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Women’s Health

FEATURE: Do I still Need a Women’s Health Check Up?

By | Feature, Women's Health

I Don’t Need a PAP Test. Do I Still Need a Women’s Health Check Up?

You’ve heard, with better understanding of abnormal paps, that you no longer need testing every year. That’s true. But do you need to see a women’s health clinician regularly? For some Comprehensive Wellness patients reading this, the answer is “no”—because you’re men. For the rest of you, the answer can be confusing. First, a little history of the confusion, then a few points that might direct you to visit your women’s health specialist.

We’ve heard the pretext of “needing a pap test” as the reason to schedule your annual gynecology exam. We are now finding that that logic may be hurting women. A pap test is about one disease—cancer, and only one body part—the uterine cervix. We can all agree there is much more to being a woman! Yet, in 2014 the American College of Physicians said healthy women do not need annual pelvic/gyn exams. Almost immediately the American College of Obstetricians and Gynecologists responded recommending that women do have annual specialty appointments. Neither organization is without bias. What does the research say?  

A recently published study looked at charts for 283 women over 40 years of age who came in for “well women” exams. The majority of the women were diagnosed with new gynecological conditions resulting in education, prescriptions, and work-ups. In other words, they identified issues that otherwise would likely have gone untreated. What are just some of the reasons for a regular checkup?

  • Dry vagina Yes, we get to say vagina in our multidisciplinary newsletter. For some women this occurs at any age, but for the majority it starts during the menopause transition. Unlike other symptoms, it progressively worsens; if left untreated, the structure of the genitalia experiences non-reversible changes. Even women without symptoms can have changes. 
  • Pelvic masses. Relax. Most pelvic masses are not cancer and, unfortunately, the exam isn’t great at finding ovarian cancer small enough for the most successful treatment. However, even benign masses can cause problems with urination or bowel movements, feeling full, heavy periods, or painful sex.
  • Leaking urine. Probably 80% of incontinence can be fixed without surgery. And it is not a normal part of aging. You need someone you can talk to about this so that you can get help.
  • Menstrual changes. Your menstrual cycle may become irregular or you may have heavier bleeding. While some changes can be normal, all menstrual changes merit attention.
  • Life stages. Though risks of birth control don’t change over time, women do! New health issues and life plans tweak not only the safety of methods, but also the added benefits. Clearing up myths about transitioning into menopause and maximizing the next third of your life needs individual teaching and planning.

But perhaps the most important reason to get an annual gynecology check-up—one hour each year dedicated to being the healthiest woman you can be—you deserve it!

Patricia Geraghty, FNP, WHNP | Director Women's Health | Comprehensive Wellness, Walnut Creek, CA

Patricia Geraghty MSN, FNP-BC, WHNP is a nurse practitioner with over 20 years of experience specializing in women’s health.  

FEATURE: Menopause & Weight Management

By | Feature, Nutrition, Women's Health

Menopause & Weight Management

I just can’t lose that extra pound no matter how much I try? Is this something that you struggle with? As women our bodies go through many changes starting from menstruation into the menopausal period.

It would be nice if menopause happened overnight and our bodies would get back to normal.

Did you know? The transition often begins between the ages 45-55. It usually lasts about seven years, but can go as long as 14 years.

During Menopause the body’s production of estrogen and progesterone changes. Our bodies begin to use energy differently and women may gain weight more easily.

In a four-year cohort study done by Dr. Samuel in Family Practice journal, they found that 25% of women aged 35-47 gained ≥10 lb. in 4 years. Women in the 35-39 age group and 40-44 were more likely to gain ≥ 10 lb. than women in the 45-49 study group. Women who were normal weight at baseline were more likely to gain ≥ 10 lb. than overweight or obese women.1

As a Licensed Dietitian having practiced for more than 15 years int the area of Integrative nutrition. I recommend five steps for Weight Management:

  1. Lower your caloric intake. As we go through menopause our metabolism slows down and we tend to need 200 fewer calories a day during 50’s than we did in our 30s and 40s.
  2. Exercise. The best way to burn excess calories is to increase cardiovascular exercise. A continuous movement at an intense pace of 45 minutes or more helps to increase heart rate and assists with weight loss.
  3. Sugar. My general rule is to try to keep sugars in your snacks, foods and beverages to 0-7 grams per serving.
  4. Vegetables. Did you know that a cup of vegetables has only 25 calories, while a cup of fruit is generally around 90-100 calories depending on the type. Fruits are great, but if you are trying to lose weight, then its best to lower their consumption to one to two servings per day.
  5. Limit Alcohol. Alcoholic beverages add excess calories to your diet and increase risk of weight gain.

In conclusion, menopause is inevitable, but with the right behavioral modifications and diet, weight management is possible.

Sahar Berjis, RD

Sahar Berjis, RD, MPH, is a licensed Registered Dietitian with 17 years of experience in traditional and functional nutrition. She practices Functional Nutrition, looking at each patient individually using the whole body approach. She spends time analyzing nutritional imbalances using in-office stomach acidity testing and more invasive testings if needed. She creates individualized plans to restore and re-balance gut health and the body using diet & natural remedies.

HEALTH & WELLNESS: Women’s Health Forum

By | Events, Therapy, Women's Health

Wednesday, April 24

5201 Norris Canyon Rd. Suite 330 – San Ramon

Join us in San Ramon for an afternoon discussion with our experts about important topics in women’s health, including:

  What Mom Couldn’t Tell You: Latest Research on Women’s Sexuality

  The Latest Procedures in Fat Reduction

Enjoy wine, hors d’oeuvres, and special event pricing on some of our popular aesthetic treatments, including Corrective Peels, CryoCorrect Treatment, Fillers, Botox®, Monalisa Touch®, PicoSure®, SculpSure®, Ultherapy, SkinCeuticals, and ZO Skin Health products.

Our Team

Patricia Geraghty, MSN, FNP-BC, WHNP
Women’s Health Specialist

Rebecca Parish, MD,
Founder & Medical Director

Denise Hilliard, MD,
Aesthetic Medicine Specialist

Renee Hilliard, MD

Paul J. Wotowic, MD, FACS,
Plastic Surgeon

Frozan Safiari,
Clinical Esthetician

RSVP by April 20

Call 925.464.3916 for more information or to RSVP!

Sign Up Today

Taking Care of You: Nutrition and Stress Management for Busy Moms

By | Events, Nutrition, Therapy, Women's Health

Nutrition & Stress Management for Busy Moms 

At this workshop, our specialists will provide valuable insights about the power of food; discuss mindfulness techniques to help manage mood, stress, and energy; and teach you how to help manage daily stress by using nutrition advice and mindfulness practices.  

October 9, 2018

$65 per participant

 Call us 925.464.3916 to reserve your spot. 

Taking Care of You: Nutrition and Stress Management for Busy Moms

FDA Statement about Vaginal Laser Therapy, as explained by Patricia Geraghty NP, Director of Women’s Health at Comprehensive Wellness

By | In the News, Women's Health

Patricia Geraghty NP, Director of Women’s Health at Comprehensive Wellness explains her take on the recent FDA Statement about Vaginal Laser Therapy.

On August 1, 2018 the FDA issued a warning regarding devices for treating vaginal conditions. I read the FDA warning itself, not just the news articles. The warning has also already received an endorsement from the North American Menopause Society. However, the news articles and reports that I have seen so far, and FDA commissioner Scott Gottlieb’s comments, are much more sensationalistic than the actual FDA statement. There is certainly no  call for Mr Gottlieb to call this a “dangerous procedure with no proven benefit.” Let’s review the evidence.

There are two different technologies covered in the FDA statement; CO2 fractional laser also known as ablative procedure and with a brand name of Mona Lisa Touch, and the radiothermal procedure also known as non-ablative. I can only speak to the laser therapy, the therapy offered at Comprehensive Wellness.

The warning states that there have been no “sham” studies done. This is where some subjects get the treatment and others get all the trappings but an actual treatment (the laser) is not delivered. These studies are underway at this time.

The warning also states that there is not enough research on the long term effects. This is true. The longest duration study to date is 12 months. Of course we want to know if the effects last longer and if there is later development of problems. A study was published just last month, a study not reviewed in this warning, showing for some women there is a sustained effect and failing to identify any adverse events.

The warning also said that there can be long term scarring, burns, and pelvic pain. I have read the studies carefully as I just completed one presentation on vaginal laser therapy for the cancer doctors and am submitting another presentation to the state NP association. None of the studies on the CO2 fractional laser report adverse events and this would be required for publication. I am in the process of searching for case reports, which are individual reports rather than subjects from formal studies. None have shown up in either the PubMed National Library of Medicine or the Google Scholar search engines.

Again, I can’t speak to the radiothermal procedure which appears to have a deeper effect (though no comparison studies have been done) and might then theoretically have higher risk for adverse events. Any procedure needs to be done by clinicians not only with knowledge of the technique, but with gynecological expertise to select the appropriate patient.

I also find the statement’s implied criticism of the word vaginal “rejuvenation” puzzling. This is actually the word that the FDA insisted upon and approved when the promotional material was formulated.

Most concerning to me is the warning citing a 2016 American College of Obstetricians and Gynecologist guideline. This guideline did not raise safety concerns and could not include reviews of the most recent and longest duration studies. The FDA statement also does not include information from a joint guideline issued by the North American Menopause Society and the International Society for the Study of Women’s Sexual Health just last month. This recent guideline included oncology experts as well as women’s health experts in the authorship. They carefully reviewed the data for all vaginal treatments, including laser therapy, for women at high risk for or with breast cancer.

So, in summary, more research is called for. That is something everyone, including the North American Menopause Society, can support. Finally, although I agree with the criticisms cited in the statement, these criticisms can also apply to any therapy in the first 5 to 10 years of use. We have to be careful to neither prematurely adopt therapies while also not applying unfair standards to women’s health care.