Author Archives: Dr. Kelly Roy, MD

About Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS Dr. Kelly Roy is a specialist in surgical gynecology and advanced laparoscopy (and hysteroscopy). She is a long-time resident of Arizona and obtained her Bachelor of Science degree in Biomedical Engineering at Arizona State University before finishing her Doctorate of Medicine at the University of Arizona in 1997. Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001. Well known for her teaching and surgical ability, she is on the faculty at the residency program at both Banner University Medical Center and Saint Joseph’s Hospital in central Phoenix and is a Clinical Assistant Professor of Medicine at the University of Arizona College of Medicine, Phoenix Campus. Dr. Roy has taught advanced surgical techniques to medical students, residents, fellows and colleagues for over 15 years. Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today. Read More About Dr. Kelly Roy, MD | WebMD Profile | Health.USNews.com Profile | Current Obstetrics and Gynecology Reports: TFA with the Sonata System

Rejoni Clinical Trial

This entry was posted in Ask An Expert and tagged clinical trial, Rejoni on July 2, 2024 by Dr. Kelly Roy, MD.

Intrauterine adhesions, also known as IUAs or Asherman’s Syndrome, are one of the most undiagnosed conditions among women in the United States. The adhesions are caused by damage to the lining of the uterus. The condition can lead to fertility issues and medical problems.

Fortunately, there is a new clinical trial on fibroids that is demonstrating the effectiveness of an innovative way to prevent the formation of these dangerous adhesions. The Rejoni clinical trial is led by physicians and features a gel-like material (Juveena™ Hydrogel) that may be effective at preventing the formation of intrauterine adhesions after surgery.

At Arizona Gynecology Consultants, we are committed to providing comprehensive healthcare for women using clinically proven techniques. Some of our clients may benefit from participating in this clinical trial on intrauterine adhesion.

What Are Intrauterine Adhesions?

The interior of the uterus is lined with a type of tissue called endometrium. During pregnancy, the embryo implants in this layer, but if no pregnancy occurs, the top layer of the endometrium is shed during menstruation. Any damage that occurs to the lining of the uterus can lead to the formation of scar tissue between the inner walls of the uterus.

Thin bands of scar tissue may form if the scarring is mild. Thick bands may form when the scarring is more severe. In either case, partial or total occlusion (blockage) of the inside of the uterus can occur.

The resulting conditions, commonly referred to as Asherman’s Syndrome, can develop after a uterine procedure like a dilation and curettage or hysteroscopy. Asherman’s Syndrome can cause serious fertility issues that require gynecology services in Arizona.

Primary adhesions can appear after pregnancy loss or surgery to remove fibroids. Secondary adhesions can happen after surgery to remove them, resulting in the adhesions returning. The adhesions may or may not cause noticeable symptoms.

How Does the Clinical Study Work?

Rejoni, Inc., a company based in Bedford, MA, is heading the study that tests whether a new hydrogel can prevent the formation of intrauterine adhesions. Any patient who is planning to undergo uterine surgery (either to disrupt existing adhesions through a procedure known as

adhesiolysis or to remove fibroids) may be a candidate for the study. Eligible participants will be randomly assigned to one of two groups: the treatment group, which will receive the hydrogel immediately after uterine surgery, or the control group, which will not receive the hydrogel. Two participants will be assigned to the treatment group for every participant in the control group. If you’re interested in this research trial, please schedule an appointment with Arizona Gynecology Consultants to determine if you qualify as a candidate.

Am I a Candidate For This Clinical Study?

If you have a history of intrauterine adhesions, you may be a great candidate for the Rejoni clinical study. Candidates may be able to prevent the recurrence of intrauterine adhesions by participating in the study. Women who have a history of being diagnosed with these types of adhesions may be good candidates for the clinical study.

If you are at least 18 years old and have received a diagnosis indicating that you require fibroid removal or adhesiolysis, you may qualify to participate in the Rejoni clinical trial or any similar clinical trial. There are no expenses associated with participating in this research. By joining this study, you can contribute to advancements in medical knowledge and potentially benefit from cutting-edge treatment options.

You will be provided with detailed information about the study procedures beforehand and questions you have will be thoroughly answered. Your participation could make a significant difference in the lives of others affected by similar conditions.

What Causes Intrauterine Adhesions?

Intrauterine adhesions can form after a surgical procedure involving the cavity of the uterus. Dilation and curettage (often used to diagnose and treat conditions) is an outpatient procedure that involves stretching the opening to the uterus and selectively removing parts of the uterus. The surgical procedures can result in intrauterine adhesions.

Dilation and curettage are often performed to control uterine bleeding and to address pregnancy complications. Less common causes of intrauterine adhesions include endometritis, surgical removal of fibroids, endometrial ablation, and cesarean sections.

What Are the Symptoms of Intrauterine Adhesions?

Intrauterine adhesions may cause significant symptoms or no symptoms at all.

Common symptoms include:

Menstrual abnormalities
Light or infrequent periods
Inability to achieve pregnancy
Recurrent miscarriages

Birth complications
Abnormal implantation of the placenta
Pelvic pain
Painful menstrual periods

These could be the symptoms of Asherman’s Syndrome or another medical problem that requires treatment at our Arizona gynecology center. We offer consultations for any of our exams and use minimally invasive treatments when possible.

How Are Intrauterine Adhesions Diagnosed?

Asherman Syndrome is often diagnosed by hysterosalpingogram, hysteroscopy, or saline sonohysterogram. Hysteroscopy is a highly accurate method for diagnosing intrauterine adhesions. It uses a lighted telescopic instrument to allow the doctor to see inside the uterus. The procedure can be performed in the operating room or a medical office.

Imaging procedures that use a special dye can view the shape of the inside of the uterus. A saline sonohysterogram uses a saltwater solution to expand the uterus so a sonogram machine can see the uterine cavity. Imaging can discover spaces where the fluid does not freely flow. While these procedures may not require anesthesia, anti-inflammatory medications may be prescribed to decrease post-procedure cramping.

Who Is at Risk For Intrauterine Adhesions?

Several factors can increase the risk of developing intrauterine adhesions. Women who have undergone uterine surgery following miscarriage, abortion, or delivery are at risk due to the potential for scarring. Certain surgical procedures like myomectomy for fibroid removal or the presence of uterine fibroids can lead to scarring.

Postpartum infections, endometritis, or genital tuberculosis can also increase the risk. When an intrauterine device (IUD) is not inserted correctly or left in place for extended periods, the device can damage the uterine lining and increase the risk of adhesions. Genetics is another leading factor, as some women may be more predisposed to developing scar tissue in the uterus.

Women may be at higher risk of developing intrauterine adhesions if they:

Have experienced complications related to cesarean sections
Have experienced repeated miscarriages
Are older
Have a condition that causes prolonged uterine bleeding, such as pelvic inflammatory disease.

Understanding these risk factors is crucial for identifying women who may be at higher risk of intrauterine adhesions and providing appropriate preventive measures or treatment.

Common Treatments For Intrauterine Adhesions

Physicians often recommend surgical treatments to address intrauterine adhesions because the scarring can lead to medical complications and fertility issues. Once the adhesions have been identified and diagnosed, your physician may use a special operating hysteroscope to cut and remove the scar tissue.

This procedure is frequently performed under anesthesia. After the adhesions have been removed, a special device may be placed to separate the walls of the uterus and decrease the chances that the adhesions will return.

To further reduce the risk of adhesions returning, your physician may prescribe hormonal treatment, nonsteroidal anti-inflammatory drugs, or antibiotics. The treatments are highly effective, but some women experience post-surgery lesions. The ongoing clinical trial on intrauterine adhesion aims to prevent the return of these types of adhesions.

Are There Risks Associated With Treating Intrauterine Adhesions?

The clinical trial may be able to prevent the return of intrauterine adhesions in some women. Any surgical procedure to remove existing adhesions can lead to absent or infrequent periods.

Women should be mindful that pregnancies after treatment could potentially be complicated by:

Miscarriage
Preterm labor
Third-trimester bleeding
Abnormal attachment of the placenta

Your women’s healthcare provider will explain how surgical removal of adhesions can affect future pregnancies and births. Women with mild-to-moderate adhesions often experience a resumption of normal menstrual function. Severe adhesions can affect fertility in some women. The Rejoni clinical trial is an important study because the advanced gel placed after surgical removal of adhesions may prevent the return of intrauterine adhesions.

Rejoini Clinical Trial FAQs

If you believe you are a good candidate for this or another ongoing clinical trial, please let someone with Arizona Gynecology Consultants know. We can determine your candidacy and help you start the process of undergoing treatment.

What Is Adhesiolysis?

A surgical procedure known as adhesiolysis treats intrauterine adhesions caused by Asherman’s syndrome. Under general anesthesia, a doctor dilates the cervix. This allows a hysteroscope to be inserted into the uterus. The surgeon identifies and removes scar tissue using a special instrument. The doctor then controls any bleeding. Patients are monitored after the procedure and given pain management if needed.

Am I a Candidate For the Rejoini Clinical Trial?

If you are 18 and older and have a history of developing intrauterine adhesions or have undergone fibroid removal or adhesiolysis, you may be a good candidate. The treatment prevents the return of adhesions following surgery. If you do not have intrauterine adhesions or a history of developing this type of scarring, you may not be a candidate for this specific clinical trial.

What Happens to the Treatment Group?

For every person selected as part of the control group, two women will be selected for the treatment group. These women will be given Juveena™ Hydrogel following the removal of an intrauterine adhesion. The study assesses whether the application of the gel prevents the return of adhesions in the uterus.

What Are the Benefits of Participating?

By participating in the Rejoni clinical trial, you may be chosen for the treatment group. The treatment gel may reduce the chances that intrauterine adhesions return. Preventing the return of adhesions could reduce the risk of fertility issues and other problems related to Asherman’s Syndrome.

How Do I Sign Up?

Before you can sign up for this clinical trial, one of our physicians will determine if you are a good candidate. We will provide you with everything you need to participate if you are found to be a candidate. At Arizona Gynecology Consultants, we are following national clinical trials and will recommend new clinical trial opportunities as they arise.

Contact Arizona Gynecology Consultants to See If You Are a Clinical Trial Candidate

Women who participate in the Rejoni clinical trial may be able to prevent the return of intrauterine adhesions. If you have a history of intrauterine adhesions and are 18 or over, you may be a great candidate for this study.

Arizona Gynecology Consultants is continually following new and ongoing clinical studies related to women’s health. When a study offers a safe and effective potential treatment for a condition we treat, we may recommend that our patients participate in the study.

It is important to remember that studies may involve the use of a control group, meaning that participating does not guarantee that you will have access to the new treatment being tested. Participation does help grow medical science’s body of knowledge, and you may directly benefit from those advancements. To learn if you are a candidate for the Rejoni clinical trial, please contact our office today.

Sources:

1. Parashar, S., Pajai, S., & Tarang, T. (n.d.). Recent Advancement in the Management of Intrauterine Adhesions Using Stem Cell Therapy: A Review Article. Cureus, 15(8), e43553. https://doi.org/10.7759/cureus.43553
2. ?Smikle, C., Yarrarapu, S. N. S., & Khetarpal, S. (2022). Asherman Syndrome. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK448088/#:~:text=Asherman%20syndrome%20(intrauterine%20adhesions%20or
3. ?Intrauterine adhesions: what are they? (n.d.). Www.reproductivefacts.org. https://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/intrauterine-adhesions-what-are-they/

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Kelly Roy is a specialist in surgical gynecology and advanced laparoscopy (and hysteroscopy). She is a long-time resident of Arizona and obtained her Bachelor of Science degree in Biomedical Engineering at Arizona State University before finishing her Doctorate of Medicine at the University of Arizona in 1997.

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Well known for her teaching and surgical ability, she is on the faculty at the residency program at both Banner University Medical Center and Saint Joseph’s Hospital in central Phoenix and is a Clinical Assistant Professor of Medicine at the University of Arizona College of Medicine, Phoenix Campus. Dr. Roy has taught advanced surgical techniques to medical students, residents, fellows and colleagues for over 15 years.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

www.azgyn.com/

A Closer Look at Birth Control Options

This entry was posted in Birth Control and tagged Contraceptives on June 5, 2024 by Dr. Kelly Roy, MD.

Contraceptives, informally known as birth control, can help prevent pregnancy when you aren’t ready for or don’t want to have children. When you’re considering which contraceptive is “right” or “best,” remember that there is no one-size-fits-all method. Any type of birth control has its upsides and downsides, depending on the user. Some methods also provide additional benefits or alternative uses.

It’s important to learn more about the types of birth control, whether you’re looking to switch or have minimal experience. You can then consider your own personal goals, the contraceptive’s degree of effectiveness, and how convenient or inconvenient it is for you so you can make an informed decision. We’ve compiled this information about the various methods of birth control, how to determine what could be ideal for you, common misconceptions, and more.

Factors to Consider when Choosing a Contraceptive Method

The first factor most people must consider when choosing a birth control method is accessibility; how accessible are the various methods for you? Will your insurance cover birth control, or is there a copay? Are you able to get it at your local drugstore or the pharmacy, or is a medical professional needed? After you’ve identified a list of affordable options or those covered by insurance, it’s important to consider a few other factors to narrow the list to the best birth control for you.

Your Lifestyle and Preferences Can Influence What Works for You

Your lifestyle has a significant role to play in your birth control choice. For example, if you don’t have sex often, you may be fine relying on condoms since they’re affordable, and you won’t need to replenish your supply often. Alternatively, if you live a busy lifestyle but have sex a bit more often, you might want to consider hormonal birth control; while some forms of hormonal birth control need to be picked up on a regular basis, they can provide consistent protection. As a result, there’s no need to plan or worry about having unprotected sex if your method has constant coverage and only a monthly pick-up.

It should be noted that all forms of birth control can only be at their peak effectiveness when used correctly. For that reason, a critical question to ask yourself is whether you will be able to use it correctly as is required every time. Some hormonal contraceptives take a bit more effort to use as instructed. For example, the Pill, which needs to be taken daily, may be more difficult for busy or forgetful individuals to take correctly. For those individuals, condoms or an IUD may be more viable options.

Your sexual activity will also have a large bearing on which contraceptives are likely to be more practical for you. Do you need additional protection from HIV and other sexual infections? It’s important to remember that hormonal birth control alone will not prevent you from contracting an STI. However, they can be used in tandem with condoms, which are the only way to prevent STIs.

Finally, it’s critical to consider whether you want to have kids in the near future. If not, there are methods that can last for years and some that last indefinitely after only one procedure. If you might want children within the next couple of years, the choice of contraceptive may have some impact on how soon you can conceive after stopping use. For example, if you want kids after coming off hormonal birth control, understand that it may take several months. However, if you want children soon and have a copper IUD, pregnancy may be possible as soon as the device is removed.

Your Health Is an Important Component

It’s also important to consider the limits your health may place on the use of certain birth control methods. You’ll need to consider the potential side effects of a particular contraceptive. Are there minor, manageable inconveniences, or are the effects likely to be more significant for you? We are all unique in that our bodies will respond to the same stimuli differently, and what may be a small downside to one person may be debilitating to another.

You should also consider whether you have any health conditions or predispositions that make a certain method unviable. Alternatively, would a certain contraceptive actually help alleviate what’s afflicting you? Some types of hormonal pills can help people regulate irregular or heavy periods due to polycystic ovary syndrome (PCOS), endometriosis, and other problems. Talking with your healthcare provider can allow you to get clarity on any aspect of birth control you’re unsure about, including helping you answer these questions.

It’s also beneficial to receive a medical professional’s insight into what the ideal type of contraception is for your unique biology, lifestyle, and preferences. They know best how various types of birth control may impact your health or aren’t wise to try at all. You’ll likely find that seeing a gynecologist (a healthcare provider who focuses on women’s sexual health) is a more comfortable or reassuring environment to discuss birth control rather than your general practitioner.

Types of Birth Control Options

Below are the different categories of contraceptives, specific methods/procedures, and their pros and cons.

Non-Hormonal Methods

As mentioned, there are many misconceptions about contraceptives. One is that the Pill and condoms are the predominant methods used for birth control. In fact, IUDs and implants have been on the rise in recent years, so it’s important to remember that everyone’s needs and what’s accessible will differ.

Most non-hormonal birth control methods are barrier methods that work by preventing sperm from reaching/fertilizing the egg. There are also some more involved, long-term types of contraception ranging in degree of invasiveness, such as IUDs and getting your tubes tied. Only condoms can prevent STIs.

Types of Barrier Birth Control

Condoms

Male condoms are thin coverings made of either latex, plastic, or lambskin. They are used externally and cover the male penis.

Female condoms are lubricated plastic tubes with flexible rings at either end, with one end closed. These are used internally and are inserted into the vagina.

Both are widely available in stores, cost-effective, and up to 85% and 79% effective, respectively. Both prevent semen from entering the uterus and must be used every time sexual intercourse takes place. Male condoms provide very effective STI protection, while female condoms may provide some.

Spermicide

Spermicide is a gel that prevents sperm from reaching the egg. It can be used alone (70% effective) or with an external condom, diaphragm, or cervical cap (94% effective). It must be used each time you have intercourse and is available at most drugstores or with a prescription (up to $270).

Diaphragm/Cervical Cap/Sponge

Diaphragms, cervical caps, and contraceptive sponges are all inserted vaginally, to be used every time (up to 88% effective). Sponges, available in most drugstores, contain spermicide. Diaphragms/caps are flexible cups designed to be used with spermicide and require a provider to determine the appropriate size for you.

Other Types of Non-Hormonal Contraceptives

Copper IUDs

A copper intrauterine device (IUD) is a small, T-shaped piece of copper-wrapped plastic to be inserted once by a provider when prescribed (if not covered by insurance, costs up to $1300). It can last up to 10 years and is low-maintenance.

They work by releasing a small amount of copper that causes a mild inflammatory response that prevents sperm from fertilizing the egg. IUDs are unnoticeable when placed correctly. They are very effective (up to 99%) and, upon wanting to conceive, easily removable. They can also be used as an emergency contraceptive when placed within five days of unprotected sex.

A common concern is they may get lost or tear your uterus; while possible, it’s rare and unlikely. Some IUDs can expel or cause a benign perforation in the uterus upon insertion but only occur in 2-10% and 0.10% of users, respectively.

Fertility Awareness/Natural Family Planning

Also called the natural rhythm, or calendar, method, this refers to tracking your cycle to learn which days pregnancy is more likely (ovulation). Then, you can abstain from sex or use other birth control.

This plan is relatively inexpensive, has no side effects, and works best for those with regular periods. However, it isn’t nearly as effective (75-88%) as other methods. Ovulation home test kits and fertility monitors can help.

Permanent Birth Control/Sterilization

Male vasectomies and female tubal ligations are very effective (99%) and permanent. Depending on insurance, the procedure may be covered or cost up to $1,000 or $6,000, respectively.

Hormonal Contraceptives

Most hormonal contraceptives use the female hormones progestin and estrogen. They work by preventing the ovaries from releasing an egg each month and causing other changes that lower the chances of pregnancy. Long-term and short-term options are available depending on individual preferences. Using them alone will not protect you or your partner from STIs, but using them in tandem with condoms can help you achieve additional protection.

Misconceptions and Myths

A common birth control myth is that hormonal contraceptives will unbalance your natural hormones and cause adverse effects on your mood. However, since the hormones in birth control are very similar to those already found in women’s bodies, stress is more likely to affect your hormones than contraceptives. If you’re concerned about hormones, a potential option could be a copper IUD over one that utilizes hormone release.

Another pervasive worry is that hormonal options can cause cancer, but there is no evidence supporting this. In fact, some hormonal options may actually reduce the risk of ovarian or uterine cancer. Similarly, the misconception that birth control will harm your fertility or the ability to have kids in the future is also inaccurate; hormonal contraceptives are unlikely to affect your ability to conceive beyond your body’s natural ability. This is why women can get pregnant if they miss several pills. The majority of birth control options are entirely reversible.

Another common misconception about hormonal birth control, specifically, is that it will make you gain weight. The truth is that each type of birth control has a different effect on your body, and nobody’s experience is universal. Researchers have yet to find a direct correlation between hormonal contraceptive usage and weight gain. Many women begin using birth control during a time when their body is already naturally gaining weight and changing overall, so it can be hard to know whether the contraceptive is a contributing factor or not.

The birth control shot may increase a person’s appetite, so there may be a potential for weight gain. Still, as with most lifestyle changes, a healthy diet and regular exercise can help you feel more regulated. Low-maintenance birth control methods like hormonal IUDs and the implant contain progestins, which are not known to cause weight gain.

Long-Acting Reversible Contraceptives (LARCs)

Hormonal IUDs

These are much the same as copper IUDs, including the benefits, but instead release a small amount of progestin to prevent pregnancy (99% effective). They can last from three to eight years, depending on the type. Potential side effects may include irregular, heavy, and/or painful periods.

Birth Control Implant

A small rod is placed under the skin by a provider when prescribed, lasting up to three years. It releases progestin, is very effective (99%), low-maintenance and costs up to $2200 when not covered by insurance. Potential side effects include irregular bleeding, period loss, sore breasts, and headaches.

Short-Acting Hormonal Methods

Pills

Prescribed pills must be taken consistently at the same time every day for maximum effectiveness (93%). They take about a month to take effect, but onwards, they provide constant protection, even during your period or when forgetting a pill. It may cost up to $50, depending on insurance. Lower-hormone mini-pills are also available to help prevent side effects.

Other benefits include lighter and/or regulated periods, less cramping, reduced acne, and minimal PMS. Side effects can include temporary breast tenderness, nausea, headaches, and period irregularity. Those containing estrogen also increase the risk of blood clots.

Hormonal Patch

The patch is worn on the skin and releases hormones to be absorbed. It must be replaced weekly with one week off monthly. Its effectiveness (93%) is dependent on consistent use, and it may cost up to $150.

Hormonal Ring

Vaginal rings are inserted into the vagina and release hormones that prevent pregnancy. They require a prescription and are to be replaced monthly, some lasting longer than others. These are 91% effective and, depending on insurance, may cost up to $200.

Shot/Injection

The shot can be administered by a doctor/nurse every three months when prescribed. The progestin contained in the shot prevents ovulation and prevents sperm from reaching the egg by thickening cervical mucus. Shots are 96% effective and cost up to $150.

Emergency Contraception Pills (ECPs)

Also called the morning-after pill or Plan B, this birth control option can be provided over-the-counter or as prescribed. It is most effective (90%) soon after unprotected sex but may be effective for up to five days afterward.

ECPs are meant to be used when another contraceptive malfunctions or is forgotten. They are not designed for regular use, as taking them routinely can render them less effective. If you are already pregnant or become pregnant despite taking the ECP, it will not cause harm.

Trust Arizona Gynecology Consultants for Your Birth Control Needs

If you are searching for the ideal contraceptive for your needs, it’s critical to consider all the factors listed above. To ensure you find the best fit for you, schedule an appointment with a trusted gynecologist. Our AZGYN team can help you narrow down the options, provide you with professional advice from our extensive experience, and write a prescription as needed. Schedule an appointment today.

Sources:

Kaiser Family Foundation. (2022, November 3). Contraception in the United States: A closer look at experiences, preferences, and coverage. Retrieved from https://www.kff.org/womens-health-policy/report/contraception-in-the-united-states-a-closer-look-at-experiences-preferences-and-coverage/
Office of Disease Prevention and Health Promotion. (n.d.). Choose the right birth control. Health.gov. Retrieved from https://health.gov/myhealthfinder/healthy-living/sexual-health/choose-right-birth-control
Office on Women’s Health. (n.d.). Birth control methods. Women’s Health. Retrieved from https://www.womenshealth.gov/a-z-topics/birth-control-methods
Centers for Disease Control and Prevention. (n.d.). Contraceptive use. Retrieved from https://www.cdc.gov/nchs/fastats/contraceptive.htm
Nationwide Children’s Hospital. (2011). Birth Control Myths. Nationwidechildrens.org. https://www.nationwidechildrens.org/specialties/bc4teens/resources/birth-control-myths

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

www.azgyn.com/

Dispelling Birth Control Myths

This entry was posted in Birth Control and tagged myths on December 27, 2022 by Dr. Kelly Roy, MD.

Unfortunately, birth control myths circulate throughout the web. But, with the right information, you can make informed choices regarding contraceptive care.

Myth: There Are Few Methods of Birth Control, and Women Are Severely Restricted in Their Choices

While the responsibility to use birth control rests almost exclusively on women, we are fortunate in that there are many methods of birth control from which to choose. Each option works in different ways, and the method that works best for your lifestyle should be strongly factored into your choice.

Consider these popular options, all readily available from a healthcare provider:

Permanent Birth Control – There are surgical procedures available that will prevent a person who can ovulate from becoming pregnant, including tubal ligation or removal of the fallopian tubes.
Implant – A small rod is placed underneath the skin in your upper arm by a healthcare provider, where it dispenses hormones that prevent pregnancy.
Intrauterine Device (IUD) – A small, t-shaped device is placed into your uterus by a healthcare provider. Some dispense hormones, and some act as a physical deterrent to pregnancy.
The Shot – This is an injection of the hormone progestin that must be given by a medical professional.
Vaginal Ring – A flexible ring containing hormones is inserted into the vagina for three weeks at a time each month.
The Patch – A sticker-like patch is applied almost anywhere on the skin every week. It releases hormones via the skin.
The Pill – This is an oral medication taken at the same time each day that releases progesterone and estrogen to prevent pregnancy.
Emergency Contraception – This is an oral medication (sometimes a copper IUD) that can be administered up to five days following unprotected sex to prevent implantation.
Condom – Either polyurethane or latex, condoms are a physical barrier between the two partners.
Spermicide – These sperm-killing chemicals can come in the form of foams, film, or suppositories and can be placed in the vagina or used with a condom
Fertility Awareness – Also termed natural family planning, this occurs when a woman tracks her cycle and avoids sex during the period when she is most likely to conceive.
Pull-Out Method – This often-ineffective method involves removing the penis from the vagina prior to ejaculation.

Choosing the birth control method or methods that will most easily fit into your routine requires research and a discussion with a healthcare provider.

Myth: Birth Control Will Cause Cancer

Though there is some truth behind this myth, the statement itself is misleading. Some studies suggest there is a potential link between birth control pills, specifically the triphasic pill, and an increased risk of cervical cancer and breast cancer. A 2017 study found a mild increase in the rates of breast cancer in women using oral contraceptives; however, this study could not control all other risk factors because it was a prospective study. The overall risk of breast cancer remains low. There is also evidence that hormonal birth control can reduce the risk of endometrial cancer, colorectal cancer, and ovarian cancer.

Myth: IUDs Are Unsafe to Use

An intrauterine device (IUD) is a small plastic or copper t-shaped object that is inserted by a healthcare professional into the uterus to prevent sperm from reaching an egg and to prevent the implantation of a fertilized egg. IUDs that contain hormones may also prevent ovulation. Either form is a safe and effective method of birth control that has a 99% success rate of preventing pregnancy. That means that for every 100 women that use an IUD, less than 1 of them will get pregnant each year.

This myth likely arises from several high-profile cases of pelvic infection and subsequent infertility that resulted from the strings of one type of IUD. These issues occurred 30 years ago. Fortunately, in response, modern devices were created to eliminate the risk of infection, and this myth is no longer true.

Myth: Birth Control Pills Cause Birth Defects in Babies

Birth control pills are highly effective at preventing pregnancy when taken as directed. However, they are not 100% effective. This means that pregnancy may occur for teen girls and women even if the pill’s instructions are followed. If a pregnancy does occur, the birth control pill will not harm the growing fetus.

There was previously some concern about other medications that used progesterone, but these claims have never been substantiated by scientific studies. Taking birth control while pregnant is not recommended, but no harm will come to the fetus if you continue taking the pills. Even if it takes weeks or months for you to notice a pregnancy while taking birth control pills, the fetus will not be affected.

Myth: Birth Control Means Using a Hormonal Method

People frequently assume that birth control means hormonal forms of pregnancy prevention. There are many hormonal methods of birth control, including pills, implants, patches, and the hormonal IUD. Still, for some people, hormonal birth control methods are not possible because they will not or cannot use them. Fortunately, these are not the only methods available.

Though many of the commonly known methods are hormonal, there are multiple options to choose from if you are attempting to avoid a hormonal route. Some of these routes are equally as successful at preventing pregnancy as hormonal birth control. The copper IUD contains no hormones but remains 99% effective at preventing pregnancy, a rate even more effective than the hormonal birth control pill. Condoms are non-hormonal and aid in STD prevention.

Fertility planning is another method of non-hormonal birth control. The woman keeps track of their menstrual cycle and avoids sex during her most fertile days to prevent pregnancy. If you have recently given birth and choose to breastfeed, this can be a viable option for birth control as it has a high success rate under some circumstances.

Myth: Birth Control Pills Are Unsafe Because They Cause Blood Clots

A serious side effect associated with birth control pills is an increased risk of thrombotic complications like myocardial infarction, stroke, and venous thromboembolism (VTE). This side effect is more commonly known as a blood clot in the heart, limbs, brain, and groin. The potential risk factor increases for women that are in midlife, those who smoke, and those who have a risk of heart disease.

These side effects can be life-altering or even deadly. However, the risk of blood clots with birth control is low. It is true that the risk can be higher for women that take the pill, but the increase is only marginal. To fully understand the increase, consider that the risk of a blood clot while taking the pill is lower than the risk during pregnancy, delivery, and post-partum—just one in 3,000.

Myth: You Should Not Consider an IUD if You Have Not Already Had Children

IUDs are extremely successful at preventing pregnancy, with over a 99% success rate. Better yet, they offer long-term pregnancy prevention. For these reasons, IUDs should be included in any birth control conversation that you have with your gynecologist. This myth arose because a woman’s cervix and uterus will be slightly larger after giving birth, so IUD implantation and use may be more comfortable after childbirth. This is an old myth, IUDs are safe and effective even if you have not had any children.

Myth: All Birth Control Pills Work the Same

There are two distinct types of birth control pills: progesterone-only pills and combination estrogen and progesterone pills.

Progesterone-only pills are known as the mini pill. Progesterone alters the lining of the uterus, so it is less favorable for embryo implantation and changes the cervical mucus so sperm cannot move as easily to the egg. These are most frequently prescribed to breastfeeding mothers because they are at a higher risk for stroke but can be given to almost any woman. This type of pill may simply be a personal preference for some women.

Combination estrogen and progesterone pills contain both hormones. This difference in the amount of progesterone is what can cause the various side effects, so a doctor may need to adjust the dose to ensure a positive experience with the medication. Estrogen results in the suppression of luteinizing hormone (LH), which signals the ovaries to release eggs. Therefore, a reduction in LH will prevent eggs from progressing to the uterus, where they would be fertilized. The effects of progesterone on the cervical mucus, endometrium, and motility are also included with the combination pill. Recent alterations to the pills have also included shorter placebo intervals and longer periods of hormones so the woman can experience fewer menstrual periods.

Myth: Birth Control Increases the Risk of Stroke

There are some risks involved with taking hormonal birth control, but they are not blanket risks and will not apply to everyone. There are specific risk factors that can make a stroke more likely to develop from birth control use.

These risk factors include:

Obesity
Certain types of migraines
Smoking over the age of 35
A history of cardiovascular disease

There are avenues that can be taken to mitigate these risks, like using non-hormonal birth control or birth control that does not contain estrogen. Choosing the best birth control method for you should involve your own research and a conversation with a medical professional. However, it is important to note that the risks associated with pregnancy could be higher than the risks associated with birth control. The United States’ maternal mortality rate is increasing, making it one of the few countries where it is currently more dangerous to go through a pregnancy and childbirth than it was generations ago.

Myth: Birth Control Can Affect Your Fertility Even After You Stop Using It

Infertility is defined as the inability to get pregnant after one year of having sex without a contraceptive or barrier. The timeline might be shortened to six months if the woman is 35 years or older. Birth control does not cause infertility, but when the birth control method is stopped, the effects may stop immediately or diminish over time as the hormones leave your system. The exact timeline of your fertility return will depend on the individual and the type of birth control used. Fertility can return immediately, but it could take a few months for fertility to return as the body removes the birth control hormones.

This myth arose because of birth control’s questionable history. Studies were fraught with both a lack of consent and a lack of full disclosure. The hushed side effects and lack of informed consent made women wary of birth control, even more so in 1974 after the Dalkon Shield intrauterine device did cause infertility. Fortunately, contraception has become much safer and no longer has permanent effects on fertility.

Even if you chose a permanent form of birth control, like tubal ligation, you could still become pregnant. The uterus and ovaries are left intact, but the route an egg travels from the ovary to the uterus is broken. Therefore, IVF is a remaining option for you to carry a child that is biologically yours.

Myth: The Only Purpose of Birth Control Is Pregnancy Prevention

The primary purpose of birth control is to prevent pregnancy, but there are other uses. Women with heavy or painful periods can take hormonal birth control to help prevent excessive or long-term bleeding. Birth control methods like the pill, shot, patch, implant, and hormonal IUD can all cause shorter, lighter periods. They can also regulate menstrual cycles or even eliminate bleeding altogether, depending on the individual and type of birth control.

In this way, birth control can also improve some symptoms related to:

Ovarian cysts
Menstrual migraines
Hormonal acne
Uterine fibroids
Endometriosis
Polycystic ovary syndrome

Myth: Your Body Needs to Take a Break From Birth Control

Almost all types of birth control are safe to use continuously for as long as you choose. Birth control is essentially putting your menstrual cycle on a temporary pause. Choosing to begin pregnancy attempts is the only reason to take a break from birth control.

The only exception to this rule is the Depo-Provera injection. Because it has been linked to bone mineral loss, it is only recommended to be used continuously for two years. However, if you have concerns about the length of time that you will be or have been on birth control, you should have a conversation with a healthcare professional about more permanent forms of birth control, like tubal ligation.

Understanding Birth Control Myth vs Fact

Birth control has existed for decades, and many untrue myths have been in existence ever since. Though there may have been some truth to these myths when birth control was first developed, multiple advancements have been made that make birth control a safe and effective way to prevent unplanned pregnancies. Hormonal or non-hormonal, pills or implants, temporary or permanent—with a variety of options, there is a choice that is best for you and your lifestyle.

Using the latest methods and techniques, we establish a specialized plan for patients. With extensive knowledge of women’s health care, our doctors, surgeons and clinical specialists are ready to discuss any questions related to our gynecology services in Phoenix.

Sources:

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

www.azgyn.com/

What Causes Heavy Periods?

This entry was posted in Ask An Expert and tagged Menstrual Cycle on October 28, 2022 by Dr. Kelly Roy, MD.

From your first period, you’ll need to find a means of controlling heavy menstrual bleeding that meets your preferences, potentially including a pad, a tampon, or a menstrual cup. You’ll need to keep it accessible when your period is getting close, as well as some extra pants readily available in the event of a surprisingly heavy flow. Some women may also need to keep some pain relief medication on hand to reduce cramps and other uncomfortable symptoms.

Unfortunately, there is a population of women that will experience a consistently heavy flow beyond that experienced by most women, diagnosed as menorrhagia (heavy menstrual bleeding. An abnormally heavy flow should be evaluated by a healthcare professional to determine the underlying cause. Potential causes include polyps, fibroids, hormone imbalance, adenomyosis, and von Willebrand’s disease.

Is Heavy Menstrual Bleeding Serious?

Heavy menstrual bleeding can affect your daily life, hindering you from accomplishing the tasks you have for the day. As mentioned, severe blood loss can also cause symptoms of anemia, a medical condition that develops when you have too little iron in your body. This depletion of iron can be life-threatening without corrective treatment.

Even if you do not develop anemia, it is still important to see a healthcare professional about menorrhagia. Some of the underlying causes of heavy bleeding, including cancer, require early medical intervention. So, although heavy bleeding may affect anywhere from 27% to 54% of people who menstruate, its common nature should not override the severity.

What is Menorrhagia?

There is a significant difference between normal menstrual bleeding and menorrhagia, or heavy menstrual bleeding. Though any large amount of bleeding is a concern, most women will not experience heavy enough or prolonged enough bleeding to be considered menorrhagia. The bleeding must be severe enough that you cannot maintain your usual activities during your period due to blood loss and cramping.

Signs and symptoms of menorrhagia include:

A flow heavy enough to soak through one or more sanitary pads or tampons every hour for three or more consecutive hours.
The need to use double sanitary protection to contain your menstrual flow.
Waking up in the middle of the night to change your sanitary protection.
Periods lasting for a week or longer.
Passing blood clots that are a quarter size or bigger. The blood may be pink, red, brown, or rust-like in color.
Losing more than 80 milliliters of blood during your period, compared to the typical 35-40 milliliters lost by most women.
Restricting your daily activities because of the heavy menstrual flow.
Anemia symptoms like fatigue, tiredness, or shortness of breath.

Along with anemia, you could also notice symptoms of a condition called pica. These symptoms include pale skin, hair loss, and the urge to eat non-food items (hair, paper, dirt, and more). Contacting your provider is important if you experience any of these symptoms.

How Do I Know If I Have Menorrhagia?

Unfortunately, many people that experience heavy menstrual bleeding do not get medical help because they assume their periods are supposed to be uncomfortable and inconvenient. Their concerns may have been dismissed by family members that experience similar symptoms or even healthcare providers that did not take their concerns seriously. However, your flow should never require you to accept inconvenience or restrict activities long-term.

During your period, you should be able to:

Wear a standard absorbency pad or tampon for three to four hours without changing it for a new one.
Wear a single sanitary product without needing to double up (two pads or two tampons at the same time) at any point.
Leave your home for a few hours without planning to bring extra bags of pads or clothing changes.
Live your life as you normally do, without avoiding public places or missing work.

If your period is disrupting your life, it is time to visit your healthcare provider and start working on a plan to find and treat the cause.

What is the Cause of a Heavy Menstrual Bleeding?

Heavy menstrual bleeding can be caused by many different conditions, ranging from hormone imbalances to medical conditions and even stress.

Hormone Imbalance

Hormones like estrogen and progesterone are produced by your body and regulate your menstrual cycle. If these hormones are not produced in the right amounts at the right time, heavy periods can result. There are medical conditions that will affect your hormones and can cause imbalances that result in heavy menstrual bleeding. These include:

Thyroid Disease

The thyroid gland is wrapped around the trachea in the front of the neck. It makes and stores hormones essential for the function of every cell in the body. Along with the menstrual cycle, these hormones help regulate blood pressure, heart rate, body temperature, and how food is converted to energy. Thyroid disease is a general term used when the thyroid fails to make the proper level of hormones, whether it is too much (hyperthyroidism) or too little (hypothyroidism). The cause of the disease will dictate treatment, but it can include medication, surgery, and radioactive iodine.

Anovulation

Anovulation occurs when an ovum, or egg, fails to release from your ovary during your menstrual cycle. It is a common cause of infertility, as an egg is required for pregnancy. A build-up of the uterine lining and insufficient levels of progesterone from anovulation can cause heavy bleeding. Treatment for this condition depends on your specific hormone imbalance but can include managing your stress, medication, and hormone injections.

Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder that is common among women of reproductive age. It is caused by the ovarian overproduction of androgens; male sex hormones typically present in women in small amounts. This disorder is normally characterized by fluid-filled sacs that form on the ovaries if the ovary fails to release an egg.

Treatment depends on whether you want to become pregnant or not. If you do want to become pregnant, treatment options include medication to induce ovulation and surgery. Birth control is a common treatment for those that do not want to become pregnant.

Infection

Some infections, including sexually transmitted infections (STI), can result in heavy menstrual bleeding.

Chlamydia

Caused by an infection of a bacteria called Chlamydia trachomatis, chlamydia is an STI that can cause heavy menstrual cycles. It can also cause inflammation of the cervix, which results in spotting between periods. Chlamydia is treated with antibiotics.

Gonorrhea

Gonorrhea is caused by an infection of the bacteria Neisseria gonorrhoeae and is commonly a co-infection with chlamydia. Like chlamydia, it can also cause irritation of the cervix that results in bleeding in between cycles. Gonorrhea is also treated with antibiotics.

Chronic Endometriosis

Though the exact cause of endometriosis is unknown, it is believed to be retrograde menstruation, where menstruation blood flows from the uterus back through the fallopian tubes and into the pelvic cavity. This condition can cause very heavy or very light menstrual flow. Endometriosis is treated with hormone therapy, surgical treatments, and pain medications.

Noncancerous Growths in the Uterus

Even though these growths are benign and noncancerous, they can still cause cells to grow improperly in your uterus, which can result in heavy menstrual bleeding.

Polyps

Uterine polyps, or endometrial polyps, are growths in the inner lining of the uterus (endometrium). The polyps are caused by an overgrowth of endometrial tissue, may be round or oval, and can range from a few millimeters to a few centimeters. Polyps can cause your menstrual cycle to become irregular or heavy. Treatment for polyps depends on their location and size, but they are frequently surgically removed.

Uterine Fibroids

Uterine fibroids, also termed leiomyomas, are growths composed of connective and muscle tissue from the wall of the uterus. They are rounded growths that can grow as a single nodule or in a cluster. They can cause painful and excessive menstrual bleeding. There are many treatments for fibroids, including medication and surgical removal, but they can also be left in place if they are nonsymptomatic.

Adenomyosis

Adenomyosis occurs when tissue from the endometrium grows and pushes into the uterine wall, enlarging the uterus. The uterus can grow to double or triple the normal size because of the extra tissue. The enlarged uterus will then cause abnormally high blood volume during your period. Pain medication, hormonal birth control, and a hysterectomy are treatment options for adenomyosis.

Uterine Cancer

Heavy menstrual bleeding can be caused by cancers of the reproductive system. Uterine cancer is a general term that covers all cancers of the uterus, including endometrial cancer and uterine sarcoma. About 3% of cisgender women will be diagnosed with uterine cancer, and of these, most will develop endometrial cancer. Treatment for uterine cancer is typically a hysterectomy to remove all the cancerous tissue.

Heavy Menstrual Bleeding and Other Medical Conditions

Heavy menstrual bleeding can be a symptom of various medical conditions, including non-bleeding disorders and bleeding disorders.

Von Willebrand Disease

This common blood disorder is genetically inherited and prevents your blood from clotting properly. It is like hemophilia, but it usually causes less severe symptoms. The condition may be treated with medication, specifically birth control, to help reduce the blood loss during your period.

Liver Disease

Liver disease refers to any condition that can affect or damage your liver. Because your liver filters out mutated hormones, an improperly functioning liver can cause heavy or clotted menses. Treatment for liver disease depends on the underlying reason for the liver disease and how far it has progressed, but the options include medication, lifestyle changes, and a liver transplant.

How Is the Cause of Heavy Menstrual Bleeding Diagnosed?

The first step to getting a diagnosis is scheduling an appointment with your healthcare provider. You can prepare for this appointment by gathering this information and ensuring the information is thorough.

Questions they may ask during this appointment include:

What age did you first get your period?
How long do your periods normally last?
Do you have family members with a history of heavy menstrual bleeding?
What birth control are you currently taking, and what is your pregnancy history?
What other symptoms are you experiencing?
How are you managing your periods?

Once your provider has gathered your history, they will run a series of tests depending on which conditions are determined to be most likely from your answers.

The possible tests include:

Blood test
Pap smear
Sonohysterogram
Hysteroscopy
Endometrial biopsy
Ultrasound
Magnetic resonance imaging (MRI)

Menorrhagia FAQs

So, should you speak with your gynecologist about your heavy periods? How can you tell your period is heavy enough to be classified as menorrhagia? Learn more about menorrhagia with these FAQs.

Q: What Does a Normal Period Look Like?

A: There are no strict guidelines for how a period should look because everyone is different. However, while a “normal” period is hard to define, there are general parameters for a typical period. Most cycles last for 28 days, with four to five days of bleeding. The total blood loss should be 35 mL to 40 mL, and the blood clots should be occasional and smaller than a quarter.

Q: What Is Considered a Heavy Menstrual Bleeding?

A: A standard volume of blood loss for a heavy period is 80 milliliters of blood during the period with a duration of seven or more days. If you soak through one or more tampons or pads per hour for several hours or need to wear more than one menstrual product at a time to control the bleeding, you likely have a heavy period.

Q: Should Heavy Menstrual Bleeding Affect My Daily Life?

A: While all people with a period must make a few small accommodations if they want to avoid bleeding on their clothing, your period should not consistently affect your daily life. What’s more, you should not need to schedule your day around your period. If the volume of the bleeding that occurs during your menstrual cycle interferes with your social plans, daily activities, or work life, it is time to see a doctor and find the cause of the bleeding.

Q: What Usually Causes Chronic Heavy Menstrual Bleeding?

A: There is an extensive list of potential causes of excessive uterine bleeding, and a conversation with a healthcare provider may be required to discover the cause of your heavy bleeding. They will be able to administer diagnostic tests and hopefully find answers.

Common culprits are:

Hormone imbalance
Bleeding disorders
Noncancerous growths
Platelet disorders
Sexually transmitted infections

You Don’t Have to Settle For the Inconvenience of Heavy Periods

Just because you have lived your life up until now, accepting that heavy periods are normal does not mean you have to continue to do so. Even if your family has convinced you that they are to be endured or previous medical professionals have dismissed your concerns, speaking with trustworthy healthcare providers can result in a diagnosis and treatment plan that completely changes your quality of life.

Sources

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

www.azgyn.com/

Side Effects of Untreated Uterine Fibroids

This entry was posted in Health FAQs and tagged Fibroids, Uterine Anomalies on September 27, 2022 by Dr. Kelly Roy, MD.

Having a uterus can be a naturally stressful situation. Between menstruation, potential childbearing, and the various complications that can occur, it can be difficult to determine what is a normal burden of having a uterus and what is a complication that should be addressed. Uterine fibroids are one such example. Though fibroids are often harmless, they sometimes need to be addressed to keep you safe and comfortable.

What Are Uterine Fibroids?

Simply put, uterine fibroids are growths that occur in and around the uterus. Some people experience fibroids inside the uterine walls, while other times they appear on the outside of the uterus. They can even occur in the muscle tissue of the uterus. The cause of uterine fibroids is generally unknown, though experts believe that there is likely a genetic aspect involved. High levels of estrogen can also contribute to uterine fibroids.

Untreated Uterine Fibroids

Many individuals do not know that they have uterine fibroids, and therefore they go untreated for a long period of time. Others learn that they have fibroids but opt to leave them alone rather than try to eliminate them.

For the most part, people with uterine fibroids do not have severe symptoms. It is entirely possible to have fibroids and continue with life as usual, at your regularly-scheduled pace. However, this is not always the case.

Untreated Uterine Fibroids

While some patients may not experience any symptoms of uterine fibroids, others may experience heavy bleeding and pelvic pain. This pain can range in intensity, and is often chronic, as a painful fibroid will continue to cause pain until it is treated. Thus, for many people, leaving fibroids untreated means handling ongoing uterine or pelvic pain.

In some situations, untreated uterine fibroids may lead to difficulty conceiving a child. Some people suffer miscarriages at least partially due to uterine fibroids, as well. If you are having trouble conceiving or carrying a child, consult your gynecologist or OB GYN and ask if you may have uterine fibroids. Since fibroids often cause very few symptoms, they may be silently contributing to your difficulty conceiving or carrying a fetus to term.

Sonata Treatment is a minimally invasive option for treating symptomatic uterine fibroids. It has been approved by the U.S. Food and Drug Administration (FDA), making it a viable and effective option for fibroid treatment in the United States.

Other symptoms of untreated uterine fibroids include:

Constipation
Pain or soreness in the lower back
A feeling of abdominal fullness
Frequent urination
Pain during intercourse

Because uterine fibroids tend to have these fairly generic symptoms—if any at all—it is best to go to your doctor if you notice any changes in your reproductive health. Pain, abnormal bleeding, and new discomfort are all reasons to see a doctor to rule out fibroids and other medical conditions.

What Happens if Fibroids Go Untreated?

You usually do not need to worry about what happens if fibroids are not treated. If you don’t suffer significant symptoms that interfere with your daily life because of your uterine fibroids, you may opt to leave them untreated. In many cases, patients live with uterine fibroids without realizing it. Uterine fibroids are generally not dangerous, and do not require treatment unless the patient is in pain or experiencing difficulty conceiving.

The most significant risk of leaving uterine fibroids untreated is the risk of anemia. Because many fibroids cause significant bleeding, it is easy for your red blood cell count to drop below safe levels. Anemia is a serious condition that can affect your overall health. If you choose to leave your fibroids untreated, monitor your iron levels with your doctor to be sure that you do not become anemic.

Uterine fibroids are also associated with high estrogen levels. If your estrogen levels drop, your fibroids may shrink or go away entirely. Many people experience this phenomenon during perimenopause and menopause. If you are taking medications that increase your estrogen level, your doctor may make a switch to help the fibroids disappear.

Overall, it is safe to leave uterine fibroids untreated if they aren’t causing you pain and are not causing unwanted effects on your reproductive health.

Related Articles:

Reducing Your Risk of Developing Uterine Fibroids

Unfortunately, not much is known about the cause of uterine fibroids. Though there seems to be a genetic component, it is difficult for doctors to predict when someone is at risk for uterine fibroids. However, there are some situations that seem to increase a person’s chance of developing uterine fibroids, and addressing them may help lower your risk.

Address Your Weight

Obesity and being overweight can contribute to uterine fibroids. If your doctor believes that your weight is causing these issues, they should work with you to develop a care plan that makes you comfortable and addresses the issue.

Balance Your Diet

Your diet may also contribute to fibroid development. Consuming significant amounts of red meat, alcohol, or caffeine may increase your risk of developing uterine fibroids. If you consume high levels of these substances, you can reduce your risk of fibroids by cutting back on these foods and opting for alternatives.

Check For Infections

Can untreated infections cause fibroids? Yes, if you have a UTI or other reproductive system infection, be sure to treat it quickly. Always work with your care provider before making any significant changes to your diet or lifestyle. Because uterine fibroids are so unpredictable, making changes may not immediately affect your condition. Your doctor will be able to help you create a plan that is right for you.

Avoid Side Effects of Untreated Uterine Fibroids

Uterine fibroids have very few symptoms. Many individuals learn that they have fibroids after they test positively for anemia. Others experience heavy bleeding, uterine pain, or discomfort. In fact, there is no singular, telltale indication that fibroids are present, but your doctor may test for anemia as a way to determine if fibroids are a possibility. Historically, uterine fibroids have been removed using procedures such as hysterectomies and myomectomies. More recently, non-surgical solutions to uterine fibroids have been developing.

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

www.azgyn.com/

What Is Advanced Minimally Invasive Surgery for Women?

This entry was posted in Minimally Invasive Surgeries and tagged Minimally invasive on May 9, 2022 by Dr. Kelly Roy, MD.

Minimally invasive surgery is gaining popularity in gynecologic practices across the country. When performing a minimally invasive surgery, surgeons will first look for natural access points, such as through the vagina, in order to decrease incision sizes. When an incision is needed, the incision will be no greater than the size of a dime.^[1]Mori, K. M., & Neubauer, N. L. (2013). Minimally invasive surgery in gynecologic oncology. International Scholarly Research Notices, 2013. http://dx.doi.org/10.1155/2013/312982 This enables minimally invasive gynecological surgery patients to experience a more comfortable and less painful procedure, a shorter recovery time, a decrease in bleeding and scarring, and increased affordability.

What Can a Minimally Invasive Procedure Treat?

Minimally invasive procedures are becoming more common for treating a variety of gynecological issues. Procedures that once required large incisions and extensive recovery times are now being achieved through minimally invasive means, leading to a better experience for the patient. Depending on the issue you are experiencing, you may want to discuss minimally invasive options with your doctor and determine together if a minimally invasive gynecological surgery is right for you.

These are some of the most common gynecological issues that can be treated with minimally invasive procedures.

Ovarian Cysts

Developed in the ovaries, ovarian cysts can occur when abnormal ovarian pockets fill with fluid. Small cysts typically go away on their own, but larger cysts can cause irregular periods, pain during intercourse, chronic abdominal and back pain, and bloating. Larger ovarian cysts will often need to be surgically removed—potentially using a minimally invasive procedure.

Uterine Fibroids

Often found in women during their prime conception years, fibroids are noncancerous growths on the outside of the uterus. On some occasions, fibroids can cause heavy bleeding, causing the patient to become anemic. If you are considering having your fibroids removed, it is worth noting that uterine fibroid removal commonly utilizes robotic surgery.^[2]Holloway, R. W., Patel, S. D., & Ahmad, S. (2009). Robotic Surgery in Gynecology. Scandinavian Journal of Surgery, 96–109. https://doi.org/10.1177/145749690909800205

Hysterectomy

A hysterectomy is a non-reversible sterilization surgery in which your doctor will remove part or all of the uterus. Often this surgery is performed to treat uterine conditions that have not responded to other types of treatment. A laparoscopic surgery is a common minimally invasive procedure used to perform a hysterectomy.

Vaginal Prolapse

A “prolapse” occurs in a woman’s body when their pelvic organs slip out of place. This can cause discomfort, pressure, a bulge in the vagina, or bladder incontinence. Both laparoscopic surgery and robotic surgery can be used as treatment.

Vaginal Reconstruction

As the vagina endures the effects of childbirth and menopause, skin tissue can loosen, causing changes in vaginal appearance, lowering libido, and creating bladder incontinence. If you have recently given birth or are experiencing a lack of confidence in your sexuality due to the appearance of your vagina, talk to your doctor about vaginal reconstruction. These types of surgeries can address both medical and aesthetic issues, leading to better quality of life and even increased self-confidence.^[3]Karcher, C., & Sadick, N. (2016). Vaginal rejuvenation using energy-based devices [Review of Vaginal rejuvenation using energy-based devices]. International Journal of Women’s Dermatology, … Continue reading

Cervical Dysplasia

Cervical dysplasia is caused by the growth of precancerous cells on the surface of the cervix that are caused by human papillomavirus (HPV). There are no symptoms for cervical dysplasia, but if left untreated, precancerous cells can spread and multiply, leading to cervical cancer.^[4]Klobucar, A., Hrgovic, Z., Bukovic, D., Caric, V., Grgurevic-Batinica, A., & Hrgovic, I. (2004). The treatment of cervical dysplasia with laser. Medicinski Arhiv, 58(6), 355-357. … Continue reading Multiple minimally invasive treatments are available to treat cervical dysplasia. Talk to your doctor to determine which one is right for you.

Endometriosis

Endometriosis is a very painful condition in which tissue is formed on the outside of the uterus instead of the inside. Most commonly, endometriosis can be treated with a non-invasive laparoscopic surgery. Your doctor will determine which non-invasive surgery is right for your needs.

What Are the Most Common Gynecological Surgeries?

If you have a qualifying gynecological issue, you and your doctor will discuss your options and decide which treatment plan is best suited for your needs. If a gynecological surgery is necessary, your doctor will likely suggest a minimally invasive procedure to improve your recovery time and your outcome. However, there are a variety of technologies and techniques your doctor may recommend when formulating your treatment plan.

These are some of the most common gynecological surgeries.

Hysteroscopy

In this minimally invasive procedure, doctors are able to see inside your uterus by inserting a scope for visualization into your vagina, through your cervix, and into your uterus. This procedure does not require any incisions and can be performed for both diagnostic and treatment purposes, including the treatment of polyps, female genital abnormalities, scarring or other abrasions, issues relating to contraception or following a miscarriage, and abnormal bleeding.^[5]Centini, G., Troia, L., Lazzeri, L., Petraglia, F., & Luisi, S. (2016). Modern operative hysteroscopy. Minerva Ginecologica, 68(2), 126-132. https://pubmed.ncbi.nlm.nih.gov/26930389/

In many cases, only local anesthesia is needed for this procedure, if any is needed at all. However, in some rare cases, general anesthesia may be needed. Patients are typically able to leave shortly after the procedure with only minimal side effects, such as cramping or light bleeding.

Vaginal Surgery

Vaginal surgery is the least invasive form of minimally invasive surgery. It is typically used for woman who have experienced damage to the vaginal area after giving birth or women who are going through menopause and are looking to restore elasticity. This type of surgery utilizes the vaginal opening to repair or reconstruct the vagina. Results from this surgery could include an improved vaginal appearance, a reduction of pain, or increased functionality. With this method of surgical procedure, doctors will not need to make any incisions and there is an overall lower risk of surgical complications.

What Is Advanced Minimally Invasive Surgery?

Advanced minimally invasive surgery is a specialized form of surgery that requires the use of advanced equipment and technology. These devices often require additional specialization and training on the part of the surgeon and are only available at select surgical centers. These are the most common advanced minimally invasive surgeries.

Robotic Surgery

This advanced form of minimally invasive treatment allows your surgeon to operate with greater precision and accuracy. In a robotic-assisted surgery, your doctor will use a control console to control a human-like robotic hand, which is able to perform more precise movements with a much greater range of motion than an actual human hand. While the procedure is in progress, the doctor will be able to see your anatomy on a 3D screen, allowing for much greater visibility.

Laparoscopic Surgery

Most often performed during the removal of the uterus or during a hysterectomy, a laparoscopic surgery is a minimally invasive procedure in which your doctor will make a few very small incisions into your abdominal region. Through these incisions, your doctor will then insert tubes, which will be used as tools during the procedure. These tubes have cameras attached to them, providing your doctor a full view of your internal organs, leading to better accuracy and less opportunity for error. Once the doctor is completed with the operation, the small incisions can easily be sutured and treated for a seamless recovery.

In comparison to a typical hysterectomy, laparoscopic surgery is much quicker and requires less recovery time and a decreased hospital stay. On average, a patient will only need to spend one day in the hospital after the procedure and will be almost fully recovered two weeks after surgery compared with the eight weeks that is typical of a conventional hysterectomy. Patients will also experience much less pain and lose less blood, decreasing the risk of complications and increasing patient satisfaction. A shorter recovery time and quicker hospital stay also allows patients to get back to their daily routines much more quickly. In addition, due to the smaller incisions, patients will notice less scarring afterward.^[6]Mayo Foundation for Medical Education and Research (MFMER) (2022). Minimally invasive gynecologic surgery – Overview. Mayo Clinic. Retrieved March 27, 2022, from … Continue reading

Is Minimally Invasive Surgery the Best Choice for You?

Deciding if minimally invasive surgery is the right decision for your gynecological care can be a difficult, but ultimately rewarding, decision. Choosing to undergo a minimally invasive gynecological procedure can lead to multiple benefits to both your health and your self-esteem. We’ve listed the most commonly cited advantages.

Shorter Recovery Time

Undergoing an invasive surgery takes time, and an extensive amount of time is usually needed to recover. Typically, patients who undergo an invasive procedure have a fairly long hospital stay of three to eight days on average. Minimally invasive surgeries, on the other hand, are typically same-day procedures, meaning you can go home the same day as the procedure. Because a minimally invasive surgery produces a smaller wound, the skin will also be able to heal much faster, making recovery time as quick as two weeks. With a quicker recovery time, your life and independence can safely return to normal, without the interruption on your life or daily routine.^[7]Mori, K. M., & Neubauer, N. L. (2013). Minimally invasive surgery in gynecologic oncology. International Scholarly Research Notices, 2013. https://doi.org/10.1155/2013/312982

Less Risk for Infection

Since the wound is smaller and heals faster, there is less risk of infection. A smaller wound is also easier to nurse and can help you avoid some of the precautions necessary with a larger or more exposed wound.

Decreased Scarring

As compared with large abdominal scars, the incisions made in minimally invasive procedures are no bigger than a dime. Only one or two stitches is needed to close them. Scarring is therefore minimized, and scars will often not be visible after healing is complete.

Less Prescription Medications

Patients who undergo invasive surgeries are often put on multiple medications that can cause unwanted side effects like constipation, slowed breathing, confusion, drowsiness, and even dependency. It is not uncommon for patients to have a hard time weaning off these medications after their recovery period is over. Fortunately, less invasive procedures typically require fewer pain relieving medications taken for a much shorter period of time.

Increased Confidence

After undergoing minimally invasive procedures, patients often notice increased confidence. Whether it be following a reconstructive vaginal surgery, birth, menopause, or a surgery to help a painful or potentially embarrassing sexual problem, minimally invasive surgery can leave patients feeling confident and better than ever about their sexuality and femininity.

Minimally invasive surgery is becoming popular among gynecologists nationwide. This less-invasive procedure is performed through a small incision or natural access points, such as the vagina, and typically leads to shorter recovery time, decreased bleeding, and decreased scarring.

Is Minimally Invasive Surgery Right for You?

Based on your situation, your doctor will recommend the best treatment option or combination of options for your situation. Advanced and minimally invasive surgery options allow women with challenging gynecological issues to receive a customized surgical treatment plan to achieve their individual goals. Contact us if you would like to discuss your options with one of our providers.

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

www.azgyn.com/

References[+]

References
↑1	Mori, K. M., & Neubauer, N. L. (2013). Minimally invasive surgery in gynecologic oncology. International Scholarly Research Notices, 2013. http://dx.doi.org/10.1155/2013/312982
↑2	Holloway, R. W., Patel, S. D., & Ahmad, S. (2009). Robotic Surgery in Gynecology. Scandinavian Journal of Surgery, 96–109. https://doi.org/10.1177/145749690909800205
↑3	Karcher, C., & Sadick, N. (2016). Vaginal rejuvenation using energy-based devices [Review of Vaginal rejuvenation using energy-based devices]. International Journal of Women’s Dermatology, 2(3), 85–88. https://doi.org/10.1016/j.ijwd.2016.05.003
↑4	Klobucar, A., Hrgovic, Z., Bukovic, D., Caric, V., Grgurevic-Batinica, A., & Hrgovic, I. (2004). The treatment of cervical dysplasia with laser. Medicinski Arhiv, 58(6), 355-357. https://pubmed.ncbi.nlm.nih.gov/15648233/
↑5	Centini, G., Troia, L., Lazzeri, L., Petraglia, F., & Luisi, S. (2016). Modern operative hysteroscopy. Minerva Ginecologica, 68(2), 126-132. https://pubmed.ncbi.nlm.nih.gov/26930389/
↑6	Mayo Foundation for Medical Education and Research (MFMER) (2022). Minimally invasive gynecologic surgery – Overview. Mayo Clinic. Retrieved March 27, 2022, from https://www.mayoclinic.org/departments-centers/minimally-invasive-gynecologic-surgery/overview/ovc-20424071
↑7	Mori, K. M., & Neubauer, N. L. (2013). Minimally invasive surgery in gynecologic oncology. International Scholarly Research Notices, 2013. https://doi.org/10.1155/2013/312982

Should an Ovarian Cyst Be Surgically Removed?

This entry was posted in Minimally Invasive Surgeries and tagged Clinical Treatment, Gynecological Surgery, Ovarian Cyst, Signs And Symptoms, Surgery on February 16, 2022 by Dr. Kelly Roy, MD.

Regardless of its size or level of severity, discovering an ovarian cyst can be a stressful and confusing experience for any woman—especially if the cyst is causing you severe discomfort in your day-to-day life. However, the way a cyst is treated or even if it needs to be treated varies from situation to situation.

Ovarian cysts are relatively common (occurring in between 8% and 18% of women) ^[1]Ross, E.K. (2013). Incidental Ovarian Cysts: When to Reassure, When to Reassess, When to Refer. Cleveland Clinic Journal of Medicine; 80(8): 503–514. Retrieved from 2013 article., both pre- and post-menopausal. However, most of these cysts are benign, meaning that they’re non-cancerous. ^[2]Abduljabbar, H. S., Bukhari, Y. A., Al Hachim, E. G., Alshour, G. S., Amer, A. A., Shaikhoon, M. M., & Khojah, M. I. (2015). Review of 244 cases of ovarian cysts. Saudi medical journal, 36(7), … Continue reading In rare circumstances, though, it’s also possible for a cyst to become cancerous or to cause severe complications for the patient. Whenever a twisted ovary or rupture occurs, this can be extremely painful, and the patient must receive immediate medical care.

With so many possibilities, you might be unsure how to proceed after the discovery of an ovarian cyst. To start, take any recommendations by your doctor into serious consideration. They’ll be able to give you a clearer idea of your cyst’s condition and whether treatment is necessary.

When Should an Ovarian Cyst Be Surgically Removed?

Fortunately, in the case of most ovarian cysts, surgery isn’t a necessary treatment. ^[3]Imperial College London. (2019, February 5). Ovarian cysts should be ‘watched’ rather than removed, study suggests. ScienceDaily. Retrieved February 20, 2022 from … Continue reading The majority of these types of cysts can resolve on their own, often without symptoms or complications. However, there are a few situations where ovarian cyst removal may be the best course of action. For example, suppose the cyst is on the larger side, is actively growing, is non-functional, causes pain, or continues throughout more than two menstrual cycles. In that case, your gynecologist might suggest surgical removal.

In some cases, a cyst can be removed using a procedure known as an ovarian cystectomy. However, the ovary itself won’t be removed during this procedure. There are other times when removing the entire ovary may be the safest path to take. When just the affected ovary is removed, and the other remains intact, this is known as an oophorectomy.

Though rare, some cystic mass may be cancerous. ^[4]Jayson, Elise C Kohn, Henry C Kitchener, Jonathan A Ledermann, Ovarian cancer, The Lancet,Volume 384, Issue 9951,2014,Pages 1376-1388,ISSN 0140-6736,https://doi.org/10.1016/S0140-6736(13)62146-7. You can expect to be referred to a gynecologic cancer specialist in these instances. The surgical treatment needed in these cases can differ. However, you may need to receive a total hysterectomy. In other words, the ovaries, uterus, and fallopian tubes will all need to be removed. Other cancerous cysts are best treated with radiation or chemotherapy.

If the ovarian cyst develops after the start of menopause, your gynecologist will likely recommend surgical removal.

Functional Cysts Vs. Non-functional Ovarian Cysts

The distinction between functional and non-functional ovarian cysts is important to keep in mind, as it can dramatically influence the best course of treatment.

Functional Cysts (Follicular and Corpus Luteum)

Functional cysts come in two forms: follicular cysts and corpus luteum cysts. Both of these ovarian cysts form during someone’s menstrual cycle.

A follicular cyst may develop when an egg can’t be released from the follicular sac (where an egg grows). More often than not, follicular cysts will resolve on their own in no more than two menstrual cycles.

If the follicular sac releases an egg, but there’s a buildup of fluid, this is a corpus luteum cyst. Although these ovarian cysts often resolve on their own, they can be more painful than a typical follicular cyst. It’s even possible that they will result in bleeding.

As a whole, functional cysts are a benign type of growth. If the functional cyst is small and not causing any symptoms or pain, treatment likely won’t be needed. However, your gynecologist may prescribe birth control bills when menstrual problems or pain are involved, as this can stop new cysts from forming.

Periodic ultrasound studies can be used to monitor the cyst to ensure that it resolves on its own.

Non-Functional Cysts (Dermoid, Cystadenoma, Endometrioma, & Malignant)

When a woman develops a non-functional ovarian cyst, it isn’t a result of releasing an egg or her menstrual cycle. Although most non-functional cysts are non-cancerous, that isn’t always the case.^[5]M A Pascual, L Hereter, F Tresserra, O Carreras, A Ubeda, S Dexeus, Transvaginal sonographic appearance of functional ovarian cysts., Human Reproduction, Volume 12, Issue 6, Jun 1997, Pages … Continue reading

Non-functional ovarian cysts also come with several potential complications, including a twisted ovary or rupture. Other times, the non-functional ovarian cyst may be large enough that this alone causes the patient pain or discomfort.

There are four types of non-functional ovarian cysts, and those are:

Dermoid
Cystadenoma
Endometrioma
Malignant

Dermoid cysts are typically benign, although they can rupture or twist the ovary. ^[6]Mobeen S, Apostol R. Ovarian Cyst. [Updated 2021 Jun 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: … Continue reading They’re also present from the patient’s birth rather than developing later in life. These cysts are composed of hair, skin, muscle, or organ tissue.

Cystadenomas are large cysts that develop on the outside of the ovaries. Despite their size and the discomfort they can cause, they are typically benign. Similarly, endometriomas are usually benign cysts, although they develop due to an excess of uterine lining tissue.

As a woman ages, her cysts may become cancerous or malignant. This is a rare situation, but a “watch and wait” strategy is the best way to catch the problem early. When a patient experiences persistent ovarian cysts (especially after menopause), her doctor must perform routine ultrasound screenings to check for tumors or signs of cancer.

How Big Does an Ovarian Cyst Have to Be to Get It Removed?

Most ovarian cysts are relatively small, often with little to no symptoms or pain. However, if one of these cysts grows to a larger size, this can cause complications and necessitate surgical removal. Surgery often isn’t necessary until an ovarian cyst has grown to 50 to 60 millimeters in size or approximately 2 to 2.4 inches.

Still, these measurements aren’t a rigid guide to when a cyst should be removed. For example, for a simple benign cyst, your doctor might prefer not to surgically remove it until it’s larger than 4 inches. On the opposite hand, if an ovarian cyst is cancerous, it will need to be removed even if it’s of a much smaller size.

Ovarian Cyst Removal Side Effects and Risks

Like any surgical procedure, there are potential risks or side effects to having an ovarian cyst surgically removed. ^[7]Henes, M., Engler, T., Taran, F. A., Brucker, S., Rall, K., Janz, B., & Lawrenz, B. (2018). Ovarian cyst removal influences ovarian reserve dependent on histology, size and type of operation. … Continue reading

Some of the most common risks of ovarian cyst removal surgery are that:

It may not control the pain, despite removal.
The ovarian cysts return (after cystectomy).
An infection develops.
Scar tissue builds up at the surgical site—on the fallopian tubes, ovaries, or in the patient’s pelvis.
Damage is done to the bladder or bowel.

Ovarian Cyst Removal Recovery Time

The anticipated recovery time after ovarian cyst removal surgery depends on whether the patient had a laparoscopy or a laparotomy.

Laparoscopy involves a small incision and has a shorter recovery time. Usually, the patient can return to their day-to-day activities within a day. They should avoid strenuous exercise or activity for around a week, though.

If there’s any suspicion of cancer, a laparoscopy won’t be the most appropriate surgical option. So instead, some patients will have a laparotomy performed. This procedure gives an improved view of the female pelvic organs and abdominal muscles, involving a larger incision in the abdomen.

After receiving a laparotomy, the patient could remain in the hospital for approximately two to four days. It will also take around four to six weeks to return to their usual activities.

The Cost of Ovarian Cyst Removal Surgery

Like recovery time, the cost of ovarian cyst removal depends on the type of surgery the patient has received. In addition, whether or not the patient has health insurance coverage is also essential in determining cost.

If the patient has health insurance, the cost of their surgery usually consists of a copay and coinsurance rate of between 10% and 50% (sometimes more). However, if the cyst removal surgery is medically necessary, health insurance providers will generally cover it.

Alternatively, if the patient doesn’t have health insurance, it will typically cost between $7,000 and $15,000 to have ovarian cysts surgically removed. Depending on the patient’s location and the hospital used, the cost can vary.

Although some hospitals may charge as little as $6,500 for surgery, the figure can be several thousand dollars higher with a doctor’s fee.

If you’re an uninsured or cash-paying patient, many care providers will offer a discount of up to 30% (or more).

How Well Does Ovarian Cyst Removal Surgery Work?

If the patient receives an oophorectomy, the current cysts have been removed—so, there won’t be any risk of new ovarian cysts developing in the future.

However, a cystectomy preserves the ovary (and the patient’s fertility if this is a concern). This means that new cysts can develop in the future, whether they form on the same ovary or the opposite one.

Your doctor may prescribe birth control pills to reduce the chances of new ovarian cysts developing. ^[8]Grimes DA, Jones LB, Lopez LM, Schulz KF. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews 2011, Issue 9. Art. No.: CD006134. DOI: … Continue reading

Ovarian Cyst Treatment & Removal by Arizona Gynecology Consultants

At Arizona Gynecology Consultants, we are a team of experienced gynecology professionals in the Phoenix and Mesa areas. If you’re currently struggling with ovarian cysts, we offer both general care and minimally invasive surgical procedures.

We treat many women’s health conditions, including primary care, menopause, abnormal bleeding, pelvic pain, hormone replacement, and more. AZGYN even offers several no-incision medical treatments, including for abnormal uterine bleeding or uterine fibroid treatments.

* Editor’s Note: This article was originally published Jun, 2017 and has been updated Feb, 2022.

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

www.azgyn.com/

References[+]

References
↑1	Ross, E.K. (2013). Incidental Ovarian Cysts: When to Reassure, When to Reassess, When to Refer. Cleveland Clinic Journal of Medicine; 80(8): 503–514. Retrieved from 2013 article.
↑2	Abduljabbar, H. S., Bukhari, Y. A., Al Hachim, E. G., Alshour, G. S., Amer, A. A., Shaikhoon, M. M., & Khojah, M. I. (2015). Review of 244 cases of ovarian cysts. Saudi medical journal, 36(7), 834–838. https://doi.org/10.15537/smj.2015.7.11690
↑3	Imperial College London. (2019, February 5). Ovarian cysts should be ‘watched’ rather than removed, study suggests. ScienceDaily. Retrieved February 20, 2022 from www.sciencedaily.com/releases/2019/02/190205185156.htm
↑4	Jayson, Elise C Kohn, Henry C Kitchener, Jonathan A Ledermann, Ovarian cancer, The Lancet,Volume 384, Issue 9951,2014,Pages 1376-1388,ISSN 0140-6736,https://doi.org/10.1016/S0140-6736(13)62146-7.
↑5	M A Pascual, L Hereter, F Tresserra, O Carreras, A Ubeda, S Dexeus, Transvaginal sonographic appearance of functional ovarian cysts., Human Reproduction, Volume 12, Issue 6, Jun 1997, Pages 1246–1249, https://doi.org/10.1093/humrep/12.6.1246
↑6	Mobeen S, Apostol R. Ovarian Cyst. [Updated 2021 Jun 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560541/
↑7	Henes, M., Engler, T., Taran, F. A., Brucker, S., Rall, K., Janz, B., & Lawrenz, B. (2018). Ovarian cyst removal influences ovarian reserve dependent on histology, size and type of operation. Women’s health (London, England), 14, 1745506518778992. https://doi.org/10.1177/1745506518778992
↑8	Grimes DA, Jones LB, Lopez LM, Schulz KF. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews 2011, Issue 9. Art. No.: CD006134. DOI: 10.1002/14651858.CD006134.pub4. Accessed 21 February 2022.

Keep It Balanced: Maintain Vaginal pH Through Diet

This entry was posted in Fitness and Nutrition and tagged ph Health on December 8, 2021 by Dr. Kelly Roy, MD.

Specific foods improve your vaginal pH and overall health. This will keep your most sensitive organ functioning well and makes the necessity for multiple gynecological visits at a minimum. Fighting infection and minimizing unpleasant odors are just a few of the benefits of a good diet in foods great for your vagina.

What Is pH and What Should Your Vagina Be?

First off, pH is simply the scientific measurement to determine how acidic or basic something is. It is annotated numerically from 0 to 14, where 0 is the most acidic and 14 is the most basic. To measure this, a litmus test is conducted where a special sheet of paper is exposed to a substance and, based on its coloring, you can determine its acidic or basic level.

For reference, water should be at a 7 (in the center). As far as vaginas are concerned, your levels should be anywhere from 3.8 to 4.5; however, your healthy pH level can vary depending on age reproductively (pre-menstruation, reproductive years, and post-menopause). Generally, you want the number to be on the more acidic side.

Why the pH Level Matters

A more acidic vagina is ideal for women because it helps prevent bacterial growth and infections such as bacterial vaginosis (BV) or trichomoniasis (trich). It is important to note that a vagina that is too acidic can cause fertility problems because sperm survive better in a more basic (or alkaline) environment where their most optimal level is between 7 and 8.

Thankfully, modern science has studied and shown how different foods and natural remedies to restore pH balance to the vagina can be beneficial to overall health.

Foods That Help Balance pH

1. Cranberries

Cranberries have long been known to help prevent and treat urinary tract infections. There are two special ingredients found in cranberries: A-Type proanthocyanidins (PAC) and fructose (sugar). These ingredients concurrently prevent bacteria, which cause UTIs from clinging to the wall of the bladder.

The American Journal of Obstetrics and Gynecology studied cranberry and its effects and found that the rate of UTIs after gynecological surgery had been cut by 50%. It is important to note that in this study, women were taking cranberry supplement pills which replaced the need to drink two servings of juice. The sugar found in cranberry juice can often raise your pH levels in your vagina, making them more basic and thereby create an environment for yeast infection.

2. Foods with Healthy Fats

When we go to the grocery store, we are assaulted with foods that claim to be “low in fat” or “fat free.” This might not always be helpful to your health, especially when it comes to your vagina. Nuts, olive oils, and avocado are just three of the foods available which can keep your cholesterol and estrogen levels balanced, which keeps your pH level in your vagina balanced, as well. Go nuts on nuts and definitely add avocado to your toast in the morning to reap the benefits of these foods.

3. Kimchi, Greek Yogurt, and Other Probiotics

Kimchi contains any variation of veggies, chili peppers, salt, fish sauce, garlic, and ginger and is then canned/jarred and fermented. It can either be purchased at a regular or international grocery store or, if you prefer, made right at home with all your preferred flavors and combinations. The point overall is that the dish is fermented, which creates more acidity in your pH levels of your vagina but not so much to cause a problem.

Greek yogurt, like kimchi, is also a probiotic, which can promote good intestinal/stomach health as well as keep away bad bacteria from your vaginal area. Probiotic foods are also foods that balance pH in the stomach.

If you cannot get probiotics naturally into your diet through foods like kimchi, cottage cheese, kombucha, miso, or Greek yogurt, try a simple supplement you can get over the counter at your local pharmacy.

4. Prebiotic Foods

Naturally, where probiotic foods exist, there are also prebiotic foods. To understand the difference, think of it this way: probiotics are living microorganisms that function as good bacteria, whereas prebiotics are carbohydrates that feed “good” bacteria in the gut.

When prebiotics travel to the colon, they are undigested despite having gone through the stomach. While in the colon, they ferment and feed naturally-occurring gut bacteria. While prebiotics exist largely in plant-based foods, not all plants function in this way. Prebiotics can be found in honey, bananas, soybeans, onions, and garlic.

As far as your vagina is concerned, prebiotics feed naturally-occurring “good” bacteria, and it is suggested by doctors to be consumed with probiotics. Like probiotics, prebiotics can be taken as a supplement, so when purchasing, make sure to pay attention to the prefix in front of “biotic.”

5. Water

It’s probably not a shock to many but water and basic hydration is the best way to create a hospitable environment in your body in general. Water, besides being necessary to maintain life, can keep your vagina functioning at maximum capacity. The vagina has its own cleansing system built-in, and proper hydration only aids in its ability to keep itself clean by increasing lubrication, allowing discharges to be released, and maintaining overall balance of the pH of the vagina.

To maintain proper hydration, the good rule is to drink at least nine cups (2 liters) of water every day. Instead of gulping down that much water, it is preferable to drink little by little throughout the day evenly; gulping too much water can cause nausea and vomiting, which dehydrates you.

If you are using sports drinks to achieve hydration while working out or doing heavy physical exercise, make sure your sugar intake in these drinks is at a minimum.

6. Vitamin C

While not exactly a food, this vitamin is important to consume for vaginal pH health and can be found in a variety of different fruits and vegetables. The foods found to have the highest amount of Vitamin C are citrus fruits (oranges, lemons, etc.), bell peppers (red, green, yellow – you can’t lose), and strawberries (yum!). Any food high in vitamin C can aid in fighting infections in your body in general, but especially in your vaginal area.

Vitamin C can help maintain healthy pH levels in your vagina, as well, and can be administered through a boric acid suppository alternative if you are sensitive to any of the foods high in vitamin C.

Foods That Throw Off Your pH

Your pH can be balanced by foods, so, naturally, there are certain foods that throw off your pH to either end of the acid/base scale and cause gynecological problems. Here is a short list of foods to stray away from to maintain good pH levels in your vagina:

1. Foods High in Sugar

As we mentioned before, foods higher in sugar can throw off your pH level tremendously. On top of being bad for your pH level, high sugar foods can cause excessive weight gain, lethargy, “sugar crash,” acne/skin problems, and can degrade teeth enamel over time (think cavities). While a slice of cake every once in a while certainly will not kill you, it is important to maintain that good balance.

2. Alcohol

There is a reason those who are recovering from alcoholism crave sugary foods – it processes the same in the body. Likewise, alcohol can be as detrimental to your pH of your vagina as sugar itself can – in the end, it’s all just unnecessary glucose.

Don’t worry, however – you can still enjoy a glass of your favorite alcohol to wind down, but again, moderation is key. Red wine has been shown to increase the blood flow to your vagina and increase libido in women. It is advised with red wine, however, to limit yourself to 2 glasses only.

3. Processed Foods

At the end of the day, it is difficult to “get into gear” and cook a healthy meal from scratch. For busy people, processed foods can be a quick and easy way to prepare food, but, as with most things, too much can be harmful to your body (especially your vagina). Processed foods are any foods that are not “whole” or naturally occurring. While it is very difficult to only consume whole foods, you can supplement processed foods for simply or minimally-processed foods, such as food grown and sold organically.

4. Any Meat or Dairy with Additive Hormones

Be a savvy consumer and make sure when you purchase meat or dairy products that the animals these products come from have not been injected with hormones. Products without hormones will be USDA-certified organic or marked specifically as “hormone-free.” These hormones are called xenoestrogens and mimic naturally-occurring estrogen in animals born purely for food purposes. These xenoestrogens then transfer to your own system when you consume hormonally-treated meat or dairy and can play havoc on your own hormones. Red meat and dairy products are not harmful but make sure you know how it was made ahead of time.

Good Life Practices for Vaginal Health

There are certain activities which women should be engaging in to maintain and promote good vaginal health.

If you are not doing these things and experiencing vaginal problems/infections, this list might help aid what ails you:

Cleanliness of your vagina – Cleaning and maintaining the vagina isn’t as difficult as one might imagine. Your vagina naturally cleans itself, but if you want to clean it further, rinsing the area with warm/lukewarm water will help keep it fresh. If you need to use soap, make sure it is free of fragrance. Though tempting, cleansing products are not advised (such as douching or washes). While on your period, try to avoid any scented tampons or sanitary pad products.
Quit smoking – Besides being harmful to lung and heart health, people who smoke tobacco are more prone to infections like BV. Non-smokers in a study conducted in 2018 were found to have more Lactobacillus in their vagina versus smokers. Lactobacillus is a probiotic bacteria that is important to the vagina to function properly.
Stress-busting – A study in 2018 linked cortisol (the hormone produced during stressful events) and BV. While stress is impossible to abstain from completely, stress-busting activities such as meditation, exercise, and music/other hobbies can help maintain healthy stress levels.
Good underwear sense – Wearing a breathable but absorbent, soft fabric (such as cotton) on your vagina is incredibly helpful to keeping your pH levels regulated. Also, make sure you are cleaning your laundry with detergent, which is fragrance-free and hypoallergenic. If possible, go “commando” at night while you sleep to prevent moisture from building up in the vaginal area.
Condoms/barriers during sex – Semen, as we mentioned before, can alkalize the vaginal walls and increase risk of infection. Even digital penetration and oral sex have bacterial risks, so using a “dental dam” or “finger cot” is suggested for those activities. If you are trying to get pregnant or cannot use condoms, make sure to cleanse your vagina after sexual activity.

Times to Seek Medical Help

Even with preventative and good health practices, there are times where you might be faced with symptoms and discomfort in your vagina and need professional medical care and advice. Try not to “self-diagnose” on the internet and instead call your gynecologist to set up an appointment immediately. If you do not have a gynecologist, ask your primary care doctor for help with your symptoms or for help finding a gynecologist in your area.

Here are symptoms to never ignore:

Unusual discharge – anything that is not clear as vaginal discharge is something that should be examined.
Foul odor – don’t douche or use vaginal washes as the smell might be indicative of a larger issue.
Burning sensation – if the skin inside or outside your vagina feels like it is burning or irritated.
Itchiness – itching could be an indication of an infection or yeast infection and needs doctor-prescribed pharmaceuticals and care.

Come See the Experts in Vaginal Care

At Arizona Gynecology Consultants, we are experts in gynecological services and minimally invasive procedures for women in the greater Phoenix metropolitan area. We also provide options for those unable to travel with telehealth appointments. Our welcoming, compassionate doctors, nurses, and staff are here to help you with your concerns.

Schedule an appointment today.

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

www.azgyn.com/

Gynecological Cancer (and How to Prevent It)

This entry was posted in Health FAQs and tagged Cancer on November 30, 2021 by Dr. Kelly Roy, MD.

A gynecological cancer diagnosis, no matter what form it comes in, can be devastating. That is exactly why it’s so beneficial to take the proper precautions now to lower your risk of developing one of these cancers.

But what is gynecological cancer, really? This term refers to cancer that forms anywhere in the female reproductive organs. All women are at risk of developing gynecological cancer, although to varying degrees. Genetics can play a role, as well as the steps you have taken toward gynecologic cancer prevention. Additionally, as we grow older, our risk of developing gynecologic cancer increases.

There are five different types of gynecologic cancer, each featuring a unique set of symptoms, risk factors, and treatment options. However, with the proper gynecologic cancer awareness and prevention, it is entirely possible to reduce your risk of developing any of these diseases – all it takes is educating yourself and making key healthy lifestyle choices.

What Are the 5 Gynecological Cancers?

“Gynecological cancer” doesn’t describe a singular disease but encompasses five distinct cancers, each beginning in a woman’s reproductive system.

The five types of gynecological cancer are as follows:

1. Cervical Cancer

Cervical cancer begins in the cervix, which is a canal located at the lower end of the uterus and the top of the vagina. The cervix prevents bacteria from entering the uterus, allows menstrual blood to pass from the uterus, and creates discharge to keep the vagina clean. It changes its size and position during the menstrual cycle, grows a mucus plug to protect the fetus during pregnancy, and widens during childbirth to accommodate the passage of the fetus.

2. Ovarian Cancer

Ovarian cancer begins in the ovaries. The ovaries are two glands positioned on both sides of the uterus, and each one is connected to this organ via fallopian tubes. Their function is to produce eggs and secrete estrogen and testosterone, two sex hormones that are crucial for female development. During ovulation, eggs travel through the fallopian tubes, where they may be fertilized and then pass to the uterus for implantation.

3. Uterine Cancer

Uterine cancer begins to develop in the uterus. The uterus, also known as the womb, is the hollow, muscular organ within the pelvis between the bladder and rectum. It provides nourishment to the fetus as it develops during pregnancy.

Source: WeillCornell.org

4. Vaginal Cancer

Vaginal cancer originates in the vagina. Contrary to a popular misconception, “vagina” does not refer to the exterior component of the female reproductive system but to the hollow, elastic canal at the bottom of the uterus that connects to the vulva on the outside of the body. Lined with nerves and mucus membranes, the vagina allows for menstruation, intercourse, and childbirth.

Source: WeillCornell.org

5. Vulvar Cancer

Vulvar cancer begins in the vulva, which is the external female genitalia surrounding the opening of the vagina. The vulva protects the internal elements of the female reproductive system by opening the labia major and labia minora. It features several glands that play a role in sexual arousal and stimulation and provides lubrication and cushioning for intercourse.

Source:WeillCornell.org

What Are the Symptoms of Gynecologic Cancer?

It is important to keep in mind the symptoms of each type of gynecologic cancer aren’t the same. In fact, they can vary quite significantly from type to type. So, it is important to keep an eye out for any of the following symptoms to catch the development of gynecologic cancer as early as possible. The earlier a cancer of the female reproductive system is discovered, the better the chances that the individual will make a smooth recovery.

One of the primary systems of gynecologic cancer is abnormal vaginal bleeding. This symptom occurs in all types of gynecologic cancer except for vulvar cancer. Whenever you experience vaginal bleeding without a reason, it is important to take the issue to your physician as soon as possible. For instance, if you experience vaginal bleeding after menopause, this could indicate a serious medical problem, such as gynecologic cancer.

If you haven’t yet gone through menopause but have noticed far heavier periods, periods that last longer than they used to, or abnormal bleeding between your periods, this could also indicate a significant medical problem. Again, if you ever find yourself in this position, make sure to visit a gynecologist at your earliest convenience.

With cervical cancer, vaginal bleeding is often the primary symptom. Early along in the disease’s development, this cancer can be more difficult to recognize without the aid of a physician.

Ovarian cancer, however, has several noticeable symptoms, making it easier to detect early in its development. The most common symptoms of ovarian cancer are as follows:

Abnormal discharge or vaginal bleeding
Difficulty eating, such as beginning to feel full too quickly
Pain or pressure within the pelvis
Frequent urination
Constipation
Bloating
Pain in the back or abdomen

The typical symptoms of uterine cancer include abnormal vaginal bleeding or discharge, as well as pain or pressure in the pelvis.

Generally, individuals with vaginal cancer will experience abnormal vaginal bleeding or discharge, frequent urination, and constipation.

Finally, the most common symptoms of vulvar cancer are:

Pain, itching, tenderness, or burning of the vulva
Changes in the skin color of the vulva, such as a rash, warts, or sores

How Can I Lower My Risk of Gynecologic Cancer?

Although it isn’t possible to fully eliminate the chances of developing gynecologic cancer, there are ways in which you can lower your risk, perhaps even by a large margin. One of the most straightforward ways to lower your risk of gynecologic cancer is to keep the warning signs in mind. Although some forms will display more outward symptoms than others, careful monitoring can help you catch gynecologic cancer before it can grow and spread.

If you are looking to lower your risk of gynecologic cancer, also consider:

Getting the HPV Vaccine

Three of the gynecologic cancer types (cervical, vulvar, and vaginal) can be the result of HPV, a common sexually transmitted infection. The HPV vaccine can protect you against the varieties of HPV that most often result in gynecologic cancer.

It is possible to receive the HPV vaccine as a child, and it is even given to girls as young as eleven. Unfortunately, once a woman has reached the age of twenty-six, it is not necessarily recommended that she receive the HPV vaccine.

If you are a woman older than twenty-six but younger than forty-six, it might still be possible to receive the HPV vaccine. You will first need to talk to your gynecologist about your current HPV risk, as well as the potential benefits of receiving the vaccination. Nevertheless, if you are vaccinated against HPV at this age, it isn’t likely to be as effective because most women have already been exposed to the virus at this point.

Even if you have received the HPV vaccine, it is still a good idea to receive regular screenings for cervical cancer to reduce your risk even further.

Staying On Top of Screening Tests

One of the most effective ways to prevent disease, including gynecologic cancer, is through receiving regular screening tests. The purpose of a screening test is to check for signs of a particular disease, even if symptoms have not yet developed.

Cancer screening tests can be especially beneficial, as catching the disease early on can dramatically simplify the recovery process. For instance, cervical cancer screenings (known as Pap tests) are one of the best ways to discover the disease before it worsens. Cervical cancer presents only limited symptoms, so by the time you notice them, the disease may have already spread and become severe. The Pap test can even catch cervical cancer before it develops by locating precancerous cells on the cervix. This can then be treated before it develops into cancer.

If you have already shown symptoms of gynecologic cancer, however, you will need to receive a diagnostic exam rather than a screening test.

Discussing Your Risk with a Doctor

If you believe that you’re at an elevated risk of developing gynecologic cancer, it is valuable to have a conversation with your doctor or gynecologist. Genetics play a role in your susceptibility to the disease, meaning if you have a family history of ovarian cancer, this may indicate an increased risk. Your doctor will be able to provide you with guidance on how to lower your risk and ensure you’re informed about screening and testing options.

Some high-risk individuals could even undergo genetic counseling and testing if this is recommended by their physician.

Quitting Smoking

If you’re a smoker, this may increase your risk of fourteen types of cancers, including most gynecologic cancers. Even if you are a long-term smoker, it’s still possible that quitting will lower your risk of gynecologic cancer, as well as many other serious diseases.

Living a Healthy Lifestyle

Unsurprisingly, when you live a healthy lifestyle, you are also reducing your risk of developing diseases like gynecologic cancer. For instance, it can be highly beneficial to maintain a healthy weight.

Even small changes can make a big difference in this arena of cancer prevention. Begin introducing quick and simple workouts into your routine if you don’t currently exercise regularly. You could also begin eating more fruits, vegetables, whole grains, and lean proteins. A healthy, balanced diet can go a long way toward lowering your cancer risk.

Reducing the Risk of Ovarian Cancer

With each type of gynecologic cancer, there are some unique ways you can lower your risk that are not necessarily applicable to other types. You can bring down your risk of developing ovarian cancer by:

Using birth control – If you have been on a birth control pill regime for more than five years, then you are at a lower risk of developing ovarian cancer.
Undergoing tubal ligation, having your ovaries surgically removed, or receiving a hysterectomy.
Giving birth – Women who have previously given birth are at a lower risk.

Reducing the Risk of Cervical Cancer

Receiving the HPV vaccine (prior to exposure) is one of the most effective ways to lower your risk of cervical cancer. If you receive the vaccine over the age of twenty-six, its effectiveness will be reduced.

Also, be sure to receive regular Pap tests. This allows doctors to catch precancerous cells in the cervix before they become cancerous. If you have already developed cervical cancer, Pap smears allow you to catch the disease early.

Finally, consider receiving an HPV test to confirm whether you were exposed to the virus.

Reducing the Risk of Uterine Cancer

Using birth control pills is believed to reduce the risk of uterine cancer, as is staying physically active and maintaining a healthy weight.

If you are currently taking estrogen, it could be a good idea to also take progesterone — this can reduce your uterine cancer risk.

Reducing the Risk of Vaginal and Vulvar Cancers

Since HPV can develop into either vaginal or vulvar cancer, receiving the vaccine is beneficial to reducing your risk.

If you didn’t receive the HPV vaccine as a child but are under the age of twenty-six, be sure to get the vaccine as soon as possible. HPV is a common virus, and once you have been exposed to it, the vaccine will lose its effectiveness. If you’re over twenty-six, talk with your doctor to figure out whether the HPV vaccine could still be worthwhile for you.

Visit Arizona Gynecology Consultants

The professional team at Arizona Gynecology Consultants believes in treating the patient as a whole person whose needs are ever-changing throughout their lifetime.It’s our goal to help you stay on top of your reproductive health through preventative services and treatment options.

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

www.azgyn.com/

Clear, Unapologetic Information About Pap Smears

This entry was posted in Ask An Expert, Minimally Invasive Surgeries on November 26, 2021 by Dr. Kelly Roy, MD.

The medical world is full of many conditions, procedures, and treatment plans. While some of these are complicated life-saving techniques, others are preventative measures taken to avoid disease altogether.

A Pap Smear is one of the latter procedures. Throughout their lives, people with vaginas should get this test done regularly to ensure vaginal and cervical health, and to avoid serious disease.

What Is a Pap Smear And How Is It Done?

A Pap smear is a medical procedure developed by George Nicholas Papanicolaou, and is a procedure to test for cervical cancer. The cervix is the opening of the uterus and is located at the back of the vaginal canal (technically considered the top of the vagina). A Pap smear takes a sample of cells from the cervix and tests them for abnormalities or strange growth. These are the first signs of cervical cancer.

To retrieve the sample, a primary care doctor or gynecologist will insert a speculum into the vagina. This device opens the vaginal canal enough for the doctor to see the cervix and swab it with a long-stemmed cotton swab.

Why Are Pap Smears Necessary?

Cervical cancer is a serious disease. It can be difficult to treat and can be incredibly painful. However, the sooner it is discovered, the simpler it is to treat. Pap smears detect abnormal cervical cells. These are the first signs of cervical cancer. Detecting the cells in this early stage can significantly increase survival and recovery rates.

When Should A Woman Get A Pap Smear?

Pap smears are recommended beginning at age 21. From ages 21-29, individuals with cervixes should get a Pap smear every three years. This frequency helps to catch cancerous cell growth, but is not too frequent to be invasive.

From age 30 onward, the individual will be tested for HPV during their Pap smear. By doing this, they can reduce the frequency from every three years to every five years.

In some cases, individuals with cervixes who are 65 and older can stop getting regular Pap smears. This only occurs if they have never had an irregular Pap smear, they’ve kept up with their Pap smear schedule in recent decades, and their doctor recommends it based on their unique makeup.

It should be noted that Pap smears will often occur more frequently if irregular cells are found. These tests are used as part of a comprehensive care plan, and to track any healing that may occur.

How Long Does a Pap Smear Test Take?

Pap smears are incredibly fast procedures. They occur during a regular doctor’s appointment, and there is no recovery time afterward. Generally speaking, a Pap smear takes about 2-5 minutes. If it is scheduled as a part of an overall checkup or physical, the appointment may take longer. However, the actual time needed to obtain a sample is only a few minutes.

Remember, the actual procedure is just to get a sample of cervical cells. While a doctor may be able to tell if something is wildly wrong simply by sight, the cells need to be sent to a lab to get results. This result can take up to a week or two, no matter what the result. Wait time should not be an indication of results, and patients are encouraged to refrain from panicking if their results take longer than anticipated.

Is It Painful to Get a Pap Smear?

Many patients are curious about what to expect when getting a Pap smear, especially in reference to potential pain. Pap smears are generally not painful procedures. However, it is necessary to understand that they can be uncomfortable. Depending on the physiology of the vagina, there can be pressure when the speculum is inserted into the vagina. Similarly, the cervix is not commonly directly touched, so the sensation can be new or uncomfortable, especially the first few times.

Overall, it is rather normal to expect strange sensations over pain for a first Pap smear. They should not hurt and have nothing to worry about. In fact, they can prevent you from a lot of pain and suffering down the line.

Preparing for a Pap Smear

A Pap smear is not like a surgery or extensive procedure, so very little preparation is needed for an appointment. However, there are a few small changes that the patient should implement in the days leading up to the Pap smear.

These include:

Refraining from sexual activity for 48 hours beforehand
Refraining from inserting anything into the vagina, including menstrual cups, tampons, douches, sex toys, etc.
Avoiding powders and perfumes in the genital area

It is also not a good idea to schedule a Pap smear during menstruation. Large amounts of blood can alter the test results, leading to false negatives and other harmful missteps. If a patient gets their period in the days leading up to the exam, they should call their doctor’s office and ask what should be done. Some doctors will not perform a Pap smear on a person who is menstruating, as the risk of skewed test results is too high.

Does a Pap Smear Test for STIs?

Pap smears do not test for sexually transmitted infections. Their only purpose is to detect abnormal cervical cells for cervical cancer.

If a patient would like to get an STI test, they must inform their doctor. The method is generally the same for an STI test, the doctor simply needs to have a separate test ready. The swab is just as fast and efficient for STIs.

Pap Smear Results

After a Pap smear is finished, the patient will get their results within the next few weeks. It is important to know what the results mean, though a doctor will often explain if the situation warrants it.

Normal Results

A normal Pap smear result means that no abnormalities were found at the time of the sample. The cells of the cervix seem to be normal, and the patient can come back in their scheduled number of years for their next test.

Abnormal Results

If a Pap smear comes back as abnormal, there are several factors that could be causing it.

These include:

HPV, which is a condition that leads to cervical cancer
Inflammation or cell changes
Cancer or pre-cancer
An infection, such as a yeast infection
Changes in hormones, often found during pregnancy and menopause

If these do occur, the patient’s doctor will advise on the next steps.

Possible Next Steps

Abnormal Pap smear results can seem alarming, but they are not automatically a cause for panic or concern. In some cases, a doctor may decide that waiting a few months and getting another Pap smear is the best course of action. In some cases of inflammation, the situation clears on its own. The doctor may simply want to monitor the condition closely until she is assured that the patient is not at risk.

In other situations, a colposcopy is necessary. In this procedure, a doctor uses a small magnifying tool to examine the cervix, vulva, and vagina. A sample, or biopsy, may also be taken to send to the lab.

Patients should discuss their treatment plan with their doctor to determine what is best for their specific test results.

Are There Risks to Getting Pap Smears?

Technically there are risks to getting a Pap smear, just as there are risks to any medical procedure. However, among routine procedures, Pap smears are extremely safe.

The two main risks are:

False positives
False negatives

There is always the risk for these in any medical setting. However, Pap smears tend to be very accurate.

Can Pregnant Persons Get a Pap Smear?

Pap smears do not interfere with pregnancy. However, if a patient gets a Pap smear past 12 weeks of gestation, they may experience some increased pain. This is because the cervix begins to swell during pregnancy, making the swab site increasingly tender.

It is important to note that a normal Pap smear schedule is likely going to be altered during pregnancy. Pregnant individuals have their own set of tests and procedures that they must undergo to ensure that the baby is healthy. This may involve similar vaginal exams. The patient should communicate with their prenatal care provider and gynecologist, who can both advise them on what to do. They may simply suggest that the Pap smear be delayed until after the baby is born. However, they may suggest that keeping to a regular Pap smear schedule is preferable.

Are Pap Smears Necessary After a Hysterectomy?

Many individuals undergo hysterectomies and believe that they no longer need to get Pap smears. This is not necessarily the case. Cancer can still occur in the cervical area, even if the uterus and/or ovaries have been removed.

Many individuals who get hysterectomies do so because they have had cervical cancer or signs of untreatable cervical cancer. In these cases, a doctor will continue to check for abnormal cells to help to make sure that the cancer does not return.

Preventing Cervical Abnormalities

Cervical cancer is intimidating, but there are several ways to reduce one’s risk of getting the disease. Many of them involve protecting against HPV, which is a main cause of most cervical cancers.

Some ways to do this include:

Get the HPV vaccine
Use condoms during sexual intercourse to reduce risk
Refrain from douching, which can wash out normal cells that would fight against disease
Get HPV tests regularly
Get Pap smears regularly
Communicate with partners about STI status

Though this is not an exhaustive list of the ways individuals can protect themselves from HPV and cervical cancer, these steps can help reduce risk. The most important factor is getting regular Pap smears. Cervical abnormalities and cancer can occur for reasons outside of HPV, so regardless of one’s lifestyle, regular Pap smears are absolutely recommended.

Contact AZGYN for Expert Female Healthcare Services

Vaginal and cervical health can feel intimidating. Many women feel embarrassed or ashamed to discuss it. Here at AZGYN, we are here to create an accepting and judgment-free environment for individuals to get quality female healthcare services.

If you are concerned about an issue you are currently facing, feel free to contact us to see if we can help you with your health needs.

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

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About Dr. Kelly Roy, MD

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