A Gynecological Guide for the Ages
The 20’s: What causes vaginal itching? What can be done to treat and prevent itching?
Common causes of vaginal itching in younger women, who are otherwise healthy, are bacterial vaginosis and yeast infection. Both are due to disruptions of the normal vaginal pH causing an overgrowth of “stuff” that is normally present. The key to differentiate between them is the presence or absence of odor, as well as some various microscopic characteristics, which can be seen by your doctor.
Over the counter medications are available to treat yeast if that is suspected, but ALWAYS be seen by a doctor if symptoms don’t improve with treatment. Maintaining a normal pH and cleanliness is helpful to prevent infection. Never douche! Use probiotics, if desired, give your “parts” a chance to breathe by wearing cotton undies and occasionally go without to avoid trapping extra heat. If there is a reason for concern about sexually transmitted infections, this should be evaluated as well.
-Tracey Leaver-Williams, M.D., Board Certified in Obstetrics & Gynecology, performs a wide range of obstetrical and gynecologic procedures and enjoys connection with her patients through education and expert care. Contact her at Hilton Head Regional OB/GYN Partners.
The 30’s: What causes women to have a low libido? What can women do to increase their sex drive?
Low libido is a common issue that women of all ages come in to discuss. Often for women in their 30’s it is simply situational, they generally have young children and a lot more demands and stressors in their lives than ever before. Many times, couples counseling can be all the help they need. There are also hormonal changes that can occur at this time. Low thyroid and low testosterone levels are two areas we generally look at to see if supplementing these hormones can help. Birth control or other medications, such as antidepressants, can also significantly affect the libido and changing these types of medications may make a difference. There is also a new medication on the market called Addyi or the “little pink pill,” which is FDA approved for female hypoactive sexual desire disorder in premenopausal women. There are certain restrictions for this pill, and not everyone is a good candidate for it, so it is something that needs a doctor’s visit and discussion before prescribing, but has been shown to help with libido.
-Dr. Katherine Coley, M.D., F.A.C.O.G. has always felt passionate about providing excellent care to women as a whole, regardless of their backgrounds or stage in life. Contact her at Advanced Women’s Care.
The 40’s: What are the risks of having a baby in your 40’s?
It is absolutely possible to have a healthy pregnancy at 40, but women should be aware of increased risks for both mother and baby, and of extra tests and monitoring that may be necessary for the best outcomes for mother and child.
Older mothers are more likely to enter pregnancy with preexisting medical conditions that can complicate pregnancy, such as high blood pressure, obesity and diabetes. Babies born to women 35 and older are at increased risk of genetic abnormalities, such as Down’s syndrome, so we often offer these mothers early genetic screening and increased surveillance through ultrasound and other measures.
-By Janna Jones Kersh, CNM, a certified nurse midwife specializing in providing a safe, individualized childbirth experience for women with low-risk pregnancies. Contact her at Beaufort Memorial Obstetrics & Gynecology Specialists.
The 50’s: What are the health benefits and risks of hysterectomy?
Hysterectomy. Just the word can strike fear in some women and rejoice in others. It is such a polarizing choice among women. Why would a woman want or need a hysterectomy? The procedure can be an option for women suffering with chronic pelvic pain, endometriosis, adenomyosis, heavy periods, uterine fibroids, uterine prolapse, or abnormal pap smears. Sometimes, the need is even more urgent, as in the cases of uterine cancer, cervical cancer, or hemorrhage.
Heavy periods can cause anemia and symptoms of fatigue, weakness, or fainting and can affect daily life, activities, work and intimacy. No one feels good when they are bleeding through pads, tampons and clothing, or they can’t walk down the hall due to weakness from anemia. Some women try hormonal options, like birth control pills, IUD, depo provera injections first, but some are not able to take hormones. Some women try other surgical procedures first like a D&C, thermal ablation, or uterine artery embolization. Many women try many different options, but still bleed and make a hysterectomy their decision.
The benefits of a hysterectomy can be the end of pelvic pain and bleeding. This can let a woman return to her lifestyle she has been unable to do. It can be a life saving cure in the case of uterine or cervical cancer or hemorrhage.
Dr. Tracy Blusewicz, M.D., F.A.C.O.G., compassionate, genuine bedside manner has earned her the trust of many women for their health care needs. She can be contacted at Advanced Women’s Care.
The 60’s: I haven’t had sex in a while, and now I am dating again. What do I need to know about becoming sexually active?
Many postmenopausal patients ask this question often. There are a few things to consider after not having intercourse for a long period of time. Discomfort with intercourse is often a concern. A few things that can cause this include decreased estrogen and narrowing/shortening of the vagina. Decreased estrogen can lead to thinning of the vaginal tissue and decreased tone of the vaginal muscles. Patients often find relief with the use of vaginal estrogen, moisturizers, lubricants, as well as vaginal dilators. Decreased libido is also common among women in their 60’s. Women entering into a new sexual relationship may also not be aware of the risk of sexually transmitted infections (STI’s). It is important to discuss any concerns with your current partner and express your desire to have safe sex. Also, discuss these concerns with your healthcare provider, who can perform STI testing.
-Amanda Sutherland, M.D., of Obstetrics & Gynecology offers care for women throughout their lives, from their adolescent years to post menopause. Contact her at Hilton Head Regional OB/GYN Partners.
The 70’s and beyond: What is the link between urinary tract infections and dementia?A urinary tract infection (UTI) happens when bacteria travel up the urethra and multiply in the bladder. This infection can travel up to the kidneys and lead to a much more dangerous infection called pyelonephritis. This is a very common problem in the elderly due to several reasons:
• In women, the shortened urethra, combined with menopausal vaginal changes, predisposes them to infection.
• In men and women, the classic symptoms of urgency, burning and bladder pain are often not as severe as in younger people; therefore patients are not symptomatic of a UTI.
• Dehydration can happen more rapidly in the elderly due to decreased fluid intake and increased output from medications.
• People with chronic incontinence are often unaware of a new infection.
In an elderly person with dementia, these factors are amplified and patients often present at an advanced stage with sepsis, where bacteria enter the bloodstream. As a simple urinary tract progresses into sepsis, the immune system is called into play. But the immune system is slower to act, hence increasing the problem. Infection and stress on the immune system can lead to changes in mental status, or worsening of underlying dementia due to dehydration, electrolyte abnormalities, and low blood pressure from sepsis. It is for this reason that the elderly are screened for urinary tract infections routinely and a urinalysis is ordered immediately when dementia worsens rapidly. With proper treatment and antibiotic use, a patient can be returned to their baseline function within a day or so.
-Eve Ashby, D.O., a board-certified gynecologist, has a special interest in educating women about the choices they make about their bodies. Contact her at Beaufort Memorial Lowcountry Medical Group.