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Menopause is a natural process marking the end of a woman’s reproductive years, defined as occurring 12 months after her last menstrual period. Common symptoms include hot flashes, night sweats, vaginal dryness, mood changes, sleep problems, weight gain, and thinning hair. Postmenopausal women face increased risks, such as osteoporosis, cardiovascular disease, urinary issues, and cognitive decline.
A personalized treatment approach is crucial, as menopause affects each woman differently. Bioidentical hormone therapy (BHRT) can help restore hormonal balance. Treatment plans include an initial consultation via video or phone, blood tests to determine hormone levels, and a holistic evaluation of lifestyle and medical history. This ensures effective management of symptoms. Explore our menopause treatment plans, from initial consultation to ongoing monitoring, for tailored symptom management. Learn more about reducing your risk of cardiac disease.

Stages of Menopause

  • i. Perimenopause: Irregular cycles and symptoms.
  • iI. Menopause: One year without a period.
  • iii. Postmenopause: Years after menopause, with decreased symptoms.

Perimenopause is the transitional period before menopause when the ovaries gradually lose function, leading to a decrease in reproductive hormones, particularly estrogen and progesterone. Symptoms vary widely and can significantly impact quality of life. Common symptoms include irregular periods, low libido, mood swings, anxiety, PMS, anger, irritability, memory loss, fatigue, hot flashes, insomnia, weight gain, heart palpitations, vaginal dryness, night sweats, aches, painful joints, frequent headaches, and dry skin.

Perimenopause is characterized by fluctuating levels of estrogen, progesterone, and testosterone, causing hormonal imbalances. Maintaining optimal hormone balance is crucial for overall well-being, including brain function, cardiovascular health, bone health, and vaginal and urethral health. Bioidentical hormones can help restore these levels.

Bioidentical hormones, chemically identical to those naturally produced by the body, are used in BHRT to treat hormonal imbalances and alleviate symptoms of menopause, perimenopause, polycystic ovarian syndrome, and PMS. Derived from plant sources like soy and yams, they match human hormones such as estrogen, progesterone, and testosterone. Key Hormones:

  • i. Estradiol: Relieves menopause symptoms like hot flashes and night sweats.
    ii. Progesterone: Regulates cycles and counters estrogen therapy effects.
    iii. Testosterone: Addresses low libido and fatigue in both genders.
    iv. DHEA and Pregnenolone
BHRT Benefits:
  • i. Symptom Relief: Reduces menopause symptoms and enhances energy and cognitive function.
    ii. Cardiovascular Health: Lowers heart disease risk by up to 50% when started early.
    iii. Bone Health: Prevents osteoporosis and maintains bone density.
    iv. Sexual Health: Improves libido and satisfaction.
    v. Overall Well-Being: Supports urethral health, reducing incontinence and infections.

Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is a prevalent hormonal disorder that disrupts menstrual cycles, causes infertility, and leads to symptoms such as excessive hair growth, acne, and weight gain. Although ovarian cysts are a symptom, they are not the cause of PCOS. The condition is influenced by genetic, hormonal, and environmental factors and is commonly associated with insulin resistance, which can result in weight gain and elevate the risk of type 2 diabetes and cardiovascular diseases.


Common Symptoms:

  • i. Irregular periods
    ii. Infertility
    iii. Weight gain
    iv. Excessive hair growth (hirsutism)
    v. Acne
    vi. Dark patches on the skin (e.g., neck, underarms)

Treatment:
Effective management includes lifestyle changes such as a balanced diet and regular exercise, alongside medications to balance hormones. Regular monitoring with pelvic ultrasounds and blood tests is essential. Personalized treatment plans can help alleviate symptoms and improve quality of life. For tailored advice, consult a healthcare professional.

Pre-Menstrual Syndrome (PMS) is a common condition affecting women in the one to two weeks before their period. It manifests through physical and emotional symptoms like breast tenderness, bloating, headaches, fatigue, mood swings, irritability, and increased appetite. These symptoms are often linked to low progesterone levels and hormonal imbalances post-ovulation. While many women experience mild symptoms, severe PMS can significantly impact daily life. Fortunately, PMS is treatable and doesn’t have to be endured.

Common Symptoms:

  • i. Mood swings
    ii. Depression and anxiety
    iii. Irritability and anger
    iv. Abdominal bloating and cramping
    v. Breast tenderness
    vi. Headaches and fatigue
    vii. Back pain and weight gain
    viii. Food cravings

Treatment with Bioidentical Hormones:

  • i. Evaluation: Comprehensive assessment and female hormone profiling.
    ii. Diagnosis: Identifies hormonal imbalances.
    iii. Prescription: Personalized plans with bioidentical hormones and
    supplements.
    iv. Outcome: Reduced symptoms and improved quality of life.

Note: PMS is less severe than PMDD, which involves more intense symptoms.

Endometriosis is a painful condition where endometrial-like cells grow outside the uterus, commonly affecting the pelvic peritoneum, ovaries, bladder, and bowel. It causes severe pain and inflammation as the tissue thickens, breaks down, and bleeds each menstrual cycle.

Symptoms:

  • i.  Severe cramps
    ii. Pain in the back, abdomen, and pelvis
    iii. Heavy menstrual bleeding
    iv. Painful intercourse and bowel movements
    v. Spotting between periods
    vi. Infertility
    vii. Low mood

The cause is unknown, but factors may include retrograde menstruation, genetics, and immune issues. Diagnosis can be difficult, with many women undiagnosed for years.

Treatment:

  • i. Hormonal Supplementation: Bioidentical Hormone Replacement Therapy
    (BHRT).
    ii. Nutritional Regimes and Supplements: To alleviate symptoms.
    iii. Surgery: May be needed in some cases.

Functional medicine is a systems biology-based approach that addresses the root causes of disease by analyzing underlying factors contributing to symptoms. It involves detailed history taking, timeline creation, and advanced laboratory testing to identify these causes, leading to personalized treatment plans for better health restoration.


Key Aspects:
i. Focuses on understanding the root causes of symptoms.
ii. Uses detailed history and advanced laboratory tests.
iii. Develops personalized treatment plans.

Functional medicine is particularly relevant as chronic conditions are prevalent:
i. 50% of adults have at least one chronic health condition.
ii. 25% of adults have two or more chronic health conditions.
iii. 86% of healthcare costs are attributed to chronic diseases ($3.2 trillion in2015 and rising).


Integrative medicine blends conventional practices, psychological therapies, lifestyle changes, and complementary treatments, offering a holistic approach to health issues. This method has shown high effectiveness in managing various health problems.

Laparoscopic ovarian cystectomy is a minimally invasive surgical procedure used to remove ovarian cysts. An ovarian cyst is a fluid-filled sac on or inside an ovary. While many cysts are harmless and resolve on their own, larger or symptomatic cysts ma need medical intervention. During this procedure, small incisions (about half an inch) are made to insert instruments for cyst removal. This surgery helps confirm, remove symptomatic cysts, and rule out cancer.

Indications for Surgery:

  • i. Cysts larger than 6-7 cm
  • ii. Cysts on both ovaries
  • iii. Persistent cysts not shrinking over 2-3 months
  • iV. Non-simple cysts on ultrasound

Post-Surgery Expectations:

  • i. Resumption of normal activities, including driving and light lifting, within a week
  • ii. Encouraged walking and showering from the day after surgery
  • iii. Steady recovery at home

Risks:

  • i. Possible recurrence of cysts
  • ii. Pain control issues and scar tissue (adhesions)
  • iii. Rare complications include wound infection or hernia

Laparoscopic myomectomy is a minimally invasive procedure to remove fibroids from the uterus. Small incisions are made in the abdomen to locate and excise these fibroids, which are non-cancerous growths. This technique allows for a quicker recovery compared to traditional surgery.

Post-Surgery Expectations:

  • i. Most women can leave the hospital the same day or stay overnight if necessary.
  • ii. Early walking is encouraged.
  • iii. Avoid driving, heavy lifting, strenuous activities, tampons, and intercourse for up to six weeks.

Risks:

  • i. Excessive blood loss
  • ii. Scar tissue (adhesions)

Alternatives:

  • i. Birth Control Pills: Reduce heavy bleeding.
  • ii. GnRH Agonists: Induce temporary menopause to shrink fibroids, though they typically return to their original size once treatment stops.

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, typically in a fallopian tube. This type of pregnancy cannot develop normally and often requires intervention. Causes include blockages, hormonal issues, and smoking.

Why Surgery is Done:

Laparoscopic surgery is performed to:

  • i. Confirm the ectopic pregnancy
  • ii. Remove the abnormal tissue
  • iii. Repair any damage if the pregnancy has ruptured

Post-Surgery Recovery

  • i. Most patients can return to normal activities within a week, including driving and light lifting.
  • ii. Dressings can be removed, and showering is allowed the day after surgery.
  • iii. Activity should be based on comfort, with early walking encouraged. 

Alternatives:

  • i. Methotrexate: A medication that stops the embryo from growing and allows the body to absorb it, potentially avoiding surgery.
  • ii. If laparoscopic surgery isn’t feasible, an open surgery may be needed, especially with severe bleeding. .

A hysterectomy is a surgical procedure to remove the uterus and may also involve the cervix, ovaries, or fallopian tubes.

Reasons for Hysterectomy:

  • i. Uterine fibroids
  • ii. Endometriosis
  • iii. Uterine prolapse
  • iV. Abnormal bleeding
  • V. Gynecologic cancer 

Types of Removal:

  • i. Salpingo-oophorectomy: Both ovaries and fallopian tubes removed.
  • ii. Salpingectomy: Fallopian tubes removed.
  • iii. Oophorectomy: Ovaries removed.

Laparoscopic Hysterectomy:

  • i. Involves small abdominal incisions.
  • ii. A laparoscope allows the surgeon to view the pelvic organs.

Benefits and Risks:

  • i. Benefits: Reduced pain, lower infection risk, shorter hospital stay, faster return to daily activities.
  • ii. Risks: Post-surgery pain and the need to avoid heavy lifting until cleared by a doctor.

Post-Surgery Care:

  • Pain is managed with medication.
  • Rest is important, with gradual movement and short walks recommended.

Laparoscopy is a minimally invasive surgery used to diagnose and treat endometriosis, where tissue similar to the uterine lining grows outside the uterus. This procedure offers precise visualization and effective management of endometriosis symptoms with less pain and quicker recovery.

Preparation: Patients receive anesthesia, which may be local, regional, or general, for comfort during the procedure.

Procedure: A laparoscope, a thin tube with a camera, is inserted through a small incision near the navel. Additional small incisions may be made for surgical instruments.

Diagnosis and Treatment: The laparoscope allows the surgeon to view pelvic organs and identify endometriosis lesions, adhesions, or cysts. Treatment options include excision, laser ablation, or electrosurgery to remove or destroy the lesions. Post-Operative Care: Patients may experience mild discomfort, bloating, or shoulder pain from the carbon dioxide used to inflate the abdomen

Diagnostic hysteroscopy is a minimally invasive procedure used to examine the inside of the uterus. Performed with a hysteroscope—a thin, lighted tube inserted through the vagina and cervix—this procedure provides clear visualization of the uterine cavity.

Procedure:

  • i. Anesthesia: The procedure is typically conducted under local, regional, or general anesthesia.
  • ii. Insertion: The hysteroscope is gently inserted through the vagina and cervix into the uterus.
  • ii. Visualization: Direct imaging of the uterine cavity allows for precise diagnosis of various uterine conditions.

Treatment:

  • i. Immediate Treatment: Some conditions, such as polyps or small fibroids, can be treated during the same procedure.

Recovery:

  • i. Post-Procedure: Most patients resume normal activities within one to two days. Mild cramping or spotting may occur afterward.

Diagnostic hysteroscopy aids in accurate diagnosis and helps guide effective treatment, enhancing patient outcomes.

 

A hysteroscopy polypectomy is a procedure to remove polyps from the uterus using a hysteroscope—a thin, lighted tube inserted through the vagina and cervix. This allows the doctor to view and treat uterine conditions on a monitor.

Procedure:

  • i. Insertion: The hysteroscope is inserted through the vagina and cervix into the uterus.
  • ii. Examination: The uterus is filled with saline to expand it and improve visualization.

Recovery:

  • i. Post-Procedure Care: Patients are monitored briefly and usually go home
    the same day.
  • ii. Symptoms: Mild cramping, spotting, or light bleeding may occur for a few
    days.
  • iii. Follow-Up: A follow-up appointment is scheduled to review lab results and
    assess healing.

Benefits:

  • i. Minimally Invasive: Faster recovery and less pain compared to traditional surgery.

Risks:

            1. Infection: Minimal risk.

            2. Uterine Perforation: Rare risk of puncturing the uterine wall.

 

Hysteroscopy fibroid resection is a minimally invasive procedure to remove fibroids from inside the uterus. Using a hysteroscope—a thin, lighted tube—doctors view and remove fibroids through the vagina and cervix.

Why is it done?

Fibroids are benign tumors caused by muscle overgrowth in the uterine wall. Affecting 30-40% of women, they often don’t require treatment but can cause symptoms like heavy bleeding, pain, or infertility, making removal beneficial for symptom relief.

What to Expect After Surgery:

The procedure lasts 30 minutes to an hour. Expect lighter, more regular periods over 2-3 months and possible improvement in fertility. Post-surgery, you’ll experience mild cramping and minor bleeding. Most patients return home the same day.

Risks:

Risks include excessive bleeding, infection, organ perforation (1-2 in 1000), and excessive fluid absorption (1-5%). These are typically manageable with proper care.

Hysteroscopy for IUCD removal is a minimally invasive procedure to extract a misplaced intrauterine contraceptive device (IUCD). This technique is preferred for its precision and reduced risk of complications compared to traditional surgery, leading to quicker recovery.

Preparation:

Anesthesia, either local or general, is administered to ensure comfort throughout the procedure.

Procedure:

       1. Insertion: A hysteroscope—a thin, lighted tube with a camera—is inserted through the vagina and cervix into the uterus.
       2. Location and Removal: The hysteroscope allows the doctor to locate the misplaced IUCD. Specialized instruments are used through the hysteroscope to grasp and remove the device.

Post-Procedure Care:

After removal, the doctor checks for any remaining device fragments. Patients are monitored briefly and can typically go home the same day. Mild cramping or spotting for a few days is normal.

Follow-Up:

A follow-up appointment ensures proper recovery and discusses future contraceptive options.

Uterine septum correction addresses infertility caused by a septum in the uterus, requiring surgery for structural issues that medication cannot resolve.

Procedure:

  • i. Anesthesia: General anesthesia is used.
  • ii. Preparation: The cervix is dilated with sterile saline for clear visualization and room to work.
  • iii. Insertion: A hysteroscope (a thin, lighted tube) is inserted through the vagina to the uterus, avoiding external incisions.
  • iv. Correction: Instruments are introduced through the hysteroscope to cut or resect the septum and remove excess tissue, enhancing the uterus for fertilization.

Recovery:

  • Post-Surgery: You can leave the same day with a driver. Mild cramping or spotting is normal; pain medication is provided but often needed for only 24 hours.
  •  Follow-Up: Avoid heavy lifting, intense exercise, and intercourse for at least two weeks. Contact your doctor if you experience heavy bleeding, severe cramps, or other concerning symptoms.

Success Rate: Around 60% of women conceive successfully after surgery.

Laser therapy for vaginal rejuvenation is a non-surgical procedure designed to improve vaginal tone, elasticity, and overall health.

Procedure: Laser energy stimulates collagen production in the vaginal tissues, tightening and firming the vaginal canal. The procedure involves delivering laser energy through a probe inserted into the vagina, with no incisions needed. It typically lasts 15-30 minutes and is performed in an outpatient setting.

Benefits:

  • i. Enhances vaginal tightness and elasticity
  • ii. Increases lubrication
  • iii. Alleviates mild urinary incontinence and vaginal dryness

Recovery: Most patients experience mild discomfort or warmth during the procedure. Initial improvements may be noticed shortly after treatment, with optimal results achieved after a series of sessions.

Considerations: Consult with a healthcare provider to discuss expectations and potential risks, including mild discomfort, infection, or rare complications. Laser therapy is a popular, non-invasive option for women looking to enhance vaginal health.

Labia filler with hyaluronic acid is a cosmetic procedure designed to enhance the appearance or function of the labia. This treatment addresses aesthetic concerns like volume and symmetry, or functional issues such as discomfort during activities.

Procedure:

  • i. Injection: Hyaluronic acid, a naturally occurring substance in the body, is injected into the labia. Known for its hydrating and volumizing properties, hyaluronic acid helps improve appearance and comfort.
  • ii. Duration: The procedure is typically quick, lasting less than an hour, and is performed under local anesthesia to minimize discomfort.

Results and Recovery:

  • i. Immediate Results: Improvements are visible immediately, with the full effect apparent after a few weeks as swelling subsides.
  • ii. Longevity: Results generally last between 6 to 12 months, depending on the product and individual factors.

Risks: Potential risks include infection, asymmetry, and allergic reactions. A thorough consultation is crucial to discuss goals, expectations, and potential risks.

G-Shot
The G-Shot involves injecting hyaluronic acid into the G-spot area of the vagina, aimed at enhancing its size and sensitivity. The G-spot, located on the anterior vaginal wall, is associated with sexual pleasure.

O-Shot
The O-Shot uses platelet-rich plasma (PRP), extracted from the patient’s own blood, injected into the clitoris and vaginal walls. PRP is believed to stimulate tissue regeneration and improve blood flow.

Procedure:

  • i. Setting: Both shots are performed as outpatient procedures in a clinic.
  • ii. Preparation: For the O-Shot, a small blood sample is drawn to prepare PRP. Local anesthesia or numbing cream is applied to reduce discomfort.
  • iii. Injection: PRP or hyaluronic acid is injected into the targeted areas.

Recovery and Effectiveness:

  • i. Duration: The procedure takes under an hour. Mild discomfort or swelling is common but resolves quickly.
  • ii. Results: Effects may last several months; repeat treatments might be needed.

Consultation: A consultation is essential to evaluate potential benefits, risks, and suitability based on individual medical history and sexual health objectives.

Vaginismus is a condition where the vaginal muscles involuntarily tighten during attempts at penetration, making activities like sexual intercourse, tampon use, or gynecological exams painful or impossible. This tightening is an automatic reflex, similar to blinking when something approaches your eyes.

Causes can be physical or psychological, including past painful experiences, anxiety, fear of pain, stress, or certain medical conditions.

You’re not alone—many women face vaginismus, and it is treatable. Treatment often involves a mix of approaches, including therapy and physical exercises. Seeking help is a crucial first step toward relief and recovery. If you have questions or need support, please reach out. We’re here to help.

Pregnancy-Induced Hypertension (PIH) is a condition marked by high blood pressure that develops after 20 weeks of pregnancy. It’s a common complication that requires careful management to ensure the health of both mother and baby.

Symptoms of PIH include:

  • i. High blood pressure (140/90 mm Hg or higher)
  • ii. Swelling in the hands, face, and legs
  • iii.  Sudden weight gain
  • iv. Severe headaches
  • v. Blurred vision or seeing spots
  • vi. Upper right abdominal pain
  • vii. Nausea

Treatment depends on the severity of the condition:

  • i. Mild PIH: Managed with regular monitoring, bed rest, and medication to lower blood pressure. 
  • ii. Severe PIH/Preeclampsia: Often requires hospitalization for intensive monitoring and treatment, including medications to control blood pressure and prevent seizures.
  • iii. Early Delivery: In severe cases, early delivery of the baby may be necessary to safeguard the health of both mother and child.

Immediate medical attention is essential for managing PIH effectively.

Gestational Diabetes is a type of diabetes that develops during pregnancy, characterized by elevated blood sugar levels that typically resolve after childbirth.

Symptoms may be subtle, but some women experience:

  • i. Increased thirst
  • ii. Frequent urination
  • iii. Fatigue
  • iv. Nausea
  • v. Blurred vision
  • vi. Frequent infections (bladder, vaginal, skin)

Management includes:

  • i. Dietary Changes: Eating a balanced diet with controlled carbohydrate portions to manage blood sugar levels.
  • ii. Exercise: Engaging in regular physical activity to help regulate blood sugar.
  • iii. Monitoring: Frequent blood sugar testing throughout the day to track levels.
  • iv. Medication: Insulin injections or oral medications may be prescribed if diet and exercise alone do not control blood sugar.

Proper management is crucial to ensure both maternal and fetal health. Regular consultations with healthcare providers are essential for effective treatment and monitoring.

Intrauterine Growth Restriction (IUGR) is a condition where a fetus is smaller than expected for the gestational age, which can result in low birth weight and potential health issues both before and after birth.

Symptoms of IUGR include:

  • i. Smaller Fundal Height: The mother’s abdomen measures smaller than expected for the number of weeks pregnant.
  • ii. Low Amniotic Fluid Levels: Detected during ultrasound examinations.
  • iii. Reduced Umbilical Blood Flow: Observed in Doppler flow studies indicating abnormal blood flow through the umbilical artery.

Early detection and careful monitoring are crucial for managing IUGR and improving outcomes for both the mother and the baby.

Twin pregnancy occurs when a woman carries two fetuses simultaneously, either from two separate eggs (fraternal twins) or a single egg that splits (identical twins).

Health Considerations:

  • i. Preterm Birth: Higher risk of early delivery.
  • ii. Gestational Diabetes: Increased due to higher hormone levels.
  • iii. Preeclampsia: Elevated risk of high blood pressure.

Prenatal Care Tips:

  • i. Balanced Diet: Essential for mother and babies’ health.
  • ii. Adequate Rest: Manage physical demands.
  • iii. Stay Hydrated: Reduces preterm labor risk.

Placenta Previa is a pregnancy complication where the placenta implants low in the uterus, partially or completely covering the cervix.

 Symptoms:

  • i. Painless bleeding, often sudden and heavy, usually occurring in the third trimester.
  • ii. Unlike bleeding from miscarriage or placental abruption, it typically does not cause pain.

Diagnosis:

  • i.  Confirmed through ultrasound, which shows the placenta’s position and how much it covers the cervix.

Management:

  • i.  Monitoring: Regular check-ups to track the placenta’s position and ensure the health of both mother and baby.
  • ii. Delivery: Cesarean section is often planned to avoid complications like obstructed labor or severe bleeding.

Recommendations:

  • i. Adhere to prenatal care instructions.
  • ii. Be aware of and report any unusual bleeding immediately.

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