Heart of Texas Women's Center - Georgetown Texas

Symptoms of an Ectopic Pregnancy

2008-06-09T11:40:00.000-07:00

Ectopic pregnancy refers to a fertilized egg that implants somewhere outside of the uterus. This is generally in the fallopian tube and is sometimes referred to as a tubal pregnancy. Certain women are at a higher risk for having an ectopic pregnancy than others.

An ectopic pregnancy can start out just like a normal pregnancy. You may have a positive pregnancy test, miss your period or have other normal pregnancy symptoms. Then again, you may not have a positive pregnancy test and you should seek immediate medical help if you experience any of the ectopic pregnancy symptoms.

Many women first experience abdominal pain that can be tender to the touch, sharp or sudden, persistent or intermittent, or it could be fairly mild. Symptoms can have a wide range from person to person. Some women only have pain on one side while others have it in their entire abdomen or pelvis.

Vomiting or nausea can occur. Spotting or vaginal bleeding is also normal. Pain generally gets more severe if you are active, sneezing, coughing or laughing.

If your fallopian tube has ruptured, then you could be in immediate life-threatening danger and you should call 911 immediately if you experience any of the following symptoms. Pain in your shoulder, especially when you lie down can be caused by internal bleeding. Lying down can wash the pooling blood up to your shoulder and put pressure on the nerves, causing pain.

This is a real emergency and you may not have much time to get medical help. Do not delay in calling 911 and never attempt to drive yourself if you experience this type of pain. You may go into shock and experience a weak or fast pulse. Your skin could become pale and clammy. You can get dizzy and find it hard to balance. You can feel faint or actually pass out. Any of these symptoms should tell you that you are in immediate danger and you should get help without delay.

Your chances of having an ectopic pregnancy are higher if you have an IUD, have had a previous ectopic pregnancy, if you have had any type of surgery in or around your fallopian tubes, if you have had a cesarean section or other abdominal surgery or if you have had any type of pelvic infection, such as pelvic inflammatory disease, chlamydia or gonorrhea. Any surgeries or infections can make scar tissue grow in your fallopian tubes trapping a fertilized egg. IUD’s and progestin-only birth control pills can make your uterus inhospitable to fertilized eggs and they may implant in your fallopian tube instead.

If you are at a higher risk for ectopic pregnancy, be very mindful of the symptoms so that you can seek medical help at the slightest signs of a problem.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Cravings During Pregnancy

2008-06-09T11:38:00.000-07:00

Pregnant women are famous for having extraordinary food cravings. We have all heard the pickles and ice cream story. It may seem strange to someone that has not experienced it, but to the mom-to-be, it is a very real and very powerful urge.

Many pregnant women report food tasting different during pregnancy. Food that you used to hate, you might crave. Food that you used to love, might make you sick just to think about it. No one is sure, but most experts agree that these cravings are nature’s way of helping you to eat what you and your growing baby need. For example, if you are craving ice cream, then you might need calcium. If you are craving hamburgers, then you may need protein. But, there is actually little to no evidence to support this theory.

Another school of thought is that hormonal changes intensify your sense of taste and smell. This could affect your impressions of certain foods. Some things can taste like the best thing you have ever had in your whole life, while other foods will send you running for cover.

Some believe that pregnant women are just more likely to comfort themselves and take advantage of this precious opportunity to get what they want. They are tired, heavy, hormonal and that hot fudge brownie every night seems to take the edge off. But, many women report being repeatedly inconvenienced by their cravings and they are definitely not trying to get any extra attention or comfort themselves by having to drive to buy a candy bar in the middle of the night when they would much rather be sleeping.

There is actually a condition called pica that you should report to your doctor if you experience. Pica can cause women to crave non-food items such as sand, rocks, soil, paper, feces or clay. Some women even want to eat ingredients such as plain flour or cornstarch. These types of cravings should not be entertained and can actually harm your baby or keep your baby from receiving the nutrients that it needs. This condition is usually only diagnosed if it lasts for more than a couple of weeks. Let your doctor know if you are experiencing any types of these cravings, especially if you have indulged in any of them. Actions such as eating dirt can introduce dangerous parasites into your body. Eating some of these other substances can give your body dangerous levels of lead or iron. Flour and other food ingredients eaten plain can block your intestines and inhibit absorption of nutrition needed by you and your baby.

Most cravings that you have for normal foods are okay and quite common. It is usually okay to indulge every now and then. Just talk to your doctor if you are having any consistent cravings that could give you or your baby too much of one vitamin, iron or sugar.

About the Author: Dr. Matthew Romberg, a Georgetown Texas gynecologist specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Uterine Fibroid Diagnosis

2008-06-09T11:36:00.000-07:00

If you have been diagnosed with uterine fibroids, then you may have a lot of questions. Treatment may depend on what organs are affected by your tumors. Your symptoms may also have a bearing on decisions about how to go about treating the uterine fibroids.

If you have mild uterine fibroids, then you may be able to only treat the symptoms. This usually includes pain management and hormone suppression therapy to inhibit the progressive growth of the fibroids. In many cases, this type of treatment only delays an inevitable surgical removal of tumors, hysterectomy or embolization.

Surgery is used to remove tumors from the uterus one at a time. The procedure is called a myomectomy and is usually preferred over a hysterectomy. Uterine fibroids used to almost always mean a hysterectomy where the entire uterus is removed. Surgical advances have made it possible for many women to only need a myomectomy. Sometimes tumors can grow back and more than one surgery may be necessary. Myomectomy is almost always used over a hysterectomy if the woman is of a reproductive age. Uterine fibroids can interfere with fertility, but with treatment, having children is generally not out of the question.

Uterine artery embolization is the newest form of treatment for uterine fibroids. This is a non-surgical procedure and is far less invasive than previous forms of treatment. Tumors are like living extensions of your uterus. They need a blood supply to thrive and grow. Uterine artery embolization cuts off that blood supply.

X-rays are generally taken to identify arteries that supply the uterine fibroid tumors. Then a needle is injected into the artery. The needle is used to inject small particles into the artery. This inhibits blood flow and cuts off the tumor’s blood supply. The tumor should shrink over time and the embolization can also stop dangerous bleeding inside of your uterus.

If you choose to have the uterine artery embolization procedure, you can expect that the procedure will be fairly easy and painless. You will most likely be given a sedative and the procedure itself should leave no visible scars. However, as the tumors die off, they release toxins. This can cause severe pain that can last for several days. You may choose to stay in the hospital overnight for pain management after the procedure. Most people can go home after that first night and manage their own pain with medications at home.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

What is PID?

2008-05-19T10:11:00.000-07:00

Pelvic Inflammatory Disease (PID) is a condition that affects women’s reproductive organs. Gonorrhea and Chlamydia are the main causes of PID. Pelvic Inflammatory Disease is an infection that needs to be treated as soon as possible to avoid problems with fertility.
Infertility is common after being diagnosed with PID. This is because the inflammation in the uterus, ovaries and fallopian tubes can cause considerable scarring and damage. The effects of scarring on fallopian tubes and the uterus can also cause ectopic pregnancies. This refers to a condition that occurs when an egg is fertilized and grows outside of the uterus, generally in the fallopian tube. This can be life-threatening.

Pelvic Inflammatory Disease occurs when bacteria travel through the cervix into the uterus and fallopian tubes. If you are under the age of twenty-five then you are at a higher risk of developing PID. This is because the cervix does not fully develop until the age of twenty-five. Women who douche are also at a higher risk because douching washes away the protective flora that is normally present around the cervix. Douching sends a forceful current into the cervix which can help shuttle dangerous bacteria directly into the uterus and fallopian tubes.

Symptoms of Pelvic Inflammatory Disease can be so mild that they go undetected. This is why many women go undiagnosed until damage has occurred. In some cases, the symptoms can be more severe. Symptoms include fever, pain during intercourse or urination, irregular periods or a foul smelling vaginal discharge. If you are experiencing any of these symptoms, do not hesitate to contact your OB/GYN and seek treatment. If you delay, then the effects of PID can become much worse and even life-threatening.

Your OB/GYN may test you for Gonorrhea and Chlamydia. These are the main causes for PID, but not the only ones. Many sexually transmitted diseases can cause PID. Your doctor may order an ultrasound to see if your fallopian tubes look swollen. When the infection invades your fallopian tubes and uterus, your body will actively fight off the infection. This is what causes the swelling and the development of scar tissue.

Treatment of PID includes antibiotics to fight off the infection. If scarring and damage have occurred and you are trying to conceive, then laparoscopic surgery may be necessary to clear away scar tissue and restore your ability to conceive.

About the Author: Dr. Matthew Romberg, a Georgetown Texas gynecologist specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Endometriosis Overview

2008-05-19T10:10:00.000-07:00

Endometriosis symptoms can be deceiving. Many women experience a wide range in severity of symptoms that do not correlate to the advancement of the disease. Endometriosis is a progressive disease that can get worse over time. The symptoms you experience may be mild when the endometriosis is actually in advanced stages. On the other hand, symptoms may be severe and the endometriosis can be minimal. You can not use the severity of the symptoms to determine how advanced the disease is.

Endometriosis occurs when tissues resembling the lining of your uterus shed into your abdomen. Endometriosis implants and tissues respond to the hormonal changes that your uterine lining does. Therefore, when your uterine lining builds, the endometriosis grows. When you shed your uterine lining during menstruation, the endometrial cells also shed. This can cause painful blood pooling inside of the abdominal cavity.

Most experts agree that endometriosis occurs when uterine lining is shed and travels up and out of the fallopian tubes instead of the vagina. The uterine tissues spread through the abdomen and attach themselves to surrounding organs. The external wall of the uterus, fallopian tubes and ovaries are most commonly affected. Endometrial implants can also attach and grow in the abdominal cavity, on the bowels, kidneys, lungs and other surrounding organs. The symptoms can range from undetectable to extreme. It can be very dangerous when endometrial cells interfere with the function of the affected organs.

Hormonal therapies are common for controlling the growth of endometrial cells. Birth control pills can keep these kinds of tissues from growing. If endometriosis has invaded other organs or is causing organ dysfunction, then laparoscopic surgery may be necessary to remove as much of the endometriosis as possible. If you are trying to conceive, then endometriosis can interfere. In this case, hormonal therapy may not be an option and a laparoscopic procedure may be necessary.

The only way for endometriosis to be definitively diagnosed is through an exploratory laparoscopic procedure. This is a minimally invasive procedure where your doctor will inflate your abdomen and insert a laparoscope through a small incision in your abdomen. This laparoscope will allow the doctor to inspect your abdominal cavity and reproductive organs. Your doctor may also take biopsies of suspicious tissues, remove endometrial implants and cut loose prominent adhesions during this procedure.

If you suspect that you may have endometriosis, remember that it is a progressive disease and it can only get worse over time. Do not delay treatment and see your OB/GYN as soon as possible.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Timing Ovulation

2008-05-19T10:08:00.000-07:00

Whether you are trying to conceive or you are interested in natural family planning, you may be interested in timing your ovulation. This can help you to time intercourse around the time that you ovulate, or avoid it to lower your chances of getting pregnant.

Your ovaries produce at least one egg every menstrual cycle. The follicles in the ovaries will mature and release an egg. This is referred to as ovulation. Follicles form on the outside of your ovaries. They are essentially like tiny holes that grow and fill with fluid as the cycle progresses. The egg is housed inside of the follicle and protected by the fluid.

Over time, as the follicle matures and increases in size, it will get ready to burst open. When the follicle bursts, it sends the egg surrounded by fluid into the fallopian tube. The fluid protects the egg on its journey and also helps it to travel down the tube. If the mature egg encounters sperm, then this is when fertilization will take place. If the egg is fertilized, then it should implant when it reaches the uterus and pregnancy occurs.

Your menstrual cycle should be about twenty eight days long. Of course, some women may have longer or shorter cycles, so you will need to determine exactly when you ovulate to achieve the best results. Most women ovulate around day fourteen of their menstrual cycle.

To calculate when day fourteen is, you need to count from the first day that menstrual bleeding starts. This would be day number one. If your menstrual cycle is longer or shorter than twenty eight days, then you may want to count back instead of forward. Some women can have more than fourteen days between the first day of their menstrual period and ovulation. Some, of course, can have way less. Fortunately, you can count back from the first day of your period because almost every woman ovulates fourteen days before the first day of her period.

Irregular periods can make it nearly impossible to anticipate an ovulation. Basal body temperature and ovulation prediction kits can help you if you are having trouble pinpointing when you ovulate. Some women may rarely or never ovulate. If you are trying to get pregnant, then speak with your OB/GYN about irregular or missed ovulations. There are hormonal therapies that can help you get back on track and attain your goal.

If you are trying to avoid pregnancy, remember that sperm can live for days inside of the uterus and vagina. Diet, medications and lifestyle can change the date of your ovulation. You may not successfully avoid pregnancy by counting days alone.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Am I Pregnant?

2008-05-15T12:40:00.000-07:00

Most women are aware that a missed period can be a telltale sign of pregnancy. However, many changes take place in a woman’s body during pregnancy, some of which can help identify a pregnancy even before a missed period. Recognizing other signs of pregnancy can be particularly important for women whose periods are irregular and difficult to predict. Bear in mind that every woman’s body is unique, and signs of pregnancy vary from woman to woman and among pregnancies for the same woman. Here we examine some common signs of pregnancy that may be evident in the early stages:

-Implantation Bleeding: Some women experience implantation bleeding, which is bleeding that occurs after fertilization when the fertilized egg is implanted in the uterus. Implantation bleeding is usually lighter in color and flow than a regular period and shorter in duration.

-Fatigue: Pregnancy places a lot of new demands on a woman’s body, and a feeling of tiredness or fatigue is common. Fatigue is often most noticeable during the first trimester.

-Heightened Sensitivity to Scent: Many pregnant women experience a heightened sensitivity to scents, even to the extent that certain odors can induce vomiting. Even scents that the woman would normally enjoy may become unpleasant or unbearable. A heightened sense of smell can occur very early in pregnancy.

-Nausea/Vomiting: Morning sickness occurs during pregnancy for many women, but is not limited to the wee hours. Some pregnant women experience nausea and possibly vomiting throughout pregnancy, while some have none at all.

-Food Cravings: Cravings for specific foods strike many women during pregnancy. Developing new aversions to certain foods is also common. While you may crave something other than the clichéd pickles and ice cream, craving unusual combinations of foods is not uncommon during pregnancy.

-Mood Swings: Hormones levels in the body change dramatically during pregnancy, which can result in mood swings. Mood swings are a normal part of pregnancy. Like many other signs addressed here, mood swings can be caused by a variety of factors and do not necessarily signify pregnancy.

-Intuition: Perhaps more powerful than a checklist of symptoms is good old fashioned women’s intuition. Some women report that they just “know” they are pregnant, even when other signs of pregnancy are not blatantly obvious. Perhaps they are experiencing pregnancy symptoms but have not consciously connected them with a possible pregnancy, or maybe nature has equipped women with such strong intuition that their bodies simply “tell” them they are pregnant. Either way, women with this instinct are often right, so do not hesitate to take a pregnancy test based on a strong hunch.

Remember, not all women experience all of these symptoms during pregnancy, and the presence of these symptoms does not necessarily mean you are pregnant. It is advised to visit a doctor specializing in obstetrical care as early as possible if you suspect you are pregnant.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

When Am I Most Likely to Become Pregnant?

2008-05-15T12:38:00.000-07:00

The process of becoming pregnant varies greatly from couple to couple. While some couples try for years to conceive, others become pregnant without even trying. A woman may become familiar with her body’s fertility cycle in effort to prevent pregnancy or to determine the most fertile time if she is trying to conceive.

Every month, a woman’s ovaries release an egg into the fallopian tube during a process called ovulation. If the egg remains unfertilized, the uterine lining is shed and normal menstruation occurs. If the egg is fertilized by sperm in the fallopian tube within an approximate 24 hour time period, conception occurs. Within a few days, a fertilized egg will move into the uterus, attach to the uterine wall and begin developing into a fetus.

Though many fertility experts recommend having intercourse throughout your cycle if you are trying to get pregnant, recognizing when you are most fertile can also be helpful in increasing your chances of conception. The time period when a woman is most fertile is during ovulation as well as the five or so days leading up to it. Women who are trying to conceive should have sex every day if possible during this time period, while women who are trying to avoid pregnancy should abstain from sex or use backup methods of birth control prior to and during ovulation.
For some women, ovulation is accompanied by a pain or ache near the ovaries, a recognizable sign that ovulation is taking place. Other women may not experience any pain at all. Breast tenderness is another sign of ovulation some women experience. By being aware of some of the changes that take place around the time of ovulation, many women can predict the signs of ovulation in their own bodies.

Generally speaking, ovulation occurs between the 11th and 21st day following the first day of the menstrual period. Women with very regular cycles may chart their cycles using a calendar to predict ovulation fairly accurately, though the timing of ovulation can be affected by many factors and it is best to monitor a number of signs in attempting to predict ovulation.

One common method of detecting ovulation is tracking basal body temperature. Basal body temperature is simply the body’s temperature when at rest, which is slightly higher right after ovulation. A woman can track her basal body temperature by checking her temperature with a thermometer daily before getting out of bed. Body temperature increases are usually very slight, though they follow a pattern that can help predict ovulation. A common pattern is a slight drop in temperature just prior to ovulation, and an increase just after. Predicting ovulation by tracking basal body temperature is most effective when temperature data can be collected over multiple months.

Another way a woman can detect ovulation is by noticing changes in cervical mucus. Cervical mucus changes throughout the menstrual cycle in color and consistency. During ovulation, mucus is abundant and particularly clear, slippery and stretchy. This clear mucus plays an important role in conception by helping sperm survive. After ovulation, the quantity of mucus is reduced and it becomes stickier and less clear. Monitoring changes in cervical mucus is another way to help predict the time of ovulation naturally.

Over the counter ovulation kits are also readily available that can help predict ovulation. Be aware that all such kits are not created equal. The more expensive ones are in fact more sensitive and better able to detect when a woman ovulates.

As each woman’s cycle is unique, the most effective methods of determining when ovulation occurs vary from woman to woman. Usually a combination of methods helps predict ovulation with the most accuracy. Prior to attempting to conceive, it is advised to consult with a physician for an assessment of your health.

About the Author: Dr. Matthew Romberg, a Georgetown Texas gynecologist specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

What is a Pap Smear?

2008-05-15T12:37:00.000-07:00

Pap smears test for cervical cancer in women. They can help to determine if you are at a higher risk for cervical cancer as well. When doctors perform pap smears, they collect cells from your cervix for testing.

Your cervix is just a few inches inside of your vagina. You will be asked to undress either completely or from the waist down for the procedure. A speculum is inserted so that your doctor can more easily get to your cervix. Cell samples are taken with a small brush or spatula. This is usually painless and is sometimes undetectable by the patient.

A pap smear helps your doctor to find cancerous or precancerous cells. Early detection is helpful when treating cervical cancer and can greatly improve your chances of overcoming this disease. A pap smear enables your doctor to initiate treatment of unusual or precancerous cells. This can help you to avoid the development of cancer.

In addition to the pap smear, your doctor will usually also perform a pelvic exam. This is basically an examination of the external anatomy of your genitals, uterus, vagina and ovaries. Your doctor will be feeling for abnormalities during this exam.

It is recommended that you have a pap smear yearly after you reach adulthood. If abnormalities are suspected, you may need one earlier in your teen years. If consistent normal results are found, then your doctor may recommend that you only have a pap smear every two to three years. If abnormalities are found, it may be recommended that you have more frequent tests. You may also need more frequent tests if you have any immunity problems, such as HIV.

If very few abnormal cells are present, then they may not be detected in the pap smear. Cervical cancer develops over many years, so it will most likely be noticed in the following pap smear without severe consequence. This is another reason that it is important to regularly get your pap smear done.

Before going to the OB/GYN for your pap smear, there are a few steps you should take. Do not have intercourse for two to three days before the test. Do not use any kind of vaginal medications, spermicidal products or lubricants during this time either. Douching can also alter the results of your test. In general, anything you insert or use vaginally for the two or three days before your pap smear can wash away or obscure abnormal cells that would have otherwise been detected.

About the Author: Dr. Matthew Romberg, a Georgetown Texas gynecologist specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

How to Take your Basal Body Temperature

2008-05-15T12:35:00.000-07:00

Many women are interested in tracking their basal body temperatures when getting ready to conceive. Basal body temperature refers to the temperature of your body when it is at rest. Slight changes in this temperature can help you determine when you are ovulating. This can help you increase your chances of becoming pregnant by helping you select the optimum time during your menstrual cycle to have intercourse.

Taking your basal body temperature requires that you purchase a basal thermometer. This is because the temperature changes are so slight that a regular thermometer will not accurately tell you when the changes have taken place. You will need to measure and record your basal body temperature daily down to the tenth of a degree. Some women experience a full degree of change, but most will only see around 0.4 degree Fahrenheit of change.

Start by preparing a chart to keep track of your daily findings. It is very important that you take your temperature before you get out of bed in the morning. Take it as soon as you wake up and try not to move around. It is easiest to keep up with your daily temperature if you keep the thermometer and chart next to your bed. Make it part of your morning routine.

Many women start charting their basal body temperature around the first day of their menstrual period, but you can really start any time. If you are ovulating normally, then you should see a change around day fourteen of your cycle, day one being the first day of your period. You may see as little as a 0.4 degree change and it should stay at this point for a few days. During this time of higher temperature is when you can assume that ovulation has taken place. You may even notice a slight drop in temperature the day before the rise.

Hormone levels and changes are what cause your basal body temperature to change. The initial rise in temperature usually occurs the day after ovulation. Your best chances of getting pregnant are the few days before and the day of ovulation. Therefore, you need to determine when your body temperature rises and calculate when it will happen again. Have intercourse during the five days leading up to the temperature rise. Sperm can live for a few days inside of your uterus and vagina, so having sex before ovulation will help ensure that your egg will encounter the sperm.
If you are trying to avoid pregnancy, then you should abstain from sex for about a week prior to ovulation. Be aware that many things such as lifestyle, medications, illness, environment and diet can change the day that you ovulate. Only women with extremely regular menstrual periods have been successful in using basal body temperature and ovulation timing as a form of birth control. Even then, there have been quite a few surprises.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Do you Suspect Endometriosis?

2008-04-07T13:58:00.000-07:00

Endometriosis is a disease that affects many women in the world today. Strangely enough, most women do not realize that they have endometriosis until the symptoms are severe. Most women dismiss the symptoms as bad cramps or just a heavy period. Endometriosis can be mild or severe and the symptoms are not necessarily a good indicator of how advanced the disease has become.

Pelvic pain is the most common complaint from women with endometriosis. Pain can be centered around the pelvic area, but if it has spread to other organs and areas, patients can experience back pain as well. Endometriosis is a progressive disease that can get worse and worse over time. Women suffering from endometriosis often complain of constipation or diarrhea during menstruation. Fatigue, heavy or irregular periods and pain during sexual intercourse are also common symptoms. Some women have severe pain and very little endometriosis while others have very advanced endometriosis and little to no pain whatsoever.

Many women find out that they have endometriosis when they are unsuccessful at becoming pregnant. Infertility caused by endometriosis is very common. No one knows for sure what causes endometriosis, but the endometriosis implants are similar to uterine lining that has traveled outside of the uterus. Endometrial cells can grow and shed with hormonal changes with the uterine lining. Endometriosis can be found on reproductive organs, inside the abdominal cavity and even on intestines and other abdominal organs.

Endometriosis can only be confirmed if a diagnostic laparoscopic surgery is performed. This is a minor surgery where your doctor will insert a small tube containing a camera, called a laparoscope, into your lower abdomen. Your abdomen will be inflated with gas so that the doctor can get a good look around. During this procedure, your doctor will most likely take samples of the endometrial tissue for biopsy.

Treatments range from pain management to hysterectomy. Birth control pills are commonly used to prevent endometriosis from growing. Over the counter anti-inflammatory medications and pain killers can help improve discomfort. Surgically, your doctor can use lasers and small knives during laparoscopy to remove endometriosis implants. If you are experiencing some of these symptoms or if you are having trouble conceiving, speak with an your obstetrician/gynecologist about what options may be available to you.

If you do receive a positive diagnosis of endometriosis, keep in mind that it is a progressive disease. Severe organ damage can occur if you allow endometriosis to go untreated. It is very important to seek treatment as soon as possible if you suspect endometriosis.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Stress and Women’s Health

2008-04-07T13:47:00.000-07:00

Because stress affects a woman’s health, mental state and quality of life, it is important that women be in tune with their bodies in order to recognize the signs of stress. Stress affects different women in different ways. Some symptoms of stress are difficulty sleeping or concentrating, headache, stomach pain, depression and anxiety. Stress can stem from a range of circumstances, some of the major ones being death of a loved one, illness or injury, divorce, an accident or other emergency situation. Though these are some of the major stressors, stress can arise from any change in a person’s routine. Happy occasions such as marriage or beginning a new job can also prompt stress. Other sources of stress are the everyday pressures of work and family responsibilities.

Stress can be short or long term, and it is not just your imagination. Stress causes chemical changes in the body, and the physical symptoms you experience are the result of your body’s reaction to it. Under chronic stress, the body releases cortisol, a hormone that gives the body survival responses such as a temporary burst of energy and a heightened immunity and threshold for pain. This state of physiological arousal, which includes a heightened heart rate and blood pressure, is intended to subside once the threat of danger passes and the body’s relaxation response kicks in. Under conditions of chronic stress, cortisol levels are heightened over prolonged periods of time, the relaxation response is hindered, and health issues can result. Chronic stress has been linked to conditions such as depression, heart disease and other heart problems, insomnia, high blood pressure, and difficulty conceiving.

Establishing a life balance that minimizes stress is important to a woman’s health and well-being. The demands of juggling a family and a career often lead women to neglect their own needs. Relaxing, even briefly, is important to sustaining a healthy balance. Numerous techniques can be employed to help a woman effectively reduce the level of stress she is experiencing, some of which include:

-Getting aerobic exercise. Exercise releases natural pain and stress relievers called endorphins, and also serves as release for tension. Jogging, doing Yoga, swimming, or other activities that get your body moving are healthy ways to control stress.

-Sharing feelings. Even when there is nothing you can do to control a stressor, sharing your feelings with a friend, loved one or therapist can be a great outlet for reducing stress. Another option is writing about your situation and feelings in a journal. Putting into words the way you feel and why can help you gain a new perspective on a situation. Try to focus on the positive side of a situation and what you will learn from it.

-Saying no. Sometimes stress is the result of too many commitments. Women should take into account the level of stress they feel with their current level of obligations before taking on any new ones. A balanced lifestyle in which a woman can fulfill all of her responsibilities with some time left for relaxation is ideal.

Just as the symptoms of stress can take many forms, the methods that work best for relieving stress vary among women. Some control stress through means such as exercise, while others seek medical help to deal with high levels of stress. Finding the right treatment for your personal needs involves paying attention to your body’s needs and recognizing the symptoms of stress.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

High Risk Pregnancy (Part II): Risk Factors during Pregnancy

2008-04-07T13:42:00.000-07:00

Part I of this two-part series, Pre-Pregnancy Risk Factors, outlined some of the pre-existing conditions that may lead to a high-risk pregnancy. In this section, we examine some conditions that can appear during pregnancy and contribute to a high-risk pregnancy.

Risk Factors during Pregnancy:

The fact that alcohol, cigarette and other drug use during pregnancy pose great risk to the fetus is widely known. Many over the counter and prescription drugs are no exception, and consulting with your physician prior to taking any drug during pregnancy is advised. Here we examine some medical conditions appearing during pregnancy that can contribute to an increased risk during pregnancy:

-Anemia: Anemia can be caused by an iron, folic acid or vitamin B12 deficiency, though it can also result from other health conditions. Anemia is common in pregnant women because of the increased demand placed on their bodies by the developing fetus. Iron is needed to make hemoglobin, the protein that carries oxygen to other cells. During pregnancy, a woman has an increased amount of blood for which to produce hemoglobin, and the fetus utilizes iron to produce red blood cells, resulting in a significantly increased need for iron.

Iron and folic acid supplements or prenatal vitamins containing appropriate levels of both can prevent or treat anemia in many cases. It is important to consult with your physician to determine the best health regimen for your body’s unique needs during pregnancy.

-Infections: Bacterial or viral infections, even those unrelated to the pregnancy, can create risk for the fetus and mother. Urinary tract infections are not uncommon during pregnancy, and pose risks such as early rupture of membranes holding the fetus and premature labor. Bacterial vaginosis can also cause premature labor or rupturing of these membranes. Rubella has been known to cause heart and ear related birth defects. Fortunately, rubella is rare in America because most people are immunized against it. Antibiotics can be used to treat some infections and reduce the risk of related health issues.

-Preeclampsia: As mentioned in Part I, increased blood pressure during pregnancy is characteristic of preeclampsia. The risk of preeclampsia is greater for women with preexisting high blood pressure, women carrying more than one fetus, women in their first pregnancy and those under 15 or over 35 years of age.

-Thromboembolic Disease: Being the leading cause of death during pregnancy in the U.S., thromboembolic disease can be a legitimate concern for an expectant mother. With thromboembolic disease, blood clots form and can travel through the body and block arteries. The risk for this condition remains for a few weeks after delivery, and is more common in women who have had cesarean sections than those who have had vaginal deliveries. Prevention and treatment of thromboembolic disease are possible.

Other complications such as gestational diabetes, an excess of amniotic fluid and placental abruption also contribute to high-risk pregnancies. There are a number of factors that can contribute to the level of risk associated with a pregnancy, and each woman’s circumstances are unique. Regular medical care and monitoring of risks present before, during and following pregnancy can help reduce risk through prevention and treatment.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com/.

High Risk Pregnancy (Part I): Pre-Pregnancy Risk Factors

2008-04-07T13:36:00.000-07:00

A high risk pregnancy carries with it potential dangers to the fetus as well as the mother. While all pregnancies are susceptible to some risk, pre-existing conditions or some that can develop during pregnancy can lead to a high-risk pregnancy, posing even greater danger to mother and baby.

In this two part series, we will examine some of the factors that can contribute to a high risk pregnancy, including conditions present prior to the pregnancy (Part I) and conditions that can develop during pregnancy (Part II).

It is encouraged to consult with your health care provider prior to becoming pregnant or as soon as possible after conceiving so that your health can be assessed and precautions taken, if necessary.

Pre-Pregnancy Risk Factors:

While health conditions such as high blood pressure, heart disease, sexually transmitted diseases, cancer and diabetes increase risk during pregnancy, other factors such as carrying more than one baby, the woman’s age and physical characteristics, or a problem pregnancy in the past can also contribute to a high-risk pregnancy.

There are many pre-existing health conditions that can contribute to a high-risk pregnancy, a few of which are outlined below:

-Heart Disease: It may come as no surprise that the number one killer of women in America also contributes to increased risk during pregnancy. If heart disease is severe before a woman becomes pregnant, the risk is even greater. Because pregnancy puts increasing demand on the heart, heart disease may worsen during pregnancy, or its symptoms may appear for the first time. In many cases, women with heart disease give birth to healthy babies with no long term effects.

Because the risks associated with heart disease and pregnancy increase as the pregnancy
progresses and can affect the fetus, regular visits to your healthcare provider are important.

-High Blood Pressure: Having high blood pressure prior to pregnancy increases risk during pregnancy. Pregnancy can make high blood pressure worse and can lead to conditions such as preeclampsia, an increase in blood pressure occurring only in pregnant women. Risks include an underdeveloped fetus, placental abruption and stillbirth. If your condition is conducive, your physician may prescribe medication to help with high blood pressure. Any woman with high blood pressure should be closely monitored by medical professionals during pregnancy.

-Sexually Transmitted Diseases: Sexually transmitted diseases such as Chlamydia, syphilis, herpes, gonorrhea and HIV also pose risks during pregnancy. Many sexually transmitted diseases, such as HIV, herpes, syphilis, gonorrhea and Chlamydia can be transmitted to the baby either through the placenta or during delivery. Chlamydia increases the risk of a premature birth and can give the baby conjunctivitis, an eye infection that can also result from gonorrhea. Herpes can be passed to the baby during childbirth and cause herpes encephalitis, a dangerous brain infection. The risks associated with STDs during pregnancy vary, and discussing proper precautions or treatments with your health care provider is encouraged.

Many health conditions can contribute to a high-risk pregnancy in addition to those described above. Other factors, such as a low socioeconomic status, age (below 15 or over 35) and previous problem pregnancies also increase risks. Early and regular medical care during pregnancy can help identify risks that may be associated with pregnancy and lead to a personalized healthcare regimen to minimize those risks.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com/.

Natural Family Planning

2008-03-19T13:43:00.000-07:00

If you are interested in natural family planning, you may have heard about basal body temperature. Basal body temperature refers to your body’s temperature when it is at a resting state. Therefore, if you plan to use this method, you need to take your temperature before you get out of bed in the morning.

Tracking your basal body temperature is a fairly easy and inexpensive way of predicting when you will ovulate. You can use your best prediction if you are trying to get pregnant or if you are trying to avoid pregnancy. The first step is to purchase a special basal body temperature thermometer. This thermometer measures to a tenth of a degree, so it is more accurate than a standard thermometer. Your body temperature changes with your hormone fluctuations after you ovulate. The changes are very slight and need to be monitored closely, every day for several months.

Typically, your body temperature will drop very slightly the day before you ovulate. The day after you ovulate, your temperature will rise and stay higher for about five days. Every woman is different, so you will need to keep very accurate records in order to use this method. Most women will only experience one or two-tenths of a degree drop in their temperature before ovulation. After ovulation, some women will experience a full degree rise in temperature, while others only see about four-tenths of a degree rise.

By tracking your basal body temperature, you can very closely monitor when your body ovulates. Some women ovulate as often as every twenty days while others can have a much longer cycle. If your cycle fluctuates at all due to stress, diet, weight gain or loss, or medication, then your estimation of when you ovulate can be way off.

Use this method wisely. If you are using it to avoid pregnancy, you may not be very successful. Your egg can survive in a fertile state for up to twenty four hours after ovulation. You will need to abstain from sexual activity for a few days after ovulation to be fairly safe.

If you are trying to get pregnant, this method can be very effective for predicting ovulation. You will need to have sexual intercourse for approximately five days before ovulation and also on your ovulation day. This greatly increases your chances of conception. It may take you a couple of months to have a good estimation of when you ovulate.

If you are looking for a Round Rock OBGYN in Texas, consider Heart of Texas Women’s Center for all of your natural family planning needs.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Preeclampsia: Symptoms, Diagnosis and Prevention

2008-03-19T13:39:00.000-07:00

Preeclampsia is not all that uncommon for pregnant women in their third trimester. A little more than five percent of healthy pregnant women will develop Preeclampsia after twenty weeks gestation. Preeclampsia is characterized by swelling in the lower extremities, high blood pressure, the presence of protein in the urine and headaches.

The true cause of Preeclampsia is not really known, though it is widely believed that some fetal antigens trigger an immunity response from the mother, resulting in Preeclampsia. When Preeclampsia first starts coming on, you may not even know it. This is why it is crucial to go to every prenatal appointment so that your OBGYN can closely monitor your urine protein levels, blood pressure and swelling. You may not notice any symptoms at first, but Preeclampsia is usually a progressive condition. You may start to experience headaches, sensitivity to light, nausea and/or vomiting as well as swelling in the lower extremities. Sometimes these symptoms can come on rather quickly and you need to see your doctor immediately if you notice them.

If Preeclampsia goes untreated, it can easily progress into eclampsia. If it does, you may experience convulsions, seizures, blackouts and sometimes total unconsciousness. This is a very dangerous, life threatening condition. If you or your loved ones notice any of these symptoms, you should be immediately taken to the emergency room.

If your doctor diagnoses you with Preeclampsia, you will be closely monitored and you should be ready for an early delivery. Constant monitoring of mother and child is crucial for ensuring the safety of both. Bed rest or hospitalization may be recommended based on the progression of the disorder. You may be given magnesium sulfate to help keep eclampsia at bay. The only real cure for Preeclampsia is delivery. Through careful monitoring, your doctor will decide when the risks to you outweigh the risks to the baby and the baby will be delivered.

Most cases of Preeclampsia can be managed from home. The baby may be monitored for maturity about twice a week. Your doctor will most likely suggest that you deliver as soon as the baby is ready even if your Preeclampsia is mild. This is because things can get worse the further along you go. Induction is common with Preeclampsia patients and so are cesarean sections.

Talk to your doctor about managing your Preeclampsia at home. Diet, bed rest and stress levels can all have an effect on your condition. If you are in Texas and need to find a Round Rock OBGYN, please consider Heart of Texas Women’s Center for all of your prenatal needs.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Prenatal Diet

2008-03-19T13:31:00.000-07:00

Congratulations! You have your bun in the oven and you are already doing the right thing by researching how to take care of yourself and your baby. Diet is one of the foremost things on many pregnant women’s list of priorities. It is something you can do every day to ensure a happy, healthy pregnancy.

First, we will discuss what to avoid. Caffeine is the big one up for debate here. Some experts agree that a couple of small cups of coffee per day are fine. Others disagree and suggest that you are better off safe than sorry. If you just can not survive without it, then talk to your doctor about possible risks before you proceed to that corner coffee shop.

Seafood should be limited to about two servings per week. You should completely avoid fish containing a lot of mercury, such as shark, swordfish and King Mackerel. Your OBGYN may also have a comprehensive list of local fare that may also be high in mercury.

Artificial sweeteners are not necessarily bad in moderation, but keep in mind that the full effects of artificial sweeteners may be unknown. Some can build up in your system and become more harmful over time.

Some things, such as chamomile tea, may seem harmless but can actually be dangerous. Rose hip teas, ginger, lemon, and citrus peel teas have been found safe. If you have questions about your favorite herbal teas, be sure to check with your doctor first.

Your basic prenatal diet should consist of many fruits and vegetables plus some source of protein at every meal. It is very important not to skip meals. The baby will quickly rob you of nutrients that you need to sustain a healthy pregnancy.

Calcium is very important during pregnancy. You and your baby need a lot more than normal, about 1,000 mg or more per day. You may consider taking a supplement if you do not eat 5-6 servings of dairy per day. Vitamin D is also necessary for calcium absorption. Check your prenatal vitamins for calcium and Vitamin D content. Make sure that at least some of your calcium comes from food because it can be more absorbable than in pill form. If you can not have dairy, consider vegetable sources, such as broccoli and spinach.

Prenatal vitamins are necessary even if you eat a completely healthy and balanced diet. Prenatal vitamins contain folic acid, or folate, needed to reduce the risk of problems, such as Neural Tube Defects. Ideally, you should take a folate supplement from the first day of your pregnancy, or even before you become pregnant.

Iron is very important for the baby’s blood supply. You can get extra iron into your diet by eating nuts, red meat, chicken, whole grains and cereals that are iron fortified. Your OBGYN should test your iron levels to see if you will need a supplement.

Talk with your OBGYN about your body’s specific needs. If you are looking for an experienced and skilled Round Rock OBGYN in Texas, please consider Heart of Texas Women’s Center.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Why Hysteroscopy?

2008-03-19T13:10:00.000-07:00

If your gynecologist has recommended a hysteroscopy procedure, you may be wondering why and what you can expect. One common reason that your OBGYN may suggest this procedure is to find the cause of abnormal menstrual bleeding. Hysteroscopy can also be used to find abnormalities in the uterine size or shape. This can help if you have had problems with a missing intrauterine device (IUD), miscarriages, infertility, adhesions or other abnormal growths.

The procedure is performed with a hysteroscope. This instrument is similar to a tiny telescope that allows the OBGYN to look around inside of your uterus. Your doctor can remove polyps or fibroids and also take biopsies of tissues that may be causing you problems. They do this by inserting tiny surgical instruments through the hysteroscope.

Most doctors will recommend general anesthesia for this procedure, though it is not always necessary. Hysteroscopy is a minimally invasive surgery because no incision is actually made. The hysteroscope can be inserted through the vagina and past the cervix. The doctor can get a good look around and even inspect the openings of your fallopian tubes. This can help to identify fertility problems.

Because this is a minimally invasive procedure, recovery time is generally very fast. Discuss with your doctor what you can expect before, during and after the procedure. Hysteroscopy is frequently and successfully used as a diagnostic instrument. In these cases, complications are very rare. The hysteroscope can also be used operatively and risks can be higher depending on what type of procedure you are having done. Again, be sure that you have a clear understanding of the risks and possible complications before undergoing any surgical procedure.

When diagnosing abnormalities of the uterus, your OBGYN may suggest that a sonohysterograph procedure be performed before you undergo hysteroscopy. This is primarily a procedure to give the doctor a good idea of what they can expect when they get inside. This can help prepare if it is obvious that an operative procedure will be necessary.

The sonohysterograph is a sonogram performed after the uterine cavity is filled with fluid. The fluid will be injected through your cervix. A fluid filled uterine cavity gives a much clearer view than a basic sonogram does. This is very helpful when searching for uterine abnormalities.

If you still have questions, please talk with your OBGYN before your procedure.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Chronic Fatigue in Women

2008-03-19T13:06:00.000-07:00

It’s no wonder many women are prone to chronic fatigue. It is very common nowadays for a woman to commute to work 40 plus hours a week and to zoom home to the demands of children, aging parents, and running a household. She is expected to remain on the go throughout the day and often is so tired at the end of the day has trouble getting a good night’s sleep. Fatigue has a way of mounting up rather than going away after a rest period. Ordinary fatigue turns into chronic fatigue, a condition that can silently undermine their relationships, work, home life and eventually their health.

Often healthcare providers will not take conditions of fatigue seriously simply because it is not a disease. It is also considered a normal symptom of today’s busy life style. But left unchecked it can lead to an unhealthy downward spiral which includes premature aging, compromised immune function and eventually, a heightened risk of disease.

Once any serious medical condition has been ruled out, chronic fatigue begins as a deceptively simple problem where the demands on your body are greater than the support it is getting. The pattern starts as mild fatigue, symptoms persist and usually worsen with time, and a good night’s sleep leaves you feeling just as tired as before. Recognize this pattern as chronic fatigue. Check out the ways to get your energy back and restore your love of life before the condition takes over. Symptoms of chronic fatigue tend to slowly worsen over time. Women, who are multi-taskers, often ignore their fatigue until it leads to other symptoms such as depression, binge-eating and weight gain.

Symptoms of fatigue can show in many ways. For many women these symptoms ebb and flow with their monthly cycle. With chronic fatigue, these symptoms last for weeks or more. Eventually the symptoms are nearly constant. They include: feelings of exhaustion (both mental and physical), being tired in the morning, feeling rundown or overwhelmed, inability to bounce back from being sick, stress headaches, joint pain, uncharacteristic muscle soreness after physical exertion, depressed mood, loss of energy, poor short-term memory, confusion, irritability, lightheadedness, strong food cravings (particularly for sweets or other carbohydrates), dependence on caffeine, sugar or alcohol (especially in the afternoon and early evening), and “second winds” after 6:00pm.

If you feel any of these for more than a stretch of ten days or so, call your doctor to have some blood tests run. This will rule out any serious secondary conditions like bacterial infection or a virus. Most likely your doctor will be concerned because many illnesses and diseases begin with symptoms of fatigue. Remember a healthy, balanced body and mind, given adequate food, sleep and water, should not feel tired for any extended period of time. Being tired all the time is not an acceptable part of any age or modern life.

Even if your conventional blood tests return as normal, don’t disregard persistent symptoms of fatigue. Chronic fatigue is complicated. Sometimes modern testing doesn’t reveal the true results. Holistic and functional medicine does. Discover what your individual body needs are. How do you begin to help yourself when it comes to fatigue? Correcting patterns of some of the common causes is the way to start. Things that should be considered and carefully looked into are your sleep, emotional health, stress, dietary habits, nutritional supplements, water intake, and your daily exercise or activity program.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Emotions and Health

2008-03-19T12:57:00.000-07:00

For many years conventional medicine believed that your health was a matter of genetics, infection exposure, and lifestyle. It was a rare exception when emotional experience also played factor to your health condition. There is now solid science behind the correlation of emotional experience and a host of diseases and health conditions including heart disease, depression, obesity and chronic pain. When looking at the body as a whole, emotional experience now plays a significant part in your overall health. Fatigue and stress have been seen as culprits in hindering your health.

Without dealing with their emotional health, no one can be really well. Little progress can be made curing a physical condition, no matter what therapy is used, until there is progress at the emotional level.

Unresolved emotional issues contribute to failing physical problems. They might be emotional experiences that happened many years ago in your childhood, hidden and festering inside the body that come out later in life in the form of an adverse health condition or disease. Often for women, menopause is a time when your body is telling you it is ready to resolve emotional issues and needs healing. Both your emotional and physical health can be healed together. It can be a time when you can reclaim your self.

The most insightful place to explore the emotional roots of disease may be the breakthrough ACE Study. In the 1990’s over 17,000 patients of a large health plan were enrolled in a study to assess the link between emotional experience and adult health. The results were stunning which gave reason to reconsider the structure of primary care in America’s medical practice.

Participants were asked whether they had experienced any of eight forms of personal abuse or dysfunctional family behavior before the age of 18, each called an “adverse childhood experience” (ACE). More than half of the patients had one ACE or more. Even more surprising was the correlation to health outcomes. Those who had experienced an ACE were more likely to have an adverse health condition or disease as an adult. The health outcomes covered a wide range including heart disease, fractures, diabetes, obesity, alcoholism, and more.

The truth is that all emotional experience affects our health, whether positive or negative, and whether it occurs in the past or the present. Negative emotional experiences appear to have more lasting health effects, perhaps because we tend to ignore dealing with them.

Some psychologists and scientists believe we have five basic feelings: joy, fear, anger, grief and love, with other feeling states being variations on these five. An emotion is what your body does with one of these feelings.

The Center for Disease Control estimates that 90% of all visits to the doctor are stress-related. There are hundreds of medical studies linking stress to a host of diseases. Stress is personal. Something that is stressful to one person is not necessarily to another, because of each person’s emotional history. Our biography becomes our biology, in a sense. People develop patterns to dealing with stress. It is important to be aware of your personal patterns and to learn to control them for your emotional wellbeing and your physical health.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Alternatives to Hysterectomy

2008-03-19T12:52:00.000-07:00

Two of the most common problems women have that lead to thinking about hysterectomy are excessive menstrual bleeding and uterine fibroids. If you have one or both of these, perhaps you think that surgery is your only choice. But you should know that it’s not. There are alternatives to hysterectomy. Many are quite successful utilizing cutting-edge techniques and are much less invasive to the body.

About a third of American women have a hysterectomy by age 60. For some it goes smoothly and they have a relatively care-free experience. But for others it can be an abrupt entry into menopause causing severe hormonal symptoms and dependence on hormone replacement therapy (HRT), which often has risks attached. Many women are unprepared for the debilitating side effects they experience after hysterectomy.

Weighing the benefits versus the risks of hysterectomy with your doctor considering your particular health condition and history, is something every woman must do when faced with this decision. As with everything, the more you know, the better equipped you will be to make the right choice for yourself. Consider carefully all the alternatives and new options available.

To be clear about the risks and what is involved with having a hysterectomy, review the basics. The uterus is also known as the womb, and “uter” is Latin for “bag”. The pelvic organ is suspended by ligaments between the bladder and rectum, and is connected to the vagina with a cervix. In Chinese, the word for uterus means “palace for the child”, which is, by any standard, just about the best description.

The fallopian tubes carry eggs from the ovaries to the uterus. The lining (endometrium) of the uterus swells with each menstrual cycle becoming engorged in preparation for the implantation of a fertilized egg. The body sheds this lining with a period if the implantation does not happen. If implantation does occur, the uterus grows for nine months to accommodate the fetus’s growth, then shrinks back to pre-baby size after delivery. This process is orchestrated by the complex communication of your sex hormones (estrogen, progesterone, and testosterone). During your menstruating years, your ovaries are responsible for producing most of your body’s estrogen and progesterone.

Especially if you have been struggling with heavy bleeding or painful fibroids, it may seem easier to remove the reproductive organs in one fell swoop, as a hysterectomy would do. But consider when these organs are removed, naturally this change is going to bring on complications and confusion within the woman’s total body. Only within the last century has it been recognized that the brain has primary control over a woman’s emotions, and that the removal of her reproductive organs can often cause more problems than it solves. New insight into the aftermath of a total hysterectomy (including the ovaries) reveals that many women feel totally wrecked without the natural hormonal wash from their ovaries.

Before elective surgery, explore the many alternatives that treat heavy bleeding, endometriosis, fibroids, and polyps. Current treatment options include: medical/hormonal management, D&C and hysteroscopy, endometrial ablation and endometriosis excision, myomectomy, and uterine artery embolization (UAE).

Studies into other options are continuously underway, and new techniques are being developed and researched. Although the results of these innovations are mixed, the encouraging news is that these less invasive techniques do actually work. For many women hysterectomy is a choice, not their destiny.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.

Hypothyroidism

2008-03-19T12:49:00.000-07:00

Low thyroid function, medically termed hypothyroidism, affects millions of women especially during the peri-menopausal and post-menopausal years. It has been usually treated in the conventional way by isolating the thyroid from the rest of the body. When it is approached holistically, however, often the problem can be cured before it becomes a permanent problem.

Hypothyroidism is commonly described as an under active or slow thyroid, but there is more to it than just thyroid activity. Sometimes the problem is thyroid hormone imbalance. It is primarily caused by the underproduction of the thyroid’s main hormone, thyroxine (T4). The liver converts T4 into its active form, triiodothyronine (T3). It then has to be efficiently utilized by the body. Disruption in any one of these processes can contribute to hypothyroidism symptoms. In order for the thyroid to be healthy, the liver must be doing its job, and adequate exercise should be maintained.

Because of the connection between menopause and hormonal imbalance, thyroid problems afflict more women than men. Hypothyroidism can lead to fatigue, weight gain, depression, high cholesterol and other symptoms. Poor nutrition also impairs thyroid function. Some women suffer from hyperthyroidism, which is an overactive thyroid. Thyroid hormonal imbalance often happens to women during menopause. Over 20% of menopausal women in the US are diagnosed with thyroid dysfunction. For women in their late 30’s or 40’s, hypothyroidism is often a good indication that they are peri-menopausal. The hormonal imbalance women go through during menopause acts as a trigger for thyroid problems. The delicate balance of hormones such as estrogen and progesterone can be upset when under stress and when not receiving enough support. Peri-menopause, menopause, and pregnancy are times in a woman’s life when hormonal imbalance is particularly common. This imbalance in the ratio between estrogen and progesterone triggers hypothyroidism.

The thyroid gland sits at the very center of the endocrine system. It is just as vulnerable to stress and lack of support as every other part of your body. In addition to hormonal imbalance, other conditions often cause or contribute to hypothyroidism. It is best not to isolate the thyroid as a single entity, but to look at the body as a set of interconnected systems. There are many symptoms of adrenal fatigue that are similar to thyroid disorders. Adrenal stress impairs thyroid function because it causes the overproduction of cortisol, blocking the efficient conversion and peripheral cellular use of the thyroid hormones at many levels. For this reason, testing for adrenal function in combination with thyroid testing is a good idea.

Natural thyroid health depends on a delicate balance among all the body’s major hormones. Optimal thyroid function can happen when this balance is achieved through proper nutrition, supplements, stress management, and regular adequate exercise.

About the Author: Dr. Matthew Romberg, a Round Rock OBGYN specializing in obstetrical and gynecologic care, is the President of the Heart of Texas Women’s Center. The Heart of Texas Women’s Center provides state of the art health care including surgical procedures, family planning counseling, complete prenatal care including high risk pregnancy management, in-house ultrasonography and well-woman services. For more information, please visit http://www.hotwc.com.