Conditions and Management

Contraceptive care often plays a significant role in women’s healthcare throughout their lives. Whether women are seeking to adjust their family size to their own goals or manage their fertility in ways that empower them, navigating contraception can be a challenge.

However, in some situations, standard contraceptives may not be the right choice, and this is where emergency contraceptives come in. Emergency contraception (EC) is a type of treatment that reduces the chance of pregnancy immediately after unprotected intercourse.

It is often taken when someone experiences a failure of another protection method, such as a torn condom. Women who want to make the most informed decisions about their emergency contraception options should understand when to use it and the many misunderstandings that often come along with this treatment.

The Myths and Misunderstandings of Emergency Contraception

Emergency contraception is often misunderstood, frequently because most women do not take it regularly. Some of the most common myths that women may encounter when researching emergency contraceptive options include:

It’s too late if you wait until the afternoon.

Many women worry that if they are not able to access emergency contraceptives right away, the treatment will no longer work. After all, it is called the “morning-after pill.” The good news is that EC can work even after 24 hours, though its effectiveness declines as time passes. Women should seek care for emergency contraception as soon as possible. Still, it often continues to work into the second and even third day.

EC is only for young people.

Any woman who ovulates is at risk of pregnancy. Because emergency contraceptives prevent the formation of a zygote (the fertilized egg) and stop it from implanting into the wall of the uterus, they can work for anyone who may become pregnant at any age. However, the same rules apply: seek care as soon as possible. EC is ineffective against a fertilized egg that implants.

You don’t need regular birth control if you use emergency contraception.

Emergency contraception is just that: for emergencies. It is not effective as a form of long-term pregnancy prevention. Other birth control methods, such as the pill, an IUD, or a cervical ring, better serve that task. Emergency contraception does not work “into the future” to prevent pregnancy, as its effectiveness decreases by the hour.

Emergency contraception only comes in pill form.

While the most common form of EC is an oral pill, a copper IUD can also serve as emergency contraception if it is placed soon enough after unprotected intercourse. The copper in the IUD destroys sperm to prevent it from reaching the egg, which means that in addition to providing emergency treatment, it can continue as a long-term form of birth control.

There is no risk of pregnancy once you take EC.

Emergency contraceptives are very effective at their job; in fact, when used optimally only 1% to 3% of women will become pregnant for each cycle. However, this means that some women get pregnant even after using an emergency contraceptive. Continue to test for pregnancy until the next menstrual cycle starts. Do not be afraid to visit your gynecologist for help!

Any form of emergency contraception can work for anyone.

Each person tolerates emergency contraception differently. Some people find that they become nauseated with the morning-after pill. In contrast, others are unwilling to sit for IUD insertion. Your gynecologist can explain the available methods and provide options to make the process as smooth and simple as possible, regardless of which type of EC you choose.

When Should You Use Emergency Contraception?

Emergency contraception is best used as soon as possible after unprotected sex. Even an hour later is not too soon. For most women, the need for emergency contraception arises from:

• An accidentally broken condom
• A mistake in fertility planning
• Unwanted sexual contact
• Any time a woman believes her contraceptive method of choice may have failed
• Forgetting to take a daily birth control pill

Get the Contraceptive Support You Need

Emergency contraception leaves little time for women to think or do research; in the moment, the need for EC can be stressful and confusing. That’s why it is helpful for anyone at risk of pregnancy to understand the common myths and misunderstandings surrounding this type of treatment and when it is appropriate to use it.

The all-women team at Raleigh Gynecology & Wellness is always happy to educate our patients and help them achieve their family planning goals, including halting pregnancy if that is what you want. Contact Raleigh Gynecology & Wellness to receive emergency contraceptive help and make the best choice for your own well-being.

Women’s bodies change frequently throughout life, including breast tissue. While many people assume that these changes do not (or cannot) result in breast cancer until later in life, doctors detect and treat cancers of the breast tissue in young women as well. In fact, among women ages 15 to 39, breast cancer is the most common cancer diagnosis. Breast cancer screening remains an essential medical service for women of all ages. Still, the process may differ depending on age, medical history, and more.

If you are unsure whether you need a mammogram or what the process is for someone your age, one of the best first steps is to get informed.

Here is a basic overview of how breast cancer screenings differ by age, whether you are 20 or 70.

In Your 20s

Most young women in their 20s spend little time thinking about their breast health, but now is the time to begin. Those who have not yet become pregnant are recommended to start annual risk screenings at age 25.

Often, this means discussing breast health with a gynecologist during a yearly well-woman visit. The doctor may also do a manual exam of the breasts, and patients are encouraged to learn how to do their own self-exams at this time.

Women in their 20s who are or have been pregnant should discuss breast cancer risk with a gynecologist earlier than 25 if the pregnancy occurs before then. Hormonal changes can impact the breast tissue, so screening is a valuable tool.

In Your 30s

Once a woman reaches her 30s, she should practice self-exams alongside in-office manual checks. These will make up the bulk of her breast cancer screening habits. However, women who have a family history of breast cancer or who carry the BRCA gene (which increases breast cancer risk) may begin mammography screenings at this point.

Additionally, women in this age range who begin to experience any symptoms of potential breast cancer, such as nipples turning inward, may undergo additional screening, such as a mammogram, to check the cause behind the symptoms.

In Your 40s

For most women, their 40s is their introduction to getting mammograms. Annual screenings become the norm at this stage. However, the type of mammogram will vary depending on geographic location, health history, and more. Some facilities rely on 3D machines, others use 2D imaging, and some use a combination of both.

In between mammograms, continue to conduct self-exams of the breast. In addition, be sure to schedule visits to the gynecologist on the appropriate schedule, where they can also conduct a non-imaging breast exam. With all of these efforts combined, women identify breast cancer incidence more often than if they only rely on self-exams or mammography alone.

In Your 50s and 60s

A woman’s risk of breast cancer tends to increase over time. A woman’s 50s and 60s are when this rise becomes steeper. While around one in 204 women under age 40 will develop breast cancer, as many as one in 28 may face a diagnosis by their 60s.

This makes mammography non-negotiable during this period. Women’s breast tissue becomes less dense as they age, making mammograms more effective in detecting breast cancer. Sometimes follow-up imaging is recommended and while follow-ups do not necessarily indicate an issue, they can confirm (or clear) potential problem areas.

70 Years Old and Beyond

The highest risk of breast cancer presents from age 70 onwards, with one in 24 women in this age group facing this challenge. However, some medical professionals recommend ceasing mammogram screenings at age 74.

Reasons vary and include the increasing potential for overdiagnosis, which may itself pose more risk than the cancer. However, mammograms do continue to locate breast cancer in individuals over the age of 70. Thus, it is essential to consider this decision carefully and discuss it with a medical provider to determine whether breast cancer screening at age 70 onward is the right choice for a specific patient.

Get Screened No Matter Your Age

While breast cancer screenings differ by age, what is most important is that each person takes charge of their health and continues to monitor their breast tissue throughout their lifetime. Whether you are 20 years old or 80, your breast tissue will continue to change.

The professionals at Raleigh Gynecology & Wellness can help you monitor these changes and identify any potentially problematic developments based on a screening regimen that is right for you. Contact Raleigh Gynecology & Wellness to schedule your mammogram!

Cancer is unpredictable; some people may be more prone to it due to genetics, while others develop it in relation to lifestyle habits such as smoking. Both innate genetic expression and everyday decisions come together to impact breast health, which can be a good thing because it means that individuals can make smart choices to decrease their chances of getting cancer.

One of the best things anyone can do to reduce their cancer risk (besides getting regular mammograms!) is to incorporate regular exercise into their weekly routine. For those at risk of breast cancer (and that is both men and women!), exercise can support breast health and reduce cancer risk at the same time.

There are multiple reasons for this association between moving the body and limiting cancer risk, from how insulin is processed to the role of body fat in estrogen production. Whether a person is still in their teens or approaching retirement, it is useful to understand how exercise can support breast health and decrease cancer risk.

The Exercise-Insulin Connection

There are many reasons why exercising can reduce the risk of breast cancer. One of the most salient aspects is how exercise interacts with insulin. Insulin is produced by the pancreas in order to control how much sugar is present in the blood.

Exercise helps to regulate the insulin production cycle, reducing the development of insulin resistance. This is an essential connection, because insulin resistance is known for its correlation with breast cancer.

It can disrupt hormones, and imbalanced insulin can promote increased cell production. When more cells are being produced, there is a greater likelihood that one or more of them will replicate incorrectly, leading to cancerous growth. By exercising, individuals can keep their insulin levels stable to reduce this risk.

Moderating Estrogen with Activity

Another reason that exercise is correlated with a lower breast cancer risk is because regular movement helps to regulate estrogen production. Estrogen is associated with the tissue growth within the breast, so excess estrogen can lead to rapidly duplicating cells in the breast tissue.

As with insulin, cells that replicate quickly mathematically increase the likelihood of a cell developing incorrectly. Exercise decreases the amount of sex hormones circulating in the body, altering the ratios of specific estrogens (those that contribute to breast cancer development and those that protect against it).

Lowering Body Fat

Most people know that exercise can help them burn calories and, by extension, fat. Lowering body fat is a great way to decrease cancer risk, as fat is a primary producer of estrogen.

While exercise can improve estrogen levels, as noted previously, this impact is compounded by simultaneously decreasing fatty tissue in the body. As an added benefit, lowering the ratio of fat (and especially visceral fat around the organs) has other health benefits beyond cancer risk reduction!

Boosting Immune Function

The many cells within the immune system are the body’s innate defenders, and they can target cancerous cells in the earliest stages, as long as they can find them. Exercise facilitates this process by moving lymph throughout the body.

Lymph is the fluid within the body that carries important immune protectors, such as white blood cells, throughout the body’s tissues. Because of the forces exerted during exercise that get the heart pumping and the muscles contracting, lymph is pushed throughout the body at a higher rate than when sedentary.

This helps more immune cells circulate to even the far reaches of the tissues, where they can identify (and destroy) cancerous cells more efficiently.

Attitude and Inspiration

While exercise has plenty of tangible physical benefits, it also offers some less quantifiable advantages for patients seeking to avoid breast cancer development. When people exercise, their mood tends to improve, and over time, developing one health habit in the form of exercise can contribute to other smart choices.

Taking care of oneself is a series of decisions over an entire lifetime. Therefore, those who exercise are more likely to make smart health choices in other areas, such as regularly scheduling mammograms and actively participating in their healthcare. This helps to catch cancer early while it is still highly treatable.

Embrace Exercise as Part of Breast Cancer Prevention

Some components of breast cancer development are found in a person’s genes, which is why regular testing is so important. However, other contributing factors are left in the hands of individuals, which is an empowering thought!

By choosing to incorporate exercise into your weekly routine, you can target multiple elements correlated with an increased breast cancer risk to mitigate your odds.

One smart choice among these decisions is to schedule your regular mammograms so any issues can be caught early. Contact Raleigh Gynecology and Wellness today to schedule your mammography scan!

Breast health is impacted by various factors: lifestyle, diet, genetics, and more. While some aspects are under a woman’s control, not all contributors to breast cancer and other abnormalities are the result of voluntary decisions.

One such genetic factor is hormones, chemical messengers that travel through the body to activate or deactivate specific processes. A woman’s hormones play a significant role in her risk of breast cancer and the way her breast tissue develops and changes throughout life.

While hormones are not necessarily within a patient’s control, knowing how they work and their role in breast health is a great way to stay informed. Patients who actively engage with their medical care are more likely to see better medical outcomes and approach their appointments more confidently.

Here is an overview of the main hormones that impact breast health.

Estrogen/Progesterone

Estrogen (and its related hormone, progesterone) is the main reproductive hormone found in women. While men have estrogen as well, it is higher in women because it and progesterone are tied to bodily functions such as conception and pregnancy.

While these hormones serve an essential role, they are a significant contributing factor to why one in eight women are diagnosed with breast cancer. In contrast, one in 726 men are diagnosed with the same.

Insulin

The pancreas is the organ responsible for making insulin, a hormone that regulates blood sugar. A consistently high level of insulin (that is, insulin that is poorly regulated due to issues such as untreated diabetes) is associated with an increased risk of breast cancer.

This contributing factor occurs because insulin inhibits the production of sex hormone-binding globulin, a protein that captures excess estrogen and prevents cells from absorbing it. When insulin is too high, estrogen is not controlled properly, contributing to greater breast cancer risk.

Prolactin

Prolactin is a hormone that naturally waxes and wanes in women depending on their life stage. It is responsible for breast growth and can stimulate milk production and cessation of menstrual cycles during pregnancy.

High levels of prolactin, especially in postmenopausal women, are associated with an increased risk of breast cancer. This connection is tied to how prolactin can facilitate cell growth, which may also promote faster growth of potentially problematic cells.

Oxytocin

Oxytocin is most widely known as the “happy” hormone, and it impacts not just mood but also pregnancy-related behaviors such as milk production.

Studies are mixed on its role in breast cancer; some indicate that oxytocin can be protective against breast tumor growth, while others demonstrate that it is a cell proliferator, causing tissues to grow quickly (which can support cancer growth). Oxytocin likely performs both roles, influencing how cancer progresses, not whether it occurs in the first place.

Luteinizing Hormone

Luteinizing hormone (LH) is produced by the pituitary gland and tells the body when and how to conduct the menstrual cycle, including when the egg is released from the ovary. Studies indicate that breast cancer tissue typically contains a higher level of LH than other body tissues.

While a blood test for luteinizing hormone does not constitute a reliable method of breast cancer testing, tissue sampling does. This means that while LH may contribute to breast cancer, it is also an effective method of testing for small or hidden cancerous tissues that may not appear clearly on a mammogram.

Diethylstilbestrol (DES)

In some women, breast cancer development can be tied to diethylstilbestrol, an estrogen variant that was used between 1940 and 1971 as a potential treatment for reproductive-related medical issues, such as miscarriage and premature labor.

Any women who were treated with diethylstilbestrol face an increased risk of breast cancer. In addition, their daughters are also at greater risk not just of breast cancer but of cancers of the cervix and vagina as well.

Studies are currently reporting that even their granddaughters face an increased risk of cancer due to genetic exposure todiethylstilbestrol.

It is essential for women to maintain a complete family medical history whenever possible to identify cancer-contributing factors such as diethylstilbestrol usage.

Get Regular Breast Exams Throughout Life

Hormones play an irreplaceable role in the body. They can also contribute to cancer development, especially when they are out of balance. Routine gynecologic visits and annual mammograms arethe best way to stay informed about potential issues before they worsen.

The Raleigh Gynecology & Wellness team seeks to empower patients with the knowledge they need to confidently manage their breast health. Contact Raleigh Gynecology & Wellness today to schedule your next mammogram!

Regular doctor visits are essential for maintaining well-being and good health. However, did you know that some examinations are possible at home? Women should regularly conduct breast self-exams as a supplement to their regular gynecological visits to protect their breast health and catch issues early.

Conducting a self-exam is simple once you understand how. It can be done any time, any day, with no special preparation, so many women create a habit of checking monthly or even weekly.

Here is important information on why regular breast self-exams can make a difference, what to look for, and how to conduct an exam from the comfort of your own home.

Why Conduct Regular Self-Exams?

Breast cancer is a leading cause of mortality in women; more than 300,000 new cases of breast cancer arise every year in the U.S., and over the course of a lifetime, a woman has around a1 in 8 chance of developing this disease. Of the types of cancer that women can get, breast cancer is the second leading cause of death.

To get ahead of any potential cancerous developments, women should conduct regular breast self-exams. This allows them to become familiar with how their normal breast tissue feels. In turn, they may be able toidentify potentially cancerous masses in their earliest stages.

Failing to conduct regular breast exams, both at home and with a professional, can lead to undetected breast cancer growth. If a malignant nodule spreads (metastasizes), it can lead to cancer in other parts of the body, making treatment more complex and less successful on average.

How to Do a Breast Self-Exam

Breast self-examinations are not a difficult or time-consuming practice! In fact, many women choose to do a quick exam every time they shower or go to bed because it only takes a few minutes.

First, think of your breast as a clock. Using the pads of your fingers, glide your hand downward from 12 o’clock (at the collarbone) toward the nipple, feeling the breast tissue slowly as you go.

Next, repeat this motion using a different level of pressure. It is ideal to feel each area multiple times using light, medium, and firm pressure to check multiple depths of breast tissue.

Once you have thoroughly checked the 12 o’clock line, move on to 1 o’clock and repeat the process until you have gone in a complete circle around the breast.

Be sure to feel the areas around the collarbone, ribs, and armpit, as breast cancer does not solely develop in the meaty portion of the breast near the nipple.

In addition to the manual exam, be sure to look at the breasts visually from time to time—such as before you get in the shower.

Check to see if one is notably larger than the other (and this is new for you) or if one has changed in shape or appearance. Dimpling or nipples that are turning inward are also things to note.

What Is Normal (And What Is Not)

When conducting a breast self-exam, it is common to worry about what you feel—especially if this is your first time carefully touching your breast tissue and you are unfamiliar with the sensation. Some of the things you may notice that are normal are:

• Regular elevation changes as you press. This likely indicates that you are feeling your upper ribs.
• Textural changes, especially if you examine regularly. Breast tissue can become more fibrous during certain phases of the monthly cycle.
• Long, firm lumps. The ribs can mimic concerning lumps, but they extend sideways and remain the same over time.

Once you get an idea of what is normal for your breast tissue, you can begin to find abnormalities. Indicators that you should see a gynecologist include:

• Hard knots or lumps
• Warmth or swelling
• A patch that feels different than the surrounding tissue (for example, thicker or fuller)
• Bulges or dimples
• Itchiness, sores, or rashes similar to hives
• New or bloody discharge from the nipples
• Nipple changes (for example, shape or orientation)

Schedule Your Regular Checkup to Protect Your Health

Breast self-examinations are the first line of defense for women to catch potential breast cancer early. The good news is that many lumps and bumps are normal, or benign, meaning they will not become cancer.

If you believe that something is unusual with your breasts, schedule an appointment with a professional as soon as possible. You can also schedule your annual exam as a great opportunity to check on your health and confirm that your breast tissue is normal.

This gives you a solid baseline for how your breast tissue should feel. Contact Raleigh Gynecology & Wellness to schedule your next appointment or ask questions.