Dollars and SENSE, for some! Fewer Periods

Supporting your menstrual cycle monetarily may mean that you are due for a menstrual makeover. Working off that large insurance deductible? Only have a set budgeted amount for your contraception? There is no reason you and your gyno cannot talk strategy about what is going to be the most cost=effective contraceptive alternative for you out there. And the factors that weigh into those treatments vary from woman to woman. If your periods are heavy, maybe you need to factor in the cost of tampons and pads as well! And maybe if you are going to try for a baby in 6 months to a year, that will be a factor as well, what is cost effective for a few months may not quite be the same as what is cost effective for the long haul. And what about method switching. It turns out this may be the most cost effective strategy of all! Who would have thought that! For instance, what about the woman with those terrible cramps and clots. If you are just going to treat your heavy periods for only one year it’s most cost effective strategy to just pop on to a low dose generic birth control pill, your gyno can help you pick one out. But then when the bleeding is better, get an IUD in the second year, the PaaraGard IUD is approved for 10 years and might then be a great choice. As Paul Bluementhal reported in Contraception in 2006 when he looked at this subject in depth. Effectiveness of the therapy definitely has to be looked at as well as pure cost. So generic low dose progesterone given at the beginning of a cycle is a low cost alternative for heavy periods, but maybe not always effective at curing the problem, there for not the most cost effective either. Studies for heavy bleeding have backed this up. The Mirena IUD compared to taking monthly a small dose of progesterone for heavy menstrual bleeding (HMB) is more effective according to the 2005 Cochrane review, but compared to just being given monthly progesterone these women had more spotting and breast tenderness. If breast tenderness is already an issue with you, well, there goes the formula, it may not apply to you. And what about getting an IUD vs getting a NovaSure ablation. In one study if you got a Mirena IUD vs getting a NovaSure ablation you might have similar reduction in menstrual blood loos for two years, but the progesterone sided effects are slightly greater with the Mirena IUD, although as a group, NovaSure women had more surgical side effects. Although some of this information quoted is almost thirty years old now Nilsson reported in clinical endocrinology that the tissue levels of levonorgesterel with the Mirena are hundreds of times higher than what can be given orally. So that potent progesterone effect on the lining may be just what your gyno wants for you! New things to make sense of? This gyno thinks so, what do you think?

Passing Your Uterine Lining, Menstrual Period Norms

Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you...

You Have an IUD: But a Positive Pregnancy Test

Fortunately IUD pregnancy failures are rare. But if you have an IUD for contraception, and you get a positive pregnancy test, you probably ask yourself, what next? Well, make your gyno appointment promptly, this is a condition that is not typically an emergency, but it can be and it’s not handled over the phone or on a blog, or through self diagnosis! That being said, some researchers from University of Texas Southwestern Medical Center in Dallas decided to look back at over 4100 women who had IUDs and of those 42 cases who became pregnant in their institution, over about a year period of time, to help understand what these women could expect when they got to their gyno and what actually happened to their pregnancies. Accurate pregnancy diagnosis, pelvic examination, and pelvic ultrasound were the cornerstones of the evaluations. They had very specific ways they looked at their ultrasound to prove there was no pregnancy in the fallopian tube, or partially in the fallopian tube...

Post-Endometrial Ablation Syndrome

If you have had an endometrial ablation and have developed symptoms of pelvic pain you might have post endometrial ablation syndrome. What is post-endometrial ablation syndrome? It is a constellation of symptoms due to entrapped blood or tissue within a uterus that has previously undergone an endometrial ablation. We are able to diagnose this at Women's Health Practic e but occasionally other conditions are causing similar symptoms. Other complications of endometrial ablation include pregnancy, risks from pre-existing conditions such as a polyp or fibroid, an infection of the uterus, or a pregnancy. If you have had a tubal ligation then it is possible that the condition could be post-ablation tubal sterilization syndrome. The ablation procedure is designed to destroy all lining tissue, but in fact there is no way to confirm the completeness of the ablation. It is thought that either residual or regrowth of the tissue is producing the symptoms of post-endometrial ablation syndrom...

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