What are the treatment options for excessive bleeding?

Excessive bleeding during menstrual periods can be defined by either the volume of blood loss or the duration of the bleeding. Typically bleeding of more than 80 ml (more than 5 tampons or pads per day) or bleeding for more than 7 days is clinically categorized as excessive bleeding or Menorrhagia. Treatment is determined by the conditions effect on the patient’s lifestyle and underlying cause.

Some of the causes are:
• No identified abnormality
• Hormonal imbalance (especially involving the ovaries)
• Fibroids
• Coagulation disorders
• Cancer of the uterine lining
• Polyps within the uterine
• Pelvic inflammatory disease (PID)
• Endometriosis
• Adenomyosis

If treatment is necessary it can range from drug therapies to manage hormone level to the surgical removal of the uterus (hysterectomy). A minimally invasive alternative to a hysterectomy is called Hydro-thermal Ablation (HTA). One of the few ObGyn practices in the Salinas and Monterey County area to offer HTA is Health Care For Women adjacent to the Salinas Valley Memorial Hospital.

Since HTA can be performed as an outpatient without any surgical incisions, it usually takes only about 30 minutes. The procedure can be done with local anesthesia with some sedation, and the patient can resume normal activities within 24-48 hours. The procedure consists of inserting a small device (hysteroscope) into the uterus, sealing the cervix and filling the uterus with saline (salt water). Using the hysteroscope, the fluid in the uterus is heated to destroy the lining and eliminate or reduce menstrual bleeding. The uterus is then rinsed with room temperature saline to complete the procedure.

An important consideration before receiving HTA is the decision that the patient has completed their family and does not anticipate any future pregnancies. Although the procedure does not prevent pregnancy, any conception after the ablation of the uterine lining must be treated as high risk and may result in miscarriage. After the procedure, it is highly recommended to ensure effective birth control or sterilization such as insertion of Essure to prevent potential complications of post-HTA pregnancy.

For more information regarding abnormal menstruation, including excessive bleeding, irregular bleeding, bleeding after menopause or other Salinas ObGyn or Monterey ObGyn care, call Health Care for Women in Salinas, California or go to hcfw.com.
To make an appointment with an expert women’s health professional to discuss obstetrics or gynecology concerns, healthy pregnancies or general women's healthcare, please call 831-758-8223.

Physicians Specializing in Women’s Health

What is the difference between Obstetrics and Gynecology?

Healthcare for women can be divided into two medical disciplines based on the reproductive status of a woman. Obstetrics is concerned with the treatment of pregnancy including pre-natal and post-natal care. Gynecology, from the Greek meaning “the study of women”, deals with the overall female reproductive system throughout a woman's life from her first menstruation through post-menopause, other than those times when she is pregnant. Together these two disciplines are combined to comprise the practice of OBGYN. OBGYN physicians are experts in diagnosing problems related to the organs of the female reproductive system, as well as treating those conditions medically or surgically as the case requires.

The Monterey Peninsula area and surrounding areas, including Carmel, Gilroy, Greenfield, Hollister, Marina, Salinas, Seaside, and Soledad, have a higher than average proportion of its population comprised of women of child bearing age which creates high demand for OBGYN physicians. In addition to caring for expectant mothers and delivering babies, Salinas OBGYN physicians treat conditions such as cancer, osteoporosis (weakened bones), and endometriosis. Key diagnostics services include PAP Smears, ultrasound imaging, and bone density scans.

The most common services sought from Salinas OBGYN practices by healthy women are prenatal care, pap smears and birth control(both family planning and permanent sterilization, such as Essure). If you are a woman seeking expert professional medical care, call Health Care for Women in Salinas, California, or for any questions or concerns you may have concerning gynecology, obstetrics, healthy pregnancies or general women's healthcare, please call 832-758-8223, or visit the Health Care for Women website today.

Amniocentesis and Your Pregnancy

What is Amniocentesis?

Amniocentesis, also referred to as an amniotic fluid test, or simply an "amnio", is a prenatal procedure used to collect a small amount of the amniotic fluid that surrounds the baby in the uterus. The collected amniotic fluid contains cells shed by the developing baby and each of these shed cells contains a complete set of the baby's DNA. The cells can be cultured and the DNA analyzed in order to detect and identify certain potential health problems the fetus may have.

Why Amniocentesis?

The most common reason for having an amniocentesis is to allow early detection of certain genetic disorders or chromosomal abnormalities in the developing fetus. While an "amnio" can detect hundreds of genetic abnormalities, the most common abnormalities tested for are Down Syndrome (Trisomy 21) and Edward's Syndrome (Trisomy 18). Also, neural tube defects, which are problems with the formation of a baby's central nervous system such as spina bifida and anencephaly, can be detected with an amniotic fluid test.

The test is usually performed early enough in the pregnancy (between the 15th and 20th weeks) in order to provide the parents with time to consider their options should serious abnormalities be discovered. In some cases when a serious genetic disorder is discovered, the parents can choose to terminate the pregnancy or they may decide to continue it. It is important to realize that having an amniocentesis in no way obligates you to terminate the pregnancy if an abnormality is discovered. For some conditions, simply having a clear diagnosis can better prepare you and your physicians for taking care of a baby with special needs before and after birth.

Call HEALTH CARE FOR WOMEN in Salinas today to talk to a trained obstetrician and schedule an appointment to have your amniocentesis performed.

Also, in cases where an early delivery is being considered due to medical reasons, your obstetrician may perform an "amnio" to determine the maturity of the baby's lungs. Amniocentesis can also be used to diagnose a uterine infection, determine the gender of the baby or to evaluate any significant health issues that can arise when the mother's blood type is different from the baby's. (see Rh sensitization)

What is Involved?

A local anesthetic may or may not be given before the actual procedure. While you are lying down, your doctor will locate a pocket of amniotic fluid a safe distance from the baby using ultrasound. The doctor then inserts a syringe into the amniotic sac around the baby and a small amount of amniotic fluid is drawn for testing. The whole procedure takes only a few minutes.

After the procedure is performed, your doctor or nurse will watch for any uterine contractions or fetal distress while you rest for 15 – 45 minutes before leaving. It is suggested that you take it easy for the remainder of the day so be sure to arrange for someone to drive you home. Heavy lifting, intercourse, and air travel should be avoided for the next 48 -72 hours. It can take 1 - 2 weeks for the collected cells to be cultured and the results of the test diagnosed.

If you are interested in learning more about amniocentesis or you would like to schedule an appointment to have an amniocentesis performed, please contact Health Care For Women at our Salinas office or by filling out a Quick Contact on their website at www.hcfw.com

Who Should Be Tested?

All pregnant women are candidates for amniocentesis. Since the risk of having a baby with a chromosomal disorder can be relative to age of the mother, amniocentesis is routinely suggested to all pregnant women over the age of 35. Women who previously have had a child with a genetic abnormality or have a family history of certain birth defects, are also suggested to undergo an amniotic fluid test.

Risks Involved

Amniocentesis increases the risk of miscarriage by less than 1 percent over the baseline risk for miscarriage. Amniocentesis does not increase the risk of birth defects.

Alternatives

For patients who want information about their risk of birth defects, there are three main alternatives to amniocentesis.

The first is ultrasound, which is done routinely for all pregnancies. Ultrasound can detect some but not all types of birth defects and is less specific for the diagnosis of some syndromes. Routine ultrasounds for this purpose are done between 18 and 22 weeks of gestation.

An alternative screening method that can be done earlier in the pregnancy is the use of maternal blood markers to assess the risk of defects (sometimes called "AFP" or "quad testing"). When combined with a special ultrasound called a Nuchal Translucency measurement, this type of testing can give information about Down and Edward's syndromes as early as 11-14 weeks. Without this special ultrasound, the testing is done at 15-20 weeks. It is important to understand that this testing, similar to ultrasound, does not provide a definitive diagnosis.

For an earlier, definitive diagnosis, a procedure called Chorionic Villus Sampling (CVS) can be done between 8 and 12 weeks. More technically difficult, it carries a slightly higher risk of miscarriage than amniocentesis, but the results are available much earlier.

To schedule your ''amnio'' or any other prenatal testing call Health Care for Women in Salinas, California, or for any other questions or concerns you may have concerning gynecology, obstetrics, healthy pregnancies or general women's healthcare, please call 831-758-8223, or visit the Health Care for Women website and get in contact today.

Abnormal Periods

The Female Reproductive Cycle

To understand abnormal bleeding, it helps to understand what is normal. Vaginal bleeding, or menstruation, is what takes place as a normal part of the reproductive cycle and is commonly referred to as a “period”. Normally, each month an egg is released from one ovary and travels through the fallopian tube to the uterus to await fertilization. When fertilization doesn’t occur the uterus sheds its inner lining (endometrium) through the vagina in order to prepare the uterus to accept a new embryo during the next cycle. The amount of fluid and blood that is shed during normal menstruation varies but is usually between 4 and 12 teaspoons. The length of the menstrual cycle can vary from 21 days to 35 days with the average length of a cycle being 28 days. A normal period lasts from 2 to 7 days.

Abnormal Bleeding

When periods are heavier than a woman would expect or the flow takes place at the wrong time during the month (i.e., irregularly), it is considered abnormal, and it is suggested that you consult your gynecologist order to determine the cause.

Bleeding is always considered abnormal, regardless of the quantity, if it occurs more than once every 21 days (counting from the start of one episode to the start of the next, regardless of how many days each episode lasts), after intercourse, or after menopause. Bleeding is also considered abnormal if your regular period becomes heavier or lasts longer than it used to. If you are experiencing any of these conditions you should consult with your ob-gyn to discover the cause.

Sometimes irregular bleeding may be your first indication of pregnancy, and a pregnancy test is one of the first tests your doctor is likely to do. If pregnancy is confirmed your doctor will continue to monitor you for any new episodes since vaginal bleeding during the pregnancy can be an indication of miscarriage or ectopic pregnancy.

If you are not pregnant, it can be helpful for you to provide your gynecologist a bleeding diary that details your bleeding pattern and the amount of bleeding you experience each day. Though quantifying the amount that you bleed can be difficult, your doctor will want to know how often you have to change your sanitary pad or tampon, if you pass blood clots, and if you have had problems with anemia as a result of too much blood loss.

What are the causes of abnormal bleeding?

There are many causes of abnormal bleeding. Concerns range from pregnancy complications to cancer. Common reasons for abnormal bleeding are fibroid tumors of the uterus, polyps of the endometrium, and hormonal imbalances that cause disruption of the normal ovulation cycle. By providing a good bleeding history, you can help your doctor determine the cause.

After hearing your history, your doctor will determine which tests are necessary to make a diagnosis. Your work-up might include blood tests, a pelvic ultrasound, a pap smear, and/or a biopsy of the endometrium.

How is irregular vaginal bleeding treated?

The first priority is to determine what causes the irregular bleeding. Once the cause is diagnosed, your gynecologist can consult with you to decide if treatment is actually necessary. In some cases, if the dangerous causes have been ruled out, you and your doctor may decide that the irregular bleeding may not be enough of a problem to warrant medication or treatment.

If the abnormal bleeding is determined to be serious enough to threaten your health or if you feel that treatment is necessary because of the impact it is having on your lifestyle, then your doctor will recommend treatment that is appropriate for your specific diagnosis. Sometimes treatment with medications is likely to help; other times, surgical treatment is more appropriate. Most medications used for bleeding problems contain hormones, though there are some non-hormonal treatments available as well. Surgeries often performed for abnormal bleeding include using a camera to remove polyps and other growths from the uterine cavity (hysteroscopy), destruction of the uterine lining (endometrial ablation), removal of fibroid tumors (myomectomy), or removal of the uterus (hysterectomy).

To schedule an examination call Health Care for Women in Salinas, California, or for any other questions or concerns you may have concerning gynecology, obstetrics, healthy pregnancies or general women's healthcare, please call 831-758-8223, or visit the Health Care for Women website and get in contact today.

Birth Plan vs. Birth Reality

"Do I need to write a birth plan?" is a frequent third trimester question. My answer is always the same: if you want to, go ahead, but if you don't, things will still be OK.

A birth plan, in general, is a list of wishes that a pregnant woman and her partner have for their labor, delivery, and postpartum experience. It usually contains information about what kind of pain control she wants, who is going to be in the room for the delivery, who will cut the umbilical cord, etc. I have no idea when this concept came into vogue, but now is a commonplace discussion on most pregnancy websites and in childbirth classes. There are even online "create your birth plan" tools with multiple choice options to create your personalized plan with a few easy clicks.

From my perspective, the main benefit of the birth plan is to give families reassurance that they have some control over a frightening situation. Many women fear that once in the hospital, they will be subjected to interventions against their will, and the birth plan is a way of expressing their wishes ahead of time and making sure that they are heard (or at least seen). If you need that kind of reassurance, then, yes, you should write a birth plan. But the truth is that you really don't need one. After delivering thousands of babies, with and without plans, there are a few things that I have learned.

1. Birth is totally unpredictable, and no matter how well you plan for it, no one--not you, your partner, your doctor, or your nurse--knows what will happen.
2. Patients often choose (on their own) to deviate from their plan in the course of labor and delivery. This is normal and expected, as they wrote their plans long before they experienced labor first-hand.
   
3. Most birth plans say the same thing, and most patients who do not have birth plans have the same wishes as those who do.
4. Birth plans are almost always a first baby thing. Second time moms rarely write them because they realize that they are not necessary.
   
5. Real births almost never follow the plan exactly.

These observations alone should be reassuring to you if you are feeling apprehensive. Why? The reality is that your doctor's only goal in managing your labor and delivery is getting you and your baby through it safely. We will treat you the same whether or not you have a birth plan; that is, we will let labor proceed as naturally as possible and intervene only when necessary if that is what you prefer. If you don't want pain medication or if you want to listen to a particular song while you push, that's fine. If the doctor thinks that things are getting complicated and some sort of intervention is required, you must give your consent before it can be done. The bottom line is that when you are in the hospital, nothing can be done against your will (the one exception being a dire emergency where you are incapable of providing consent).

Perhaps more important than writing a birth plan is choosing a hospital that adheres to "baby-friendly" principles (note that this is this does not necessarily mean the hospital must be certified "Baby-Friendly"--many hospitals practice these principles without that certification from the state and very few hospitals have obtained certification to-date). This means that the hospital has a commitment to encouraging bonding between parents and their newborn and will automatically do the things you probably would request in your birth plan, such as skin-to-skin contact immediately after delivery (when safe), procedures and tests administered to the baby in your room whenever possible, and exclusive breastfeeding. At Salinas Valley Memorial Hospital, where we work, these practices are standard, so when reading patients' birth plans, I am able to reassure them that half of what they request will be done without them saying a word.

Other things, like whether or not you need an IV, are generally negotiable, and if you discuss your concerns with your doctor ahead of time, you can often reach a mutually acceptable decision. If you do write a birth plan, you absolutely should bring it in to your prenatal appointments to discuss it with your doctor ahead of time. We see your birth plan as a way of exploring your concerns about labor, and often a short discussion of your requests can allay many of your worries.

The bottom line: communication is key. If you want to write a plan, by all means, go ahead. But even if you don't, tell us your concerns so that we can take those worries off your mind!

Pregnancy and Prenatal Care

The Importance of Prenatal Care

According to the U.S. Department of Health and Human Services Maternal and Child Health Bureau, ''Babies born to mothers who received no prenatal care are three times more likely to be born at low birth weight, and five times more likely to die, than those whose mothers received prenatal care.''


Prenatal care is much more than just health care while you’re pregnant. Prenatal care is a key factor in any healthy pregnancy and vital to the health of both the pregnant mother and the unborn baby. Pregnancy causes physical, biochemical and hormonal changes in the pregnant mother that may sometimes lead to a difficult pregnancy or complications at birth. These may go undetected without regular examinations by an experienced physician trained in the field of obstetrics.



For more information about the importance of prenatal care, please visit the HEALTH CARE FOR WOMEN in Monterey County website or call 831-758-8223 to schedule an appointment with a qualified ob-gyn.



Early Pregnancy Detection

If you suspect that you are pregnant, it’s important to verify the pregnancy as soon as possible. The most common event associated with pregnancy is a missed menstrual cycle. Women who don’t have regular menstrual cycles should be alert for other signs of a possible pregnancy such as unusual fatigue, nausea, frequent urination, heartburn or tenderness in the breasts. Once you’ve missed a menstrual cycle or had some other indication of a possible pregnancy, it’s important to visit your ob-gyn as soon as possible. Even if you've taken a home pregnancy test, it's still wise to follow-up with your doctor. Your obstetrician will test for the presence of a hormone called chorionic gonadotropin, which is produced by the placenta. The presence of this hormone in the blood or urine confirms the pregnancy.



If you need help confirming your pregnancy, call 831-758-8223 to schedule your pregnancy test. Health Care For Women can also help you get started with your prenatal care.




Prenatal Care

Proper prenatal care means more than just doubling up on your vitamins and watching what you eat. Remember that it’s not just the health of the mother that needs to be monitored, but also the health of the baby.



In monitoring the health of the mother your doctor will test for conditions that can arise as a result of the pregnancy itself. Some of these can be high blood pressure, insufficient or overly substantial weight gain and diabetes (which can develop even though diabetes was not present before the pregnancy). The presence of these special conditions or any others may be indicators of a difficult pregnancy. Early detection allows your ob-gyn the opportunity to prescribe any specialized treatments or procedures that may be required to insure a healthy pregnancy and the health of the mother and child.



Your obstetrician will also monitor the health of the baby. Early detection of abnormalities for example, in the fetal heartbeat or the size and position of the fetus, will indicate to your ob-gyn that specialized procedures may be required to insure a successful pregnancy. The early detection of any abnormalities also allows your doctor the opportunity to make certain that any specialized equipment or medical personnel that may be needed will be present at the birth in order to safeguard the health of both the mother and the newborn baby.



If you're interested in finding out more about the gynecological and obstetrical services offered by the medical professionals at Health Care For Women, please visit www.hcfw.com, or call 831-758-8223 and set up an appointment for a visit to the Health Care For Women offices today.

Meet Our Board-Certified Obstetricans & Gynecologists (OB/GYNs)

Recently, each of our doctors was interviewed for a promotional video.  Here's the long version:




Yes we said "new video."  Perhaps we've been a little shy in the past, but here are our previous TV bits, en espanol:

Doctora Analisa Marki-Dunn (Dr. Analisa Marki-Dunn): La Magia Del Cuidado Prenatal, Part I





Doctora Analisa Marki-Dunn (Dr. Analisa Marki-Dunn): La Magia Del Cuidado Prenatal, Part II

Now Offering Patients Touch MD, an Online Patient Education & Collaboration System

With TouchMD you can

• Learn more about your doctor, their staff and facilities
• Explore videos about your procedure, pregnancy or medical condition
• View or print any images saved by your doctor during your office visit
• Share your medical experience with your loved ones

Existing patients in our system may use the registration code "hcfw" and login here, http://www.mytouchmd.com/

Your Ultrasound Appointment

Getting your first ultrasound can be one of the most exciting moments during your pregnancy, and the experience undoubtedly marks a major milestone in the process of slowly getting to know your baby before he or she is born. From laying eyes on those first precious images, to finding out whether the decorations are going to be blue or pink, having your ultrasound test performed by the best health care professionals can help reassure you that your growing baby is healthy and safe.

An ultrasound is a procedure that allows you to see images of your baby during your pregnancy, with the sonogram being the name of the actual picture taken of your baby during the ultrasound. Health Care For Women's 4D ULTRASOUNDS take 3D ULTRASOUND images and then adds an elapsed time element to the process, which in turn allows you the unique experience of viewing live-action images of your baby that are of a quality that you most likely never thought possible.

As one of the most useful and reliable diagnostic tests for proper prenatal care, the performance of an ultrasound test is one of the key components in evaluating and protecting the health of an unborn baby.

A prenatal ultrasound test utilizes high-frequency sound waves that are transmitted through the woman's abdomen via a transducer so that the doctor can look inside the abdomen. The echoes are recorded and transformed into photographic or video images of the baby. The ultrasound can be used during pregnancy to show images of the baby, placenta, ovaries, and amniotic sac, and the ultrasound test can also detect major birth defects or abnormalities. Ultrasounds do not use any radiation and are safe during all stages of pregnancy.

Most patients will get one or two ultrasounds during their pregnancy, depending on when they start prenatal care. Additional ultrasounds might be indicated to perform special kinds of tests or to more closely monitor high-risk pregnancies. So what can an ultrasound do?

An ultrasound performed early in your pregnancy can determine

• Your expected due date
• The gestational age (the age of the fetus)
• The presence of more than one fetus
• Measurement of the Nuchal Translucency to help detect chromosomal abnormalities
  

An ultrasound performed later in your pregnancy can determine

• The general health of the baby and detect many types of birth defects
  
• The amount of amniotic fluid around the baby
• Location of the placenta
• The expected weight of the baby
• The position of the baby
• The baby's gender
  

With the state-of-the-art 4-D ultrasound, Health Care For Women will allow you the amazing opportunity to see pictures and video of your baby before he or she is born, and the stunning image quality provided by this high-tech equipment is detailed beyond anything that has been available up until now.

The Pap Smear and HPV (human papillomavirus)

HPV
HPV (human papillomavirus) is the most common sexually transmitted disease in the world, and most people infected with HPV aren’t aware that they have it. Out of the 100 plus types of HPV that exist, about 40 of these are transmitted through engaging in vaginal or anal sex with an infected partner. Types of HPV are classified as high risk (possibly cancer-causing) and low risk (non-cancer-causing).

Discovered in the early 1940s, HPV was initially regarded as being largely benign. In the early 1980s HPV started to gain the attention of medical researchers and the professional medical community, more specifically gynecologists, when it was discovered that some types of HPV can cause cervical cancer, which is the third most common form of cancer for women. In the United States alone, 11,000 new cases of cervical cancer are diagnosed each year.

What are your chances of contracting HPV?
The United States Center for Disease Control and Prevention (CDC) reports that approximately twenty million Americans are currently infected with HPV and an additional 5.5 million – 6 million people will become infected during the next year. According to the CDC, a person who is sexually active has a 50% chance of becoming infected with genital HPV at some point during his or her life. Statistically, these new infections will occur mostly in people who are in their late teens and early 20s, but you can acquire a new HPV infection at any age.

Early Detection
Since there is currently no cure for HPV, early detection of those strains which can cause cervical cancer is absolutely critical. Naturally, treating cervical cancer in its early stages (or better yet, before it develops) has a much higher success rate than cervical cancer detected in its later stages. Later stage detection can be deadly.

At HEALTH CARE FOR WOMEN in Salinas, we can help you detect HPV early, thereby reducing your risk of serious problems later.

The Pap Test (also called pap smear)
Because early detection is the key to successful treatment of this deadly cancer, common gynecological standards suggest that starting at the age of 21 women receive regular pap smears. A pap smear can save your life by detecting cervical cancer in its earliest stages, or optimally, abnormal cells can be detected before they become cancerous.

The HPV Test Makes a Difference
A study by researchers from the Georgetown University Medical Center reported that adding HPV testing to lifetime biennial pap smears can help prevent 225 cases of invasive cervical cancer per 100,000 women and can decrease cervical cancer mortality by an additional 59% over the use of a pap smear alone (Mandelblatt et al., JAMA, 5/8).
(http://jama.ama-assn.org/content/287/18/2372.full.pdf+html?sid=c470bbc9-8eb1-4d57-afec-47dec262fb63)\ The HPV test can be a useful adjunct to the pap smear in women over the age of 30.

At HEALTH CARE FOR WOMEN in Monterey County, we can assist you in determining whether you need an HPV test as part of your routine pap smear.

Educate Yourself
The gynecologists at Health Care For Women in Salinas offer a variety of educational sources to help you learn about gynecology, pap smears, early detection and prevention. Since cervical cancer in its early stages produces no noticeable symptoms, without a pap smear, the cancer may go undetected until it is too late. At one time cervical cancer was one of the most common causes of cancer deaths in the U.S. but that number is declining since regular pap smears and other gynecological testing has become routine.

In recent years, the development of vaccines against HPV (Gardasil and Cervarix) has given new hope that cervical cancer deaths will continue to decline. These vaccines are used by girls and young women, preferably before the onset of sexual activity and possible HPV exposure. Though they do not provide 100% protection, they reduce the risk of atypical cervical cells by up to 70%. At Health Care for Women, we are happy to discuss these vaccinations with you to help you make an informed choice about your health.

All sexually active women should educate themselves about HPV and cervical cancer risk factors, prevention and treatment. This information could be critical to your enjoying a happy, healthy, long life. Your ob-gyn is an excellent source of information about gynecology in general, obstetrics, pap smears and HPV testing.

To find out more about getting a pap smear test at Health Care for Women in Salinas, California, or for any other questions or concerns you may have concerning gynecology, obstetrics, HPV or general women's healthcare, please call 831-758-8223, or visit the Health Care for Women website and get in contact today.

The Basics of Birth Control

When it comes to the wide-ranging field of birth control, it's natural for many women these days to be left feeling overwhelmed and unsure of what kind of birth control is right for them. At HEALTH CARE FOR WOMEN in Salinas, patients have a wide variety of options to explore when it comes to finding the birth control that works best for them- whether it's hormonal methods like birth control pills, intrauterine devices, barrier methods like condoms, natural family planning, or sterilization, HEALTH CARE FOR WOMEN'S medical professionals can help women of all ages explore their options and find the method or methods that they are most comfortable with. HEALTH CARE FOR WOMEN can also educate women about emergency contraception, like the over-the-counter Plan B option.

Some women may not know this, but even if you have not yet started having your period, or if you are getting close to menopause, you could still be running the risk of pregnancy if you are engaging in unprotected sex. Statistics show that each year approximately 85% who don't use birth control have an unplanned pregnancy, and in the United States about half the pregnancies every year are unplanned.

So what are some of your options when it comes to birth control? Getting a brief introduction into the methods will likely give you a better idea of what type of birth control is best for your specific needs and preferences.

• Barrier Methods - Generally speaking, barrier methods do not prevent pregnancy as effectively as hormonal methods or IUD's, and they must be used EVERY TIME that you have sex. Barrier methods Include condoms, sponges, and diaphragms. Condoms have the advantage of protecting against some types of sexually transmitted infections.
• Hormonal Methods - Birth control that uses hormones is statistically very good at preventing pregnancy. Hormonal methods include birth control pills, the vaginal ring (Nuva Ring), the patch (Ortho Evra), the Depo Provera injection, and Implanon, the single-rod implant. Some of these methods must be used every day. Others are longer-acting; Implanon lasts 3 years.
• Intrauterine Devices (IUD's) - IUD's are inserted into your uterus, work for 5-10 years at a time, and are a very safe and effective way to prevent pregnancy. They are as effective as sterilization methods but are reversible. The Mirena IUD contains a hormone that can help with heavy periods and cramping. The Paragard IUD is hormone-free.
• Natural Family Planning - Also referred to as "fertility awareness", Natural Family Planning can be effective provided that you and your sexual partner are extremely careful, and are especially mindful of what times of the month are best to engage in sexual activity. Women practicing natural family planning are strongly encouraged to keep good records so as to know when they are fertile; and for times when you ARE fertile, you will need to abstain from sex, or use a barrier method. This method is not appropriate for women who do not have regular menstrual cycles.
• Sterilization - Permanent birth control methods are appropriate for couples who have completed their families. Options for women include tubal ligation and Essure. Men can undergo a procedure called vasectomy.

When choosing your birth control method, it is important to consider your lifestyle and desire for future childbearing. At HEALTH CARE FOR WOMEN, our physicians are happy to discuss these issues and help you find th birth control method that is best for you.

First Time to an OB/GYN?

From a simple check-up, to more serious concerns like the treatment of certain kinds of cancer or sexually transmitted diseases, a certified OB/GYN at Health Care For Women can provide you with the best possible health care experience when visiting us at our Salinas office.

The job of an OB/GYN is to screen, and potentially diagnose and treat women for certain diseases that are specific to women's health care. An OB/GYN can also specialize in helping women have safe and healthy pregnancies that increase the chances of a healthy newborn, and OB/GYN's also perform surgical procedures related to women's health, including hysterectomies, C-sections, laparoscopy, and the LEEP (Loop Electrical Excision Procedure).

So when is the time to make your first appointment to see an OB/GYN? It's widely agreed that teenage girls should see an OB GYN between the ages of 13-18, though pelvic exams are very rarely required during this first visit. The initial meeting with an OB/GYN is to establish a relationship with a doctor, and to go over your personal medical and sexual history. This first visit is also viewed as a good opportunity for young women to get important information about sexually transmitted diseases and contraceptives.

According to the American College of Obstetricians and Gynecologists, from the age of 21 every woman is encouraged to make an appointment with her OB/GYN every year. Women who are sexually active under the age of 21 should also see a gynecologist annually.

So what are some of the signs that indicate when you should contact an OB/GYN? A few of these circumstances include:

• Abnormal Bleeding (I.e bleeding between periods)
• Pelvic Pain
• Intense and/or debilitating Menstrual Cramps
• Unusual discharge
• Vaginal or lower abdominal pain or swelling
• You plan on becoming pregnant
• You think that you might have a sexually transmitted disease

If you're interested in scheduling your first visit with a Gynecologist, or you're simply interested in finding a new OB GYN that is a better fit for you and your specific needs, whatever they may be, Health Care For Women in Salinas, California provides patients with a safe, comfortable, and relaxing environment for treating your health care needs.