Anyone with a cervix should get their first Pap smear at age 21 and another every three years before turning 30. Those ages 30 to 65 should have a Pap test every three to five years.

“If you are younger than 21, the American College of Obstetricians and Gynecologists (ACOG) says you do not need this type of screening,” said Amy E. Farrell, M.D., OB/GYN with Norton Women’s Care.

What is a Pap smear test?

A Pap smear (also referred to as cervical cytology or Pap test and named for its developer George Papanicolaou, M.D.) can detect abnormal, precancerous cervical cells. 

Precancerous changes to cervical tissue, or cervical dysplasia, won’t cause any symptoms, but can be identified through lab testing. A Pap test is a very effective cervical screening test. Early detection allows for early treatment, which can be the most successful. A regular Pap smear can identify abnormal cervical cells before they develop into cancer. Even if cervical cancer has started to develop, a Pap test can detect it and lead to early treatment that can preserve fertility. 

READ MORE: What’s the right age to start getting Pap smear tests?

The test is very brief, and while it may be a bit uncomfortable, it doesn’t hurt. You’ll lie on your back with your feet in stirrups and a drape over your legs. Your gynecologist or other health care provider will insert a speculum in your vagina to hold it open to provide access to your cervix. A small brush collects cervical cells and is placed in a tube for testing.

For two days prior to your Pap smear test, refrain from vaginal sex, stop using tampons, vaginal creams, medicines, lubricants or douches. Schedule your appointment for after your period ends. If you have your period on the day of the exam, contact your provider, as menstruation could alter the results.

A pelvic exam is not the same thing as a Pap smear. Although they commonly occur during the same visit, both tests are not a requirement for every appointment. They serve as important ways to keep you healthy, including prevention of certain medical conditions and screening for cancer.

According to ACOG, a pelvic exam is not necessary — unless certain symptoms are present or there is a risk of specific conditions — but a patient and provider should make this decision together.

Is a Pap smear also an HPV test?

Cervical cells collected during a Pap smear are also tested for HPV, a very common virus that often has no symptoms and clears up in a year or two without causing cancer. An HPV infection that persists for many years can lead to precancerous changes that can develop into cervical cancer. 

HPV testing and vaccination can significantly reduce the risk of cervical cancer.

After an abnormal Pap test result

If you get an abnormal Pap test or HPV result, you and your provider will discuss next steps, which could include:

• A review of your medical history with an emphasis on relatives who may have had cervical or another gynecologic cancer
• A physical exam that includes feeling your lymph nodes for any abnormalities
• Follow-up test called a colposcopy: This test gives your health care provider a magnified view of the surface of your cervix. As with a Pap smear, you’ll lie on your back, and your provider will insert a speculum in your vagina to provide access for the colposcopy. The exam causes no more discomfort than a Pap smear. A weak solution of acetic acid (the same acid in vinegar) will be applied to your cervix to highlight abnormal areas. A small piece of cervical tissue may be removed for a biopsy to determine whether there are signs of cervical precancer, cancer or neither. 
• A cone biopsy retrieves a bit of tissue for testing and can serve as treatment by removing all the abnormal cervical tissue. The small piece of tissue is cut in the shape of a cone and may leave you with some discomfort for about a week.

The post What’s the right age to start getting Pap smear tests? appeared first on Norton Healthcare.

Irregular periods are characterized by variations in the length of the menstrual cycle or the amount of bleeding. There are multiple conditions that can contribute to irregularities in the menstrual cycle.

Abnormal bleeding

• An abnormal period may involve:
• Irregular bleeding
• Heavy menstrual bleeding
• Severe period pain
• Pelvic pain
• Menstrual irregularity
• Abnormal uterine bleeding

“There are multiple causes of abnormal uterine bleeding. Some of the ones we see most often include fibroids, adenomyosis, endometrial polyps, clotting disorders and hormonal issues. Rarely, abnormal bleeding can be a sign of a more serious health condition, so it’s important to talk to your doctor and get it checked. Pinpointing the exact cause is usually possible after an exam in the office, an ultrasound and lab work” said Steven J. Radtke, M.D., FACOG, FMIGS, minimally invasive gynecologic surgeon at Norton Urogynecology Center, part of Norton Women’s Care.

Symptoms of abnormal bleeding may include:

• Bleeding between periods
• Bleeding after sex
• Irregular, unpredictable periods
• Menstrual flow that is much heavier than usual
• Bleeding after menopause
• Bleeding that is accompanied by severe pain or cramping
• Bleeding that lasts for more than seven days

New or sudden changes to your menstrual cycle, including amount of flow or more painful cramps, potentially can indicate other health conditions. Worsening pain is another red flag.

It is important to address any concerns regarding painful or irregular periods with your provider to determine the underlying cause and develop an appropriate management plan tailored to your individual needs and health goals, such as family planning.

“Nowadays there’s a wide range of treatment options available, surgical and nonsurgical, that can help address these symptoms and improve a patient’s quality of life — tailored to their particular circumstances and goals. It’s always a good first step to talk to your primary care doctor or OB/GYN about your concerns,” Dr. Radtke said.

Period pain

Dysmenorrhea, commonly known as period pain, is a condition that affects many people during their menstrual cycle. The primary symptom of dysmenorrhea is cramping in the lower abdomen, which can range from mild to severe, and often can radiate to the lower back and thighs. Other symptoms that are associated with dysmenorrhea may include nausea, vomiting, diarrhea, headaches and fatigue.

Treatment options for dysmenorrhea aim to alleviate pain and discomfort. Over-the-counter pain medications, such as ibuprofen or acetaminophen, often are recommended to help manage cramps and reduce inflammation, in addition to the use of a heating pad. For more severe cases, a health care provider may prescribe birth control or higher-strength nonsteroidal anti-inflammatory drugs for pain relief. Additionally, lifestyle changes such as regular exercise and dietary modifications can help alleviate symptoms of dysmenorrhea.

Primary dysmenorrhea and secondary dysmenorrhea are two distinct conditions that involve painful menstrual periods. Primary dysmenorrhea is typically related to normal menstrual processes, while secondary dysmenorrhea is caused by an underlying medical condition and requires specific treatment to address the root cause of the pain.

Primary dysmenorrhea refers to common menstrual cramps that occur in the absence of any underlying gynecological issues. These cramps typically are caused by the contractions of the uterus as it sheds its lining during menstruation. The pain usually is felt in the lower abdomen and can be managed with over-the-counter pain medication and lifestyle changes.

Secondary dysmenorrhea involves period pain that is a symptom of an underlying medical condition, such as endometriosis, fibroids or pelvic inflammatory disease. The pain with secondary dysmenorrhea is often more severe and may worsen over time. Treatment for secondary dysmenorrhea targets the underlying cause and may involve medications or surgery.

If you are experiencing dysmenorrhea, especially severe or new pain, you should consult with your health care provider.

Uterine fibroids and endometriosis

Uterine fibroids and endometriosis are two common gynecological concerns. Period pain from uterine fibroids or endometriosis is considered secondary dysmenorrhea. Both conditions also may cause painful periods and chronic pelvic pain.

Fibroids are noncancerous growths or tumors that develop in the uterus, often causing symptoms like heavy menstrual bleeding and pelvic pain. Endometriosis is a condition where tissue similar to the inside lining of the uterus starts growing in places where it doesn’t belong, such as the pelvic sidewall, bladder, rectum, etc.  This produces an inflammatory response that worsens during menstrual cycles. Common symptoms include severe pain, bloating, painful vaginal intercourse, painful urination and painful bowel movements. Some patients also may experience infertility.

“A patient is considered to have advanced endometriosis when: No. 1, there is a high burden of disease, for instance, if lesions are covering a large percentage of the pelvis. And No. 2, if endometriosis implants are located on critical structures, such as the bladder, ureters, intestines, diaphragm, etc.,” Dr. Radtke said.

Symptoms of endometriosis often are controlled with hormonal medications such as birth control pills, or medications that temporarily decrease estrogen levels in the body. However, surgery may be recommended in cases where symptoms are severe, are not improving with conservative measures, if advanced disease is suspected, or if a patient does not want to take hormonal medications. Surgery involves removing the tissues affected by endometriosis, allowing the body to regenerate new healthy tissue in its place (excisional surgery).

“Chronic pelvic pain in reproductive-age females is caused by endometriosis 70% of the time, but there can be other issues that cause it as well, such as ovarian cysts, scar tissue, issues with the bladder, intestines or pelvic floor muscles,” Dr. Radtke said. “It is important to talk to your doctor in order to start investigating possible causes.”

Minimally invasive surgical treatments

There are numerous minimally invasive gynecologic surgery (MIGS) options for patients, including those who desire to get pregnant.

“For patients with endometriosis who desire to preserve fertility and want to avoid hormonal medications, the surgical treatment involves making small incisions — less than 1 centimeter — in the abdomen and ‘stripping’ the endometriosis off the affected structures,” Dr. Radtke said. “During this process, scar tissue is also removed in order to restore normal anatomy. We also test the fallopian tubes to make sure they are not blocked.

“When patients are done with childbearing, performing a hysterectomy at the time of endometriosis surgery significantly decreases the chances of it coming back in the future. We usually recommend not removing the ovaries, unless they are very abnormal.”
A MIGS procedure may be considered for some patients with complex conditions.

Patients should speak to their provider about a referral for a MIGS evaluation for the following complex conditions: 

• Advanced endometriosis (affecting bladder, gastrointestinal tract, diaphragm, etc.)
• Chronic pelvic pain without apparent cause
• Frozen pelvis
• Severe scar tissue
• Large leiomyomas (fibroids)
• Large ovarian cysts
• Conditions that may make surgery more complicated, such as obesity, diabetes, chronic anticoagulation or circulatory issues

Addressing the root cause of painful or irregular periods is crucial for maintaining reproductive health and overall well-being. Consulting with your provider for proper diagnosis and treatment options is essential when it comes to managing your reproductive and overall health.

“If you feel like your life revolves around pelvic pain, or worrying about your next menstrual cycle, we’re here to help you get your life back,” Dr. Radtke said.

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Both can perform basic health assessments, write prescriptions, and provide flu shots or other immunizations.

Most insurance plans cover an annual visit with each.

What is the difference between a primary care provider and an OB/GYN?

An OB/GYN is focused on health issues related to women’s health. This includes reproductive and sexual health, breast health, pregnancy, menopause and issues that arise, such as heavy periods, sores, rashes or itchiness in genital areas, and urinary tract infections.

A primary care provider does not ignore women’s health issues, but is focused on the whole person. They are trained to treat a wide range of conditions, including heart disease, diabetes or depression.

“OB/GYNs and primary care physicians are specially trained in their fields, and their expertise is different. That’s why seeing both an OB/GYN and a primary care provider is the best way for a woman to be healthy and stay healthy,” said Christina Breit, MD with Norton Community Medical Associates primary care offices.

READ MORE: What’s the right age to start getting Pap smear tests?

OB/GYNs are trained in two specialties, obstetrics and gynecology. Obstetrics covers all aspects of pregnancy care. Gynecology involves all other women’s health issues. An OB/GYN is primary care physician, but the focus is on women’s health.

Pediatric gynecologists typically see patients up to when they turn 21.

What is the difference between an annual checkup versus a women’s well exam?

By making an annual wellness visit to an OB/GYN, a woman can receive a pelvic exam, and a Pap smear, and can take care of other women’s health-related issues. An OB/GYN also is trained in issues such as infertility, menopause, high-risk pregnancies and cancers of the reproductive system.

A primary care provider includes doctors in family medicine, internal medicine and pediatrics, nurse practitioners, and physician assistants. Their focus is overall health. Primary care providers can perform screenings and care for chronic conditions and other health issues.

An annual check up, or physical, is recommended for women and men so a primary care provider can review their medical history, look for potential health risks, update vaccinations, and discuss mental health and other issues. A primary care provider can also make referrals to specialists such as cardiologists, oncologists, endocrinologists and more.

A board-certified primary care physician has received obstetrics and gynecology training, though not as much as an OB/GYN, and they are more concerned with overall health. Still, many primary care physicians do pelvic exams, screenings for sexually transmitted infections, Pap smears and breast exams as part of an annual well-woman exams.

“If you’re healthy and have no specific gynecological issues, then you can go to your primary care provider for your annual well-woman exam, but it’s a good see an OB/GYN and establish a rapport with a woman’s health specialist for times when issues arise,” Dr. Breit said.

What do obstetricians do?

If you are planning to become pregnant, or are pregnant, you should see an OB/GYN.

Obstetricians provide care before you conceive, while you’re pregnant and through delivery. Aside from providing prenatal care for you and your baby, an obstetrician can diagnose and treat complications that may come up.

Obstetricians are caring for you and your unborn baby. When you’re pregnant, conditions such as high blood pressure or preeclampsia, gestational diabetes, and morning sickness can be addressed by an obstetrician.

Obstetricians also perform surgical procedures such as episiotomies, cesarean delivery if a vaginal delivery isn’t safe, and cervical cerclage.

If necessary, your obstetrician may work with a maternal-fetal medicine specialist to help you through a complex pregnancy. Maternal-fetal medicine is a specialty that takes care of you and your unborn baby. Your Norton Women’s Care OB/GYN connects you to a comprehensive range of women’s specialists, including the team at the Norton Heart & Vascular Institute Women’s Heart Program.

The post Why having a regular primary care provider and a gynecologist is a good idea appeared first on Norton Healthcare.

“You should visit your OB/GYN once a year for a well-woman visit after you turn 21 or when you become sexually active,” said Katherine K. Holland, APRN with Norton Women’s Care. “Although it’s common to feel some apprehension about this type of visit, your provider can help ease any anxiety and answer whatever questions you may have — about your health and what to expect during the visit.”

READ MORE: What’s the right age to start getting Pap smear tests?

Many young patients have questions about Pap smears and pelvic exams. Here’s what to expect, why an OB/GYN visit is important and how often you should have one.

Is a pelvic exam the same as a Pap smear?

No, a pelvic exam is not the same thing as a Pap smear. They commonly occur during the same visit, but both are not a requirement for every appointment. Both serve as important ways to keep you healthy, including prevention of certain medical conditions and screening for cancer.

What is a Pap smear test?

A Pap smear (or Pap test) checks for cervical cancer and/or human papillomavirus (HPV). A Pap test can detect abnormal cells that can lead to cervical cancer. A Pap smear is a very brief test and involves brushing a tool against the cervix. This sample of cells is then tested for abnormalities.

How often should you get a Pap test?

Women should get their first Pap test at age 21. This test should occur every three years for woman ages 21 to 29. Women ages 30 to 65 should have a Pap test every three to five years.

What is a pelvic exam?

A pelvic exam consists of a physical exam of the outer and inner portions of your pelvic organs, including the vulva, vagina, cervix and uterus.

After your provider looks at your external genitals, they will insert a tool, called a speculum, into your vagina, which opens the vaginal walls enough to see the cervix. This is when a Pap test happens if it is needed. Afterward, your provider will check your uterus and ovaries by inserting a gloved finger (or two) into the vagina while palpating your abdomen.

If, at any point during the exam, you become uncomfortable, you can ask the provider to stop or pause. If it improves your comfort level, you can request that the provider explain what they are doing during each step of the exam and why it is happening.

How often you should get a pelvic exam?

A pelvic exam is required if you are experiencing symptoms, such as pelvic pain, abnormal vaginal discharge or bleeding, or pain during sex. A pelvic exam also is necessary if you are pregnant or have a history of gynecological conditions. A routine pelvic exam serves as an important part of preventive care and can catch some medical conditions early. However, the American College of Obstetricians and Gynecologists recommends patients have pelvic exams only when they have symptoms or have a medical history that requires it. Talk to your OB/GYN provider to discuss your medical history, concerns and goals — and make this decision together.

The post What is the difference between a Pap smear and a pelvic exam? appeared first on Norton Healthcare.

“The reason for cramping could be a normal part of your menstrual cycle or could be a sign of a more serious underlying health issue,” said Steven J. Radtke, M.D., FACOG, FMIGS, gynecologic surgeon with Norton Women’s Care. “Be sure to inform your provider if you experience what feels like period pain — but isn’t.”

Here are several common reasons for what causes cramps but no period.

Normal ovulation pain

If you feel period cramps, have no period and you’re only midway through your cycle, it could be normal ovulation pain. The pain, known as “mittelschmerz,” is caused by the ovary that is releasing the egg. It can be dull or sharp, is felt on one side of the lower abdomen and can last minutes, hours or up to a couple of days. The pain usually appears around 14 days after starting your period and it goes away without treatment.

RELATED: 8 common causes of pelvic pain

Ovarian cyst

Many ovarian cysts do not cause symptoms, but sometimes they can cause pelvic pain. This type of period-like pain could be from a cyst that has grown or a cyst that has ruptured. A ruptured ovarian cyst can cause sudden, sharp pain on one side of the lower abdomen. Other cysts may cause a dull pain or a feeling of pressure.

Endometriosis

This chronic condition causes endometrial tissue to grow outside of the uterus and can cause pain that feels like period cramps. The pain can appear intermittently or last throughout the month. These types of cramps may be felt in the pelvic area and often appear in the lower back as well.

RELATED: Chronic Pelvic Pain’s persistence poses challenges for patients and health care providers

Pregnancy

If you think you’re having period cramps with no period and your cycle is late — take a pregnancy test. Early symptoms of pregnancy can mimic premenstrual symptoms, and the process of implantation, where the embryo attaches to the uterus, also can feel like period cramps. These cramps tend to be minor and may appear around the time you expect to start your period.

Miscarriage

A miscarriage can feel like period cramps at first, and then the cramping becomes more severe. Cramps can appear with spotting or bleeding. If you are pregnant and experience these symptoms, you should contact your provider. If you are experiencing heavy bleeding or passing large clots, visit an emergency room.

Ectopic pregnancy

An ectopic pregnancy, in which the embryo implants outside the uterus, is a health emergency. It results in miscarriage, and if left untreated it can be fatal to the mother. These cramps are felt in the pelvic region and can range from mild to severe. If severe cramps are accompanied with vaginal bleeding, lightheadedness or fainting, seek emergency treatment.

Digestive issues

Pain that resembles period cramps may not have anything to do with your pelvic health. It could be a sign of digestive conditions. Lower abdominal pain can be attributed to constipation or other gastrointestinal conditions, such as inflammatory bowel disease.

When pelvic pain is an emergency

Pay attention to your body. If your pelvic pain becomes excruciating and is accompanied with a fever or nausea, contact your provider or seek treatment at an emergency department. It could be a sign of an infection or health emergency.

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Ways to help prevent cervical cancer

The best steps that can be taken to prevent cervical cancer include the following:

• Vaccinations (the Gardasil vaccination can be given to boys and girls as young as 9 and young adults up to age 45)
• Minimizing exposure (abstaining, wearing barrier protection such as condoms, having fewer partners)
• Following recommended screening guidelines

“This is one of the truly curable gynecological cancers if detected at an early stage,” said Justin W. Gorski, M.D., gynecologic oncologist with Norton Cancer Institute. “The Pap smear really does save lives, and the vaccine is a complete game changer. It gives us the opportunity to eradicate cervical cancer if widely used.”

READ MORE: What’s the right age to start getting Pap smear tests?

Screening for cervical cancer

Cervical Pap screenings should begin at age 21. Based on the results, a patient then can continue with routine screening or begin more intensive surveillance. The screening also can detect whether steps need to be taken to address any concerns.

Early signs of cervical cancer

Often there are no signs, which is why regular screening is so important. Abnormal screening Pap smears, bleeding after intercourse, irregular bleeding, discharge or pain can be signs associated with cervical cancer.

Risk factors for cervical cancer

The biggest risk factor is exposure to HPV, a virus that is widespread. There are hundreds of strains of HPV. Some of these are considered “high risk” strains for developing cervical cancer. Most sexually active women will be exposed to HPV at some time in their life.

In addition to HPV, smoking and immunocompromised states (HIV, transplant patients on anti-rejection medications or other immunosuppressive medications) are additional risk factors for developing cervical cancer.

What’s the latest treatment for cervical cancer?

Standard treatment for cervical cancer typically includes surgery (only if it is caught early enough), radiation with chemotherapy, or chemotherapy alone. If the cancer returns or progresses, additional chemotherapies or clinical trials may be available.

How will the HPV vaccine for boys prevent cervical cancer?

Vaccinating both girls and boys could reduce the incidence and prevalence of the viruses that cause cervical cancer. So far in studies, vaccine efficacy against HPV is very high — 90.4%.

The post How to prevent cervical cancer appeared first on Norton Healthcare.

Dysmenorrhea is another term for pain associated with the menstrual period, also known as period pain. It often involves period cramps that can be felt in the lower abdomen and/or lower back.

“Many women experience menstrual cramps for a couple of days during each cycle — but not all pain is normal,” said Rosemary C. Sousa, M.D., OB/GYN with Norton Women’s Care. “If you have painful periods, it’s important to discuss this with your provider so we can figure out what’s causing it.”

What is the main cause of dysmenorrhea?

There are two types of dysmenorrhea. Primary dysmenorrhea is caused by a chemical imbalance due to the body producing too much of a hormone called prostaglandin, which makes the uterus contract in order to shed its lining. This type of period pain often can be treated with basic pain relievers or lifestyle changes. Secondary dysmenorrhea is related to cramping caused by an underlying health condition, such as endometriosis, ovarian cysts or uterine fibroids.

How painful is dysmenorrhea?

Period pain can range from mild, dull cramping to deep or sharp pain that can keep a person from being involved in their regular activities. Painful periods shouldn’t interfere with your daily life or cause a person to miss work or other obligations. Discuss your symptoms with your OB/GYN so they can help you find relief from this common menstrual disorder.

How do you treat dysmenorrhea?

Over-the-counter pain relievers that can help with period cramps by targeting prostaglandin production include ibuprofen (Advil) and naproxen (Aleve). Heating pads also may provide some relief.

Birth control — birth control pill, patch, vaginal ring, implant or injection, or an intrauterine device (IUD) — can be an effective method for treating painful periods.

Incorporating healthy lifestyle habits also may help reduce cramping. This includes incorporating regular exercise and stress-reducing activities plus getting adequate sleep each night.

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The answer is yes!

If you’ve scheduled an appointment with your gynecologist and you’re on your period, there is no need to cancel the appointment. Normal vaginal bleeding should not get in the way of a Pap smear or pelvic exam.

“An OB/GYN still can perform an exam when you’re on your period, but it’s also OK to reschedule the appointment if you are feeling uncomfortable,” said Rosemary C. Sousa, M.D., OB/GYN with Norton Women’s Care. “Menstrual bleeding shouldn’t impact important tests we do during an exam, such as a Pap smear, pelvic exam or STI [sexually transmitted infection] testing.”

READ MORE: What’s the right age to start getting Pap smear tests?

What should you do on the day of the appointment?

First of all, there is no need to feel embarrassed. After you check in for your appointment and a medical assistant takes you to the exam room, let them know that you are on your period. You can remove your tampon, pad or menstrual cup in the restroom.

Inside the exam room, pads are available to lay underneath you if needed. A swab may be used to remove remaining menstrual blood inside the vaginal canal so the provider can check that everything looks healthy. Otherwise, the exam should proceed completely as normal.

The most important aspect of a gynecological visit is that you, the patient, feels comfortable. If you have heavy bleeding or cramps, it’s OK to cancel the appointment — however, your provider should be made aware that you are experiencing any painful or abnormal symptoms.

The bottom line

It’s totally normal to talk about your menstrual health with your gynecologist; and if you are on your period, you should feel comfortable enough to attend the appointment without feeling embarrassed.

If you decide to cancel the appointment, be sure to reschedule it. A Pap smear and pelvic exam can be lifesaving screenings that can impact your overall health and fertility.

The post Can you get a Pap smear or pelvic exam on your period? appeared first on Norton Healthcare.

How long does yellow discharge last after pregnancy?

After having a baby, you may have some type of vaginal discharge for six to eight weeks. In the first few days after giving birth, it is normal to bleed, similar to a heavy period, followed by light bleeding or spotting for up to two weeks. During this time, the discharge may be light red, pink or brown in color.

Eventually, the light spotting may turn into a creamy white or yellow discharge. This discharge is caused by white blood cells that are working to heal the lining of the uterus. It is normal for this type of yellow discharge to last for an additional two to four weeks. It may be heavier in the mornings or while breastfeeding.

This process is happening because the body is shedding the mucous membrane that lined the uterus during pregnancy. It also helps the uterus return to its normal size.

Do not use tampons

When experiencing bleeding or yellow discharge after giving birth, you should use only pads. Do not use tampons. Tampons can cause infections or damage the vagina while it is healing. The hospital should provide patients with heavy-duty pads to use for the first few days. Nothing should go inside the vagina for at least six weeks after giving birth.

When should I be worried about discharge after giving birth?

Bloody or yellow discharge after birth may have an odor similar to menstrual blood. However, the discharge should not smell foul or fishy. If your discharge has a foul odor, you may have an infection and should contact your provider.

Also contact your provider if you are still bleeding heavily one week after giving birth or your bleeding has slowed down or stopped and suddenly starts again.

Get emergency help right away if:

• You have sudden, extremely heavy bleeding (soaking a pad within an hour and/or passing large blood clots).
• Your bleeding is accompanied by a fever, pelvic pain or tenderness.

The post Is it normal to have yellow discharge after birth? appeared first on Norton Healthcare.

Although a pelvic exam can help screen for various gynecological conditions, including fibroids and cancer, the procedure may feel intrusive or triggering for some trauma survivors, said Rebecca P. Walker, M.D., OB/GYN with Norton Women’s Care.

“A pelvic exam can be traumatizing for patients who have experienced sexual abuse, and it may not be necessary to conduct one every time a patient sees us,” said Dr. Walker. “Providers should be patient, listen to their patient’s concerns and take the appropriate trauma-informed approach during the visit.”

How to feel more relaxed before a pelvic exam

If the patient feels comfortable, they can share their trauma history with their provider so they can make adjustments to help ease any discomfort. Patients also can advocate for more control over their visit, and should speak up if they feel uncomfortable. The provider can stop the exam for them at any time.

Providers also can keep the patient informed before and during each step of the exam, so the patient knows what is supposed to happen during the procedure and why it is happening. The patient also may ask to bring a trusted person, like a relative or friend, to accompany them inside the exam room to help them remain comfortable and work through any triggers. A nurse also can be in the room with the patient for additional support.

The encounter also can be broken down into more than one visit, allowing the patient to have the opportunity to get used to the office, staff and the exam.

For many women, it may be difficult to relax during a pelvic exam, but it can be a traumatizing experience for survivors of sexual abuse.

Although a pelvic exam can help screen for various gynecological conditions, including fibroids and cancer, the procedure may feel intrusive or triggering for some trauma survivors, said Rebecca P. Walker, M.D., OB/GYN with Norton Women’s Care.

“A pelvic exam can be traumatizing for patients who have experienced sexual abuse, and it may not be necessary to conduct one every time a patient sees us,” said Dr. Walker. “Providers should be patient, listen to their patient’s concerns and take the appropriate trauma-informed approach during the visit.”

How to feel more relaxed before a pelvic exam

If the patient feels comfortable, they can share their trauma history with their provider so they can make adjustments to help ease any discomfort. Patients also can advocate for more control over their visit, and should speak up if they feel uncomfortable. The provider can stop the exam for them at any time.

Providers also can keep the patient informed before and during each step of the exam, so the patient knows what is supposed to happen during the procedure and why it is happening. The patient also may ask to bring a trusted person, like a relative or friend, to accompany them inside the exam room to help them remain comfortable and work through any triggers. A nurse also can be in the room with the patient for additional support.

The encounter also can be broken down into more than one visit, allowing the patient to have the opportunity to get used to the office, staff and the exam.

The post How sexual trauma survivors can feel more relaxed during a pelvic exam appeared first on Norton Healthcare.