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Frequently Asked Questions
on Women's Health
Questions from visitors to our Ask-an-Expert
site might provide the answers you're looking for!
| Q | | Should my daughter get the Gardisil vaccine after being diagnosed with HPV? At her second exam she was negative for HPV. | | A | | Gardilsil provides protection from four strains of HPV, so it may be beneficial to her to be vaccinated, even though she has already been exposed to at least one strain.
| | | Answered by Heather York, MD, Obstetrics/Gynecolog, Eugene, Women's Care (11/25/2007) | | |
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| Q | | I am a second-time mom who had an emergency C-secton with my first birth, due to a non-dilating cervix. I have recently learned of some midwfery techniques to help ripen the cervix for this time around (e.g., evening primrose oil, etc.) I went back to the same doctor who delivered my first child and wonder now if I should ask her about these techniques, or if I should consult with a midwife. I REALLY don't want to go through that surgery again if it can be helped...suggestions? | | A | | My recommendation is that you stay with a physician (OB/GYN) who is well-qualified to take care of you whether you have a vaginal birth or another cesarean section. Of course you should ask your doctor about cervical ripening!
| | | Answered by Heather York, MD, Obstetrics/Gynecolog, Eugene, Women's Care (5/23/2007) | | |
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| Q | | I had done some research on prolapsed cervical wall and had come to the conclusion this might be what I have. I consulted a doctor about this. She told me it was just a normal part of aging (at the time I was 47), that my "squeeze" was weak, bladders leak, and "have a nice day". Now that I am approaching 50, things seem to be "falling out", and intercourse with my husband is painful at times. This is not a normal part of aging, is it?
My last period was in November, 2004, so I'm thinking, "yes" to menopause. What should I tell the next doctor I plan to see? | | A | | It does sound like you are menopausal since you have not had a menstrual cycle in over a year. What you describe sounds like uterine prolapse and possibly a bladder prolapse or cystocele. This often occurs as women age, but is not necessarily a consequence of menopause. Your symptoms are not normal and need to be treated.
You need to see a gynecologist to have this evaluated and, I would recommend that you tell them just what you have written to me. Describe the sensation of everything "falling out" and the problems you have noted with bladder control and with intercourse.
| | | Answered by Linda Frison, MD, Obstetrics/Gynecolog, Eugene, PHMG/OBGYN-Willamette (4/10/2007) | | |
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| Q | | I am seven months pregnant and was wondering why I am not supposed to lift heavy objects? Is it because I may hurt myself or hurt my baby, or both? And if so, how would this occur? | | A | | The ligaments of the back and pelvis soften in pregnancy. This makes the pregnant back more susceptible to injury. In theory, lifting excessive weight could increase the pressure in the abdomen and harm the pregnancy. Usual daily activity such as lifting toddlers is safe.
| | | Answered by Cristin Babcock, MD, Obstetrics/Gynecolog, Springfield, Women's Care (8/21/2006) | | |
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| Q | | I have had menstrual-type cramps for a few months now. They ease up a little here and there but I have them pretty much all the time. I told my doctor about it in December when I had my physical and she didn't seem too concerned at that point even though it had been going on for about three weeks. I'm not sure if the pain I'm having is really something else and/or if I need to be concerned? | | A | | Yes, I would be concerned. You need more evaluation. I can think of several things that could be causing this, including both gynecologic problems and intestinal problems. If there is any chance of pregnancy you should be evaluated for a tubal pregnancy. You should see a gynecologist to rule out ovarian cysts and endometriosis.
| | | Answered by Linda Frison, MD, Obstetrics/Gynecolog, Eugene, PHMG/OBGYN-Willamette (2/9/2006) | | |
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| Q | | How would they test for ovarian cancer? Would it show a really high white blood cell count? | | A | | There is no definite test for ovarian cancer. Screening for ovarian cancer includes a thorough medical history and physical exam, including a pelvic exam. Other tests that are sometimes done include pelvic ultrasound and CT scan. There is a blood test known as CA-125 that is used to evaluate for this as well. High white blood cell counts are associated with infection and not with ovarian cancer.
| | | Answered by Linda Frison, MD, Obstetrics/Gynecolog, Eugene, PHMG/OBGYN-Willamette (8/29/2005) | | |
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| Q | | I have been having irregular vaginal bleeding and it has lasted several days. I am on Yasmin. I had a pap smear in June that came back normal. I have been under some stress. I am away from home until September and I am concerned. | | A | | The irregular bleeding is probably due to the Yasmin as the most common side effect of the birth control pill is irregular bleeding. If you have any concern about pregnancy, you should do a pregnancy test. If it is negative, then you need to take the Yasmin every day at the same time. Because it is a low dose pill, it is more likely to cause irregular bleeding if you go more than 24 hours between doses. The bleeding is a nuisance and annoying, but is not serious (assuming a negative pregnancy test). If your pregnancy test is positive then you need to see your doctor. The irregular bleeding usually resolves within the first 3 to 4 months on the birth control pill. If it does not, then you should see your doctor as well.
| | | Answered by Linda Frison, MD, Obstetrics/Gynecolog, Eugene, PHMG/OBGYN-Willamette (8/1/2005) | | |
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| Q | | I am 21 yrs old. In January of 2005 I had a miscarriage. That same month I was informed that I had an abnormal pap, which led me to get a LEEP surgery in April, 2005. My husband and I are wondering when is the best and safest time for us to start trying to conceive again? It's still very emotionally hard to remember what we've been through these past few months, but we will to do whatever it takes for us to one day be blessed with a child of our own. Please respond to us as soon as you can, to put us both at ease. | | A | | After a miscarriage, it is recommended that a couple delay conceiving for about three months. This is partly to recover physically and emotionally, and also because a sooner conception has a slightly higher chance of miscarrying again.
After a LEEP, you should delay conception a little bit and it depends on your exact circumstances. I recommend you call or see the doctor who did the LEEP and ask that exact question.
| | | Answered by Dickinson, Katherine, M.D. , Family Practice, Bellingham, Katherine Dickinson MD (5/20/2005) | | |
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| Q | | I am pregnant and my doctor told me that I have leukocytes in my urine. I would like to know what this means? Is this something I should worry about? | | A | | It can sometimes be the sign of an asymptomatic bladder infection. Usually the urine is cultured, and if an infection is present, you are treated with antibiotics. In pregnancy, a bladder infection can move up to a kidney infection if untreated.
| | | Answered by Paula Jewett, MD, Obstetrics/Gynecolog, Eugene, Women's Care (5/16/2005) | | |
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| Q | | Can I get a paternity test at eight months of pregnancy? I had the amniocentesis done at four months of my pregnancy. | | A | | Paternity testing requires cells from the mother, the infant, and the man who is being identified as the infant's father. This is normally done after birth with a blood sample from each person.
I don't know if there is any way of doing the test on the cells obtained from the infant at amniocentesis. You should ask that question of the doctor who did the amniocentesis, and find out if any cells are actually left now, 4 months later.
| | | Answered by Dickinson, Katherine, M.D. , Family Practice, Bellingham, Katherine Dickinson MD (4/26/2005) | | |
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| Q | | Would you please explain why, "An ultrasound generally does not replace the need for a mammogram", when it's less invasive and safer to use ultrasound? Is it because insurance companies won't pay for an ultrasound instead of the traditional mammogram? | | A | | Ultrasound cannot be considered a primary imaging tool for breast disease, especially detection of breast cancer. Over the past three decades, screening mammography and breast self examination have contributed to statistically significant improvements in breast cancer detection and survival. Mammography is not a perfect tool and does not detect all breast cancers; however, it can detect changes of some early (small) breast cancers by detecting small calcifications. Some early cancers deposit small calcifications in the ductal system. Detecting these is one of the most important things mammography can do and no other breast imaging technique can reliably detect these small calcifications.
Breast ultrasound is mainly used as a problem solving technique onece a finding is made mammographically or by physical exam. Women with very dense (glandular) breast tissue are more difficult to evaluate with mammography and sometimes breast ultrasound or MRI is used as an adjunct to mammography in these women, especially if they are considered to be at high risk for breast cancer (usually by family history).
| | | Answered by Jon Ekstrom, MD, Radiology: Diagnosti, Eugene, Radiology Associates, PC (4/4/2005) | | |
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| Q | | I am 17 years old and have had sexual intercourse. If my mother takes me to the doctor, can the doctor tell if I have had sex before? | | A | | It is easier to determine if someone has never been sexually active than if they have been sexually active. That is because the hymenal ring does stretch. So, it is not always obvious if someone has been sexually active.
If you are worried about your mother finding out, you could see a health care provider on your own by making an appointment with someone at Planned Parenthood or ask for an exam to be confidential between you and your health care provider.
| | | Answered by Randall S. Lewis, MD, Obstetrics/Gynecolog, Eugene, PHMG/OBGYN-Willamette (3/21/2005) | | |
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| Q | | I am 33 yrs old and had a tubal ligation done in 1995. I am wanting to get a reversal done now because my fiance is coming home from Iraq. I am starting to research everything now..dr's, procedure etc. My operative report states thet I had the Pomeroy technique (it mentioned bipolar cauterization and the measurement of 2cm). I have 3 healthy girls, and never had trouble conceiving.
My questions are this --How soon after the procedure should a couple begin trying to conceive? Should the attempts be EVERY month until conception? (he may have to go back to Iraq 4 months after the procedure but he'll stay for 2-3 months). On average, how long does it take to ovulate after the reversal? I want to get the procedure done prior to his homecoming so we can try to conceive when he gets back. Should I get the procedure done a month prior? two months?
| | A | | I recommend you have hormone levels check prior to undergoing tubal reversal. If all is well, have the procedure done about 6-8 weeks prior to attempting conception. The procedure should not affect your menstrual cycle
| | | Answered by Heather York, MD, Obstetrics/Gynecolog, Eugene, Women's Care (1/28/2005) | | |
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| Q | | I am 12 and I have already started my menstrual cycle for the first time April 1. It is now June 7 and I have skipped two cycles. I still have cramps and other symptoms you get during your period. I have also told my mom about it, I would like to know if I should see a doctor for this or if it is normal.I am sort of scared and for any information or answers you give me I would be very thankful! | | A | | It is very normal to skip periods after you first start. It can take up to 3 years for cycles to become regular. The cramping may mean that you will start soon. I would not worry about this unless the cramping becomes more severe or interferes with your activity. In that case you should see your doctor.
| | | Answered by Linda Frison, MD, Obstetrics/Gynecolog, Eugene, PHMG/OBGYN-Willamette (6/8/2004) | | |
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| Q | | I am on a fertility workup and I am on my 3rd visit with my doctor. I just got my lab work back and he told me that my progesterone level was too low to even carry a baby. He gave me some clomid to start taking when I start my cycle, which is 3 days late. Can you tell me a little bit more about my progesterone level and can it really prevent me from having kids? | | A | | Progesterone is the hormone which maintains the lining of the uterus to allow for implantation. When the progesterone is low, it generally means that a woman has either not ovulated or is ovulating very poorly. To improve ovulation, clomid is given. Make sure that your physician rechecks your progesterone on the clomid to insure that improvement is demonstrated.
| | | Answered by Douglas Austin, MD, Gynecology, Eugene, Women's Care (5/1/2004) | | |
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| Q | | This is in regards to blood tests that are taken during pregnancy -- what are you tested for when the blood is taken? | | A | | That is a question with a lengthy answer. Initial blood work includes a blood type, Rubella (measles) immunity, Hepatitis, syphillis, and blood count.These are state mandated tests. Also offered are HIV, and cystic fibrosis. Later in the pregnancy, tests for Down's syndrome are offered, and at 28 weeks a test for diabeties of pregnancy. Your health care provider can explain these in detail if you desire.
| | | Answered by Tina Schnapper, MD, Obstetrics/Gynecolog, Eugene, Women's Care (4/5/2004) | | |
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| Q | | I'm on my third pregnancy. Both of my previous ones were complicated by preterm labor, which as far as I can tell was only diagnosed by frequency of contractions as measured by one of those belts around my belly. A friend told me she had lots of contractions, up to every two minutes, but that her doctor did a test that indicated it wasn't true labor. What test(s) are available to determine if contractions are labor or just Braxton-Hicks. I'm not looking forward to bedrest again, and would like to be certain it is necessary. | | A | | This is an important question and needs a longer discussion with your doctor rather than a brief e-mail reply. You should be cared for by an experienced obstetrician who is familiar with high risk pregnancy. The test you are referring to is probably the "fetal fibronectin test" which is a special swab of the upper vagina done between 22 and 35 weeks of the pregnancy. It is only one of a number of variables which diagnose premature labor or the risk of premature labor.
| | | Answered by Robert Olson, MD, Obstetrics/Gynecolog, Bellingham, Whatcom Ob/Gyn (4/5/2004) | | |
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| Q | | I have had a recurrent yeast infection for years. I have been to two different gyn, they give me medicine--to no avail. My paps come back normal. Any ideas? I need relief! I've been researching the Yeast Syndrome. | | A | | It sounds like you need a thorough evaluation to check the vaginal and vulvar area for not only infections, but possibly other skin irritations. Other systemic problems such as diabetes should be ruled out as well. A gynecologist who has a special interest in vulvar dystrophy should be able to help you.
In the Healthwise Knowledgebase there are various articles on Vaginal Yeast Infections. You might find the Home Treatment and Prevention sections useful as well.
| | | Answered by Linda Frison, MD, Obstetrics/Gynecolog, Eugene, PHMG/OBGYN-Willamette (3/25/2004) | | |
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| Q | | Your website does not detail or even say anything about your maternity or nursery services in Longveiw...does this hospital have nursery or maternity services? and if so could you please detail them for me? | | A | | St. John Hospital has a complete labor and delivery floor along with nursery services. We also have a Women's Health Pavilon that is listed on our Web site under Women's Services. We have family practice doctors at PeaceHealth Medical Group that do OB care and delivery, as well as OB/GYN doctors at the Women's Health Pavilion that do prenatal care and delivery at St.John Hospital.
| | | Answered at 2/13/2004 | | |
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| Q | | I have heard that condyloma can be cancerous. Is this true? | | A | | The human papilloma virus (HPV) or the wart virus, or condyloma, is one of
the most frequent and common sexually transmitted diseases (STD). Most women
and men are asymptomatic, as this is a microscopic virus that you cannot
see. Occasionally, this can cause bumps or warts that can be seen and felt.
If either partner has a wart, they should seek medical attention.
The HPV virus can cause changes on a woman's cervix (the opening to her womb
at the top of her vagina). This can be reflected in an abnormal Pap smear.
Uncommonly, this can be associated with abnormal cells, which are
precancerous. Rarely, these cells can turn into cervical cancer. This takes
a long time, and if a woman is visiting her doctor on a regular annual
basis, the Pap smear should turn abnormal many years prior to cancer
developing.
A regular annual exam by a physician is important for all women.
| | | Answered by Robert Olson, MD, Obstetrics/Gynecolog, Bellingham, Whatcom Ob/Gyn (11/17/2003) | | |
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| Q | | I have had problems getting a pap smear for the last two years. Can you tell me what is a CLOSED CERVIX? Can you get a true reading from a pap smear taken outside of the cervix? What causes a closed cervix? What are the dangers of having a closed cervix? Can and should this be corrected? | | A | | It sounds like your endocervix is tucked up in your cervical canal. Many things can cause this including normal anatomy, menopause, scarring from pregnancy and delivery or any surgical procedures, etc. In order to obtain a useful, reliable Pap, the endocervical transformation zone must be sampled. This transformation zone is where the endocervical cells (usually tucked up inside the cervix) meet the surface cervical squamous cells.
There are specifically designed tools for sampling the endocervical canal and if these do not provide a good sample, then an endocervical curettage can be done. These procedures can both be done without surgically "opening" the cervix.
I would recommend that you have your pelvic exams and pap smears performed by a gynecologist who would have these extra pap equipment items available.
| | | Answered by Linda Frison, MD, Obstetrics/Gynecolog, Eugene, PHMG/OBGYN-Willamette (10/15/2003) | | |
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| Q | | This is a GYN question. Can you tell me what causes clitoral pain or spasm? Is this common in women? | | A | | Clitoral spasm is not common. It can be caused by many different factors, including infection, vascular (blood supply problems), diabetes, tumors, etc. I would recommend you see your Gynecologist to evaluate this.
| | | Answered by Linda Frison, MD, Obstetrics/Gynecolog, Eugene, PHMG/OBGYN-Willamette (9/22/2003) | | |
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| Q | | What is the purpose of having an annual pap smear when you've already had your uterus, tubes and one ovary removed back in 1976? | | A | | A pap smear is a screening test for cervical cancer. If your cervix has been removed (not always the case at the time of hysterectomy) then you could have pap smears less often, at the discretion of your physician. It is important however to have a pelvic exam annually to examine the vagina and remaining ovaries. You should also have a rectal exam annually if over age 40.
| | | Answered by Tina Schnapper, MD, Obstetrics/Gynecolog, Eugene, Women's Care (2/12/2003) | | |
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| Q | | What are the pros and cons to having a breast reduction? Do insurance companies usually cover this surgery? | | A | | This is a very complex question and will require a specific answer for your particular problems from a personal healthcare provider. However, I can give you a few pointers from my point of view. Usually a breast reduction is desired due to the medical conditions arising out of heavy breasts. These often are chronic back pain, posture difficulties, and other structural physical issues. The purely cosmetic indication that a woman does not like her large breasts is usually not accepted by many insurance companies. If you believe you have these medical issues due to heavy/large breasts, then you should find an experienced plastic surgeon to provide a consultation. They may tell you whether you are a candidate for this procedure.
The pros for reduction are that the woman may have fewer back and other aches. However, sometimes there is no benefit for those complaints. The cons are that it is a big operation, with scars that cross the underside of the breasts and surround both nipples. Healing takes some time, and repeat "revision" type surgery may be necessary.
This certainly is an individual decision which should be weighed very carefully with plenty of medical advice
| | | Answered by Cary S. Kaufman, MD, Surgery: General, Bellingham, Bellingham Breast Ctr (10/28/2002) | | |
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| Q | | Have you ever heard of a procedure called LEEP? I believe it's to remove abnormal cells, but I'd like to know more information on it. When someone should have it done? | | A | | A "LEEP" is a Loop Electrosurgical Excision Procedure and is used to treat dysplasia or pre-cancerous cells on the cervix . It can be performed in the office with local anesthesia. A small piece of the cervix is removed (the part with the pre-cancerous cells), and it usually will treat the problem completely. Women who have severe dysplasia or have mild dysplasia that lasts one year should have a LEEP.
| | | Answered by Tina Schnapper, MD, Obstetrics/Gynecolog, Eugene, Women's Care (8/13/2002) | | |
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| Q | | How much do Depo shots cost, and exactly how effective are they? Is "the pill" more effective? How much does it cost? | | A | | Both the Depo-provera shot and the pill require an office visit which would cost between $25 -$125 depending on the provider, clinic, nurse, or doctor. Depo-provera costs $55 for the medicine and $50 for the injection every 3 months.This is my office charge and may be cheaper in other settings. The pill costs $12 -$30 /month from a pharmacy. Both are extremely effective means of birth control. The pill is about 99% effective if taken every day, but a typical user has only a 97% effective rate if she misses an occasional pill, and someone who forgets the pill often would have an even higher failure (pregnancy) rate. The Depo-provera shot is 97% effective as long as a women gets her shot every 3 months. Neither method protects against sexually transmitted disease and a women should always make her partner use a condom. If money is a factor, Planned Parenthood is a very low cost source for care and can be found in the white pages of the phone book.
| | | Answered by Robert Olson, MD, Obstetrics/Gynecolog, Bellingham, Whatcom Ob/Gyn (2/26/2002) | | |
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| Q | | I want to know about the neonatal heart beat. While still in the womb, which baby has the faster heart beat, a girl or a boy? | | A | | Usually the answer is that a boy has a slower heart rate and a girl a faster one. This of course is not very accurate, but can be fun when trying to guess the baby's gender.
| | | Answered at 12/14/2001 | | |
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| Q | | I recently found out I am pregnant. However, I am only 15 years old. I haven't told my parents, but in the past they have said that if my sister or I were to get pregnant we would have to give the baby up for adoption. I really want this baby more than anybody could ever know but I don't want to have it if my child is going to end up in the hands of some stranger. There is one catch though: the father is 21. I know that is statuatory rape, but I really love him and he loves me. He said he would help me take care of it, but I don't want him to go to jail. Is there anything I can do? What are the laws? | | A | | First, you should go see an obstetrician/gynecologist to begin prenatal care. Your parents cannot make you give up your baby for adoption. You can consent to prenatal treatment since, by nature of your pregnancy, you are considered an emancipated minor. Yes, this is considered a statuatory rape and would have to be reported. I discussed this scenario with the prosecuting attorney's office in our area, and she said that the magic age is 16. Younger than that would warrant a police investigation.
You have a lot to think about and some serious decisions to make. I would urge you to find an adult you can trust to talk about your options--perhaps someone at your school such as a counselor or a social worker.
| | | Answered by Tom Ewing, MD, Family Practice, Eugene, PHMG/Admin-Willamette (5/31/2000) | | |
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| Q | | I had a prolapsed uterus and bladder, followed by TAH and a vault repair. I had an SP catheter in place until it was removed eight days later. Previous to this I had no problem with incontinence at all. Now I do--much to my dismay. I wake up at night and find I am unable to get to the bathroom in time. Is this normal for a period after this type of surgery? | | A | | Unfortunately, repair of prolapse sometimes corrects an anatomical "kink" which may have prevented urinary leakage in the pre-op, or uncorrected, state. However, this could also be a simple bladder infection or an over-active bladder with urge incontinence. In any case I think you should consult a urologist.
| | | Answered by Robert Olson, MD, Obstetrics/Gynecolog, Bellingham, Whatcom Ob/Gyn (5/9/2000) | | |
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