daily basis. For more information on the O-Shot procedure, we invite you to email Oshot@cherokeewomenshealth.com or call our office at 770-720-7733.

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