Women's Health FAQs
CAN I GET A PAP SMEAR OR PELVIC EXAM WHEN BLEEDING?
A Pap smear is the part of your gynecology exam when the doctor examines and swabs cells from your cervix in order to screen for cervical cancer. The collected cells are then sent to a lab for testing. It is not unusual for you to have spotting after getting a Pap smear.
But what if you are bleeding already due to your menstrual cycle or unknown cause, should you reschedule?
No. Remember your gynecologist is trained to find the cause of abnormal bleeding and would rather you keep your appointment than delay your screening. Although heavy bleeding may result in inconclusive results, light to normal period bleeding in most cases, will not interfere with your testing.
Bottom line, it is better to plan for routine screening when you don’t expect to be bleeding but if it cannot be avoided, it is always better to be seen than to delay your visit.
WHY DO I LEAK URINE WHEN I COUGH OR EXERCISE?
Do you sometimes laugh so hard that tears run down your…LEG?
Stress urinary incontinence is leaking when “stress” (coughing, sneezing, exercising) forces the bladder to open. Many women also experience stress incontinence during intimate moments.
Although, incontinence is often not a dangerous condition, it can negatively impact quality of life, activities, and social interactions.
A detailed history and thorough examination is needed to diagnose whether you have stress, urge, or mixed type of incontinence. New or suddenly worse incontinence, especially when associated with frequent urination may be a sign of an infection or overactive bladder syndrome (OAB).
There are both surgical and non surgical interventions for the various types of incontinence.
Schedule your consultation today.
DO I NEED TO HAVE A PERIOD?
A menstrual cycle or period is bleeding from the uterus that happens when the brain, ovaries, and uterus are communicating normally with each other. This communication is through hormone levels that are biologically programmed to start signaling at puberty until menopause.
Hormonal medications, like birth control, can be used to regulate this process and even prevent periods. Once normal cycles have been established, many women choose to use medications to limit them or prevent them completely until pregnancy is desired.
However if you are not on hormonal medication and have not had a period by the age of 14 or you are having periods that come too often or skip months, “something” is wrong.
Menstrual cycles should typically start by age 14, occur every 28 days, and last no more than 7 days. Your period should not be too heavy or painful that it limits your activities.
Schedule a consultation with your gynecologist to discuss any irregular bleeding or symptoms related to your period.
HOW OFTEN SHOULD I BE TESTED FOR SEXUALLY TRANSMITTED INFECTIONS (STIS)?
The CDC recommends that all sexually active women younger than 25 years of age should be tested yearly for STI’s including Gonorrhea or Chlamydia.
Sexually active women 25 years and older with risk factors including new or multiple sexual partners should be tested for Gonorrhea, Chlamydia and other possible STI’s such as Trichomonas every year.
You should also contact your gynecologist for evaluation if you are experiencing any signs of an STI infection such as abnormal vaginal discharge, odor, itching, irritation or if you have had a possible exposure to an STI.
All adults and adolescents between the ages of 13 to 64 should be tested at least once for HIV.
Anyone who has unsafe sex or participates in IV drug use and shares needles should also be tested for HIV once a year.
Other STI’s including Hepatitis, Syphilis, HPV and Herpesvirus are also included in an evaluation for STI’s depending on a patient’s possible exposure and symptoms.
There is often shame associated with vaginal complaints that leads to unnecessary suffering. Please call us today if you have any concerns. We are here to help.
HOW MUCH BLEEDING IS TOO MUCH DURING MY CYCLE?
Too much menstrual bleeding has been referred to as Menorrhagia. This is when you bleed for longer than 7 days in length or if you lose more than 80ML of blood in a single period. 80ML is equivalent to 1/3 cup or 16 teaspoons.
If you change your (soaked) tampon or pad more frequently than once every 2 hours or you are passing large clots (greater than the size of a quarter) you should contact your gynecological provider for evaluation for menorrhagia.
Untreated heavy menstrual bleeding can lead to anemia and cause you to feel tired or weak and can lead to other health concerns.
If you are experiencing heavy menstrual cycles that interfere with your life activities such as missing school or work or avoiding other activities than it is important to be evaluated.
There are many possible reasons for menorrhagia including uterine or hormonal related problems or other underlying illnesses or disorders such as a bleeding or thyroid disorder. Abnormal bleeding can also be a symptom of certain cancers.
There are many different treatment options depending on the cause of your heavy menstrual cycles. Call today to schedule your evaluation.
WHAT CONTRACEPTION OPTIONS ARE NOT HORMONAL?
If you are not able to take hormones or your prefer to use a non-hormonal birth control method you have options.
Barrier devices prevent pregnancy by blocking sperm from reaching an egg. There are multiple barrier devices including Male and Female Condoms, Diaphragms, cervical caps and the sponge.
These barrier methods are effective but only if used appropriately and still may carry a risk of undesired pregnancy even if used as recommended.
Gels and Foams are non-hormonal spermicides (Kill sperm) or will change to PH of the vagina to immobilize sperm. They help prevent undesired pregnancy by being inserted into the vagina with an applicator prior to intercourse. Some patients may experience symptoms of a vaginal infection such as vaginal itching and burning as well as urinary tract infections.
Withdrawal method is commonly used but does often result in undesired pregnancy even if timed perfectly.
Natural family planning/fertility awareness using a calendar or phone application to determine your time of ovulation and fertile window can be a useful tool in pregnancy prevention. If used perfectly there is still a chance of undesired pregnancy.
Lactational Amenorrhea: When lactating and nursing after pregnancy the release of a hormone called Prolactin is increased. Prolactin inhibits the hormones that cause menstruation. This is effective but still carries a risk of undesired pregnancy.
Copper IUD (Paragard) is an intrauterine device that can be inserted in the office. It contains Copper and is a T shaped device that sits in the uterus and prevents sperm from reaching an egg and also can prevent implantation into the uterine lining. It can stay in the uterus for up to 12 years.
Sterilization is a surgical procedure that is a permanent form of birth control. Second to abstinence, this is the most effective non hormonal form of birth control. There is a risk of ectopic pregnancy if pregnancy does occur.
When it comes to pregnancy prevention, aside from abstinence, no one method comes with 100% guarantee. This is where your gynecologist can help guide you to the best options for you.
WHAT IS HUMAN PAPILLOMA VIRUS (HPV) AND DO I REALLY NEED THE VACCINE?
The Human Papilloma Virus is the most common sexually transmitted infection. HPV can cause warts on different parts of the body such as genital warts.
Many people don’t have any symptoms but can still transmit the infection to others through sex.
High risk strains of the HPV virus can lead to cancers in both men and women including cervical, vaginal, vulvar, anal, penile and esophageal cancers.
There is no cure for the HPV virus and many people will clear the virus on their own without intervention. Treatment focuses on removal of any visible warts and screening for cervical cancer.
The CDC recommends a vaccine that prevents the HPV strains that are most likely to cause genital warts and cancers. It is recommended for both girls and boys. The vaccine is usually given between the ages of 11-12 by their pediatrician. If given prior to age 15 the vaccine is given as a series of two injections at 0 and 6 months. If age 15 or older the vaccine is given in a series of three injections at 0, 2 and 6 months. It is important to have the vaccine prior to exposure as this can prevent cancers later in life.
The vaccine is also approved for adults up to the age of 45 years old, if not received prior.
HPV is so prevalent because it can be spread to others even in the absence of symptoms. Make sure you discuss HPV testing with your gynecologist along with decisions regarding vaccination.
WHAT IS A PHYSICIAN'S ASSISTANT/ASSOCIATE (PA)?
PAs are medical professionals who diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal healthcare provider. With thousands of hours of medical training, PAs are versatile and collaborative.
PAs practice in every state and in every medical setting and specialty, improving healthcare access and quality.