http://www.chesterfieldmonthly.com/index.php/health/medical-politics

The ‘pill’ as it is known has been commercially available in this country for 50 years. It’s primary use is for contraception; and, has provided women the opportunity for controlling when they get pregnant, advancing their ability to have careers outside the home. As a public health perspective, the fewer unintended and unplanned pregnancies there are, the lower the number of maternal deaths associated with pregnancy. The lifetime risk of dying in pregnancy is probably </= 1:1000 in this country; in the 3^rd world it is closer to 1:30.

Between WW 1 and WW 2 hormones were first discovered, and subsequently research focused on extraction compounds from plants instead of from animals. The precursor to modern day contraceptives as we know them, was the use of progesterone for inhibiting ovulation in infertility patients,; and, the first use of a combined estrogen/progesterone pill was for treating menstrual disorders followed in a few years by a lower dose combination approved by the FDA for pregnancy prevention.

With the passage of time, lower and lower doses of estrogen and progesterone combinations have been produced and marketed without a significant reduction in effectiveness. In addition, low dose progesterone only pills are available as well. Typically pills come with different pill-free intervals (placebo pills) to allow for a withdrawal bleed(menses) from 2-7 days. Others are packaged for continuous use for several months between these placebo intervals. Also available is a ‘mini’ dose progesterone only pill.

The pill is also used to treat women with menstrual irregularities to control frequency and flow of cycles; used frequently at the onset of menstrual function in teenagers and peri-menopausal women later in life

The primary method of action is ovulation prevention.  Another explanation for prevention of pregnancy is the change in cervical mucous inhibiting sperm penetration; this is especially true for the progesterone only pill.

Many patients will do well with any pill; others do better with some as opposed to others. In general most experience a decrease in menstrual flow; breast symptoms associated with their cycles; while others report pregnancy like symptoms with initial use; e.g. nausea, breast soreness and/or skin changes.

Women with a history of heart disease, history of blood clots, coagulation abnormalities, other cardiovascular diseases, breast cancer or liver disease should not use the pill.

It is reported that for any complication with the pill, that same risk in pregnancy is 9 times greater.

Many of the reported side effects of the pill are unsubstantiated by research with conflicting data on the pros/cons of these issues. Therefore, each patient has to be evaluated based on their symptoms and complaints, if any.

The newer generation of hormonal therapies include the patch, vaginal ring and dermally implanted devices.

Without getting into a discussion of the political debate surrounding pill usage, it is safe to say that the pill is a significant contribution to the improvement in women’s well being, health and quality of life as compared to the first half of the 20^th century.

(this overview/synopsis facilitated by texts and Internet review-the information can be found in more detail there).

The wellness forum will feature Dr. Peter Murchie on Thursday, February 9, 2012.  The event takes place at 114 Broad Street, Suite C.  The forum is free to the public and starts at noon.  A free lite lunch will be provided by Silver Diner.

To attend the forum please RSVP to rburns@vaphysicians.com.  Be sure to bring a friend!  See you there!

http://news.brevardtimes.com/2011/12/walmart-recalls-enfamil-baby-formula.html

The top 3 raffle prizes are:

First Prize:  $50 Visa Gift Card

Second Prize:  $25 Gift Card to La Cucina Ristorante

Third Prize:  $25 Gift Card to Rituals Salon Spa

Shannon E. Brim, MD, although born into a military family, has spent most of her life in Virginia.  She went to Virginia Tech for college and considers herself a Hokie through-and-through.  After graduating, she attended The University of Virginia for medical school where she stayed to complete her residency.  She is married and has two young sons.  She enjoys all aspects of obstetrics and gynecology but is especially fond of caring for pregnant women.  She is fluent in Spanish and enjoys integrating this into her medical practice.  When not working, she likes spending time with her boys, traveling, reading, and cheering on the Hokies.

Jennie E. Draper, MD, is originally from Bridgewater, VA in the Shenandoah Valley and first moved to Richmond for medical school.  She is excited to be returning to the area after completing her residency in the northeast.  Her special career interests include international medical missions, adolescent medicine, and minimally invasive surgery including the da Vinci Robot.  She has been recognized for her teaching skills. Outside of work Jennie’s hobbies include running, cooking and photography. She also loves travelling and spending time with friends.

Jonelle U. Haigh, DO, was born and raised in the Upper Peninsula of Michigan.  After graduating from Western Michigan University she attended medical school at the Virginia College of Osteopathic Medicine at Virginia Tech.  There she met her husband, Aaron.  The two of them moved  to the Detroit suburbs of Michigan to complete their residencies, but Dr. Haigh is now very excited to return to warmer climates.  In her spare time, she loves reading, shopping, traveling, and the outdoors.  She enjoys all aspects of obstetrics and gynecology with special interests in family planning and endometrial ablation.

Please call 804-897-2100 to schedule an appointment.

]]> http://vpfw.com/blog/?feed=rss2&p=262 0 http://vpfw.com/blog/?p=260 http://vpfw.com/blog/?p=260#comments Fri, 12 Aug 2011 20:06:35 +0000 admin http://vpfw.com/blog/?p=260 We are pleased to announce, that effective Monday, August 15th, 2011, VPFW has relocated to 2025 Waterside Road Suite 100, Prince George, VA 23875 (Map It).

Directions: Patients coming from Hopewell, Fort Lee, Prince George should take Temple Avenue to the light at Puddledock Road and turn left at the light. Take the first left right past Burcham Cycles and then an immediate right. There will be three buildings which are alike and we are in the middle building (one story brick buildings). We are in the same general area as the Unos and Lowe’s.

Patients coming from 95 should take the Temple Avenue exit and make a right at the end of the exit ramp onto Temple Avenue. Continue on Temple Avenue past the mall, past Arbys, past Harley Davidson and then make a right at the next light onto Puddledock Road. Take the first left immediately after Commonwealth Powersports and then an immediate right. There will be 3 identical one story brick buildings and we are in the middle building.

Please make note that our office at 280 Charles Dimmock Parkway, is now closed. For all appointments please visit our new location.

VPFW

The raffle ends at midnight on June 30. If you are unsure on how to use @mentions there is a How-To-Guide below.

To use Facebook’s @Mention feature, go to your profile page and type an “@” before the name of your Facebook friends in your status message.
Next, a drop-down menu will appear listing Facebook friends with similar names. Click the corresponding Facebook friend to continue to link their Facebook profile to your status message.
A copy of your status message will automatically appear on your friend’s Facebook wall, in addition to being visible to all your Facebook friends.
Good Luck Everyone!

For updates on other things happening at VPFW please visit our facebook page www.facebook.com/vapfw

Bleeding in a menopausal woman may arise from the uterus, cervix, vagina, or vulva, or from non-genital sites such as the urethra or rectum. The most common causes include atrophy(thinning of the lining of the uterus or the vagina due to low estrogen levels), endometrial(intrauterine) polyps, and uterine cancer or uterine hyperplasia(thickening of the uterine lining). It is important to note that 95% of cases of postmenopausal bleeding arise from benign causes. However, since the incidence of uterine cancer increases with age, it is a more common diagnosis in older women with bleeding. Endometrial adenocarcinoma is the most common genital cancer in women over age 45, thus much of the diagnostic evaluation will be directed towards ruling out this malignancy.

When visiting their gynecologist, women who present with postmenopausal bleeding will be asked questions about the onset and duration of bleeding, the possibility of trauma or association with sexual activity, and the presence of other symptoms and signs such as fever, pain, and change in urinary or bowel habits. In addition, they should be prepared to report all medications recently taken, especially hormones and blood thinners.

A thorough physical examination will be carried out, to examine the vulva, vagina, and cervix for lesions or atrophy, and to determine the shape and contour of the uterus and ovaries. A pap smear will be performed, if not up to date. If an obvious source of bleeding other than the uterus is not determined, then further evaluation of the uterine cavity is warranted. This may include an endometrial biopsy, to obtain a tissue sample from the uterine lining, a transvaginal ultrasound, or both. If either test is non-diagnostic, raises the suspicion of malignancy, or if there is persistent bleeding in spite of a negative in-office evaluation , an outpatient surgical procedure called hysteroscopy, which directly visualizes the uterine cavity, may be performed in conjunction with a D&C.

The treatment of postmenopausal bleeding will depend upon the final diagnosis, and includes treatment of genital atrophy, removal of polyps, and further surgery, such as hysterectomy if a malignancy is confirmed. Luckily, the prognosis for endometrial carcinoma is excellent if found at an early stage, therefore do not delay a visit to the office if you should experience any bleeding after menopause.

Ingrid A. Prosser, M.D., F.A.C.O.G.