Author: The Group For Women

What to Expect During Menopause

The average age women experience menopause is around 51 years of age.  At this point, the ovaries begin to make less estrogen.  In fact, one of the most common signals of approaching menopause is a chance in your menstrual cycle.  A lighter or heavier flow than normal may appear and even skipping one or more periods can occur.  At some point in this process, the ovaries stop producing estrogen and the menstrual period concludes.images (3)

Menopause brings about a different experience for each woman; some are heavily affected, while others notice little to no change.  The most common symptom of menopause experienced are hot flushes, or “hot flashes”.  Nearly 75% of women in menopause will experience these sudden feelings of heat.  During one of these occurrences, the skin may redden and a sweat may break out, lasting from a few seconds to a few minutes.  While hot flushes are uncomfortable and a bit of a nuisance, they are not harmful.

Other issues which may occur during menopause include trouble sleeping and emotional changes.  A lack of sleep may be caused by occasional hot flushes or simply because there is a lack of REM sleep which allows the body to feel rested.  Emotional changes can take place because of this additional stress and a change in hormonal levels can increase feelings of nervousness, irritability and overall tiredness.  Some women may also develop less of a sex drive around and after menopause as hormone levels decrease.

Along with a lowered sex drive, a lack of estrogen can cause the vagina to dry and as the lining becomes thinner.  This can cause increased pain during intercourse and higher chances of infection.  To combat many of these issues, maintaining routine healthcare is essential.  You should continue to visit your doctor once a year and have regular exams and tests performed.

As you go through these changes during menopause, remember, these are all natural events.  Although physical changes occur during this process, there is nothing that should prevent you from continuing to enjoy your life.  Be sure to speak to your physician about maintaining good nutrition, getting enough essential vitamins and calcium, as well as sticking with an appropriate exercise plan.

IUDs: What Are Your Options?

What is an Intrauterine Device (IUD)?

When it comes to birth control, the Intrauterine Device (IUD) offers a safe, effective and reversible protection against pregnancy. There are currently two types of IUDs available for women; the hormonal IUD and the copper IUD. Let’s look more closely at each of these options. iud

The Hormonal IUD:

This type of IUD is replaced once every 5 years to ensure protection against pregnancy. This device releases a small amount of progestin into the uterus which thickens the cervical mucus to decrease the chance of sperm entering the cervix and keeps the lining of the uteurs thin, making it less likely for fertilized egg to implant.

The Copper IUD:

This IUD only requires replacement every 10 years. The device works by releasing a small amount of copper into the uterus to prevent the egg from being fertilized or attaching to the wall of the uterus. The copper substance also works to prevent sperm from entering the fallopian tubes and decreases the sperm’s ability to fertilize an egg.

Whichever IUD you and your physician decide is best for you, the process of insertion is similar. For these devices, your physician will put the IUD in a long, plastic tube and place this through the vagina and cervix into the uterus. Here, the IUD is released and opens into place as the tube is withdrawn. Once the device is in place, be sure to discuss the processes of checking to ensure the “string” or “tail” is in place.

There are several instances which may prevent you from using an IUD. If these descriptions fit you, speak to your physician about another method of birth control:

  • You are pregnant
  • Have had pelvic inflammatory disease in the past 3 months prior to insertion
  • Have abnormal vaginal bleeding
  • Have had a pelvic infection in the last 3 months prior to insertion
  • Have an STD
  • Have certain liver conditions (hormonal IUD)
  • Are allergic to any aspect of the IUD
  • Have uterine fibroids

Overall, this is a good choice of pregnancy prevention for many women. As a whole, during the first year of use, about 8/1000 women using a copper IUD and 1/1000 women using the hormonal IUD become pregnant. If you have additional questions about this process and if it may be a good option for you, give us a call or schedule an appointment!

Your First GYN Visit: What to Expect?

As young women mature, it is important they have their first GYN visit and learn to make good choices for their overall health. A woman’s first women’s health visit can cause feelings of nervousness and apprehension. In many cases, it may be appropriate for a first visit to simply consist of speaking with the physician regarding what to expect and getting to know one another.

During these first appointments, physicians will ask a variety of questions regarding your menstrual cycle, sexual activity and family health history. Giving honest answers to the questions asked is imperative to receiving accurate care from your physician. Remember, your doctor is there to answer any questions you may have.

At your first visit, depending on your age, there are several types of exams that may be performed. These include: general physical exam, breast exam, pelvic exam, pap test and past due vaccinations.   During a physical exam, items such as height, weight and blood pressure will be recorded. When a breast exam is performed, your doctor may check your breasts for abnormal growths or lumps. This is carried out by simple moving their fingers around the breast in a pattern and applying slight pressure.

In many cases, at a first appointment, your doctor will not perform a pelvic exam. However, if this is necessary (you have engaged in sexual intercourse or have certain issues) your doctor will look at the vulva, internal organs (through the use of a gloved hand) and use a device known as a speculum to view the vagina and take a small sample to test for STDs. This process allows the doctor to check for and detect possible abnormalities. This procedure may cause brief discomfort, but not pain. If needed, a Pap Test may be performed during the pelvic exam which consists of taking a small sample of cells from the cervix using a swab. After removed, these cells are examined under a microscope for abnormalities.

Finally, your physician will want to review simple tips for staying strong and healthy and review that your vaccinations are up to date so you are adequately protected from viruses and disease. Please know that we understand this first visit can be a nerve-wracking experience. We want to ensure the experience is as easy and painless for you as possible, so we encourage you to ask questions throughout the appointment or even meet with us beforehand to gather information about what to expect!

Rep. Rigell Visits The Group for Women

Rep-Rigell-visits-The-Group-for-WomenOn October 31, Dr. Holly Puritz and her colleagues at Mid-Atlantic Women’s Care hosted Representative Scott Rigell (R-VA) in Norfolk, VA. Congressman Rigell was pleased to see his constituents doing what they do best. Dr. Puritz thanked him for signing the Flores-Maffei SGR Repeal Congressional Sign-on Letter and spoke to him about the next steps and need for his support. She provided him background on how long ACOG has been lobbying for SGR reform and the cost of another SGR patch, rather than a full fix. He learned about private medical practice and the difficulty of being a small business owner as Rep-Rigell-visits-The-Group-for-Women2well as a healthcare provider. They also discussed other important issues, including graduate medical education funding and the Affordable Care Act, and their effects on small private practices. After the visit, Representative Rigell said “What a pleasure it was to meet Dr. Puritz and her colleagues at Mid-Atlantic Women’s Care. From the moment we were greeted I was impressed by their warmth, professionalism and concern for their patients. We left with an even deeper understanding of why prenatal care is so critically important, and with practical ideas to help address the challenges facing OBGYN’s.”

Congratulations Dr. Holly Puritz for Winning the Medical Society of Virginia’s “Salute to Service Award”


Congratulations to Dr. Puritz, the winner of “The MSV Salute to Service Award”.

This award was given to Dr. Puritz for her work on safety and quality improvement to reduce early elective induction statewide. The work was done in collaboration with ACOG, MSV, Virginia Hospital Association and MARCH OF DIMES.

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