Tag Archives: Signs And Symptoms

Low Estrogen: What It Means and What Symptoms to Look For

Low Estrogen: What It Means and What Symptoms to Look For

Estrogen plays a significant role in a woman’s life. Estrogen contributes to reproductive health as well as regulating aging. Most women understand that estrogen levels usually decrease during perimenopause or menopause, a sign that they are leaving the childbearing years behind.

Sometimes, it can happen early, such as when a woman over-exercises on a regular basis (exercise addiction), or she suffers from an eating disorder like anorexia, and her body can no longer maintain estrogen levels.

Decreasing estrogen levels, although considered a normal part of menopause, may cause adverse effects to a woman’s body and her health.

Estrogen in the Body

Estrogen is most notably responsible for the sexual development of girls during puberty. These levels of estrogen fluctuate throughout a woman’s lifetime up until menopause, when low levels of estrogen completely prevent menstruation and ovulation.

Estrogen also regulates:

  • Changes in breast tissue during adolescence and pregnancy
  • Menstrual cycles
  • Body weight, by helping control metabolism
  • Development and growth of healthy bone tissue
  • Healthy cardiovascular activity

With so many effects on various parts of the body, it is important that estrogen levels maintain a healthy standard. Low estrogen levels can be a sign of age, but seriously low levels can have lasting negative effects.

Causes for Concern

Any condition that impairs the ovaries can reduce estrogen production. The most common risk factor for women is age. As women age, perimenopause and menopause cause the body to produce less estrogen. Estrogen levels can also decrease for various other reasons, including:

  • Premature ovarian failure
  • Congenital conditions: Turner syndrome
  • Thyroid disorders
  • Excessive exercise
  • Being severely under or overweight
  • Chemotherapy
  • Low functioning pituitary gland

Other unique cases can include excessive exercising and eating disorders such as anorexia. If a woman is more than 15 percent underweight, the body can no longer maintain normal estrogen levels. In order to maintain healthy levels of estrogen, a woman should maintain a healthy diet, lifestyle, and weight.

Physical Symptoms of Low Estrogen

Effects and Symptoms

As women approach the age of 40, they may wonder what symptoms to look for that herald decreasing levels of estrogen. Estrogen depletion can bring on a combination of hormonal and biochemical fluctuations that can lead to changes in the brain and nervous system.

Irregular Periods

Estrogen is the critical hormone in regulating a woman’s period and menstrual cycle. Low estrogen levels can cause irregular periods, including shorter or longer periods, light or heavier flow, spotting, or missed periods altogether.

Infertility

Low estrogen directly affects ovulation. Without estrogen, ovulation will not occur making it difficult to become pregnant. This is considered infertility.

Hot Flashes and Night Sweats

The most common symptoms and probably the least liked, hot flashes and night sweats can go on for a long time: 7 to 11 years. They are caused by the hypothalamus which controls body temperature. When estrogen levels start going down, the hypothalamus can no longer regulate body temperature and even the slightest change can cause hot flashes or night sweats to bring the temperature down, or chills to bring it back up.

Insomnia and Fatigue

Estrogen produces serotonin, a neurotransmitter in the brain that triggers melatonin, a hormone that helps a person sleep. Once a woman goes into menopause, the depleted estrogen levels produce less serotonin and by extension, less melatonin. With the night sweats that interrupt sleep, fatigue and insomnia become the new normal.

Mood Swings

Hormonal imbalances, that often make teenagers moody and difficult, are back during menopause, making women grumpy. Add lack of sleep and it can get worse. Mood swings – laughing, crying, anger and upset – at the drop of a hat – are all part of the package.

Depression and Difficulty Focusing

Serotonin also affects mood and social behavior, as well as memory, sexual desire and function.  With lowered serotonin levels, depression, not just mood swings, can occur and it becomes more difficult to recover from it. Memory lapses and trouble focusing or concentrating are two more symptoms of low estrogen and serotonin levels. Some experts believe that they put women at a greater risk for Alzheimer’s and dementia.

Physical Symptoms of Low Estrogen

The brain and nervous system are not the only parts of a woman that are affected by menopause and lowered estrogen levels. Of course, the reproductive system’s ability decreases with age as ovary function and estrogen levels go down. But the skin, heart, bones and urinary systems are also affected.

Dry Everything and Low Sexual Desire

Dry skin, dry eyes and a dry vagina are more signs of menopause and low estrogen levels. These can be allayed with moisturizing fluids, such as lotion, eye drops and lubricant (in that order). Unfortunately, reduced sexual desire comes from decreased estrogen and serotonin levels. Menopause also makes the vaginal walls thinner and they lose elasticity, coupled with vaginal dryness, sex can be painful.

The skin loses its moisture-holding abilities as well as its elasticity, leading to dryness, itching, and an increase in wrinkling and sagging. Also, it becomes more susceptible to injury, such as bruising, due to thinning of the skin and it doesn’t heal as quickly. Researchers are beginning to study the lack of estrogen as a possible connection to melanoma, a serious type of skin cancer.

The Heart Connection

As women get older, they become more vulnerable to cardiovascular issues, such as heart attacks, strokes, or other heart-related problems. Hypertension, or high blood pressure is the biggest cardiovascular risk for women in and after menopause. Normally estrogen increases levels of nitric oxide, which is a very powerful dilator of blood vessels, and dilated blood vessels are conducive to healthy blood pressure.

Lowered estrogen levels make hypertension an increasingly bigger factor in women.

Though this may not start until just before perimenopause, it can quickly increase until about age 60, when the new level of blood pressure stabilizes to a new norm.

The Beautiful Bones

After the age of 30, new bone production cannot keep up with bone loss and once menopause hits and estrogen levels decrease, women have an increased risk for low bone mineral density, osteopenia and osteoporosis. This bone density loss can lead to weakening of the bones and an increased risk for fractures and other injuries.

The Urinary System

No laughing matter, incontinence is one of the signs of decreased estrogen levels. Just as with the vaginal walls, the reduced levels of estrogen cause the urethra walls to thin, dry and lose elasticity. This causes the incontinence when coughing, laughing, sneezing or lifting heavy objects. It also leads to feeling the need for frequent urination and an increased risk for developing UTIs.

Weight Gain

Estrogen plays a significant role in weight management and how the body stores fat. During perimenopause and menopause low estrogen contributes to weight gain. Specifically women store more fat in their thighs and hips, which can change during menopause. Eating a healthy diet and exercising regularly can help combat weight gain with low estrogen levels.

Diagnosis and Treatment for Low Estrogen

If any of the above-noted symptoms appear, the first step is to get a physical exam by a trusted physician who can review your medical history and symptoms. It may be necessary to do a blood test to check hormone levels. The doctor may also recommend additional tests to rule out other conditions that might be causing symptoms similar to low estrogen.

Synthetic Hormone Treatment

Hormone Replacement Therapy or HRT is sometimes recommended for women who do not have high blood pressure or other cardiovascular problems. There are various types of HRTs available, including one that combines estrogen with progesterone, a hormone that maintains pregnancy. There are side effects that need to be considered, but these can be discussed with a doctor, to determine which HRT is best.

Sometimes all that is needed are serotonin-boosting antidepressants for those women who end up suffering from depression more than the other symptoms.

Estrogen Therapy

Estrogen therapy is recommended by a doctor or medical expert. In some cases, small amounts of estrogen can be used to combat those who have had small changes in their estrogen levels, such as women who have had their ovaries removed. In other instances, estrogen therapy may be used to treat certain symptoms of perimenopause and menopause.

Natural Treatments

Natural remedies include natural food and soy supplements, maintaining a healthy weight and, in some cases, decreasing the intensity or frequency of exercise. Soy or soybean isoflavones are, at best, an alternative treatment for HRT, and at worst, a controversial treatment with increased risk for breast cancer. It’s best to speak to your doctor or healthcare professional before adding this or any supplement to your diet.

Exercise and eating foods rich in calcium and adding vitamin D supplements during and after menopause is a good way to maintain and increase bone density. Low-fat milk, cheese and dairy products, green leafy vegetables like broccoli, cabbage and okra, as well as soybeans and soy products such as tofu, are great for getting the extra calcium needed. It is important to remember that exercise must also be sufficient, but not excessive. Too much exercise and too little body fat can further decrease levels of estrogen.

Estrogen Overview

Reduced estrogen levels can cause many problems for women, including an increased risk of serious conditions, including heart disease, osteoporosis (softening of bone tissue), and obesity.  However there are ways to lessen the symptoms and the impact of lower estrogen levels to a woman’s overall wellbeing, including her physical, emotional, and sexual health.

The sooner a woman can be screened for low estrogen levels, the better chance she has at combatting the negative effects listed above. AZGYN’s Gynecology Services and Minimally Invasive Procedures can be the solution for many women. They provide an assortment of general health practices and specialized services by expert staff and surgeons. If you are a woman and suspect you have low estrogen levels, contact AZ Gyn today.

What Are The Signs of Perimenopause

What Are The Signs of Perimenopause?

This entry was posted in Menopause and tagged , on by .

Perimenopause is the stage before menopause, also known as menopause transition. As the female body begins to transition into menopause, it also produces less estrogen. This natural transition indicates the end of reproductive years, until eventually the female body no longer produces eggs. During perimenopause, women still have their periods, but the cycles’ durations can change, becoming longer, shorter, or skipped altogether.

Once a woman has not had a period in 12 consecutive months, perimenopause is over, and menopause has begun. The signs of perimenopause are a result of decreasing estrogen, and can be uncomfortable and unexpected. For women approaching menopause, it is important to understand what the signs of perimenopause are. Seeking the right professional counsel and treatment can help make your perimenopause experience more tolerable.

When Does Perimenopause Start?

The change of life that occurs with perimenopause is different for every woman. Typically, the process begins when a woman is in her 40s, but can occur as early as her 30s. Changes in the body due to hormonal fluctuations mark the beginning of perimenopause. However, the true beginning of perimenopause is at birth. At birth, every woman has the total number of eggs she will ever have in each ovary. During puberty, the body ovulates and prepares itself for reproduction. During perimenopause, the opposite takes place. As perimenopause takes place, the body has depleted its supply of eggs ending the natural reproductive cycle. It is important to be honest with your healthcare provider and loved ones if you feel you are in perimenopause.

How Long Does Perimenopause Last?

Perimenopause lasts until menopause begins, which is after 12 consecutive missed periods. In years, perimenopause typically lasts for four years, but some women may only experience perimenopause for a few months, or it may last up to 10 years.

Estrogen During Perimenopause

Changing levels in circulating oxygen throughout the female body are the direct cause of perimenopause. During puberty and a woman’s natural reproductive years, estrogen within the body rises and falls at regular intervals. Two hormones specifically control estrogen: follicle-stimulating hormones (FSH) and luteinizing hormones (LH). Various amounts of FSH and LH control regular ovulation, causing the egg to fall during ovulation. Ultimately, this process is what causes pregnancy, but if pregnancy does not occur, the cycle begins again. Changes in these two hormones during perimenopause alter the cycle completely, until menstruation ceases to occur.

What Are Early Signs of Perimenopause?

Perimenopause might seem to happen unexpectedly, but there are early signs that indicate perimenopause. Symptoms vary among women, and never occur to the same degree. It is important for woman to be observant of their bodies as they approach common perimenopause age. Some of these early symptoms of perimenopause may include:

  • Breast tenderness
  • Worsening premenstrual syndrome
  • Changing cholesterol levels
  • Fatigue
  • Mood swings
  • Vaginal dryness
  • Discomfort during sex
  • Urine leakage
Perimenopause

Women who are unsure if they are experiencing perimenopause should consult their doctor. A doctor can usually diagnose perimenopause based on symptoms alone, otherwise a blood test may be helpful. Blood tests will measure hormone levels, but while hormone levels are changing, it is common practice to take several blood tests at different times for comparison.

What Are Common Symptoms of Perimenopause?

Perimenopause is a biological change in hormones, however common life changes due to aging also play a role in perimenopausal symptoms. A woman should understand what are the symptoms of perimenopause specifically, and differentiate between lifestyle changes such as children leaving, changes in careers, or death or illness of parents common at this time.

  • Perimenopause periods: Irregular cycles and spotting instead of a period characterize perimenopause periods. Changes in periods may include shorter or longer cycles, heavy or lighter flows, spotting, or skipping periods altogether. A change of seven days or more indicates perimenopause, while a change of 60 days or more indicates late perimenopause. 
  • Hot flashes: Most women believe that hot flashes are only characteristic of menopause, but they often begin in perimenopause. Hot flashes can vary from a slight feeling of warmth to an overwhelming feeling of consumption by fire, inside and out. A significant hot flash can induce facial and upper body redness, swelling, chills, visible perspiration, and even confusion. 
  • Decreasing fertility: Irregular ovulation inevitably means that the likelihood of conception and pregnancy decreases. However, even during perimenopause pregnancy is not impossible. Pregnancy is still possible until a woman hasn’t had a period for 12 consecutive months. 
  • Changes in sexual function: Significant changes in a woman’s body will often cause changes in sexual function such as lower sex drive and a decrease in arousal. Vaginal dryness and changes in bladder function can also contribute to changes in sexual function. Restoration of sexual drive should occur after perimenopause has passes. 
  • Nausea: Perimenopause nausea is a result of varying levels of estrogen in the body. When levels of estrogen are particularly high, nausea is highest as well. In some women, this may require rehabilitation through medication or other treatment. 
  • Loss of bone: Loss of bone is also known as osteoporosis. Osteoporosis is a common occurrence as men and women age, but there is a direct link between decreasing estrogen levels and loss of bone.

These are the most common symptoms of perimenopause, but physicians do not consider all signs harmless. In order to rule out other conditions, a woman should consult her doctor if she experiences any other changes in bleeding, such as:

  • Heavy periods with blood clots
  • Periods that last several days longer than usual
  • Spotting between periods
  • Spotting after sex
  • Periods that occur close together

Any of these symptoms can be a result of other issues within the body not associated with perimenopause.

What Are My Perimenopause Treatment Options?

Perimenopause is a natural occurrence within the female body, but treatment is available for symptoms that get in the way of daily functioning. Doctors recommend improving general health and well-being through regular exercise and following a healthy diet, but other treatment options are available.

  • Hormone therapy: Hot flashes are one of the biggest concerns. Hormone therapy, in the form of pills, skin patches, gels or creams, can often alleviate the symptoms.
  • Vaginal estrogen: A vaginal estrogen cream applied directly to the tissue can help alleviate vaginal dryness, discomfort during intercourse, and some urinary problems.
  • Antidepressants: Antidepressants can help alleviate both mood swings and hot flashes.

Perimenopause occurs in all women, as early as their 30s or anytime throughout their 40s. If symptoms are mild, perimenopause may go unnoticed. Perimenopause has officially ended when a women has missed 12 consecutive periods, known as menopause. The most common symptoms of perimenopause include hot flashes, irregular periods, a decrease in fertility, nausea, and changes in sexual function.

Perimenopause is a natural occurrence within the female body. However, it is still important to consult your doctor when these changes occur. Specialists at AZ Gyn can provide early screening for women with low estrogen and treatment for perimenopause. AZ Gyn’s Gynecology Services and Minimally Invasive Procedures assist women towards attaining optimal health, including the treatment of perimenopausal and menopausal symptoms, enabling relief through compassionate, personalized care.

You Should Know These 5 Facts About Birth Control

You Should Know These 5 Facts About Birth Control

Estimates state that more than 99% of the country’s women aged 15 to 44 who have ever had sexual intercourse have used some form of birth control. It’s well past time for a frank discussion on some of the lesser-known facts about birth control every woman should know.

  1. There Is A Wide Variety Of Birth Control Methods

Birth control these days is about more than just the pill and condoms; in fact, a wider variety of options exists than ever before, with over a dozen methods approved for use in the United States alone. Here’s a look at some of the most popular, non-permanent methods:

  • Birth Control Pill

    The birth control pill has long been the most popular method of hormonal birth control for both teenage girls and women. It’s effective when women use it correctly, and can offer positive hormonal side effects for many, such as lightened menstrual periods and their associated pain.

  • Male Condom

    Condoms are the only method that also provides some protection against sexually transmitted infections. This barrier method of birth control has the added benefit of producing almost no side effects for women not allergic to latex.

  • IUD

    Both medicated and copper IUDs provide a barrier to implantation of an embryo into the uterine lining, while the medicated IUD also prevents sperm from reaching the egg, making it even more effective at preventing pregnancy without much chance of user error.

  • Injectable

    Commonly known as “the shot,” injectable methods of birth control feature a hormonal shot when, if given on the proper schedule, prevents pregnancy for up to three months at a time.

  • Other Methods

    Several other methods of birth control exist, though less than two percent of the population uses them. Options include vaginal rings, implants, patches, emergency contraception, barrier methods such as the female condom and diaphragm, and spermicidal methods like vaginal jelly and foam.

What is the preferred form of birth control in your state? Find out here.

 

  1. Most Women And Teenage Girls Aren’t Utilizing The Most Effective Methods

    Most women between 15 and 44 aren’t using the most effective methods of birth control. In fact, the most popular method used by family planning providers is the IUD, though only about seven percent of all women in the US use it. Health care professionals also suggest it for teenage girls for its long-term efficacy, zero chance of user error, and reversibility. Once women receive education about all the methods available to them, over 75% chose the IUD, a drastic increase from the national average.

  1. Different Methods Have Different Side Effects

    Chances are you’ve heard a TV announcer read the side effects list of the advertised birth control method and wondered to yourself if all the side effects are really worth it. While it’s true that most hormonal forms of birth control have potential side effects produced by the different hormones used – and their levels – they have different, and even positive, effects on the user. Combined hormone methods utilize estrogen and progestin, and tend to have a slightly more pronounced signs and symptoms, at least at first. Progestin-only methods skip the estrogen, a trade-off that minimizes hormonal side effects but slightly decreases the efficacy rate.

  1. The Side Effects Truly Are Minimal

    You’ve likely heard one friend or another citing the negative effects of her birth control method, including weight gain, irritability, and altered periods. However, for most women – that is, women without additional health concerns – most side effects decrease in severity and eventually disappear over time. The series of adjustments your body needs to make to incorporate the hormones involved will lessen, and weight loss is even possible at this stage.

  2. Find A Method That Works For You

    Of course, you shouldn’t stick with a birth control method that’s making you miserable – all the FDA-approved methods available in the US are effective and you have a wealth of options available. Try a hormonal method with lower levels of hormones, or an IUD without hormones. If you’re having trouble taking your birth control regularly, switch to a method with less hands-on time. The important thing is making your birth control work for you, so it can have its desired effect – pregnancy prevention.

Birth Control Isn’t Taboo

Birth Control As mentioned above, when more women learn about all the types of birth control available to them, they tend to make different choices that better fit their lifestyles. Discussion regarding your reproductive health isn’t – and shouldn’t be – taboo. Learn about the different methods of birth control that may work for you, and after you make your choice, research the side effects, risks, and how to properly use them.

Deciding when and if you want to get pregnant is one of the most significant health decisions you can make, and talking about your options with a women’s healthcare provider like Arizona Gynecology Consultants is a great first step.

What Is Seborrheic Vulvitis FAQs For Women - Arizona Gynecology Consultants

What Is Seborrheic Vulvitis? FAQs for Women from Women’s Health Professionals

“Do you have vulvar itching that sometimes gets worse with exercise, heat, sex, stress or hormone changes? Do you suffer from ‘chronic yeast infections’ but symptoms seem to return shortly after being treated with pills and creams?

“You may not be suffering from a yeast infection but a condition called seborrheic vulvitis.  Seborrheic vulvitis can be caused by a yeast organism called malassezia globosa.  It lives on all of us and has a job but can sometimes overpopulate causing intense itching, burning, irritation, and even small tears called fissures.  

“Seborrheic vulvitis is not worrisome or contagious but it is bothersome symptoms CAN be treated with the right medications.” 

Wende Scholzen, WHNPWende Scholzen, WHNP
Arizona Gynecology Consultants Women’s Health Nurse Practitioner

What Is Seborrheic Vulvitis?

Seborrheic vulvitis is a form of seborrheic dermatitis that effects the vulva (external female genitals). It is quite common in women, is not considered a serious condition, and can be treated. The condition may also be referred to as vulvovaginitis, or seborrheic dermatitis.

What Is Seborrhea (Seborrheic)?

Seborrhea is defined as “an excessive and/or abnormal discharge from the sebaceous glands.” The sebaceous glands are simply the small glands in your skin that secrete oil (sebum) onto hair follicles to lubricate the hair and surrounding skin. Seborrheic simply means that the condition is directly related to the overactivity of these glands.

What Is Vulvitis?

Vulvitis is inflammation of the vulva, the external parts of female genitalia, including the labia majora and labia minora. Seborrheic vulvitis usually affects the outer skin, closer to where hair follicles are present. However, it can spread to the inner anatomy from outside genitalia.

Symptoms of Vulvitis? 

  • Itching (increasing in intensity and constant)
  • Pain or burning sensations in the vulva area
  • Redness and swelling of the lips of the vagina and vulva area
  • Dry, cracking skin in the vulva area
  • Vaginal discharge
  • Blisters or sores on the vulva area
  • Thick, scaly patches of skin or flaking near and on the vulva

What About Vaginal Itching that Is Not a Yeast Infection? 

Many women who complain of vaginal itching to their gynecologist and women’s health professional adamantly explain that they don’t believe that the chronic dryness and itching is related to a yeast infection – which can have similar symptoms. And those women are often correct.

In many cases, vaginal itching – if it is not due to a yeast infection – is due to some form of dermatitis. The dermatitis could be considered contact dermatitis, if it is due to a reaction from coming into contact with irritating substances such as:

  • Vaginal lubricants
  • Spermicides
  • Latex condoms
  • Latex diaphragms
  • Chemicals in clothing (dyes, laundry detergents, etc.)
  • Scented toilet paper
  • Tampons or sanitary pads
  • Shampoo, soaps or hygiene products

If the symptoms of itching or burning are localized to just the outer parts of the vulva, the condition is more likely to be dermatitis related, rather than a serious condition affecting the interior female genitalia.

Vulvitis: Is It Contact Dermatitis or Seborrheic Dermatitis?

When your gynecologist or women’s health nurse practitioner narrows down the symptoms to dermatitis, the next step is to determine what the cause of the dermatitis is. In many cases the dermatitis surrounding the vulva is found to contact dermatitis – caused by the vulva coming into contact with allergens.

In these cases, the treatment could be as simple as cutting out the allergens and irritants and treating the existing vulvitis with anti-inflammatory medications or creams.

Malassezia Globosa Vulvar Infection 

Malassezia Globosa Vulvar Infection - CDC

Malassezia Fungus (Source: phil.cdc.gov)

Is the cause of symptoms actually seborrheic dermatitis of the vulva, particularly due to malassezia globose? Then, your doctor may choose to prescribe medications to get rid of the fungus. Your doctor may also try to treat the existing inflammation and any damage, scratching or infection that has occurred in the vulvar area.

Talk to Your Women’s Health Doctor

It is so important for women to feel comfortable and trust in talking to their doctor about their vaginal health. It is all too common for women to worry themselves about what women’s health symptoms could be, instead of just sharing with their doctor their worries.

Seborrheic vulvitis is the perfect example of this; the condition is very common and not serious, but because the condition shares symptoms with many more serious conditions, many women fear the worst. If you have vaginal or vulvar itching, burning or other symptoms, speak to your doctor to sort out the cause, instead of guessing.

Find Answers to Women’s Health FAQs

What Are Congenital Uterine Anomalies - Arizona Gynecology Consultants

What Are Uterine Anomalies?

A congenital uterine anomaly is a uterus malformation that occurs during embryonic development. In the earliest stages of the life cycle, a woman’s uterus forms in two separate halves that grow together over time. Any small missteps in this development cycle can lead to a misshapen or malformed uterus, creating uterine problems later in life.

Congenital uterine anomalies happen to less than 5 percent of women. However, about 25 percent of women who miscarried have some sort of congenital uterine anomaly. Congenital uterine anomalies mostly occur due to random variations during embryonic development, but some uterine anomalies can result from in-utero exposure to certain substances.

For example, baby girls exposed to diethylstilbestrol (synthetic estrogen) are more prone to develop congenital uterine anomalies than others. Doctors often used this medication between 1938 and 1971 to help prevent miscarriages and premature births. Today, there are no known risk factors proven to increase the potential of developing a congenital uterine anomaly.

Types of Congenital Uterine Anomalies

Ultrasound is one of the most-used methods for diagnosing the type of uterine anomaly present in a patient. Doctors will use ultrasound imaging to determine how the patient’s uterus developed and what type of complications the anomaly may present later in life. Different anomalies will produce different effects and lead to varying long-term health complications.

Septate Uterus

One of the most common types of uterine anomalies, a septate uterus, describes a uterus with a normal uterine surface, but with two endometrial cavities. This anomaly occurs when the two halves of the uterus only partially combine during fetal development.

Bicornuate Uterus

The other most common uterine anomaly is a bicornuate uterus. Like the septate uterus, a bicornuate uterus has two endometrial cavities and one external uterine surface. However, a bicornuate uterus has an indented and abnormal uterine surface.

Arcuate Uterus

This uterine anomaly describes a uterus with a 1 cm or smaller indentation in the endometrial cavity.

Unicornuate Uterus

A unicornuate uterus develops only on one side. During fetal development, a baby girl’s uterus develops in two halves that gradually combine to form a single uterus. This anomaly occurs when only one half develops.

Didelphys Uterus

This uterine anomaly describes when the two halves of a developing uterus never combine, resulting in two separately developed halves.

Müllerian Anomalies

This congenital disorder affects about 4 percent of females and occurs during fetal development. This condition results from a malformation of the process of developing Müllerian ducts in the female reproductive system.

These conditions are more than just uterine anomalies, and kidneys often suffer as a result. A woman with a Müllerian anomaly may be missing a kidney, leading to additional medical complications later in life.

Symptoms of Uterine Anomalies

One common thread shared by all the different possible uterine anomalies is that most are asymptomatic. Some women may experience increased pain and discomfort during menstrual cycles, but for the most part, these anomalies do not create significant symptoms on their own.

However, the resulting symptoms often interfere with pregnancy and contribute to lost pregnancies and infertility. Many women do not discover they have a uterine anomaly until they undergo screening for infertility or miscarriage.

After one or more miscarriages, a woman may decide to have a screening to determine the cause, and this is the point when doctors diagnose most uterine anomalies. Women who do experience negative symptoms typically report inconsistent periods or no periods, but the most commonly reported symptoms relate to pregnancy.

Identifying Uterine Anomalies

Doctors use ultrasound imaging to determine which type of uterine anomaly a patient has, and treatment can include many options. Uterine anomaly surgery is a viable option for some women, as it may help restore uterine function and allow for a healthy pregnancy.

However, some anomalies are more difficult to treat, often leading to more significant medical complications. Doctors may also use hysterosalpingograms or MRI procedures to help diagnose uterine anomalies.

Treating Uterine Anomalies

Most uterine anomalies will not require treatment, but treatment generally involves surgery for uterine anomalies. After a positive diagnosis for a uterine anomaly, a women’s surgery specialist will advise the patient about her options.

Most corrective surgery is minimally invasive with little risk, but physicians will recommend surgery only if the uterine anomaly:

  • Prevents pregnancy
  • Results in miscarriage
  • Causes significant pain

Women who have a septate or bicornuate uterus may have the septum wall between the two endometrial cavities removed to restore healthy uterine function. In the case of a unicornuate uterus, the surgeon may remove the undeveloped portion of the uterus, and the patient could possibly have a viable pregnancy using the intact portion. Women at greater risk for premature delivery may require a cervical cerclage to prevent premature cervical dilation.

Is Surgery Right for Me?

Physicians only recommend surgery for a uterine anomaly if the condition prevents pregnancy or prevents the woman from maintaining a pregnancy to full term. In some cases, uterine anomalies can prevent a placenta from attaching correctly, resulting in a miscarriage.

Here are some vital facts to know about uterine anomalies an pregnancy:

  • A woman with a septate uterus has a 25 to 47 percent chance of experiencing a miscarriage.
  • A woman with a bicornuate uterus will have a higher risk of going into preterm labor.
  • Someone with a unicornuate uterus will have about a 37 percent chance of experiencing a miscarriage, and about a 17 percent chance of preterm labor.

Other medical issues, including cervical insufficiency and uterine fibroids, can also interfere with pregnancy and full-term delivery. It’s up to the individual to decide whether her anomaly warrants surgical intervention.

Ultimately, a uterine anomaly may result in only a slightly higher risk of miscarriage for a small malformation, but more significant uterine anomalies can make pregnancy or maintaining a pregnancy to full term impossible. Women should consult their physicians if they have trouble conceiving or experience a sudden onset of symptoms that could indicate a uterine anomaly.

Learn More About Infertility Problems and Testing

How Long Does Menopause Last on Average - Arizona Gynecology Consultants

How Long Does Menopause Last on Average?

This entry was posted in Menopause and tagged , on by .

The menopausal transition, or simply “menopause,” is a normal part of female aging. Once you start the transition, you’ll probably want to know exactly how long symptoms will last.

While every woman is different, here’s what to expect on average.

About Menopause

Estrogen Levels During Menopause Ages Graphic - Arizona Gynecology ConsultantsAll women experience menopause, with several different symptoms.The symptoms vary from woman to woman, and menopause is as unique a journey as the woman herself.

Menopause symptoms may include:

  • Hot flashes
  • Chills
  • Sleep problems / insomnia
  • Mood Swings / irritability
  • Pain during sex / vaginal dryness
  • Depression
  • Dry skin, dry eyes or dry mouth
  • Urinary urgency (a pressing need to urinate more frequently)

In few cases, women don’t have trouble with these symptoms. Once the menopausal transition is complete, you will no longer have to worry about periods or getting pregnant.

Hot Flashes

For most women, menopause is a relief that feels freeing in many ways. Getting through the transition, however, can be trying.

Knowing about how long your symptoms will last can help you focus on the light at the end of the tunnel. While you’re going through abrupt hot flashes and night sweats that keep you awake at night as well as irritability from lack of sleep, knowing that you’re just X amount of days from it being over can ease your mind.

 

Related Reading: Identify the Signs of Menopause [Infographic]

 

While there is no guarantee of exactly how long the transition will last, you can get a good idea of where you are on the journey by understanding the process and studying an average timeline.

The Average Timeline for Menopause

The menopause age range varies by more than a decade. The average age is 51, but menopause can start in women from their mid-40s to late 50s. Most women experience the menopause stage in this age range, while some report symptoms into their 60s.

Natural menopause happens in three stages:

  • Perimenopause
  • Menopause
  • Postmenopause

Sometimes perimenopause is confused with menopause. Perimenopause is when a woman starts to have hot flashes, night sweats and vaginal dryness. This can start as early as the 30’s or as late as the 60’s. This is considered either early or premature menopause and late menopause, and can occur for a variety of reasons, such as surgeries or hormonal changes.

Some women in perimenopause may also have the following symptoms:

  • Breast tenderness
  • Worsening of premenstrual syndrome (PMS)
  • Irregular periods or skipping periods
  • Periods that are heavier or lighter than usual

Additional symptoms may include:

  • Racing heart
  • Headaches
  • Joint and muscle aches and pains
  • Changes in libido (sex drive)
  • Difficulty concentrating, memory lapses (often temporary)
  • Weight gain
  • Hair loss or thinning

These symptoms are normal as part of the loss of estrogen production. However, if these are new symptoms after starting perimenopause, consult your doctor in order to rule out other health issues.

Menopause that occurs before the age of 45, regardless of the cause, is called early menopause. Menopause that occurs at 40 or younger is considered premature menopause. Perimenopausal symptoms and age will be as individual as each woman. Talk to your doctor if you’re not sure whether you’re beginning the menopausal transition. 

Contributing Factors 

Primary Ovarian Insufficiency (POI) is another cause of premature menopause. With POI, younger women under 40, who have occasional  or no periods, and elevated levels of follicle-stimulating hormone (FSH), will have fewer eggs in their ovaries. This means lower estrogen levels as well and can cause bone density issues.

Happy womenAccording to the SWAN (Study of Women Across the Nation) study, smoking, either as a current smoker or former smoker, can also cause early onset of perimenopausal symptoms, such as hot flashes and night sweats, by at least two years. Being overweight, stressed, depressed, or anxious can also start the ball rolling early. Ethnicity also plays a factor. African American women have a longer period of hot flashes – almost 11 years, while Japanese and Chinese women had half the time of dealing with hot flashes.

How Long is Menopause?

The perimenopausal stage can last from 10 months to four years on average, but has been known to last up to 10 years. It involves the body gradually decreasing in estrogen production until the last year or two, when estrogen levels drop dramatically. Perimenopause officially ends when a woman does not have her period for 12 consecutive months. 

Stages and symptoms of menopause

The woman is now at menopause. This is a point in time, rather than a period of time. The period of time after menopause is called postmenopause. Perimenopausal symptoms, such as hot flashes and night sweats may continue for another few months or even years after menopause has been reached. 

Other symptoms that may continue are sleep problems, cognitive issues, mood changes and muscle and joint pain. Vaginal dryness is a symptom that will continue and tends to get worse with age. Although, less than 30% of women experience it during perimenopause and only half experience it in postmenopause.

So, how long does menopause last? From the start of perimenopause to the final cessation of all menopausal symptoms, the average transition takes between two and 10 years. There are some women who go through the process more quickly or more slowly than the median time.

If you experience early or late menopause, you may need to add or subtract a year or two to this average timeline. Every woman should rely on medical professionals to assess symptoms, estimate the duration and prescribe treatments for symptom relief.

Do You Have Early or Late Menopause?

Figuring out if you’re going through the transition early or late can help you gain a better understanding of how long menopause will last. If you start having irregular periods in your mid-40s, you may be experiencing early or premature menopause.Menopause Infographic

Heavy bleeding, spotting, a period after a year of no periods, or periods that are noticeably longer or shorter than normal can all signal early menopause, especially in combination with other common menopausal symptoms. 

If you are 55 or older and still haven’t noticed menopause symptoms, your doctor may diagnose you with late-onset menopause.

Late menopause may actually have some health benefits, while early menopause could potentially cause problems. During menopause, the production of estrogen and progesterone by the ovaries declines. In early-onset menopause, this cessation may cause problems such as osteoporosis. The longer your ovaries produce estrogen and progesterone, the longer you can avoid osteoporosis.

If you’re still having periods in your late 50s and 60s, see your doctor. Each woman’s reproductive system is different, so don’t be alarmed until you’ve spoken to a doctor.

Treating Menopause Symptoms

You may experience one or several symptoms, or hardly any symptoms at all. You may not notice perimenopausal symptoms until you’ve almost reached the menopause phase. Your entire transition could finish in just a few years, or could last longer than a decade.

Everyone is unique, and there is no concrete answer. It takes seeing a primary doctor to evaluate your symptoms, locate where you are on the general timeline, and estimate how much longer you will have to put up with symptoms.

obgynWhile you are combating symptoms for an unknown period of time, look into common forms of relief. If you have medical conditions exacerbating the symptoms of menopause, such as arthritis, chronic pain, anxiety or depression, your doctor can help address these issues to potentially reduce menopause symptoms.

Menopause is a normal part of life, and several tried-and-true treatment options exist to help control and tolerate common symptoms. You can maintain your desired lifestyle while experiencing menopause with a tailored treatment plan. We have expert women’s health services, if you are seeking a gynecologist in Phoenix. Talk to us about your symptoms and concerns, especially if your perimenopausal symptoms negatively affect your quality of life. We’re here to help.

Identify The Signs And Symptoms Of Menopause - Arizona Gynecology Consultants

Clinical and Holistic Remedies for Menopause

Have you entered pre-menopause? Or are you already dealing with menopause?

Looking for ways to deal with the onslaught of changes your body is dealing with?

To illustrate the signs and symptoms of menopause, we have taken the time to produce an expansive, helpful infographic that features not only signs that menopause may be starting, but also clinical and holistic ways of alleviating these symptoms.

Signs Symptoms and Holistic Clinical Remedies for Menopause Infographic - Arizona Gynecology

Learn Even More About Menopause

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.

 

Related Reading: How Long Does Menopause Last on Average?

 

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.