Your due date is creeping closer and closer until it passes and your baby still isn’t here. What are you supposed to do when your pregnancy goes past your due date? 

The first thing to do is remember that due dates are simply a calculated estimate of when your baby will be 40 weeks. Your due date does not mean an exact date of when your baby will come and it’s normal to give birth before or after your due date. 

Should I get tested for my post-term pregnancy?

Prenatal care will continue after you pass your due date. During these visits following your due date, your OBGYN will continue to check the baby’s heart rate, position, and your baby’s movements. If you’re over your due date, your OBGYN might do fetal heart monitoring, a non-stress test, and in some cases, labor induction may be recommended. 

What is labor induction and how is labor induced?

Labor induction is the stimulation of uterine contractions during pregnancy to achieve a vaginal birth before labor begins naturally. There are a few methods used to induce labor and these methods include:

• Cervical ripening balloon: Your OBGYN will place a small inflatable balloon-like device into your cervix to mechanically dilate it and prompt labor
• Prostaglandin analogs: These are a type of medication that is placed in your vagina to start cervical ripening
• Rupturing the amniotic sac: Your OBGYN will make a small hole in the amniotic sac to release the fluid (“break the water”)
• Oxytocin: Oxytocin can be given through an IV tube, causing the uterus to contract
• Stripping or sweeping the amniotic membranes: Your OBGYN sweeps a finger over the thin membranes that connect the amniotic sac to the wall of the uterus 

What are the risks associated with labor induction?

There are potential risks associated with labor induction which include: changes in fetal heart rate, infection, contractions of the uterus that are too strong, or induction not working. You and your fetus will be monitored throughout the entire process to ensure you are both tolerating it well.

Use our contact page or call 757-461-3890 for more information today.

If you think only older women develop ovarian cysts, think again. Ovarian cysts can occur at any age and are far more common than you think. There are many types of ovarian cysts, and while they might sound scary and uncomfortable, most women who have them do not experience any abdominal pain or pelvic pain. It is, however, important to monitor ovarian cysts in case of complications such as cyst ruptures.

If you are concerned about developing ovarian cysts, regular pelvic exams can help detect the signs and symptoms of ovarian cysts and can provide medical advice to protect your personal and reproductive health overall. The Tidewater Physicians for Women team is ready to help keep you healthy and well.

What is an Ovarian Cyst?

Cysts are fluid-filled sacs inside or on the surface of the ovaries. Women have two ovaries, one on each side of the uterus, and each is about the same size and shape as an almond. The ovaries exist to develop and mature eggs, which are released every month of a woman’s childbearing years during ovulation as part of your normal menstrual cycle, then are shed during menstruation if unfertilized. This cycle continues until menopause.  

You can develop ovarian cysts naturally, and they are quite common. Most of the time, they cause little to no discomfort and are entirely harmless. In most cases, they clear up on their own and do not require treatment. Sometimes, however, ovarian cysts can twist or rupture, which can cause serious and even life-threatening symptoms. This is why it is so important to visit your gynecologist healthcare provider regularly for pelvic exams and to be familiar with the signs that let you know when you are at risk.

Most ovarian cysts are relatively small and do not cause symptoms. They are often found during a routine pelvic exam or imaging test. 

Cysts that come with symptoms may cause a dull or sharp ache in the abdomen, bloating, swelling, and pain during certain activities. Larger cysts may cause twisting of the ovary, which causes pain on one side that comes and goes. Cysts that bleed or burst can cause sudden, severe pain. 

You may want to consider going in for annual exams with your OBGYN to ensure everything is healthy.

What Are the Different Types of Ovarian Cysts?

The major types of cysts are functional, which are naturally occurring and necessary to your body, and other types of cysts unrelated to menstrual cycles. Functional cysts result from natural growths called follicles, which produce estrogen and progesterone, and when they break open, they release eggs for ovulation. The two types of functional ovarian cysts are follicular cysts and corpus luteum cysts. Other types of cysts, unrelated to your menstrual cycle, are benign neoplastic cysts such as dermoid cysts, cystadenoma, endometriomas, and malignant cysts.

Follicular Cysts

Follicular cysts occur when the follicle fails to release its egg. When the follicle does not rupture to start ovulation, it continues to grow into a cyst.

Corpus Luteum Cysts

Corpus luteum cysts occur after a follicle releases its egg. At this point, the follicle is supposed to shrink and start producing estrogen and progesterone, which are essential during pregnancy. The follicle at this point is called the corpus luteum. When the egg gets blocked, and fluid backs up inside the corpus luteum, it becomes a cyst.

Benign Neoplastic Cysts (Dermoid Cysts)

Dermoid cysts are also called teratomas. They are the most common type of benign neoplastic cysts. They form when reproductive cells, called germ cells which make eggs, misbehave. These cysts can contain hair, skin, and even tooth tissue. They are rarely cancerous.

Cystadenoma

Cystadenoma develops on the surface of the ovaries and could be filled with mucous or a watery liquid. They can grow very large and may cause discomfort.

Endometrioma

Endometriomas are cysts that arise as a consequence of endometriosis. Endometriosis is a condition where cells, like those inside the uterus, begin to grow outside the uterus. When this happens, some of this tissue can attach to one of the ovaries and become a cyst called an endometrioma.

Malignant Cysts

As stated above, the vast majority of cysts are benign and can clear up naturally, but any cyst carries the risk of becoming malignant or cancerous. Malignant cysts are also called tumors and are an indication of ovarian cancer. Cysts are considered malignant if certain characteristics are present during a medical examination by your healthcare provider, from an unusual ultrasound, or when the patient has a family history of cancer. Biopsy or removal are the next steps if a cyst is potentially malignant.

What Are the Causes of Ovarian Cysts?

Polycystic Ovarian Syndrome (PCOS)

Polycystic ovary syndrome, or PCOS, is a hormonal problem that occurs during a woman’s reproductive years. Symptoms of PCOS include irregular periods, either periods that do not happen very often or those that can last for much longer than usual. Some women who have PCOS have too much androgen in their body. During this disorder, many cysts develop around the ovary, which are failed follicles. Weight loss can help to manage this condition, as can early diagnosis and medical treatment.

Weight Gain

Weight gain, as mentioned above, can be a risk factor for polycystic ovary syndrome. This is one of the risk factors that can be managed through a healthy diet, exercise, and medical advice from women’s health and wellness clinics. Healthy weight loss can help to control the risk of cysts.

What Are Some Natural Remedies for Ovarian Cysts?

In many cases, home remedies for ovarian cysts can help to manage any symptoms you might have. Your doctor may suggest any of these home remedies, including heat therapy, warm baths, to help with pain management.

Heat Therapy

Sometimes, a simple heating pad can help to ease symptoms of menstrual cramping and cyst pain. The doctor will likely recommend applying your heating pad or hot water bottle to your abdomen, indicating that it may be as effective as over-the-counter pain medication. You can make your own heating pad using a hand towel, a plastic zipper bag, and a microwave. Just soak the towel, stick it in the bag, place it in the microwave with the bag open for 2 minutes, seal it up and wrap it in another damp towel.

Warm Baths

Warm baths work the same as heat therapy. It can ease cramping and cyst pain and relax your muscles. Try adding some magnesium sulfate to the water to make the bath even more effective. Magnesium sulfate is also known as Epsom salts, which can be found at major grocery stores, your local pharmacy, or a discount store.

How Long Does an Ovarian Cyst Take to Go Away?

Without any complications, an ovarian cyst usually takes one to three months to go away. Some resolve quicker, while others take longer. Usually, this happens naturally, without treatment necessary.

Can Ovarian Cysts Become Cancerous?

While rare, ovarian cysts can be cancerous, especially among post-menopausal women. Pathological ovarian cysts can potentially cause ovarian cancer, and underlying conditions like endometriosis can also increase the risk of cancer growth. Different types of cancer can develop, depending on where the cancer began. The most common is the epithelial ovarian tumor, which starts outside the ovaries.

Signs of ovarian cancer include pelvic pain and abdominal discomfort, bloating, loss of appetite and feeling full, issues with bowel movements, frequent need to urinate, pain during sex, abnormal menstrual periods, vomiting, and fever.

When Should I Seek Medical Treatment for Ovarian Cysts?

The vast majority of ovarian cysts are harmless. If the cyst ruptures or you experience any of the symptoms above, you should seek medical attention immediately. If you know you have a cyst, inform the doctor to help them make a diagnosis.

The doctor will ask about your medical history and symptoms and conduct a physical and pelvic examination. You may need additional tests to rule out appendicitis, kidney stones, or ectopic pregnancy.

Surgery may be recommended if the cyst is large or if cancer is suspected. The type of surgery performed depends on several factors: how large the cyst is, the age of the patient, if she desires to have children, and the existence of a family history of ovarian or breast cancer. 

If the cyst is benign, minimally invasive surgery is recommended and done using a small incision and a laparoscope. Open surgery may be used if cancer is suspected or if the cyst is too large to be removed with laparoscopy. Open surgery requires a larger incision that is made horizontally or vertically on the lower abdomen. 

Signs of a Ruptured Cyst

Many of the signs of a ruptured cyst are similar to those of cancerous cysts. A major symptom of ruptured cysts includes sudden and severe abdominal pain. This is the most common and immediate indicator. Other signs include feeling cold, rapid breathing, weakness, lightheadedness, and clammy skin. Some women may experience pain in the lower back instead of or in addition to abdominal pain. If you experience any of these symptoms, talk to a doctor immediately.

We offer women’s wellness exams, family planning, health and wellness counseling, pregnancy assessment and care, maternity care, and expert treatment and diagnosis of reproductive system ailments such as ovarian cysts. From young teens to post-menopausal women, we are here to help you with your unique health and wellness issues and be by your side whole way. Call us at 757-461-3890 to schedule an appointment.

During this unprecedented time, it’s important to continue to stay motivated and pursue a healthy lifestyle. Whether it’s workouts you can do from the comfort of your home, healthy meals you can plan around your busy schedule, or tips on homeschooling your kids while you’re on the clock, we hope you find something helpful to take away from this guide. 

Get Up and Get Moving

There are countless apps, websites, and live streams offering free virtual workout routines including the YMCA, Planet Fitness, DanceBody, Nike Run Club, CorePower Yoga, and ClassPass just to name a few. 

Here are a few tips to make your at-home workout a success:

• Dedicate a space to your workouts where you can leave your equipment out and ready. Bypassing the step of getting out all the equipment each time you want to workout will encourage you to stick to it.
• Just like you pencil in a gym class on your calendar, do the same with your at-home workouts. Schedule them, mark them on your calendar, and hold yourself accountable. 
• Seek a healthy balance between cardio, strength, and stretching. Alternate between cardio and strength workouts.
• Social media is meant to be just that: social! Post online about your workouts and encourage your friends to be doing the same, that way you’re holding each other accountable. 
• When you don’t feel like doing a workout at all, tell yourself you’ll just do a light workout or half of a video. Chances are that once you’ve started, you’ll feel motivated to do the whole thing.
• Wear workout clothes that make you feel good about yourself. It doesn’t matter that no one will see you in them, this step is completely for you!

Nutrition

Quarantine Grocery Lists

• Click here to see what 3 registered dietitians are stocking up on to make healthy, delicious meals all quarantine long. 
• Click here to see what these nutritionists recommend you have on your grocery list.
• Click here to learn how to plan your shopping trip so that you can be as quick, efficient, and healthy as possible. 

Emotional & Stress Eating

Are you stress eating while working from home? Here are some resources to help you cope and minimize snacking:

Tips to Manage Stress Eating

Emotional Eating: What You Should Know

13 Ways to Prevent Stress Eating When You’re Stuck at Home

Stress eating these days? Here’s some help

Are you stress-eating while working from home? Here’s how to break the habit.

Additional Resources:

Check out these healthy eating and meal planning apps: 

• Choose MyPlate
• Fooducate
• MyFitness Pal
• Calorie King
• eMEals
• Healthy Eating Meal Plan

Eating for Life was designed by a registered dietitian nutritionist to help you obtain the skills and knowledge to eat the right amount and types of food to promote optimal health.

Healthy Habits Healthy You is a diabetes and heart disease prevention program. You can learn how to prevent heart disease and diabetes by making healthy food choices, maintaining a healthy weight, and exercising every day. 

Access both here. 

Tobacco

PIVOT has produced a mobile app as the digital component of their evidence-based, comprehensive quitting program. Within the app, users participate in practice quotes, take lessons in cognitive behavioral therapy, learn how to cope with the stress and anxiety associated with quitting, and are guided through a tried and true reduction and/or quit plan. 

Users are also able to engage with other users in the Pivot Community where they can share experiences, inspiration, wisdom, and motivation. 

To get started, visit https://account.pivot.co/pivot4all to register for this free app.

Get Some Sleep

American Academy of Sleep Medicine–Sleep tips during isolation: Supporting the body clock.

National Sleep Foundation–Sleep Guidelines During the COVID-19 Pandemic.

Virgin Pulse–Why a Good Night’s Sleep is so Important Now, More Than Ever.

Healthy Habits Healthy You–Learn more about how sleep affects your health and tips for better sleep. 

Homeschooling

cNet–Connect with other homeschooling parents and share survival tips on Twitter during the coronavirus lockdown. 

NYU Langone Health–School’s Out: A Parents’ Guide for Meeting the Challenge During the COVID-19 Pandemic.

SEL Labs–SEL in An Unplanned Home School Setting.

SEL Labs–I Homeschool My Kids and Also Work From Home — Here’s How I Do It.

Heavy menstrual bleeding is more common than you might think. It is estimated that about 1 in 20 women consult their gynecologist about it every year. No matter how common it is, however, it can really disrupt a woman’s life and could potentially be an indication of a bigger health problem. 

If you are worried that your bleeding is too heavy, you should consult your gynecologist. Read on for some of the most frequently asked questions regarding heavy menstrual bleeding. 

What is considered “heavy” menstrual bleeding?

Menstrual bleeding is considered to be “heavy” if it meets any of the following criteria:

• Bleeding that leaks through one or more tampons or pads every hour for several hours in a row.
• Bleeding that lasts longer than 7 days in a menstrual period.
• Bleeding that requires you to wear more than one pad at a time.
• Bleeding that requires you to change pads or tampons during the night.
• Bleeding with blood clots that are the size of a quarter or larger.

What can heavy menstrual bleeding indicate about my health?

Heavy menstrual bleeding could potentially be a sign of an underlying health problem that may require treatment. Blood loss due to heavy periods can lead to a condition called iron-deficiency anemia which can cause shortness of breath and increase the risk of heart problems. 

What causes heavy menstrual bleeding?

There are many possible causes for heavy menstrual bleeding which may include:

• Medications like blood thinners, aspirin, and copper intrauterine devices (IUDs), especially during the first year of regular use.
• Bleeding disorders where your blood may not clot properly.
• Growths like Fibroids or polyps.
• Cancer, specifically an early sign of endometrial cancer most often diagnosed in women in their mid-60s who are past menopause.
• Irregular ovulation, which may cause the lining of the uterus to become thick and result in heavy menstrual bleeding.

Some causes are not known but no matter what the cause, you should always consult your gynecologist to help find the best solution. 

How will my doctor evaluate my heavy menstrual bleeding?

When you have an appointment with your OBGYN regarding heavy menstrual bleeding, he/she may ask you questions about the following:

• Your birth control method of choice.
• Your menstrual period including the date they started, how long the bleeding lasted, and the amount of flow.
• Your pregnancy history.
• Your past and present medical history and surgical procedures.
• What medications you may buy over the counter.

From there, you may have a physical exam which may include a pelvic exam while some laboratory tests may be conducted. Your doctor may also have you take a pregnancy test and tests for sexually transmitted infections. Depending on your particular symptoms and your answers to the above criteria, your doctor may need to conduct additional tests. 

If you are experiencing heavy menstrual bleeding, we want you to know that you do not have to go it alone. There are treatments out there including medications and procedures that may be able to help the problem. Contact our office today or call 757-461-3890 in order to find out what your options are. 

Sexually Transmitted Infections (STIs) are among the most common infections in the US, with over 20 million Americans suffering from an STI every year. If you feel any symptoms, contact your provider as soon as possible. Remember to always have safe sex practices and always be open & honest with your partner.  

What are STIs?

STIs are infections spread through sexual contact. They can be transferred through mouth, rectum, genitals, skin, or body fluids. A lot don’t have immediate symptoms, so make sure you’re being open with your doctor about your sexual history and getting tested regularly, especially after having unprotected sex. 

How do I know if I have an STI?

Common symptoms for a lot of STIs are sores or bumps around the genitals, rectum, or mouth/throat, abnormal discharge (can be thick and/or frothy and discoloured, usually a yellow, green, or grey hue), and pain or itching in the infected areas. Even if these symptoms go away, still seek professional guidance, as you may still be infected.

What are some common STIs?

Chancroid, Gonorrhea, Chlamydia, HIV, Genital Herpes, Scabies, Genital Warts, Syphilis, Trichomoniasis vaginitis, Hepatitis B, amongst others. 

How do I prevent STIs?

• Condoms: Use them, always! Latex condoms are recommended every time oral, vaginal, or anal sex occurs. 
• Limit your sexual partners: An ideal situation would be agreeing with a single partner to only have sex with each other. However, even with a verbal agreement, it’s still a safe bet to always wear condoms. 
• Abstinence: This is the only way to truly abstain from the risk of an STI. Even with this option, however, infections like HPV and herpes can still be caused by skin-to-skin contact. Some HPV infections can be prevented with a vaccination.
• Get immunized: The HPV and hepatitis B vaccines are traditionally administered to children around the age of 11 or 12. For HPV, men and women can receive the vaccine from ages 9 – 45 years old. 

Conclusion

For more information contact us or you can also read our guide on birth control here.

As we’re coming off Breast Cancer Awareness Month, it’s important that people take the necessary precautions all year round to check for signs and symptoms of breast cancer. One of the most common screening tests performed on individuals is mammography. These are the questions we most commonly get about screening tests and mammography.

What is mammography?

Mammography is the primary tool used to detect and screen for breast cancer and other problems in that area of the female body. Mammography uses x-ray technology to view the interior of the breasts and create an image called a mammogram. A physician called a radiologist will then read and interpret those images. 

Mammography is done for one of two reasons:

1. It can be used as a screening test to check for breast cancer in women who have no signs or symptoms of the disease.
2.  It may be used as a diagnostic test to check lumps or other symptoms that have been found either in a self-breast exam or by an OBGYN or other health care provider. 

How do I prepare for a mammogram?

Day of your test, you should not wear any lotions, deodorants, or powders. These products have substances within them that can show up on the X-ray as irregular conditions or make the mammogram hard to read.

What is the mammogram process?

A mammogram requires that you completely undress from the waist up and put on a gown. You may be asked to stand in front of an X-ray machine and one of your breasts may be placed between two flat plastic plates. This will result in firm pressure being applied on your breast as the plate will flatten your breast as much as possible so that the most amount of tissue is visible.  These steps will be repeated on the other breast as well. 

What is breast density?

When breasts are dense, they have more of the fibrous tissue and less of the fat that gives breasts their shape. Breast density is a common thing to find on a mammogram, but it can make it harder for the radiologist to read the mammogram and detect breast cancer. If your report says that you have dense breasts, your healthcare provider may discuss other screening options for you in addition to mammography. 

When should I start getting mammograms?

Women with an average risk of breast cancer –  meaning they have none of the risk factors associated with high risk such as a family history of breast cancer, BRCA1 and BRCA2 mutations,  and chest radiation treatments at a young age – are recommended to have screening mammography every year beginning at the age of 40. 

For more information, read our guide on the most common questions we get about gynecology including information on mamograms.

Menopause is the time in a woman’s life when she naturally stops menstruating, her ovaries have stopped producing estrogen. The average age at which a woman reaches menopause is 51 years. 

In the years leading up to menopause, called perimenopause, the amount of estrogen produced by the ovaries will start to fluctuate, usually beginning in a woman’s 40s. This fluctuation commonly results in changes in her menstrual cycle where cycles may become longer or shorter than usual and some periods may be missed altogether. You may notice that your flow becomes lighter or heavier and although these changes are normal during perimenopause, you should still report them to your OBGYN in case they need to address problems of abnormal bleeding. 

What are other symptoms of menopause?

While some women may experience none of the following symptoms, others may have severe symptoms. Here are the symptoms you will see most often:

Hot flashes

A hot flash is a sudden feeling of heat that can overcome the upper body and face, lasting anywhere from a few seconds to several minutes or longer. Some women have hot flashes a few times a month while others may deal with them several times in a day. Hot flashes that occur during the night (night sweats) may disturb your sleep, leaving you feeling sluggish and tired the following day.

Sleep problems

You may find yourself suffering from insomnia during this period or waking up long before your usual time, sometimes caused by night sweats that disrupt your sleep pattern.

Vaginal and urinary tract changes

As your estrogen levels decrease, you may find that the lining of your vagina has become dryer, thinner, and less elastic which can cause pain during sex, irritation, and an increased risk of urinary tract infections. 

What are my treatment options for menopause?

Hormone therapy can help to relieve the symptoms associated with perimenopause and menopause. Hormone therapy entails taking estrogen sometimes in addition to progestin.

Estrogen can be taken in pill form but it is also available in skin patches, gels, and sprays that are applied to the skin. 

There are also antidepressants available to aid with sleep problems and ease hot flashes and selective estrogen receptor modulators (SERMs) that act on tissues that respond to estrogen which helps with vaginal dryness and hot flashes as well. 

At Tidewater Physicians for Women, we know this period of change can be hard on you and your body which is why we encourage you to discuss your menopausal symptoms with one of our doctors. 

There are many different types of birth control on the market and determining which may be best for you and your body can be difficult. Not only will this guide help to distinguish between the different forms but you should also discuss with your doctor what the best method of birth control may be. 

Which birth control methods also protect against sexually transmitted infections?

The best protection against STIs is the male condom with the female condom providing less protection. You should use a male condom in addition to the other methods of birth control to protect against STIs. Many STIs are spread through the physical contact of infected body parts and so birth control methods that do not create a barrier between those parts cannot effectively protect against infection. 

What are the different methods of birth control?

There are many different birth control methods available nowadays and finding the best one for you means speaking with your gynecologist and considering the following:

• Any health problems you may have.
• How well each method prevents pregnancy.
• How easy it is to use.
• If you need a prescription in order to get it.
• If it protects against STIs

Birth control pill

Birth control pills are a pill you take orally at the same time every day. It contains hormones that work to prevent pregnancy. There are quite a variety of birth control pills available but your health care provider will be able to determine the best one for you and your needs. If you do miss taking a pill one day, the package that your pills come in will address what you should do. 

Vaginal ring

The ring is a flexible ring that is inserted into the upper vagina and releases hormones into your body from there. It is worn inside your vagina for 21 days and then removed for seven days in which you have your menstrual period. Following that period, a new ring is inserted.

Birth control shot

A shot containing hormones that prevent pregnancy is administered as an intramuscular injection or buttock muscle. 

Implantation

The implant is a small plastic rod about the size of a matchstick that your doctor will insert under the skin of the inner arm. The implant can be used for up to 3 years. 

Intrauterine device

The IUD is a small, T-shaped device that’s inserted into the uterus. There are 2 types of IUDs: (1) a hormonal IUD which is approved for up to 5 years of use, and (2) the copper IUD which is approved for up to 10 years of use.

Condoms

Condoms are available in both male and female varieties. Condoms are often used in tandem with spermicides to prevent pregnancy and are the best method for preventing the spread of STIs.

Diaphragms

A diaphragm is a small dome-shaped device that’s made of either latex or silicone and fits inside the vagina, covering the cervix. Your doctor may need to do a pelvic exam in order to find the right size diaphragm for you and you will need a prescription to obtain it. 

Emergency contraception

If you have sex without using any form of birth control or if the birth control method used did not work (for example, the condom broke during sex), you can use emergency contraception to prevent pregnancy. Emergency birth control is available in pill form which must be taken within 72 hours of unprotected sex.

Conclusion

That wraps up this post on what you need to know about birth control.  If you have any other questions, please give us a call today 757-461-3890.

If you’ve never been to the gynecologist, not knowing what to expect might make you feel anxious about your first annual physical exam. But tending to your reproductive health is imperative in addition to the other services that we take care of during these exams, such as screening for cervical cancer and verifying that your body is developing as expected. So we want to address the concerns you may have about your annual physical exam.  

So, what is a well-woman exam?

“Well-woman exam” is another term you might commonly hear in reference to your annual physical exam and is a periodic visit to your gynecologist for an overview of your reproductive health and preventative care.

Pap Smear

You may have a pap smear performed. The frequency at which you should have cervical cancer screening and which tests you should have depends on your age and health history. The point of this procedure is to gather a sample of cells from your cervix to be tested for signs of cancerous or pre-cancerous cells. 

Breast Exam

How is a clinical breast exam performed?

Your doctor may examine your breasts during routine checkups. This is called a clinical breast exam. The exam may be done while you are lying down or sitting up. The breasts are checked for any changes in size or shape, puckers, dimples, or redness of the skin. Your doctor may feel for changes in each breast and under each arm.

What is breast self-awareness?

Breast self-awareness focuses on having a sense of what is normal for your breasts so that you can tell if there are changes – even small changes – and report them to your ob-gyn.

Why is breast self-awareness important?

Breast cancer often is found by a woman herself. This happens in almost half of all cases of breast cancer in women aged 50 years and older. In women younger than 50 years, more than 70% of cases of breast cancer are found by the women themselves.

How to Prepare for an Annual Physical Exam

We want to make you feel comfortable and confident in your health and life. Here are steps you can take to prepare and relax for your appointment:

• Decide if you’ll feel more comfortable being seen by a male or female doctor prior to making your appointment.
• Make note of any special things you want to discuss with your gynecologist. These topics may include birth control; protection against STIs; changes in your period, vaginal discharge, or breasts; irregular pain or symptoms that come along with your period; or issues related to sex. 

Contact Tidewater Physicians for Women for More Information

At Tidewater Physicians for Women, we are passionate about women’s health and reminding women of the importance of scheduling their well-woman exam every year. Call us to schedule your appointment today!

Can you remember when your last period was and how long it lasted? If not, it may be time to take notice starting with tracking your menstrual cycle and identifying important changes. While irregular cycles are sometimes nothing to worry about, they can sometimes signal health problems that you and your gynecologist should be aware of. 

What is a menstrual cycle?

A menstrual cycle is a series of changes that a woman’s body goes through monthly preparing for the possibility of pregnancy. Every month, the ovaries release an egg in a process called ovulation. At the same time, hormonal changes in the body prepare the uterus for pregnancy. If ovulation occurs but the egg goes unfertilized, the lining of the uterus sheds out of the vagina. This entire process is called a menstrual cycle. 

Menstrual cycles can occur every 21 to 35 days and last from two to seven days. 

Comparing your menstrual cycle to another woman’s will not give you an accurate sense of what’s regular or irregular; it’s comparing your own cycles that will confirm regularity. Does your cycle come about the same time and length each month or is it somewhat inconsistent? Is your cycle light or heavy? Painful or painless? Do they last two days or seven? What we refer to as “normal” is what’s normal for you. 

Bear in mind that the use of some methods of contraception, such as birth control pills and intrauterine devices (IUDs), can alter your menstrual cycle. Your gynecologist can give you a better sense of what to expect. 

How should I track my menstrual cycle?

To figure out what a normal menstrual cycle looks like for you, you should start keeping track of it. There are countless apps on the market that allow you to track your cycle on your phone or you can use a calendar. Start by tracking the start date several months in a row to get a sense of the regularity of your menstrual cycles. You can also make a note of the following:

• End date: How long do your menstrual cycles typically last?
• Abnormal bleeding: Are you bleeding in between your menstrual cycles?
• Pain: Does the pain feel worse than usual? Is there pain in a different area than usual?
• Flow: Record the heaviness of your flow. Have you noticed blood clots? Does your flow seem lighter or heavier than usual? How often do you find that you need to change your feminine hygiene products? 
• Any other changes: Have you noticed a change in mood or behavior during your cycle?

What’s causing my irregular menstrual cycles?

• Pregnancy or breastfeeding: A missed menstrual cycle may be an early sign of pregnancy. Some women may experience lighter than usual or late cycles before their menstruation cycle ends altogether. Breastfeeding generally delays the return of menstruation after pregnancy.
• Stress: The hormone caused by stress, cortisol, directly impacts the amount of estrogen and progesterone the female body produces. Too much cortisol that comes along with high-stress levels will change the time and flow of your menstrual cycle. 
• Birth control pills: Your body may take several months to get used to the hormones that birth control pills add to your body which will then affect your menstrual cycle. 
• Polycystic ovary syndrome (PCOS): Women with this endocrine system disorder have enlarged cysts form on the ovaries. The presence of these cysts can cause irregular menstrual cycles. 
• Extreme weight loss and excessive exercising: A woman’s body needs energy in order to menstruate. If too much of that energy is being used up at the gym, her menstrual cycles may become irregular. Low body weight is also a common cause of missed or irregular cycles. 
• Pre-Menopause: As much as 10 years before the start of menopause, a woman may start to experience irregular cycles as her hormone levels have already started to change. 

What can I do about my irregular menstrual cycles?

If you have concerns about your irregular periods, the most important thing to do is to schedule an appointment with us at Tidewater Physicians for Women. Our caring physicians offer comprehensive gynecological services and will be able to find treatment to regulate your menstrual cycles or for any underlying problems that could be causing your irregular menstrual cycles.  Please give us a call 757-461-3890 or use our contact page if you have any questions! 

This is a guide to the most common questions we hear as Gynecologists and women’s health experts.

Question #1: Is a pap smear really necessary?

Yes, a pap smear is necessary and we’ll tell you why. But first, let us put your minds at ease: you may not need a pap smear at every annual exam. In order to understand the importance of a pap smear and that it’s not just a way for your gynecologist to invade your privacy, you have to know what we’re testing for. 

An abnormality in your pap smear test could potentially be a sign of cervical cancer or human papillomavirus (HPV) in which case you will need additional testing. 

So, yes it is necessary that you get a pap smear regularly, particularly if you have a prior history of cervical cancer, HIV infection, immune-system compromise, or exposure to DES (diethylstilbestrol). 

Question #2: My periods are awful. How can I make it better?

If your periods are giving you a lot of trouble every month, you don’t just have to suck it up and deal, we have solutions! A painful period could mean such heavy bleeding that you soak through your clothes unexpectedly or it could mean physical pain and cramps that force you to miss work or other activities due to immense discomfort. It looks different for every woman but modern medicine can help. 

A pill is an option that many women choose to help manage their periods even if they don’t need it for contraception. The IUD is another way to help control your periods and minimize the painful effects of your menstruation cycle. It uses the hormone progestin to prevent the endometrium or uterine lining from proliferating resulting in lighter periods or nothing at all. 

Long story short, life is too short to be losing a few days each month dealing with a painful period. We want to help, you just have to let us know.

Question #3: I want to get pregnant. What do I need to do to prepare?

Pregnancy health starts way before conception so it’s important to talk to your OB-GYN about how to stop bad habits that can harm your baby and begin good habits to increase the chances of carrying a healthy baby to term. Those bad habits include quitting smoking and drinking and placing more emphasis on a healthy lifestyle and weight gain. These steps should be taken at least six months before you start trying to conceive. During your first meeting with an OB-GYN, your doctor will discuss with your family, medical, and genetic history, medications that you are currently taking, and how to make sure your lifestyle aligns with a healthy pregnancy. You should also start taking a prenatal vitamin with folic acid three to six months before pregnancy to ensure optimal health for both you and your baby-to-be.

Question #4: Why do I smell down there?

Do you find that there’s a strange odor coming from your vagina even when you’ve just showered? It’s more common than you think.  

The vagina has a natural scent but it shouldn’t be unpleasant, yeasty, or “fishy.” If you find any of these things to be true, it could be a sign of infection and you need to bring this up with your gynecologist on your visit. 

Question #5: How often do I need to get a pelvic exam?

A pap smear and pelvic exam are not one and the same. A pap smear is the collection of cells from the cervix to screen for HPV and cervical cancer. A pelvic exam is the inspection of the pelvic organs which includes the vagina, vulva, cervix, uterus, bladder, and rectum. You should have a pelvic exam every year. This is important to not only screen for problems that can arise in the pelvis, but also to make sure everything in that area is working properly. 

Question #6: Do I really need a mammogram or can I just do a breast exam and be done? 

A breast exam will generally be part of your annual exam as your doctor will check for breast lumps, nipple discharge, and irregular thickening of tissue. A mammogram, however, is a much more comprehensive process and it can find things that a physical breast exam can’t. There is no industry standard of when you should start getting mammograms, so you should talk to your gynecologist but a general consensus is that you should start getting annual mammograms at the age of 40 and 50. We also recommend a monthly self-breast exam.

Question #7: What are you going to do to me at my annual exam?

We call our annual exams well-woman visits too. The focus of a well-woman visit is preventative care. The choice to address both well care and medical issues is offered for the convenience of avoiding two visits; however, you may owe a cost-share/copay for this additional service.

The following is what is included in a well-woman visit: 

• A review of your current health and medical history.
• Counseling about ways to improve your health.
• A physician exam tailored to your preventative care needs.
• Immunizations and screening tests, if needed (Some insurances will not cover these tests).

Question #8: What’s the best birth control method?

It’s probably not the answer you wanted to hear but it really depends on your specific situation, your medical and family history, your health needs, etc. There are a lot of birth control options out there nowadays so it’s important that you discuss with your doctor the pros and cons of each one.

Conclusion

Those are the most frequently asked questions that we hear for a gynecologist.  If you have any other questions please give us a call at 757-461-3890 or use our contact page today!