Routine Gynecologic Care

Essential Takeaways:

• A breast ultrasound is a safe, noninvasive imaging method that employs sound waves to produce clear pictures of the breast tissue.
• Breast ultrasound complements a diagnostic mammogram by helping distinguish between fluid‑filled cysts and suspicious solid masses that may need further evaluation.
• Ultrasound can be invaluable for women with dense breast tissue, where mammography may miss abnormalities.
• The combination of breast ultrasound and mammography increases cancer detection sensitivity, improving the odds of detecting issues early.
• While ultrasound is an important tool, it is not used alone for routine screening but as part of a thorough diagnostic breast imaging strategy.

Importance of Ultrasound for Breast Health

You may be here because you recently received a referral for a breast ultrasound or because you simply want to know more about your breast imaging options. Either way, you are doing something powerful and proactive for your health. Find out what a breast ultrasound is, how it supports a diagnostic mammogram, and what you can expect when you undergo this safe and practical imaging test.

Breast Ultrasound and How It Works

A breast ultrasound is a specialized imaging procedure that relies on high-frequency sound waves to generate internal images of the breasts. It is different from a diagnostic mammogram, which uses low‑dose X‑rays. Instead, ultrasound uses sound waves to produce images that help doctors see structures inside the breast that might not be visible on a mammogram.

One of the major advantages of breast ultrasound is that it does not expose you to radiation, and most women find it comfortable and quick. During the exam, a technician or radiologist moves a small handheld device, known as a transducer, over your skin after applying a warm gel. The transducer transmits sound waves into your breast tissue and detects the echoes that bounce back, turning them into visible images displayed on a screen.

How Ultrasound Complements Diagnostic Mammography

It is important to remember that breast ultrasound is not often used alone as a first‑line screening tool for breast cancer. A mammogram is widely regarded as the primary standard for routine breast cancer screening in most women.

However, when something unusual is found on a mammogram or when you have symptoms such as a lump, pain, or nipple discharge, an ultrasound becomes an essential part of diagnostic breast imaging.

Ultrasound uses breast imaging techniques that are particularly effective at distinguishing between solid masses and fluid‑filled cysts. Cysts are typically benign and often don’t require further testing, while solid masses may need more evaluation. This distinction can help your healthcare provider determine which step comes next.

Why Ultrasound Matters for Women With Dense Breasts

Many women have dense breasts, in which fibrous and glandular tissue make up a greater proportion of the breast than fatty tissue. Dense tissue can make it challenging for mammograms to differentiate between normal and abnormal areas because both dense breast tissue and potential tumors appear white on mammograms.

Ultrasound may help fill this gap by providing sound‑wave‑based images that are less affected by tissue density.

For women with dense breasts, ultrasound can increase the chances of spotting a small mass that might otherwise be hidden on a mammogram. While dense breast tissue does not necessarily mean you have cancer, it can make detection more challenging, and that is where ultrasound may be a valuable part of your diagnostic care plan.

What You Can Expect During Your Ultrasound

If your provider has recommended a breast ultrasound, here is what you should know before you go:

• Before the exam: A breast ultrasound usually requires minimal preparation. Your provider may simply ask you to avoid applying lotion or powder to your chest on the day of the exam.
• During the exam: The process is non‑invasive. You will lie still while a warm gel is applied to your skin and the transducer is moved across the breast. Most women report that the test is painless. You may feel light pressure but no significant discomfort.
• After the exam: A radiologist will interpret the images, and your provider will talk with you about what they mean. If further testing, such as a biopsy, is needed, your care team will guide you through the next steps.

Ultrasound Is Part of a Bigger Picture

Your breast health experience may require complementary breast imaging tests such as MRI or 3D mammography, in addition to ultrasound and diagnostic mammograms. Each tool has its strengths, and your healthcare team will recommend the best combination based on your individual risk factors, symptoms, and breast tissue characteristics.

Contact Raleigh Gynecology & Wellness for Guidance and Support

Knowing your breast imaging options can help you feel more in control of your health and choices. Ultrasound for breast health is a safe, practical tool that provides valuable information when used alongside diagnostic mammography. It can help clarify suspicious findings and guide further care in a way personalized to you.

Ready to take the next step in your breast health with professional support? Book your ultrasound with our experienced women’s health team at Raleigh Gynecology & Wellness today.

Essential Takeaways:

• Mammograms can be safely performed during or after breastfeeding when medically indicated, and there is no need to interrupt lactation.
• Breastfeeding can increase breast density, which may make imaging slightly more complicated to interpret without proper preparation.
• Emptying your breasts by nursing or pumping right before imaging can improve comfort and image clarity.
• Routine breast cancer screening should not be delayed solely due to concerns about breastfeeding or milk production.
• Combining mammograms with breast ultrasound provides a reliable evaluation for lumps or other concerning changes postpartum.

Getting a Mammogram During or After Breastfeeding

You’ve just welcomed a new life into the world, and your body is still adjusting to the whirlwind of hormones, feedings, and postpartum changes. During this stage, you might be due for a breast cancer screening and may wonder if you can even get a mammogram while breastfeeding. Is it safe? And how accurate are the results with milk-filled breasts? These questions are entirely normal, and you’re not the only one asking them.

While breast tissue naturally becomes denser during lactation, this doesn’t mean you should delay necessary imaging if your healthcare provider recommends it. With proper preparation and radiology expertise, mammograms can be both safe and effective, even during breastfeeding. Find out how breastfeeding affects mammograms and what to expect during the procedure.

Why These Concerns Are so Common

Taking preventive measures to maintain your health is a sound decision, but it can also raise concerns. When your provider suggests a mammogram during or shortly after breastfeeding, it’s normal to hesitate. Many moms worry about:

• Radiation exposure to themselves or through breast milk
• Impact on milk supply or potential harm to the baby
• Accuracy of imaging when breast tissue is changing postpartum

These concerns are understandable. However, evidence and professional recommendations show that mammography can be performed safely, using thoughtful techniques that preserve both your breastfeeding goals and your peace of mind.

Mammograms Are Safe Even While Breastfeeding

Research and clinical guidelines confirm that breast imaging, including mammography, is safe during both pregnancy and lactation when medically indicated. You do not need to stop breastfeeding before or after the exam, and there’s no reason to “pump and dump” afterward.

Exposure to radiation during a mammogram is very low and directed solely at the breast tissue. It doesn’t accumulate in the milk and doesn’t pose a risk to your baby. That’s why leading groups, including the American Society of Breast Surgeons, explicitly recommend that screening shouldn’t be delayed during lactation if screening or diagnostic evaluation is necessary.

How Breastfeeding Affects Mammogram Images

Breastfeeding causes increased breast density because your milk ducts and glands are fuller and more active. Roughly 88% of pregnant, lactating, or postpartum women undergoing breast imaging have dense or extremely dense breasts, which can make mammograms a bit more challenging to interpret.

Dense tissue isn’t dangerous in itself, but it can sometimes obscure small changes, such as early tumors or cysts, on routine mammography. That’s why your radiologist may recommend:

• Ultrasound, in addition to mammography
• Imaging after you’ve nursed or pumped to reduce milk volume
• Additional views, if needed, to assess tricky areas

Emptying your breasts immediately before imaging helps reduce discomfort and tissue density, improving the clarity of the images your radiologist sees.

No Effect on Milk Production or Supply

One of the most common concerns is whether a mammogram will harm your ability to breastfeed. It’s important to know that the compression used during mammography won’t reduce your milk production or harm your ducts. The slight discomfort you may feel during compression is temporary, and many women find that feeding or pumping right before the appointment helps.

Unlike some imaging tests that require contrast dyes (such as certain MRIs), standard mammography doesn’t affect breast milk. You can resume feeding your baby immediately after the exam without worry.

When Mammograms Are Particularly Important

Mammograms aren’t always done routinely during lactation, but they are recommended if:

• You have a family member with a history of breast cancer
• You feel a lump that doesn’t resolve after a week
• You experience unusual changes, such as persistent pain, nipple discharge, or thickening
• Your primary imaging (e.g., ultrasound) suggests further evaluation

In those situations, delaying imaging for fear of breastfeeding concerns could postpone diagnosis and treatment of something important. While dense or lactating tissue can complicate interpretation, experienced breast imaging teams know how to use combined modalities (ultrasound and diagnostic views) to obtain accurate results.

Self-exams remain essential, too. If something feels different or doesn’t go away with time, don’t hesitate to reach out to your women’s health provider.

Ready to Take the Next Step?

If you’re pregnant, breastfeeding, recently postpartum, or juggling it all and have questions about mammography, breast cancer screening, or breast health concerns, we’re here for you.

Our experienced breast care team at Raleigh Gynecology & Wellness specializes in compassionate, evidence-based healthcare for women at all stages of life. Schedule an appointment with us today and get the clarity, reassurance, and personalized care you deserve.

Essential Takeaways:

• The first three months with an IUD are often an adjustment period with temporary symptoms.
• Spotting, cramping, and cycle changes are common early IUD side effects.
• Hormonal and copper IUDs can affect your period in different ways.
• Most symptoms improve as your body adapts over time.
• Open communication with your women’s health provider helps your IUD remain safe and comfortable for you.

The Adjustment Period No One Fully Explains

An IUD offers reliable, long-term protection, but your body may need time to adapt. During the first few months, you could notice changes that feel unfamiliar or even concerning. Spotting, cramping, and cycle changes are common early on. Knowing what to expect during this adjustment phase can help you feel prepared instead of concerned. Here’s what you can realistically expect during those first 90 days and how to care for yourself along the way.

The First Few Days: Cramping and Rest

It’s common to experience cramping immediately after IUD insertion. Your uterus is responding to a new device, and that can cause mild to moderate discomfort. For many women, cramping improves within a few days, though some feel intermittent cramps for a few weeks.

Using a heating pad, resting, and taking over-the-counter pain medications can help. Light spotting is also typical in the first days after placement.

If you have severe pain that doesn’t improve or pain accompanied by fever, contact your provider right away. These symptoms are rare, but they warrant a medical evaluation.

Weeks 1 Through 4: Spotting and Irregular Bleeding

As the first month continues, spotting becomes a common concern. You may notice light bleeding between periods or longer cycles than usual. This is especially common with hormonal IUDs.

Yale Medicine states that irregular bleeding and spotting are expected during the first three to six months of hormonal IUD use. Over time, bleeding usually becomes lighter and more predictable.

For women with copper IUDs, their periods may be heavier or more crampy at first. Research shows that up to 70% of copper IUD users report increased menstrual bleeding in the early months. For most women, this improves gradually.

Tracking your cycle can help you see patterns and understand whether your symptoms are stabilizing.

Months 2 and 3: Hormonal Shifts and Cycle Changes

By the second and third months, many women begin to notice their bodies settling into a new rhythm. With hormonal IUDs, periods often become lighter and shorter. Some women eventually stop having periods altogether.

Clinical data show that about 20% of women using a levonorgestrel IUD stop having periods after one year. During the first three months, however, it is common to experience unpredictable bleeding before things level out.

You might also notice breast tenderness, mild acne, or mood changes with a hormonal IUD. While the hormone dose is low and primarily localized in the uterus, some systemic symptoms can occur. These usually improve as your body continues to adjust.

Checking the Strings and Monitoring Placement

During the first few months, your provider may recommend periodic checks of your IUD strings.

Expulsion, which means the IUD partially or completely comes out, occurs in about 2 to 10% of users, per ACOG’s Committee on Gynecologic Practice. It is more likely in the first year, especially in the early months.

If you have very heavy bleeding, can’t feel the stringsor notice unusual pain, schedule an appointment. In many cases, everything is fine, but it is reassuring to confirm placement.

What Is Not Normal

While adjustment symptoms are common, some signs require evaluation. Contact your health provider if you experience:

• Severe or worsening abdominal pain
• Fever or chills
• Foul-smelling vaginal discharge
• Very heavy bleeding, such as soaking through a pad every hour
• Signs of pregnancy

These symptoms are fairly uncommon but shouldn’t be ignored. Early evaluation can provide peace of mind.

The Emotional Side of the First Three Months

Beyond physical symptoms, the adjustment period can feel emotionally uncertain. You may find yourself wondering whether you made the right choice. You might compare your experience to a friend’s and wonder why yours feels different.

Remember that everybody responds in their own way. Some women adjust quickly with minimal symptoms. Others need a few months before feeling fully comfortable. Both experiences are valid.

Remind yourself that the first three months are a transition. If symptoms are mild and gradually improving, that is often a sign your body is adapting.

When To Follow Up

Many providers schedule a follow-up visit a few weeks after IUD insertion. Even if you do not have a scheduled appointment, you can always reach out with concerns.

Open communication makes a difference. Whether you are dealing with persistent spotting, mood changes, or discomfort during intercourse, your provider can discuss options. Sometimes, reassurance is all you need. In other cases, small adjustments can improve your experience.

Contact the Team at Raleigh Gynecology & Wellness

The first three months with an IUD are often about adjustment, patience, and communication. While some side effects are common, most improve with time.

If you are considering an IUD, have recently had one placed, or have concerns about your symptoms, our team at Raleigh Gynecology & Wellness is here to listen. Contact us today to discuss your experience and make sure that your birth control choice continues to meet your needs.

Essential Takeaways:

• Screening mammograms can find breast cancer in its earliest stages, usually before you start to have noticeable symptoms.
• Diagnostic mammograms are recommended when there is a particular concern, such as an abnormal screening result or lump.
• While the technology is the same, screening and diagnostic mammograms are performed for different reasons.
• Most screening mammograms are normal, and follow-up testing does not automatically mean cancer.
• Knowing how these procedures differ can help prepare you for your appointment.

How Screening and Diagnostic Mammograms Differ

Being told you need additional breast imaging can naturally raise concerns. Hearing terms such as “screening mammogram” or “diagnostic mammogram” can be confusing, especially if you are unsure what they mean. When it comes to your breast health, clear information can make a stressful moment feel more manageable.

A screening mammogram is part of routine preventive care. A diagnostic mammogram, on the other hand, is used to take a closer look at a specific area of concern. Both are important tools, but knowing how they differ can help you approach your appointment with greater peace of mind.

What is a Screening Mammogram?

Screening mammograms are routine X-rays used to check for breast changes even if you have no symptoms. Its goal is early detection. These images are used to look for small changes in breast tissue that you may not feel.

The ACS recommends that most women start annual screenings at age 45, with the choice to begin as early as age 40.

Screening matters because early detection saves lives. According to the CDC, breast cancer is the second most common form of cancer among women in the U.S., with about 279,000 new cases diagnosed each year. When breast cancer is found localized and early on, the five-year survival rate is about 99%.

During a screening mammogram, your provider will typically take two images of each breast. The appointment is usually brief, and if results are normal, you will simply return for your next scheduled exam.

Diagnostic Mammograms Explained

A diagnostic mammogram is more detailed and focused. It is recommended when there is a reason to look more closely at breast tissue. This may include:

• A lump you or your provider can feel
• Breast pain in one specific area
• Nipple discharge
• Skin changes
• Abnormal findings on a recent screening mammogram

Unlike a routine screening, a diagnostic exam involves additional images from multiple angles. The radiologist may review images in real time and request more views to better evaluate the area of concern.

If you are called back following a screening mammogram, it is natural to feel anxious. However, being called back does not mean you have cancer. In fact, the National Cancer Institute reports that about 10% of patients are asked to return for additional imaging after a screening mammogram, and most of these follow-ups don’t lead to a cancer diagnosis.

Why You Might Be Called Back

One of the most common reasons for additional imaging is dense breast tissue. Dense tissue can make it harder to interpret screening images because both tumors and dense tissue appear white on mammograms.

According to research, about 40 to 50% of women between the ages of 40 and 74 have dense breasts. Dense breast tissue is very common, but it sometimes requires additional imaging to clarify findings.

Other times, overlapping tissue may appear suspicious on a screening image but resolves when viewed from a different angle. A diagnostic exam helps separate normal anatomy from areas that require further evaluation.

During Your Mammogram Appointment

Being aware of the process ahead can make your visit less stressful.

For a screening mammogram, you can expect:

• A short appointment, often 20 minutes or less
• Standard images taken of each breast
• Results provided within 1-2 weeks

For a diagnostic appointment, you may experience:

• A longer visit
• Additional images focused on a specific area
• Possible ultrasound if needed
• Preliminary feedback before you leave

Both procedures are considered safe as they use low-dose X-ray technology. The radiation exposure from a mammogram is carefully regulated.

If further testing is recommended, your provider will explain the next steps clearly. Many findings turn out to be benign cysts, fibrocystic changes, or other noncancerous conditions.

Staying Proactive About Breast Health

A routine screening mammogram is considered a highly effective tool for early detection. When needed, a diagnostic exam can accurately evaluate findings and ease any concerns.

Rather than viewing follow-up imaging as a setback, consider it part of a careful and complete approach to your health. Each step is built to protect you and give you clear answers.

Trust Raleigh Gynecology & Wellness to Support You During Your Diagnostic Mammogram

Whether you are scheduling your first routine screening or have been advised to have a diagnostic mammogram, you deserve clear guidance and supportive care. Our professional staff takes time to explain your results and answer any questions. If you have any concerns about a recent finding or are due for a screening, contact Raleigh Gynecology & Wellness today.

Essential Takeaways:

• Perimenopause affects a majority of women and includes symptoms such as hot flashes, mood changes, sleep disruption, and irregular periods.
• Fatigue, irritability, and sleep problems are among the most commonly reported perimenopause symptoms across varying populations.
• Many women feel unprepared or misdiagnosed during perimenopause, highlighting the importance of knowledgeable care.
• Lifestyle changes such as regular exercise, sleep hygiene, and balanced nutrition can help ease perimenopausal symptoms.
• Personalized treatment plans created with a perimenopause doctor can help you manage symptoms effectively and improve your quality of life.

Managing Perimenopausal Symptoms on Your Terms

As your body transitions through perimenopause, the experience can feel overwhelming, frustrating, and often unpredictable. Many women in their 40s and 50s find themselves juggling hot flashes, mood changes, sleep struggles, and irregular periods all at once.

It’s common to feel unsure which symptoms are “normal” and what options are available to help you feel more comfortable. No matter where you are in this transition, partnering with a perimenopause doctor can give you the clarity and support you need to feel more like yourself again.

Recognizing the Most Common Symptoms

Perimenopause is the stage that leads up to menopause when hormone levels, especially progesterone and estrogen, start to fluctuate. These hormonal shifts can show up in many ways, influencing both your physical health and emotional well-being. In an international survey of women aged 35 and above, participants most frequently reported feeling unusually tired (83%), easily irritated (80%), experiencing low or depressed moods (77%), and struggling with sleep disturbances (76%).

Hot flashes and night sweats are often what many people associate with this stage of life, and while they are very common, not every woman experiences them in the same way. Other symptoms can include irregular periods, vaginal dryness, reduced libido, and cognitive changes such as forgetfulness or difficulty concentrating.

Talk With a Health Care Provider Early and Often

A common obstacle many women encounter is uncertainty about when to reach out for support or where to turn for guidance. Survey data reveal that nearly 40 percent of women felt they were misdiagnosed during perimenopause, and many report that their concerns were not fully addressed by their initial provider.

This highlights the importance of working with a health care professional who understands perimenopause and can guide you through symptom management. A perimenopause doctor can help you sort out which symptoms are likely related to hormonal changes and which may need further evaluation.

Lifestyle Adjustments That Can Make a Difference

Many women find that simple, consistent lifestyle changes can reduce the severity of perimenopausal symptoms and make daily life more manageable.

Prioritize Quality Sleep

Sleep disturbances are a hallmark symptom for many women during perimenopause. Hormonal shifts can disrupt your body’s natural sleep rhythms, and night sweats can prevent restful sleep. Research shows that sleep problems can affect up to 40 to 60 percent of women during the menopausal transition.

Strategies to improve sleep include establishing a consistent sleep routine, keeping your bedroom cool and dark, avoiding caffeine in the afternoon, and turning off screens at least an hour before bed.

Stay Physically Active

Exercise is one of the most effective natural tools to ease many perimenopausal symptoms, such as mood swings, sleep issues, and even hot flashes. Regular physical activity supports healthy hormones, improves sleep quality, and boosts your mood by releasing feel-good neurotransmitters.

Make it a goal to complete at least 30 minutes of moderate activity on most days each week. This can be brisk walking, cycling, swimming, or even a dance class you enjoy.

Eat for Hormone Balance

While no single food will erase symptoms, a balanced diet rich in whole foods can support your overall well-being. Select healthy proteins, eat a variety of vegetables and whole grains, and choose healthy fats (i.e., salmon, nuts, and avocados). Cutting back on refined sugars and heavily processed foods can also support a more stable mood and steady energy throughout the day.

Remember, hydration also matters. Drinking adequate water during the day can support digestion, skin health, and overall comfort.

Medical Treatments That Help

For many women, lifestyle changes on their own are not always enough. Fortunately, there are medical treatments that can significantly improve quality of life for perimenopausal symptoms.

Hormone Therapy Options

Hormone therapy (HT) remains one of the most effective treatment options for vasomotor symptoms such as night sweats and hot flashes. Depending on your medical history and symptom severity, your perimenopause doctor may recommend estrogen therapy, often in combination with progesterone, to rebalance hormones and reduce symptoms.

It is important to discuss the benefits and risks of hormone therapy with your provider to find the best approach for you.

Non-Hormonal Medications

Some women may not be candidates for hormone therapy. There are also non-hormonal options that can help with mood changes, sleep disruption, and other symptoms.

Antidepressants in certain classes, low-dose gabapentin, and medications targeting neurochemical pathways can be helpful for some women. Each option should be discussed with your provider, so the treatment aligns with your health goals and medical needs.

Emotional Support Matters Too

Perimenopause does not only affect your body. Emotional symptoms such as mood swings, anxiety, and feelings of overwhelm can be just as disruptive as physical ones. Studies show that mood symptoms are experienced by many women during this transition, sometimes similar to symptoms experienced in premenstrual syndrome.

Support groups, therapy, or counseling can offer a comfortable space to talk through what you are feeling, validate your experience, and develop healthy coping strategies.

Ready to Take the Next Step With a Perimenopause Doctor?

If you are struggling with perimenopausal symptoms and are unsure where to start, reach out to our team of women’s health experts at Raleigh Gynecology & Wellness. We can build a plan that addresses your symptoms, supports your goals, and offers the care you deserve. Contact us today to schedule your appointment and begin managing perimenopause more comfortably.