Tag Archives: Clinical Treatment

When Should an Ovarian Cyst Be Surgically Removed?

Should an Ovarian Cyst Be Surgically Removed?

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

Non-Functional Ovarian Cysts

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?

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.

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.
Urinary Incontinence

What You Need to Know About Urinary Incontinence

Let’s face it; some medical concerns are a bit harder to share than others. One concern that is often pushed under the rug is urinary incontinence. This complication can impact both men and women, and the possible triggers for this issue are numerous. What is most soothing is the fact that it can often be completely treatable or at the very least manageable.

What is urinary incontinence?

Simply put, it is the leaking of any urine that you are unable to control. It is hard to gather specific statistics because of an assumed level of reserve due to embarrassment; this can impact your medical situation and your emotional, psychological, and social life. It ultimately keeps a person from thoroughly enjoying their life. Millions of Americans are affected by this issue, so there is no reason to feel shame or embarrassment. The faster an individual finds an excellent treatment plan, the sooner they can return to regular life.

Understanding Risk for Incontinence

Understanding Risk for IncontinenceWhen it comes to the risk of developing urinary incontinence, the chances vary drastically. Some symptoms of UI can point to larger issues that may need to be seriously addressed, while others may be milder and more temporary. The good news is that for most, these risks can be resolved quickly, leading to an only temporary risk of developing urinary incontinence. Risks can include:

  • Pregnancy, the form of delivery, and number of children.
  • Post-menopause or instances where you may have a drop in your estrogen levels.
  • Prostate issues, especially for men.
  • Poor health, such as diabetes, stroke, high blood pressure, or obesity.

What Are the Symptoms of UI?

The truth is that these symptoms can vary depending on the type of UI you may have. The basic concept is that there is a miscommunication between your brain and your bladder. Your bladder stores the urine, and the muscles in your lower pelvis are responsible for holding tight. When ready, your brain sends a signal to the bladder, the muscles contract, and urine is forced through the urethra. When it comes to dealing with urinary incontinence, it can impact a variety of these steps. There are four most common types of urinary incontinence.

Stress Urinary Incontinence (SUI)

This result is from weak pelvic muscles. It is the stress caused by physical pressure versus mental stress. It is one of the most common instances of UI. The common symptoms include small amounts of urine escaping while exercising, walking, bending, lifting, sneezing, and coughing. These symptoms can range from mild, moderate to severe. How is UI treated? For this type, there is no medical specific treatment. Lifestyle changes may help, as well as utilizing Kegel exercises to strengthen your pelvic walls. With today’s advancement in technology, all you need is a small device and a smartphone to conveniently exercise your pelvic walls. This condition is usually caused by pregnancy or childbirth, menopause, hysterectomy, age, or obesity.

Overactive Bladder (OAB)

This is another common form of UI. This is also known as the “urgency” incontinence. Your body essentially gives you a little warning when it comes to needing to urinate. You could suddenly feel an urge due to shifting position, hearing running water, or even during sex.

What are the symptoms of UI?

In this case, your bladder tells you it needs to empty, even when it isn’t full. You can’t control or ignore the symptoms of this form of a UI. It can hit unexpectedly, leaving your life and daily activities interrupted, often without a moment’s notice. This impacts at least 30% of men and 40% of women in the U.S. alone. This can be caused by cystitis, which is an inflammation of the lining of the bladder. It can also be caused neurologically through multiple sclerosis, stroke, and Parkinson’s.  An enlarged prostate can also cause it.

Mixed SUI and OAB

This sounds exactly how it is. You’re impacted in part by both the most common issues of UI. You may “leak” a bit at times unexpectedly, following a good sneeze or even a laugh. You may also feel the sudden, undeniable urge to pee without a moment’s notice.

Overflow Incontinence

This is where your body makes more urine than it can hold, or your bladder may be full but for whatever reason can’t empty. This is rare in women and is most often found in men with prostate problems. This is typically created through a blockage or obstruction caused by an enlarged prostate, a tumor pressing onto the bladder, urinary stones, or constipation.

Total Incontinence

While less likely, certain individuals may have to deal with this form of UI. It can be caused by various factors, including anatomical defects from birth, a spinal cord injury that impacted the communication between the brain and the bladder, or a fistula. A fistula is a tube or channel that develops between the bladder and a nearby area, usually the vagina.

General Symptoms of Incontinence

Symptoms of IncontinenceThe good news is that not all these symptoms are long-term. Many are short-term and potentially treatable. There are some general symptoms, including vaginal infections, irritations, medication use, constipation, general mobility, and UTI (urinary tract infection) that are often common causes.

Temporary Symptoms of Incontinence

Sometimes, all fingers can point toward your diet when it comes to issues with UI. Different foods, drinks, and medicines can all affect your urinary continence. Drinks such as alcohol, caffeine, and carbonated drinks can impact your body differently. This also includes artificial sweeteners, spicy foods, sugar, acid, even chocolate!

Potential Complications of UI

Dealing with a UI can impact many different facets of your life. You may also develop skin problems. This could include sores, rashes, and infections caused by the skin being wet or damp most of the time. This can lead to complications with any wound healing and can promote fungal infections. Prolapse is rare but still a risk to consider, especially if your UI goes untreated. This is when a part of the vagina, bladder, or urethra falls into the entrance of the vagina, typically due to an extremely weak pelvis wall. In an instance such as this, surgical intervention will be necessary.

When Should I See a Doctor?

The short answer is the sooner, the better! If you notice an increase in frequency that can’t be easily explained, such as a dramatic increase in water intake, it may be a sign of a larger concern. This especially becomes a concern when it starts to impact the overall quality of your life. If you find yourself restricting activities such as going out for dinner, having drinks with friends, enjoying outdoor adventures or sports, this is no good!

You shouldn’t have to limit your social interactions due to urinary concerns. Your quality of life should be your number one priority. There is no reason to suffer in silence, especially because there are numerous remedies to many different UI issues. You’ll also want to consider your age. The speed at which you may make it to and from the bathroom can vary with age, weight, and other mobility factors. You’ll want to be aware of additional risks of falling and other injuries when trying to race against a sometimes unpredictable clock. There is also the risk that your UI is a sign of a much larger issue. You’ll want to handle these issues early on before they lead to more serious complications down the line.

Urinary Incontinence Diagnosis

Wondering how UI is diagnosed? Many different methods can be used to determine if you have a UI and what form you may be experiencing. These methods vary, so it is best to try to explain your situation as well as possible to your medical professional. This may help put the focus on what is most likely impacting you.

Bladder Diary

This may seem a bit silly at first, but it can help pinpoint precisely what form of UI you may be dealing with. You’ll want to keep track of how much you drink to start. You may want to specially note if your intake has suddenly increased or decreased for whatever reason. You’ll also want to keep track of when urination occurs, as well as if you experienced any incontinence throughout the day. Even the smallest leak can interrupt your day, so keeping track of the small nuances can make a huge difference.

Physical Exam

Your doctor may not necessarily ask you about your bladder health. The largest stigma with UI is the feeling of embarrassment, but if you don’t share with your doctor, they will not be able to help you. When getting your physical exam, be sure to share your concerns with your doctor. Millions of Americans struggle with UI issues, so there is no reason to be shy. Upon your physical exam, your doctor can check for the strength of your vaginal walls, or for men, any risk of having an enlarged prostate.

Urinalysis

This will help determine if you have any signs of infection or abnormalities.

Blood

Simple blood work can rule out many potential issues, especially when it comes to kidney function, which can impact your urinary health.

Postvoid Residual (PVR) Measurements

This test can help determine how much urine is left in the bladder after urination. For those who suffer from an overactive bladder or one that tends to overflow, this could finally lead you and your medical professional in the right direction for treatment.

Pelvic Ultrasound

If a typical physical examination doesn’t provide enough information, a pelvic ultrasound may be the next best step. This creates an image of your pelvic area that can help pinpoint any abnormalities or inconsistencies that may not have been initially discovered.

Stress Test

This form of testing can include testing your body’s ability to react to sudden pressure.

Urodynamic

This test determines how much pressure your bladder and urethra can withstand.

Cystogram

This x-ray focuses explicitly on the bladder to check for any abnormalities or concerns that wouldn’t be found in a typical exam.

Treatments for Urinary Incontinence

How is UI treated? There are many different methods when it comes to treating UI. Many of these treatments will vary depending on the severity of your condition. These treatments can range from at-home activities to surgical intervention. Some of the most common forms of treatment include:

Bladder Training

This can involve a few different types of exercises. Most commonly, they are:

  • Delay-control urge—This is feeling the need to urinate but training your body to wait, even if it is only for short periods at first.
  • Double voiding—This is the process of urinating, waiting, and then urinating again.
  • Toilet timetable—Sometimes routine is key. This bladder training is structured so that you create specific times in which to use the bathroom, for example, every two hours. This makes a predictable routine for your body to follow.

Medications

Medicine is rarely used alone. It is often paired with other techniques or exercises to improve UI symptoms. Medicines often prescribed include:

  • Anticholinergics—This is a medicine that can be used to calm an overactive bladder.
  • Topical estrogen—This helps reinforce the tissues in the urethra and vaginal areas. It can also help to lessen symptoms caused by UI.
  • Imipramine—A tricyclic Dealing with complications in such an intimate part of your body can lead to depression, anxiety, and a desire to pull away from certain social interactions. It is important to allow your medical professional in so that they can try to alleviate some of these issues.

You May Have Urinary Incontinence, But So What?

Talking to doctor about Urinary IncontinenceMillions of Americans deal with some form of UI every day. This number is hard to measure due to the feeling of embarrassment that stops many from sharing their experience. The truth of the matter is that many people deal with various forms this condition may present itself in. Whether you feel you go to the bathroom too much, too little, or just too unexpectedly, there are various exercises and treatments that could help alleviate your symptoms. What matters most is your ability to be open and honest with your health care professional. You may feel you are alone, but in fact, you are with a great majority of people who experience similar issues. Break the silence and give yourself the opportunity to truly live life to its fullest. You should never feel chained to the restroom.

Life is too short to let UI stop you from living each day to the max.

 

Editor’s Note: This article was originally published August 7, 2017 and was updated May 27, 2021.

What Is Seborrheic Vulvitis FAQs For Women - Arizona Gynecology Consultants

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

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

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

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

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

What Is Seborrheic Vulvitis?

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

What Is Seborrhea (Seborrheic)?

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

What Is Vulvitis?

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

Symptoms of Vulvitis? 

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

What About Vaginal Itching that Is Not a Yeast Infection? 

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

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

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

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

Vulvitis: Is It Contact Dermatitis or Seborrheic Dermatitis?

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

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

Malassezia Globosa Vulvar Infection 

Malassezia Globosa Vulvar Infection - CDC

Malassezia Fungus (Source: phil.cdc.gov)

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

Talk to Your Women’s Health Doctor

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

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

Find Answers to Women’s Health FAQs

Identify The Signs And Symptoms Of Menopause - Arizona Gynecology Consultants

Clinical and Holistic Remedies for Menopause

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

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

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

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

Learn Even More About Menopause

What Is Infertility - Arizona Gynecology Consultants

Infertility – What It Is and How to Treat It

Medical professionals define infertility as the inability to conceive a child after at least one year of attempts. Every woman is unique and will conceive best under different circumstances, but getting pregnant is much easier for some women than others.

A diagnosis of infertility can also apply to women who can successfully become pregnant but then miscarry. Overcoming infertility is sometimes possible with various treatments and modern fertility technology.

What Is Infertility: The Fertilization Process

It’s quite difficult to become pregnant, considering the exact chain of events that must occur for conception to happen:

  • First, the woman must release a mature egg from one of her ovaries (called ovulation).
  • Next, the egg must travel through the fallopian tube into the uterus.
  • During this journey, a sperm cell from a male partner must come into contact with the egg and fertilize it.
  • Finally, the fertilized egg must implant itself on the inner wall of the uterus.

Anything that interferes with any step of this process can cause infertility. Different medical conditions can interfere with ovulation, fertilization and implantation.

If the male partner is the root of the couple’s inability to conceive, methods including artificial insemination and embryo cultivation may prove effective. If the infertility is due to an issue with the female partner, there are many possible explanations.

Problems with Ovulation

Some medical conditions such as ovarian cysts can interfere with a woman’s ovulation cycle. If a woman’s ovaries cannot mature and release an egg during ovulation, cysts can form and block the process. In other cases, inflammation in the ovaries or the fallopian tubes can prevent proper egg release.

Physical problems with the uterus can also prevent ovulation, such as uterine fibroids. One of the first signs of an ovulation problem is irregular periods or missed periods. Abnormal uterine bleeding and inconsistent menstrual cycles can make conception more difficult.

Lifestyle Factors

A woman’s lifestyle has a tremendous impact on her ability or inability to conceive. Diet, exercise, stress and medical conditions all impact fertility in different ways. For example, a woman with a poor diet, stressful job and inconsistent sleeping schedule will likely have a difficult time becoming pregnant. Or, her body may reject a fertilization due to the woman’s poor health.

Other lifestyle choices such as tobacco use and alcohol consumption can interfere with pregnancy as well. The medical community has heavily discouraged smoking and drug use among pregnant women for decades because of the serious harm these things can do to both mothers and unborn babies.

For example, a baby born to a mother who consumed alcohol while pregnant may have fetal alcohol syndrome. A baby born to a mother addicted to opioids will likely be born addicted to opioids as well.

Finally, sexual activity can have a big impact on fertility. Sexually transmitted diseases can cause a host of fertility problems and damage the reproductive system in different ways. Although some people have believed in the past that certain sexual positions increase or decrease the chances of conception, there is little scientific evidence to support these theories.

Testing for Infertility

When a couple is struggling to become and stay pregnant, their doctor will need to perform an extensive series of tests to uncover the root of the problem. This process can be stressful and emotional, and it’s important to be patient while the doctor performs the necessary tests to reach a definite answer for your infertility.

Typically, fertility testing will begin with the male partner. Male infertility issues are easily detectable and almost always revolve around problems with sperm. The first male fertility test is usually a semen analysis to determine the man’s sperm count, quality and shape.

If the male partner shows no clear evidence of being the cause of infertility, the doctor will then examine the female partner. The first step is to determine if and when the female is ovulating. There are many different methods a doctor may use to calculate a female patient’s ovulation cycle.

Female fertility tests often involve various imaging procedures such as X-rays and ultrasounds, but may also include hysterosalpingography, a process of injecting a special dye into the vagina that spreads throughout the reproductive system. This makes it easier for the doctor to spot blockages, blood clots or anatomical problems preventing pregnancy.

Some women may require a laparoscopic inspection. During such a procedure, the doctor will use a laparoscopic tool inserted into an abdominal incision to inspect the reproductive system from the inside.

Treating Infertility

Some couples who are experiencing fertility issues can find a solution with simple lifestyle changes, medication or other easy methods. Other couples will require a more robust form of treatment.

Medical science has progressed to an incredible degree, and various techniques can help modern couples conceive more easily. Artificial insemination and other assisted reproductive technologies are tremendously successful for many couples.

Arizona Gynecology Consultants works with a vast network of trusted medical providers who have experience in handling all types of infertility issues. If you’re curious about solutions for your fertility concerns, reach out to us and ask about the resources and options available in your area.

What Causes Abnormal Pap Tests - Arizona Gynecological Consultants

What Causes Abnormal Pap Tests?

All women will eventually undergo a Pap test, or Pap smear test, as a regular part of their routine medical examinations. Most women begin yearly Pap smear tests at age 21 or within three years of becoming sexually active. This procedure is one of the best methods for detecting signs of cervical cancer as early as possible, but it can detect other medical conditions as well.

During a Pap smear test, the gynecologist uses a special medical swab to remove a cell sample from the cervix, the lower opening of the uterus that connects to the vagina. Most women barely feel the test, but some experience mild cramping and discomfort as the gynecologist scrapes the cervix.

Reasons for Abnormal Pap Test Results

Some abnormal Pap smear test results happen because of relatively innocuous issues like yeast infections, bacterial infections or immune system irregularities. Smoking can cause abnormal cervical cell changes as well. Other times, an abnormal result can indicate a more serious infection.

Most abnormal Pap test results are the result of some types of the human papillomavirus (HPV). This sexually transmitted disease can linger dormant in a woman’s system for years before manifesting noticeable symptoms.

A woman may have HPV for years without ever noticing anything is wrong. The cell changes that occur from some types of HPV will fade on their own over time. Although, other types of HPV can lead to cervical cancer.

Limiting Your Risk of Contracting HPV

Since HPV is a sexually transmitted disease, maintaining responsible sexual habits and practicing safe sex are two of the best ways of protecting yourself from the virus and other sexually transmitted infections.

Women who have sex with multiple partners, have sex without condoms, or have sex with one partner who also has other partners are at a higher risk of contracting HPV than women in monogamous sexual relationships.

Symptoms of Abnormal Pap Tests

A Pap smear test detects changes in cervical cells, but these changes do not entail symptoms on their own. Depending on the type of change occurring, a woman may experience a variety of possible symptoms.

Different sexually transmitted diseases cause their own set of symptoms, such as:

  • Abnormal vaginal discharge
  • Lumps
  • Blisters
  • Sores
  • Warts on the genital area
  • A burning sensation or discomfort during urination or intercourse
  • Rashes

What Do My Test Results Mean?

Gynecologists deliver Pap smear test results with different classifications based on the doctor’s findings. A result of “normal” indicates that the sample cells are healthy, and that there are no irregularities in the patient’s cervix.

An “unsatisfactory” result indicates a problem with the test sample. If the lab technician cannot properly read a sample, the patient will have to retake the examination.

Another possible outcome is “benign changes,” or a relatively normal result with some minor irregularities. These benign changes can include inflammation of the cervical cells, and the gynecologist will likely recommend further tests or treatment for the cause of the inflammation.

Finally, some Pap smear tests will lead to “ASCUS” results, or “atypical squamous cells of undetermined significance.” These results break down further into more specific categories.

Possible Results and Follow-Up Tests

After an ASCUS reading, the gynecologist will sometimes recommend another Pap test later or send the patient for additional screenings. Women under the age of 24 who receive abnormal Pap test results typically receive one of the following diagnoses:

ASC-H

Women who receive this diagnosis have cervical cells that display signs of HPV. The doctor will recommend a colposcopy as a follow-up exam. A colposcopy is a more in-depth inspection of the vulva, vagina, cervix and uterus using cameras and illumination devices to spot signs of infection and other abnormalities.

Low-Grade Squamous Intraepithelial Lesion (LSIL)

This result indicates infection with HPV. The gynecologist will assess the patient’s condition, and if she appears healthy, she may not require further action aside from another Pap test the following year. If the next Pap test has the same result, the doctor will send the patient for a colposcopy.

High-Grade Intraepithelial Lesion

This result is a more advanced version of a LSIL result and indicates the patient is at a high risk of developing cervical cancer.

Atypical Glandular Cells

This result indicates changes in the glandular cells of the cervix, and the patient will need a colposcopy for further examination.

Cancer

This is rare, but some women unfortunately develop cervical cancer at a young age. The doctor will refer the patient to an oncologist to begin cancer treatment. This is one of the most important reasons for women to undergo yearly Pap smear tests.

Receiving abnormal results can be alarming, but it’s important for women to understand that an abnormal result does not necessarily indicate cervical cancer. An abnormal result simply means that the cells fall outside the normal range and require closer examination. The chance of receiving a cancer diagnosis from an abnormal Pap test result is quite small.

Ask Questions and Take Charge of Your Health

Patients at Arizona Gynecological Consultants can rest assured that the providers we work with are committed to patient health and safety. Be sure to ask all questions you may have about your Pap smear test or results at your next appointment.

What are the Types of Birth Control - Arizona Gynecology Consultants

What Are the Different Types of Birth Control?

Birth control is a major decision for every woman. Choosing the right birth control option isn’t always about contraception, either; some women use different types of birth control to manage the symptoms of gynecological conditions such as endometriosis, ovarian cysts and abnormal uterine bleeding issues.

Birth Control Preferences by State

If you’re considering starting birth control, changing the type of birth control you use, or making other decisions about birth control, it’s important to know your options and speak at length with your doctor about your concerns with any of those options.

Types of Birth Control

Birth control exists in both preventive and situational forms. Some women with hormone irregularities benefit from hormone-based birth control options while other prefer intrauterine devices (IUDs) that have a less hormonal impact. Other women prefer permanent birth control methods.

Before starting any type of birth control, make sure you fully understand the intended effects and potential risks.

Hormonal Birth Control

Hormonal medications in pill form are how millions of American women manage their family planning and control any uterine conditions. It’s easily the most popular form of birth control,

Hormonal birth control exists in pill form as well as dermal patches, injections and implants. Some intrauterine devices also qualify as hormonal birth control, because they release different hormones into the bloodstream.

It’s vital to consider the potential side effects of these options, however. Some women prefer alternatives to hormonal medications due to their effects on mood, cognition and sleep.

Intrauterine Devices

IUDs provide an effective alternative to hormonal medications. It’s important to remember, however, that some IUDs still contain hormones. Non-hormonal IUDs physically obstruct the fertilization process and last anywhere from five to 10 years. Some women elect to have IUDs with low doses of hormones to manage severe menstrual cramping.

Some patients experience complications with IUDs due to anatomical difficulties, incompatibility with materials, and other factors. If you have an IUD implanted, it’s crucial to follow your doctor’s directions and call immediately if you believe the IUD has dislodged from its proper position.

Barrier Contraceptives

As the name suggests, this method of birth control involves placing a barrier between the uterus and a partner’s sperm cells. One of the most common forms of barrier birth control is condom use, but it’s important to remember that condoms are not foolproof.

Condoms can break or degrade, and it’s important to always check a condom for expiration date and package integrity first. If a condom’s package is open, damaged, punctured or torn, discard it and use a new one. If a condom breaks during intercourse, it’s best to stop and have your partner put on a new one before continuing.

Other forms of barrier birth control devices include diaphragms and vaginal sponges. These methods are not surefire methods for preventing pregnancy and require reapplication or reinsertion every time you have sex.

A diaphragm is essentially a reverse condom that fits inside the vagina and holds to the cervix with a ring. The outer layer protrudes from the vagina and the partner enters inside the diaphragm, which then catches the partner’s sperm cells.

Vaginal sponges, on the other hand, effectively soak up the partner’s sperm cells for disposal.

Fertility Awareness

Some couples do not use traditional birth control methods for personal or religious reasons. These couples can often successfully manage their family planning by keeping close tabs on the woman’s menstruation and ovulation schedule. During times when the woman is most fertile, the couple can simply abstain from sex or use barrier contraceptives.

Sterilization

Some women and couples do not wish to ever have children. In these cases, permanent methods of birth control work very well. Sterilization involves either a vasectomy for men or a tubal ligation for women.

A vasectomy is an outpatient procedure that is minimally invasive, reversible and entails very mild discomfort and easy recovery. Tubal ligation is a more invasive and permanent option, so couples should discuss these options at length to decide what would work best for them.

Managing Your Birth Control

Unless you plan to rely solely on barrier birth control methods or fertility awareness, you need to know the various effects any type of birth control will have on you and your body. Hormonal birth control medications and devices can sometimes complicate preexisting medical conditions or conflict with certain aspects of your lifestyle. For example, birth control may not be as effective for a smoker as it would be for a non-smoker.

Women who are pregnant or breastfeeding should not use birth control until a doctor advises that it is safe to do so. The hormones in most birth control options can cause serious fetal harm or other complications with pregnancy.

Women who have had different types of cancer, undergone certain medical procedures or who have serious health problems (such as heart disease, blood clots, diabetes or high blood pressure) need to be careful with birth control as well.

The staff at Arizona Gynecology Consultants is always available to answer patients’ questions and address all concerns about birth control. Starting or changing birth control isn’t an easy thing to do, and our providers aim to provide holistic care that treats the whole person. Learn more about the different birth control options by contacting Arizona Gynecology Consultants today.

What is a Cystoscopy - Arizona Gynecology Consultants

What is a Cystoscopy?

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A cystoscopy is a medical procedure intended to locate irregularities within a woman’s urethra or bladder. During a cystoscopy, the physician performing the procedure uses a very thin instrument with a light source to look for any problems. The physician will fill the patient’s bladder with sterile fluid to expand the bladder walls to make it easier for the camera to see.

It’s important for anyone expecting to undergo this procedure soon to know how to prepare for it and what to expect afterward.

Preparing for a Cystoscopy

Patients should drink plenty of fluids the day before a cystoscopy. This will hydrate the patient and help flush waste through the bladder, so it is as clear as possible before the examination.

A doctor will typically ask the patient for a urine sample before performing the cystoscopy. Patients who have urinary tract infections or weak immune systems may need to complete a round of antibiotics before undergoing a cystoscopy.

The test will require the use of anesthesia, and different patients may receive different types of anesthesia. If a patient requires general anesthesia, she will likely need to fast for several hours before the cystoscopy. General anesthesia renders a patient completely unconscious, and food in the patient’s stomach can cause life-threatening complications while under the effects of general anesthesia.

Other patients may require only a regional or local anesthetic. A dose of regional anesthesia will take the form of an injection in the spine that numbs the patient from the waist down. Local anesthesia will numb only the area of the body that houses the bladder, and the patient will be awake during a procedure. Patients who undergo general or regional anesthesia should expect a hospital stay of at least a few hours following a cystoscopy.

A Note About Anesthesia

Doctors have a legal requirement to fully inform their patients about the risks of any procedure or treatment option, and this includes anesthesia. Once you have decided on the route you prefer to take for your cystoscopy, it is imperative that you follow your doctor’s preparation instructions. If you forget something or otherwise fail to follow your doctor’s directions, tell your doctor immediately so he or she can make the necessary adjustments.

The Cystoscopy Procedure

When the time comes for the patient to undergo a cystoscopy, the doctor will first instruct the patient to empty her bladder and put on a hospital gown. If the patient receives general anesthesia, she will lose consciousness at this point and awaken after the procedure ends. Patients who receive local or regional anesthesia may also receive sedatives for the duration of the procedure.

The doctor will then numb the urethra with an anesthetic spray or gel. After lubricating the test device with gel, the doctor will insert it into the patient’s urethra. Patients who are conscious of their cystoscopy procedures may feel a sensation like needing to urinate or a slight burning.

Types of Cystoscopy Procedures

Doctors generally perform two types of cystoscopies:

  • Investigatory
  • Biopsy

An investigatory cystoscopy will involve the use of a thin, flexible scope to easily move around the inside of the urethra and the bladder to look for problems. If a more in-depth cystoscopy is necessary for biopsy, the doctor may instead use a rigid scope to allow the insertion of other surgical instruments into the bladder.

During a biopsy, the doctor will extract a cell sample from the target area to have it tested for cancer. A cystoscopy performed with a larger, more intrusive instrument may lead to more severe recovery symptoms.

Patients who receive local or regional anesthesia should expect the cystoscopy to last about five minutes. Procedures with general anesthesia usually take 30 minutes or longer.

Common Postoperative Recovery Symptoms

A cystoscopy can leave a patient with several uncomfortable symptoms that can last several days or longer. One of the most common symptoms reported by patients is a persistent need to urinate or more frequent urination for two or three days after a cystoscopy.

It’s important to remember not to hold it in for longer than necessary during this time. Some cystoscopy procedures may cause bleeding inside the bladder or urethra, and holding it in can cause a blood clot or blockage.

Blood in the urine is another common symptom after a cystoscopy, especially if the doctor performed a biopsy during the procedure. Excessive bleeding or the appearance of bright red blood or bloody tissues in urine are major problems. Patients who experience this, high fever, persistent stomach pain or the need to urinate (but cannot) should contact their doctors immediately.

In some cases, a cystoscopy can lead to a swollen urethra or an infection. A swollen urethra is very common after a cystoscopy and can make urination more difficult. However, this should subside within about eight hours.

If you cannot urinate more than eight hours following a cystoscopy, call your doctor. The appearance of an infection may simply require a round of antibiotics.

Any Other Questions on ‘What Is a Cystoscopy?’

The team at Arizona Gynecological Consultants takes patient satisfaction very seriously and strives to provide the highest standard of care possible. If you have questions about a cystoscopy procedure, reach out to us for more information about preparation and what to expect during and after the procedure.

What Is Abnormal Uterine Bleeding - Arizona Gynecology Consultants

What Is Abnormal Uterine Bleeding?

No two women will have the exact same menstruation cycle, but when a woman’s period schedule falls outside of certain boundaries, physicians consider it abnormal.

Abnormal uterine bleeding may sometimes only cause inconsistency with a woman’s menstrual cycle, but other symptoms are also possible and can cause greater discomfort, such as excessive bleeding and cramping. Women should understand how to manage abnormal uterine bleeding and know the options for doing so.

Causes of Abnormal Uterine Bleeding

Almost all abnormal uterine bleeding cases happen because of hormone problems. The menstrual cycle revolves around different hormones in the bloodstream, so inconsistencies or irregularities with hormones can result in abnormal uterine bleeding.

A typical adult menstrual cycle is 21 to 35 days long, while a typical teen cycle is 21 to 45 days long. Each period generally lasts for four to six days. Women with inconsistent hormone levels may have periods more frequently or far less frequently.

Abnormal uterine bleeding can also occur when a woman doesn’t ovulate. During the menstrual cycle, one of the ovaries releases a mature egg in a process called ovulation. When a woman doesn’t ovulate, it throws off the hormone balance in the bloodstream and can cause sudden bleeding. Failure to ovulate can also be a sign of other uterine problems like fibroids or ovarian cysts.

Other uterine issues such as fibroids can cause excessive uterine bleeding, and some women may mistake a miscarriage for an abnormal uterine bleeding incident.

Doctors will perform a series of tests to determine the cause of the abnormal uterine bleeding and address it appropriately. Possible tests include:

  • Blood analysis
  • Pelvic examination
  • Ultrasound
  • Other imaging methods

In some cases, a doctor may insist on a biopsy to detect the presence of cancerous cells that may be causing abnormal uterine bleeding.

Symptoms

The first telltale sign of an abnormal uterine bleeding problem is the timing of a woman’s menstrual cycle. Periods happening fewer than 21 days apart or more than 35 days apart are abnormal.

Periods lasting more than seven days are another warning sign. If your menstrual schedule aligns with any of these variables, schedule a visit with your gynecologist as soon as possible.

Menstrual timing issues also present other problems. A woman who experiences period symptoms sooner than every 21 days must deal with menstrual cramping, fatigue and bleeding more often than a woman on a typical schedule.

Some women experience significant cramping and sudden heavy bleeding as the result of hormonal imbalance. Doctors typically define excessive bleeding as menstrual bleeding that produces blood clots or completely soaks through tampons or menstrual pads each hour for two hours or more at a time.

Women may experience sudden irregularities in their menstrual cycles that go away on their own relatively quickly. However, once abnormal uterine bleeding issue becomes a pattern, it can pose serious health problems. If you experience abnormal menstrual symptoms for three cycles in a row, contact your doctor.

Treating Abnormal Uterine Bleeding

Depending on the cause of the bleeding, a doctor may suggest one of several possible treatment methods. When hormone irregularities cause abnormal uterine bleeding, progestin pills or daily birth control pills can be helpful.

Some women receive birth control prescriptions simply to manage excessive bleeding and cramping. Some types of hormonal birth control can offset other uncomfortable menstrual symptoms as well. Balancing the hormone levels in the bloodstream helps regulate the menstrual cycle and keeps discomfort minimal.

Some women benefit from a short-term course of high doses of estrogen. This technique helps women who experience dangerously heavy bleeding.

A levonorgestrel IUD is another option, and this device releases a hormone similar to progesterone into the bloodstream. This type of IUD will limit menstrual bleeding and prevent pregnancy.

In rare cases, estrogen blockers can resolve abnormal uterine bleeding problems. Medications that stop menstruation and estrogen production can have significant side effects and are only acceptable methods of treatment in special cases. For women who suffer from endometriosis or other uterine conditions, surgery may be the only effective solution.

Regular Checkups and Screenings Are Important

A doctor may not be able to completely identify the cause of an abnormal uterine bleeding issue at first. In some cases, a wait-and-see approach is necessary to monitor a patient’s cycle and determine the best course of treatment. A doctor may recommend an anti-inflammatory medication to manage menstrual cramping and bleeding until the root cause is more discernible.

Very young women often experience irregularities with their menstrual cycle that stop after several cycles. Women in menopause should expect their periods to eventually stop entirely.

Contact your doctor if you have any concerns about your menstrual symptoms or schedule. Maintaining a regular schedule of checkups and screenings and verifying your concerns with your doctor are crucial.

Treatment at All Stages of Life

At Arizona Gynecology Consultants, we understand that women’s needs change from adolescence to retirement. Our providers are experienced in all aspects of gynecological health and focus on the needs of each individual patient.

Abnormal uterine bleeding is incredibly common and can happen for many reasons. The providers we work with can help identify the cause of an abnormal uterine bleeding problem and recommend an effective treatment.