FAQ

By Personalized Women’s Healthcare

What Are Polyps?
Polyps are fleshy fingerlike growths of tissues, which are attached to normal tissue by a stem. They are almost always non-cancerous and can be found in any part of the human body. The most common sites for growth are the nasal passage of the nose, the vocal cords (larynx) and colon (colorectal polyp). The two types unique to women are uterine polyps and cervical polyps.

Uterine polyps: Also called endometrial and intrauterine polyps develop inside the womb (uterus). If they grow in the lower part of the uterus and grow large enough they can stick out through the cervix into the vagina.
Cervical polyps: These grow on the cervical tissue and usually extend into the vagina.

What Are The Causes?
The cause of cervical polyps is not completely understood. They often occur after an injury to the cervix and in the healing process new tissue becomes overgrown resulting in a polyp. Sometimes increased levels of estrogen during pregnancy can stimulate overgrowth. Cervical polyps are rare in girls who have not yet started menstruating and are more common in women over 20 who have had babies. Uterine polyps tend to occur around the time of menopause and the incidence rate declines rapidly thereafter. Although the exact cause of uterine polyps is unknown, they too appear to be estrogen sensitive. Most women will have only one cervical or uterine polyp but some develop two or three.

What Are The Symptoms?
Both uterine and cervical polyps frequently cause no symptoms. Sometimes they can cause abnormal vaginal bleeding or spotting between periods – particularly after intercourse or after menopause (when periods have ceased). They occasionally cause heavy periods (Menorrhagia) or a watery bloody discharge. This discharge can be foul smelling if the polyps become twisted and infected. If a polyp becomes large and sticks down through the vagina it can cause cramping. If it blocks the entrance to the cervix it can cause infertility in premenopausal women. Fortunately, having the polyp removed easily restores fertility.

How Are Polyps Diagnosed?
Cervical polyps and uterine polyps that protrude into the vagina are easily spotted during a pelvic examination. Many polyps in the uterus however cannot be visually spotted unless a hysteroscopy, (SIS) saline infusion sonogram or a dilation and curettage (D&C) is performed.
These procedures can also be used to remove any polyps found.

How Are They Treated?
Cervical polyps are simple to treat. They can be twisted or snipped off with a forceps under local anesthesia. This procedure can be performed in a doctor’s office or as an outpatient in hospital. If they recur, which is quite possible, a D&C is usually recommended. Uterine polyps usually require a D&C or hysteroscopy to remove them. As some polyps may be missed it is quite common to repeat the procedure. If polyps continue to recur and cause bothersome symptoms a hysterectomy may be recommended – in premenopausal (younger) women, a hysterectomy is mainly done for convenience. In postmenopausal women who still continue to bleed from polyps a hysterectomy is strongly recommended. This is mainly because doctors fear they could be missing some underlying cancer. While it is extremely rare for polyps themselves to turn cancerous, the bleeding they cause is hard to differentiate from bleeding of unrelated endometrial cancer.

By Personalized Women’s Healthcare

A hysterectomy is the surgical removal of your uterus. Your doctor may recommend you have a hysterectomy if you have been diagnosed with:

• Endometriosis
• Heavy menstrual bleeding
• Fibroid tumors
• Pelvic prolapse
• Cancer

Common Gynecologic Symptoms
Pain – Pain can be described in many ways. It is often measured with a simple 0-10 scale where 0 equals no pain and 10 is the worst pain you can imagine. Describing your pain can help your doctor pinpoint the condition. Each of the following may indicate a different condition:

• Pelvic discomfort
• Pelvic pressure
• Abdominal tenderness
• Abdominal cramps
• Back ache, Back Ache
• Painful urination and/or bowel movements
• Pain during intercourse

Bleeding – Monthly periods are different for each woman. Menstrual bleeding can also be different before and after childbirth, with age, and with any medications you regularly take. The following are examples of bleeding patterns that are linked to specific gynecologic conditions:

• Very heavy or abnormal bleeding
• Bleeding longer than 7 days
• Periods lasting longer than 21 days
• Periods more than 35 days apart
• Spotting/bleeding between periods
• Spotting/bleeding after menopause
• Passing blood clots
• Bleeding after intercourse

Other Symptoms – Besides pain or irregular bleeding, there are other symptoms many women have that are linked to certain gynecologic conditions.

• Difficulty urinating or having bowel movements
• Infertility (cannot get pregnant/miscarriages)
• Feeling of pressure on your bladder or rectum
• Slipping or dropping of your vagina or uterus
• Feeling heaviness or pressure in your pelvis
• Constant abdominal pressure
• Swelling or bloating
• Urgent need to urinate
• Recurrent urinary tract infections

Gynecologic Conditions
Many benign (non-cancerous) conditions can affect a woman’s health and reproductive system. Your uterus, vagina, ovaries and fallopian tubes make up your reproductive system.

Common gynecologic conditions that can affect your reproductive system include: fibroid tumors (non-cancerous growths in the uterine wall), endometriosis (non-cancerous growths of the uterine lining) and pelvic prolapse (falling or slipping of the uterus).

By Personalized Women’s Healthcare

What is Genital HPV Infection?
Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection (STI). There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat. Most people who become infected with HPV do not know they have it. HPV is not the same as herpes or HIV (the virus that causes AIDS). These are all viruses that can be passed on during sex, but they cause different symptoms and health problems.

How do people get HPV?
HPV is passed on through genital contact, most often during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.
A person can have HPV even if years have passed since he or she had sexual contact with an infected person. Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner.

What are the potential health problems of HPV?
Genital warts usually appear as a small bump or groups of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. Health care providers can diagnose warts by looking at the genital area during an office visit. Warts can appear within weeks or months after sexual contact with an infected partner—even if the infected partner has no signs of genital warts. If left untreated, genital warts might go away, remain unchanged, or increase in size or number. Warts will not turn into cancer

Cervical cancer usually does not have symptoms until it is quite advanced, very serious and hard to treat. For this reason, it is important for women to get regular screening for cervical cancer. Screening tests can find early signs of disease so that problems can be treated early, before they ever turn into cancer.

Other HPV-related cancers might not have signs or symptoms until they are advanced and hard to treat. These include cancers of the vulva, vagina, penis, anus, and oropharynx (cancers of the back of the throat, including the base of the tongue and tonsils).

Prevention
There are several ways that people can lower their chances of getting HPV:
Vaccines can protect males and females against some of the most common types of HPV. HPV vaccines are safe and effective. They are given in three doses over six months. It is important to get all three doses to get the best protection. The vaccines are most effective when given at 11 or 12 years old.

Girls and women: Two vaccines (Cervarix and Gardasil) are available to protect females against the types of HPV that cause most cervical cancers. One of these vaccines (Gardasil) also protects against most genital warts. This vaccine has also been shown to protect against anal, vaginal and vulvar cancers. Both vaccines are recommended for 11 and 12 year-old girls, and for females 13 through 26 years of age, who did not get any or all of the doses when they were younger.

For those who are sexually active, condoms may lower the risk of HPV infection. To be most effective, they should be used with every sex act, from start to finish. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that are not covered by a condom – so condoms may not fully protect against HPV.
People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and being with a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected. Not having sex is the only sure way to avoid HPV.

By Personalized Women’s Healthcare

What is chlamydia?
Chlamydia is a common sexually transmitted disease (STD) caused by a bacterium. Chlamydia can infect both men and women and can cause serious, permanent damage to a woman’s reproductive organs.

How common is chlamydia?
A large number of cases are not reported because most people with chlamydia do not have symptoms and do not seek testing. Chlamydia is most common among young people. It is estimated that 1 in 15 sexually active females aged 14-19 years has chlamydia.

How do people get chlamydia?
People get chlamydia by having sex with someone who has the infection. “Having sex” means anal, vaginal, or oral sex. Chlamydia can still be transmitted even if a man does not ejaculate. People who have had chlamydia and have been treated can get infected again if they have sex with an infected person.

Chlamydia can also be spread from an infected woman to her baby during childbirth.

Who is at risk?
Any sexually active person can be infected with chlamydia. It is a very common STD, especially among young people. It is estimated that 1 in 15 sexually active females aged 14-19 years has chlamydia. Sexually active young people are at high risk of acquiring chlamydia for a combination of behavioral and biological reasons. Men who have sex with men (MSM) are also at risk for chlamydial infection since chlamydia can be transmitted by oral or anal sex.

What are the symptoms?
Chlamydia is known as a ‘silent’ infection because most infected people have no symptoms. If symptoms do occur, they may not appear until several weeks after exposure. Even when it causes no symptoms, chlamydia can damage a woman’s reproductive organs.

In women, the bacteria first infect the cervix (structure that connects the vagina or birth canal to the uterus or womb) and/or the urethra (urine canal). Some infected women have an abnormal vaginal discharge or a burning sensation when urinating. Untreated infections can spread upward to the uterus and fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), causing pelvic inflammatory disease (PID). PID can be silent, or can cause symptoms such as abdominal and pelvic pain. Even if PID causes no symptoms initially, it can lead to infertility (not being able to get pregnant) and other complications later on.

Some infected men have discharge from their penis or a burning sensation when urinating. Pain and swelling in one or both testicles (known as “epididymitis”) may also occur, but is less common. Chlamydia can also infect the rectum in men and women, either through receptive anal sex, or possibly via spread from the cervix and vagina. While these infections often cause no symptoms, they can cause rectal pain, discharge, and/or bleeding (known as “proctitis”).

What is the treatment?
Chlamydia can be easily treated and cured with antibiotics. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV-negative.

Persons with chlamydia should abstain from having sex for seven days after single dose antibiotics, or until completion of a seven-day course of antibiotics, to prevent spreading the infection to partners. Repeat infection with chlamydia is common. Persons whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple chlamydial infections increases a woman’s risk of serious reproductive health complications, including pelvic inflammatory disease and ectopic pregnancy. Women and men with chlamydia should be retested about three months after treatment of an initial infection, regardless of whether they believe that their sex partners were successfully treated. Infants infected with chlamydia may develop conjunctivitis (infection of the membrane lining the eyelids) and/or pneumonia. Chlamydial infection in infants can be treated with antibiotics.

By Personalized Women’s Healthcare

What is bacterial vaginosis?
Bacterial vaginosis (BV) is the name of a condition in women where the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain bacteria. Discharge, odor, pain, itching, or burning sometimes accompanies it.

How do people get bacterial vaginosis?
The cause of BV is not fully understood. BV is associated with an imbalance in the bacteria that are normally found in a woman’s vagina. The vagina normally contains mostly “good” bacteria, and fewer “harmful” bacteria. BV develops when there is an increase in harmful bacteria.

Not much is known about how women get BV. There are many unanswered questions about the role that harmful bacteria play in causing BV. Any woman can get BV. However, some activities or behaviors can upset the normal balance of bacteria in the vagina and put women at increased risk including:

• Having a new sex partner or multiple sex partners
• Douching

It is not clear what role sexual activity plays in the development of BV. Women do not get BV from toilet seats, bedding, swimming pools, or from touching objects around them. Women who have never had sexual intercourse may also be affected.

What are the signs and symptoms?
Women with BV may have an abnormal vaginal discharge with an unpleasant odor. Some women report a strong fish-like odor, especially after intercourse. Discharge, if present, is usually white or gray; it can be thin. Women with BV may also have burning during urination or itching around the outside of the vagina, or both. However, most women with BV report no signs or symptoms at all.

How is it diagnosed?
A health care provider must examine the vagina for signs of BV and perform laboratory tests on a sample of vaginal fluid to look for bacteria associated with BV.

What is the treatment?
Although BV will sometimes clear up without treatment, all women with symptoms of BV should be treated to avoid complications. Male partners generally do not need to be treated. However, BV may spread between female sex partners.

Treatment is especially important for pregnant women. All pregnant women who have ever had a premature delivery or low birth weight baby should be considered for a BV examination, regardless of symptoms, and should be treated if they have BV. All pregnant women who have symptoms of BV should be checked and treated. BV is treatable with antibiotics prescribed by your physician. Two different antibiotics are recommended as treatment for BV: metronidazole or clindamycin. Either can be used with non-pregnant or pregnant women, but the recommended dosages differ. Women with BV who are HIV-positive should receive the same treatment as those who are HIV-negative. BV can recur after treatment.

How can bacterial vaginosis be prevented?
BV is not completely understood by scientists, and the best ways to prevent it are unknown. However, it is known that BV is associated with having a new sex partner or having multiple sex partners.

The following basic prevention steps can help reduce the risk of upsetting the natural balance of bacteria in the vagina and developing BV:

• Be abstinent.
• Limit the number of sex partners.
• Do not douche.
• Use all of the medicine prescribed for treatment of BV, even if the signs and symptoms go away.