No matter your relationship status, Sexually Transmitted Infections (STIs) should be on everyone’s health radar. STI rates are higher than ever before in the US, and both chlamydia and gonorrhea have the potential of becoming antibiotic-resistant. While there may be stigmas surrounding STIs that need to be banished, it is important that you are knowledgeable about STIs, their prevalence, and how they can affect you. Too few women are seeking out screening for sexually transmitted diseases. 

You should not feel ashamed about your sexual activity or STI status, but rather you should take responsibility for your health and safety and that of your sexual partners. The answer to how often you should get tested for STIs may surprise you. 

Getting Tested for STIs

Because STIs are so common, it’s a safe bet to get tested once a year, even if you’re practicing safe sex and using protection. Your doctor may not automatically test you at every appointment so make sure to ask about it if they don’t offer it. 

Here are some testing recommendations for prominent STIs:

STI Testing for Gonorrhea and Chlamydia

• If you have HIV.
• If you are sexually active and at risk for STIs, which can include new or multiple sexual partners.

Testing for gonorrhea and chlamydia is done using a cervical swab or a urine test which is then taken to a lab and analyzed. 

STI Testing for Hepatitis, Syphilis, and HIV

While these infections are not as prevalent, you should still get tested for them annually. These are checked with a blood test.

STI Testing for HPV

Certain types of HPV can develop into cervical cancer while other types of the virus can manifest as genital warts. Many people that are diagnosed with HPV in their lives never develop symptoms and the virus typically leaves the body within two years. 

Women may be tested for HPV through a Pap smear or an HPV test. If your pap smear shows abnormal results, your doctor will likely recommend further testing and your doctor may check your cervix for HPV or cancerous cells. 

You should get tested for HPV every few years if you have had an abnormal pap smear in the past. 

STI Testing for Genital Herpes

Genital herpes is a bit harder to test for because there are no concrete tests that can be done to detect genital herpes. A culture of a genital sore may be taken but usually only when you have symptoms. A blood test may be able to help detect a herpes outbreak, but the results are often inconclusive because it will not show if you had exposure to oral or genital herpes. 

The dedicated health professionals at Mid-Atlantic Women’s Care want to restore your peace of mind. If you or a loved one has any questions about STIs or are looking to get treated for them, please contact us today.

Women are no strangers to the different ways that menstruation can affect life. For many women, this looks like a monthly bout of bloating, cramps, and occasional mood swings. But if you have endometriosis, symptoms can be far more severe and can halt daily life, leaving you miserable and in pain. If you think you may have endometriosis, you are likely filled with questions: What causes it? What are all of the symptoms of this condition? What are my treatment options? Not to worry, we have answers to the most commonly asked questions about endometriosis and treatment options.

What is Endometriosis?

The inner layer of the uterus is lined with a tissue that is called the endometrium. During menstruation, the tissue grows thicker as the tiny blood vessels multiply to prepare for a fertilized egg. If pregnancy does not occur, the tissue breaks down and the blood exits the body through menstruation. 

Endometriosis is a condition in which the endometrium travels outside the uterus and surrounds other reproductive organs, most commonly the ovaries and the fallopian tubes, or it attaches itself to other tissues in the pelvis. As the endometrium is displaced from the uterus, the extra blood and tissue have no way to exit the body which, in turn, can cause cysts to form on the ovaries. For many women that are diagnosed with endometriosis, this means severe pain during their menstrual cycle. 

Endometriosis occurs in about 1 in 10 women of reproductive age. Most often, it is diagnosed in women who are in their 30s and 40s. 

What Causes Endometriosis?

The cause of endometriosis is unknown. However, endometriosis is a condition more likely to develop in women who have other family members who have been diagnosed with endometriosis, women who have undergone a cesarean, and women who have fewer than 25 days between menstrual cycles. 

Endometriosis is diagnosed first by a physical exam, including a pelvic exam performed by your OBGYN. However, the only way to truly tell if a woman has endometriosis is through a surgical procedure called laparoscopy. Sometimes a bit of tissue will be removed during this procedure in a process called a biopsy. 

What Are The Symptoms of Endometriosis?

Some women with endometriosis do not show symptoms, however, those who do show symptoms experience them right before their period. The most common symptom of endometriosis is chronic (long-term) pain in the pelvic region. Endometriosis can also cause pain during sexual intercourse. Endometriosis can also affect the bowel and bladder causing pain during bowel movements or urination, respectively. Heavy menstrual bleeding is another common symptom of endometriosis. Symptoms can be severe enough that they disrupt daily life and can include

• Heavy periods
• Severe lower back pain
• Intense cramps
• Intense stabbing pains
• Severe migraines
• Bloating
• Nausea
• Diarrhea or constipation
• Pain during urination and/or bowel movements
• Pain during sexual intercourse

Endometriosis can also make it difficult to get pregnant. Almost 40% of women with infertility have endometriosis. The inflammation caused by endometriosis can damage the sperm or egg or interfere with their movement through the fallopian tubes and uterus. In more severe cases of endometriosis, the fallopian tubes may be blocked by adhesions or scar tissue. 

What Are the Treatment Options for Endometriosis?

Treatment for endometriosis will depend on the severity of the condition, the symptoms the patient experiences, and whether or not the patient plans to get pregnant. Endometriosis may be treated with medication, surgery, or both. 

If you or someone you love are suffering from endometriosis, you don’t have to go it alone. The staff at Mid-Atlantic Women’s Care is knowledgeable when it comes to this common condition and we understand what you’re going through. Contact us to schedule an appointment and find the best course of action for you.

IUDs or intrauterine devices are one of the most popular methods of birth control among women, particularly in recent years. Many women like that it offers many benefits that the pill cannot: it is a “set it and forget it” method of birth control, involving a one-time payment, and the patient does not have to remember to take a pill at the same time on a daily basis. If you are considering getting an IUD, there are a few things you should know before having it inserted. 

What is an IUD?

An IUD is a small, flexible, T-shaped plastic device that is inserted into the uterus by a healthcare professional. There are five brands of IUD divided into two different types:

• Copper IUDs (a.k.a. ParaGard)
• Hormonal IUDs (include Mirena, Kyleena, Liletta, and Skyla)

Hormonal IUDs work by using the hormone progestin to thicken cervical mucus which blocks sperm. Copper IUDs are wrapped in a small bit of copper, are nonhormonal, and act as spermicide, damaging sperm mobility and viability. The body’s response to the IUD varies from person to person; for some, ovulation is prevented too while for others, it is not. Generally, they all work by preventing sperm from getting to the egg. 

The main difference between the two types of IUDs is how long you can keep them in without benign replaced. ParaGard can remain in place for up to 12 years while the Mirena and Liletta can for six years, Kyleena for five years, and Skyla for three years.

IUDs are ranked for the same effectiveness at preventing pregnancy as getting your tubes tied but they do not impact your future fertility. The IUD has a 99% rate of effectiveness, largely because, unlike the pill, it is not something you can forget to take, therefore, there is no user error involved. 

How is an IUD inserted? Is it painful?

In the insertion process, the cervix is opened and the IUD is placed into the uterus. While the insertion process can be slightly painful, the procedure generally takes just a few minutes. You may experience cramping for about 24 to 48 hours after the procedure as this is a common response among women after an IUD is inserted.

Will an IUD affect my period?

Whether or not your period alters, depends on the type of IUD you choose. Hormonal IUDs tend to make periods lighter and shorter and lessen cramps. IUDs may instead cause a heavier period, but this generally fades over time. Every woman reacts differently but if you are concerned about how you may react to an IUD, you should discuss this with your OBGYN during your consultation appointment. 

What are the pros and cons of an IUD?

In addition to the advantages previously mentioned, IUDs have long-lasting effects but can be reversed simply by removing the IUD. What makes the IUD appealing to many is that you visit an office once to have it inserted then you don’t have to remember on a daily basis to take a pill. It is the most effective but also reversible form of contraception. 

The biggest disadvantage of IUDs is the discomfort they can cause women. There are a wide array of side effects that can come along with them including abdominal or pelvic pain, nausea, vomiting, migraines, headaches, spotting or irregular bleeding, and breast tenderness. The side effects vary depending on which type of IUD you get. 

This does not typically happen but there is a slim chance your IUD could fall out, most commonly during a period in the first three months. Your OBGYN may recommend that you check to feel for the IUD string occasionally but never pull it out. If your IUD does become dislodged, see your OBGYN ASAP to have it reinserted.

Finding out that you have a sexually transmitted disease (STD) can come with a host of overwhelming emotions including surprise, anger, and fear and even more questions. You wonder if it’s curable or how it will affect your life. You worry about having to tell future sexual partners or how it might affect your plan to have children someday if that is your hope. Whether or not it will affect your fertility depends on your condition as well as how early you detect it. 

Which STDs can cause infertility?

The problem is that some STDs don’t come with identifiable symptoms so people can live with them for years without being aware of them. This increases the risk of developing complications like infertility or infecting future sex partners. Early detection is the best way to avoid such risk as infertility caused by STDs is highly preventable.

Chlamydia

This is one of the most common STDs. On its own, the disease doesn’t cause infertility, however 40% of women with chlamydia develop pelvic inflammatory disease (PID). PID affects the cervix, uterus, fallopian tubes, and ovaries, often leading the woman to become infertile. 

Chlamydia is one of the STDs that doesn’t have symptoms so most women that have it are unaware that they do. In some rare cases, a woman may experience signs of the infection including unusual vaginal discharge, a burning sensation while urinating, and painful sex. 

Fortunately, chlamydia can be cured with antibiotics which is why it is so critical that it is caught and treated early.

Gonorrhea

Here is another example of an STD that rarely shows symptoms. People who do show symptoms may experience spotting between periods, burning while urinating, or vaginal discharge that is white, yellow, or green. The infection can affect the urethra and cervix.

Gonorrhea can also be treated with antibiotics but, if left untreated, it can spread to the uterus, fallopian tubes, and ovaries. It can cause the fallopian tubes to scar, making it difficult for the sperm to reach and fertilize the egg and also increasing the possibility of the person getting pelvic inflammatory disease. 

Human Papillomavirus (HPV)

HPV is the most common STD in the US. This is a group of more than 150 viruses, some of which can lead to cancer of the reproductive organs. Most people don’t have symptoms which is why it’s so important that you are scheduling annual exams with your OBGYN. Detecting HPV early can decrease the risk of it developing into cancer of the vulva or cervix which can cause infertility.

Preventing infertility caused by STDs

Since STDs can remain in the body for years without ever showing signs, all sexually active women should have annual screenings where they are tested for STDs.

While it is pretty common for women to have ovarian cysts, it is important to understand where they come from, how they affect your body, and what you should look for and do about them. Ovarian cysts can come in many different forms and most are pretty harmless. However, when you start to consistently feel bloated, feel sharp random pains, or experience pain during sex, these are signs that you should make an appointment with your OBGYN and get yourself checked out. 

What are ovarian cysts?

Ovarian cysts are fluid-filled sacs that can form in a woman’s ovaries, generally during her menstrual cycle and they typically go unnoticed. While most are painless, cysts can become a problem when they are enlarged or don’t go away. 

It is normal for a woman to experience having at least one ruptured cyst a month because during a normal menstrual cycle, the ovaries produce a cyst that intentionally ruptures to release an egg, allowing the woman to become pregnant. When the cyst ruptures, fluid is released into the pelvis in a process called ovulation. If the egg that was released is fertilized by sperm, a pregnancy occurs. If not, a period occurs. 

While the vast majority of ovarian cysts are benign (non-cancerous) and harmless, if you have abnormal pains or discomfort for an extended period of time, you should look out for these signs: 

Irregular or delayed periods

Periods can be complicated and irregularities can occur for a number of reasons (check out our article on the causes of irregular periods). Ovarian cysts can be yet another factor that complicates periods further and can add pain and discomfort. Some months, the cyst that forms is larger and releases more fluid, causing immense pain while other months the cyst is smaller, releasing less fluid and causing slight discomfort. 

Sharp pain around your pelvic region

While mild to moderate pain may come with your period, if you experience random, excruciating pains outside of your menstrual cycle, it may indicate complicated cysts. You will most likely feel this pain in your lower pelvic region where your ovaries are located. Look out for a pain that stays in one specific area and stays even after your period goes away. 

Sex is painful

If you find yourself experiencing pain during sex when that has not normally been the case, you should make an appointment with your OBGYN. Enlarged cysts can make sex incredibly uncomfortable and even painful. 

You constantly feel the urge to go to the bathroom

If you constantly feel like you need to use the bathroom, it may be that a large ovarian cyst is pushing on your bladder and applying constant pressure to that organ. An easy way to detect if this is the case for you is to monitor how many times you are using the bathroom throughout the day and note what you’re doing on each trip. If you often get to the bathroom and find you don’t have the urge to urinate, you should schedule an appointment with your doctor. 

You feel hormonal

Polycystic ovarian syndrome (PCOS) is a condition where women have several small cysts on their ovaries that affect their hormones and can cause irregular periods, sudden weight gain, and acne. Because there are so many cysts on such a small space, it can cause an imbalance in estrogen, testosterone, and progesterone, which triggers the above-mentioned symptoms. The only way to diagnose PCOS is by having a doctor run a blood test or conduct an ultrasound exam. 

How can I prevent and treat ovarian cysts?

Unfortunately, there are no preventative measures a woman can take to keep ovarian cysts from forming. They occur naturally as part of the menstrual cycle or on their own. However, if you feel any of the aforementioned symptoms: vomiting, heavy bleeding, or excruciating pain, there may be complications and you should consult your OBGYN. He or she will conduct a pelvic ultrasound to diagnose enlarged ovarian cysts and then conduct a follow-up ultrasound three to four months later during a period. Enlarged cysts typically disappear within that time. 

Some cysts will require surgical removal but in the majority of cases, cysts are nothing to worry about.

A period, also known as menstruation or a menstrual cycle, occurs when the lining of a female’s uterus breaks down and leaves the body, usually every month. The lining is made up of blood, tissue, and nutrients – the development of which is the body’s preparation for pregnancy. If pregnancy does not occur, meaning the woman’s egg is not fertilized by a sperm, hormones tell the body to shed the lining that’s been built over the last 28 days (on average), resulting in a period that varies in length from one woman to the next.

When do periods begin and end?

Periods start during puberty, which is when a girl’s body begins to change, typically between the ages of 8 and 15 years old. It’s important to remember that periods look different for everyone so the side effects, ages at which it starts and ends, and how long each menstrual cycle lasts vary from person to person. However, as a rule of thumb, if a girl’s period has not started by the age of 16, she should be evaluated by a physician to assess the cause of the delay.

Periods end when women enter menopause which generally falls between the ages of 45 and 55 years old.

What side effects come along with a period?

Side effects may start up to two weeks before the start of a menstrual cycle. Women may notice a change in the body with symptoms called Premenstrual Syndrome (PMS). These can include:

• Back pain
• Fatigue
• Acne and breakouts
• Headaches
• Abdominal cramps
• Bloating
• Mood swings
• Insomnia
• Swollen or tender breasts

As these symptoms recur each month around the same time, they usually start to become predictable and more manageable. When symptoms start to become overwhelming, there are steps you can take to ease them:

• Limit intake of fat, salt, sugar, caffeine, and alcohol. An adjustment in diet can help to ease the side effects of PMS.
• Exercise regularly.
• Over the counter medications like acetaminophen and ibuprofen can effectively lessen symptoms.
• Consider hormonal birth control like the pill.

If you find that any of these premenstrual symptoms are overwhelming to the point that they are impacting your daily life, you should talk to your OBGYN. He or she may be able to find ways to ease the intensity and frequency of your symptoms. 

Should I use pads, tampons, or a menstrual cup?

There is no right or wrong answer here because all three methods allow women to go about their daily lives by collecting the blood that the body releases during a period. It is, however, important to know the basics of each option to make the best decision for you.

Pads are worn outside of the body so they collect the blood after it exits the body. Most pads are disposable after one use while others are made of cloth and meant to be washed after use. The material is highly absorbent to avoid leakage. Many women start off using pads when they first start their periods because they don’t require insertion into the vagina and are easy to use.

Tampons act almost like a plug that’s inserted into the vagina where it absorbs the menstrual blood before it leaves the body. Tampons generally come with an applicator that makes for easy and quick insertion and have a string that makes for easy removal. They are also highly absorbent and disposable after one use (up to 8 hours). Many women prefer tampons because they are small and discreet, they are usually not felt once they’ve been properly inserted into the body, and they allow women to engage in a greater range of activities than pads do, including swimming and other active sports. It is very important to change tampons every 4-8 hours (overnight is also ok) to avoid bacteria buildup which can result in a very rare condition called Toxic Shock Syndrome (TSS). This rare but serious condition can result from wearing a tampon for longer than 8 hours.

Menstrual cups look like little inverted bells and similarly to tampons, they are worn inside the vagina. Rather than absorbing the blood like both pads and tampons, menstrual cups are made of medical-grade flexible silicone and collect the blood while inside the vagina. They are then emptied, washed, and reinserted into the vagina. Menstrual cups are more environmentally-friendly as they are not thrown out after a single use, which is why many women prefer this method. Women also like menstrual cups because they can be worn for up to 12 hours at a time without the risk of developing Toxic Shock Syndrome.

Can you get pregnant on your period?

You sure can! Although the risk of pregnancy is lower during your period, it is still a good idea to use some form of birth control to avoid unintentional pregnancies. 

What to do if your period comes late

First, do not panic! It is common for periods to not always come 28 days apart on the dot. A typical menstrual cycle falls between 21-34 days, but there are quite a few factors that can affect the regularity of periods including weight gain or loss, stress, diet, medication, excessive exercise, and other lifestyle factors.

If your period does not come within 35 days and you are sexually active, you should take a pregnancy test even if you are on birth control. If a pregnancy test comes back negative or you are not sexually active, you should check in with your doctor who may want to conduct tests to determine the cause of this irregularity. 

If you have additional questions, our highly knowledgeable staff has answers. Call us to set up an appointment: 757-455-8833.