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Many women experience some form of abnormal uterine bleeding throughout their lifetime.
Abnormal uterine bleeding can be described as bleeding or spotting between periods, bleeding after intercourse, heavy bleeding during your period, menstrual cycles that are longer than 35 days or shorter than 21 days, periods that last longer than 8 days, or bleeding after menopause. These are all scenarios where it is important to be evaluated by an Ob/GYN.
Abnormal bleeding can occur at any age, but it is more common to have irregular bleeding when a woman first gets her period or when a woman nears menopause. There are many causes of abnormal bleeding. The most common causes are problems with ovulation, uterine polyps, fibroids, endometriosis/adenomyosis, bleeding disorders, medications, pregnancy or miscarriage, and certain forms of uterine cancer.
Most causes of abnormal bleeding can be easily diagnosed by an Ob/GYN. It can be helpful to track your menstrual cycle before seeing your doctor. Based on the symptoms that a patient is having an ob/GYN will do a physical exam. They may do a pregnancy test, cultures, or bloodwork.
If there is a concern for a structural abnormality an imaging study such as a pelvic ultrasound may be done. If there is a concern for uterine cancer if may be necessary to have a biopsy taken from the endometrium, which is the lining of the uterus. Depending on the cause of the bleeding, it may be treated with medication. This includes hormonal birth control such as the pill or an IUD.
If there is a polyp or a fibroid inside the uterine cavity this may require surgery. If medication does not control the abnormal bleeding, endometrial ablation may be discussed. This is an outpatient procedure that destroys the endometrial lining of the uterus and reduces heavy menstrual bleeding. In some cases, if medication or ablation are unsuccessful a hysterectomy may be needed.
If there is any concern that a patient is experiencing abnormal uterine bleeding they should contact their ob/GYN.
If you have any questions or would like to make an appointment with Dr. Sarah Schmitz call 716.656.4077.
You’re not alone! And for women with this medical issue, we have great news for you. If you are living with stress urinary incontinence (SUI), whether it’s from childbirth, surgery, or age, we are excited to offer you an innovative new therapy.
Until recently, the best treatment options for SUI were surgical or device-based. Now, you can talk to Dr. Armen Kirakosyan, a board-certified urogynecologist at General Physician, PC, to discuss whether you are a candidate for Bulkamid®. Bulkamid is a non-mesh, nonsurgical, long-lasting treatment that quickly relieves the symptoms of SUI in women.
Recently FDA-approved in the United States, Bulkamid is a water-based gel that is injected into the soft tissue of the urethra using a syringe. The natural, safe hydrogel thickens the urethral tissue close to the opening of the bladder and creates a seal that helps prevent the loss of urine when the bladder is met with sudden pressure.
The minimally invasive procedure is performed in the doctor’s office and takes just 10-15 minutes. There is no downtime after the procedure, and you can usually resume normal activity the same day. The majority of women treated with Bulkamid report symptom improvement as soon as the procedure is completed and long-term studies have demonstrated greater than 80% success rates lasting more than 5-7 years.
To learn more about this state-of-the-art option or to make an appointmentwith Dr. Kirakosyan, please call our Snyder office at (716) 656-4077.
All year long, Western New Yorkers have one thing on our mind. I hear it time and time again as I sit down and talk to my patients on a daily basis.
“WHEN WILL SUMMER BE HERE?”
The first moment the sun shows up and we feel the warmth, albeit only 50 degrees and sunny, we let our skin show. Now as the summer days are long, and the sun is bright, we stay outdoors as long as we can. We are so grateful to finally have warmth on our bodies that we forget about sun safety.
The Centers for Disease Control and Prevention (CDC) along with the National Institute for Occupational Safety and Health (NIOSH) provide wonderful reminders to keep our skin safe while still enjoying those warm and kind sun rays.
They remind us first and foremost that ultraviolet (UV) rays are part of sunlight that is an invisible type of radiation. UVA and UVB cause aging and damage to the skin cells and are the most dangerous and cancer-causing types of sun rays. We also know that skin cancer is the most common form of cancer in the United States. The most common types of skin cancers include basal cell carcinoma, squamous cell carcinoma, and melanoma.
In order to protect our patients and ourselves, there are several things we can do to minimize our risk of skin damage. They include regular and routine use of broad-spectrum SPF 15 or greater sunscreen even when in the shade. Remember to reapply if you stay out in the sun for more than two hours and after swimming, sweating, or toweling off. Wear clothing made from tightly woven cloth with SPF protection when possible, stay in the shade, wear a wide-brimmed hat, and sunglasses that preferably block UVA and UVB rays.
Lastly, if you do get too much sun, by accident of course, here are some simple tips to help your body recover: stay hydrated to prevent fluid loss, comfort skin burns with cool baths or clothes, take over-the-counter Tylenol or ibuprofen for fever or headaches, and remain out of the sun until you are feeling better.
Katherine Sumner, PA-C is accepting new patients at 1091 Main Street, Suite 301, Buffalo. For more information on health safety or if you are worried about damage to your skin, call our office at 716.248.1420 to schedule an appointment.
It has been a very challenging few months. Due to COVID-19, many women had to delay their annual exams and screenings such as PAP smears and mammograms.
The primary purpose of the annual exam and screening is to catch a disease as early as possible and address it in a timely fashion. While waiting for a month or two is not usually a problem, delaying your healthcare visit for a more extended period could be a problem.
Even more pressing issues like seeing a doctor for a problem or renewing medications have been delayed because of the COVID-19 crisis. As you probably know, the Coronavirus pandemic forced us to stop all non-urgent surgeries in NY State and nationwide. Even though we restarted performing same-day procedures recently, the majority of elective surgeries are still on hold.
What are elective surgeries? Elective surgeries are planned operations that are scheduled weeks or months in advance. Delaying surgical treatment is negatively impacting patients by prolonging symptoms, decreasing quality of life, and sometimes could make surgery more difficult.
At General Physician PC, your safety and well-being are our primary priorities. We don't want you to delay your care. Rest assured that at all our offices, we have implemented robust procedures to ensure a safe and clean environment. We have changed our routine significantly by incorporating an initial screening upon entrance to the office, eliminating the need to wait in the waiting area, utilizing extreme sanitary measures to clean exam rooms as well as full mask regimen. All these changes are necessary to ensure patient safety in our offices.
We understand, however, that some people may still be concerned about coming to the office. We now offer telemedicine visits so you can talk to your doctor via phone or video. This type of appointment is an excellent way to discuss your concerns with your doctor, renew or change medication, follow up on chronic issues, and get all of your questions answered. If the problem is more challenging and requires a physical examination, we would recommend you schedule an in-person visit with your doctor.
We are happy to see a definitive decline in the number of COVID-19 cases in NY State. With these positive changes, it is an excellent time to start thinking about your routine health again and take care of yourself.
For more information or to make an appointment with Dr. Kirakosyan please call 716-656-4077.
Armen Kirakosyan, MD, FACOG, FPMRS, FACS https://www.gppconline.com/armen-kirakosyan-mdWomen's Health, Urogynecology https://www.gppconline.com/specialties/medical-specialties/urogynecology
Many people often complain of leg pain that is accompanied by leg swelling, heaviness, cramping, itching, varicose veins, skin discoloration, hair loss, and/or ulceration. Some people will experience pain at rest or pain with activity. Disease states that are responsible for these symptoms are related to disorders of the arteries and veins of the legs.
Deep Vein Thrombosis
Blood clots in the leg, also called Deep Vein Thrombosis (DVT), can form in the lower leg, thigh or pelvis. DVT is caused by prolonged rest or travel, family history, obesity, pregnancy, blood disorders, and cancer. When clots form they block the flow of blood from the lower extremity back to the heart. This produces leg swelling and heaviness which then leads to leg pain, warmth, and redness. These blood clots can travel from the leg to the lung and cause blood clots trapped in the pulmonary arteries, called a Pulmonary Embolism (PE) producing shortness of breath and chest pain. This can be life threatening and must be treated emergently. Call 911 if you think you may be suffering from a PE. Untreated DVT can also cause post-thrombotic syndrome (PTS) which results when DVT causes long-term damage to the valves in the veins. Symptoms of PTS include pain, swelling, discoloration, scaling of the skin and ulcers. In some cases, PTS can lead to permanent disability.
Treatment for DVT includes blood thinners and minimally invasive surgery. If medication doesn’t work or symptoms are too severe minimally invasive surgery using advanced medical technology can rapidly remove the blood clot from the veins restoring blood flow, resolve the symptoms, and prevent PE and PTS. The goal of treatment is the rapid relief of symptoms and improvement in the quality of life.
DVT prevention is also critical. The best thing you can do is keep mobile and hydrated during times of rest. Squeezing your calves or flexing your calves and wearing compression stockings can keep blood flow moving. Stay hydrated, make sure you drink at least four 16 oz bottles of water a day. This will keep your blood thin.
Veins that can no longer return the blood back to the heart are called insufficient. This can be caused by prolonged standing or sitting, previous DVT, family history, and obesity. Veins have one-way valves that direct the flow back to the heart. When these veins become damaged, like from DVT or from prolonged standing, they can no longer direct flow back to the heart, and the blood pools in the feet and ankles resulting in leg pain at rest, leg swelling, heaviness, and varicose veins. When this goes on for too long it can result in skin discoloration, skin thickening and ulcerations. Sometimes small blood clots form in the varicose veins causing inflammation and pain. In some cases, this can lead to permanent disability.
Treatment of Venous Insufficiency is done using compression stockings and minimally invasive techniques using a small catheter to close the diseased vein by using heat or glue. This a rapid and efficient treatment that will reroute blood from your legs to your heart using healthy veins significantly improving your symptoms.
Venous Insufficiency prevention is critical. The best thing you can do is wear compression stockings if you are in jobs that require prolonged standing, prolonged sitting, intense labor, or lifting heavyweight. Take a rest when you can!
Peripheral Arterial Disease
Peripheral Arterial Disease (PAD) occurs when the arteries become blocked or narrowed and can no longer deliver their cargo efficiently. Arteries of the leg are the delivery system of nutrients and blood to bone, muscle, and skin. Reduced blood flow can result in leg pain with activity, hair loss, loss of muscle tone, skin discoloration, and ulcerations. PAD is caused by plaque build-up in the artery the narrows the space within the artery and can eventually lead to artery blockage. This plaque buildup can be caused by genetics, family history, diet, smoking, chronic renal disease, coronary artery disease, stroke, and diabetes.
Claudication is a common presenting symptom of PAD. Claudication is described as pain with walking. If you develop muscle cramps and pain after walking short distances it can be a sign of arterial narrowing. Occasionally, the arteries can be blocked rapidly and cause quick onset leg pain that is unbearable called Acute Limb Ischemia. This should be treated emergently. If your leg has suddenly turned blue or pale in color, has lost a pulse, feels numb or overly sensitive call 911.
Critical Limb Ischemia is commonly seen in people that have chronic kidney disease, diabetes, and who smoke cigarettes. The common symptoms are pain at rest, muscle wasting, and ulcerations.
Treatment of PAD is done using medication and minimally invasive surgery with catheters to restore the normal size of the artery to return normal blood flow to the leg. Medication is used to thin the blood to prevent blood clots and reduce plaque build-up which usually are lifelong medications. In some cases, untreated PAD can lead to permanent disability.
PAD prevention is also very critical. Maintaining a healthy active lifestyle is the best choice you can make. Activity and exercise promote arterial health. A heart-healthy diet or caloric restricted diet is important to keep weight off and prevent plaque build-up. You should not smoke and if you do, I encourage you to quit. There are many support groups and medications that can help you fight the urge and be smoke-free.
Vascular Interventional Radiology is the future.
At Great Lakes Medical Imaging, our Vascular Interventional Radiologists are here for you now. They are highly trained physicians that have expertise in the latest methods to manage and treat arterial and venous disease using x-ray technology and minimally invasive surgery with small catheters – thin tubes that are threaded through the diseased vessel to reduce your symptoms and improve your quality of life. Call Dr. Chohan and his team of Vascular Interventional Radiologists at 716-836-4646 to speak more about leg pain and if there is a treatment option for you!
Great Lakes Medical Imaging www.greatlakesmedicalimaging.com
Urinary Tract Infections (UTIs) account for roughly 8.1 million annual doctor visits, and about 60 percent of women will experience a UTI in their lifetime. To understand why UTIs occur, it is helpful to understand the urinary tract, which makes and stores urine in the kidneys, and travels down the ureters to the bladder where it is stored until emptied. Urine is emptied through the urethra, a tube that connects the bladder to the skin. The opening of the urethra is at the end of the vaginal opening in females. Normal urine doesn’t have bacteria in it, but bacteria can get into urine through the urethra.
UTI symptoms include a need to urinate more often, and burning or pain when urinating. It can also cause a strong urge to urinate even when you don't have much urine in your bladder. The urine may also smell bad and appear cloudy or even bloody. It is important to call your health provider if you experience any of these symptoms. Noticing any blood in the urine may indicate a sign of something more serious, making the need to call your health provider more urgent.
One of the primary causes of UTIs in women is that they have shorter urethra than men. However, some women are more prone to UTIs compared to others. Women who are going through menopause typically have a higher chance of getting a UTI due to a reduction in their estrogen levels. Some women are genetically predisposed to UTIs. Sexual intercourse can trigger and also increase the frequency of UTIs, as can the use of diaphragms and condoms with spermicidal foam.
Sometimes the cause of UTIs is an abnormality in the urinary tract. Such abnormalities include diverticula that harbor bacteria in the bladder or urethra or blockages, such as an enlarged bladder, that prevents the body from completely draining urine from the bladder. Individuals with diabetes are also at a higher risk, as their bodies don’t fight germs off as well.
To decrease the risk of UTI, it is helpful to drink plenty of fluids, refrain from putting off urinating, or not fully emptying the bladder due to being in a rush to urinate. Drinking cranberry juice or taking over-the-counter cranberry supplements can also help prevent UTIs.
Fortunately, most women have simple UTIs that can be successfully treated with a short course of antibiotics, after which symptoms are alleviated. Postmenopausal women who experience UTIs can often be helped with topical hormone replacement with estrogen. When a UTI is complicated, a longer course of antibiotics is required, sometimes intravenously at a hospital. Women who get UTIs often should see their health provider for testing and treatment.
Armen Kirakosyan, MD, FACOG, FMPRS, FRCSC, FACS is a board-certified urogynecologist at General Physician, PC. He is experienced in treating a wide range of issues, from the most basic to complex surgeries. Learn more. To make an appointment with Dr. Kirakosyan, click here or call 716-656-4077.
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