Pink Prescriptions - June 2015

Just the Facts. Period.

Prescriptions web

Sometimes when I have sex with my partner it really hurts. What are some of the reasons it can be painful? Is there anything I can do to relieve the discomfort? 

Sex should not be painful! When a woman is aroused her natural lubrication increases and the vagina dilates, which helps lead to achieving pleasurable intimacy for both partners. If it’s the first time it has hurt consider:

Switching positions; communicating with your partner how you’re feeling; don’t rush, give your body (and mind) time to respond; use additional lubricant.

If the pain continues, consider: Does the pain occur with foreplay, entry, movement or after? Are there other symptoms—vaginal dryness, vaginal discharge, vaginal lesions, heavy periods, pain with urination, constipation, fever?  Can you use tampons or get a pap smear without pain?  Are you depressed or anxious?  Have you recently had a baby, infection, surgery or trauma?

If you have continued pain—or have never been able to have painless sex—you need to talk to your doctor. With a thorough exam and possible pelvic ultrasound or other testing, many times the underlying cause of the pain can be treated and relieved. 

As with any pain, you will start avoiding the activity that causes it! This can lead to feelings of depression, anxiety, fear, lack of intimacy, stress with your partner and a very unsatisfying sex life.  So ladies, pay attention to your bodies and get help when something isn’t feeling right.

Dr. Tracy Blusewicz, MD, Advanced Women’s Care of the Lowcountry

I know I’m supposed to see my gynecologist once a year, but I get so busy, I tend to blow it off. What are the risks of missing my annual gynecological check-ups?

Annual visits provide the opportunity to offer patients preventive care. They allow the doctor to make a risk assessment of the patient’s history over the last year to reduce the chance of the patient developing a morbidity or intervene at an early stage of illness. Many common conditions, such as human papillomavirus (HPV), breast cancer and cervical cancer can exist in the body without symptoms and the annual visit provides an opportunity for early detection.

Women of all ages are recommended to have a Pap smear every 3-5 years, provided their first test is negative. Whether you’re due for a pap smear or not, you should have a pelvic exam every year to make sure there are no abnormal cysts or tumors on your ovaries. A clinical breast exam should be performed annually as well, even if you have a yearly mammogram. An OB-GYN can also perform other screenings, including blood sugar and cholesterol tests.  

And of course, you can ask questions or talk to your doctor about any issues you may be experiencing like frequent bladder infections or painful intercourse.

Dr. Claude Tolbert, MD, FACOG, Beaufort Memorial Obstetrics and Gynecology Specialists

I’ve always had trouble with my period—like spotting—but now, sometimes, the blood is very dark and occasionally there are clots. Is this abnormal? Should I be worried?

Spotting in between periods can occasionally be normal, but spotting that happens recurrently and/or develops into irregular bleeding with clotting can be due to many causes.  If it happens early on during the teenage years, it can be from the immaturity of the menstrual system due to lack of ovulation. However, if it happens later, during the reproductive years, it can be due to many things ranging from early pregnancy complications to uterine polyps to uterine fibroids and even cancer. Later on, in the premenopausal years, occasional irregular bleeding can be normal due to falling hormonal signals, but can also indicate a more serious problem.

Recurrent spotting, and especially heavy bleeding, occurring more frequently than your monthly period, need to be addressed by your health care provider—even if you are on birth control pills. Once you reach menopause (after you have stopped having regular cycles) ANY bleeding has to be addressed after the FIRST time it occurs, as it could mean a more serious problem, even if you are taking hormone replacement therapy.

Dr. Eve Ashby, DO, Beaufort Memorial Lowcountry Medical Group

I’m not always good about taking my birth control pill. My friend is using a contraceptive that’s in her arm. Another friend recently got an IUD. Can you tell me about both?

As you’re obviously aware, the pill is a great form of birth control…but only if you remember to take it! If you are interested in other methods, consider what you are looking for:

-Do you want something you leave in and don’t have to remember?

-Do you feel OK putting something in your vagina or on your skin?

-Do you want a longer acting form of birth control?

-Do you have other symptoms you need help with: like acne, PMS or heavy periods?

Nexplanon is a soft, flexible rod that is about the size of a matchstick and is implanted into the underside of your arm by a physician in the office. It contains only progesterone and is time-released over three years.  It can make periods lighter or even stop them. It can be removed anytime. If you want to continue, after the three years, you can have a new one placed. If covered by insurance, it is usually more economical than paying a monthly co-pay at the pharmacy.

IUD’s are another form of longer acting birth control.  An IUD can last 3, 5 or 10 years depending on the IUD you choose and they can also be removed at any time. An IUD is inserted into the uterus at the physician’s office. It is placed with a speculum and the placement is checked with an ultrasound. There may be some initial bleeding and cramping, but once in place you cannot feel the IUD and can use tampons and continue with all routine activities. Once the IUD is removed, there is an immediate return to fertility.

If a woman is looking for help with acne and/or heavy or painful periods the birth control patch or vaginal ring are good options. They contain progesterone and estrogen just like the pill. The patch is worn on the skin and changed weekly; the vaginal ring is replaced monthly by the woman at home.

Remember, condoms are the only form of contraception that protect against STD’s so consider them in addition to another method of contraception if starting a new relationship!

Dr. Tracy Blusewicz, MD, Advanced Women’s Care of the Lowcountry

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