Monthly Archives: August 2017

What is Menopause - Arizona Gynecology Consultants

What Is Menopause?

Menopause is a gradual process that eventually leads to the cessation of menstrual periods. Once a woman becomes menopausal, ovarian functions cease, and she will no longer be able to have children.

Menopause generally occurs in the early 50s, but some women can experience it as young as the 30s or as old as the 60s. There is currently no way to predict when a woman will experience menopause. The time at which a woman begins having menstrual periods is not an indication of when menopause will occur.

Women experience menopause differently, and it can be an emotional experience. The loss of the ability to have children will hit some women harder than others. A woman who has already given birth may not consider it as devastating, but a woman who has never had children and who experienced menopause earlier than usual may find the news crushing.

Symptoms of Menopause

Menopause generally includes three stages. The perimenopause stage is the onset of menopause, during which various negative symptoms may manifest.

The second stage is menopause, during which menstrual periods cease. The last stage is the postmenopausal stage, and women who have completely experienced menopause will sometimes need to make adjustments to this new reality.

First Stage: Perimenopause

Perimenopause can last for quite a long time and generally entails symptoms that prepare the woman’s body for menopause. During the years between the onset of perimenopause and menopause itself, women generally experience:

  • Low estrogen levels
  • Decreased sexual interest
  • Worsened premenstrual symptoms
  • Fatigue
  • Vaginal dryness
  • Urinary incontinence
  • Breast tenderness
  • Hot flashes

Perimenopause lasts for about four to five years or until menopause occurs, which is when the ovaries stop releasing eggs altogether.

Second Stage: Menopause

The full onset of menopause refers to the cessation of menstrual cycles for one full year. During this time, women may experience a wide range of possible effects, and may develop other medical conditions as a result.

For example, some women develop osteoporosis or heart disease during menopause. Many women also experience:

  • Mood changes
  • Hot flashes
  • Vaginal discomfort
  • Urinary problems

Doctors can provide customized treatment to individual patients to address their unique symptoms.

Final Stage: Post-Menopause

The term “postmenopausal” simply refers to women who have already reached menopause. Every woman will experience menopause and the postmenopausal stage differently.

Hormonal imbalances can lead to the appearance of more body hair in some women, as testosterone production continues while estrogen production diminishes. Some women experience weight fluctuations and changes in skin texture.

External Causes Of Menopause

Although every woman will inevitably experience menopause, some women experience it at earlier ages due to external influences. Some medical conditions and diseases may require surgeries that cause menopause to begin very soon thereafter. For example, a woman who must have a hysterectomy will experience menopause immediately afterward.

Women who experience menopause in this manner often report more significant symptoms than women who experience menopause naturally. However, some women who undergo surgical removal of the ovaries do not report any symptoms afterward.

Ovarian Complications

Some women will experience menopause early due to problems with the ovaries. If a woman develops ovarian cysts or ovarian cancer, her doctor may recommend surgical removal, which will then spur the onset of menopausal symptoms. Typical menopause entails a full year of cessation of ovarian function, so surgical removal of the ovaries will lead to menopause.

About 1 percent of all women experience premature ovarian failure – or ovarian failure before 40. Doctors cannot predict when this will occur and do not know for certain why it happens; many researchers suspect genetic links and autoimmune diseases as contributing factors.

Cancer Treatment

Women who develop some cancers and undergo radiation treatment and chemotherapy may also experience menopause sooner than expected. Depending on the location of the cancer and the treatments, an ovulating woman can experience menopause due to interference from these treatments.

Menopause symptoms may start during or immediately after cancer treatment, but some women do not report experiencing such symptoms for quite a long time after completing cancer treatment.

What Is Menopause: Treatment Options

Although some external factors can cause menopause early, naturally occurring menopause is a fact for every woman. While menopause is not a medical condition and does not require treatment, it can still produce negative symptoms for some women. Doctors can prescribe different medications to handle hot flashes, mood swings, cramps and other issues. Some women benefit from hormonal treatment.

Doses of estrogen can help make up for lost natural estrogen production. Women who experience vaginal dryness, unwanted hair growth and hot flashes can find relief with hormone therapy.

However, doctors are often hesitant to prescribe these options unless necessary, due to their links to increased risk of stroke, heart disease and breast cancer. Estrogen and progestin can increase these risks in different ways, and estrogen-based hormone therapy can lead to the development of endometrial cancer.

See Infographic on Remedies for Menopause

Finding the Right Solution for You

Every woman experiences menopause differently, and it’s vital for every woman to know the best options for handling the potentially unpleasant side effects of the different stages of menopause.

The providers who work with Arizona Gynecology Consultants have experience handling all aspects of menopause and postmenopausal health, so contact us for more information about resources in your area.

What Is Urinary Incontinence - Arizona Gynecology Consultants

What Is Urinary Incontinence?

Urinary incontinence is the accidental release of urine. Although this can be embarrassing, it does not pose any significant health problems. This issue is common among older women and women who have undergone some medical procedures.

Incontinence may only be a temporary issue for some women. Treating the root cause of a temporary case of urinary incontinence will usually solve the problem.

Types of Urinary Incontinence

Doctors categorize urinary incontinence patients by how long their symptoms last, and by which symptoms they display. The most common type of urinary incontinence in women is stress incontinence or incontinence caused by pressure or stress in the bladder. This can cause urine to leak while:

  • Running
  • Laughing
  • Coughing
  • Sneezing
  • Doing any other physical activity that puts pressure on the bladder

The other type of urinary incontinence is urge incontinence, or leaking preceded by a strong urge to urinate. Some women will have little to no warning before leaking occurs, while others may experience an overwhelming need to urinate and do not make it to a restroom in time.

Some women have overactive bladders that can respond to stimuli like the sound of running water or by placing a hand in running water. Older women often experience a combination of both types of urinary incontinence.

Diagnosing Urinary Incontinence

A doctor will assess a patient’s medical history and patterns of incontinence to determine the root cause and best method of treatment. During the screening process, the doctor may use:

  • Ultrasound imaging
  • Cystoscopy
  • Urodynamic testing
  • Urinalysis

A doctor may also wish to perform a bladder stress test to gauge whether a patient is struggling with stress incontinence or urge incontinence, as the treatments for the two types of incontinence differ.

A doctor may also ask a patient to keep a “bladder journal,” or to start recording urination times, stressors that cause leaking, and daily nutrition intake. This helps form a more accurate picture of a patient’s incontinence issues.

Causes of Stress Incontinence

Stress incontinence develops over time or after certain life events, such as sudden weight gain or childbirth. Women who have previously had little to no trouble with urinary incontinence may suddenly experience more significant leaking after events such as these.

Other medical conditions, injuries or physical activities that weaken the muscles of the pelvic floor can also lead to stress incontinence. When the pelvic floor muscles cannot support the bladder, it will drop down and press against the vagina, making it difficult or impossible to use the muscles that close the urethra.

Causes of Urge Incontinence

The root of a case of urge incontinence is an overactive bladder muscle. Such a muscle will push urine out of the bladder, even if only a small amount is present. Some neurological conditions like Parkinson’s disease and stroke can lead to urge incontinence, while other cases develop due to stress or bladder irritation.

What Is Urinary Incontinence: How to Treat It

Treatment for stress incontinence, urge incontinence or a combination thereof can involve several possible options. Some women benefit greatly from physical therapies such as Kegel exercises that strengthen the pelvic floor muscles. This is a proven effective method for women who suffer from stress incontinence.

Other women may find devices like pessary rings to be effective. These small, removable devices fit inside the vagina and put pressure on the urethra, preventing leaks.

Certain medications may prove useful for some patients, but most medications that improve stress incontinence come with a host of unpleasant side effects. You should speak with your doctor at length about the pros and cons of medication for stress incontinence.

Finally, surgery is a last resort option to restore the bladder to its original position. Doctors generally only recommend this if other treatment options have failed.

Lifestyle and Behavioral Therapy

Women who struggle with urge incontinence may benefit from “bladder training,” or performing regular exercises to help them learn to hold it longer. These exercises may not work for every woman, so doctors will sometimes prescribe medication to regulate bladder urges. In some cases, simple dietary changes like limiting caffeine intake can help.

Overcoming Urinary Incontinence

Women of all ages who struggle with urinary incontinence can find solutions that work for them. Minor cases may only require temporary solutions like period pads during times when incontinence is predictable. For example, some women may only experience urinary incontinence while jogging. So doing Kegel exercises to strengthen the pelvic floor muscles could be an effective solution.

For more advanced or complex cases, medication or surgery may be the only solutions. Women should consult their gynecologists and other health care providers closely to find a safe and effective solution for urinary incontinence. While often effective, some medications and surgical procedures will entail significant side effects.

Arizona Gynecology Consultants helps patients connect get connected to a large network of trusted, experienced providers who can address all aspects of gynecological and uterine health. Women who experience urinary incontinence issues can contact us for more information on resources and providers in Arizona, or for more info on the services we offer.

What Are Uterine Fibroids - Arizona Gynecology Consultants

What Are Uterine Fibroids?

Uterine fibroids are small, benign tumors that grow in the uterus. They are made of the same type of cells found in the walls and connective tissues of the uterus.

In some cases, they embed in the walls of the uterus, but some fibroids will project from the outer surface of the uterus into the abdominal cavity. Others can cluster inside the uterus and project into the interior space of the uterus.

The cause of uterine fibroids is not known, but some women are at higher risk of developing them than others. Black women receive uterine fibroid diagnoses 2 to 3 times as often as other women, and uterine fibroids only rarely appear in young women who have not started menstruating.

Uterine fibroids will stop growing and dissolve over time after menopause.

What Does My Uterine Fibroid Diagnosis Mean?

Uterine fibroid diagnoses are incredibly common, and about 70 to 80 percent of women will receive a uterine fibroid diagnosis before age 50. If your doctor recently diagnosed you as having uterine fibroids, don’t be alarmed: Uterine fibroids are not cancerous, and the worst symptoms they cause are manageable.

While this condition can cause some unpleasant symptoms, many women with uterine fibroids do not have any symptoms at all, and the condition is not medically threatening.

Possible Symptoms of Uterine Fibroids

Most uterine fibroids do not cause any noticeable symptoms. If a doctor discovers uterine fibroids that are asymptomatic during a routine gynecological exam, he or she will likely suggest a wait-and-see approach for monitoring the fibroids in the future. The doctor may wish to confirm the uterine fibroid diagnosis with imaging scans like an ultrasound or pelvic MRI.

Women who experience negative symptoms from uterine fibroids typically report painful or excessive bleeding during periods, or bleeding between periods. Uterine fibroids may also cause abdominal swelling or a feeling of fullness.

If fibroids compress the bladder, the woman may experience a frequent need to urinate or may have difficulty urinating. Uterine fibroids can also cause lower back pain and pain during sexual intercourse.

Excessive bleeding during periods is a common issue, and some women develop anemia from the blood loss and can suffer other medical complications as well. If these symptoms are severe enough, the woman’s doctor may recommend one of several possible treatment options.

What Are Uterine Fibroids: Treatment Options

A doctor will only treat a case of uterine fibroids if they are causing the patient significant discomfort. The type of symptoms the patient displays, and the severity of those symptoms, typically determines the best course of treatment.

Women who experience only mild pelvic pain may benefit from over-the-counter anti-inflammatory and painkiller medications like ibuprofen. If the pain is too severe for these drugs to handle, the woman’s doctor can prescribe a stronger medication.

Hormone Treatment

While doctors have yet to pinpoint the causes of uterine fibroids, they do believe that uterine fibroids have an easier time developing in an estrogen-rich system. Some doctors may wish to treat uterine fibroids with hormonal medication to limit estrogen production, but it’s important that women understand the effects of hormonal medications.

While a birth control pill may contain hormones that reduce excessive bleeding and decrease a woman’s pain during menstruation, birth control pills that contain estrogen can cause uterine fibroids to grow. This treatment would effectively only manage the symptoms while making the cause of those symptoms worse.

Uterine Fibroids and Pregnancy

Some women may wonder if uterine fibroids interfere with pregnancy. Since estrogen encourages fibroid growth, a woman’s existing uterine fibroids may enlarge during the first trimester when estrogen levels are highest. However, the tumors will later shrink after birth.

Surgical Options

Advanced cases of uterine fibroids that cause significant pain and discomfort may require surgery. The two types of surgery that can solve a uterine fibroid problem are:

  • Hysterectomy
  • Myomectomy

If a woman undergoes a hysterectomy during her childbearing years, she will no longer be able to have children. Some women may not wish to have children, or any more children, and find this acceptable if it stops the unpleasant symptoms of the fibroids.

Women who wish to remove their uterine fibroids but still want to be able to bear children may opt for a myomectomy instead. A myomectomy procedure removes the uterine fibroid tumors while leaving the uterus intact.

Doctors perform myomectomies in three different ways:

  • Laparotomy: The doctor enters the uterus through a small incision in the abdomen to remove the uterine fibroids.
  • Laparoscopic myomectomy: The doctor uses a small, thin telescopic instrument through a small incision in the navel to reach the uterine fibroids.
  • Hysteroscopic myomectomy: A procedure which involves inserting a hysteroscope through the cervix to extract the uterine fibroids through the vaginal opening.

Finally, if a woman does not wish to undergo surgery and wants to keep her fertility intact, she can opt for a fibroid embolization procedure. This is a minimally invasive outpatient procedure during which an interventional radiologist shrinks the uterine fibroids by cutting off their blood supply. The patient will often be able to go home the same day as the procedure after a short recovery period.

Know Your Options

Uterine fibroids can be unpleasant and cause a host of problematic symptoms, so women should always refer to their gynecologists for their recommendations for treatment and handling symptoms. Arizona Gynecology Consultants works with a large network of trusted medical providers, so reach out to us if you have questions about managing your uterine fibroids.