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Dr. Yarroch Talks About Endometriosis


Mar. 22, 2018 5:31 pm



Are you doubling over in pain during your period? Do you have cramps you just can't seem to shake throughout the month? For 1 in 10 women, these killer cramps are more than just your average visit from Aunt Flo, they're a symptom of endometriosis. Although endometriosis affects 176 million women worldwide, many go undiagnosed. Here's what you need to know about this painful disease and how to find out if endometriosis could be affecting you.

What is Endometriosis?
"Endometrial cells are what make up the lining of the uterine cavity," Dr. Yarroch explains. "In women with endometriosis, these cells are found in implants outside of the uterus where they cause inflammation."

This inflammation can result in pain and significant scarring to the surrounding tissue.

What Causes Endometriosis?

"There are various theories about what causes endometriosis, but the most accepted theory was first described in the 1920's and is referred to as retrograde menstruation," Dr. Yarroch says.

In this theory, it is proposed that there is a backflow of menstrual blood and tissue from the uterus through the fallopian tubes and into the pelvis.

"We do have evidence that there is an increased risk of endometriosis in women with heavy menstrual bleeding and longer or more frequent menstrual cycles," Dr. Yarroch says.

Doctors also know that estrogen plays a role and women who have a close female relative with endometriosis are 5-7 times more likely to have it themselves.


Spotting the Symptoms
Although it's a common misconception that endometriosis only occurs in women over the age of 20, the truth is that the disease can develop as soon as a girl gets her first period and can span the rest of a woman's reproductive years.

"The most common symptom of endometriosis is pelvic pain," Dr. Yarroch says. While this pain usually coincides with menstruation, some women can experience this symptom throughout their entire cycle.

Other symptoms to look out for include:
Pain during or after sex
Severe cramps that do not go away with NSAIDs or that impede the activities of your everyday life
A heavy menstrual flow
Periods that last longer than 7 days
Nausea or vomiting
Urinary and bowel disorders
Difficulty getting pregnant

Not every woman will experience all of these symptoms, but approximately 30%-40% of women who have endometriosis will experience issues with fertility.

Getting a Diagnosis
If you suspect that you may have endometriosis, we encourage you to speak with your doctor or make an appointment with one of the amazing providers at Women's Care. The only way to know for sure whether or not you have endometriosis is through a surgical procedure called laparoscopy.

Treating the Symptoms
There are a wide range of treatment options for endometriosis and your doctor may suggest a few less invasive methods before ordering a biopsy. At Women's Care, we work with you to choose a plan that fits your needs and your lifestyle. Some of the most common treatments include:

The use of NSAIDs, such as ibuprofen (advil, motrin) and naproxen sodium (aleve). NSAIDs can help relieve or lessen the pain caused by endometriosis by stopping the release of prostaglandins, one of the main chemicals responsible for painful periods. While NSAIDs can help manage the pain-related symptoms of endometriosis for some women, it's not effective in every case.

Birth control methods such as the pill, the patch and the ring are often helpful to treat the pain associated with endometriosis because they reduce heavy bleeding. This method works best for women who only have severe pain during their period and not during the rest of their cycle.

Progestins are recommended for women who do not get pain relief from or who cannot take hormonal birth control that contains estrogen (such as smokers). This synthetic form of the natural hormone progesterone is available by prescription as a pill or an injection.

GnRH therapy uses medicines that work by causing temporary menopause. The treatment actually causes the ovaries to stop producing estrogen, which causes the endometriosis implants to shrink.

For some women, surgery may be the best treatment method. While there isn't a cure for endometriosis yet, it is possible to remove some of the the scar tissue and lesions with surgery.
If you have endometriosis, surgery could be an option if you:
Have severe pain
Have tried medications, but still have pain
Have a growth or mass in the pelvic area that needs to be examined
Are having trouble getting pregnant and endometriosis might be the cause

"It is important to note that there are other conditions that can cause many of the same symptoms as endometriosis," Dr. Yarroch explains. "An OB/GYN can help determine if endometriosis is the appropriate diagnosis."

So What Now?

"Endometriosis can have a significant impact on a woman's life. Fortunately, there are treatment options available to manage pain and minimize recurrence," Dr. Yarroch says.

If you have endometriosis or believe you could have endometriosis, we strongly encourage you to speak with your doctor or one of our highly trained providers. We want you to know that at Women's Care, we're devoted to you and your health. We're here to meet both your physical and your emotional needs each step of the way, from diagnosis to treatment and recovery.

Join our Circle of Care and request an appointment with us today!

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When Should My Daughter Have Her First Gynecologist Visit?


Jan. 15, 2018 4:29 pm




For many young women, the thought of seeing a gynecologist for the first time can feel scary or even embarrassing, but this should be a time when your daughter feels comfortable and is able to ask questions about her developing body. We talked with Dr. Valary Gass of Women's Care to provide you with the information you need to help your daughter feel more positive and less stressed out about her first gynecologist visit.
What Age Should I Schedule My Daughter's First Gynecologist Visit?
"The American College of Obstetrics and Gynecology recommends that girls between the ages of 13-15 visit with a gynecologist," Dr. Gass explains.
For many parents, a reasonable time to talk with your daughter about scheduling her first appointment is after her first menstrual period. The real purpose of this appointment is to establish a relationship between your daughter and her gynecologist so she can feel comfortable asking questions and learn about what changes she can expect as she develops.
Preparing For Your Daughter's First Gynecologist Visit
The most important thing you can do to help ease your daughter's nerves is talk to her. Explain to her why this visit is important and help her understand what she can expect. Having an open dialogue with your daughter will encourage her to ask questions and feel more comfortable about the experience.
It is also a good idea to have your daughter create a list of questions she may have for her gynecologist before the visit. Sometimes being nervous can cause us to be forgetful, so writing these questions down on a piece of paper will help her make sure she doesn't leave anything out. Common topics for questions include periods, hormones, birth control, sex, and sexually transmitted infections. These are all normal topics for your daughter to have questions about. Remind her that anything discussed with her gynecologist is protected by privacy laws, so she shouldn't feel embarrassed about asking these questions.
What Your Daughter Can Expect During Her Visit
"Most of the time, a girl's first gynecologist appointment does not involve a pelvic exam," Dr. Gass says, "but it should include taking a careful medical history, addressing any concerns like bad periods, and considering things like HPV vaccinations."
During your daughter's first gynecologist visit, she can expect to have a general physical exam where the nurse will record her height, weight, and blood pressure. Her gynecologist may then check for common health problems and talk with her about her medical history.
While her gynecologist will probably not conduct a pelvic exam during her first visit, it is likely that your daughter will have an external genital exam. During the external genital exam, your daughter's gynecologist will exam her vulva and may use a mirror to help her identify parts of her own body that she has yet to discover.
The most important thing to keep in mind is that this visit is an opportunity for your daughter to speak openly with her gynecologist and ask questions.
When Is a Pelvic Exam Necessary?
"The American College of Obstetrics and Gynecology suggests that most women begin regular Pap smear screening at age 21," Dr. Gass says. At that point, women should continue regular screening every three years until age 30 when they can switch to having a Pap smear with HPV co-testing every five years.
Your daughter most likely will not need a pelvic exam during her first gynecologist visit, unless she has expressed complaints of lumps, bumps, pelvic pain, or abnormal discharge. In these instances, her gynecologist may decide a pelvic exam is necessary.
When Should My Daughter Stop Seeing Her Pediatrician?
Once your daughter is seeing a gynecologist regularly, you may wonder if she needs to continue seeing her pediatrician. This is largely up to you and depends on the specific needs your daughter has as well as her gynecologist's preference for their practice. It is perfectly normal for your daughter to continue seeing her pediatrician well into college and it can be helpful if she has a complicated medical history. Just make sure your daughter continues her annual gynecologist visit as well.
Schedule An Appointment
If you would like to schedule an appointment with one of our providers at Women's Care, you can call us at 920-729-7105 or click here.



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