STDs

STD’s are common and occur in women of all ages. Many women with one are unaware because they have minor or no symptoms. They can occur in women with only one partner.

STD’s include diseases such as chlamydia, gonorrhea, herpes, genital warts, hepatitis, HIV, and syphilis. Many of the STD’s are treatable, but some are incurable. Abstinence, or no sexual relations, is the only way to prevent the spread of STD’s completely. Always use latex condoms if you choose to have sexual relations.

Cause

Most STD’s are spread through body fluids. Genital warts and herpes can be spread by skin to skin contact. Some women have no symptoms but can have the disease and pass it on to others. Symptoms in women may include: burning with urination, vaginal discharge, and genital cuts or sores. If left untreated, STD’s can cause infertility, chronic pelvic pain, or genital cancer.

More than 12 million Americans have some form of an STD. If you learn you do have an STD, you can take measures to free yourself of the disease; this will also help protect others who may contract the STD unknowingly. If you have questions and concerns about having an STD be sure to contact us here at Metroplex Women’s Care.

Risk Factors

  • Having had one or more sexual partners

  • Having a partner who has or has had more than one sexual partner

  • Having sex with someone with an STD

  • Having a history of STDs

  • Using intravenous drugs (injected into a vein) or your partner uses intravenous drugs

Reduce your risk
  • Know your sexual partners and limit the number

  • Use a latex condom every time you have vaginal, oral, or anal sex

  • Avoid risky sex practices that tear or break the skin

  • Get immunized-A vaccination is available that will help prevent hepatitis B

Types of STDs

Hepatitis

A severe infection of the liver that is caused by a virus, hepatitis B, and C can be sexually transmitted and spread by direct contact with the body fluids (vaginal fluids, blood, semen) of a person infected. Infection of hepatitis B has a chance of being prevented by a vaccine. However, there is no vaccine to prevent hepatitis C infection. Most people infected with hepatitis B or hepatitis C recover thoroughly. However, some develop chronic liver infections, which can lead to long-term health problems.

HIV Infection

The human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). The rate of HIV infection is increasing most rapidly among women who have sex with men. HIV enters the bloodstream through body fluids, usually semen or blood. Once inside the blood, the virus then invades and kills cells of the immune system-the body’s natural defense against disease.

HIV weakens the immune system, which can lead to AIDS. With AIDS, a person’s immune system is so weakened that other life-threatening conditions, such as infections or cancer may occur. Although there is no cure for HIV, treatment may prevent or delay the onset of AIDS, which can be fatal.

Genital Herpes

Millions of Americans carry the genital herpes virus. Sores around or on the genitals are the most common symptom of herpes. Appearing as red spots, bumps, or blisters, they can last from a few days to a few weeks. The virus remains in your body after symptoms go away, which often occurs by themselves. Treatment can help heal sores, but can’t kill the virus. Usually, the infection is transmitted to others without knowing it, so it is important to be tested.

Trichomonas

A microscopic parasite that is spread through sex is Trichomonas vaginitis. Although many people have not symptoms, the disease can be cured with treatment. Symptoms include discharge from the vagina and vaginal itching and redness.

 

Menopause

Menopause is a unique experience for each woman. There are women who experience little to no symptoms but most women notice some changes. The main difference that most women notice is their cycles changing.

 

 

Menopause

A lucky few note that their cycles get lighter and less frequent but most experience an increase in flow and duration. Luckily there are many ways to address this, ranging from medication to simple in-office medical procedures.

Changes

There can be other changes as well, body metabolism slows, and women often find that it is easier to gain weight. Hot flashes, night sweats, cold chills, moodiness, low libido, and sleep disruption can also occur. Sometimes these symptoms are mild and can be addressed with lifestyle changes, but many women find that they need to consider hormonal management. There are many options in this regard with no one size fits all solution.

Rockwall Menopause Specialists

Each woman will need to consider her concerns and needs. As a specialist in this area, we are very familiar with this problem and can review all of the options for improving quality of life. We understand how frustrating this period can be and are dedicated to doing everything we can to smooth this transition.

Hormones

Menopause is often perceived as the end of menstruation, but it also describes a long-term change in hormone production that signals the end of a woman’s ability to have children. The ovaries slowly decrease the production of estrogen and progesterone, and this disrupted balance of hormones can cause specific symptoms.

Hormone Replacement Therapy

Using prescription drugs to replace the hormones that the ovaries stop producing during menopause, hormone replacement therapy is usually effective in relieving menopause symptoms. However, there can be potential dangers, including the risk of blood clots, stroke, and breast cancer, so it is essential to speak with us to ensure all options are considered.

Some benefits and results acquired from pellet hormone therapy include:

  • Support for some menopausal symptoms

  • Regulation of bone density

  • Improved sleep patterns

  • Consistent sex drive

  • Depression relief

  • Reduced anxiety, irritability & mood swings

Symptoms

Most symptoms start during perimenopause, the first stage of menopause. Woman experiences differ widely by, and some women do not experience any noticeable symptoms at all. However, others have pronounced symptoms and intense discomfort, which may be lessened by working to re-balance hormone levels in the body.

  • Breast tenderness

  • Decreased libido (sex drive)

  • Fatigue

  • Hot flashes

  • Irregular periods

  • Mood swings

  • Sleeping difficulty

  • Urine leakage when coughing or sneezing

  • Urinary urgency (a pressing need to urinate more frequently)

  • Vaginal dryness; discomfort during sex

  • Worsening of premenstrual syndrome

Medication and Caution

Before taking medications or supplements be sure to contact us to ensure they will not interfere with medicines you are already taking. It is important to mention all medications and supplements but most important ones taken daily.

The U.S. Food and Drug Administration does not regulate herbal medications, use caution when taking any herbs or supplements. Make sure to stop taking herbal supplements immediately and get medical attention if you experience hives, difficulty breathing or confusion. Do not take more than the recommended dosage of any medication or herbal supplement.

Laparoscopy

A Laparoscopy is best described as a procedure where a light thin instrument with a camera is inserted, through a small incision made near the navel, that allows visualization that would normally require larger incisions.

Uses

  • Check for and/or remove abnormal growths (such as tumors) in the belly or pelvis.

  • Check for and/or treat conditions such as endometriosis, ectopic pregnancy, or pelvic inflammatory disease (PID)

  • Diagnose conditions that possible make it difficult for women to become pregnant. These conditions include fibroids, cysts, adhesions, and infection. Laparoscopy may be done if initial infertility tests do not show the cause for the infertility

  • Biopsies

  • Check for cancer in other areas of the body that has spread to the belly

  • Check for damage to internal organs, such as the spleen, after accident or injury

  • Do a tubal ligation (permanent birth control)

  • Fix a hiatal hernia or an inguinal hernia

  • Removal of organs, such as the uterus, spleen, gallbladder
    (laparoscopic cholecystectomy), ovaries, or appendix (appendectomy)

  • Partial removal (resection) of the colon

  • Finding cause of sudden or ongoing pelvic pain

Recovery Time

Recovery from small laparoscopic incisions is more rapid. Patients are typically discharged the same day of the surgery or at the most kept overnight for observation and then released the next day. The recovery time after a laparoscopic depends on the surgery.

Medical science has given you many choices when deciding the method for your procedures and laparoscopy helps make that procedure safer with quicker recovery. Give us a call or contact us today to discuss the most ideal method for you.

Da Vinci Robotic Surgery

In traditional surgery, there is a video screen that must be referenced while performing surgery and causes the surgeon to look away from his or her hands and perform the surgery by subsequent viewing. This is avoided with the use of Da Vinci Robotic Surgery.

Da Vinci Robotic Surgery is handled by a console with four interactive robot arms which are controlled by the console, and the surgeon may remain seated and stable, aligned with the instruments. To move the robotic arms, the surgeon must only move his or her arms.

Office Surgery

One Friday each month an anesthesiologist brings in his crew of nurses and a mobile Operating Room to our office. Typically we complete between 5 to 8 office surgeries that day.

Transportation to the office is not available so, please have someone able to drive you to our office and home. An IV is given as well as IV sedation for procedures; this will allow you to sleep during your brief procedure. Once the procedure is complete, you can wake up quickly from the sedative and can then be driven home by your driver.

Common Procedures

  • Endometrial Ablations (treats the inside lining of the uterus eliminating or reducing menstrual blood flow) such as Novasure and HTA.

  • ESSURE (permanent birth control)

  • LEEP (loop electrocautery excision procedure) for pre-cancer cells on the cervix

  • Dilation and Curettage (D&C) in select cases.

Infertility

If you attempted pregnancy for 6-12 months and have not become pregnant, you may need an evaluation as a couple. The initial work-up for infertility includes physical exam and current PAP smear.

You will need some blood work timed during your cycle. Your partner will need a semen analysis. The final piece of the work-up will evaluate the uterus and fallopian tubes. You will need either an HSG (hysterosalpingogram) or laparoscopy to complete your work-up.

If at any time during the work-up something is abnormal we will need to address that before going on to the next step. We manage anovulation with oral infertility medicine. We do not do injectables or IVF. We can refer you on to an infertility specialist if this is necessary.​

Obstetrics

Prenatal

A variety of factors contribute to having a healthy baby, and they all start well before the delivery. Many questions should be asked about what is appropriate for your growing baby. Rockwall female health doesn’t come any more personal and professional than at Metroplex Women’s Care. Precautions are also essential to make sure your baby is born healthy and safely. The following are our tips for a healthy pregnancy.

Diet

  • No soft, aged or unpasteurized cheeses (Feta, Brie, Blue or Queso Fresco)

  • No lunch meats (deli) unless heated or steamed (pan-fried, microwave or broil) You may have ham, turkey, and chicken

  • No Sushi or raw meats

  • No more than 12 ounces of cooked/canned fish in one week

  • No Sweet n Low

  • Due to a higher concentration of mercury found in Shark, Tilefish, Mackerel Swordfish and Albacore tuna, please limit consumption of these foods

  • Please limit caffeine and aspartame to no more than one serving daily

Activity

  • No hot baths, hot tubs or saunas

  • No high impact exercise

  • No tanning beds or self-tanning lotions

  • Do not change your cat’s litter box

  • Avoid lifting anything weighing more than 25 pounds

  • Use gloves and scooper if cleaning up after your dog outside

  • Beginning your 30th week, you should not travel more than one hour away

  • You may perm and color your hair

  • You may use water based and oil based paints if in a well-ventilated area

Exercise

  • Healthy women(nonexercisers and moderate exercisers) should begin or continue moderate-intensity aerobic activity during pregnancy at least 150 minutes a week.

  • Women who exercise vigorously may continue their exercise provided they remain healthy and hydrated

Do Not Exercise If:

  • Your doctor advises against exercise

  • You have previous preterm delivery before 34 weeks

  • Vaginal bleeding

  • Complications of pregnancy

  • Placenta problems

  • Baby not growing well

 

Medications

The following medications are safe to take while pregnant for their respective symptoms, for questions about any of these medications, please contact us.

• Pain Relievers

 – Regular Tylenol

 – Extra Strength Tylenol

*No Aspirin or Ibuprofen Products

• Leg Cramps

 – Caltrate

 – Calcium

• Nausea

 – Emetrol

 – Nestrex

 – Dramamine

 – Small, Frequent Meals

 – Ginger Snaps/Ginger Ale

• Antacids

 – Maalox

 – Tums

 – Mylanta

 – Pepcid AC

 – Zantac 150

• Sinus Drainage/Allergies

 – Benadryl

 – Claritin

 – Claritin D

 – Zyrtec

 – Zyrtec D

 – Mucinex

 – Chlor-trimeton

• Nasal Decongestants

 – Sudefed

 – Sudafed Plus

 – Afrin Nasal Spray

 – Ocean Nasal Spray

• Cough

 – Robitussin (not CF or DM)

 – Mucinex (not DM)

• A sore Throat

 – Salt Water Gargle

 – Cepstat Throat Lozenges

• Anti-Diarrhea Agents

 – Imodium

 – Kaopectate

• Yeast Infection

 – Monistat

 – Gyne Lotrimin

• Constipation

 – High Bran Diet

 – Metamucil

 – Surfak

 – Senokot

 – Colace

 – Miralax

• Hemorrhoids

 – Preparation H

 – Anusol HC

 – Sitz baths

 – Tucks Pads or wipes

 

Delivery

Intimate, and sometimes stressful, childbirth is a unique experience for every woman. These are some of the options that you have during delivery.

Laboring Options

  • Music

  • Natural Delivery

  • Birthing Ball

  • Various Position

  • Epidural if Desired

Delivery Options

  • Vaginal Birth

  • Cesarean Section

Vaginal delivery is the most common birthing option; however, every experience is catered to specific needs of the mother and the circumstances during the birth. These help to establish a comfortable, relaxing and peaceful atmosphere.

Postpartum

After giving birth, it is crucial to not only take care of your newborn bundle of joy but also yourself. During the first few weeks after you give birth, you will want to monitor your diet, activity, breasts and vaginal healing. We will discuss methods and ways to best take care of yourself before and after the delivery, just another way we provide Rockwall family planning for countless women.

You need to be seen for a postpartum visit six weeks after delivering; it is best to schedule this appointment as soon as possible. If delivery were done via cesarean section, you would need to plan both your delivery and postpartum appointments at the same time. This ensures that the six-week followup date is met. The following are tips are guidelines to follow after giving birth:

Diet

  • Maintain a nutritious diet especially if breastfeeding.
    Everything the mother eats will end up in the breast milk within two to four hours after consumption. This will affect not only the taste of the milk but also the baby’s health.  Intake plenty of fluids throughout the day, to help produce an ample supply of milk.

  • Drink plenty of water.
    Women who had episiotomies, or experienced perineal tearing during delivery may experience some pain during bowel movements. Drinking plenty of water and also maintaining a high fiber diet will help to keep stools soft.

 

Activity

  • Gradually increase activity each day.
    After the first couple of days home from the hospital, it may still be challenging to move about, by increasing activity each day gradually; your body should feel back to normal within around six weeks. Light exercise is appropriate after two or three weeks after the delivery. Please note, however, abdominal activities should be avoided until approved by a healthcare provider.

Breasts

  • Breastfeeding Best Practices
    For breastfeeding mothers, the most important consideration is whether or not the baby is latching on appropriately.  If not latching on correctly, the baby may not feed well and may cause tenderness to the nipples. To help your baby into the proper latching position, bring your baby to your nipple without leaning down to reach the baby. Put a pillow on your lap and rest the baby on this elevated surface. This will help put the baby at breast level. Then you will want to gently stroke your nipple across the baby’s cheek until the mouth opens. Let your baby take your nipple, and most of your areola, about an inch deep into his/her mouth.

    Even if not breastfeeding, wearing a firm and supportive bra is recommended. This helps alleviate tenderness in the breasts.

  • Complications
    If there are any complications while breastfeeding, please contact us.  Cracked or bleeding nipples are common for breastfeeding mothers, but localized tenderness, hardening, or redness of the breast, along with experiencing fever or flu-like symptoms, could suggest signs of mastitis.

Vaginal Healing

  • Taking care and signs to watch out for
    The body undergoes a significant amount of stress during pregnancy. It is vital for proper postpartum care to be taken for approximately six weeks until the body is back to normal and all wounds are healed. Vaginal bleeding is normal for around two to six weeks after the delivery.  The flow gradually lessens and becomes darker in color. Avoid using tampons, stick with sanitary napkins instead.  If persistent bleeding does continue, and you have to change pads every hour, contact us. You should also contact Metroplex Women’s Care should there be a foul-smelling vaginal discharge or passing of golf ball-sized blood clots.

  • Treatment of Soreness
    Women who undergo episiotomies, or perineal tearing during delivery, will experience different levels of vaginal soreness.  To alleviate pain or tenderness, place an ice pack, or a chilled witch hazel pad between a sanitary napkin and the wound.  The wound should always be kept clean. After urination or bowel movements, the area should be rinsed clean, and patted dry; pouring warm water over the wound during urination may also help soothe the pain.

 

Gynecology

Highly recommended for all women, annual exams are the perfect opportunity to ask questions or concerns you may have with your body.

Annual Exams

  • Breast exam

  • Pelvic exam

  • Pap smear

  • Evaluation of menstrual history and current lifestyle

If it is necessary, you will be recommended for specific screening tests, including colon cancer, breast cancer, and cervical cancer. You will be responsible for scheduling these screening tests, as well as additional laboratory tests we may recommend. If there are abnormalities found in the test results, you will be phoned. Other arrangements can be made for receiving your test results, just let us know what is most convenient for you. You are welcome at any time to call for your test results, but it will take at least seven business days following the test date before we receive your results. All of our regular test results will also be mailed directly to you.

Hysterectomy

A procedure to remove the uterus, a Hysterectomy is performed for a variety of reasons including:

  • Control heavy menstrual bleeding

  • Resolving pain associated with endometriosis

  • Prolapse of the reproductive organs.

Traditionally hysterectomy was performed through a total vaginal approach or an abdominal incision. The laparoscopic procedure gives a much quicker recovery time and has fewer complications.  Patients undergoing laparoscopic hysterectomy are typically discharged the next day, while abdominal hysterectomy patients may require 2 or 3 days in the hospital. They may also have a longer post-operative recovery time. Most women elect to keep their ovaries to avoid immediate menopause. For information about our various other procedures accomplished through laparoscopy click here.

Urinary Incontinence

The accidental or involuntary loss of urine that is usually due to weak muscles in the urinary tract.  There can be several factors that contribute to incontinence including primarily vaginal birth, and menopause that is due to decreased levels of estrogen.

Factors can also include neurological, gastrointestinal and pulmonary disease, nervous system disorders, smoking, obesity. Caucasian females are most likely to be affected by urinary incontinence.

The Numbers

There are reportedly 13 to 25 million people in the United States affected by urinary incontinence. However, this number is a low estimate; many cases are not reported because of embarrassment or the belief that there may not be a treatment. We offer comprehensive treatment for urinary incontinence in Rockwall, so please give us a call if you are currently suffering from or have questions regarding urinary incontinence.  We provide office-based treatments and surgical-based options so give us a call to find out which is best for you

Types

Stress Incontinence (SUI)

Stress incontinence is an accidental loss of urine, released upon intraabdominal pressure; this can occur when walking, sneezing, coughing or laughing.

Urge Incontinence/Detrusor Instability (DI)

Also known as detrusor instability, this is the involuntary loss of urine associated with a strong, abrupt, and often uncontrollable desire to urinate.  The detrusor is the smooth muscle wall of the bladder when it experiences over activity the result is incontinence.

Urge Incontinence/Detrusor Instability may be related to conditioning.  One such case may be people when they are out all day are continent, but when arriving home are unable to control sudden urges due to familiarity with routine urination.  People with DI may also experience an urge when they see a bathroom or hear the sound of running water.

Mixed Incontinence

When people experience both stresses (SUI) and urge (DI) incontinence symptoms, they have what is known as mixed incontinence.  40% or more of women experiencing incontinence suffer from mixed incontinence symptoms. If you happen to be one of them give us a call or contact us here.

Overflow Incontinence

This occurs when small amounts of urine escape a constantly full bladder without feeling the urge to urinate. This most commonly happens when women stand, bend, or exert themselves. It is very common for women with a large cystocele and could also be caused by under activity of the detrusor muscle.

Procedure

Metroplex Women’s Care offers Rockwall female urinary treatment through extensive diagnosis and treatment. Proper diagnosis is achieved through:

  • In clinic evaluation

  • Daily diary tracking spontaneous voids over a 1 to 3 day period

  • Physical examination of the lower urinary tract

  • Urinalysis and culture – a clean, midstream urine sample

  • Formal office Urodynamics.

Treatment

Stress incontinence can be treated by behavioral modification, surgical management or pharmacological treatment. Women with urge incontinence are best treated by behavioral techniques or medications. Our treatment plans offer the least invasive approach first, surgical options are reserved for women who decline, or don’t improve following conservative management. There are numerous products available providing security against unplanned voids including protective perineal pads. These products are only temporary fixes however and will not cure the problem.

Incontinent women should always avoid excess fluid intake and should limit their intake to about 2 liters a day. Caffeinated beverages should not be taken at all or at least reduced to no more than 8 ounces per day.