Routine Gynecologic Care

Mammograms are often recommended to women ages 40 or older. From 45 to 54, it is advised that women get a mammogram once a year, according to the American Cancer Society.
Screening mammograms are highly effective at detecting breast cancer early.

A mammogram can generally find lumps two to three years before they can be felt. Based on data published by the National Cancer Institute, breast cancer deaths in women have dropped 43 percent since regular mammography use began in the 1980s.

What Is A Mammogram?

A mammogram is a type of low-dose x-ray that enables radiologists to identify changes in a woman’s breast tissue. This specialized medical imaging equipment is typically used to check for breast cancer in women who have no outward signs or symptoms of cancer. It can also be used as a diagnostic tool on women who have discovered a lump or other signs of breast cancer.

The two main types of mammograms include:

• Screening Mammogram – To detect breast changes, this is the most common type of mammogram. This routine procedure is normally performed every one to two years in women over 40 who have experienced no breast abnormalities. The main goal of a screening mammogram is to detect breast cancer before any clinical signs are noticeable.
• Diagnostic Mammogram – A diagnostic mammogram may be recommended if a woman or health provider discovers a suspicious breast change, such as a lump, unusual skin, breast pain, nipple discharge or nipple thickening. This type of mammogram is used for diagnostic purposes or to further evaluate abnormalities found on a screening mammogram. During a diagnostic mammogram, more images are taken than what is normal with a screening mammogram.

What Happens During A Mammogram?

The average mammogram takes about 20 minutes and is performed by a qualified professional. If possible, a patient should bring their old images to the appointment or grant the health care provider access to these images from the prior provider. This allows the new provider to compare old and new results which can help diminish the risk of false negative or false positive readings.

Do not apply lotion, powder or deodorant prior to a mammogram appointment, but do wear a loose top and bra that are easily removed. Before the screening, the health care provider will usually have the patient put on a front-opening gown. The patient stands facing an x-ray machine, and puts one breast on a platform. The technician releases a plate that presses down the breast. Once images of the first breast are taken, then images of the other breast occur.

The breast is flattened to spread out the tissue, making it easier to spot tumors or other signs of breast cancer. Although this process can be uncomfortable, it lasts just a few seconds. It is normal to experience some soreness following a mammogram. The technician should be notified if severe pain is felt. Good technicians will take their time to minimize pain during the procedure.

After the mammogram is completed, the technician will review the x-rays to ensure that the results are satisfactory, and that no further images are needed. Remember that technicians do not look for signs of cancer.

Instead, the images are transferred to a radiologist who reads the results. The amount of time it takes for a radiologist to read the x-rays and get results can vary from a few days to a month. Mammograms are usually performed while the patient is in a standing position.

It is important not to move during the procedure as any movement can cause the images to blur. The technician will ask the patient to hold her breath for several seconds while the image is taken. If a patient is prone to fainting during medical procedures, a provider may recommend that the patient sit in a chair during the mammogram.

If the results of a mammogram are found to be abnormal, the health care provider will recommend further testing. Abnormal results do not necessarily mean cancer, but more tests are most often needed to make that diagnosis. For diagnostic purposes, a health care provider may recommend a biopsy, core-needle biopsy, ultrasound or a diagnostic mammogram.

Schedule A Mammogram

A mammogram is one of the best tools for detecting breast cancer during its early stages. Each year, mammograms save countless lives, especially when women remember to schedule regular appointments.

It is normal for patients who have never had a mammogram to feel anxious, but knowing what to expect helps diminish any worries or fears. For more information about what to expect from a mammogram or to schedule a mammogram appointment, reach out to the professionals at Raleigh Gynecology & Wellness.

A nurse practitioner (NP) basic role in a GYN practice is much the same as an NP in other specialties: providing health care management to their patients, fostering and educating patients about disease prevention, and promoting overall good health practices.

As a GYN specialist in a practice like Raleigh Gynecology and Wellness, the NP is an essential member of the health care team that focuses on female sexual and reproductive health. Read more to learn what a GYN NP does every day.

Overall Responsibilities of the GYN NP

The GYN NP helps deliver primary health care to women beginning at adolescence and continuing through childbearing to advanced age.

The NP’s duties depend very much on where the NP works, but at Raleigh Gynecology and Wellness, the NP performs a panoply of tasks integral to delivering quality care.

On any given day, the NP may be responsible for conducting annual screenings, giving immunizations, counseling patients on preventative care, family planning, fertility, and urogynecology, treating episodic or chronic illnesses and sexually transmitted diseases. As part of those responsibilities, the NP may need to:

• Review the patient’s health history.
• Take blood pressure and check other vital signs.
• Perform physical exams such as pelvic exams and breast exams.
• Order laboratory tests and procedures such as ultrasounds, mammograms, and breast biopsies.
• Make simple diagnoses.
• Prescribe medication (in some states, the NP is permitted to prescribe medication without the attending doctor’s oversight), such as birth control pills or antibiotics.
• Make referrals.
• Perform certain procedures, such as inserting a contraceptive implant or taking a tissue sample.
• Maintain patient records.
• Educate and counsel a patient about healthy lifestyle behavior.
• Manage nursing staff.

Patient Profile

Almost all of the patients of a GYN NP are female in all stages of life. At Raleigh Gynecology and Wellness, the NP will have patients following a well-woman care regimen, seeking contraceptive options, inquiring about fertility and family planning, and seeking treatment for pelvic disease or sexually transmitted disease.

NP’s Typical Daily Schedule at the Clinic

By the time an NP joins Raleigh Gynecology and Wellness, the NP has become accustomed to the demands and rigors of the job through the GYN nurse educational experience.

The requirements to become a GYN NP include earning a nursing degree, earning a master’s degree in nursing, passing the testing necessary to obtain a nurse license and then gaining enough practical experience.

On any given day, an NP at Raleigh Gynecology and Wellness can expect the schedule to look something like this:

Upon Arrival in the Morning until First Appointments Begin: Review patient materials needing attention – lab results, mammogram results, prescription refills, patient messages and physician feedback. Follow up on each item as appropriate.

Patient Appointments until Noon: Patient appointments can involve well-woman care, contraceptive consultations, conduct ultrasounds, IUD fittings, and so forth.

Noon to Early Afternoon: NP again reviews patient materials and messages that have come in during the morning hours and follow up as appropriate. Follow-ups may consist of consulting with the doctor about more complex matters.

Early Afternoon to Early Evening: Patient appointments resume.

Early Evening to Closing: Before the NP’s day is complete, the NP will review any patient materials that came in during the afternoon and tend to any urgent matter.

The NP often has a scheduled lunch break, but it usually lasts no more than 30 minutes. On some days, the NP will also have to budget time to participate in office meetings and conferences necessary for the efficient administration of the practice.

On those days, the NP may have to arrive earlier than usual, stay later than usual, or rearrange the schedule to handle those duties.

It is clear from the typical schedule that the GYN NP’s day can be lengthy and exhausting. However, the quality of care delivered by Raleigh Gynecology and Wellness is only possible with the dedication and compassion of their talented NPs.

Other Professional Responsibilities

The GYN NP has to make time to fulfill professional obligations pertaining to continuing education. Additional specialty education for GYN nurses consists of attending professional conferences and presentations sponsored by various professional nursing organizations. 

Those organizations offer various educational courses during their conferences with instructor-led sessions, and many maintain an online learning center.

Contact the Professionals at Raleigh Gynecology and Wellness for More Information about Women’s Reproductive Health

The Nurse Practitioners at Raleigh Gynecology and Wellness are a vital part of the quality women’s health services that the practice is so proud to offer.

Their patients are comfortable being treated by our GYN NPs for any women’s health issue.

Getting health care gives the patients privacy and the sense of security that they are seeing a women’s health specialist for their care.

The women’s health office at Raleigh Gynecology and Wellness is equipped with all of the necessary supplies and other equipment needed to provide top-notch women’s health care.

They are available to answer your questions about any aspect of women’s health and to schedule an appointment for you.

Taking good care of your breasts involves keeping up with routine breast exams. By incorporating regular breast exams into your health regimen, you will be better able to recognize problems developing at an early stage and improve your chances of having a long and healthy life.

Breast Examinations and Their Benefits

Regular breast examinations are the best way to detect changes in your breasts that could be signs of a serious health problem. As the years go by, your breasts will change. These changes are common. Many times, the changes are consistent with hormonal changes that occur with normal aging. The good news is that most of the changes you notice in your breasts are hormonal and not caused by cancer.

Regular examination will help you notice when something has changed in your breasts. Regular examinations enable you to detect any change at its earliest stage. Early detection allows your health care provider to diagnose the issue and develop appropriate testing and treatment protocols.

If the diagnosis is breast cancer, your doctor can treat it before it becomes life-threatening. In short, good breast care through regular examinations can be life-saving.

Routine Breast Examinations

There are several types of routine breast examinations. They include:

Self-Examination

Many women who have had breast cancer reported that the first sign of their breast cancer was a new breast lump that they discovered during a self-examination. Self-examination is important because it helps you improve your breast awareness so that you understand what is normal and better able to detect changes in them.

When performing a self-examination of your breasts, you should do a visual inspection for changes in how they look, and use your hands to determine any changes to the way they feel. Make sure to do your self-examination at a time when you are not having your period. Your hormone levels fluctuate during your menstrual cycle, which can cause your breasts to become tender and the tissues to swell. A good time to perform a self-exam is the week after the end of your period.

If you do notice anything new, you should discuss it with your doctor. Again, changes are common and most of them are not cancer. However, the changes could be an infection or skin condition that needs medical treatment. In particular, you should promptly see your doctor if you notice any of the following conditions:

• A hard lump in one or both of your breasts, even if it is very small
• Unusual or unexplainable pain, warmth, swelling, or tenderness.
• Fluid leaking or discharge from a nipple
• One of your nipples appears to be pulling inward instead of poking out
• The skin of one of your breasts is turning red, dimpling, or puckering

Screening Mammogram

A mammogram is a special x-ray of your breasts. A mammogram can detect problems in your breasts and cancer before you can feel a cancerous lump. A screening mammogram can provide your doctor with a baseline of what is normal for your breasts. After that, the frequency of a screening mammogram depends on your age and health profile. Your doctor can advise you on how often you should have a screening mammogram for optimal breast care.

Special Examinations

If a mammogram has detected an abnormality in your breasts, your doctor will recommend that you get a more detailed examination. It is important for your health that you follow through with the additional testing to properly diagnose the abnormality. There are a number of tests that your doctor may order for you. These include.

Diagnostic Mammogram

During a diagnostic mammogram, the technologist will take several detailed images of the suspicious area as directed by the radiologist. The detailed images will help in the evaluation of your screening mammogram.

Breast Ultrasound

Frequently, an ultrasound will be performed along with a diagnostic mammogram to evaluate the suspicious area identified in your screening mammogram. It is a painless procedure that uses sound waves to make images of the inside of your breast. It is used to help determine if a lump in your breast is a benign cyst or a solid mass and to pinpoint the position of a tumor.

An ultrasound is also a good breast health test for women whose breast tissue is too dense for a mammogram, pregnant women, and women younger than 25 years old.

Biopsy

A biopsy is an out-patient procedure where your doctor uses a small needle to take tissue from part of your breast. The tissue is evaluated under a microscope. A biopsy is the only way to know for sure if the tissue is cancerous.

Follow Up

Sometimes, the doctor will recommend follow up testing every three or six months to make sure there are no abnormal changes occurring in your breasts. By closely monitoring your breast health, your doctor will be able to quickly treat any problems that develop in between your regular mammograms. Early treatment is imperative to your overall health.

Contact the Breast Care Experts At Raleigh Gynecology and Wellness

Good breast care is an important aspect of good health care overall for women. Consult with the women’s health experts at Raleigh Gynecology and Wellness for more information about breast health and schedule an appointment.

Practicing good breast health habits doesn’t require making significant changes in your life. Incorporating healthy breast habits is relatively simple and could be life-changing these regular routines are recommended by leading breast health experts and can improve your breast health, help you detect problems early, and allow you to enjoy better health and overall quality of life.

Ways to Promote Good Breast Health

Tip #1. Eat a well-balanced diet and stay hydrated.

Experts believe that good nutrition is one of the best ways to protect yourself against breast cancer, and it can slow or prevent the disease’s progression or recurrence.

A healthy, well-balanced diet involves eating vegetables, lean proteins, and whole grains.Fruits and vegetables full of cancer-fighting substances include broccoli, cabbage, kale, and watermelon. Consume foods rich in omega-3 fatty acids, such as walnuts, fish, soybeans and pumpkin seeds.

One food to incorporate into your diet is dark chocolate. It contains a compound that researchers believe may fight fast-growing cancers. Researchers believe that a particular compound in dark chocolate interacts with an enzyme, which causes cancerous cells to die but leaves normal cells alone. Depending on the ongoing medical research results, dark chocolate could be included in some cancer treatments.

Avoid refined sugars and fats, which cause you to gain weight and subject you to a higher risk of breast cancer. Get in the habit of reading food labels when you are grocery shopping. Look for sugars and fats in the product and avoid consuming foods loaded with ingredients that are bad for your health.

Drinking lots of water will keep your cells hydrated and it will help your stomach feel full, too. Ideally, you want to drink 2 to 3 liters of water a day.
Also, limit alcohol consumption to no more than one serving per day. One serving of an alcoholic beverage is 12 ounces of beer, 5 ounces of wine or 1 1/2 ounces of hard liquor. Drinking more than that increases your risk of developing breast cancer. I if you have been diagnosed with breast cancer in the past, you increase the risk that it will return by drinking just three or more drinks per week.

Tip #2. Maintain a healthy weight.

Following tip #1 will help you follow tip #2. Achieving and maintaining a healthy weight reduces your risk of cancer and many other diseases.
When a woman becomes overweight, estrogen-sensitive breast cancer tissues are exposed to more estrogen than in women of a healthy weight. Over exposure to estrogen can stimulate the growth and progression of breast cancer.

Medical research has shown that obese women with a body mass index (BMI) of 30 or higher diagnosed with breast cancer often have more advanced disease when diagnosed than women with a BMI mass index below 25. Obese women also have a greater risk that the disease spreads and becomes fatal. They also have a greater risk that the cancer will return after it has been treated.

Tip #3: Exercise to keep your body fit

Regular exercise can prevent all types of cancer, including breast cancer. Exercise boosts the immune system, helps prevent obesity, and lowers estrogen and insulin levels. In fact, being physically active reduces your chances of getting breast cancer by as much as 25%.

Exercise gives you other health benefits as well. It can improve cardiovascular health and bone mass—h, Healthy bone mineral density wards off osteoporosis and bone fractures.

You do not need to engage in strenuous activities to reap health benefits. Strive to get at least thirty minutes each day for four to five days each week. Walking is the easiest type of exercise to get started with and is easy on your bones and joints.

Tip #4: Take vitamins, especially vitamin D.

Keep your vitamin D level up. Medical experts think that low levels of vitamin D can increase your risk of developing breast cancer. Also, breast cancer survivors with low vitamin D levels may have a greater risk of disease recurrence.

The best way to get enough vitamin D is through sun exposure. However, too much sun can increase your risk of skin cancer. Ask your doctor check your vitamin D levels. If your levels are low, consult with your doctor about taking a good vitamin D supplement.

Consume spinach and foods fortified with folate such as cereals and grains. Folate helps boost your body’s ability to repair DNA. Damaged DNA has been linked to higher risks of cancer. Ideally, you should strive to consume 400 micrograms daily.

Tip #5: De-stress your life.

Take time each day to relax and consider mediation or yoga classes. Deep breathing exercises, a good book or and relaxing with friends are ways to de-stress.

Consult with the Women’s Breast Health Experts at Raleigh Gynecology And Wellness

If you follow the advice outlined above, you will be taking important steps to good breast health. Learn about what other steps you can take by talking with the experts at Raleigh Gynecology and Wellness. They can give you advice on breast health and schedule an appointment for a breast examination.

Barrier contraception methods prevent pregnancy by blocking the sperm from reaching an egg and fertilizing it. Barrier contraceptives consist of a range of devices and medically formulated substances. Each has its advantages and disadvantages, as described below.

Types of Barrier Contraceptives and Their Pros and Cons

Barrier contraceptives are popular because they are easy to use and most are easily obtained from any pharmacy, grocery store, convenience store, or online store. They are relatively safe because they do not introduce hormones or chemical substances into the woman’s body. Although hormonal contraceptives are more effective than barrier contraceptives in preventing pregnancy, hormonal contraceptives are not safe for some women with certain health conditions. Also, some women object to the idea of ingesting hormonal substances, and other women experience unpleasant side effects. Barrier contraceptives are a viable alternative for all of those women.

Male Condom

Male condoms are the most commonly used barrier method. Male condoms are usually the first type of contraceptive that young people use. Condoms are available made of latex, polyurethane, or lambskin. Some are coated with silicone, water-based gel, or spermicide. Use of the male condom is controlled by the male. The male condom wraps the penis during sex and blocks semen from entering your vagina.

Pros: Easily available and affordable, condoms can prevent the spread of STDs when used properly.

Cons: Effectiveness as a contraceptive is compromised when the condom is damaged or not used properly. Using a male condom requires a pause just before the sex act resulting in people foregoing using it at all. It can reduce sensitivity during sex. Condoms can only be used once—a new condom must be used for each act of sex.

Female Condom

The female condom is a thin membrane that is placed inside the vagina no more than eight hours before having sex. Use of the female condom is controlled by the female. With a female condom, a male condom cannot be used.

Pros: The female condom is less likely to tear than the male condom. Like the male condom, the female condom also helps prevent the spread of some STDs.

Cons: Can become dislodged or the penis can penetrate between the membrane and the vagina. Can be uncomfortable for the woman. Can only be used once. A new condom must be inserted for each act of sex.

Contraceptive Sponge

A contraceptive sponge is a small, round sponge that is placed in the vagina near your cervix before sex. It is infused with a spermicidal substance. The sponge helps to block sperm from reaching your cervix and also kills sperm that comes into contact with the sponge.

Pros: You can have sex more than once with the sponge left in place. You can leave the sponge in place for up to 24 hours.

Cons: Requires planning Not as effective in preventing pregnancy for women who have had a vaginal birth.

Vaginal Spermicide

Vaginal spermicides kill sperm or inhibit sperm from reaching an egg. If you use a spermicidal tablet or suppository, you must insert it into your vagina about 30 minutes before having sex. Creams, foams and gels are inserted just before sex. They start working up to 15 minutes after applying them and are effective for up to 60 minutes.

Pros: Can be used in combination with some other barrier methods

Cons: Spermicides are not very effective when used alone. They work best when used with other barrier contraceptives. You have to reapply spermicide before each act of sex. Also, you must leave it in place for at least 6 hours after you apply it. Spermicide may irritate vaginal mucosa. They can be difficult to find in local stores.

Diaphragm

A diaphragm is a soft silicone dome that covers the cervix to block sperm from entering the uterus. It can be inserted three hours before sex and left in place during sex and for at least six hours afterward. It must be removed within 24 hours after sex.

Pros: An advantage of the diaphragm over a condom is you can have sex more than one time with the diaphragm left in place.

Cons: To get a diaphragm, you will need an appointment with your healthcare provider for an examination and fitting. A diaphragm requires planning and careful insertion, as well as the use of spermicide for maximum protection. Users will need a re-fitting after weight gain or pregnancy. It can create a higher risk of urinary tract infections

Cervical Cap

The cervical cap is similar to a diaphragm. It is a small rubber cap that covers the cervix to block sperm from entering the uterus. You must insert the cap before sex and leave it in place for up to eight hours afterward. Like the diaphragm, you can have sex more than one time with the cap left in place. However, you should remove it within 48 hours after having sex.

Pros: Same as a diaphragm.

Cons: Same as a diaphragm. Not as effective in preventing pregnancy for women who have had a vaginal birth.

Drawbacks of Barrier Contraceptives

Barrier methods of contraception are not as effective in preventing pregnancy as many hormonal methods of contraception. The reason for this is that barrier contraceptives are subject to being damaged and improperly used. For that reason, barrier contraceptives are only about 70-75% effective. That means that of 100 women who use barrier contraceptives per year, around 20 or 25 of them will become pregnant.

The most effective barrier contraceptives in preventing pregnancy are the male condom and diaphragm.

Contact Our Specialists to Learn More About Your Options

Barrier contraceptives are convenient and affordable. Many women use them to avoid health risks associated with hormonal contraceptives. To learn more about your options for contraceptive methods, contact the women’s health experts at Raleigh Gynecology and Wellness. They are available to answer your questions and schedule an appointment with one of their experienced professionals.