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Raleigh Gynecology & Wellness

North Carolina GYN Care & Treatment

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How Often Should You Have A Mammogram?

Conditions and Management

Raleigh Gynecology · November 2, 2020 ·

A patient undergoing mammogram screeningMammograms are an important, non-invasive tool for identifying changes in your breast tissue and early detection of cancer. Knowing how often you should get a mammogram can help you to stay healthy as you age.

What Is A Mammogram?

A mammogram is an x-ray of the breast. It is performed using a safe, low-dose x-ray machine designed to take images of your breast tissue.

Risks And Benefits Of Mammography

The benefits of mammography are significant for women between age 40 and 70, as well as for those women at higher risk of cancer. The most significant benefit is that a mammogram can detect breast cancer at an early stage. Early detection improves a woman’s chance of survival, reducing the risk of dying from the disease by 25-30% or more. Having a mammogram done regularly provides a simple way for a woman and her doctor to monitor changes in her breast health over long periods of time.

For most women, the benefits outweigh the risks which include overdiagnosis and overtreatment. This occurs when a mammogram finds ductal carcinoma in situ (sometimes referred to as “DCIS”) or a small breast cancer that would have never caused symptoms or problems if left untreated. These types of breast cancers may never present a health problem, or a person may die from another cause before the breast cancer became a problem.

Other risks include false positives which require the patient to undergo additional testing, such as an MRI, ultrasound or biopsy to diagnose a possible issue. In most cases, the abnormality is not cancer.

The Necessity Of Mammograms

Mammogram scanner in a hospitalAccording to the Center for Disease Control (CDC), breast cancer is the second most common type of cancer in women in the United States. For many women, a mammogram is one of the best ways to detect breast cancer before it becomes life threatening.

A mammogram can detect abnormal breast tissue as much as two years before it becomes cancerous. It can also detect it before it becomes large enough to be felt through a manual examination of the area.

If your mammogram shows abnormal tissue, you will likely have to undergo additional testing. This testing may include an ultrasound of the breast or an MRI for a more detailed image of the area of concern identified in the mammogram. In some cases, you may have to undergo a biopsy procedure to remove a sample of the abnormal breast tissue and have it laboratory tested to determine if the tissue is cancerous.

Mammography Recommendations Based On Age

Breast cancer in women younger than 50 is much less common than in older women. As women age, however, their risk of developing breast cancer increases. For most women of any age, a mammogram every one to two years is beneficial, with some exceptions as described below:

Recommendations For Women Under Age 40

For women under age 40, mammograms are recommended only if abnormalities in the breast tissue have been detected through manual examination or other testing. The breast tissue in younger women tends to be dense which can obscure signs of cancer, making detection by mammography difficult and unreliable.

As women age, dense breast tissue becomes less of an issue. With age, the breast tissue becomes fattier and less dense.

Recommendations For Women Age 40-49

After age 40, a mammogram is more reliable in helping to detect breast cancer. That said, leading health organizations disagree to some degree on when to begin getting mammograms and how often they should be repeated.

The American College of Obstetricians and Gynecologists (ACOG) recommends screening mammography every 1–2 years beginning at age 40 years for women at average risk of breast cancer. Screening should continue until at least age 75 years.

The United States Preventive Services Task Force, the American College of Physicians and the American Cancer Society recommend that women in the 40-49 age group discuss the need for a mammography with their doctors, and make informed decisions based on the woman’s risk profile, concerning when she should start mammography screening and the frequency.

The most important factors in that decision will be the woman’s individual cancer risk profile, family history and personal preferences about the health risks presented by a mammography. If breast cancer runs in your family, you should begin mammography screening by age 40, and some women at very high risk may need to begin screening even sooner.

Recommendations For Women Age 50-69

Portrait of a woman. For women ages 50-69, the benefits of mammography easily outweigh the risksFor women ages 50-69, the benefits of mammography easily outweigh the risks. Women in this age group realize the most overall benefit of mammography because the condition of their breast tissue makes mammograms more reliable. Women aged 50-59 who got mammograms had a 14 percent lower risk of dying from breast cancer than those who did not have a mammogram. Women aged 60-69 who had mammograms, had a 33 percent lower risk of dying from breast cancer than those who did not have one.

Most leading health organizations agree on the recommendation that women ages 50-69 have regular mammograms. At Raleigh Gynecology and Wellness, we recommend that women in this age group continue to have a mammogram every year in addition to monthly self-examinations.

Recommendations For Women Over Age 70

For many women age 70 and older, regular mammography every one to two years continues to be beneficial. For some women over 70, however, the benefits of mammography may not be worth the risks.

In this age group, mammograms can result in overtreatment and subject elderly women to the risks of harmful side effects of breast cancer treatment.

Also, women aged 70 to 75 are more likely to die from other causes than from early stage breast tumors detected through mammogram screening. When breast cancer is diagnosed, the treatment can be difficult for an elderly woman to endure. Some women are at increased risk for complications from surgery and for side effects caused by chemotherapy and hormone therapy. Women in this age group should discuss the risks and benefits with their doctor to decide whether the benefits of regular mammograms outweigh the risks in their individual case.

Regularity In The Procedure Is Best

Routine mammography decreases the risk of death from breast cancer by 30 to 48%. Medical research has shown that the vast majority of deaths due to breast cancer occur in women who have never had mammographic screening.

Regular mammography helps detect cancers that grow very quickly. Fast growing cancers can spread to your lymph nodes even while they are still small and are even able to double in volume in just one month. Keeping up with regular mammograms can prevent this kind of cancer from becoming deadly.

Talk To The Mammogram Professionals At Raleigh Gynecology And Wellness

If you have questions about the risks and benefits of regular mammography screening, contact the mammogram specialists at Raleigh Gynecology and Wellness. They are available to answer your questions. If you have breast cancer in your family or you are over age 40 and have never had a mammogram, contact us to schedule an appointment. You can also reach us by phone at (919) 636-6670.

Raleigh Gynecology · September 7, 2020 ·

Endometriosis on woman`s body.It is a common disorder on a woman’s uterus.Endometriosis is a common disorder of a woman’s uterus. It typically affects the pelvic organs ovaries, fallopian tubes, bowels, bladder, rectum, and the tissue lining your pelvis, but it can affect any other organ in your body.

Endometriosis implants respond to changes in estrogen, a hormone in a woman’s body. Endometriosis cells respond to your menstrual cycle and bleed just like the normal endometrial cells lining the inside of your uterus. Endometrial cells in your body or on your organs cause inflammation and discomfort and can interfere with the normal functioning of the affected organs.

In some cases, endometriosis can block your fallopian tubes and it can also cause cysts in your ovaries (endometriomas). It can form scar tissue and adhesions that can bind your organs together in ways that can cause significant pain and quality of life issues for you.

Common Causes of Endometriosis

Endometriosis affects about 10% of American women between 15 and 44. It is not a condition that can be prevented. Despite the prevalence of the disease, medical researchers are uncertain about the precise causes of endometriosis; however, it tends to run in families. It also occurs more often in women with certain menstrual patterns. Common theories of the causes of endometriosis include:

Retrograde Menstruation

One long-standing theory on the cause of endometriosis is called “retrograde menstruation”.
In a normal ovulation cycle, your uterine lining—the endometrium— thickens just before ovulation to provide a cushion for an egg released from your ovary. If the egg is not fertilized, the endometrium breaks down and bleeds with your menstrual cycles. Your body expels the endometrial tissue along with any unfertilized egg through the vagina.

Retrograde menstruation occurs when menstrual blood flows back through your fallopian tubes into your pelvic cavity instead of leaving your body through the vagina. That could allow endometrial cells to reach other organs of your body and attach to them.

Embryonic Cell Transformation

Another possible cause of endometriosis is cell transformation. The theory is your hormones transform the cells outside of the uterus into cells like the endometrial cells lining the inside of your uterus.
Embryonic cell transformation is the theory that small areas of your abdomen convert into endometrial tissue. The basis for that theory is that cells in your abdomen grow from embryonic cells. Embryonic cells can change shape and become endometrial-like cells.

Surgical Scar

Another theory for the cause of endometriosis is a surgical procedure that can release microscopic particles of menstrual blood into the pelvic cavity. It can be any procedure involving the pelvic area, such as a Cesarean section (c-section).

Immune System Malfunction

A healthy woman drinking citrus juice. Low immunity can harbor various gynecological issues in women.A faulty immune system could be another culprit. When the body cannot expel the cells through the menstrual process, the body’s immune system may destroy them. However, an immune system that is not healthy may be unable to destroy renegade endometrial cells. In that case, the cells eventually will attach themselves to other organs.

Lymphatic System

Your lymphatic system may transport the endometrial cells out of the uterus and into other parts of your body.

Mullerian Theory

This theory holds that endometriosis actually starts in the woman’s fetal period during the development of her sexual organs. Abnormal cell development of certain ducts (known as Mullerian ducts) may occur and endometrial cells grow outside of the uterus. Those cell tissues then respond with the onset of puberty and hormone releases.

How to Diagnose Endometriosis

You should discuss your symptoms with your doctor. To diagnose it, your doctor may perform one or more of the following procedures:

  • Pelvic exam, where your doctor may feel for large cysts or scar tissue behind your uterus.
  • Ultrasound or MRI to detect ovarian cysts.
  • your doctor may prescribe hormonal medications to reduce pain and lower the amount of estrogen in your body.
  • Laparoscopy, a surgical procedure that allows the doctor to observe any growths and take tissue samples for analysis.

Talk to the Experienced Gynecologists at Raleigh Gynecology and Wellness

Young woman and a gynecologist at a clinic. Endometriosis is a common condition in many women.Endometriosis is a common condition in many women. Symptoms can include pelvic pain, pain with intercourse, abnormal menstrual bleeding, and abnormal bowel or bladder function. It also can interfere with your ability to become pregnant, and if left untreated, can result in infertility. The specialists at Raleigh Gynecology and Wellness are available to answer your questions about endometriosis and talk to you about symptoms and treatment. Contact them today for more information about endometriosis or any other women’s health matter and schedule an appointment.

Raleigh Gynecology · July 27, 2020 ·

a woman grasping her stomach in pain from endometriosisEndometriosis can be a painful condition for many women. It occurs when microscopic bits of endometrial tissue escape from your uterus, attach to other organs in your body and grow. It usually affects organs in your pelvic area such as ovaries, fallopian tubes, and the tissue lining your pelvis, but it can affect other organs in your body.

Medical experts are not sure exactly what causes endometriosis. Some experts believe that small amounts of menstrual blood containing endometrial cells find ways to pass back through your fallopian tubes and spill into your pelvic cavity, where they can attach themselves to your organs. Other experts believe that women have a genetic predisposition to the condition. Here is more info on how do you test for endometriosis?

Symptoms of Endometriosis

The symptoms of endometriosis resemble symptoms for other common disorders. Also, some women with extensive endometriosis will have few symptoms, while other women with a mild case can experience severe symptoms. All of this makes diagnosing endometriosis difficult.

How to test for endometriosis? How do you know if you have endometriosis? Some of the most common symptoms are:

Unusual Pain and Cramping

Many women experience cramps during their menstrual period. With endometriosis, the cramping may be so painful that it interferes with your daily activities.

The pain and cramping are caused by the endometrial-like cells that are growing outside of your uterus on other parts of your body. These cells create inflammation that can irritate your organs and cause them to stick together.

This endometrial-like tissue acts like the normal endometrial tissue lining your uterus. It thickens, breaks down and bleeds just like the healthy endometrial tissue. However, the healthy endometrial tissue lining your uterus is expelled through your vaginal canal during menstruation; this is not the case with the endometrial tissue growing outside of your uterus. Your body has no way to expel that tissue residue once it breaks down. The spent tissue becomes trapped and with no way to escape the body, it can form cysts, called endometriomas, irritate other organs and tissue, and develop scar tissue and adhesions.

You may also have pain and cramping during sexual intercourse and with bowel movements or urination when you are menstruating.

Excessive Bleeding

a microscopic view of red blood cells in great number in someone with endometriosisWomen with endometriosis often experience heavy menstrual periods, longer than normal periods, or bleeding between periods.

Lower Back Pain During Menstruation, Bloody Urine or Stools, or Bleeding from the Rectum
If you only experience these symptoms during menstruation, or if they worsen during menstruation, one possible cause could be endometriosis.

Infertility

As many as 40% of women who have trouble getting pregnant have endometriosis. The exact reason is unclear, but medical experts suspect that inflammation plays a role. The inflammation caused by endometriosis damages the sperm or egg or makes it harder for them to move. Also, endometrial scar tissue might block your fallopian tubes.

Other

a woman suffering from fatigue is a common symptom of endometriosisOther symptoms of endometriosis include fatigue, nausea, diarrhea, or constipation and bloating.

As noted earlier, these symptoms can be vague and sporadic. The severity of the symptoms is not indicative of the severity of the case. If you experience the symptoms frequently or regularly during your menstrual cycle, you should be examined for endometriosis.

How Do You Test For Endometriosis

Diagnosing endometriosis can be difficult, especially when you have few if any symptoms. You cannot safely self-diagnose it; the symptoms make the condition easy to mistake for other types of health disorders such as irritable bowel syndrome or ovarian cysts.

Diagnosis and subsequent treatment involve a multiple-step process:

Pelvic Exam

The first step in diagnosing endometriosis is a pelvic exam by your gynecologist. Your gynecologist will manually examine your pelvic area for abnormalities.

Ultrasound of Your Pelvic Region

An ultrasound test uses high-frequency sound waves to create images of the inside of your pelvic region. It may be performed by pressing a device called a transducer against your abdomen or inserting it into your vagina.

Magnetic Resonance Imaging (MRI).

An MRI uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body. It can give your gynecologist a detailed view of cysts and scar tissue that can help in treatment.

Laparoscopy

The best diagnostic exam for endometriosis is a laparoscopy. It is a surgical procedure that allows a surgeon to view inside your abdomen using a slender viewing instrument called a laparoscope. During a laparoscopy, your surgeon may be able to fully treat endometriosis possibly eliminating the need for another surgery.

Contact Raleigh Gynecology For More Info On Testing For Endometriosis

Endometriosis is a serious health condition that often escapes early diagnosis. It can cause infertility and other health problems. It also may raise your risk of ovarian cancer or another cancer called endometriosis-associated adenocarcinoma.

If you are having any symptoms of endometriosis, it is important to get it diagnosed and treated as soon as possible. Contact the women’s health and reproductive specialists at Raleigh Gynecology and Wellness for more info on how do you test for endometriosis and to schedule an appointment.

Raleigh Gynecology · June 1, 2020 ·

Emergency Contraception Explained

emergency contraception pillsThe term “emergency contraception” refers to a post-coital birth control regimen that is administered to a woman for the purpose of preventing a pregnancy. They work by delaying a woman’s ovulation. Emergency contraception should not be used to terminate a pregnancy. Also, emergency contraception pills will not treat or prevent sexually transmitted disease.

Events that warrant emergency contraception include a failed birth control method such as missing two or more birth control pills during a monthly cycle. Emergency contraception is also appropriate after a woman has unprotected sex, such as a condom failing during sex, or rape.

Forms of Emergency Birth Control Used to Prevent Pregnancy

Emergency contraception is administered in one of two ways: pills given orally, or intrauterine device (IUD).

Some pills require a prescription and may only be sold to women over the age of 17. Other brands of contraceptive pills are available without a prescription.

Common Types of Emergency Contraceptive Pills

Different types of emergency contraceptive pills are available. Which ones are best for you depends largely on how much time has elapsed since your unprotected intercourse? Other factors are relevant, too, as explained below.

Hormone-Based Pills

hormone based emergency contraception pillsSeveral brands of emergency contraceptive hormone-based pills are available without a prescription. These pills contain the hormone levonorgestrel. Only one dose of one pill is needed. It works by temporarily blocking the woman’s eggs from being released, by stopping fertilization, or by keeping a fertilized egg from becoming implanted in the uterus. Common brands include:

  • Plan B One-Step®
  • My Way
  • Take Action

To be most effective, it should be taken as soon as possible after unprotected sex but no more than 72 hours afterward. When taken as directed, levonorgestrel can reduce the chance of pregnancy by close to 90%.
If you are over age 17 and want to use the two-dose version, you can ask your pharmacist for it. It is sold under the brand name of Next Choice®. You need to take one pill as soon as possible within 3 days after unprotected sex and the second pill 12 hours later.

Levonorgestrel will not terminate a pregnancy.

For women who are overweight, however, levonorgestrel may not be effective. The better contraceptive regimen for these women is an IUD. An IUD will prevent pregnancy by preventing a fertilized egg from implantation in the uterus. The IUD must be inserted within 5 days of having unprotected intercourse. IUDs are also highly effective at preventing pregnancy.

Ulipristal Pills

Contraceptive pills containing ulipristal require a prescriptionContraceptive pills containing ulipristal require a prescription. Ulipristal is a non-hormonal drug that works by interfering with key hormones necessary for conception. The brand name for this drug is Ella®. Only one tablet in one dose is needed. It can be taken up to 120 hours after sex.

If you may be pregnant, consult with your healthcare provider about taking Ella®. The effect of the drug on the fetus is unclear.

Birth Control Pills

Birth control pills can also be used as emergency contraception, but they are not as effective as those described above. Using birth control pills in this way can also make you nauseous because you have to take more than one pill at a time to prevent a pregnancy. If you opt for this treatment, you will need to consult with your healthcare provider to acquire a prescription for the correct pills and dosage.

What Are the Side Effects of Emergency Contraceptive Pills?

Contraceptive pills are safe, but they can cause side effects. They include nausea, abdominal cramps and pain, fatigue, headaches, and irregular menstruation. Your healthcare provider can discuss these and any other risks with you.

You should not use emergency contraceptive pills as a form of birth control. Moreover, you should be careful when taking emergency contraceptive pills along with birth control pills. Be sure to discuss this with your healthcare provider.

Is the Cost of Emergency Contraceptive Pills Covered by Insurance?

Contraceptive pills and insuranceYes, most health insurance plans cover FDA-approved prescriptions for emergency contraception and birth control at no cost to you. Since you can buy Plan B One-Step® without a prescription, talk to your health insurance provider to find out if your plan covers over-the-counter emergency contraception. Your plan may require you to get a prescription if you want your insurance plan to pay for it.

If you have Medicaid, check with your state’s Medicaid program for information about coverage for emergency contraception. Coverage varies between states.

Another way to find emergency contraceptive pills at low or no cost is to contact a local family planning clinic. You may be able to get emergency contraception from them for free or at a significantly lower cost than you would pay at the pharmacy.

Consult with Raleigh Gynecology and Wellness

For more information about emergency contraception and the best birth control option for you, be sure to contact the women’s health specialists at Raleigh Gynecology and Wellness. They can answer any of your questions about these and any other women’s health issues and schedule an in-person appointment.

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  • About
  • Blog
  • Contact
  • Patient Forms

Conditions & Management

  • Abnormal PAP Smears
  • Endometriosis
  • Initial Evaluation of Infertility
  • Menopause & Peri-Menopause Care
  • Menstrual Disorders
  • PCOS
  • Pelvic Relaxation & Prolapse
  • Sexual Health & Sexual Dysfunction
  • Urinary Problems
  • Vaginal Dryness & Painful Sex
  • Vaginitis Care

Procedures

  • Colposcopy
  • Endometrial Biopsy
  • IUD Insertion
  • LEEP
  • MonaLisa Touch
  • Nexplanon
  • Pelvic Floor Therapy
  • Pessary Fitting
  • Sonohysterography & Ultrasound

Routine Care

  • Breast Care
  • Contraceptive Care
  • Emergency Contraception
  • Gardasil Vaccination
  • GYN Wellness Screening
  • HPV Counseling
  • Mammography
  • PAP Test
  • STD Testing

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