All hormone therapy is not the same.  If a woman has had a hysterectomy (removal of
the uterus) and wants to go on hormone therapy, she only needs estrogen.  If she has a uterus, she will usually take
both estrogen and progesterone therapy.
If a woman has a uterus and is on estrogen without progesterone, she will increase her risk for uterine cancer.

There are substantial differences in risk of breast cancer whether a woman is on estrogen
alone or estrogen and progesterone. According to the Women’s Health Initiative Study, women who take only
estrogen appear to have no increased risk for breast cancer (2006).  Only women taking both estrogen and
progesterone have a slight increase risk in breast cancer.

There are also differences in cholesterol changes in women on estrogen versus estrogen plus
progesterone.  Women taking estrogen and progesterone can experience an increase in their cholesterol levels that may
increase risk for heart disease.  On the other hand, women on estrogen alone do not experience similar cholesterol changes.

Estrogen is the component of hormone replacement that decreases the side effects of menopause
such as hot flashes, vaginal dryness, insomnia, etc.  Progesterone is added to estrogen therapy in
women with a uterus to prevent uterine cancer. If estrogen is given alone, the uterus may respond with overgrowth of
the uterine lining creating an environment where cancer will start.

Estrogens come n many forms.  Some come from animal
sources, some from plant sources, and some from direct manufacturing.  All are available by prescription and in
multiple dosages.  Women and their octors should attempt to decrease estrogen dosages as low as possible but
still control menopausal symptoms.  Many omen will be able to wean off the medications if done slowly.  Many other women will never be comfortable
without the use of estrogen.  This is a ecision you and your doctor will make over time.

Progesterone is hormone used in menopause solely to prevent uterine cancer in women taking
estrogen for menopausal symptoms.  For ealthy menopausal women, progesterone has no other benefits or indications for
use.   In fact, because the addition of progesterone to estrogen in the menopause increases risk for breast cancer and
increases cholesterol, there may be health risks to its use.  Progesterone comes in two main products.  One is the synthetic Provera and the second
is a more natural product Prometrium.  Both are sufficient to prevent uterine cancer.

“The only two choices for permanent sterilization are vasectomy or tubal ligation with an abdominal incision.”

This is a huge myth that is no longer true, let me help you understand your options.

 

Tubal ligation involves permanently blocking the fallopian tubes to prevent sperm from
fertilizing an egg released by an ovary.
In the past, tubal ligation has been performed in the operating room
under general anesthesia.  An alternative
method for sterilization is vasectomy, also requiring small incisions to
perform.

During a traditional tubal ligation procedure, small incisions are made on the abdomen
and a portion of the tube is either removed, burned, clipped, or banded.  These procedures are usually associated with
a one week recovery period and continued pain for up to several months in the
incision sites.  Most all tubal ligations
performed in these ways are less effective than vasectomy.

For men, vasectomy involves making one or two small incisions in the scrotum and
blocking the tubes that carry sperm prior to ejaculation.  Most men will require 2 to 3 days off of work
and will experience 2 to 3 weeks of discomfort.
Pregnancy can still occur for many months after vasectomy until all
sperm have been cleared from the male system past the blockage.

However, a new procedure came to the market in 2002.
This FDA approved procedure has shown an improved effectiveness over
traditional tubal ligation and is as effective, if not more effective, than
vasectomy in preventing pregnancy.  This procedure, called ESSURE, is usually performed in the gynecologist’s office
under light sedation and can be performed in about 7 to 10 minutes.  Unlike vasectomy or traditional tubal
ligation, ESSURE requires no incisions and a woman can return to normal
activities the day following the procedure.
This method involves passing a small camera through the opening of the
cervix and into the uterus, finding the openings of the fallopian tubes, and
placing a small metal coil in the center.
The coils are very sate and constructed with similar metals used for
decades to make cardiac stents, blood vessel clips, and artificial hips.  Over a three month period of time, the
fallopian tubes will scar down and occlude, preventing pregnancy.  After this period of time, a confirmatory
test is performed in the radiology department to be sure the tubes are blocked.

The ESSURE procedure is beneficial because no incisions are made and there is minimal
cramping, if any pain at all, during or after placement of the coils.  There is no change in a woman’s hormones,
periods, or sexual functioning.  The coils, which are not removable, cause no long term side effects.  They, however, will show up on future X-rays.  Not all gynecologists perform
this procedure, so you may need to find a physician or medical center close to
you that specializes in placing these coils.

For more information visit my website.  http://www.drbasinski.com/surgical/essure.html

Men can dramatically improve the quality and quantity if sex if they make an effort to become emotionally attached to their partners. I tell women and men that it is not fair to roll over in bed at 10:00 at night and expect sex after a long, stressful day. Sex is an intricate emotional act for women. If a couple is not connected emotionally then it is very difficult to have a good sex life. Being connected emotionally takes a lot of work. Men must be willing to touch their partners in a non-sexual way, like hugging, kissing or caressing, without expecting sex to follow. They also must be willing to talk to their partners in loving ways. In turn, I ask women to think about sex more frequently during their regular day. Thinking of enjoying sex will often help women want to have sex. Creating sexual tension over a period of time with your partner will often pay off down the road for both of you.
Another strategy I often promote is “date night.” Plan an evening that you and your partner agree to spend time alone with each other. The purpose of the night is to connect both emotionally and physically. The most important aspect is to emotionally connect with each other. Also, this allows each person to prepare and think about the night and, again, create sexual tension.
Taking time to work on your relationship outside of sexual activity will provide many benefits. You will become closer as a couple and as friends. Having a better emotional relationship will usually lead to a better sexual relationship.

Myth: PMS is just an excuse for bad behavior.

PMS, otherwise known as premenstrual syndrome, is real. Women may experience many symptoms that can include irritability, bloating, depression, appetite changes, cravings and mood swings. Often, women can become very distressed because they understand they are negatively impacting their families during this time of their menstrual cycle.
PMS occurs during the luteal phase of the cycle. This is the time right after ovulation and before the start of a woman’s period. The luteal phase lasts about 14 days. There is good evidence to support that during the luteal phase, serotonin produced in the brain decreases, causing many of the mood changes (Luecha, 1998; Elliott, 2002).
Fortunately, PMS can be treated. Exercising, eating healthy, cutting back on caffeine and getting appropriate rest can improve these symptoms. If these natural methods do not work, then medication may be necessary. Doctors have looked at many types of medicinal treatments, including herbal supplements, and the only useful products proven to consistently work are antidepressant medications. These are medications like Prozac, Lexapro, Zoloft, etc. Progesterones, birth control pills, or other medications have shown no effectiveness over placebo treatments (“Premenstrual Syndrome,” 2000). I have prescribed antidepressants for many women and they often stop me on the street to thank me for how wonderful they feel.
A note to husbands, boyfriends and families:
PMS is a real condition. I never had significant PMS until I reached 35. Suddenly, life during my luteal phase became a lot more difficult. It is very strange to describe the feeling of PMS. For me, it is like I have lost control of my body and temper. Things that usually don’t bother me can drive me up a wall during this time. I know I am not being rational but I cannot help feeling the way I do. During this time, the sound of my husband chewing too loud is like fingernails on a chalkboard to me. He is not doing anything wrong, but I cannot help the feeling I have inside.
I am able to control this edginess with self talk and quiet time, but some women need more. A first step is for a husband, boyfriend or family to understand, not get angry, and “lay low” during this time. If symptoms are increasingly severe, encourage the one you love to get treatment.
Thank You,
Your Wife, Mother, Sister,
Friend

 

     The way a person approaches a problem or difficult situation is very telling as to how they perceive life.  Life is not meant to be free of pain, anxiety, fear and sadness.  All of these experiences let us know that we are alive.  They also help us to appreciate the good things that happen to us.  Pain is a natural response from our bodies to tell us to take better care of ourselves.  Most aches and pains are just part of being human.

      It is a testament to healthcare that medicine can help you lead a more pain-free life.  However, do not make the mistake that all pain is bad.  For example, most women will be able to feel when they ovulate or release an egg from their ovary because this reproductive event will produce pelvic pain.  I do not know why the female body was designed to feel this pain, but it certainly is not abnormal or dangerous.  This pain is actually a reassuring sign of fertility.

       You can drive yourself crazy worrying about every ache and pain or you can decide to accept that most pain is normal.  By choosing not to accept pain as a natural part of life, you can actually do harm to yourself when surgeries or medications are overused for some harmless conditions.

       Having said this, some pain does require medical attention.  This kind of pain is usually very obvious.  This type of pain is often ongoing for many weeks to months and is something that you have not experienced before.  I encourage you to talk to your doctor about any pain that concerns you, but realize that not all pain requires treatment.  Again, controlling your emotional response to pain and not allowing yourself to overreact is most beneficial to you by preventing over-treatment and unnecessary anxiety.

Getting a Pap smear for many women may not be necessary every year.  Women at low risk for cervical cancer are:

1. Without a history of abnormal Pap smears
2. Involved in a completely monogamous relationship for many years
3. Absent of a history of sexually transmitted diseases such as HIV, Chlamydia, gonorrhea, HPV
4.  Noted to have three normal consecutive Pap smears
5. Over the age of 30 years old

(“Human Papillomaviruses”, 2008)

     If you fit into all of these categories, you can talk to your doctor and see if you can undergo decreased Pap smear tests.  The recommendation by many medical institutions is that you can decrease Pap smears to every 3 years.  Also, performing a Pap smear along with an HPV test after the age of 30 may be helpful in knowing if you can decrease Pap smears.  If your Pap smear is normal and your HPV test is negative, performing Pap smear testing only every 3 years may be safe and more cost effective.  If you have had a hysterectomy due to a reason other than an abnormal Pap smear, you do not need to undergo Pap smear testing at all in the future.

       Even if you do not need a Pap smear every year, it is very important that you receive routine annual health exams.  We still need to evaluate your blood pressure, breasts, ovaries and other health care needs.