Yes, it’s true: Not all women need a Pap smear

By Dr. Diana Sarmiento, The Blogging Doc | Yahoo! SHE

If you’ve ever had a Pap smear, you know that the experience of lying on a cold examining bed half-naked can be very unpleasant.

With your genital area exposed, a doctor inserts an instrument called a speculum in your vagina and scrapes off some cells from the cervix. These cells are sent to the laboratory to screen for the earliest sign of cervical cancer, the third leading cause of death in women.

Introduced 60 years ago, the Pap smear remains the mainstay when it comes to the early diagnosis of the disease.

If you are one of those women who have been putting off your doctor's visit because you dread the pap smear, the October 17, 2011 issue of the Annals of Internal Medicine suggests that women younger than 20 and older than 65 do not need a Pap smear.

A review of multiple studies and trials showed that there is no improvement in detecting cervical cancer for the mentioned age groups. In addition, the incidence of cancer in women under 20 is rare.

Down-There News You Need Right Now

Four crucial updates you've just gotta have before your next gyno visit

Rennie Solis

 

Your yearly visit to the gynecologist is critical to your health—period. What's also key: going in with a list of specific questions, so your gyno can tailor her recommendations to your needs, says Jill Maura Rabin, MD, a spokeswoman for the American Congress of Obstetricians and Gynecologists. To get more out of your time in the stirrups, consider discussing these important findings with your doc.

Update #1: New relief for heavy periods

If you have menorrhagia—periods so heavy and painful they interfere with daily life—your gyno may have suggested going on the Pill or taking some other hormonal medication. If that didn't work, your only other option was surgery, from endometrial ablation (which destroys the uterine lining) to a hysterectomy (total removal of the uterus). Now there's a new nonhormonal way to lighten the flow: tranexamic acid, a prescription drug that works by stabilizing a protein that helps blood to clot. While the drug does carry a risk of side effects, such as unwanted clotting, Dr. Rabin says it's "a great option for women who can't or don't want to take hormonal treatments."

Update #2: A surprise upside to hormone therapy

Talk about confusing: First, hormone replacement therapy (HRT) was hailed as a miracle drug that might not only ease menopause symptoms, such as hot flashes and insomnia, but also reduce the risk of osteoporosis and heart disease. Then the landmark Women's Health Initiative (WHI) study found that an HRT treatment of estrogen plus progestin increased the stroke and breast cancer risk in some women. But in April, a WHI report yielded some good news: For one group—postmenopausal women in their 50s who'd had a hysterectomy—taking an estrogen-only form of HRT for up to six years lowered the rate of breast cancer without increasing any other risks. If you're seeking relief from menopause, talk to your doctor about HRT's pros and cons—whether you still have your uterus or not.

Update #3: Beat fibroids without surgery

Rennie Solis

Fibroids—or benign tumors in the uterus—don't always cause symptoms. But for an unlucky minority, they can lead to heavy bleeding, pain, and even infertility. Hysterectomy is a traditional treatment for the condition, but a recent study shows that two less-invasive options preferred by patients can help them just as much. One, called uterine artery embolization, involves injecting particles into the arteries supplying blood to the fibroids to block them. The other, a focused ultrasound, heats and kills fibroid cells. "Though all treatments may not be suitable for all patients, they all lead to a significantly improved quality of life," says lead author Fiona Fennessy, MD, a radiologist at Brigham and Women's Hospital.

Update #4: You may need even more folic acid

Sure, you know you need folic acid right before and during pregnancy to help prevent neural-tube defects, such as spina bifida. Since 1996, many common foods, like breads and pastas, have been fortified with this B vitamin. But you still may not be getting enough. While fortification has cut spina bifida rates in half, "many women now miss out on fortified foods because they're cutting back on carbs," says OB-GYN Diana Ramos, MD, consultant to the March of Dimes. Even if you're a carb addict, she says, not all the folic acid from food is absorbed by your body—and you need it in your system at least a month before you conceive to reap the benefits. Play it safe by taking a multivitamin with at least 400 milligrams of folic acid even if you're not pregnant or trying (half of all pregnancies are unplanned!); bump it up to 600 milligrams if you are.

http://www.health.com/health/condition-article/0,,20489182_2,00.html

Gravity and Its Effects on Women

By Amy S. D. Lee, MS, WHCRNP, Nurse Practitioner

When I start thinking about how the force of gravity tugs and pulls on the female body, I usually reflect on the various parts of me that I can see have begun to sag!

Unfortunately, gravity can cause some of our organs, such as the uterus, to fall down or slip out of place. But there are ways to handle this condition, which we in medicine commonly refer to by the catchall term, prolapse. Prolapse literally means "to fall out of place," and it affects the vagina and the bladder as well.

What is prolapse?

Prolapse is a condition in which the pelvic organs begin to sag into, and even out of, the vagina. There are varying degrees of severity of prolapse, and the severity of the symptoms a woman will experience are usually related to the degree or extent of the prolapse.

Women who have never had children may have prolapse, but it's more common in women who have had vaginal deliveries. Other factors contributing to prolapse include

• older age
• heavier weight
• constipation
• prolonged cough
• pelvic tumors (like heavy uterine fibroids)
• perhaps a genetic predisposition

Common Symptoms of Prolapse

• pelvic pressure
• feeling of vaginal fullness
• leakage of urine
• pain with sex
• constipation (both a cause and a symptom)

Diagnosis

Diagnosis of mild prolapse can be made during a pelvic exam at your GYN visit. A more severe prolapse sometimes will become evident when the pelvic organs can be seen or felt protruding from the vagina. Your healthcare provider should then confirm the diagnosis with a pelvic exam.

While it can be quite alarming to discover that you have prolapse, it’s usually a pretty benign condition that can be corrected.

Treatment

Treatment of a prolapse often depends on the severity of both the prolapse and the symptoms. Mild prolapse can often be treated with vaginal topical estrogen andvaginal exercises (Kegel exercises), both of which strengthen the vaginal walls. Other tactics for treating milder prolapses include avoiding heavy lifting and avoiding caffeine (which acts as a diuretic).

More severe prolapse can be treated with a device called a pessary. Pessaries come in a variety of designs and are fitted by your healthcare provider. They stay in the vagina and lift the organs back into normal position. (No, you can't feel them.)

Last, the most severe cases of prolapse can be addressed with surgery. Severe uterine prolapse may require a hysterectomy, followed by repair of the vaginal muscles to lift the bladder back into position. There are also surgical procedures that can be done to suspend the bladder to or from other parts of the abdomen. Women who do not plan to ever be sexually active again may choose to have a procedure that closes the vagina, thereby lifting the organs into place and preventing them from falling back down.

What if you think you have prolapse?

The first thing ALL women should be doing--whether they have a prolapse condition or not--is the Kegel exercises. We should start doing them early (even as teens and young adults) to keep the vaginal muscles strong. Practice by squeezing the vaginal muscles (like starting and stopping the stream of urine) 10 times at least 10 times per day. If you are concerned that you have prolapse, or are at risk of prolapse, discuss your situation with your healthcare provider. Early intervention is an important part of prevention.

http://health.yahoo.net/experts/womentoday/gravity-and-its-effects-women