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Frequently asked questions about pelvic health

I recently participated in a live chat with Swedish to answer questions that women had on urine leakage, bladder control treatments, pelvic floor disorders, and other pelvic health topics.

Click here to read through the archive of the chat. I also wanted to answer a few other questions I get asked, but didn't come up in the chat:

What you should know about Long Acting Reversible Contraceptives or IUDs

Does it seem that more of your friends are using IUDs or contraceptive implants?  IUDs, intrauterine devices, and contraceptive implants are becoming more popular in the United States.  In this post, we will discuss these birth control methods and why they are gaining in popularity. 

IUDs are plastic devices that are placed in the uterus by a healthcare provider.  There are three products available in the U.S.:

How to get the most out of your OB/GYN appointment

Unless you are having a baby, seeing an OB/GYN often makes women feel very nervous.  This can lead to forgetting questions, forgetting important information about your condition and leaving feeling dissatisfied.

In order to get the most out of your appointment here are some simple tips:

1. Come prepared!
  • Bring a list of your medications; this can help us be sure that anything we prescribe will be safe for you.  Your problem may also be related to your medication – for example, blood thinners can cause heavy periods.
  • Know your family history. Things that are important for OB/GYNs to know include family member with blood clots, recurrent (more than 3) miscarriages, family members with cancer of the breast, ovary, uterus or colon (bowel.)  It is also helpful to know the age they were diagnosed.
  • Bring a list of questions! The more you ask, the more you’ll know.  We want our patients to be well informed so that we can help you make the right treatment plan for you. Also, there may not be time to go over everything in one appointment so make sure you start with what is important to you.
2. Check your inhibitions at the door!
  • Trust me, we have seen and heard everything and there is very little than can shock us! It is important that you are open and honest so that we can make sure we understand exactly what is going on to come up with the right diagnosis. 
  • It is likely that ...

4 alternatives to a hysterectomy

There are many reasons women need a hysterectomy.

Some of the most common are:

  • Heavy periods that are not controlled on hormones or an inability to take hormones to control the period.
  • Large fibroids that press on the bladder or the bowel, or are so large they can be felt on the abdomen.
  • Endometriosis (usually if this is requiring a hysterectomy it is due to both pain and bleeding).
There are several treatments to avoid hysterectomy:

  • Uterine artery embolization where microscopic plastic beads are inserted into the uterine arteries to block the majority of blood flow to the uterus.  This causes the uterus to slowly shrink in size.  The uterus may decrease to half of its normal size within 2-3 years.  Initially there is a lot of inflammation of the uterus as it loses its blood supply.  The pain associated with this will usually require ibuprofen and narcotics.  Most women stay in the hospital for overnight, and it is usually about 2 weeks before you are feeling well enough to resume normal activities.
  • Myomectomy, a surgical removal of the fibroids.  There are two ...

When should I have my first pelvic exam?

A good time to schedule a visit with a gynecologist (or women’s health specialist) is when you first have problems or concerns with menstrual periods, including premenstrual moods, acne around menses, vaginal discharge or any other cyclic discomfort. That appointment will involve a conversation about what is bothering you and may include a pelvic exam or may not.  Likely the doctor will ask you questions and together you will decide whether or not an exam is necessary.

Around age 13, even if you feel fine and are just wondering when you should come in for a routine exam, is a good time to schedule an appointment to discuss your female health, contraception and screening for sexually transmitted infection.  Vaccinations may be recommended if you have not already received routine immunizations. Some of the things that may be discussed include your health history, family health history, your habits with regard to diet and exercise, smoking or any drug use and sexual activities.  Some of these topics are things you may find difficult to discuss with friends and family.  In the gynecologists office we talk about those things all of the time!  Often we give you pamphlets or point to online resources for you.  The conversation is confidential and it is okay for you to remind the health care provider that you wish it to remain confidential. 

What is a pelvic exam and why might I need one?

A pelvic exam is ...

Swedish Mill Creek to Host Free Seminar Feb. 21 on Treatment Options for Heavy Menstrual Bleeding

MILL CREEK, WASH., Feb. 19, 2013 – If heavy periods are interfering with your daily activities, you’re not alone. It is estimated that one in five women deal with this problem every month. The good news is that there is a wide range of treatment options that can reduce or eliminate those symptoms and get women back to their regular activities.

Do self breast exams matter?

Self breast exams: to do or not to do?

Remember when there were monthly emails you could sign up for to remind you and your friends to do your self breast exams at home? Remember seeing the news anchors talking about their monthly self breast exams in an attempt to remind you to do your breast “due diligence?” What happened to self breast exams and are they still important?

Initially, self breast exams were recommended as a screening tool to help early detection of breast cancer. Unfortunately long-term studies have not confirmed that they actually live up to their hype. Two large studies looking at over 200,000 women in both Russia and China didn’t show any difference in breast cancer mortality after 15 years between the women who were performing routine self exams and those who were not. In fact, the women that were practicing self exams found more lumps and underwent more biopsies for benign reasons. Reviews of several other studies failed to show a benefit of regular breast self-examinations including no benefit of early diagnosis, or reductions in deaths or stage at diagnosis. Hence in 2009, the US Preventative Services Task Force advised that clinicians no longer recommend routine self breast examination as a screening tool for breast cancer detection.

Even though you don’t need to be doing a monthly self exam, you should...

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