Every woman will experience menopause. The average age for women in the U.S. 51 years, though it can occur earlier or later and peri-menopause, the time leading up to the complete cessation of menses is extremely variable in duration and can last from months to years. Some women seem to go through this transitional period with only minor and fleeting changes while other women deal with very unpleasant symptoms such as hot flashes, mood swings, vaginal dryness and other issues. These can be a bit more challenging to tackle. Our Upper East Side, NY, gynecologist Dr. Sharon Diamond has some answers to help manage your menopause and peri-menopausal symptoms.
Hormone Replacement Therapy (HRT)
Once women reach menopause the amount of estrogen and progesterone the body produces is dramatically reduced, and during peri-menopause the production of these hormones can be very erratic – reaching record highs and lows. These changes can lead to a variety of symptoms such as hot flashes, headaches and night sweats. For some women a short course of hormone replacement therapy might be appropriate to combat the symptoms and restore or improve quality of life. For these women our Upper East Side, NY, OBGYN will provide you with the hormone replacement best for you, usually bio-identical treatments (hormones identical to those your own body produced during reproductive years). Treatment can come in the form of oral medication, gels, implants or patches which modestly increase estrogen or progesterone levels to successfully reduce and even eliminate your symptoms.
For some women, for example those with a history of, or at high risk for certain malignancies, hormone therapy would not be appropriate. For those women, or for those who choose not to take hormones, there are also simple measures you can take to reduce symptoms of menopause in your day-to-day life:
Treating Hot Flashes and Night Sweats
If you deal with intense hot flashes it’s a good idea to wear lighter, loose-fitted clothing of natural fibers, and to dress in layers. Turning down the temperature at night before going to bed or placing a fan next to your bed while you sleep can also help. Also, document which foods might also be causing your hot flashes. You may find that caffeine, spicy foods, or alcohol are triggers for you. Avoiding or reducing your intake of these foods and drinks can help reduce the frequency of your hot flashes and night sweats.
Treating Mood Swings
If you suddenly feel like you have a short fuse with those around you or you are finding yourself dealing with depression or anxiety, it is important that you talk to your doctor about these issues. There are certain non-medicinal approaches you can take to reduce stress and anxiety. Finding an outlet for your anxiety such as taking up yoga, meditation or even being referred to a therapist can help with your anxiety and negative feelings and help you find a sense of balance.
Menopausal women are also more likely to report sexual issues including discomfort or pain at this time. This is usually due to the decrease in estrogen that results in vaginal and vulvar dryness, thinning, and loss of elasticity. If you find that you are suffering from these changes, there are many options to help including vaginal products such as hyaluronic acid gels, or prescription local estrogens such as creams, suppositories, or rings. The MonaLisa Touch laser treatment is another option as are the use of special lubricants to help improve these uncomfortable symptoms.
Menopause may be a challenging time in a woman’s life but our expert gynecological team here in Upper East Side, NY, can help. We are happy to sit down with you and figure out a treatment plan that truly works.
Pap smears are an important part of the gynecologic examination and Dr. Sharon Diamond in the Upper East Side of New York, NY, urges her patients and all women to make sure they see their doctors regularly. How frequently to have a Pap test is determined by an individual woman’s history and risk factors and is an important part of the healthcare discussion with her physician. The incidence of advanced cervical cancer in the United States has decreased by about 50 percent in the past 30 years in large part because of widespread screening with the Pap test and so having this important test is an integral part of well women care.
The Pap test involves analyzing the superficial cells of the cervix for abnormalities and should be performed for women starting at the age of twenty-one. The doctor will sweep a plastic spatula across the cervix and use a tiny soft brush called the cytobrush to obtain some cells from the external part of a woman's cervix and from the internal, lower part of the cervix. These will then be examined under the microscope in a laboratory. If no abnormal cells are found, the results will come back as negative. An important additional test is also run on smears from women over the age of thirty or on smears from women of any age if the Pap is abnormal- this is testing for Human Papilloma Virus (HPV) which is a virus that, although often not significant, may have the potential to cause serious abnormalities in the cervix including cervical cancer, especially if present for many years.
Abnormal Pap Smear Classification System
Dr. Diamond uses the standard Pap classification system in her Upper East Side office in New York. This system analyzes patients' results so that they can better understand them:
- Normal/Negative: This means there are no cancer or pre-cancer cells.
- Atypical squamous cells of undetermined significant (ASC-US): this is one of the more common abnormal results and is usually not significant unless also accompanied by the presence of HPV. Depending on whether or not HPV is present, the Pap may just be repeated in 6 months or a year or additional testing may be needed – colposcopy. Colposcopy is an examination performed with the use of a binocular magnifier that enables abnormal areas to be seen and biopsied.
- Squamous intraepithelial lesion (SIL): There is a low-grade form (LSIL) which is caused by HPV cells that typically go away on their own, and a high-grade (HSIL) form which means there may be a more serious problem present. Depending on the age of the patient and other risk factors colposcopy may be performed for women with LSIL but is always warranted when HSIL is present.
- Atypical squamous cells, cannot exclude HSIL (ASC-H): Further testing including colposcopy is needed at this stage.
- Atypical glandular cells (AGC): This is indicative of the presence of pre-cancer cells within the cervix or uterus and colposcopy, sonography and biopsies of the lining of the uterus may also need to be performed.
- Cancer: a very rare finding in women who have been having regular Pap smears but which must be addressed immediately.
For more information on Pap smears, just call Dr. Diamond at her Upper East Side, NY, office at 212-876-2200 and arrange for an office consultation and examination.
Dr. Sharon Diamond offers birth control counseling for women at her Upper East Side Manhattan, NY gynecological practice. Young women often have a lot of questions when it comes to their sexual health and preventing pregnancy. Here are a few of the most common FAQs that women have about birth control.
What Are the Benefits of Birth Control and Why Is It Important?
Women often wonder about the benefits of birth control. The obvious benefit is that you get to have control over your reproductive process and you decide if and when you’re ready to have children. There are other benefits as well, including the following:
- Birth control pills can help some women have more manageable, less painful, and more regular periods.
-Certain IUD’s can also reduce the amount and duration of menstrual flow and also decrease cramping
- Condoms, another popular contraceptive, can help you avoid or lower your risk of certain STDs.
- Becoming pregnant when she wants to helps increase the likelihood that when a woman does choose to get pregnant, she has the resources and support she needs for a healthy pregnancy.
- Some contraceptive devices are designed to prevent pregnancy for up to 12 years (however they can be removed whenever requested).
What Birth Control Methods Are Now Available?
Prior to the 20th century, women had very limited options when it came to safe birth control. Today, there are numerous birth control methods to choose from. Here are a few offered at Dr. Diamond’s Upper East Side birth control counseling office:
- Birth control pills and rings and emergency contraception (Plan B, also known as the morning after pill).
- IUDs (intrauterine devices).
- Condoms, diaphragms, and sponges.
- Contraceptive patches.
- Vaginal rings.
- Tubal ligation for patients who have decided to stop having children.
Is Any Birth Control 100 Percent Effective?
While no birth control method is 100 percent effective, many are highly reliable. Birth control pills have a 99 percent rate of success when used exactly as prescribed. The IUD also has a 99% rate of effectiveness. The patch rate is 91 percent and condoms have an 82 percent rate of reliability in preventing pregnancy (estimates by Planned Parenthood). Discuss these rates more with your gynecologist.
Ask More Questions at Your Appointment
Make time for birth control counseling with Dr. Sharon Diamond at her Upper East Side Manhattan, NY office. It’s crucial to your sexual health, overall wellness and family planning goals. Call 212-876-2200today to schedule an appointment.
Menopause is different for every woman. Although it is a natural part of the aging process, hormonal changes in the body may lead to symptoms that vary in duration and intensity in each individual. Dr. Sharon Diamond, a gynecologist on the Upper East Side offers comprehensive and individualized menopause management in NYC.
Gynecology and Menopause Management Upper East Side, NYC
Menopause is the stage of a woman's fertility and reproductive years when the ovaries stop releasing eggs and menstruation comes to an end. In the years leading up to menopause (known as perimenopause), estrogen and progesterone production declines, and periods may begin to fluctuate. During perimenopause, there is sometimes an imbalance between the production of these two hormones that can cause irregular of heavy bleeding that has to be addressed. The process usually begins sometime in the mid to late 40s, but can begin earlier in some women. The average age for menopause is 51 but can happen earlier or later. A woman is generally considered to officially be in menopause after menstruation has ceased for an entire year.
Some of the most common symptoms of perimenopause include:
- Hot flashes and night sweats
- Irregular periods (heavier or lighter periods, longer or shorter in duration, skipping periods)
- Irritability and mood swings
- Hair loss/thinning
- Difficulty sleeping
- Weight gain and bloating
- Vaginal dryness
- Loss of libido
Some women do not experience noticeable symptoms. While there is no "cure" for menopausal symptoms, there are medical, lifestyle, and behavioral modification options that can help to relieve the intensity of symptoms, manage discomfort, and improve the quality of life for women going through menopause. The most common management techniques include estrogen and progesterone (bio-identical) hormone replacement, diet and nutrition counseling to help with healthy weight management and strength training and other weight bearing exercise to build muscle and bone strength. Emotional wellbeing is also an important factor in adjusting to life after menopause, and counseling can also help women find peace and a new sense of balance with the changes to their mind and body.
Find an Upper East Side Gynecologist in NYC
For more information on personalized and compassionate menopause management, and other gynecology services on the Upper East Side, contact our office by calling 212-876-2200 to schedule an appointment with Dr. Diamond today.
Sex shouldn’t be painful. Find out what could be causing your discomfort during intercourse.
If sex has turned from a fun, pleasurable experience to something uncomfortable and even painful, then it’s time to talk to our Upper East Side gynecologist, Dr. Sharon Diamond, about what might be going on.
As women get older, particularly around the time they reach menopause, they may experience an increase in vaginal dryness and a loss of vaginal elasticity due to the reduction in circulating estrogen that comes with menopause. These are some of the more obvious causes of pain can often be effectively treated.
Other causes of painful intercourse include:
- Vaginal infections
- Cervical or uterine infections
- Fibroids and other uterine problems
- Ovarian cysts
- Pelvic inflammatory disease (PID)
- Sexually transmitted diseases (STDs)
- Skin conditions such as lichen sclerosis, psoriasis or excyma
- Psychological or related issues
How is pain during intercourse treated?
The first step is to accurately diagnose causes of discomfort and then to address them. A thorough history and physical examination is necessary with a caring physician. For example, it is common for new mothers to have pain at the entrance to the vagina after childbirth, whether or not an episiotomy has been performed.
Waiting until six weeks after childbirth to have sex and using over-the-counter lubricants when experiencing dryness may be certain simple measures than can be taken in this situation to reduce sexual discomfort.
If your dryness is due to the menopausal drop in estrogene, it’s time to talk to our Upper East Side women’s doctor about prescription medications or over-the-counter options. Prescription local estrogen in cream, suppository or ring form may be useful. If medications have not been found to be helpful or if they are contra-indicated because of other medical or family history or conditions, we are also pleased to offer the MonaLisa Touch. This treatment is used to reduce symptoms such as dryness, pain with sexual activity and burning.
What is MonaLisa Touch?
This FDA-approved medical laser is designed to stimulate and restructure collagen within the vagina to increase natural lubrication and elasticity. This can be a wonderful option for women dealing with this uncomfortable problem for whom hormonal treatments are not appropriate. It may also be effective for treating skin conditions such as lichen sclerosis when other therapy has not been effective..
The therapy consists of three treatments, each performed about six weeks apart. They are performed right here in our office and there is little downtime. You can walk right into our office for care and walk right out after it’s done, making it a convenient treatment for those with busy schedules.
Don’t let pain become the norm, call our Upper East Side, NY gynecology office today to schedule your next appointment.
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