Tag Archives: Signs And Symptoms

What Are Uterine Fibroids - Arizona Gynecology Consultants

What Are Uterine Fibroids?

Uterine fibroids are small, benign tumors that grow in the uterus. They are made of the same type of cells found in the walls and connective tissues of the uterus.

In some cases, they embed in the walls of the uterus, but some fibroids will project from the outer surface of the uterus into the abdominal cavity. Others can cluster inside the uterus and project into the interior space of the uterus. [1]Farris, M., Bastianelli, C., Rosato, E., Brosens, I., & Benagiano, G. (2019). Uterine fibroids: an update on current and emerging medical treatment options. Therapeutics and Clinical Risk … Continue reading

The cause of uterine fibroids is not known, but some women are at higher risk of developing them than others. Black women receive uterine fibroid diagnosis 2 to 3 times as often as other women, [2]Stewart, E. A., Nicholson, W. K., Bradley, L., & Borah, B. J. (2013). The burden of uterine fibroids for African-American women: results of a national survey. Journal of Women’s Health, … Continue reading and uterine fibroids only rarely appear in young women who have not started menstruating.

Uterine fibroids will stop growing and dissolve over time after menopause.

What Does My Uterine Fibroid Diagnosis Mean?

Uterine fibroid diagnoses are incredibly common, [3]Zimmermann, A., Bernuit, D., Gerlinger, C. et al. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Women’s Health 12, 6 … Continue reading and about 70 to 80 percent of women will receive a uterine fibroid diagnosis before age 50. If your doctor recently diagnosed you as having uterine fibroids, don’t be alarmed: Uterine fibroids are not cancerous, and the worst symptoms they cause are manageable. While this condition can cause some unpleasant symptoms, many women with uterine fibroids do not have any symptoms at all, and the condition is not medically threatening.

Possible Symptoms of Uterine Fibroids

Most uterine fibroids do not cause any noticeable symptoms. If a doctor discovers uterine fibroids that are asymptomatic during a routine gynecological exam, he or she will likely suggest a wait-and-see approach for monitoring the fibroids in the future. The doctor may wish to confirm the uterine fibroid diagnosis with imaging scans like an ultrasound or pelvic MRI.

Women who experience negative symptoms from uterine fibroids typically report painful or excessive bleeding during periods, or bleeding between periods. Uterine fibroids may also cause abdominal swelling or a feeling of fullness. [4]Viva, W., Juhi, D., Kristin, A. et al. Massive uterine fibroid: a diagnostic dilemma: a case report and review of the literature. J Med Case Reports 15, 344 (2021). … Continue reading

If fibroids compress the bladder, the woman may experience a frequent need to urinate or may have difficulty urinating. Uterine fibroids can also cause lower back pain and pain during sexual intercourse.

Excessive bleeding during periods is a common issue, and some women develop anemia from the blood loss and can suffer other medical complications as well. If these symptoms are severe enough, the woman’s doctor may recommend one of several possible treatment options.

What Are Uterine Fibroids: Treatment Options

A doctor will only treat a case of uterine fibroids if they are causing the patient significant discomfort. The type of symptoms the patient displays, and the severity of those symptoms, typically determines the best course of treatment.

Women who experience only mild pelvic pain may benefit from over-the-counter anti-inflammatory and painkiller medications like ibuprofen. If the pain is too severe for these drugs to handle, the woman’s doctor can prescribe a stronger medication.

Hormone Treatment

While doctors have yet to pinpoint the causes of uterine fibroids, they do believe that uterine fibroids have an easier time developing in an estrogen-rich system. Some doctors may wish to treat uterine fibroids with hormonal medication to limit estrogen production, but it’s important that women understand the effects of hormonal medications.

While a birth control pill may contain hormones that reduce excessive bleeding and decrease a woman’s pain during menstruation, birth control pills that contain estrogen can cause uterine fibroids to grow. This treatment would effectively only manage the symptoms while making the cause of those symptoms worse.

Uterine Fibroids and Pregnancy

Some women may wonder if uterine fibroids interfere with pregnancy. Since estrogen encourages fibroid growth, [5]Borahay, M. A., Asoglu, M. R., Mas, A., Adam, S., Kilic, G. S., & Al-Hendy, A. (2017). Estrogen Receptors and Signaling in Fibroids: Role in Pathobiology and Therapeutic Implications. … Continue reading a woman’s existing uterine fibroids may enlarge during the first trimester when estrogen levels are highest. However, the tumors will later shrink after birth.

Surgical Options

Advanced cases of uterine fibroids that cause significant pain and discomfort may require surgery. The two types of surgery that can solve a uterine fibroid problem are:

  • Hysterectomy
  • Myomectomy

If a woman undergoes a hysterectomy during her childbearing years, she will no longer be able to have children. Some women may not wish to have children, or any more children, and find this acceptable if it stops the unpleasant symptoms of the fibroids.

Women who wish to remove their uterine fibroids but still want to be able to bear children may opt for a myomectomy instead. A myomectomy procedure removes the uterine fibroid tumors while leaving the uterus intact.

Doctors perform myomectomies in three different ways:

  • Laparotomy: The doctor enters the uterus through a small incision in the abdomen to remove the uterine fibroids.
  • Laparoscopic myomectomy: The doctor uses a small, thin telescopic instrument through a small incision in the navel to reach the uterine fibroids.
  • Hysteroscopic myomectomy: A procedure which involves inserting a hysteroscope through the cervix to extract the uterine fibroids through the vaginal opening.

Finally, if a woman does not wish to undergo surgery and wants to keep her fertility intact, she can opt for a fibroid embolization procedure. This is a minimally invasive outpatient procedure during which an interventional radiologist shrinks the uterine fibroids by cutting off their blood supply. The patient will often be able to go home the same day as the procedure after a short recovery period.

Know Your Options

Uterine fibroids can be unpleasant and cause a host of problematic symptoms, so women should always refer to their gynecologists for their recommendations for treatment and handling symptoms. Arizona Gynecology Consultants works with a large network of trusted medical providers, so reach out to us if you have questions about managing your uterine fibroids.

References

References
1 Farris, M., Bastianelli, C., Rosato, E., Brosens, I., & Benagiano, G. (2019). Uterine fibroids: an update on current and emerging medical treatment options. Therapeutics and Clinical Risk Management, 15, 157–178. https://doi.org/10.2147/TCRM.S147318
2 Stewart, E. A., Nicholson, W. K., Bradley, L., & Borah, B. J. (2013). The burden of uterine fibroids for African-American women: results of a national survey. Journal of Women’s Health, 22(10), 807–816. https://doi.org/10.1089/jwh.2013.4334
3 Zimmermann, A., Bernuit, D., Gerlinger, C. et al. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Women’s Health 12, 6 (2012). https://doi.org/10.1186/1472-6874-12-6
4 Viva, W., Juhi, D., Kristin, A. et al. Massive uterine fibroid: a diagnostic dilemma: a case report and review of the literature. J Med Case Reports 15, 344 (2021). https://doi.org/10.1186/s13256-021-02959-3
5 Borahay, M. A., Asoglu, M. R., Mas, A., Adam, S., Kilic, G. S., & Al-Hendy, A. (2017). Estrogen Receptors and Signaling in Fibroids: Role in Pathobiology and Therapeutic Implications. Reproductive Sciences (Thousand Oaks, Calif.), 24(9), 1235–1244. https://doi.org/10.1177/1933719116678686
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 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.