Boss Women are busy women, no doubt. With work meetings, project deadlines, and networking events filling-up our schedules, it’s easy to put off that annual physical or Ob/Gyn visit. In an effort to change this behavior, we asked you in a previous post to take a moment to check-in with yourself about your health and submit your questions to our partners at Methodist Dallas.
Thank you to all who submitted questions! We received 86 submissions in total. From those, we picked the 7 most popular questions and sought answers from an experienced Ob/Gyn, Theresa Patton, MD. Dr. Patton is an obstetrician and gynecologist on the medical staff at Methodist Dallas Medical Center. She completed a combined undergraduate and medical doctorate program at the University of Missouri-Kansas City Medical School in 1999, and an Ob/Gyn residency at Methodist Dallas Medical Center in 2003. In addition to seeing patients, Dr. Patton is also a part-time, voluntary faculty member for the Ob/Gyn residency program at Methodist Dallas where she trains physician residents.
Scroll down to read Dr. Patton’s answers!
Question 1 (Q1): How do I perform a proper breast self-exam?
Dr. Patton: The most important thing is to do a self-exam on a semi-regularly basis, monthly if possible. If you feel the entirety of the breast tissue by moving it around and flattening it as much as possible against the chest wall you will get used to what your breasts feel like and be able to recognize anything new that arises. Some time ago a national organization came out with a recommendation that called for doctors to not teach patients how to do a breast self-exam because their study showed that very few true abnormalities were picked up by self-exams. I respectfully disagree with this recommendation. I think it’s a good idea to know your body. Breast exams, skin exams, vulvar exams (with a mirror), are all good things to do on a monthly basis. Bring concerns to your doctor and let him/her reassure you that it’s nothing to worry about if that is the case. However, if you do find something on a self-exam that when you talk to your doctor about it he/she determines it could be something important, you will be forever grateful you were paying attention to your body.
Q2: Are Kegel exercises safe and if so, how often should I do them?
Dr. Patton: Kegel exercises are safe and effective. The best way to learn how to do them is to start while you’re in the restroom. While emptying your bladder, stop the stream of urine, hold for a few seconds, and then release. After doing this a few times you will be able to learn which muscles to tighten even when you aren’t voiding. Once you know this, then I recommend doing the exercises while you’re in the car, sitting at your desk, or on the couch when you’re not physically active in other ways. Kegel exercises can help with urinary incontinence and pelvic prolapse, but so can general exercise and weight loss. Talk with your doctor about what types of exercise are safe for you.
Q3: What’s normal when it comes to vaginal discharge?
Dr. Patton: I truly want to thank those of you who asked this question!! You’re right—there are some normal discharges from the vagina that are not a problem or infection. The vagina is a mucous membrane. Because of that, there should be moisture and mucous. It becomes a problem that needs to be evaluated when you also have itching, irritation, burning, urinary frequency, or new odor. And, not every infection is yeast. If you have frequent infections or one that persists after an over-the-counter yeast treatment then you need to see your doctor. Plus, remember that many sexually transmitted infections (STI’s) may not cause symptoms at all. So get tested routinely if you are sexually active, but remember that testing does not prevent these infections. It only catches them if they are there. Abstinence and condom use can help prevent the transmission of STI’s.
Q4: Why do I feel pressure in my vagina and pelvis?
Dr. Patton: You have to remember that almost all of the weight you carry falls to the pelvic floor. That’s why it’s called a floor! Some very small (but very strong) muscles take on this pressure and give you support. Even without a problem, you can feel pressure in these areas especially if you are carrying more weight than you are used to. If you’ve ever been pregnant just reflect back to all of the pressure you felt carrying that extra load! As we age and after pregnancies, some of the strength of those muscles/tissues can wear down especially if you have a family history of prolapse (yes, you actually have to talk with your mother about this!). When these tissues become less strong, pelvic prolapse can happen. This comes in a few different forms—the bladder falling down, the uterus falling down or out, the rectum popping up into the vagina, or the bowel pushing its way into the vagina. No matter the form, if it needs to be fixed surgically, you need to repair all of the areas involved to get the best result. In my opinion, patients facing this issue should consult with a specialist who performs these types of procedures on a routine basis. Sometimes that’s a urologist, sometimes a gynecologist, and sometimes a urogynecologist. It’s important to have an honest conversation with your doctor about how often he/she surgically treats pelvic prolapse because, even in the best surgical hands with the best possible healing, the procedures tend to only last 5-10 years and then the prolapse can recur.
Q5: How often should I be tested for sexually transmitted infections (STIs)?
Dr. Patton: This takes me back to some of what I said in regards to STI screening in Q3. Again, testing does not prevent infection. So use condoms! But, if you have a possible exposure through unprotected sex then you should be tested at 2 weeks (sooner may not pick up some of the infections) then again at 6 months and a year. If you are in a relationship that you believe to be monogamous and just want reassurance, you should be tested if you have any new symptoms or during your annual exam. Also, while same-sex female relationships are at lower risk for STI exposure, there are still some that can be transmitted with touching, oral sex, and close genital contact so discuss with your doctor when and what you should be tested for.
Q6: What are my birth control options?
Dr. Patton: SO MANY! There are five good options that work hormonally by stopping your ovulation: pill, patch, ring, Depo-Provera injection, and Nexplanon device (which this last one is implanted in the arm). Then you have intrauterine devices (IUDs) that can be placed inside the uterus and work by preventing a pregnancy from implanting. You can also use over-the-counter methods like condoms, birth control sponges, and spermicides. Other methods out there include lactational amenorrhea or monitoring of your cervical mucus, as well as diaphragms. Lastly, there are also permanent birth control (i.e. sterilization) options. There are pros and cons to all of these options including ease of use and effectiveness, both of which differ widely between them. Be sure to discuss with your doctor what options are best for you.
Q7: Why are my periods so heavy?
Dr. Patton: It’s really hard to answer this question without evaluating each individual patient because there are MANY reasons why cycles are heavy. However, know that you are NOT alone. This is one of the most common reasons why patients come to my office. The evaluation with a doctor to investigate a reason for heavy periods will likely involve going over personal history, a physical, a sonogram, and some blood work. Usually, with this information, a reason for the heavy periods can be found, but even if we can’t find an absolute reason there are still plenty of treatment options depending on what your future fertility wishes are. Contact your doctor and stop living with heavy cycles!
If you need an Ob/Gyn or a primary care physician, please visit methodisthealthsystem.org/doctors/