Before a woman decides to become pregnant she may choose to sit down and discuss her family planning goals with her OBGYN. This is known as preconception counseling, and this appointment between a woman and her doctor is an important part of planning a healthy, complication-free pregnancy for the future. After all, having a healthy pregnancy begins even before you find out you are pregnant.
Before becoming pregnant you may choose to make certain lifestyle changes that could improve your health before getting pregnant. During preconception counseling your gynecologist can discuss the many ways in which you can improve your chances of having a healthy pregnancy. Some of these lifestyle changes include changing medications, avoiding alcohol, quitting smoking, eating a healthier diet, and getting regular exercise.
A preconception counseling appointment can happen at any point when a woman is considering becoming pregnant; however, the ideal time to have this appointment is about three months before you begin trying to get pregnant. This appointment will cover a variety of topics and health issues to ensure that everything is taken into consideration before becoming pregnant. Some of the things your gynecologist may discuss with you include:
Your family history (and even your partner’s family history): Everything from chronic health conditions to genetic disorders should be discussed in depth with your OBGYN during this counseling appointment. Knowing your family history can provide us with information we need to determine if there are any additional tests or screening tools that we will need to perform during the course of your pregnancy.
Your personal history: We won’t just delve into yours and partner’s family history but also your own. This includes everything from preexisting conditions and current medications to past surgeries and hospitalizations. Being honest and upfront about your own medical history is important for your gynecologist to get an idea of what your future pregnancy will look like and to take the necessary precautions to prevent complications from happening.
While your gynecologist is already delving into your general medical history they will also go through your medical chart and OBGYN history. This history may include past infections, sexually transmitted diseases, abnormal pap smears, menstruation history, and any previous pregnancies.
Your lifestyle: Your gynecologist will also want to discuss your current lifestyle, which includes your diet, exercise, drug use, and environment, to look for potential issues that could affect your future pregnancy. Your doctor will discuss certain changes you will need to make even before you become pregnant.
After going through your medical history and talking with you about your family planning needs, your gynecologist may also perform a physical exam, Pap smear, STI screening, and lab tests.
If you are planning to become pregnant within the next year then it’s time to talk with your gynecologist to make sure that there are no surprises. Your OBGYN can provide you with the guidance, support and medical care you need before, during and after your pregnancy.
If you are dealing with unusual or unexplained uterine bleeding you aren’t alone. This is a common problem for women of all ages and it has many different causes. While women can experience a menstrual cycle that lasts up to 8 days, bleeding is considered abnormal if it occurs after sex, between periods, or after menopause. If your menstrual cycles are shorter than 24 days or longer than 38 days this is also worth discussing with your gynecologist, especially if it’s accompanied by irregular bleeding.
It’s important that you do not ignore abnormal bleeding. A simple visit to the gynecologist can provide you with the answers and care you need. Common causes of abnormal uterine bleeding include:
- Fibroids and polyps
- Bleeding disorders
- Ovulation issues
- Ectopic pregnancy
- Certain cancers (rare)
Most of the time the problem isn’t serious and can be simple to treat; however, other causes of abnormal bleeding can be serious and require immediate medical attention. This is why it’s important to see your OBGYN if you notice unusual bleeding.
During your appointment, your gynecologist will ask questions about your medical history, personal history and menstruation. Expect to answer questions about the symptoms you are experiencing and how long you’ve experienced them. A physical examination will also be performed, as well as blood tests to rule out certain disorders and infections. In some cases, a pregnancy test is also performed to rule out an ectopic pregnancy or miscarriage.
Based on your symptoms and medical history your gynecologist will then perform one or more tests before reaching a diagnosis. These tests may include an ultrasound, endometrial biopsy, MRI, or CT scan.
Treating Abnormal Bleeding
In many cases, medication is usually the first course of action against handling excessively heavy or irregular menstrual cycles. These medications usually include hormonal birth control, as well as gonadotropin-releasing hormone agonists and tranexamic acid.
If medication does not work, then surgery may be necessary. The type of surgery performed will be based on certain factors including the patient’s age and the cause of their bleeding. Common surgeries to treat abnormal uterine bleeding include:
- Endometrial ablation
- Uterine artery embolization
If you are dealing with unusual bleeding between periods it’s important that you talk with your gynecologist right away to find out what might be going on. Schedule your appointment today.
If you have been told by your OBGYN that you are a high-risk pregnancy it’s natural to have questions. You may want to know if there are any lifestyle changes you’ll need to make or how often you’ll need to visit your obstetrician for routine checkups throughout your pregnancy. The goal of your OBGYN is to provide the care you and your baby need for a healthy pregnancy and delivery, so don’t be afraid to ask any and all questions that you may have.
What makes a pregnancy high risk?
A high-risk pregnancy may be the result of certain factors that already existed before your pregnancy or the result of a medical condition that occurs during the course of your pregnancy. Here are some factors that can cause a high-risk pregnancy:
Advanced maternal age: pregnancy complications are higher for women who are over 35 years old, as well as women under 17 years old
Lifestyle factors: smoking, alcohol, and using drugs can also affect pregnancy
Medical history: women who have chronic conditions such as diabetes, high blood pressure or heart disease are also more likely to experience other health problems during the pregnancy (talk with your OBGYN about any pre-existing health problems you have)
Multiple births: there is a higher chance for pregnancy risks when a woman is carrying two or more babies at a time
If I have a high-risk pregnancy what can I do?
The most important thing you can do to ensure a healthy, risk-free pregnancy is to make sure that you have an obstetrician that you trust. It’s very important that you keep up with routine checkups and exams. Women who have high-risk pregnancies may need to visit their OBGYN more regularly. In some instances, you may be referred to a maternal-fetal medicine specialist or other physicians.
Along with your routine checkups your OBGYN may also recommend various screening tests along with the standard prenatal screening tests. Some of these tests include specialized ultrasounds, amniocentesis, chorionic villus sampling (CVS), cordocentesis, and lab testing.
Eating a healthy diet, getting regular exercise and following the necessary steps to protect against infections can also go a long way to maintaining a healthy, risk-free pregnancy. If you find yourself dealing with high levels of stress this is something to discuss with your doctor to find the most effective strategies for reducing stress.
Whether you just found out you are pregnant or you are looking for an OBGYN to provide you with preconception counseling before getting pregnant, you want a doctor who puts your needs first. While a high-risk pregnancy can feel overwhelming at first your obstetrician will help guide you throughout the course of your pregnancy to make sure you get the care you deserve.
If you are experiencing regular pain during sex this can be a source of embarrassment and concern. Something that is enjoyable and a source of pleasure has become uncomfortable. Painful intercourse, also known as dyspareunia, has many causes and affects nearly all women at some point during their lifetime. While it may be a fleeting issue for some, for others this problem may become long term.
Causes of Painful Sex
If you suddenly experience pain during sex this could be a sign of a gynecological problem such as fibroids, endometriosis, or ovarian cysts. Other causes of painful sex include:
- Hormonal fluctuations (e.g. perimenopause)
- Vaginitis: inflammation of the vagina
- Vaginismus: tightening of the muscles near the opening of the vagina
- Skin conditions
- Urinary tract infections
- Vulvodynia: a pain disorder that affects the vulva
Pain can take on many different forms. Some women experience deep vaginal pain, while others may notice muscle spasms or cramping during or after sex. While painful sex may often be physical, when there are no physical problems it’s also important to consider that the problem may be psychological.
The goal of your gynecologist is to pinpoint what’s causing pain during intercourse as soon as possible so that a treatment plan can be created. During your checkup, your OBGYN will ask you questions about your symptoms, as well as medical history. From there, a physical examination and pelvic exam is performed to check for signs such as cysts or fibroids, which could be leading to pain. Depending on your sexual history and the symptoms you are experiencing, your doctor may also recommend getting STD testing to rule out any sexually transmitted infections.
Sometimes an ultrasound or other diagnostic testing is needed to further evaluate the reproductive organs to pinpoint problems. There are some simple measures you can take to try and alleviate pain during sexual intercourse. Some of these options include:
- Taking a warm bath prior to sex
- Using a lubricant
- Talking with your partner
- Applying an ice pack to the area if burning occurs after intercourse
The treatment that your gynecologist will recommend will depend on the cause of your pain. For example, a urinary tract infection can easily be treated with medication. If women experience pain as a result of the effects of menopause they may be given an estrogen vaginal cream to treat atrophy of the vaginal walls. Vaginal relaxation exercises and behavioral therapy may be recommended for certain conditions such as vaginismus, to reduce muscle contractions and tightening around the vagina.
If you are experiencing persistent pain during sex that is taking the enjoyment out of being intimate with your partner it’s important that you turn to an OBGYN who can help you figure out what’s going on and how to best treat it.
Uterine fibroids are a common problem, affecting women of reproductive age. Sometimes these benign tumors don’t cause symptoms, so a woman may not even realize that she has fibroids until she visits her OBGYN for an annual checkup. Fibroids may be detected during a regular pelvic exam; however, further testing such as an ultrasound is usually needed for a diagnosis.
What Are Fibroids?
Sometimes fibroids can cause symptoms such as pelvic pain, bowel and urinary problems, pain during sex, and heavy bleeding. While these tumors are benign and very prevalent they can affect fertility; therefore, it’s important that you see a gynecologist once a year for a full gynecological checkup even if you aren’t experiencing symptoms. The symptoms you experience depend upon how many fibroids are present, as well as their location and size.
Since fibroids affect women differently there isn’t just one way to treat them. Often, your gynecologist may recommend just watching and monitoring the fibroid if you are experiencing little to no symptoms. Since fibroids usually grow slowly or don’t grow at all there isn’t much concern that the fibroid will continue to grow if left untreated.
There are also medications that your OBGYN can prescribe to treat issues affecting your menstrual cycle such as heavy bleeding or pelvic pain. These medications won’t get rid of fibroids but they can shrink them. Common medications used to treat uterine fibroids include gonadotropin-releasing hormone agonists, a progestin-releasing intrauterine device (IUD) and tranexamic acid.
If the fibroids are large or causing severe symptoms then your gynecologist may suggest surgery or noninvasive procedures also geared toward removing the uterine fibroids. One such procedure uses a noninvasive MRI-guided ultrasound surgery in order to destroy fibroids while also preserving the healthy uterine tissue. There are also minimally invasive procedures such as a uterine artery embolization or laparoscopic myolysis. Women who are looking to get pregnant may not be right for some of these procedures; therefore, it’s important to talk with your doctor about the pros and cons of these treatments before deciding on the best approach for treating fibroids.
If you are experiencing symptoms of fibroids it’s important that you talk with your gynecologist to find out what’s going on. Even though these growths are benign it’s still important to make sure that you are getting the treatment and care you need to reduce symptoms and potential complications.
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