Your mom is flashing with the pause, and what does she do. She runs off to the Gyno Gab Gal and we work and work and work on the hormone dose, a bit more estrogen, a bit more progesterone, a bit more testosterone, a bit less testosterone, check the blood levels, check the vaginal lining, ultrasound the ovaries, check the hormone effect on the lining of the uterus, try a patch, a cream, a spray, a combination, a bioidentical, check your weight, your other medicines, your diet, change change change. What about you, you? You are on birth control pills. Have side effects or symptoms that are still somewhat bothersome and need the tweak? Does it remind you of what mom is saying about her hormone therapy? There are over 80 pills available, but when it comes to pills, it's sort of one size fits all. Within a fairly narrow range, we can switch brands, but regardless of your size, it is, what it is. No gyno would say, hey gal, you're a big gal, so just double 'em up, or triple 'em up to get to the dose those mini sized girls are taking. Sounds hilarious right? But we have 20 and 30 mcg of estrogen pills out there now. And we used to have 150 and 180 mcg pills out there in the dawn of the pill days, actually much less than just doubling up if you think about the dosing.Tweaks are available, but not as many as we would like to see. Some of those same tests can be run to see what the issues are, but few docs do run hormone tests on pill users in an effort to change the doses, it's just not managed that way as there are no studies to direct the care in that way. More studies are being performed including the obese woman. More physicians are aware that this can be important, but few gynos are honestly taking the dose of your pill and directly correlating it with your headaches or anger or moodiness or sex drive. But this may be something to consider for the future and gab about with your gyno.
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...
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