Probably the most common side effect that is reported as the result of an endometrial biopsy is the pain afterward. This usually comes in the form of cramping, and will usually last several hours after the procedure, but may continue for several days. Doctors will usually prescribe some sort of narcotic pain medication as a result of this procedure, because so many report pain afterward. The level of discomfort is different for each person that undergoes the procedure, but usually the cramping is similar to that of menstrual cramping and can be dealt with.

Another symptom that people often experience after an endometrial biopsy is spasms in the uterus, which are similar to cramps. However, one of the positive things about these spasms is that they do subside fairly soon after the procedure is over.

Some women also experience dizziness after they have this procedure done. The dizziness may vary from one person to another. Some will feel light headed right after the procedure and others will feel dizziness for a short time afterward. The symptoms will usually subside, but for this reason if you are having this procedure done you should probably have someone else drive you home.

Fainting is also a possible side effect. Not all women experience fainting, but those that do experience it usually during the procedure itself, considered a vasovagal reaction from the procedure due to the heart slowing slightly. Some women may also experience spotting or bleeding as a result of an endometrial biopsy.

There are some risks associated with an endometrial biopsy, but they are usually very minor. One risk that is a possibility is extended bleeding after the procedure, but this is usually cleared up. Also, as with any medical procedure, there is the risk of infection following an endometrial biopsy. In very rare cases, the uterus may be nicked or pierced during the procedure or the cervix might be torn. However, these risks are all very minor and should not deter anyone from getting this procedure if they need it.

The bottom line is that if you need to have an endometrial biopsy done you should. It can be one of the best tools to detect endometrial cancer and if you are experiencing any of the symptoms that point to this type of cancer you should visit your doctor and find out if you should have this procedure done.

Colposcopy is a special method

What is colposcopy?

Colposcopy is a painless examination of the cervix and vagina with a colposcope. This exam is usually done between menstrual periods and generally takes less than ten minutes. A woman lies down in the position used to take a Pap smear and a speculum is inserted into the vagina to give a view of the cervix and vagina. After cleansing the cervix with a special solution, the clinician uses the colposcope from outside the vagina, like binoculars. Most of the time is spent just looking at the cervix and vagina through the colposcope.

What is a colposcope?

A colposcope is like a set of binoculars with a bright light mounted on a stand, used to look at the cervix and vagina under magnification.

Why are some women advised to have colposcopy?

If a Pap smear indicates the presence of abnormal cells or if the cervix looks abnormal, colposcopy may help in diagnosis and in planning of treatment.

It is impossible to diagnose diseases or other problems simply by looking at the cervix with the naked eye. A magnified view is necessary to find any abnormalities, or to show that the cervical areas in question are not cause for concern. When abnormal areas are found, colposcopy helps to determine the areas where biopsies should be taken.

What is a biopsy of the cervix?

Biopsy is the removal of a small piece of tissue from the cervix using a specially designed instrument. One or more biopsies may be necessary during your colposcopy. This tissue is then sent to a laboratory where it is examined under a microscope by a doctor. No examination or test is 100% accurate, and no guarantee can be made about the correctness of the diagnosis.

Is a biopsy painful?

Most women describe the procedure as feeling like a sharp pinch. Some experience a menstrual-type cramp. There may be slight spotting or bleeding for a few days after a cervical biopsy, especially if more than one biopsy is done. A dark vaginal discharge may also appear for a few days after the biopsy.

What should I do after colposcopy?

There are only a few special instructions after colposcopy:

• If a biopsy is taken, you should wait 2 weeks before having vaginal intercourse to allow the cervix to heal. If a biopsy is not taken, you can resume sexual activity whenever you want to.
• If you take the Pill or other medications, you should take them as usual.
• You may shower or bathe as soon as you want.
• Do not use a tampon for your next period, unless you are told something different at the time of colposcopy.
• Call the clinic if you have:
  • Bleeding (heavier than spotting) at a time you are not having your period;
  • Severe pain in the lower abdomen;
  • Fever or chills; and/or
  • Heavy, yellow-colored, or bad smelling vaginal discharge.

What treatment will I need?

Sometimes the examination shows that no immediate treatment is necessary and that you need further follow-up only. If treatment is needed, we can usually provide it at NYUHC-WHS. In the event your condition requires more specialized evaluation or treatment than we can provide, we will refer you to a physician consultant for further management.

If you engage in unprotected sexual activity,

There are three types of sexually transmitted infections (STIs), and they are viral, bacterial or parasitic. Bacterial infections are easily treatable and include gonorrhoea and chlamydia. An example of a parasitic STI is trichomonas vaginalis, which is also easily treatable. Viral infections are usually not curable and can lead to recurrent outbreaks of symptoms for the rest of your life. Genital herpes and genital warts are examples of viral STDs.

Most STDs can be treated with a straightforward course of antibiotic treatment. Even for incurable STIs such as genital herpes, the outbreaks themselves are easily treatable. To buy a treatment online from euroClinix, you simply need to complete a free consultation which is subject to approval from one of our doctors. The doctor will then be able to recommend the most appropriate treatment for your sexually transmitted disease (STD), which will be sent to you via free overnight delivery.

It’s important to note that, if you have been diagnosed with an STI, you should refrain from any form of sexual contact with your partner until you are sure that your infection is completely clear, otherwise you risk passing your infection onto someone else.

What is a natural or bio-identical hormone?

Examples of bio-identical hormones include:
* estriol, estradiol, and estrone
* progesterone
* testosterone
* DHEA

Is there a difference between bio-identical and synthetic hormones?
YES!! Bio-identical hormones cause the same response as your own hormones. Synthetic hormones cause some of the same actions, but because they have been chemically altered may have different and/or unintended effects. Our body recognizes a bio-identical hormone as a friend, someone it has seen before and knows what to do with.

Why should I consider bio-identical hormone replacement therapy anyway?
Even before menopause, certain symptoms may be signs that hormonal adjustments are needed (breast tenderness and fibrocystic breast disease, migraines and headaches, bloating, mood swings, anxiety, and hot flashes, for example).Use of bio-identical hormones in the proper doses will not only control menopausal and peri-menopausal symptoms, but will greatly improve quality of life both short-term and long-term. Protection against heart disease, reduced risk of breast cancer, improved cholesterol and lipid profiles, and osteoporosis prevention are all valid reasons for monitoring hormone levels and using individualized bio-identical hormone replacement therapy (HRT).

Are there side effects associated with use of bio-identical hormones? Can these hormones increase the risk of breast cancer, stroke or heart disease?
Because bio-identical hormones are just like the ones produced by your body, there are relatively few side effects. Women in general tolerate bio-identical HRT better than synthetic hormone therapy. The risks identified are primarily associated with excess estrogen levels, whether the excess occurs naturally or as a result of hormone replacement therapy, even bio-identical hormones. The body=s natural mechanism for moderating estrogen includes progesterone, and studies have demonstrated its effectiveness in decreasing the risks of breast cancer and cardiovascular disease. We are confident that it is safer to restore hormone balance with bio-identical hormones than to leave the body with a state of deficiency or excess. Bio-identical hormones must be dosed properly for each individual in order to avoid adverse effects.

Should bio-identical hormone replacement therapy (HRT) be individualized?
YES!! HRT is not a one size fits all situation. A womans need for hormones is as individual and unique as she is. The few selected strengths of hormones manufactured by pharmaceutical companies do not meet the needs of every woman. Bio-identical hormones can be compounded on prescription to meet your exact needs. Ask our pharmacists for more information!

Should I quit or change my hormone replacement therapy?
Always consult your healthcare provider before stopping any medication, including hormones. Discuss your situation and the options available to you with both your physician and pharmacist. You do have choices regarding HRT and we encourage you to learn as much as possible about the pros and cons of the different options before making your decision. Our pharmacists are knowledgeable and experienced with bio-identical hormones, and are available to answer more detailed questions.

So, how do I get started on bio-identical HRT?
Review the information in this handout. Talk with your physician. Often one cannot determine the types and amounts of necessary hormones by symptoms alone. We now have the ability to tailor bio-identical HRT more precisely by measuring active hormone levels in saliva rather than in blood. Our pharmacists can speak with you about your symptoms and what hormone levels might be checked. Saliva test results can be interpreted for you taking into consideration your symptoms, history and needs. A recommendation for possible therapy, which might include both prescription and OTC products, can be developed for you and your provider to consider.

Ten Reasons Why Your Hormones Are Imbalanced
Estrogen dominance (too much estrogen in relation to progesterone) can be created by both an excess of estrogen and a deficiency of progesterone.

Too much estrogen may be caused by:

1. Foods that have hormones added to them, such as commercial meat, milk, eggs, and dairy products
2. Herbs that have an estrogenic effect in the body, such as licorice, black cohosh
3. Birth control pills that contain estrogen
4. Environmental toxins that mimic the actions of estrogen (known as xenoestrogens); the largest source of xenoestrogens is pesticides
5. Exposure to radiation, which increases estrogen levels in the blood
6. Chronic constipation which interferes with the bodys ability to eliminate estrogen properly; estrogen then builds up in the colon and can be reabsorbed by the body
7. Estrogen supplements as part of a hormone replacement therapy for menopausal symptoms

Too little progesterone may be caused by:

1. Birth controll pills or HRT with synthetic progestins, which decrease the body’s natural production of progesterone
2. Chronic stress
3. Lack of insufficient ovulation (which is a natural consequence of going into menopause)

Once you have gone an entire year without a period you are now considered post menopausal and you have successfully transitioned through perimenopause. Being post menopausal does not mean your life is over, in fact some women feel very librated with the cessation of their periods. Other women unfortunately continue to suffer with symptoms that started during perimenopause. Women often complain of vaginal dryness and urinary tract infections, which can be common menopausal symptoms.

Not only is it important to look at the female hormones during peri-menopause, but it is also important to look at Cortisol and Thyroid hormones. Cortisol, the stress hormone, is a key factor in energy levels and can be a contributing factor in poor sleep. Thyroid hormone helps regulate metabolism, weight, and temperature. Since the hormones are all linked it is important to monitor all of them if we start working with one.

Having a clear picture of your hormone cycles including estrogen, progesterone, testosterone, DHEA and Cortisol is an important step in determining which therapies will give you the easiest transition through menopause. Saliva testing gives us a picture of what is free or bio-available for the body to use, and should be tested over the course of a month to show the entire cycle. Urine testing is a great way to monitor people who are currently on hormones or are using natural treatments, because the urine allows us to see what is being eliminated from the body as metabolites.

Bio-identical hormones can be a helpful way to support the body as you go through the transition into menopause. Bio-identical hormones are yam based and have been formulated to be identical to our body’s own hormones. Using a compounding pharmacy, we are able to give you the specific amount of hormone that you need as determined by your labs. Some people need a little more progesterone, while others need estrogen, progesterone and testosterone to get things back in balance.

As you transition through the changes associated with peri-menopause there are many natural treatment options for your unique symptoms. What might have worked for your friend might not work for you and vice versa. Herbal remedies can be helpful for all of the common symptoms relating to menopause including hot flashes and insomnia. Herbal tinctures work best when they have been individually tailored and can help to balance estrogen, progesterone and testosterone. I have often used herbs in my practice to effectively calm mood swings. Utilizing hormone testing, a specific herbal prescription can be formulated that will not interfere with your current medications.

Diet and exercise also play a huge role in symptom relief. As we get older dietary needs change and nutritional deficiencies show up, which can make symptoms worse. Simple changes to ones diet and exercise plan can help to manage symptoms along with giving you lifelong anti ageing benefits. Nutritional supplements help to balance deficiencies and support the body in the millions of metabolic processes it does each day. Blood testing is available to create a targeted approach to nutritional supplementation.

One of the best things you can do is to maintain a positive outlook, knowing that perimenopause is only a transition. There are many natural options to help support your body and your sanity as you go through this transition. You do not have to go through this transition on your own.

Once you are post menopausal it is very important to get any unexplained “periods” or bleeding checked out by your doctor. It is better to be cautious and make sure you are properly examined, than to just dismiss unexplained bleeding, which can be the first sign of something more serious. Continue to receive your pap screenings along with yearly mammograms. Your doctor will know the correct screening schedule for you.
Along with regular pap screenings, DEXA scans give vital information about bone density. Our bones are the strongest at age 30 and slowly start to lose mineralization as we get older. The DEXA scan measures bone strength and can determine whether supplemental treatment is necessary for prolonged health.
Changes in your body can seem overwhelming, but remember to enjoy the transition, the freedom, and the wisdom that comes as you continue to grow as a woman. Menopause is not the end of life, but rather the beginning of a new chapter. It is a time where you can celebrate the end of your menstruating years and the start of a new adventure as a non-menstruating woman.

Please know that you do not need to suffer with hot flashes, night sweats, vaginal dryness, insomnia, or any other uncomfortable symptoms. There are many natural options available.

“Annual screening mammographies and evaluations of palpable masses are important tools for breast cancer detection,” said Dr. Jamie Caughran, co-author of a study to be presented at the 2011 Breast Cancer Symposium in San Francisco starting Thursday.

This report, released Tuesday, is the latest volley in an ongoing controversy about the utility of mammograms and self-exams, particularly in younger women.

In 2009, the U.S. Preventive Services Task Force set off a furor when it recommended that women wait until the age of 50 before having regular mammograms, and even then they counseled that mammograms should take place once every two years rather than annually.

Previously, most guidelines had recommended that women start annual mammograms at age 40.

More information

To learn more about mammograms, visit the U.S. National Cancer Institute.

(SOURCES: Sept. 6, 2011, news conference with: Jamie Caughran, M.D., medical director, Comprehensive Breast Center, Lacks Cancer Center, Grand Rapids, Mich., and Andrew Seidman, M.D., medical oncologist, Memorial Sloan-Kettering Cancer Center, New York City)

In order to maintain good reproductive and sexual health, women have to visit the gynecologist for an exam about once a year. During each annual exam, the gynecologist typically asks questions about the woman’s sexual activity and menstrual cycle, as well as physically examines the woman’s breasts and genitals. Understandably, this doctor visit can cause a considerable amount of anxiety for women, since they must be open about fairly private parts of their bodies and their sex lives. Although the thought of going to the gynecologist may make some people uncomfortable or nervous, periodic gynecological exams are crucial to a woman’s sexual and reproductive health and should not be skipped. In addition, going to the gynecologist does not have to be a dreaded visit for women, as long as they are aware of what to expect from the exam. Prepared with the knowledge of what actually happens during an annual exam, women often find that the annual exam can be a fairly easy procedure.

When You Should See the Gynecologist

Generally, women begin to visit their gynecologist around the time when they should have their first Pap smear test, which is three years after their first vaginal intercourse or by the age of 21 (even if they are virgins at that age). However, many women visit their gynecologist before the age of 21 for numerous reasons, such as seeking treatment for irregular periods, STIs or vaginal infections and seeking information about safe sexual activity and contraceptive methods. Women who are sexually active or are considering becoming sexually active should visit a gynecologist in order to help protect their sexual health. In addition, women who are experiencing menstrual difficulties or any genital or breast health concerns should also see their gynecologist for diagnosis and treatment. After a woman has had her first visit, she normally will go to the gynecologist once a year for routine exams.

Information to Know Before Your Visit

Before a gynecological visit, there are several things that women should do to prepare. First, appointments should not be scheduled during the time of menstruation, since there is a chance that menstrual fluid can interfere with the examination as well as lab tests. Also, it is a good idea to create a list of questions and problems for the gynecologist before your appointment. The gynecologist needs to know about any irregular vaginal bleeding, discharge, odor, or pain. The gynecologist will ask questions about your menstrual cycle, so it helps to come to the appointment knowing the when your last period was and how long your periods typically last. Women should abstain from sexual intercourse and oral sex for about two days before their appointment, because sexual activity may irritate the vaginal tissue and increase the chance of incorrect Pap test results. ”

What to Expect During the Exam

The typical gynecological exam can consist of discussions about personal and family medical history, sexual history, safe sex and birth control counseling, testing for sexually transmitted infections, a breast exam, and a pelvic exam. At the beginning of the visit, the nurse will usually record the patient’s weight, blood pressure, and the date of last menstrual period. It is also advised to urinate before the exam to empty the bladder, since the pelvic exam may feel uncomfortable with a full bladder. Before the exam begins, the woman will be able to privately change out of her clothes into an open-front gown and drape cloth that is provided.

During the exam, the gynecologist will ask a variety of questions about the patient’s health, including questions about her menstrual cycle, sexual history, contraception usage, family medical history, and lifestyle. While some of these topics of discussion can be very private areas of a woman’s life, it is extremely important that women are honest and straight-forward with their gynecologist during their discussions. Any private or secret information that you tell your gynecologist will remain between you and doctor, since he/she must uphold patient confidentiality. Also, being honest will best help your doctor assess your overall health and provide appropriate solutions to any problems.

The other parts of the gynecological visit are more physical in nature, and this is when some women may feel anxiety or embarrassment. It is perfectly normal for women to feel nervous with having their breasts and genitals physically examined, since these are private areas of their bodies. However, there is no need to feel overly embarrassed with exposing these areas to your doctor, since it is the gynecologist’s job to examine many women’s breasts and genitals every day. To further ease the patient’s possible anxiety, the doctor will most likely tell the patient what he/she is doing, step-by-step. In addition, many women going to the gynecologist for the first time are often relieved and surprised to find out that the breast and pelvic exams are quick and painless.

The Breast Exam:The purpose of the breast exam is to feel the woman’s breasts for any lumps or irregularities. The doctor asks the woman to lie on her back and open her gown. The doctor will then gently feel the woman’s breasts making circular and linear motions with his/her fingers. This part of the exam should generally feel as if the doctor is massaging your breasts and only lasts about a minute. If you feel discomfort or pain when the doctor is feeling your breasts, be sure to notify your doctor of this pain. The doctor may also tell the patient how to perform a breast self-exam, which is an important task for women to do on their own to check for lumps. After the breast exam, the woman will remain lying down for the pelvic exam.

The Pelvic Exam:The pelvic exam consists of the doctor inspecting the woman’s external and internal genitalia. The patient places her feet on the footrests, slides her hips towards the end of the examination table, and lets her knees spread apart. While this position can make the woman feel very open and exposed, it is important for the woman to try to remain relaxed in this position in order for pelvic exam to go easily and smoothly. A drape cloth is usually provided so that the woman can rest the cloth over her thighs and hips to feel more covered. The pelvic exam should last only about five minutes and is over quickly. It is very important for the woman to remember to relax her muscles and take deep breathes, because becoming tense will make the pelvic exam more difficult and uncomfortable.

Image from http://content.answers.com/main/content/img/medTest/f011001.jpg

The doctor will first examine the woman’s exterior genitals (or vulva) to check for signs of irritation, infection, or sores. Next, the doctor will insert a speculum into the woman’s vagina, using a good amount of lubricant so that it can be inserted easily. A speculum (shown right) is a thin metal device that resembles the shape of a duckbill, and opens to help the gynecologist view the inside of the vagina. The closed speculum is inserted into the vagina and then slowly opened, separating the vaginal walls.

If the patient relaxes during this part of the exam, the speculum should not cause much discomfort, but only a slight amount of pressure. The gynecologist will look inside the vagina to examine the cervix for any irritation or abnormalities, and possibly swipe the cervical mucus with a cotton swab to test for STIs.

Image from: http://www.plannedparenthood.org/sexual-health/women-health/gyn-exams.htm

After the doctor uses the speculum, he/she will then manually examine the patient’s reproductive organs. Wearing latex gloves, the doctor will insert one or two lubricated fingers into the vagina and press on the lower abdomen with the other hand, in order to physically feel the woman’s internal organs, including the ovaries and uterus.

As with the other parts of the exam, this part is a quick procedure and should only cause mild pressure or discomfort. If the patient experiences any pain during this part, she should let her doctor know.

After the gynecologist has completed the physical examination, there will be a final opportunity for the patient and doctor to discuss any more concerns they may have. Remember that your gynecologist is an honest and trustworthy source, so do not be embarrassed to ask him/her about any of your questions. Regular, annual visits to the gynecologist are vital for ensuring and maintaining your sexual health and safety as a woman.
References

Planned Parenthood Gynecological Health

 I am proud to be a native of New Orleans, an alumna of Ursuline Academy and Loyola University, where I graduated with a BS in Biology and Secondary Education. I spent many summers riding horses at a summer camp near St. Joseph Abbey, which left me with the dream of someday living in that area. In 1981 my husband, Eddie, and I moved to Folsom to raise our family of two daughters and three sons, whom I home schooled until they entered high school. We’re empty-nesters; our youngest is now away at college. Our grandchildren number five, and we hope for many more! In addition to my job here at Dr. Bea’s office, I am also the music director at St. John’s Church in Folsom, and am very blessed to love both jobs. I have been a rabid Saints fan since year one, when I was a fifth grader, and am an avid member of our family’s fantasy football league. I am a Weight Watcher, having lost almost 100 pounds, feeling great, and still working on it. Life is sweet!