Breast Pain and Issues
Breast pain, or mastalgia, is a fairly common problem with many causes. These include hormonal changes that occur just prior to the menstrual cycle due to fibrocystic breast changes, early pregnancy-related changes and infections. Other common causes are medications such as birth control and breast cysts. Additionally, after pregnancy, the breasts may become engorged with milk often resulting in breast pain and fevers. Rarely, breast pain may be a sign of breast cancer.
Breast masses are fairly common and are usually not cancerous. Common causes of breast masses include fibrocystic changes, which is a thickening of the breast tissue, and breast cysts. Fibroadenomas are another fairly common benign breast masses that result from excessive growth of both glandular and connective breast tissue. Breast cancer may also cause breast masses. It is typically a very firm and irregular mass.
Breast leakage may be a sign of a breast problem, but there are several normal causes of breast leakage. Obviously, it is normal in women who are pregnant or breastfeeding. In non-pregnant women, breast stimulation or expression may cause a normal nipple discharge. As long as this is not bloody, it is considered normal. Leakage may also be a sign of infection. If bloody fluid is noted or if fluid leaks without breast or nipple stimulation or if there is associated pain, a gynecologist should be consulted to evaluate this problem.
Pelvic Pain and Conditions
Pelvic pain is a common problem experienced by many women at some point in their lives. There are many causes such as urinary tract infections, an ectopic pregnancy, ovarian cysts, menstrual cramps, uterine infections, tubal infections (PID), endometriosis, adenomyosis, appendicitis, bladder infections, kidney stones, adhesions from prior abdominal surgeries, hernias, and, less commonly, cancer of the cervix, uterus or ovaries. A gynecologist can obtain a patient’s history and perform an exam that will help identify the cause so that a treatment plan can be developed to alleviate the pain.
A PAP smear is a screening test for precancerous and cancerous changes of the cervix. It is obtained when the doctor looks into the vagina with a speculum which is an instrument that holds the vagina open so that the cervix and vaginal lining can be seen. A small plastic device is then used to gather the shedding cervical cells that are sent to the lab to be evaluated for abnormalities. Other problems like infections and cervical polyps can be detected during this exam. This exam typically takes about 20-30 seconds, should not hurt and is an extremely important part of a woman’s wellness health plan due to the extremely common occurrence of pre-cancerous changes of the cervix.
Bladder infections are a common cause of pelvic pain. Symptoms of a bladder infection are frequent urination, painful urination, low back pain, foul smelling urine and a sense of urgency to urinate with only small volumes being eliminated. The infections usually occur when bacteria that live in the vaginal and anal areas enter the bladder through the urethra. Chlamydia, gonorrhea, and trichomonas can also cause bladder and urethral infections. Bladder infections are more common in pregnancy and after sex. The risk of developing bladder infections can be reduced by drinking plenty of water in order to keep the urine and bacteria flowing out of the bladder, urinating when the first urge occurs, urinating after sex and by wiping from front to back after urinating. If bladder infections are not treated, they may occasionally spread to the kidneys which can be much more serious. Also, bladder infections may often be confused with certain vaginal infections, so if you develop these symptoms, see your gynecologist as soon as possible so that the exact cause of the symptoms can be identified and treated properly.
Vaginal and Vulvar Infections
Vaginal and vulvar infections can also cause pelvic pain. Common infections of the vagina and vulva include yeast, bacterial vaginosis, trichomonas, syphilis, aerobic vaginitis, herpes and Group B Strep vaginitis. Symptoms of these infections include pain, discharge, odor and sores. Many of these infections have similar symptoms, so it is important to see a gynecologist to identify the exact cause so that proper treatment may be administered.
Sexually Transmitted Infections
Sexually transmitted infections include chlamydia, gonorrhea, trichomonas, syphilis, herpes, HIV, and Human Papilloma Virus (HPV). There are a few others, but they are extremely rare in the United States. All of these infections can have devastating health consequences for the infected individual. The most common of these infections is HPV which infects about 80%-90% of sexually active men and women by the age of 25. It is the cause of precancerous and cancerous changes of the cervix, vagina and vulva and is now the number one cause of head and neck cancers and anal cancer. Chlamydia, gonorrhea and trichomonas infections can cause tubal damage resulting in fertility problems. Syphilis can also cause permanent health problems and death if it is unrecognized and left untreated. Herpes is an extremely common life-long infection with 15%-20% of sexually active people estimated to be infected. HIV is also a life-long infection that results in premature death.
Risk factors for developing these infections include having sex with more than 1 partner in a lifetime and not using condoms for protection during sex. The best way to protect yourself from these infections is to first realize that sexual activity can have extremely severe health consequences if one or more of these infections is acquired. So, in order to reduce your risk, you should limit your sexual partners to as few as possible and always use condoms for protection. They are not perfect, but they do reduce the risk. Also, if possible, you and your partner may want to consider being screened for STD’s before taking the next step into sexual activity in your relationship. Additionally, a significant proportion of HPV infections can be prevented with the HPV vaccine which is available for men and women between the ages of 9 and 26.
If you are concerned that you may have been exposed to one of these infections or if you have questions about them, see your gynecologist as soon as possible for proper treatment and/or counseling.
Fertility problems are another common reason that women may visit an OB/GYN. A fertility evaluation should be considered when a couple has not conceived after six months of efforts. There are numerous causes for fertility problems including hormonal problems resulting in anovulation (no egg production), infections, tubal damage, endometriosis, fibroids, polyps and inadequate sperm. Initial evaluations to help identify the cause(s) of infertility include gathering a medical and gynecologic history, a physical exam, blood tests, ovulation predictor kits and semen analyses. Other tests that may be performed include a hysterosalpingogram (HSG) to see if the tubes are blocked and surgical evaluations of the pelvis and uterus with laparoscopy and hysteroscopy. The vast majority of couples who experience trouble conceiving will be successful after the problem is identified and treated. If you are experiencing fertility problems, we, at Florida Woman Care of Jacksonville, will be privileged to evaluate your situation and are excited to help you succeed in growing your family.
Approximately 40% of women experience involuntary urinary leakage known as urinary incontinence. It is an embarrassing problem that can significantly disrupt a woman’s lifestyle. Unfortunately, the majority of women suffer in silence because they are embarrassed to discuss it because they think it is a normal part of aging or because they think surgery is necessary to fix it. Fortunately, if patients will discuss it, most cases can be cured or markedly improved without surgery after the underlying cause is identified. Common causes of urinary incontinence include bladder infections, urethral diverticula, bladder, rectal and urethral support problems, bladder spasticity, pregnancy, neurological problems and weakness of the pelvic floor muscles. If you suffer from urinary incontinence, we, at Florida Woman Care of Jacksonville will identify the cause and develop a treatment plan with the goal of eliminating this embarrassing problem.
At Florida Woman Care of Jacksonville, women’s health is our expertise and we excel at evaluating and educating patients about their health conditions and options for treatment.