Women's Health: everything you Need To Know
Motherhood - Obstetrics and fertility
When it comes to reproductive health - whether the aim is to prevent or achieve pregnancy - communication and preparation are key, says Christina Han, MD, director of Maternal-Fetal Medicine at UCLA Health. It is a recommendation that every person consider reproductive planning.
For anyone who is pregnant, particularly those with medical concerns, it will be helpful to have realistic expectations about the future and their present timelines. For clinicians providing medical care, assessing every patient with a reproductive lens will help connect them with an obstetrician-gynecologist, or for those at higher risk, with maternal-fetal medicine, in a more timely manner," Dr. Han says, "which can potentially affect how their entire future pregnancy will evolve."
Getting pregnant and maintaining pregnancy are potentially complicated processes, she adds, that involve anatomical, hormonal and metabolic changes. Dr. Han states that these are topics that are not taught to laypeople, discussed in community and sometimes stigmatized. She cites miscarriage , adverse pregnancy outcomes and other issues. Being open with your obstetrician, communicating early and looking for resources can reduce anxiety.
Gynecologic care: Menstruation, menopause, and beyond
A yearly well-woman exam is an important component of overall health care, regardless of a woman's age or fertility status. From the reproductive years through menopause and beyond, this annual gynecological visit is "an opportunity to make sure any symptoms a woman is experiencing - and findings on the breast and pelvic exam - are normal. Andrea J. Rapkin MD, says that if they aren't normal, any concerns can be addressed immediately or at a later visit.
While cervical cancer screenings (Pap smear) are no longer recommended annually for women with a history of normal results, a yearly visit to a gynecologist can cover a range of issues, from painful periods and premenstrual syndrome to sexual functioning, screening for sexually transmitted infections and contraceptive needs, Dr. Rapkin says: "Any concerns about overall breast, pelvic, vaginal or vulvar health can be addressed." Women should continue these annual exams even after menopause to discuss such potential symptoms as vaginal dryness, urinary urgency, pain during intercourse, mood alterations and sleep problems.
"The well woman exam visit in general does not cover the above issues in depth. "Take into account that Dr. Rapkin may recommend additional visits to help you delve deeper into some of these concerns," she says.
Family Planning: Pre-conception and contraception services
Amy Stoddard MD, MD, suggests optimizing your health prior to trying to conceive. You can do this by changing to pregnancy-friendly medications, getting your blood pressure and weight in order, and looking at family history and medical risk.
According to Dr. Stoddard, it's important to monitor menstrual cycles in order to detect irregularities. This can be a sign that there may be an underlying medical condition that makes it harder for women to have children.
Prenatal vitamins should be taken at least one month prior to trying for a baby by a woman who has regular periods and is free from any other health issues. According to her, prenatal vitamins are important for ensuring that a woman's folic acid level is high when she conceives.
Even women on birth- control pills who are thinking about getting pregnant can begin taking prenatal vitamins quitting their contraception. No "wash-out" period is required to return to fertility after using birth control pills or other hormonal contraceptives, Dr. Stoddard says. "A woman can use the contraceptive method of her choice until the month she desires to conceive." One exception is the Depo-Provera shot, which can delay fertility for up to six months after injection. Make an appointment with a UCLA Health Family Planning Expert
Breast health: Mammogram and screening
Breast cancer is the most common cancer in women second only to skin cancer. Breast cancer screening is vital to early detection and improved patient outcomes. Screening modalities traditionally include breast self exams, breast awareness, clinical breast exams and breast imaging.
Routine clinical breast exams by a healthcare provider are offered starting at age 25. In addition, patients are encouraged to develop "breast awareness at home," rather than practice monthly self exams, says Jacqueline Fahey, MD. "Essentially, breast awareness is where women have a sense of the normal appearance and feel of their breasts, so they would be aware if they happen to notice a change. Then you would reach out to your OB-GYN provider, so we can do a thorough, systematic exam of the breast and, if needed, order breast imaging."
Routine mammography typically starts at age 40, though women who are low risk for breast cancer may elect to begin these exams later. We recommend women who have not started mammography before age 40, to do so by the age of 50.
Mammograms are recommended every one to two years until age 75, when a woman and her physician can discuss the pros and cons of continuing the screenings. Start the journey to early detection
Bladder health: Center for women's pelvic health
"The biggest risk factor for pelvic floor dysfunction is childbirth ," says Amy Rosenman, MD. "We want women to know that they can have certain problems right after childbirth that can heal without any intervention. Sometimes they may need minor treatment. You might need to intervene if they have serious problems. We're here for any intervention." Exacerbating risk factors during childbirth include episiotomy or laceration, pushing for more than two hours and forceps delivery, Dr. Rosenman says.
Pelvic floor disorders include bladder issues, vaginal prolapse and problems with defecation. The first options for patients younger than 40 years old are conservative and nonsurgical treatments. This may include pelvic floor physicaltherapy or a pessary system. Corrective surgery is possible for more serious cases and for women after menopause.
One obstacle to treatment is the embarrassment factor, Dr. Rosenman says, adding that she encourages her medical trainees to facilitate the conversation with women. She says, "Patients need to be empowered to raise it because they have specialists trained in helping them." It is important to intervene. Get in touch with one of our Pelvic Health experts today.
Treatment and Prevention
Ritu Salani MD says that HPV vaccination is a good way to lower your risk for endometrial or cervical cancers. This vaccine is usually administered between the ages of 9 and 26. Although it's not meant to replace pap testing and HPV screening, it can significantly reduce the risk.
Screening tests are not available for ovarian and uterine cancers. It is important to understand your family history, including whether or not any of your first-degree relatives have been diagnosed with cancer. Genetic testing is recommended if there are significant family histories.
Gynecologic cancers can present as abnormal bleeding, especially postmenopausal bleeding. "A lot of women attribute these symptoms to age, weight gain , or changes in diet, but one of the things about ovarian cancer, particularly, is it has vague symptoms," Dr. Salani says.
UCLA Health offers a number of gynecologic specialists to help with these kinds of cancers. There is also a new survivorship program for patients to assist them in recovery and maintaining their health. More information on UCLA Health's services and prevention.
Surgery for women's health: Minimally invasive gynecologic surgery
Gynecologic surgery that is minimally invasive can be performed for various conditions, such as endometriosis or fibroids . This will allow for faster recovery and reduce the need for medication. Valentina Rodriguez Trina, MD, says that it is important to try and perform a patient's procedure using minimally invasive methods. Patients can often leave our office the same day for many of our procedures.
She says that minimally invasive surgery techniques can also be used to prevent pregnancy (sterilization), and affirm gender for transgender people. Laparoscopy, robotics and even hysterectomies are possible.
Dr. Rodriquez Trina states that there are many surgical methods available to treat different types of pathologies. "And while not everybody would be a good candidate for these types of techniques, every woman should ask if this is the surgical route she should take. Because we know the recoveries are safer and faster for women to get back on their feet." Find out if a surgical route is right for you
The attendees could get eye exams, screenings for teeth, and blood pressure checks.
These are some things to keep in mind when you're researching family plans.
"I don't want trauma response to be a one-off"