Routine Gynecologic Care

Many factors, such as dietary habits and exposure to harmful substances, impact the risk of breast cancer. However, one of the most impactful drivers behind the development of breast cancer is a family history. If other people in a woman’s family have experienced breast cancer, those related to them may have an increased risk as well.

Women at increased risk for breast cancer based on family history may require modified breast cancer screening, including earlier mammography, more frequent breast exams or even additional forms of breast imaging such as breast MRI or ultrasound.

Each woman needs to understand her family history to make wise decisions about her breast healthcare. Those who no longer have access to their family history, such as in the case of closed adoptions, still have options to uncover whether they, too, face a higher risk.

The Genetic Component of Breast Cancer

The reason that some people face a higher chance of developing breast cancer than others comes down to heredity. Because a person’s genes are influenced by their parents, some problematic genes can continue to move through generations. In fact, between 5% and 10% of breast cancer cases are in those with an increased risk through family history. Multiple genetic factors may increase breast cancer rates. Several genes have been identified related to breast cancer risk.

About 70% of what contributes to breast cancer development via heredity is still not clear; what doctors do know is that when people’s family history predisposes them to breast cancer, they may also face an increased risk breast cancer that develops on both sides, a younger than average age of cancer onset, and an increased risk of other types of cancer such as ovarian cancer.

Who Is at Risk?

Knowing whether a woman is facing an increased risk of cancer due to genetics can be challenging. The main people who must contend with higher risk are:

• Those with a known genetic mutation (such as BRCA1 and BRCA2, or “breast cancer gene 1/2″)
• Anyone of Jewish ancestry
• Those whose family has had previous cancer development at young ages
• Those whose parent or sibling had breast cancer before age 40 (or, if male, developed breast cancer at all)
• Those whose parent or sibling developed cancer in both breasts, regardless of age
• Those whose family has had at least three cases of breast cancer among parents, siblings, aunts, uncles, and grandparents

How to Be Assessed for Genetic Risk

Genetic counseling is available for those who have been deemed high-risk due to their family history. Doctors still cannot test for every factor that contributes to an increased risk of cancer, but several genes have been identified that can contribute to breast cancer risk.

In addition to BRCA1 and BRCA2, the most common genetic variants associated with increased risk, other things the genetic test may uncover relate to genes such as:

• TP53
• CDH1
• PTEN
• STK11
• RAD51C
• RAD51D
• ATM
• CHEK2
• BRIP1
• PALB2

Patients do not need to know what these genes mean or stand for! Instead, they should understand that many genes can contribute to breast cancer risk, often because the genes are “turned off.” Where most people’s genes work to suppress tumors or accurately copy DNA, people who have the above-mentioned genetic variants may not have tumor suppression genes that are properly activated, or their DNA may be more likely to be copied incorrectly.

How Family History Impacts Mammograms

A person’s family history should indicate how often they schedule their mammograms. Women with no family history should receive a mammogram at least once every other year, ideally once a year, starting at age 40. Those with the BRCA genes or other variations still receive a mammogram only yearly.

However, they may also be encouraged to get a breast MRI annually to provide further visualization of the breast tissue. These screenings also typically start earlier for those with a family history, potentially as young as 25, depending on the details.

Get Your Mammograms Often

Mammograms are an invaluable tool for diagnosing breast cancer, both in those with no family history and those whose families have faced this health challenge before. Knowing your breast cancer risk from genetics is essential for making smart decisions about your healthcare and when to receive screening.

The friendly team at Raleigh Gynecology & Wellness is always happy to welcome our patients who have questions about the genetic components of their health. Our women-only team understands that uncertainty around cancer risk can cause much anxiety, and we are happy to help you stay healthy and informed! Contact Raleigh Gynecology & Wellness today to schedule an appointment.

When the time isn’t right to start or grow your family, birth control offers a reliable and convenient way to manage your contraceptive care. Although several choices are available, two of the most common progestin-only methods are the birth control shot (Depo-Provera) and the birth control implant (Nexplanon).

Both provide long-lasting pregnancy prevention but work in different ways. Find out the differences between the shot and implant to make an informed decision about your contraceptive care.

The Shot

The birth control shot is an injectable contraceptive that offers long-term pregnancy prevention. As a progestin-only method, it does not contain estrogen, making it a suitable option for individuals who cannot use combination hormonal contraceptives.

How It Works

Women who value convenience often favor the shot as it’s only administered once every three months. It works primarily by blocking ovulation, thickening the cervical mucus to stop sperm, and thinning the uterine lining to prevent implantation. For maximum effectiveness, it must be received on a schedule.

Pros:

• Highly Effective – When used correctly, the shot is over 99% effective.
• Low Maintenance – Only requires an injection every three months, reducing the need for daily or frequent reminders.
• Discreet – There are no visible signs of birth control, and it does not require insertion or a device.
• May Reduce Menstrual Symptoms – Many users experience lighter periods or stop having periods altogether over time.
• Estrogen-Free – A good option for women who cannot take estrogen-based contraceptives.

Cons:

• Requires Regular Injections – Missing a shot can reduce effectiveness, requiring strict adherence to a schedule.
• Potential Side Effects – May cause weight gain, mood changes, headaches, and irregular bleeding.
• Bone Density Loss – Long-term use has been linked to decreased bone mineral density, which may be a concern for some users.

Depo-Provera

Depo-Provera is the brand name for a birth control shot that contains depot medroxyprogesterone acetate (DMPA) as its active ingredient. It is typically injected into the muscle of the upper arm or buttocks. As it lasts for three months, it provides a convenient alternative for those who prefer not to take daily birth control pills but are not ready for longer-term options, such as an implant or IUD.

The Implant

The birth control implant is a long-acting, reversible contraceptive that provides years of highly effective pregnancy prevention. It’s a tiny, flexible rod measuring approximately 1.6 inches and is inserted just under the skin of the upper arm.

How It Works

Implants work by releasing steady, low doses of progestin into the bloodstream to block ovulation, thicken cervical mucus to stop sperm, and thin the uterine lining to prevent implantation. Once inserted, it remains effective for up to 3 years.

Pros:

• Extremely Effective – Over 99% effective at preventing pregnancy, with a failure rate lower than most other contraceptive methods.
• Long-Lasting – Protects against pregnancy for three years without requiring maintenance.
• Low-Hormone Option – Releases a consistent, low dose of progesterone, avoiding hormonal fluctuations.
• Reversible – Can be removed at any time, and fertility typically returns quickly after removal.
• Estrogen-Free – Suitable for individuals who cannot use estrogen-containing birth control.

Cons:

• Requires a Minor Procedure – Must be inserted and removed by a healthcare provider, which may cause slight discomfort.
• Potential Side Effects – Some users experience irregular bleeding, headaches, mood changes, or weight gain.
• Not Suitable for Everyone – May not be recommended for individuals with certain medical conditions, such as those with a history of blood clots.

Nexplanon

Nexplanon is the most commonly used brand of birth control implant. The tiny plastic rod is placed under the skin of the upper non-dominant arm in a fast outpatient procedure. Nexplanon is radiopaque, meaning it can be detected by X-ray if necessary. Once inserted, it continuously releases progestin to provide long-term pregnancy prevention, making it a highly convenient and effective contraceptive option.

Which Option Is Best for You?

Choosing between the birth control shot and implant depends on your lifestyle, health needs, and personal preferences. If you prefer a low-maintenance, long-term option that lasts for years, the implant may be the best choice.

However, if you like the flexibility of an injectable method that isn’t permanent, the shot may be a better fit. Consider factors such as side effects, scheduling requirements, and future pregnancy plans. Always consult with a healthcare provider to determine the best contraceptive care for you.

Trust Raleigh Gynecology & Wellness for Your Contraceptive Care

Both the birth control shot and the implant offer highly effective, long-term contraception, but the right choice depends on your individual needs and lifestyle. While the shot provides flexibility with regular injections, the implant offers years of hassle-free protection. By knowing the pros and cons of each method you can make an informed decision about your contraceptive care.

If you’re unsure which option is best for you, contact Raleigh Gynecology & Wellness today to speak with a healthcare professional about your birth control options. We offer specialized and compassionate care for women of all ages to ensure that you receive services that best suit your needs.

Mammograms can tell a woman much about her breast health, but they are an easy thing to avoid. In fact, about two-thirds of women expect mammograms to be painful, which plays a significant role in whether they choose to schedule them on time every year (or at all).

While it is true that mammography will not be as pleasant as enjoying a home-cooked meal, it does not have to be severely uncomfortable! There are many things a woman can do before and during her mammogram to make the process more comfortable.

From scheduling strategically to working with a trusted team, any patient can take charge of their mammography and see better (and more comfortable) results.

Schedule Before Problems Worsen

One way to improve the comfort of a mammogram is to schedule it as soon as a problem becomes noticeable (or even before any issues seem to exist). Waiting until the breast tissue itself becomes uncomfortable not only exposes a patient to a higher risk of breast cancer but also contributes to discomfort during testing.

A woman who is experiencing swollen nipples or who feels a large lump may feel more discomfort when these tissues are put under pressure with mammogram testing. This is why regular mammograms are important, as they can spot issues before reaching this point.

Wait Until After Your Period

Breast tissue changes throughout a woman’s menstrual cycle as hormones fluctuate. Immediately prior to and during a woman’s period, the breasts can be especially tender. It is smart to schedule a mammogram for the week after menstruation, when the breasts have recovered and are no longer as sensitive to touch or pressure.

Choose Water

While many women begin their days with coffee, this could be a less-than-ideal choice for mammogram day. Soon after consumption, caffeine functions as a vasoconstrictor, narrowing the blood vessels.

This narrowing (and the increased blood pressure that comes with it) is why some people experience headaches after drinking caffeine. However, it can also be a driver of discomfort during a mammogram.

Because the breasts experience higher blood pressure than normal, the force exerted by the mammography machine can increase this pressure to even greater levels, causing discomfort. To avoid this, be sure to drink water for a few days before the mammogram.

Try OTC Medications

It is safe to take over-the-counter pain relievers, such as ibuprofen, before a mammogram. Studies show that women who took acetaminophen (Tylenol) one hour before their screening reported less discomfort than those who did not. Just be sure that taking this medication will not interfere with other medicines!

Stay Still

A mammogram exerts pressure on the breast tissue in specific ways to gain a clear picture. Remaining as still as possible helps to make sure the machine is putting pressure in the right places instead of pressing on a sensitive area.

If a patient needs help standing still, such as if they regularly use a walker, a good mammography team will always be happy to assist.

Communicate

Many women assume they should be quiet during their screenings so the technicians can work. However, women are encouraged to communicate with their team! If they are feeling discomfort, patients should let their practitioner know so they can adjust the positioning.

Get to Know Your Team

It can be very stressful to be poked and prodded by strangers, and this sense of unfamiliarity can lead to an increased sense of pain. From being tense to anticipating pain where none exists, patients face real consequences when they do not know the team they are working with!

Take time before a mammogram to get to know the people operating the machine or taking notes. By trusting those in the office, women can approach mammography with less tension and discomfort.

Do Not Fear a Mammogram

A mammogram does not have to be a cause for concern! Whether you have experienced an uncomfortable mammogram in the past or are nervous about your first time, it is important to choose a team that understands what you are going through.

Raleigh Gynecology & Wellness’ all-woman team has been right where you are, and we know just how intimidating a mammogram can be with the wrong people. That is why we are eager to help our patients have a positive experience so they can approach their breast health with confidence. Contact Raleigh Gynecology & Wellness today to schedule your appointment!

Birth control has come a long way throughout history. There have been many changes from the acacia leaves of ancient Egypt to the development of a once-a-day estrogen pill. As technology continues to advance, so too does the improvement of existing birth control options and the development of new and exciting contraceptives.

But what’s next for contraception? Researchers are working on a few key areas: accessibility, how long a method offers protection, and how easy it is to use. These factors increase the success rate through patient compliance while simultaneously making birth control easier for everyone.

Here are some innovations that could be coming down the pipeline soon.

The Monthly Pill

One of the most significant challenges doctors see among patients taking the once-a-day pill is that it is easy to forget. Whether a person misses a dose completely, takes it at the wrong time, or even loses the packet, their protection could be compromised.

In order to address this issue, doctors are working hard to develop a monthly pill. This single dose could protect for an entire month, reducing the failure rate due to patient behaviors while delivering something much more convenient.

A Long-Term Injection

Contraceptive injections are currently available, but patients have stated their dissatisfaction with how often they need to be administered. Most injections last no more than three months. However, innovations in contraceptive injections could produce a shot that lasts for six months or even a year. With fewer jabs, more patients are likely to consider this option.

A Dissolvable Patch

Not everyone wants to take pills, and an injection may not be the right fit for some. To provide an alternative, medical researchers are developing a patch that can be applied to the skin (usually on the arm). The patch contains microneedles too small to be seen by the naked eye (and thus too small to produce the discomfort of an injection).

When the patch is applied, these small needles enter the skin to provide exposure to contraceptive hormones. The patch can then be removed, leaving only the medication in the needles behind. The needles dissolve before the next treatment is due.

Biodegradable Implants

Contraceptive implants can currently be placed under the skin of the arm. However, they must be removed once their efficacy has decreased. Biodegradable implants could be left permanently in the body, where they will go away on their own rather than requiring a second procedure.

Pod IVRs

An IVR, or intravaginal ring, already exists as a birth control option. However, the current selection is limited; the ring contains the prescription, which is absorbed directly in the vaginal cavity, but flexibility in what that ring can contain remains limited.

Innovations are leading toward a “pod” IVR, which incorporates multiple pods of different types of medications. This allows for treatment targeted toward the patient’s specific needs in more controlled and varied doses, potentially with multiple hormones or medications.

An Adjustable Microchip

One of the most technologically advanced options on the table in the future is the microchip-based contraceptive. Researchers are considering an implantable, programmable device that could release contraceptives on command (e.g., when a patient is sexually active) and then be turned off at will (e.g., when the patient wants to get pregnant or when they are not sexually active).

While this can limit the long-term adverse side effects of many types of birth control, scientists have expressed some concerns about the microchip option. Women in abusive relationships could find that their partner turns the contraceptive off remotely to trap them in a pregnancy. Scientists also wonder if a device with a remote connection could be considered secure from outside influence. Development in this area is ongoing!

Male Birth Control

For years, people have been clamoring for a male birth control option, and development has finally made strides. YCT-529 is being studied as a pill option that prevents the development of sperm, and a gel option shows great promise in stopping sperm production faster than ever, which is one of the primary challenges that male contraceptives face.

Explore Birth Control Options

Medical technology has evolved by leaps and bounds in recent decades, and this advancement is not expected to slow down anytime soon. This can mean some great things for birth control for both men and women. To determine which type of contraceptive is right for you, and to stay on top of new options, be sure to keep up with your regular wellness visits and screenings!

Contact Raleigh Gynecology & Wellness to schedule your appointment or set up a mammogram to take charge of your health.