Florida Woman Care of Jacksonville https://fwcjax.com Jacksonville OBGYN Fri, 31 Aug 2018 19:57:48 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.8 https://fwcjax.com/wp-content/uploads/sites/75/2016/05/cropped-FWC-512-32x32.png Florida Woman Care of Jacksonville https://fwcjax.com 32 32 Benign Ovarian Cysts: Symptoms and Treatments https://fwcjax.com/benign-ovarian-cysts-symptoms-treatments/ https://fwcjax.com/benign-ovarian-cysts-symptoms-treatments/#respond Tue, 27 Jun 2017 18:28:59 +0000 https://fwcjax.mvmg.site/?p=429 Ovarian cysts are categorized as benign or malignant and today, I am going to discuss benign ovarian cysts because they are so much more common than malignant ovarian cysts. Benign ovarian cysts are either physiologic – meaning that they are normal – or pathologic – meaning that they are abnormal. The Most Common Benign Ovarian […]

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Ovarian cysts are categorized as benign or malignant and today, I am going to discuss benign ovarian cysts because they are so much more common than malignant ovarian cysts. Benign ovarian cysts are either physiologic – meaning that they are normal – or pathologic – meaning that they are abnormal.

The Most Common Benign Ovarian Cysts

The most common physiologic ovarian cysts are follicular cysts and luteal cysts. These cysts occur every month if a woman is still ovulating. The follicular cyst is a fluid-filled collection on the ovary that contains the maturing egg. This cyst usually develops slowly over a two-week interval and it produces estrogen primarily. When it reaches about an inch in diameter it ruptures, releases the egg and then shifts to producing primarily progesterone. This cyst is then known as a luteal cyst. The luteal cyst typically resolves in about 2 weeks if no pregnancy occurs and this is when the progesterone levels decline, causing the menstrual cycle to occur.

There are rarely any symptoms from these cysts unless there is significant bleeding when the follicular cyst ruptures to release the egg. If this occurs, there is usually a rapid onset of severe pain which may be accompanied by nausea, vomiting, and lightheadedness. In rare cases, the bleeding may not stop which can result in an emergent surgery to stop the bleeding.

Post Menopausal Ovarian Cysts

Postmenopausal ovarian cysts are much less common and are often physiologic cysts that represent small fluid collections within the ovary. They are rarely symptomatic and they are typically monitored with intermittent ultrasounds to make sure they are not growing which could indicate that they may not be benign physiologic cysts.

Pathologic Ovarian Cysts

Pathologic cysts of the ovary result from growth and development of various types of cellular tissues within the ovary and these include dermoids, serous cystadenomas, mucinous cystadenomas, endometriomas and Brenner’s tumors. When these cysts enlarge significantly they may create a variety of symptoms including pelvic pain, bloating, frequent urination, pain during intercourse nausea and vomiting. They are usually diagnosed with ultrasound and can sometimes be felt during the pelvic exam. These cysts do not resolve on their own and require surgery for removal. Fortunately, the cysts can typically be excised with minimally invasive surgical techniques so that patients recover quickly.

If you have any questions about ovarian cysts please discuss this with me or our group of medical professionals.

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Telemedicine Mobile Healthcare Solution – Carie and FWCJax https://fwcjax.com/telemedicine-mobile-healthcare-epicmd/ https://fwcjax.com/telemedicine-mobile-healthcare-epicmd/#respond Tue, 13 Jun 2017 18:20:21 +0000 https://fwcjax.mvmg.site/?p=427 Hi. I’m Dr. Daniel McDyer and I want to thank you for placing your trust in me to provide your healthcare. I place a very high value on providing outstanding personalized healthcare for my patients and I strive to always be available when my patients have urgent medical needs. However, I realize that accessing healthcare […]

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Hi. I’m Dr. Daniel McDyer and I want to thank you for placing your trust in me to provide your healthcare. I place a very high value on providing outstanding personalized healthcare for my patients and I strive to always be available when my patients have urgent medical needs. However, I realize that accessing healthcare when you urgently need it is not always convenient and that no matter how hard I try, I’m not always available when you need me. In those unfortunate situations, I always want my patients to get the best care. That’s why I’m excited to introduce you to Carie a revolutionary, cost-efficient and convenient way to access medical care from board certified physicians from wherever you happen to be located by using your smartphone, tablet or computer.

This innovative telemedicine company with top tier physicians and technologies has placed the power of a medical consult conveniently in the palm of your hands. The consult is extremely easy to request and the average response time to see a physician is 7 minutes. They are able to evaluate and treat a large number of problems.

Some example problems evaluated with this telemedicine solution include:

  • Upper Respiratory Problems
  • Earaches
  • Sore Throat
  • Cough
  • Sinus Problems
  • Allergies
  • Asthma
  • Backache
  • Yeast Infections
  • Abdominal Pain
  • Constipation
  • Diarrhea
  • Headache
  • Laryngitis
  • Rashes
  • Bladder Infections
  • Vaginal Infections
  • Counseling

After the evaluation is completed, the physician can call in a prescription to your pharmacy when it is appropriate, so that you can initiate your care immediately.

The benefits of this mobile healthcare service are pretty obvious:

Nearly immediate access to care when you need it – there is no more waiting for appointments to be seen several days after your problem developed.
Convenience– you can see the doctor from the comfort of your home, work, vacation or wherever you may be.
Cost savings – A one-year membership is typically less expensive than a single co-pay for a trip to the ER
No long waits in the ER, Urgent Care or the doctor’s office.
Outstanding care from guaranteed Board Certified physicians

So, when my patients have an Carie membership, I know that they’re receiving outstanding evaluations and treatment during the unfortunate times when I’m not available. That’s why I strongly endorse this service. The mobile healthcare membership is $29 per month for an individual and $49 per month for a family of up to 5 members which grants you unlimited access to the EPIC MD physicians 24 hours a day and 365 days per year.

I am confident in saying that the Carie is revolutionizing and simplifying outstanding, efficient healthcare when you need it and where you need it.

 

To enroll for telemedicine with an Carie mobile health care membership, please speak with my office staff and they can help you become a member or sign up below.

Sign Up Now!

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Missed Periods When Taking Birth Control Pills https://fwcjax.com/missed-periods-when-taking-birth-control-pills/ https://fwcjax.com/missed-periods-when-taking-birth-control-pills/#respond Mon, 13 Mar 2017 18:41:04 +0000 https://fwcjax.mvmg.site/?p=164 A relatively common concern of my patients is missing their menstrual cycles (AKA missed periods) when they are taking their birth control pills, the patch or the birth control ring (Nuvaring). This can be a bit unnerving for patients as it creates the concern that they might be pregnant or that there is something wrong […]

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A relatively common concern of my patients is missing their menstrual cycles (AKA missed periods) when they are taking their birth control pills, the patch or the birth control ring (Nuvaring). This can be a bit unnerving for patients as it creates the concern that they might be pregnant or that there is something wrong with them.

What Missed Periods on Birth Control Means

Generally speaking, missing your menstrual cycle while you are taking your birth control pills is a common event, especially with the extremely low dose pills that are now available. If you do miss one or more menstrual cycles, be sure to check a pregnancy test to confirm that you are not pregnant. If it is negative and you were having normal and regular cycles prior to starting the pills, you can rest assured that there is nothing wrong with you unless you have had a recent uterine surgery or a severe uterine infection… and these are both things you would have been aware of if they had occurred.

How Birth Control Hormones Affect Menstruation

The reason that many women miss their menstrual cycles while taking the birth control pill, patch or ring is due to the low doses of hormones in these methods and the dominant effect of the progesterone in them. As you probably know, almost all pills, the patch and the ring contain estrogen and progesterone. Progesterone’s effect is to shrink the menstrual tissue layer of the uterus and the estrogen component provides a minor balancing stimulatory effect so that the menstrual tissue does not break down and cause bleeding on the days that you are taking the pills, also known as breakthrough bleeding. Progesterone’s “shrinking effect” on the menstrual layer is why most women experience lighter and shorter cycles while using these methods of birth control. In some cases, especially with very low dose pills, the menstrual tissue has such minimal stimulation for growth and development that there is no tissue to lose as a menstrual cycle when the end of the month of use is reached. This results in a missed menstrual cycle.

Next Steps After Missed Periods

So, if you have experienced a missed menstrual cycle while using birth control pills, the patch or the ring, and you are not pregnant– do not fret! You are fortunate to be experiencing one of the beneficial and harmless effects of these methods. Your menstrual cycles should return to your normal experience once the birth control method is stopped. Contact us today if you are experiencing a missed period when taking birth control pills and we’d be happy to schedule a consultation.

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Video: What is Osteoporosis & Osteopenia https://fwcjax.com/video-what-is-osteoporosis-osteopenia/ https://fwcjax.com/video-what-is-osteoporosis-osteopenia/#respond Fri, 09 Dec 2016 18:51:49 +0000 https://fwcjax.mvmg.site/?p=151 Hi. I’m Dr. Stephen Suhrer of Florida Woman Care of Jacksonville and I am going to take a few minutes to discuss two related problems that affect well over 40% of postmenopausal women – osteopenia and osteoporosis. Osteopenia is a disorder of weakening bone strength and is a precursor of osteoporosis which exists when a […]

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Hi. I’m Dr. Stephen Suhrer of Florida Woman Care of Jacksonville and I am going to take a few minutes to discuss two related problems that affect well over 40% of postmenopausal women – osteopenia and osteoporosis. Osteopenia is a disorder of weakening bone strength and is a precursor of osteoporosis which exists when a person’s bones have weakened to the point where they are brittle and are at significant risk of fractures, especially at the hip, wrist, and spine.

Diagnosing Osteoporosis and Osteopenia

These disorders are exceptionally important to diagnose because of the difficulties created by fractured bones, especially hip fractures, which can be catastrophic. Why? Because hip fractures require surgical repair and because twenty to thirty percent of all people who suffer a hip fracture related to osteoporosis die within the first year from a complication directly related to the hip fracture. Additionally, osteoporotic fractures of the spine can occur simply with the trauma of daily life and can result in postural changes creating severe back pain and changes in appearance such as this woman who suffers from a Dowager’s hump of the upper back which is irreversible. So, osteoporosis presents a very costly personal and societal problem.

In order to understand these disease processes, it is important to realize something that many people don’t understand…….that bone is a living tissue. Its structure is similar to that of a building with steel trusses inside of it that provide its support and strength. Within the trusses, there are two main populations of cells called osteoblasts and osteoclasts. Osteoblasts make new bone and create the trusses while osteoclasts tear down the aged and broken trusses, kind of like Pac-Men, so that new ones can be made to replace them.

The degree of activity of these two different bone cell types changes as we age creating several phases of bone health. In our younger years, more new bone is made than is destroyed. In our late 30’s to early 40’s, the activity of the osteoblasts and osteoclasts equilibrates resulting in a stable amount of bone. Then, in our mid to late 40’s, the rate of bone destruction exceeds the rate of bone production. This results in a slow and methodical breakdown of the bone which can lead to osteopenia and, eventually, osteoporosis, if nothing is done to counteract these effects.

This decline in bone production in the mid 40’s and after menopause is due to lower estrogen levels at these phases of life. It seems that this important hormone slows the activity of the bone-destroying cells, the osteoclasts. As the estrogen levels decline, bone destruction increases. This is why osteopenia and osteoporosis are so common after menopause.

Osteoporosis Risk Factors

In addition to the declining estrogen levels with older age, there are several other risk factors for the development of osteopenia and osteoporosis. These include any other states of low estrogen levels, such as in women who stop menstruating due to excessive exercise or those who have the eating disorder, anorexia nervosa.

Unchangeable risk factors include being white or Asian, having a family history of osteoporosis or having a small body frame. The behavioral risk factors include tobacco use, alcohol intake, and a lack of exercise. The medical risk factors include excessive thyroid hormone production, certain medications, such as steroids, low calcium intake, gastric bypass and removal of part of the intestine.

Recognizing osteopenia and osteoporosis before they result in a fracture is critically important. They are diagnosed by a simple low dose x-ray called a DEXA scan which determines the density or strength of bone in the spine and hip. This is typically ordered after menopause or when some of the above risk factors are present prior to menopause.

When the DEXA results indicate that a patient has osteopenia, the fracture risk is 2 to 4 times higher than average and the treatment usually involves calcium and Vitamin D supplementation along with recommendations for weight bearing exercise. For unknown reasons, weight bearing exercise stimulates the osteoblasts to make new bone. Occasionally, if patients have other risk factors for osteoporosis, medications may be used to treat osteopenia with the goal of reversing the problem.

If the DEXA scan indicates osteoporosis is present, the fracture risk is 4 to 8 times higher than average and treatment is necessary to reverse the problem. Treatment for osteoporosis includes the same as for osteopenia PLUS one of a variety of medications. These include medications that slow the bone-destroying activity of the osteoclasts, such as Reclast, Boniva, Fosamax, Actonel, Evista and Prolia. Another medication available to treat osteoporosis is Forteo which actually increases bone production rates. If possible, it is best to avoid ever developing osteopenia or osteoporosis. The risk can be significantly lowered by making efforts to develop strong and healthy bones at a young age through exercise and healthy eating including adequate amounts of calcium and Vitamin D intake.

If you have any questions about these interesting problems, their treatment or their prevention, please ask your doctor and he or she will gladly discuss these topics with you. Schedule your consultation today!

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Video: BRCA Gene Testing for Cancer https://fwcjax.com/video-brca-gene-testing-cancer/ https://fwcjax.com/video-brca-gene-testing-cancer/#respond Fri, 02 Dec 2016 17:49:59 +0000 https://fwcjax.mvmg.site/?p=146 Hi, I’m Dr. Daniel McDyer and I would like to discuss with you a revolutionary topic in women’s health that is known as testing for Hereditary Breast and Ovarian Cancers. These tests, known as BR CA 1 & 2, or BRACA 1 & 2, check for mutations or changes in these 2 genes that increase […]

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Hi, I’m Dr. Daniel McDyer and I would like to discuss with you a revolutionary topic in women’s health that is known as testing for Hereditary Breast and Ovarian Cancers. These tests, known as BR CA 1 & 2, or BRACA 1 & 2, check for mutations or changes in these 2 genes that increase the risk for breast and ovarian cancer.

These abnormalities are responsible for about 5% of all breast cancers and about 15% of all ovarian cancers. When a patient suffers from a mutation in one or both of these genes, her risk of developing breast cancer may be as high as 85% and her risk of developing ovarian cancer may be as high as 40%. These mutations are usually passed from parents to their children and affected individuals have a 50% chance of passing these mutations to their children.

You should consider getting this test if you or your close relatives have a history of breast or ovarian cancer or if you are of an Ashkenazi Jewish background with these risk factors.

What Does a Positive BRCA Gene Test Mean?

When patients are candidates for this test, they frequently ask me why they should have the test done and many fear the results. It is important to understand that a positive BRACA result does not mean that a patient will definitely develop breast or ovarian cancer. It simply indicates that there is an increased risk which allows us to develop a personalized plan for closely monitoring those patients or perform preventative interventions with medicines or surgery that can significantly lower the risk and save lives. As a matter of fact, you may have heard of some celebrities like Angelina Jolie and Christina Applegate who recently had their lives saved by having the BRACA test performed and learning that they had a BRACA mutation.

In order to provide patients with the most valuable, affordable and efficient BRACA testing, the doctors and scientists at Quest Diagnostics have developed a unique program called BRCAvantage to help guide you through this testing process. Like us, they believe that well-informed patients are empowered patients. This is why they have dedicated their services to provide outstanding educational resources and genetic counseling services to help patients determine if they should have the test performed and to help them understand the meaning of their results in partnership with us.

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Video: What are Hot Flashes? https://fwcjax.com/video-women-experience-hot-flashes/ https://fwcjax.com/video-women-experience-hot-flashes/#respond Sat, 26 Nov 2016 15:31:21 +0000 https://fwcjax.mvmg.site/?p=144 Hi. I’m Dr. Daniel McDyer of Florida Woman Care of Jacksonville and I would like to take a few minutes to discuss an interesting and frustrating problem from which many women suffer around the time of menopause: hot flashes. Approximately 85% of women experience hot flashes in the few years prior to menopause or after […]

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Hi. I’m Dr. Daniel McDyer of Florida Woman Care of Jacksonville and I would like to take a few minutes to discuss an interesting and frustrating problem from which many women suffer around the time of menopause: hot flashes.
Approximately 85% of women experience hot flashes in the few years prior to menopause or after menopause. They can be quite disruptive to normal daily activities or to sleeping patterns as many women frequently experience them at night.

The exact cause of hot flashes is uncertain, but it appears that the lower estrogen levels experienced in pre-menopause and menopause may alter the body’s temperature control mechanisms in an area of the brain called the hypothalamus resulting in increases in the core body temperature. When the core temperature increases, the blood vessels at the skin surface dilate open to allow more blood to flow to the skin in order to expel body heat. This is why many women have extremely red skin during the hot flash and it results in the heat sensation which is frequently accompanied by profuse sweating. The heat sensation typically begins in the face or chest and it may spread throughout the entire body. It typically lasts between 2 to 30 minutes. A rapid heart rate may also accompany these symptoms. They may occur a few times per week or multiple times throughout the day. Occasionally, they may create adverse consequences if they disrupt the sleeping pattern which may result in alterations of mood and impaired concentration. Fortunately, their intensity and frequency usually diminish as time passes.

The most effective treatment for hot flashes is estrogen replacement or hormone replacement therapy. It seems that providing estrogen normalizes the body temperature control mechanisms alleviating the hot flashes for the vast majority of women. Other medications that may help include antidepressant selective serotonin reuptake inhibitors, like Paxil, and a blood pressure medication called Catapres. Herbal remedies that may help include plant-based estrogens called phytoestrogens and isoflavones in ginseng and flaxseed oil. The weak estrogens in these substances may also beneficially affect the body’s temperature control mechanism. Extracts from black cohosh root have been shown to help, too.
Additionally, certain lifestyle changes may help relieve hot flashes. These include avoiding caffeine, hot drinks, chocolate, spicy or hot foods and alcohol.

Some treatments are more effective than others and some have side effects that certain women may want to avoid. If you suffer from hot flashes, please discuss this with your doctor so that he or she can help you determine a personalized treatment plan that is right for you.

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Video: The Importance of Prenatal Vitamins https://fwcjax.com/video-importance-prenatal-vitamins/ https://fwcjax.com/video-importance-prenatal-vitamins/#respond Sat, 19 Nov 2016 18:59:38 +0000 https://fwcjax.mvmg.site/?p=141 Hi, I’m Dr. Daniel McDyer and today I would like to discuss the important topic of prenatal vitamin use during pregnancy. As we all know, the best way to get all of the important nutrients that your body needs is to eat a healthy, well-balanced diet. However, even in the most ideal circumstances, our diets […]

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Hi, I’m Dr. Daniel McDyer and today I would like to discuss the important topic of prenatal vitamin use during pregnancy. As we all know, the best way to get all of the important nutrients that your body needs is to eat a healthy, well-balanced diet. However, even in the most ideal circumstances, our diets may fall short of supplying a few important nutrients to keep our bodies functioning at peak performance. The importance of good nutrition is even more apparent if you are pregnant or trying to get pregnant as the growing baby places increased nutritional demands on your body. Prenatal vitamins can help fill the voids left by your diet or your pregnancy and they can play a key role in developing a healthier baby.

Nutritional Importance of Prenatal Vitamins

The most important nutrients supplied by prenatal vitamins in doses higher than regular vitamins are folic acid and iron. Iron supplementation is important to help prevent you from developing anemia or a low blood count while pregnant because the baby demands more of your iron stores to develop its own blood cells. Folic Acid supplementation is also very important because it helps prevent serious birth defects of the spine and brain. Other important nutrients in superior prenatal vitamins include omega-3 fatty acids which help the baby’s brain development and calcium and Vitamin D which help with the baby’s bone development.

Recent important discoveries have shown that up to 50% of people may not be able to utilize folic acid appropriately which may increase their risk of folic acid deficiency. In order to prevent this, a unique form of folic acid called Quatrefolic has been developed and is included in a few select prenatal vitamins, such as VitaMed MD, to help prevent the adverse effects of folic acid deficiency which include brain and spinal defects. For your convenience, and to ensure that you are receiving the highest quality prenatal vitamin, the doctors and scientists at VitaMed MD have assembled a unique, affordable and convenient program called vitaCare that will allow for their prenatal vitamins to be shipped directly to you free of charge.

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Permanent Sterilization Procedure Options for Women https://fwcjax.com/permanent-sterilization-procedure-options-women/ https://fwcjax.com/permanent-sterilization-procedure-options-women/#respond Sat, 12 Nov 2016 09:12:22 +0000 https://fwcjax.mvmg.site/?p=136 When a woman has decided that she would like to pursue permanent sterilization, there are 2 different procedures that can be performed. The first is a bilateral tubal ligation, also known as having your tubes tied. The second is an Essure tubal occlusion or tubal blockage. These two hormone-free procedures are performed in entirely different […]

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When a woman has decided that she would like to pursue permanent sterilization, there are 2 different procedures that can be performed. The first is a bilateral tubal ligation, also known as having your tubes tied. The second is an Essure tubal occlusion or tubal blockage.

These two hormone-free procedures are performed in entirely different fashions. The bilateral tubal ligation is performed in the operating room while you are asleep with general anesthesia. During this procedure, one or two small incisions are made on the abdomen to allow for the placement of a small clip onto each fallopian tube to permanently block the tubes. The Essure tubal occlusion does not require any incisions. It is a gentle procedure that is typically performed in the comfort of the doctor’s office using oral sedation and a small injection of local anesthetics into the cervix.

Thereafter, the doctor passes a small camera through the cervix into the uterine cavity and then places a soft, flexible micro-insert into each fallopian tube. Over the next few weeks, the tubal tissue forms a natural barrier around the micro-inserts to permanently block the tubes.

Permanent Sterilization Recovery Time

These procedures also differ with respect to how patients recover from them. With the bilateral tubal ligation, women typically recover from the pain of the procedure within 1 – 2 weeks, whereas, with the Essure tubal occlusion, women typically recover within 1 – 2 days.

Three months after an Essure tubal occlusion is performed, a brief x-ray called an Essure Confirmation Test is performed to confirm that the tubes are blocked. There is no x-ray performed after a bilateral tubal ligation.

Permanent Sterilization Effects on the Body

Another difference between the two procedures is how they may affect the menstrual cycle. Studies indicate that the bilateral tubal ligation slightly increases the risk for irregular bleeding. The Essure tubal occlusion has no effect on the bleeding pattern.

The success rates of the two procedures are quite similar with approximately 4-5 women per thousand getting pregnant in a lifetime after the procedure. However, the Essure tubal occlusion has a higher success rate than any other form of women’s birth control.

If you are interested in permanent sterilization, please discuss this topic with Dr. McDyer or Dr. Suhrer so that he can help determine the proper procedure for you.

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What is Cervical Dysplasia? https://fwcjax.com/what-is-cervical-dysplasia/ https://fwcjax.com/what-is-cervical-dysplasia/#respond Sat, 05 Nov 2016 19:18:40 +0000 https://fwcjax.mvmg.site/?p=129 Cervical dysplasia is a very common disorder that, unfortunately, affects a large number of patients. It is a pre-cancerous change of the cells that line the surface of the cervix. There are, however, preventative measures that a woman can take as well as treatments after a diagnosis. Anatomy of the Cervix The cervix is the […]

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Cervical dysplasia is a very common disorder that, unfortunately, affects a large number of patients. It is a pre-cancerous change of the cells that line the surface of the cervix. There are, however, preventative measures that a woman can take as well as treatments after a diagnosis.

Anatomy of the Cervix

cervical dysplasiaThe cervix is the lowest portion of the uterus and it opens into the vagina. It is covered by a tissue similar to that which lines the inside of your mouth. Near the opening of the cervix , there is a special area called the transformation zone that undergoes frequent cellular changes during a woman’s life. These changes make it the most susceptible area of the cervix to the effects of an infection with a virus known as HPV or Human Papilloma Virus which is the most common sexually transmitted infection in the world.

It is the exclusive cause of almost all pre-cancerous and cancerous changes of the cervix and studies indicate that by the age of 25, 80-85% of men and women are exposed to this infection. The reason that it is so common is because the infection has no symptoms – there is no itching, burning, bleeding, pain or discharge that accompanies it. So, since the people who have it don’t know it, they can easily and unknowingly transmit it when they have unprotected intercourse. Fortunately, the body’s immune system usually attacks this infection quickly and eliminates it before it can cause any harm.

The Immune System and Risk of Infection

However, in some circumstances, the immune system has trouble eliminating the infection and it begins to cause the disorder known as dysplasia which is a precancerous change of the cervix. There are several factors that increase the risk of the infection to result in dysplasia. One risk factor is the person’s age. For some reason, women over the age of 30 have a bit more difficulty eradicating the infection and are thus, more susceptible to dysplasia. Another factor is the strain of the virus that is infecting the cervix. There are about 40 strains of HPV that typically infect the genital area and 13 of these are called high-risk strains. These high-risk strains are more likely to cause prolonged infections and the subsequent pre-cancerous and cancerous changes of the cervix. Other factors that increase the risk of dysplasia and cervical cancer include smoking, HIV, low folic acid levels in the bloodstream and a vaginal bacterial infection known as bacterial vaginosis.

Causative Relationship Between HPV, Cervical Dysplasia, and Cancer

The causative relationship between HPV infections resulting in cervical dysplasia and cancer is certain. The way that this happens is the HPV-infected cells on the surface of the cervix begin to grow and develop faster. This is because HPV affects certain cellular growth control mechanisms. As these cells begin to grow faster, they reach the surface of the cervix in a more immature state. This stage of the disease is called dysplasia and there are three stages of this – mild, moderate and severe dysplasia– that are determined by how much of the surface cell layer of the cervix is involved with the immature cells.

If this growth and development is allowed to continue without either the immune system stopping it or without medical intervention, these surface cervical cells may begin to invade the foundation upon which they grow called the basement membrane. Once they pass through this barrier, cervical cancer is present and it may begin to spread to other areas of the pelvis or to other areas of the body through the bloodstream or the lymphatic system. Fortunately, this process of progression from dysplasia to cancer is generally very slow and these changes probably take 5-15 years after the causative HPV infection occurs.

Degrees of Cervical Dysplasia

cervical dysplasiaHere are representations of the differing degrees of dysplasia. Mild dysplasia consists of immature cells involving the inner third of the surface cellular layer. Moderate dysplasia involves two-thirds of its thickness and severe dysplasia is present when the entire cell layer is occupied by the dysplastic cells. Cervical cancer is present when the cells break through the basement membrane.

Pap Smears to Detect Cervical Dysplasia

Of course, no one ever wants to allow cancer to develop, so what can you do to detect dysplasia before it becomes cancer? The answer is to have a PAP smear performed at the appropriate interval that is determined by your doctor. The PAP smear detects dysplasia between 70 and 80% of the time and it is fairly accurate at determining the degree of severity. It can detect dysplasia because these immature cells tend to fall off of the cervix very easily. When a PAP smear is performed, it gathers a sample of the cells that are shedding from the surface of the cervix and then these cells are sent to a lab where they are examined under a microscope.

Dysplastic cells have distinct characteristics that make them look suspicious and when they are identified, the doctor will notify the patient that she needs additional testing to see where the dysplasia is located and how severe it is. This test is called colposcopy and involves a magnified view of the cervix after it is stained with vinegar which highlights abnormal tissue. If this is seen, a biopsy is performed that allows the doctor to determine the degree of severity of dysplasia.

Treatment for Cervical Dysplasia

The treatment of dysplasia is dependent upon these results. After decades of research, it has been determined that mild dysplasia has a tendency to regress spontaneously without any treatment whereas moderate and severe dysplasia have a greater tendency to progress toward becoming cancerous.

Therefore, if a patient has mild dysplasia, she will simply have PAP smears at more frequent intervals(q)to monitor for regression or worsening. If it regresses, which happens in the majority of episodes, PAP smears will be performed at their normal intervals once again. If it worsens, it is then treated in the same way that moderate and severe dysplasia are treated. Unfortunately, there are no medications available that treat dysplasia yet, so treatment currently consists of removal of the affected area of the cervix in order to eradicate the abnormality.

The most common excisional treatment is called a LEEP procedure which is typically done in the comfort of the doctor’s office. Occasionally, the dysplasia must be treated with a deeper excision known as a cone biopsy. This is done in the operating room. These treatments are very successful at eliminating dysplasia when its treatment is necessary.

HPV Interventions

Given the fact that HPV is so common, it is important to discuss the interventions that might prevent the infection altogether. The first step in prevention is to avoid having multiple sexual partners because each new partner represents an entirely new set of his or her past exposures. Another critical component of prevention is to have “safe sex” by always using a condom until a couple is in a mutually monogamous long-term relationship. This does not guarantee protection, but it is the best way to minimize genital HPV exposure.

A rather new and extremely important method of prevention is to receive the HPV vaccine if you are between the ages of 9 and 26. This vaccine prevents infection from nine of the most common cancer and wart-causing strains of HPV known as HPV. Although this vaccine provides fantastic protection, it is important to remember that there are over 30 other HPV strains for which they will not provide protection.

Education is Key in Prevention

Despite decades of attempts to educate people about these preventive measures, cervical dysplasia remains an incredibly common problem. That’s why PAP smears play such a vital role in women’s health. Since its development in 1927 by Dr. Papanikolau, the PAP smear’s ability to detect dyplasia and allow for its treatment has prevented millions of cases of cervical cancer and has saved millions of women’s lives in the process. So, when you are putting yourself through the uncomfortable process of sacrificing your modesty to undergo this test, be thankful that you have access to it because it is truly a test that has revolutionized women’s health for over 85 years.

Thanks for learning about this interesting topic. If you have any additional questions about cervical dysplasia or one of the HPV vaccines, please discuss these with Dr. McDyer or Dr. Suhrer during your visit. Schedule your annual pap smear today!

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Menopause: Treatments for Hot Flashes https://fwcjax.com/menopause-treatments-for-hot-flashes/ https://fwcjax.com/menopause-treatments-for-hot-flashes/#comments Thu, 27 Oct 2016 18:49:33 +0000 https://fwcjax.mvmg.site/?p=128 Approximately 85% of women experience hot flashes in the few years prior to menopause or after menopause. They can be quite disruptive to normal daily activities or to sleeping patterns as many women frequently experience them at night. However, there are many effective treatments for hot flashes that can alleviate this common menopause symptom. What […]

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Approximately 85% of women experience hot flashes in the few years prior to menopause or after menopause. They can be quite disruptive to normal daily activities or to sleeping patterns as many women frequently experience them at night. However, there are many effective treatments for hot flashes that can alleviate this common menopause symptom.

What Causes Hot Flashes?

The exact cause of hot flashes is uncertain, but it appears that the lower estrogen levels experienced in perimenopause and menopause may alter the body’s temperature control mechanisms in an area of the brain called the hypothalamus resulting in increases in the core body temperature. When the core temperature increases, the blood vessels at the skin surface dilate open to allow more blood to flow to the skin in order to expel body heat. This is why many women have extremely red skin during the hot flash and it results in the heat sensation which is frequently accompanied by profuse sweating. The heat sensation typically begins in the face or chest and it may spread throughout the entire body. It typically lasts between 2 to 30 minutes. A rapid heart rate may also accompany these symptoms. They may occur a few times per week or multiple times throughout the day.

Occasionally, they may create adverse consequences if they disrupt the sleeping pattern which may result in alterations of mood and impaired concentration. Fortunately, their intensity and frequency usually diminish as time passes.

Low estrogen → increased core temperature → increased blood flow to the skin

Treatments for Hot Flashes

The most effective treatment for hot flashes is estrogen replacement or hormone replacement therapy. It seems that providing estrogen normalizes the body temperature control mechanisms alleviating the hot flashes for the vast majority of women. Other medications that may help include antidepressant selective serotonin reuptake inhibitors, like Paxil, and a blood pressure medication called Catapres.

Herbal remedies that may help include plant-based estrogens called phytoestrogens and isoflavones in ginseng and flaxseed oil. The weak estrogens in these substances may also beneficially affect the body’s temperature control mechanism. Extracts from black cohosh root have been shown to help, too.

Additionally, certain lifestyle changes may help relieve hot flashes. These include avoiding caffeine, hot drinks, chocolate, spicy or hot foods and alcohol.

Some treatments are more effective than others and some have side effects that certain women may want to avoid. If you suffer from hot flashes, please discuss this with us so we can help you determine a personalized treatment plan that is right for you.

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