- Women’s Health
- Healthy Living
- Health Conditions
- Nurse Barb
It’s important to note that guidelines are just that, guidelines based upon data from large populations, however they may not apply to every woman that you encounter, especially to those who have unique circumstances and let’s face it, are more challenging and more rewarding as we provide personalized, individualized care.
The current American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines for pap smears differ from those of the US Preventive Services Task Force (USPSTF)
The USPSTF guidelines recommend that Pap smears be stopped at age 65 if there have been adequate prior screens, however it’s not clear what the definition is of adequate prior screens.
There are as many different experiences of menopause as there are women. For some women, menopause arrives like a gentle breeze with barely a feeling of warmth or any other bothersome symptom, while others experience menopause like a Class 5 Tropical storm with overnight drenching hot flashes and night sweats, mood changes and a complete disruption in life.
While many clinicians understandably and appropriately focus on hot flashes and night sweats, many women may be more concerned with sleep disturbances, weight gain, loss of libido, vaginal dryness, incontinence and mood changes.
When women come to my office with any one or all of the following complaints from no periods to excessive bleeding, difficulty losing weight, excessive hair growth and acne or infertility, I see this as an important opportunity to change a woman’s life for the better. Many of these women have seen many other health care providers, who more often than not aren’t able to provide a diagnosis or who may not be able to provide a comprehensive plan of care. Many women with PCOS have symptoms that impact their appearance, their self-esteem, sense of shame and guilt as well as fears of infertility.
Using the Rotterdam Criteria for diagnosis provides an objective starting point for evaluating women. A diagnosis of PCOS can be made if 2 out of the following 3 conditions are met: Signs of hyperandrogenism such as hirsuitism, acne, absence of regular ovulation and/or seeing 10 or more small cysts on 1 or both ovaries with an ultrasound.
It’s estimated that 1.4 million US women will experience abnormal uterine bleeding (AUB) each year. This includes an estimated 50% of women in perimenopause, who have an increased incidence of polyps, fibroids and who are not ovulating which leads to their AUB. In addition, over half of women with heavy menstrual bleeding report that their periods interfere with their lives compared to women with lighter cycles.
The American Congress of Obstetricians and Gynecologists (ACOG) defines Abnormal Uterine Bleeding this way
ACOG Definition of Abnormal Uterine Bleeding (AUB)
Bleeding that requires more than 1 pad/hour for more than 1 day
Bleeding for more than 7 days at a time
Bleeding intervals that are less than 20 days apart
Bleeding in excess of 80 cc a month
– a super tampon or pad can hold approximately 10 cc of blood
Bleeding that causes anemia
Bleeding that leads to disruption in life style
Source: ACOG, Committee Opinion. April 2013 (reaffirmed 2015), number 557.
I just gave a talk to a group of about 75 women at midlife. When I asked for a show of hands for how many women experience urine leaking with a cough, sneeze or laugh, about 1/2 raised their hands.
Yes, about a third to a half of us are having a little pee pee problem. Fear not! There’s an App for that now too!
Strengthening the pelvic floor means you’ll be less like to deal with this possibility.
When I ask my patients to do a Kegel or to try to squeeze their pelvic floor muscles during an exam, it’s clear that only about 1/2 are able to isolate and squeeze the right muscles. Many use their abdominal muscles, many push out and many simply don’t have the sensation. Once we work on how to do the exercises and get women started practicing, most report that their lives have changed, for the better because they aren’t leaking at all or nearly as much.
We’re all busy, so here’s some options to help you stay dry and a surprising option at the end.
At home Kegels! There’s an App for that
For women who want to work on their pelvic floor muscles in the privacy of their own home, here’s a few new options:
Discreet vaginal inserts
Lightweight, small, discreet vaginal inserts that use Bluetooth technology connected to your smartphone so you can see if you’re doing your Kegels correctly. (more…)