GynoFiles

Every year new gynecologic therapies come about that reduce the numbers of hysterectomies done in the United States. At Women's Health Practice we are committed to alternatives, often have trials enrolling for heavy menstrual bleeding, and urge you to come and discuss! But, some hysterectomies are necessary, and then you do have choices regarding the type of hysterectomy you will undergo. All decisions with hysterectomy have risks and benefits, and shared decision making with your gyno is the most important first step.. Hysterectomy means removal of the uterus, so if you have had a removal of the uterus, but your cervix was conserved, this is called a subtotal hysterectomy. For some women there are over-riding reasons to have a subtotal hysterectomy. For others the decision to keep your cervix may be based on personal preference rather than scientific fact. Also discuss the health of your pelvic floor. If you are planning a hysterectomy, think about having sex afterwards a...

Our "core" is defined from the pelvic floor to the rib cage. Your gynecologic health is thus intertwined with your core health.  Basically working on core strength stabilizes your pelvis, your back, your abdominal muscles and can enhance sports fitness, sexual health, and the everyday calisthenic tasks including lifting and dishes! The interlacing muscle groups including those s of the pelvic floor, those that wrap around your spine and abdomen, all function together so well that research shows that one single element of the core is 'the most important' component. They all need to be strong! Various core exercises can work to improve your strength and mobility. These exercises will improve your posture, and your posture needs to be maintained to help keep your pelvis healthy. The special way that Pilates has you breathe and suck in the abdomen can recruit little used internal muscles and help you relax the sacroiliac joint. Some women with chronic pelvic pain have te...

In a medical review today, published on line ahead of print, t he treatments of for the least known aspect of endometriosis, the condition adenomyosis, is reviewed . Adenomyosis, a name of Greek origin , is a condition whereby the glands of the uterus become trapped deep within the wall of the uterus and produce symptoms. The symptoms of adenomyosis can be variable, but most likely will at least cause heavy painful periods. The diagnosis of adenomyosis used to just be made at hysterectomy, but we have gradually recognized that ultrasound and MRI examinations can determine whether a woman has adenomyosis as the cause of her heavy periods. The condition of adenomyosis could be asymptomatic, and if a woman has no symptoms she does not need treatment. But in a large percentage of cases adenomosis causes the uterus to be enlarged. The uterine enlargement can be from the endometrial glands filling the walls, but also due to blood within those glands. Many treatments have been tried, includi...

Most endometriosis is like what is seen in this picture, a small powder burn hidden deep in the pelvis seen at the time of laparoscopy. But some endometriosis is found by the presence of a cyst of the ovary. Indeed that cyst, known as an endometrioma, probably is due to a simple ovarian cyst that is invaded by endometriosis. Cysts are relatively easy to find, the endometriosis shown here is much harder to find. And now a study by the Ovarian Cancer Association Consortium is pointing out the links between ovarian cancer and endometriosis and the importance of controlling endometriosis to help prevent ovarian cancers. Pelvic endometriosis is most often found when evaluating a patient for pelvic pain, infertility, or literally stumbled upon when a woman is getting pelvic surgery for another reason. Endometriosis is common, occurring in 1/10 women. Endometriosis, however is rarely felt on exam, found on an x ray or an ultrasound, unless a woman has a large ovarian mass. For most, this...

This is a pelvic ultrasound of what appeared to be a large pelvic cyst, probably of one of the ovaries, but no ovarian abnormality was found at surgery. All abdomens have fluid that in actuality prevents the tissues from sticking together. Some women who have had infections, surgery, endometriosis or other conditions can develop pelvic scar tissue also called adhesion.Medically there can be a number of complications from pelvic or abdominal adhesions . These adhesions act like internal passageways and entrap fluid thus a women may have a mass on examination and then found to have fluid collections that appear on ultrasound to be a cyst of the ovary. Blood tests and other test may offer a clue to diagnosis but otherwise final diagnosis has to be made at the time of surgery.