Trans Healthcare: What Your Gynecologist Wants You to Know

At Covington Women’s Health Specialists, we pride ourselves on being a practice for and by women in our community. We also serve a demographic who needs gynecological healthcare just as much as everyone else: Transgender people.

What Does It Mean to be Transgender or Non-Binary?

People have identified as transgender and non-binary in multiple cultures as early as 5000 to 3000 B.C. Roughly 150,000 minors and 1.4 million adults living in the United States identify as transgender, according to the American College of Obygesticians and Gynecologists.

While a transgender person‘s identity differs from the sex that was assigned at birth, a non-binary person identifies as transgender or gender-nonconforming and does not identify as a man or woman on the gender spectrum.

Do Trans Men and Non-Binary People Even Need Gynecology Care?

Yes! Even after gender-affirming procedures like top surgery (a double mastectomy) or hysterectomy, trans men and nonbinary individuals are still recommended to have an annual gynecology exam. Additionally, while taking testosterone may lower fertility, this is not a reliable birth control method so these individuals should also seek medical consultation from their gynecologist regarding these needs.

For trans people who are interested in having children, fertility services and pregnancy care can still be performed. However, patients who are taking testosterone will need to get off of it when they are ready to take the next step.

Are Pap smears still necessary if I have never had penetration?

Yes! If you have your cervix, screening for cervical cancer is still needed. Most cervical cancers are caused by the Human Papillomavirus which is spread by genital to genital contact, oral to genital contact, and HPV can be spread while sharing toys. All people are at risk.

What Safety Issues Do Trans People Face in Healthcare?

Due to stigma, trans people deal with discrimination on a daily basis. Due to negative and traumatic experiences that many of them have had when accessing care, many avoid it out of fear of mistreatment, according to Contemporary OB/GYN.

They may also face barriers to accessing health care, according to the American College of Obstetricians and Gynecologists. Another study found that 26 percent of trans respondents had been denied healthcare and 52 percent had difficulty accessing health services.

How Can I Build Trust with My Gynecologist and Get Comfortable Talking About Sex?

Finding the right provider for you can involve trial and error. You still have to get out there and visit the practice in person to find the one for you! However, you can get a feel for their standard practices and values through their social media and website.

Discussing sexual activity with a healthcare provider can be awkward, no matter your gender or sexual identity. On top of that, trans and other LGBTQIA+ people may fear being judged or treated poorly due to their identity.

What Happens If You Have an STD While Pregnant?

Discovering you have an STD can be upsetting under any circumstances. If you’re diagnosed while you’re pregnant, it can be especially concerning. You may have questions about how the condition will affect your pregnancy, your baby, or long-term health for you both. First, try to remain calm. You’re certainly not alone in this experience, and we’re here to answer your questions.

STD Facts at a Glance

While many of us have been led to believe that STDs are rare, according to 2020 data from the CDC, one in five individuals has an STD or an STI (sexually transmitted infection). Though you might think you’d know for sure if you had one, infections frequently do not cause symptoms.  This is one factor that allows infections to be so easily spread.

Still, despite their common nature, it seems STDs continue to wrongly be considered taboo. “The idea that STDs are these gross, life-altering conditions is also deeply stigmatizing, not to mention largely inaccurate,” insists Amy Marturana Winderl, CPT, in her 2018 article for SELF. “In reality, many STDs can be cured with a round of antibiotics, while others can be managed with medication.”

Whether common or not, effectively treating any condition a mother experiences during pregnancy is of the utmost importance to ensure the safety of both you and your newborn.

Having an STD While Pregnant

While STDs can cause the same health issues in pregnant women as non-pregnant women, the challenge is that certain STDs can also affect babies, as they can be passed along during pregnancy, birth, or while breastfeeding. Even if they are not spread to your child, other complications can be serious for you, including premature labor, pelvic inflammatory disease, and uterine infection.

OB/GYNs minimize these risks by testing patients once or twice during their pregnancies.   For example, at the first visit when the pregnancy is confirmed, you will be tested for HIV, syphilis, chlamydia, hepatitis B and gonorrhea.  Later in the pregnancy, you will be re-tested for common infections such as chlamydia or infections that can affect the baby such as syphilis and HIV.

Infections caused by bacteria are usually cured with pregnancy-safe antibiotics.  However, viral infections cannot be cured, but they can be controlled with medications to prevent spread to the developing baby. In the case of HIV, for example, antiviral medications can be safely administered during pregnancy to reduce symptoms and decrease the chance of HIV transmission. In addition to using antiviral medications during pregnancy, to further protect the baby, delivery by cesarean section and treatment of the baby with antiviral medications after birth is recommended.

STD prevention is a solid way to keep both you and the baby safe. Limiting the number of your sexual partners, practicing protected sex, and staying away from shared needles or razors (anything that may expose you to another person’s blood or body fluids), are all advised.

Whether you’re concerned about an infection during pregnancy or you’re simply seeking a trusted partner for your maternity care, allow our providers to help. Our compassionate team is here to support you through every phase of pregnancy, including prenatal and postpartum care. To schedule an appointment, call (770) 385-8954, or fill out a request form online.

Postpartum Hair? How to Cope with the Loss

Most women expect their bodies to change in significant ways during pregnancy and after birth. (Growing and birthing a human are remarkable feats, after all!) But it can be surprising to discover just how pronounced an effect pregnancy can have on virtually every area of the body — including your hair.

If you feel as if you’ve started shedding more hair after having a baby, you’re not alone. The American Pregnancy Association confirms that 40% to 50% of women experience hair loss during or after pregnancy.

We understand that simply knowing that this is a common situation doesn’t make it any less upsetting. So, here’s what you should know about this frustrating postpartum symptom.

Why Does Postpartum Hair Loss Occur?

While the average person will shed between 50 and 100 hairs a day, shedding often slows down significantly during pregnancy. Both estrogen and progesterone keep hair follicles from shedding their individual strands of hair. When these hormone levels change during pregnancy, women often end up with thicker hair, because they’re simply losing less. So, when their hormone levels go back to normal postpartum, there are nine months’ worth of hair follicles that are all ready to lose their strands.

This normal, post-pregnancy process typically peaks four months after giving birth, though it can start anywhere between one to six months postpartum and may continue for a period of up to 18 months. Though many women experience regrowth earlier, no matter how long it lasts, unlike other types of hair loss, dermatologists note that postpartum hair loss is temporary.

How to Deal with Postpartum Hair Loss

While you certainly don’t have to do anything to address it, you may feel more like yourself by tweaking your hair care regimen until your mane regains its fullness. Here are a few tips to try.

Continue taking prenatal vitamins.

Certain vitamins in your prenatals may help to sustain nail and hair growth after giving birth. Folic acid, in particular, can be helpful for promoting healthy hair.

Try a new style.

Many women find that postpartum hair loss is most noticeable right at the start of the hairline. Switching up your part may be enough to cover up the areas where the hair loss seems most pronounced. Or, consider taking a few inches off the length to create the illusion of fullness.

Switch up your routine.

When you’re already shedding hair, it’s a good idea to do what you can to avoid even more hair loss. To that end, try to use a gentler styling routine whenever possible. Instead of using a curling iron, which can lead to damage, try braiding your strands while they’re damp for heat-free waves. Similarly, allow your hair to air dry whenever possible in lieu of blow drying. Be extra cautious when drying your hair; consider using a microfiber towel or t-shirt instead of roughing up your hair with a regular towel.

Modify your diet.

One 2017 study has linked accelerated hair loss to low protein intake. But eating a nutrient-rich diet is beneficial in many ways — particularly while breastfeeding — so consider addressing any nutritional gaps in your diet. If you’re concerned, you could also ask your doctor about having blood work done to check for vitamin deficiencies.

While hair loss is a normal part of postpartum hormone changes, we’re here to help with any health concerns you may have through pregnancy and beyond. To discuss any women’s health topics with our providers, request an appointment online or by calling (770) 385-8954.

Signs of Menopause (Regardless of Your Age)

Sometimes referred to as “The Change” in pop culture, menopause is more formally defined as “the time when your menstrual periods stop permanently and you can no longer get pregnant.”

When, exactly, does the transition into menopause begin? Age, family history, and prior medical conditions can all play a part in its onset. According to the Endocrine Society, “In the United States, the average age for menopause is 51 for non-smokers and 49 for smokers, with a typical age range somewhere between 47 and 55 years. Some women experience menopause sooner — before age 45 is considered early menopause, and before age 40 is considered premature menopause.”

Still unsure when to expect yours? As the North American Menopause Society admits, there’s “No clear starting or ending point, odd diversions, and an estimated time of arrival that could span years.”

But there are a few signs you can look for, and we’re here to help you navigate them.

Irregular Periods

A ‘change’ can mean a lot of things when it comes to your menstrual period,” The American College of Obstetricians and Gynecologists explains. “It could be a change in the length of your cycle. It could mean your period is coming more often or less often. The flow could be heavier or lighter than you’re used to. You also could have some bleeding or spotting between periods.”

If you’re experiencing irregularity in an otherwise “you-could-set-your-clock-to it” menstrual cycle, this may signal the beginnings of menopause (also known as perimenopause). Regular appointments with your gynecologist can help track these changes and determine whether you are truly in menopause or not.

Mood Shifts

“During menopause, it’s common to experience mood changes such as irritability, sadness, lack of motivation, aggressiveness, problems focusing, stress, difficulty concentrating, and depression,” Mental Health UK explains. These mood changes can be due to normal hormone shifts in your body, a previous history of depression or mental health issues, mid-life psychological changes, and other factors.

If you’re noticing unexplained changes in your mood — those that sharply veer from your stable “norm” — talk to your gynecologist to help identify whether normal menopause hormone changes may be the source.

Hot Flashes

These sudden, uncomfortable temperature changes in your body are practically the calling card for menopause. (When they happen at night, they’re referred to as night sweats.) The experts at Breastcancer.org succinctly explain their cause this way: “As your estrogen level falls, this has a direct effect on the hypothalamus, the part of the brain responsible for controlling your appetite, sleep cycles, sex hormones, and body temperature. Somehow (we don’t know exactly how), the drop in estrogen confuses the hypothalamus — which is sometimes referred to as the body’s ‘thermostat’ — and makes it read ‘too hot.’”

As with other symptoms of menopause, the intensity, frequency, and length of time you might experience hot flashes varies among individuals, which can make it challenging to determine the most effective treatment. Several different solutions may be useful, including hormone therapy, stress management, dietary changes, or alternative medicine practices, but working with your gynecologist will help you find the combination best suited for your specific needs.

Sleep Disturbance

Night sweats can also be connected with difficulty sleeping. But they aren’t the only reason why menopause impacts your rest. The Sleep Foundation reports that “The most common sleep problems . . . include hot flashes, insomnia, sleep-disordered breathing, and other mood and sleep disorders,” including restless legs syndrome.

Lack of sleep can negatively impact both your physical and mental health, and cause serious health problems if it continues long term. Your gynecologist can help you manage challenging symptoms, as well as create a healthy sleep routine.

Vaginal Dryness

Though vaginal dryness can happen at any age for a variety of reasons, as SELF magazine explains, “it’s most common when estrogen levels tank during menopause.” This normal drop in estrogen production can also lessen your body’s natural vaginal moisture and secretions, resulting in dryness that can cause:

  • irritation, burning, or itching
  • lowered sex drive
  • post-sex bleeding
  • recurring urinary tract infections

If this menopausal symptom is getting in the way of your sex life (or general quality of life), your gynecologist can recommend a variety of remedies for you.

Menopause is a normal, biological process for every woman, but as you can see it’s also individually unique. Schedule an appointment online or call (770) 385-8954 to connect with our compassionate team, and get the right support through every phase.

Covington Women’s Health Specialists Sponsors 39th Annual Fuzz Run

On Sep 11, 2022, Covington Women’s Health Specialists had the honor of being a diamond-level sponsor for the Fuzz Run.

Taking place every September, the Fuzz Run is organized by Police Who Care, Inc. The PWC Fund was created almost 40 years ago as a means to help Covington Police Officers with medical bills and other financial difficulties.

We had such a wonderful time meeting current and future patients! Thank you to everyone who stopped by and had a chat with us. Until next year!

In the meantime, you can see Covington Women’s Health at our practice. Make an appointment with us today.

How Our In-Office Guidelines Help Us Provide Quality Care

Thank you for your trust in us to provide you or your loved one with quality medical care!

Covington Women’s Health Specialists is proud to be offering women’s healthcare to our community for nearly 20 years. We are here to support and empower the women of our community and do our best to take care of as many patients as we can.

Due to the increased cases of COVID-19 and the health and safety of all of our patients and staff, we are continuously updating our Guidelines for Our In-Office Visits. Please be sure to familiarize yourself with the most updated version of our policies before your visit and feel free to give our office a call for any questions or clarifications needed.

We ask for patience, kindness, and understanding when you address our staff and discuss our practice in our community and online. Your cooperation as we strive to accommodate your needs and keep everyone healthy is greatly appreciated.

Midwife in the Making: What’s a Catheter Cervical Ripening Balloon?

The Midwife in the Making is a series written by Jennifer Walker, a Nurse Midwife graduate student at Frontier Nursing University. She is currently completing her clinical rotation at Covington Women’s Health Specialists and Piedmont Newton Women’s Services Department. She will be joining the team of Covington Women’s Health Specialists as our sixth midwife after graduating in fall 2022.

Have you ever seen a medical tool with two-headed bubbles attached to some tubes? You may have seen a catheter cervical ripening balloon. While it may look intimidating, I promise it is not as bad as it seems!

Cervical ripening balloons are one of several methods used to help induce labor. Every induction varies for each person depending on a multitude of factors, which means that not everyone will be a candidate for a cervical ripening balloon.

As a labor and delivery nurse, I was always fascinated by cervical ripening balloons. You can imagine my excitement when I successfully placed my first cervical ripening balloon in a patient recently. Followed by the little victory dance and fist pump I did!

Cervical ripening balloons are used for mechanical dilation of the cervix. There are two small balloons on the end of the catheter. When placed correctly, each balloon will be filled up with water to create steady pressure on the internal and external cervical os, creating mechanical dilation.

It can stay inserted inside of you for up to 12 hours but many times I have seen it fall out before the 12 hours was up. Funny side note: I had a patient sneeze hers out! I would not have believed it if I had not seen it myself! And she was 4 centimeters—score!

Now, does it hurt? That answer is subjective. I’ve heard them described mostly as “uncomfortable” and “a crampy feeling” during placement. The good news is that this is one of the many methods we can use for induction. While it may not be for everyone, it is certainly a good option for some.

— Jennifer, Student Nurse Midwife

 

Stop the Doomscroll: How to Take Care of Your Online Mental Health

If you’ve lately found yourself experiencing a “tendency to continue to surf or scroll through bad news, even though that news is saddening, disheartening, or depressing,” (as Health magazine describes), likely you’re participating in some “doomscrolling.” It’s a habit that worldwide news headlines or even celebrity gossip can drive you to, but it can especially become an issue when researching a medical condition.

Though it’s tempting to lean on the Internet’s many benefits to help you gain a better understanding of a health condition, an overwhelming amount of negative information can damage your health. A 2014 study in Cyberpsychology, Behavior and Social Networking reported that “For some individuals, repeated searches for medical information on the Internet exacerbate health anxiety.” The reason for this, as clinical psychologist Dr. Amelia Aldao explains, is that “Our minds are wired to look out for threats. The more time we spend scrolling, the more we find those dangers, the more we get sucked into them, the more anxious we get.”

Your doctor or gynecologist should serve as your primary reference for any health concerns you have, but following a few guidelines about online medical research may empower you to be smartly (and healthily) informed.

The Source of Your Material Matters

Identifying the difference between quality online sources and those that are less reliable is one place to start.  “As a rule,” the National Institute on Aging advises, “health websites sponsored by Federal Government agencies are good sources of information.” Save a Life by National Health Care Provider Solutions also suggests turning to the CDC, the American Medical Association, or the World Health Organization. You can also look to well-established professional organizations and highly reputed medical schools.

Remember that your doctor uses the Internet too! The providers at Covington Women’s Health Specialists use the websites UpToDate, Mayo Clinic, and The American College of Obstetricians and Gynecologists (ACOG) as resources, which have patient educational materials on them.

The article’s author and publication date can also tell you a lot. Check to see if the information is current, or fact-checked by a credentialed medical professional. If a site is peppered with a lot of patient testimonials, you may want to click past. “Compelling personal testimonials often dissuade people from accepting scientific evidence,” PsychCentral warns. “The vividness of personal testimony often trumps evidence of higher reliability.”

Establish Guardrails Ahead of Time

Before you log in, NPR advises you set goals for your search beforehand by “reminding yourself why you’re there, what are you looking for, what information are you trying to find. And then periodically checking in with yourself — have I found what I needed?”

HuffPost also recommends limiting your search time by setting a timer, using apps that monitor screen time, or carving out dedicated time blocks. This is not only a good way to keep any doomscrolling in check, but can help improve your overall mental health. A 2017 study published in Preventive Medicine Reports “showed that moderate or severe depression level was associated with higher time spent on TV watching and use of computer.”

Partner With a Loved One

Share what you’ve found online with a friend or family member who can ask caring questions, and help you sort through the most valuable information. Their long-time knowledge of you, your lifestyle, emotions and preferences can provide extra support, and you may learn from their own health experiences. “Friendship isn’t just about fun, fellowship and emotional health,” as LiveScience points out. “Having friends can improve physical health, too.”

Remember that your doctor, nurse, gynecologist and other health specialists are here for you in the same way. Each member of our award-winning team considers themselves your partner in your healthcare. Listening to you and communicating with you are what they do best! To arrange a personal appointment call us at (770) 385-8954 or schedule online.

 

Four Ways Alcohol Can Affect Your Long-Term Health

It wasn’t just a plot point for the character Miranda in the recent HBO series, “And Just Like That”: Women now drink the same amount of alcohol as men, if not more, to cope with life stressors. While this trend was on the rise even pre-pandemic, psychological stress and anxiety that often leads to drinking has only increased since COVID-19 appeared two years ago.

In 2021, about one in four of all adults reported an increase in drinking due to pandemic-related stress. But according to WebMD, this increase has been especially apparent in women, which is especially problematic, as there are many specific long-term effects alcohol has on a woman’s health.

1. Brain Function

Your brain reduces in size naturally as you age — regardless of your gender. But heavy drinking also shrinks brain matter. Specifically, researchers at the University of Oxford found that alcohol shrinks the hippocampus, the part of the brain associated with memory, learning, and reasoning.

Other studies also show that women may be more susceptible to the brain shrinkage caused by alcohol. This effect is permanent, making it one of many reasons to limit alcohol intake, especially for women.

2. Heart Disease

For both men and women, excessive drinking can lead to high blood pressure, stroke, or heart failure. “Women who drink excessively are at increased risk for damage to the heart muscle at lower levels of consumption and over fewer years of drinking than men,” the CDC reports. And even women who only moderately drink alcohol have an increased risk of cardiomyopathy, which is a disease that makes it difficult for your heart to pump blood.

3. Breast Cancer

Alcohol consumption can also impact the way a woman’s body processes estrogen. This may  leave more estrogen in your body, thereby increasing your risk of hormone-related breast cancer. This risk increases with every glass of alcohol. In fact, over 10% of alcohol-related cancer cases were attributed to consuming only one bottle of beer or two small glasses of wine daily.

4. Weight Gain

Alcohol consumption can also impact weight gain for every gender. While it isn’t impossible to lose weight while drinking, even moderate drinking can significantly slow down your body’s process of burning fat.

Alcohol also impacts how your body internally manages food intake, making it difficult for you to know when you are actually full. It can also make you feel hungrier while drinking, affecting how much you actually eat. Many alcoholic drinks also have a high-calorie count, filling your body up with empty calories. If you are trying to lose or maintain weight, staying away from alcohol may be even wiser advice than avoiding the ice cream.

How to Take Care of Your Health

Though you may have come across research that indicates health benefits of alcohol, many experts agree that there is actually no safe amount to consume. If total abstinence proves impossible, light to moderate drinking is advised. The National Institute on Alcohol Abuse and Alcoholism defines moderate drinking as one drink or less per day for women, though keep in mind that even that can still lead to long-term health issues.

If you are concerned about your alcohol consumption or any other aspect of your health, Covington Women’s Health Specialists are here to help! Call for an appointment at (770) 385-8954 or schedule one online.

 

What Should You Know About Endometriosis During Pregnancy?

Endometriosis occurs when tissue similar to the uterine lining grows outside of the uterus. It affects 6-10%  of women in the United States, can cause severe menstrual pain, and may make conception or pregnancy difficult.

Although 70% of women with mild to moderate endometriosis can become pregnant and have no problems with their pregnancy, (regardless of how their endometriosis is treated) it is important to understand the risk factors and implications when it comes to pregnancy.

What happens during pregnancy with endometriosis?

Sometimes, pregnancy can actually lessen endometriosis symptoms due to increased progesterone levels that occur. Progesterone’s synthetic counterpart, progestin, has been demonstrated to lessen endometriosis pain in 90% of women.

This relief of symptoms is not always guaranteed, however. In some cases, pregnancy can worsen endometriosis symptoms due to the uterus’s continuous expansion, or increased levels of estrogen, which may incite more endometrium growth. Even if pregnancy relieves your symptoms, it is not a cure, and endometriosis difficulties can return afterward.

Pregnancy Risk Factors

Along with fluctuating symptoms, there are a few more conditions to watch for during pregnancy if you have endometriosis:

Placenta Previa (Low-Lying Placenta)

Placenta previa refers to a condition when the placenta covers, or almost covers, your cervix. This can cause bleeding throughout the pregnancy and delivery. Placenta previa is commonly associated with endometriosis and often results in the recommendation of a C-section.

Ectopic Pregnancy

Ectopic pregnancies occur when a fertilized egg begins to grow outside the uterus, such as in the fallopian tubes, and endometriosis increases your risk. While ectopic pregnancies can present in the same ways as conventional ones, consultation with your doctor is needed. Symptoms of ectopic pregnancy include lower back pain, vaginal bleeding, or mild pelvic cramping.

Preterm Birth

A birth is determined “preterm” if the fetus is delivered before the mother’s 37th week of pregnancy. Women with endometriosis have a 33% greater risk of preterm birth. If you have been diagnosed with endometriosis, stay in close communication with your doctor (and your own body) during your first two trimesters.

Miscarriage

A miscarriage occurs when the pregnancy is lost before the mother reaches her 20th week of pregnancy. Endometriosis can significantly increase the risk of a miscarriage, but continuously monitoring with your doctor can alert you to possible warning signs, so you both can take preventative measures that will help you carry to term.

What can you do?

To prepare for pregnancy with endometriosis, you may consider surgery or hormone therapy treatment ahead of time. Surgery involves removing patches of the outside lining, while hormone therapy may reduce excess tissue, although often comes with undesirable side effects. In-vitro fertilization (IVF) is another procedure that may assist with conception, should endometriosis cause challenges.

Above all, prior to conception and throughout your pregnancy, always express your worries to your doctor and monitor your symptoms with them together. Frequent visits, clear communication, and strong awareness of your body can all help minimize complications.

If you have endometriosis or suspect you may, are looking to conceive, or are already pregnant, we are here to provide you with exceptional care. Call us for an appointment at (770) 385-8954 or schedule one online.