Last week I had a heated debate with a friend of mine over what she feels is the nonchalant attitude of physicians over the topic of genital herpes.  I have a colleague, a gynecologist, no less, who feels that testing people who have never had any symptoms of herpes only serves to “ruin their lives”.  I include testing for herpes when patients specifically ask to be screened for sexually transmitted diseases.  The Center for Disease Control (CDC) recommends routine testing for patients in high risk groups.  If you live in Purity-ville your chances of having Herpes type 2 is less than if you live in Sexanddrugs-town.

Another point to be made here is that there are people who have been given the diagnoses of herpes and make a conscience choice not to tell their partners, usually because they are afraid of losing someone they love or really like.  Here are some reasons that I’ve heard: “It’s not like it’s life threatening”,  ”I’ve never had an outbreak and don’t think that I will” or “I just can’t tell him (or her)”.  Before you weigh in, here are a few facts from the CDC that you should know: Read more…

My dad quit smoking years ago.  He often fell asleep on the couch while ashes from a lit cigarette fell to the floor.  The fact that his bed once caught afire, did not temper his cravings.  Today, in addition to being a cigarette Nazi, he takes to the treadmill regularly and continues to adhere to a vegetarian diet.  His diabetes is under good control but he’s sure that his naturopathic teas will bring him closer to a ‘complete cure’.  My mother, in contrast, flirted with cigarettes when she was a young hot party animal.  She hasn’t smoked since her twenties, but she has an affinity to cheesecake despite her uncontrolled diabetes, her weight and her hypertension.  She has cardiovascular disease.  Ladies and gentlemen, your lifestyle matters. Read more…

Menopause is one of the biggest turning points in women’s lives. It is defined as the permanent cessation of menstruation.  Some women make smooth transitions, while others face torrents of hot flashes accompanied by perfuse sweating, mood swings and debilitating insomnia.  The severity of the symptoms is based on several factors.  Here are a few: genetics, number of cigarettes per day, number of drinks per day, chronic illness, chemotherapy and diet.  What we do about these symptoms is based on cultural background, access to information, fears and believes about what constitutes a good quality of life.

For those who prefer the au natural approach, here is some information on one of the most popular alternative supplements: black cohosh. Read more…

The answer is “yes” but not necessarily every year and not at every age.  Here is why…

Now that we have clearer understanding of how HPV (human papillomavirus) affects the cervix at different points in women’s lives, we can now target certain women while reducing the number of procedures that we do on others.

Every year, millions of women are infected with HPV in the United States — but relatively VERY FEW actually develop cervical cancer.

HPV is the most common sexually transmitted virus. It’s spread through sexual intercourse.  But know that it is easily spread through skin-to-skin contact, so penetration during sex is not required to get HPV.  Infection with HPV peaks between ages 16 and 24.  This is the time when most women are exposed to HPV, which is often when they become sexually active. Read more…

It is such a frightening topic to read about.  Some mistakenly believe that the danger has been subdued.  One could possibly go an entire week without hearing it mentioned on the news.  Even so, in America, it is the 5th leading cause of death for women between the ages of 19-39.  For black women, it is the leading cause of death for those between the ages of 25 and 34.  Most women are being exposed to the virus by having sex with men who are infected.

AIDS (Acquired Immunodeficiency Syndrome) was first reported in 1981.  Two years later, scientists were able to find the cause of this disease: HIV  (Human Immunodeficiency Virus).  The infection has touched lives in every part of the world.  Countries in regions of the world with little resource: Sub-Saharan African, the Caribbean and Asia, have seen millions of their citizens die from this disease.  HIV in contracted by contact with infected blood and body fluids.  The virus then attacks the immune system, leaving the body unable to defend itself against infections that might otherwise be effectively eliminated. Read more…

Have you ever heard of preeclampsia?

I chose this topic because recently I had several patients who were diagnosed with this syndrome and most of them had no idea of what this disease meant for them or for their unborn child.

Simply, Preeclampsia is a type of high blood pressure that affects pregnancy.  It is diagnosed when there is both an increase in the mother’s blood pressure and when a certain amount of protein is found in the urine.

We don’t know what causes preeclampsia and we have not found a way to prevent it.  But, we do know that certain women are more prone to developing this disorder. Here are some of the top risk factors: women having their first baby, those who have had preeclampsia in a previous pregnancy and those with a family history of preeclampsia.  Some other really important risk factors include: women who are obese, those who were diagnosed with high blood pressure before they became pregnant (or who were diagnosed in the beginning of the pregnancy), women who have kidney disease, those carrying two or more babies and those who are genetically prone to develop blood clots. Read more…

I had a patient today who insisted on staying on birth control because she was terrified of getting pregnant.  She’s fifty three.  I have come to realize that many women believe, fiercely, that they are still fertile way into their 40s and 50s.  They believe that spin classes and eight servings of bottled water a day, will mean that they can wait until they are in their 40s to start thinking about children….just like Halle Berry.  On this point, I have always thought it unfair that many celebrities do not disclose the emotional and financial costs of getting pregnant when older.  Invitro fertilization, donor egg (using the egg of another or younger woman), even donor sperm, all costs money!  And, depending on the State in which you live, these interventions may not be covered. Read more…

Interestingly enough, even as a gynecologist, I hear a lot about erectile dysfunction (ED)—the inability to achieve or maintain an erection to complete sexual activity.  Women do get frustrated when their sexual partners cannot perform.

Keep in mind, men suffer from some of the same ailments that women do, namely emotional and relationship problems that get them down…no pun intended.

But, I wanted to alert you about the fact that erectile dysfunction can be a sign of serious medical problems like coronary heart disease, hypertension and diabetes.  Diabetes can affect the penile nerves and atherosclerosis (build up of fatty material like cholesterol in the arteries) also affects the penis! Read more…

A myomectomy is another option for the treatment of leiomyomas (lie-o-my-o-mas), generally known as fibroids.  This too can be done via an abdominal incision, laparoscopically or via the vagina.  The location, size, number of fibroids and the desire to preserve future fertility are the four major factors that determine which route is used.

In general, this procedure is reserved for patients who want to keep their uterus for future childbearing. Incisions are made in the uterus itself and the fibroids are “shelled out”.  Because the uterus has such a vibrant blood supply and because the technique involves multiple cuts into the uterus, there can be a fair amount of bleeding.  Sometimes, 1/1000, the uterus cannot be saved because it has been completely ‘taken over’ by the fibroids and the patient will need a full hysterectomy. Read more…

Most women are terrified of Human papillomavirus (HPV).  But, once you enter the world of sex, an infection with HPV is almost inevitable.  If you have one lifetime partner, who in turn, has only had sexual relations with you, you might have a shot.  Keep in mind that HPV is transmitted even without penile penetration. Contact with the genitalia is enough!  The good news is that a healthy immune system, one not weakened by chronic disease, smoking or certain medications, will usually clear the virus in a matter of months.  It’s true that some women continue to harbor the virus and these women are most at risk for abnormal pap smears that signal worrisome changes on the cervix (also referred to as dysplasia or ‘pre-cancerous changes’).  Don’t have a melt down!  It takes many years to progress from an abnormal pap smear to cervical cancer.  For most, close monitoring is all that is needed.  For others, a simple procedure to remove the abnormal area on the cervix can be done in about ten minutes.

Testing for HPV helps us to target those women who need to be followed closely.  It’s up to you to remember to keep your annual gynecological visits.

There you have it, now spread the word!