Blog - West Des Moines OBGYN

May
26
2021
What are Ovarian Cysts and What to Do If You Have One

As a natural part of the ovulation process, the ovaries release eggs, and fluid-filled sacs called ovarian cysts to form. Usually, these pockets of fluid cause a few mild symptoms that most women associate with their cycle. However, some types of ovarian cysts can be more serious, causing sudden, severe pain or make it difficult to get pregnant.

The symptoms of ovarian cysts include pressure, swelling, and bloating. Occasionally, they can cause irregular periods and pain during sex or your period. Severe abdominal pain should always trigger a call to the doctor, urgent care, or emergency room. With regular pelvic exams, your OBGYN may be able to identify if you have ovarian cysts before they cause a problem.

Several Types of Ovarian Cysts

In women who have regular menstrual cycles, ovarian cysts are very common. The most common types of ovarian cysts include follicle cysts and corpus luteum cysts. Follicle cysts form when a follicle in the ovary decides not to release an egg as it should. This common occurrence rarely causes symptoms, and the follicle cyst dissipates after a few weeks.

Corpus luteum cysts occur after the follicle releases the egg. That empty follicle sac then shrinks to form a mass of cells called the corpus luteum, which prepares hormones for the next cycle. But sometimes, something goes wrong, and the sac reseals, causing the corpus luteum cyst to form. These can fill with fluid and become large, resulting in pain and bleeding, especially if they burst.

Some cysts are associated with other conditions, including endometriosis and polycystic ovarian syndrome. If you have endometriosis, you may experience blood-filled cysts called endometriomas. Polycystic ovary syndrome is a condition that some women have that causes multiple follicular cysts on the ovary. This condition can make it more difficult to get pregnant because ovulation is irregular.

If you have symptoms that indicate you might have cysts, your OBGYN will do an examination and possibly order an ultrasound, as well. The goal of the pelvic exam is to discover the size, location, and type of cyst. She will find out whether it is solid or filled with fluid, which can help indicate the makeup of the ovarian cyst. A pregnancy test can help rule out pregnancy as a cause of your symptoms. Hormone and blood tests can also help your doctor discover related problems.

Surgical removal of cysts doesn’t occur often, and cancerous cysts are rare. If surgery is required, it will likely be minimally invasive, using laparoscopic surgical techniques. Cysts may be tested for cancer following removal. The majority of ovarian cysts are benign. Malignant cysts indicate ovarian cancer. As such, if a cyst is detected, ultrasounds and other tests can determine what your doctor will recommend for treatment. Hormones such as birth control pills may be prescribed to lower your risk of getting future cysts.

When to Schedule an Appointment

While ovarian cysts are a common occurrence, they usually last a month or two and resolve on their own. However, it’s important to be informed about the symptoms so you can be aware of what you might experience during your menstrual cycles—and know when to schedule an appointment. If you are experiencing irregular cycles, painful sex, or other symptoms of cysts, please contact West Des Moines OBGYN Associates for your appointment. We offer convenient in-office procedures such as ultrasounds, so your doctor can more rapidly reach a diagnosis for the symptoms that bother you.
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Categories:

Gynecology

Obstetrics
Apr
26
2021
An Overview of Birth Methods: Vaginal, Cesarean & VBAC
For centuries, there was one way to have a baby, and that was a vaginal birth. Fortunately for today’s mothers and babies, 21st-century medicine offers other methods for childbirth that can help ensure safe, healthy delivery. The C-section or cesarean delivery method involves the surgical removal of the baby. Another option is a vaginal birth after cesarean or VBAC. To help you prepare for the delivery of your newborn, we’ll outline these three methods and address the process for each style of childbirth.

Vaginal Birth

A vaginal birth takes place when the baby is born through the birth canal. Most pregnant women should plan for vaginal birth unless there is a medical reason not to. Planning for a vaginal birth can be tricky. While you will know your due date, you may go into labor at any time. However, typically spontaneous usually begins between 37 to 41 weeks of the pregnancy.

Vaginal birth provides several benefits, including more immediate contact and breastfeeding with the newborn. For the mother, vaginal birth typically results in shorter hospital stays, faster recovery, and lower infection rates than a C-section birth. For the baby, passing through the birth canal seems to boost their lung health, among other benefits.

Vaginal birth can also be difficult in that the onset and length of labor can’t be predicted. Labor is painful and physically exhausting. The process can be made easier by preparing for labor. Ask your OBGYN for more information at one of your appointments.

If certain conditions occur, your OBGYN may recommend inducing labor. This can be helpful in terms of scheduling the birth, too, but the important thing is the health of you and your baby. For an elective induction without a medical complication, the baby should be at least 39 weeks along to ensure the best outcome.

It is common to have vaginal tearing at the time of delivery, especially for first-time mothers. Episiotomies are not routinely performed by our obstetricians and if needed they will discuss this at the moment.

Cesarean or C-section

Sometimes surgical delivery is necessary and the C-section is the preferred technique to get the baby out safely. In fact, up to one-third of babies born in the United States are delivered via C-section. During a cesarean, an incision is made in the abdomen and uterus in order to remove the baby. This leaves a scar just above the pubic bone. The recovery period is longer due to the healing process.

C-sections can be planned and scheduled for reasons such as a history of prior cesarean, an expected large baby, or if the baby is in the breech or transverse position. Cesareans are more common in twin deliveries often due to their positions.

A cesarean may also be done in an emergency. This typically happens due to increased stress on the infant in labor or a very sick mom. Cesarean births can also be necessary due to heart disease, high blood pressure, or infections in the mother. Your OBGYN will be able to provide guidance for your birth method.

C-sections are considered major surgery, and the risks of surgery apply. One of the risks of cesarean birth is infection. Hemorrhaging or blood clots, reactions to anesthesia, and surgical injuries to you or the baby can also occur. You will stay in the hospital for 2 to 3 days following a C-section for post-surgical care, and it will require several weeks of healing at home. During that time, you will need to avoid heavy lifting and strenuous activity. You’ll be able to take care of your baby, but the incision may make many normal tasks, such as driving, uncomfortable.

In some cases, C-section can be a one-time experience. As long as the incision is made in a low transverse manner on the uterus it may be safe to attempt a trial of labor with your next pregnancy. However, depending on the reason for the first C-section and the timing of pregnancy, you may still need a cesarean in the future. This is something to discuss with your obstetrician if you are interested.

Vaginal Birth After Cesarean (VBAC)

In the past, if you had a C-section, that meant you would have to deliver future babies via C-section. Now, when a mother has had a C-section, she may have the option of a trial of labor. This is made possible by advances in the surgical technique used for a modern cesarean.

While there are benefits to a vaginal birth as mentioned before, VBAC still may not be right for every woman. Pregnancies too close in proximity and other pregnancy complications can prevent a successful VBAC.

Your OBGYN can address VBAC with you in detail. Here are a few facts about VBAC that might influence your decision or affect your VBAC process.
- Spontaneous labor works better for VBAC than inducing labor. The medications used to induce labor can increase the risk of uterine rupture.
- If you’ve had a vaginal birth before, the odds of a successful VBAC are much higher than if you’ve only had a C-section.
- Previous C-sections due to difficult or slow labor may rule out a VBAC because it is likely that you will experience the same labor problems again.
-VBAC carries a 2 percent risk of uterine rupture which is a surgical emergency

Ask Your OBGYN About Delivery Methods

Whether you are planning your first birth or having a second or third child, knowing the birth options can put your mind at ease. Be sure to check out our obstetrics FAQ for other common questions about having a baby, and contact us to schedule your appointment.
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Categories:

Obstetrics
Mar
16
2021
COVID-19 Vaccine During Pregnancy

As we begin the second year of the COVID-19 Coronavirus pandemic, pregnant women everywhere are making decisions about whether to pursue one of the COVID-19 vaccines. The good news is that several vaccine options are now available. Unfortunately, none of the clinical trials for these vaccines included pregnant women. Based on the science that is available to us today, the doctors at West Des Moines OBGYN Associates can help you decide if the COVID-19 vaccine during pregnancy is right for you. Let’s review what we know.

Pregnancy and other health factors put you at higher risk for severe COVID-19.

Reporting from hospitals has shown that pregnancy is an independent risk factor for increased ICU admission, the need for oxygen, and death from COVID-19. Those who are pregnant and also in one of the other risk factors, such as overweight, diabetic, or heart disorders, have particularly elevated risk factors. Remember that the list of high-risk individuals includes those who have had cancer, kidney disease, COPD, heart conditions, immune diseases, smoking, and sickle cell disease. In addition, people of color also fall into the higher risk category, so Black, Latino and Hispanic women, in particular, could be at much greater risk. Check the CDC website to learn more about medical conditions that have been linked to more severe COVID-19 illness.

We also will point out that as your baby develops, your lung capacity will decrease, which could make COVID even more difficult and severe. Learn more about pregnant women’s risk for severe illness from the CDC website.

In summary, the fact that you are pregnant puts you at higher risk for severe illness from COVID-19. If you are not yet pregnant, keep these risk factors of Coronavirus in mind.

Three vaccine options are available in Iowa as of March 2021.

As you have most likely heard, Pfizer, Moderna, and Johnson & Johnson have all developed vaccines to help prevent getting sick from COVID-19. These have all started to be administered across Iowa, starting with the initial phase of elderly, front-line healthcare workers, and now, those with preexisting conditions such as diabetes, high blood pressure, and immune diseases.

Moderna and Pfizer both developed mRNA-based vaccines that require two shots spaced a couple of weeks apart. While these vaccines contain genetic material and encode a protein in the virus, they are not live vaccines. They degrade rapidly and bear no risk of genetic modification. Once both doses are received, they are about 95 percent effective in preventing the virus.

The Johnson & Johnson vaccine, which was actually produced by Janssen Biotech, requires only one dose in the form of a shot. This vaccine uses an adenovirus to carry the Coronavirus protein. This type of vaccine has been used for the Ebola virus, HIV, and RSV vaccines, and those were clinically tested in pregnant people with no adverse pregnancy outcomes. The Johnson & Johnson vaccine trials indicate that it is 100 percent effective in keeping trial participants out of the hospital, even if the person contracts Coronavirus.

The vaccines have very few incidences of major side effects.

All of the vaccines have been shown to be safe for most people. The side effects range from minor fevers to more severe allergic reactions. Anecdotally, some experience more symptoms following the second dose of the two-dose vaccines. When people receive their vaccinations, they will be asked to wait 15 minutes before leaving. This is so the staff giving the vaccines can watch you for allergic reactions.

Coronavirus self-reported data doesn’t show any major issues with vaccines in pregnant women.

Even though pregnant women weren’t included in the vaccine trials, the CDC has been collecting information from pregnant people who have contracted COVID-19 through the CDC v-safe program. More than 30,000 women have self-reported outcomes, including miscarriage, stillbirth, pregnancy complications, ICU admissions, infant hospitalizations, birth defects, and more. The observations from these reports show no concerning pregnancy outcomes.

The Vaccine Adverse Event Reporting System (VAERS) has collected data related to pregnant women who received the vaccine. Miscarriage was the most frequently reported adverse pregnancy outcome, but the numbers were within expected rates. Based on these self-reporting systems, there have been no patterns that indicate safety problems with Pfizer and Moderna vaccines. Because it is so new, the Johnson & Johnson vaccine doesn’t have much data yet. We look forward to seeing more information as women report their experiences.

You could help the medical community learn more about pregnancy and COVID-19 by participating in these public health surveys. To learn more about reporting your experiences with COVID-19 or the vaccines, visit the CDC website.

Contact your OBGYN to discuss the Covid-19 vaccine during pregnancy.

While we know that COVID-19 can make pregnant women sicker, there is no evidence that indicates the available vaccines present a greater risk than getting COVID-19. Please contact us to discuss your Coronavirus risk factors and to learn more about the vaccines.

Another trusted resource for Coronavirus information is the American College of Obstetricians and Gynecologists. Visit our Obstetrics page to find links to ACOG’s pages on the topic, including patient FAQs.

We hope this information helps clarify information about the covid-19 vaccine during pregnancy. Please discuss this topic with your obstetrician.
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Categories:

Obstetrics
Mar
08
2021
Is an IUD the Right Birth Control for Me?

When it comes to birth control, we are fortunate to have many safe and effective choices. The IUD or intrauterine device is among the long-term birth control options because it gets inserted into the uterus. But is it right for you?

Let’s explore the IUD birth control options so you can have a productive conversation with your partner and your OBGYN.

Overview of IUDs

The first thing you need to know is that an IUD is a small device that typically offers 99% effectiveness in preventing pregnancy. Plus, once it is inserted into the uterus, it can remain in place and effective for 3 to 10 years. The length of time it can stay usually depends on the brand.

There are two types of IUD-progesterone and copper. Progesterone IUD brands include Mirena, Skyla, Kyleena, and Liletta. They release varying amounts of hormones to help prevent pregnancy by thinning the uterine lining and thickening the cervical mucus. Paragard is a copper-based birth control IUD, offering effective birth control without hormones. The copper creates a reaction that is toxic to sperm. Review these brands of IUD and discuss the pros and cons of these different types with your OBGYN to find your fit.

Like all birth control, there may be side effects to an IUD. It is common to have irregular bleeding for the first few months. You may also experience headaches, nausea, and acne. After the first few months, these side effects may disappear. There is a rare chance that the IUD will migrate or perforate the uterus. It may also be expelled by your body.

Am I a Candidate for an IUD?

A progesterone IUD can be especially helpful for women who have heavy menstrual bleeding, cramping, or endometriosis. You will need to talk to your OBGYN about any unusual vaginal bleeding to make sure the cause is known prior to an IUD.

One of the benefits of the IUD is that it is effective immediately after insertion. So, if you have trouble remembering to take pills or use other birth control methods, it could be a good choice for you. However, it does not prevent sexually transmitted infections or diseases, so condoms should still be used.

Large uterine fibroids can interfere with the placement of an IUD, so women with fibroids may not be the best candidates for the IUD.

Other conditions and previous pelvic infections can also indicate that the IUD is not the best option for you. Talk with your doctor about all of your conditions and medications.

An IUD can be inserted by your OBGYN anytime. Following childbirth, it is recommended you wait a few weeks to have one put in, as that can increase the chance of expulsion or perforation.

Talk to Your OBGYN

If you would like a low-maintenance, effective, long-term birth control option, the IUD could be right for you. It can prevent pregnancy for three years or longer with little thought, and it can have other benefits, too. Think about your plans and your health, and discuss this option with your OBGYN.
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Categories:

Gynecology

Obstetrics
Jan
27
2021
What to Expect at My First OB Appointment

Whether you have plans to conceive a baby or you have already taken a positive pregnancy test you should schedule your visit with an OB. Your first appointment can be a preconception visit or a prenatal visit. Either way, we are thrilled to work with you to achieve a healthy pregnancy!

Preconception OB Visit

Even before you try to get pregnant, you can benefit from seeing your OB-GYN for a preconception care visit. You can schedule this visit up to a year in advance of your plans to get pregnant. By planning for your pregnancy early, you can ensure your lifestyle is healthy and your body is ready for the nine-month journey of pregnancy.

At the preconception visit with your OB, you will learn more about preparing to conceive. Your OB will provide guidance on a number of factors that are important to getting pregnant. Those include diet and exercise, quitting smoking, alcohol, and drugs, and taking folic acid and other prenatal vitamins.

Your OB may examine you and take blood for additional testing. Pre-conceptual genetic testing may also be offered.

At the preconception visit, you should tell your OB provider about any health history or health concerns that may affect your pregnancy. Those include chronic medical conditions, such as high blood pressure, diabetes, and thyroid disorders, as well as whether you have had treatment for cancer. You should also review your medications with your provider. If you have had prior pregnancies these will also be reviewed.

Your OB provider will review your health history and discuss any factors that may make your pregnancy high risk. Having had pregnancy complications or premature births in the past also factor in. Learn more about high-risk pregnancies now.

If, after your first preconception visit, you have trouble getting pregnant, infertility and infertility treatment may also be something your OBGYN can help you navigate. Learn more about primary and secondary infertility in our previous blog post.

In summary, the preconception visit can prepare you for a healthy pregnancy and help identify potential issues. It also helps you understand the risks involved with becoming pregnant. You will benefit from knowing all you can about the process of pregnancy and about the prenatal OB visits you will need to schedule to ensure a healthy baby.

Prenatal OB Visit

If you took a positive home pregnancy test, you may be wondering, “Now what?” You’re probably very excited and even nervous, especially if this is your first pregnancy. The prenatal OB visit includes testing to confirm your pregnancy and a discussion of important lifestyle guidelines for your pregnancy. It will likely include an ultrasound to confirm your due date. You will want to get on the schedule for your first prenatal appointment around 8 weeks of your pregnancy, so call your provider right away when you test positive at home for pregnancy.

Prenatal care provides both you and your baby with regular checkups and guidance on optimal lifestyle choices. You will have many questions about caring for yourself and your baby. Your OB provider will be happy to answer any questions you have! You can also find many answers to common obstetrics questions on our Obstetric FAQs page.

You may want to make a list of questions and concerns you have about the baby growing inside your womb. Those questions may include questions about calculating your due date or about the COVID-19 coronavirus and its effects on pregnancy.

You and your provider will discuss the three trimesters and what is involved in each stage of your baby’s development in the womb. Each visit will monitor your blood pressure, weight, urine protein, and glucose levels. Your OB will also listen to your baby’s heartbeat. West Des Moines OB/GYN also provides in-house ultrasounds for monitoring the baby’s progress as needed.

Once you have confirmed that you’re pregnant, there will be a number of appointments your OB will recommend. It will be important to get these on your schedule, so your baby and you receive the best possible care and monitoring.

Schedule Your First Visit with West Des Moines OB/GYN

Whether you are in the family planning stage or already pregnant, our female OBGYN providers all have the same goal: To ensure you have the healthiest possible pregnancy. We have cared for women and babies in the area for more than 25 years, and we offer two convenient locations in Indianola and West Des Moines. We invite you to learn more about obstetrics care and schedule your appointment today.
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Categories:

Obstetrics
Dec
10
2020
Primary and Secondary Infertility

Are you and your partner having trouble getting pregnant? You are not alone. Approximately 1 out of 6 couples has difficulty conceiving a baby. When a couple tries without success to get pregnant with their first child for at least 12 months, that is called primary infertility. Secondary infertility is the term used when the couple has difficulty conceiving another child after having one or more children.

Primary and Secondary Infertility

Oftentimes, the only symptom of primary infertility is simply not getting pregnant. If couples keep trying, some may eventually conceive, whether or not they seek treatment. However, treatment can make the process of starting a family happens more quickly. It can also address issues that will benefit your gynecological and general health.

The causes of infertility are split between the male and the female. In other words, it isn’t always the woman’s physiology at the source of the problem, as some people think. For the purposes of this article, we will focus on the female causes because our OBGYN team works with women every day to help diagnose infertility issues and other women’s reproductive issues, among other things. Keep in mind that male infertility can be involved.

The fact is that infertility symptoms do not always show up until you try to get pregnant. Early risk factors for future infertility include irregular and infrequent periods. A history of the pelvic inflammatory disease can lead to infertility. Endometriosis can also make it difficult to conceive.

Irregular & Infrequent Periods

When you have irregular periods, hormonal imbalances may be to blame. A variety of hormones must work together to stimulate ovulation. Some hormonal disorders that affect ovulation include polycystic ovary syndrome, hyperthyroid or hypothyroid conditions, and extreme stress.

Endometriosis

Endometriosis, a condition in which endometrial tissue grows outside of the uterus, often affects the function of multiple organs in the pelvis. This includes the ovaries, fallopian tubes, and even the bowels because the errant tissue can attach lots of places within the pelvic region. The adhesions can cause very painful periods and affect fertility.

Painful periods can be a sign of conditions like endometriosis. Sex may also be painful. If you want to have a baby, it is important to seek treatment for excessive pelvic pain, whether it is related to your menstrual cycle or sex. Your OBGYN can help you manage the pain and any conditions that could hinder your ability to get pregnant.

Abnormal Anatomy

Physical abnormalities can pose a threat to fertility, as well. If the cervix or uterus has an abnormal shape or position, that may affect the ability of the sperm to fertilize the egg. Damage to fallopian tubes can also be a problem. If the fallopian tubes are blocked by inflammation or scarring from previous pelvic inflammatory disease, the egg can’t reach the uterus.

Other types of abdominal adhesions can also hinder the ability to get pregnant. For example, abdominal surgery such as appendectomy or bowel resection surgery can cause internal scarring that can affect the function of reproductive organs.

Other Risk Factors

There are several risk factors for primary infertility. Age of 35 or older, past cancer treatment and previous miscarriages should be discussed with your doctor. These preexisting conditions can impair your fertility.

Women’s fertility declines rapidly in the mid-30s. The quantity and quality of the eggs drop. The same applies for men over age 40, as their sperm count drops, as well.

Being underweight or overweight can also make it difficult to get pregnant. A regular, moderate program of exercise will help you enhance your health and fertility. The same goes for your partner.

Of course, tobacco, alcohol, and drug use should be stopped if you want to get pregnant. Women who smoke have higher risks of miscarriages and complications with pregnancy. Drinking alcohol is out of the question if you want to get pregnant and have a healthy baby. Studies also indicate that men should also ease up on smoking and drinking while trying to conceive, because heavy use of either can decrease sperm count and increase the risk of erectile dysfunction.

When you are ready to get pregnant, contact your OBGYN to address any issues you have with your periods, and stay in touch as you try to get pregnant. If you have difficulty getting pregnant, we are here for you. Our OBGYN doctors will find the source of your symptoms and treat them to enhance your chances of getting pregnant.
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Categories:

Obstetrics
Nov
30
2020
Got Heavy Periods? Learn the Source.

If you have heavy periods that cramp your style, you may think you’re unlucky, but there may be a real medical reason for heavy flow, long periods, and painful cramps. The medical term for heavy or long menstrual periods is menorrhagia. Periods that are very heavy can also have further medical effects, such as anemia and iron deficiency.

When periods require you to change your pad or tampon hourly for 24 hours, this can obviously disrupt your life. You may also have severe cramps. It’s very hard to get anything done when you spend several days dealing with heavy flow and cramps that are more than a little uncomfortable. You may lose sleep because you have to get up to replace a pad or tampon in the middle of the night. Long periods that last more than a week can really zap your energy and affect your health, and you have every reason to seek treatment for your symptoms.

We encourage women with period symptoms that seem excessive to see their OBGYN to pinpoint the cause. Heavy periods can be caused by a number of conditions, including adenomyosis, fibroids, endometriosis, polyps, hyperplasia, and even uterine cancer. Getting to the root of the cause can lead to more effective treatment.

Adenomyosis

Adenomyosis is a condition in which the endometrium, or the lining of the uterus, grows into the muscle of the uterus. Because the lining is encased in muscle, this can cause increased cramping as well as heavy, extended bleeding.

Endometriosis

Endometriosis is a condition in which the endometrium grows outside of the uterus on structures such as the ovaries, fallopian tubes, outer uterus, and bowel. This can result in painful cramping, pelvic pain, painful intercourse, and even painful bowel movements.

Fibroids

Fibroids are tumors that grow within the uterus. The can be located within the muscle, in the uterine cavity, or on the external surface of the uterus. Fibroids make periods dysfunctional. Making them longer and heavier. They are typically benign.

Hyperplasia

Endometrial hyperplasia is a condition that thickens the lining of the uterus. Risk factors for hyperplasia include high levels of estrogen that is unopposed by progesterone. This can happen with polycystic ovarian syndrome, obesity, and taking estrogen as a hormone replacement without proper progesterone supplementation.

Polyps

Small growths called polyps can grow within the lining of the uterus. Like fibroids, they can cause your periods to be long, heavy, and difficult to manage.

Diagnosis & Treatment

To diagnose the cause of your heavy periods, your OBGYN will do an exam and order tests such as a Pap smear, pelvic ultrasound, and blood tests. They may also do a biopsy of the endometrium.

Treatments for these conditions vary from taking birth control pills, placing an IUD, or taking medication to alter hormones and lighten periods. There are also surgical procedures to reduce menstrual flow. Procedures may be required to remove fibroids or polyps or reduce the thickness of the endometrium. Other procedures to treat severe symptoms include endometrial ablation, resection of polyps and fibroids, and hysterectomy. Many of these treatments may affect your ability to bear children, which you will want to discuss with your doctor.

It’s important to treat heavy bleeding, not only to improve your quality of life and reduce the pain and inconvenience but also to avoid other side effects. Anemia can result from losing too much blood during your period. When you have anemia, your body doesn’t produce enough red blood cells. This makes your heart work harder to get oxygen throughout the body. This nutritional deficit can cause paleness and fatigue, too.

If you experience heavy, long periods, we encourage you to discuss your symptoms with your OBGYN. We can work on diagnosing the cause and exploring your treatment options to make your life better.
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Categories:

Gynecology
Oct
27
2020
How to Perform Your Breast Cancer Self-Exam

Mammograms are one of the best diagnostic tests for detecting breast cancer early, and your annual exam in your doctor’s office also includes a clinical breast exam. Another path to detecting breast abnormalities early is through breast self-exams. Our OBGYN staff believes it is always a good idea to be familiar with your body just in case you notice changes. That is why we recommend monthly breast self-exams. Through a regular familiarity with your breast tissue, you are more likely to detect a change in the way the breast tissue feels or looks.

You can do a breast self-exam at any time, but the most comfortable time is right after your period. At that time, there should be less tenderness than right before your period. Here are a few things to know about performing a breast self-exam.

Look for Visual Changes

First, stand in front of a mirror with your arms by your sides. Are your breasts smooth of lumps and dimples? Are your nipples inverted? Turn to each side to view your profile. Raise your arms and view your armpits, as well. Look for anything outside of your normal appearance. That could include areas of redness or discoloration, depressions or tightness in the skin, and other noticeable differences. Some kinds of cancer are more like spaghetti than lumps. This makes them difficult to detect, but if your breasts are not pointing the same direction, this may indicate a change that you can’t see under the skin. The more familiar you are with how your breasts look on a daily basis will help ensure that you know when to call your doctor about an abnormality.

Perform the Self Exam

You can perform a self-exam in the shower or lying down. As you begin the manual part of the self-exam, you will want to develop a pattern and method so you can more easily remember the feel and detect changes. Plan to use the pads of the middle fingers on your hand to feel the tissue with different levels of pressure. Follow a slow, methodical approach. Begin at the collarbone and move back and forth in sections down each breast. Go all the way to the underarm and rib cage area. Apply different levels of pressure in each area.

If a spot hurts or is numb or feels lumpy, make a note of where that is. Some people find it helpful to chart their breasts so they have a baseline for how their tissue feels. Again, performing this monthly provides the best way to monitor your breast health. If you have questions about how to perform your breast self-exams, please let us know.

Pay Attention to Physical Symptoms

Some symptoms tell us about possible infections or problems. If you have detected any discharge from the nipple, make note of the color, consistency, and any odor. These symptoms can indicate mastitis or other issues. Other physical symptoms include pain, although it can sometimes be difficult to detect the difference between a pulled or strained pectoral muscle and other types of breast pain. Pain isn’t normal, so if it persists, you should make an appointment for a clinical exam.

So, what are other indications that you should see your doctor? If you feel a hard lump anywhere on your breast or near your underarm, or feel changes like fullness or thicker tissue, you should make an appointment with your doctor. If you see bloody nipple discharge, unusual puckering or bulging or a recently inverted nipple, call your doctor. They can perform a clinical exam to determine the cause, and they may order a mammogram or other diagnostic tests. There is no reason to panic when you find these changes. Many changes in breast tissue are benign. Some changes occur due to aging or the stage of your menstrual cycle.

Keep Your Annual Exam Appointment

One of the best ways to control your health is through your annual exam. At this appointment, you will receive a clinical breast exam. Your OBGYN will perform the exam, following a similar procedure to the breast self-exam. You can share what you’ve observed about your breasts, ask questions, and get information about your risk factors. We recommend that women start annual mammograms at age 40. If you have a family history of breast cancer then you may qualify for genetic testing and annual breast MRIs. This can help ensure the early detection of breast cancer.

Mammograms have come a long way in recent years, with a 3D option available from some providers. Using the same machine setup as regular mammograms, the 3D mammogram is a high-resolution method that is especially good for women with dense breast tissue. Dense breast tissue, as opposed to fatty breast tissue, can be difficult for a radiologist to read on a regular mammogram. The breast self-exam will not help you detect the density of your breasts—density is only an issue for mammograms. Read more about dense breast tissue on the National Cancer Institute website.

We always encourage all of our patients to do everything in their power to take control of their health. One of the ways to do this is by performing monthly breast exams at home. It’s an easy way to know your body and potentially detect changes that can indicate minor or serious health issues. Please let your physician at West Des Moines OB/GYN Associates know if you have questions about breast self-exams, breast cancer risk factors, or mammograms.
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Categories:

Preventative Care
Oct
27
2020
Coping with a Miscarriage

Although most don’t speak of it, early pregnancy loss is relatively common. Early pregnancy loss or miscarriage is a term for any loss earlier than 20 weeks of pregnancy. The majority of loss occurs within the first trimester or prior to 13 weeks gestation. Studies have shown that the rate of miscarriage is as high as 15%-20% of all pregnancies.

If you or someone you know has experienced a miscarriage, you are probably aware of how emotionally difficult it can be. However, there are ways to cope with this loss so you can grieve and continue on with life and starting a family.

Call Your OBGYN

If you have bleeding or unexpected pain in pregnancy, call your OBGYN. It is crucially important to address it and determine the cause. Your doctor will likely recommend an initial ultrasound and blood work if you have not yet confirmed your pregnancy.

Know That You Are Not Alone.

Thousands of women experience miscarriage every year. Mainstream media has created an open forum for pregnancy loss and celebrities like Chrissy Teigen have been very open about their personal experience with loss.

While knowing you are one of many doesn’t make it easier, it may provide some comfort to you and your partner to realize others are grieving a similar loss. Keep in mind that your partner will grieve this loss, too. However, their experience may be different than yours. Go easy on yourself and each other. You have both lost something and must grieve it in your own ways.

Be Aware of Your Mental State.

The effects of grief following a loss can present as psychological and physical symptoms. Sadness, anger, and confusion can follow the loss, and it may come up at unexpected times. They say time heals all wounds, but grief does not follow a linear path. Do not ignore symptoms that affect your ability to function. For example, if you are too tired and depressed to do daily activities or take care of your basic needs for days at a time, contact your doctor. Consider seeking support through counseling or online support groups for pregnancy and infant loss.

Make Self Care a Priority.

Self-care is something many women put aside, but it’s incredibly important when you’re grieving a miscarriage. You’ve been through a lot. Give yourself the time you need to heal your body and emotions by taking time for yourself. That could include taking time off from work or spending time with a friend. Other self-care activities include getting a facial, writing in your journal, reading, and crafting. Take time to rest when you need it so you can return to your regular activities when you are ready.

Accept Support.

If your sister brings you dinner, accept it with gratitude. If you need company, call a friend who has reached out to you in the past. Reconnect with people at your own pace, but allow kindness to help you heal your heart.

Your doctor at West Des Moines OB-GYN can help guide you to organizations that help families through the difficulties of miscarriage and loss of a child. The March of Dimes organization has a long history of helping families have healthy babies. Their website also addresses the complications and loss of a pregnancy. Please reach out to your ob-gyn if you are having difficulty coping with a miscarriage.
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Categories:

Obstetrics
Sep
09
2020
What is Uterine Prolapse and How is it Treated?

Uterine Prolapse & Weakened Pelvic Muscles

Uterine prolapse can be a disturbing occurrence. A Uterine prolapse occurs when the uterus drops into the vaginal canal. In severe cases, the uterus can even protrude out of the vagina. While many think it occurs as part of aging, this issue can occur at any age, whether you are past menopause or not. Fortunately, most cases are mild, and there are some steps you can take to strengthen the pelvic floor muscles and ligaments. Receiving prompt treatment for uterine prolapse symptoms may help you avoid a more serious case.

Uterine Prolapse Symptoms

Uterine prolapse occurs when the muscles and ligaments in the pelvis weaken to the point that they no longer provide support for the uterus. It can occur in women of any age, but it is most likely to occur in women who have had multiple vaginal deliveries who are past menopause.

Symptoms to watch for include heaviness or pulling sensations in the pelvis, sexual health issues, and looseness in the vaginal tissue. Constipation, incontinence, urine retention, and recurring bladder infections may also be signs of weakening pelvic muscles. When uterine prolapse occurs, there may be vaginal bleeding or increased discharge as well as tissue protruding from your vagina. You may feel like you are sitting on a ball or something is falling out of your vagina. When the symptoms affect your normal life or cause discomfort, it is time to seek treatment.

Avoid Stress on the Pelvic Floor

Some of the causes of uterine prolapse include delivering a large baby, repeated heavy lifting, obesity, chronic coughing and constipation. These issues may result in stress to the pelvic floor muscles that support the vagina and urethra.

You may be able to protect your pelvic floor by avoiding added stress in that area. Losing weight is one way to reduce the pressure on the organs and pelvic floor muscles. Adding vegetables to your diet can help with weight loss while also avoiding the discomfort and strain associated with constipation. And if you have a chronic cough, be sure to treat it appropriately. Also, avoid stressors such as repeated heavy lifting.

Correct lifting is easier on your body, including your pelvic region. Remember to use your legs to lift. Try not to bear down at the trunk or use your waist or back to lift heavy items or weights.

Complications of Uterine Prolapse

If left untreated, uterine prolapse can become severe and other pelvic organs may begin to prolapse. The tissue around the bladder can weaken and cause the bladder to bulge into the vagina. This is called anterior prolapse or cystocele. A posterior vaginal prolapse is when the tissue around the rectum weakens, causing the rectum to bulge into the vagina.

Diagnosis & Treatment

If you think uterine or pelvic organ prolapse is causing you discomfort and interfering with your life, you’ll want to visit with your OBGYN. Let them know about the symptoms you’re experiencing and expect to receive a pelvic exam. In the pelvic exam, the physician will insert a speculum into the vagina so the vaginal canal and uterus can be examined. The doctor may ask you to bear down in order to evaluate the severity of the prolapse. Your exam may also involve a catheter to check or bladder function.

Mild cases of uterine prolapse may not require intervention, but some simple preventive treatments could help avoid a more serious issue. One thing you can do to strengthen the pelvic floor is to perform Kegel exercises. These simple exercises can be done when the bladder is empty by clenching and releasing the pelvic floor muscles for 10 seconds at a time. Ask your OBGYN for details about Kegel exercises so you do them properly. Pelvic floor physical therapy can also be helpful in reducing symptoms and strengthening the pelvic floor.

Other Treatments

Other treatments include Pessaries and surgery. Some cases of uterine prolapse can be treated by wearing a device called a pessary. The pessary is inserted into the vagina. It fits in the vagina and supports the prolapsing tissue whether it be the uterus, bladder, or rectum. Vaginal estrogen may also be prescribed in conjunction with a pessary to restore hormones needed for the muscles and tissues in the genital region to function well.

Surgery may be required to treat more serious cases of uterine prolapse. A hysterectomy removes the uterus so it can no longer prolapse. Many times a repair over the bladder and rectum are done simultaneously to correct anterior and posterior prolapse. Ligament suspensions are utilized in order to prevent further prolapse of the vaginal vault. A Sacrocolpopexy suspends the vaginal vault utilizing mesh.

How We Can Help

With proper treatment of symptoms, you may be able to avoid a more serious case of uterine prolapse. Contact your gynecologist at West Des Moines OBGYN Associates to learn more about the prevention and treatment of pelvic organ prolapse.
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Categories:

Gynecology