Questions To My Gynecologist

Stress Incontinence: 7 Things Your Gynecologist Will Need to Know

2010-01-17T15:20:00.000-08:00

Stress incontinence is defined as leaking urine involuntarily under situations that stress your bladder, such as lifting something, sneezing or laughing. Embarrassing as this can be, it isn’t a lifetime diagnosis! When you see your gynecologist about the problem, you'll probably have plenty of questions to ask -- and so you should. Information on the internet and available at the library can only be given in the most general sense, so you need to know what questions to ask your gynecologist about their proposed treatment for your stress incontinence. In order to give you good info, though, they'll have to ask a few questions of their own! Here we look at the information you should come armed with to a stress incontinence appointment.

Do you leak urine when laughing, coughing, lifting, and so on?
If the answer is yes, you will certainly be diagnosed with some degree of stress incontinence. The management may be different depending on your individual situation, though.
Do you leak urine on the way to the bathroom, when you have a strong urge to pee?
If you do, this might indicate that you have overactive bladder syndrome in conjunction with stress incontinence.
Are you woken up by the urge to urinate in the nighttime?
Your gynecologist will need you to distinguish between being woken by other things and then feeling the need to wee, and waking because of the urge to wee.
Do you wear incontinence pads, and how often doo you need to change them?
This will help them diagnose how severe your stress incontinence is, and will help determine whether you are given exercises to do, or medication or surgery is recommended.
How often do you empty your bladder in the daytime?
You can record this if you like and show your doctor, to give an accurate picture of what is going on with your bladder.
Are you always aware of the leaking occurring?
If you sometimes leak urine without being aware of it, an upgraded management plan might be devised.
Does it hurt when you urinate?
This might indicate the need for antibiotics to treat a urinary tract infection before any further diagnoses are made. Your stress incontinence could be caused by nothing more than an easily killed little germ!

The Top Five Questions Women Wish They Could Ask Their Gynecologist

2010-01-04T10:06:00.001-08:00

In a perfect world, every woman would meet with her gynecologist and ask every private question about topics like pelvic pain or stress incontinence that had her troubled. But in reality, embarrassment and anxiety often prevent women from asking certain questions. We've developed our list of the top five questions women wish they could ask their gynecologists. Can you identify?

Question #1: What's Causing My Pelvic Pain?
Pain in the pelvic area has many possible causes, but many women assume it's simply bad cramps. Many women seem to be trained not to complain about menstrual pain. Even more embarrassing, it may only occur during sex. Being embarrassed about the reason for pelvic painmay keep women from asking their doctors to investigate.

If you're feeling unusual pain in the pelvic region, by all means, write down when it occurs, how severe it becomes and any thoughts you have about its cause. Then take your list of questions and symptoms to your doctor and relieve the anxiety you've been feeling.

Question #2: Can Anything Be Done About My Stress Incontinence?
This is a big one, especially after childbirth or menopause. Women don't always talk to each other, much less their doctors, about why their bladders leak. That's sad, because so much can be done to relieve stress incontinence! If this is your private question, find a way to ask your doctor to help you.

Question #3: What's Causing This Heavy Flow?
What an embarrassing thing flowing heavily can be! Although having periods is the most natural thing possible for women, they still sometimes have trouble talking to a doctor when things don't seem right. Whether it is fibroids, anemia or any number of other reasons causing the problem, as soon as you start asking your doctor questions, healing can begin.

Question #4: Why Can't I Get Pregnant?
Infertility questions can be tied up with all sorts of guilt and anxiety. Is it my fault? Won't I ever have children? Getting to the root cause of infertility takes a lot of thoughtful discussion with your doctor. Start that discussion by asking the questions that are on your mind.

Question #5: Will I Change After a Hysterectomy?
You may have already made the decision, along with your doctor, to have a hysterectomy, but have lingering questions about what changes to expect. Arm yourself with a list of questions before the surgery, to save yourself anxiety afterward. Each woman's body is different, but there are several things that are consistent after hysterectomy that might seem puzzling if you don't have the answers you need.

Learning to talk frankly with your gynecologist and having the freedom to ask any questions you may have is a wonderfully empowering experience. Break the sound barrier and start asking! That's when health and vitality really become possible.

All About Tubal Ligation Reversal

2009-11-30T20:44:00.001-08:00

Many women are undertaking tubal ligations on the understanding that the procedure is reversible. What every woman needs to understand, though, is that the tubal ligation operation is not reversible in every case… and the results if it weren't able to be reversed would be heartbreaking. In many cases it is successful -- today we are looking at tubal ligation reversal and how it works.

Success Rates
The statistics differ according to the populations sampled, of course. What is important to understand before comparing tubal ligation reversal success figures is that the chance of a woman younger than 30 trying to have a baby is around 85% in one year. The chance of success for a woman older than 30 trying to have a baby is around 80% in one year. Don’t compare the success figures to an assumed 100% success rate in the general population -- it won’t give you an accurate picture.

One set of figures
A set of figures collected by a gynecologist are as follows. Percentages indicate women in the sample who became pregnant within 12 months of their reversal operation:
For tubal ligation reversal when the patient is younger than 40:
Clipping - 85-90%
Cut and tie - 55-70%
Diathermy (burning) - 75-90%

For tubal ligation reversal when the patient is older than 40:
Clipping - 40-45%
Cut and tie - 30-35%
Diathermy (burning) - 35-40%

In vitro fertilization
If the man and woman are otherwise healthy, and especially if they have had healthy children before the reversal, in vitro fertilization is quite a reliable method of achieving pregnancy. However in most areas across the world this will not be covered by public healthcare, and many private insurers also do not cover the cost.

Alternatively, you can bypass the reversal altogether and go straight to in vitro fertilization.

Guide to Kegels for Stress Incontinence

2009-11-30T20:41:00.001-08:00

Kegels are one of the most important things a woman can do for her reproductive health. They are right up there with quitting smoking, sticking to a healthy weight and keeping alcohol consumption to a minimum. Many women have good intentions, but aren’t sure if they are doing the exercises correctly -- it is a difficult exercise to illustrate! Today we give you a step by step guide to doing Kegels to help reduce stress incontinence … and perhaps improve your sex life along the way.

Finding the muscles
The standard way to find your pelvic floor muscles is to try to stop the flow of urine in mid-stream, next time you go to the toilet. However, do not do all your Kegels this way! It is likely to cause bladder or urinary tract infections as much as cure your stress incontinence.

Preparation
You should empty your bladder first for best results from your muscles. Sit or lie down -- whatever makes you comfortable. Eventually sitting will be easier, as you are more likely to do Kegels while sitting and doing something else.

Technique for curing stress incontinence
Many women do hundreds of fast, light Kegels -- this is not useful for either stress incontinence or preventing prolapse. You should alternate between:

* Sets of 10-15 very strong, fast Kegels to improve the muscle's aerobic fitness
* Sets of five to ten very strong Kegels held for as long as possible, to help improve the muscle's anaerobic fitness (stamina)

Keep pushing yourself to improve -- when you can easily do sets of ten, start doing sets of twelve. Then move up to sets of fifteen, and then move to two sets of twenty.

Concentrate first, automate after
Eventually you will want your Kegels to become automatic. It is not possible for our brains to actually focus on two things at once … so make sure you focus on your Kegels while you are setting up your routine. When you eventually feel that they are automatic enough for you to do them while concentrating on other tasks, you will be more likely to maintain correct technique. Remember that bad technique can sometimes increase the likelihood of developing stress incontinence.

When to do Kegels
If you associate Kegel time with a particular task, you are more likely to remember to do your exercises in the long run. For example:

* Do you watch the news every day, or another TV program regularly?
* Do you have a break from work for sit-down lunch?
* Do you check your email before going to work in the morning?
* Do you stand at the counter chopping vegetables for dinner every night?

These are just some suggestions -- but the key to Kegels success and stress incontinence

Avoiding Myths About Hysterectomy

2009-11-09T13:14:00.000-08:00

Why is it that intelligent, educated women, when faced with a surgery like hysterectomy, sometimes fall victim to myths passed along by friends and family? Here's a common-sense strategy for dispelling the myths and facing your surgery armed with the best information.

Step One: Collect Your Questions
Rather than panicking when your doctor mentions hysterectomy as an option, take the time to build your list of questions. This is your body, your surgery and your future, so slowing down the process long enough to have your questions answered is a good first step.

One mistake some women make when faced with hysterectomy is to rush about asking the women they know who've had the surgery about their experiences. While we all like to know what to expect, finding a balance between the stories our friends tell and good, solid medical advice can help us to make better decisions.

Write down the things that concern you. Are you worried about hormonal changes? Do you know what to expect post-surgically? Does the prospect of pain have you panicky?

Your friends and family members may be well-intentioned, but try to avoid getting caught up in horror stories about their hysterectomies. Medical issues women face, from pelvic pain to tubal ligation, aren't always experienced the same way.

Step Two: Go to the Best Source
A good OB/GYN practitioner is engaged enough with patients to want to make sure their questions are answered. Armed with your list of questions, got to your doctor and learn what you need to know.

Hysterectomy is a major surgery, and certainly shouldn't be taken lightly. That's why it's essential to ask your questions before you take the next step. You may have plenty of people offering "advice" about whether or not to have this procedure, but only you, with the help of your health care practitioner, can decide what's best.

Step Three: Make an Informed Decision
After speaking with your doctor about your options and having all your questions answered, you can now make a decision that makes sense for your life. No need to shun well-meaning friends when they rush to share their hysterectomy experiences, but keep in mind their lives, bodies and surgeries may be very different from your own.

Whether or not you go forward with having a hysterectomy, talking it through with a caring medical professional is the best way to gain the knowledge you need. Make a decision that you can live with based on facts, and use your network to provide emotional support. You'll find it's much nicer having the support of old friends rather than basing such an important decision on the tales they might have.

Are You Ready for Tubal Ligation?

2009-10-31T19:45:00.001-07:00

Many women have said in jest, after dealing with several children all day, that they'd gladly have their tubes tied. But it's actually a serious decision to opt for tubal ligation. Before you take a step this big, let's look at what's involved in the procedure.

Tubal ligation is the general name for a surgical procedure which blocks your fallopian tubes so eggs can't be fertilized. Because it's a surgical intervention, it's much more permanent than other forms of birth control.

There are several different ways tubal ligation is accomplished. One procedure uses electric current to make a small (painless) burn on each fallopian tube so that a scar will form, blocking the tubes. Another way tubal ligation is done is with a small mechanical device attached to the tubes to close them off. Should you decide on tubal ligation, be ready to ask your doctor which method they normally use.

No matter which method will be used, there are two ways tubal ligations are done. One is shortly after a woman gives birth, and is called "postpartum tubal ligation." The other is called a "bilateral laparoscopic tubal ligation" and is accomplished by use of a scope and instruments through three small incisions in the abdomen.

And so, the surgical procedure known as "tubal ligation" is considered to be a permanent form of birth control, with a very low failure rate. Like any surgery, it involves some risks, and your doctor should be able to explain them to you.

That should give you a quick overview of what a tubal ligation involves. Be prepared, when you meet with your doctor, to ask any questions you may have about the procedure, its risks and rare complications like future pelvic pain.

But there's another whole set of questions to ask yourself. Because tubal ligation is a serious step that ends your ability to bear children, you may want to consider these questions:

1. How many children do you now have, or have you chosen to be child free?
2. If there's a partner or spouse in your life, how will a tubal ligation affect your relationship?
3. Do you have a medical condition that can cause surgical complications?
4. Are you ambivalent about perhaps wanting children in the future?

Weigh your answers to these questions carefully when deciding on a permanent change in your child-bearing ability. No matter what your decision is, arm yourself with good information about what to expect. Write down any questions that come up and take them to your doctor's appointment.

With the right information, women are empowered to make good decisions about their health care. When considering tubal ligation, combine what you know about your own situation with the right questions to ask your doctor. You will have a list of the necessary questions to ask your doctor, and with the information your doctor provides, make a decision that's right for your life.