{"id":1124,"date":"2020-12-15T17:05:32","date_gmt":"2020-12-15T17:05:32","guid":{"rendered":"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/?page_id=1124"},"modified":"2020-12-22T17:54:36","modified_gmt":"2020-12-22T17:54:36","slug":"gynecology","status":"publish","type":"page","link":"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/gynecology\/","title":{"rendered":"Gynecologist in Tampa Bay"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-parallax-none nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-background-position:center bottom;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:10%;--awb-padding-bottom:10%;--awb-background-image:url(&quot;https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2020\/12\/Gynecology-Header-section-image.jpg&quot;);--awb-background-size:cover;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_5 1_5 fusion-one-fifth fusion-column-first\" style=\"--awb-bg-size:cover;width:20%;width:calc(20% - ( ( 4% + 4% ) * 0.2 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_3_5 3_5 fusion-three-fifth fusion-animated\" style=\"--awb-padding-top:1px;--awb-bg-color:rgb(99,171,220,0.63);--awb-bg-color-hover:rgb(99,171,220,0.63);--awb-bg-size:cover;width:60%;width:calc(60% - ( ( 4% + 4% ) * 0.6 ) );margin-right: 4%;\" data-animationType=\"fadeInDown\" data-animationDuration=\"0.6\" data-animationOffset=\"top-into-view\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-one\" style=\"--awb-text-color:#ffffff;--awb-margin-top:30px;--awb-margin-bottom:30px;--awb-margin-top-small:20px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:63;line-height:1.1;\"><strong>Gynecologist in Tampa Bay<\/strong><\/h1><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_5 1_5 fusion-one-fifth fusion-column-last\" style=\"--awb-bg-size:cover;width:20%;width:calc(20% - ( ( 4% + 4% ) * 0.2 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-equal-height-columns padding-wrapper custom-toggle\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:7%;--awb-padding-right:0px;--awb-padding-bottom:4%;--awb-padding-left:0px;--awb-background-color:#f7f8fb;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first fusion-column-no-min-height padding-null\" style=\"--awb-padding-bottom:5%;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 8% ) * 0.5 ) );margin-right: 8%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-text-color:#63abdc;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:46px;\"><h2 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;font-size:1em;--fontSize:46;line-height:1.09;\"><strong>Gynecology Care<\/strong><\/h2><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last fusion-column-no-min-height phone-services\" style=\"--awb-padding-bottom:5%;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 8% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_1_5 1_5 fusion-one-fifth fusion-column-first fusion-no-small-visibility\" style=\"--awb-padding-top:46px;--awb-padding-right:20px;--awb-padding-bottom:46px;--awb-padding-left:20px;--awb-bg-color:#63ABDC;--awb-bg-color-hover:#63ABDC;--awb-bg-size:cover;--awb-margin-bottom:0px;width:20%;width:calc(20% - ( ( 0 ) * 0.2 ) );margin-right: 0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-fa-align-center\"><i class=\"fb-icon-element-1 fb-icon-element fontawesome-icon fa-mobile-alt fas circle-no\" style=\"--awb-font-size:45px;\"><\/i><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-1 fusion_builder_column_inner_4_5 4_5 fusion-four-fifth fusion-column-last\" style=\"--awb-padding-top:25px;--awb-padding-right:20px;--awb-padding-bottom:40px;--awb-padding-left:20px;--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;--awb-border-color:#63ABDC;--awb-border-top:2px;--awb-border-right:2px;--awb-border-bottom:2px;--awb-border-left:2px;--awb-border-style:solid;--awb-margin-bottom:0px;width:80%;width:calc(80% - ( ( 0 ) * 0.8 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-text fusion-text-1\"><p style=\"color: #fff; margin-bottom: 0;\"><span style=\"color: #63abdc;\">Telephone<\/span><\/p>\n<\/div><div class=\"fusion-text fusion-text-2\"><p style=\"font-size: 37px; line-height: 41px; margin-bottom: 0;\"><strong><a href=\"tel:+18135537700\"><span style=\"color: #888888;\">(813) 553-7700<\/span><\/a><\/strong><\/p>\n<\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div>\n<\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container hundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-background-color:#f7f8fb;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_2 1_2 fusion-flex-column fusion-flex-align-self-flex-start fusion-column-no-min-height\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:0px;--awb-icon-size:20px;--awb-content-font-size:16px;--awb-icon-alignment:left;--awb-hover-color:#f9f9f9;--awb-border-color:#e5e5e5;--awb-background-color:#ffffff;--awb-divider-color:#dddbdb;--awb-divider-hover-color:#dddbdb;--awb-icon-color:#63ABDC;--awb-title-color:#63ABDC;--awb-content-color:#585858;--awb-icon-box-color:#6abf16;--awb-toggle-hover-accent-color:#63ABDC;--awb-title-font-family:&quot;Roboto&quot;;--awb-title-font-weight:900;--awb-title-font-style:normal;--awb-title-font-size:20px;--awb-content-font-family:&quot;Roboto&quot;;--awb-content-font-style:normal;--awb-content-font-weight:400;\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-1124-1\"><div class=\"fusion-panel panel-default panel-6e6cbe32951034044 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_6e6cbe32951034044\"><a aria-expanded=\"false\" aria-controls=\"6e6cbe32951034044\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-1\" data-target=\"#6e6cbe32951034044\" href=\"#6e6cbe32951034044\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Annual Exams<\/span><\/a><\/h4><\/div><div id=\"6e6cbe32951034044\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_6e6cbe32951034044\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><strong>How can I prepare for my exam?<\/strong><\/p>\n<p>The most important thing to do before your gynecological exam is research. Women should be prepared to discuss their family medical history and be ready for questions about their menstrual cycle. Commonly asked questions your provider may ask to include:<\/p>\n<ul>\n<li>When was your last period?<\/li>\n<li>How long does your period typically last?<\/li>\n<li>At what age did you start your period?<\/li>\n<li>Are you sexually active?<\/li>\n<li>What should I expect for my annual exam?<\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The pelvic exam only lasts a few minutes and the exam itself doesn\u2019t hurt. Most physicians will explain the process before beginning the exam, asking questions throughout the process is encouraged. The pelvic exam consists of the following steps:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Your doctor will typically begin with a breast exam to check for lumps that may be a sign of cancer.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Your physician will then check the external genital area for irritations, cysts or other problems.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Next, the physician will insert a speculum, which is an instrument that is used to examine the cervix and vaginal walls. During this time, the doctor will also conduct a pap smear to check for cancerous and pre-cancerous cells.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The last step in the physical exam is for the physician to check the uterus, fallopian tubes and ovaries by inserting gloved fingers into the vagina and pressing on the abdomen.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Not only does the annual exam ensure that you maintain good gynecological health, but it is also an opportunity for you to catch health problems in the early stages.<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-5e7ed4d6d4fe9cdb3 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_5e7ed4d6d4fe9cdb3\"><a aria-expanded=\"false\" aria-controls=\"5e7ed4d6d4fe9cdb3\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-1\" data-target=\"#5e7ed4d6d4fe9cdb3\" href=\"#5e7ed4d6d4fe9cdb3\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Contraceptive Counselling and options<\/span><\/a><\/h4><\/div><div id=\"5e7ed4d6d4fe9cdb3\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_5e7ed4d6d4fe9cdb3\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p>Contraceptive counseling has great potential as a strategy to empower women who do not desire pregnancy to choose a method of birth control that she can use correctly and consistently over time, thereby reducing her individual risk of unintended pregnancy.<br \/>\nMany elements need to be considered by women, men, or couples at any given point in their lifetimes when choosing the most appropriate contraceptive method. These elements include safety, effectiveness, availability (including accessibility and affordability), and acceptability. Voluntary informed choice of contraceptive methods is an essential guiding principle, and contraceptive counseling, when applicable, might be an important contributor to the successful use of contraceptive methods.<br \/>\nIn choosing a method of contraception, dual protection from the simultaneous risk for HIV and other STDs also should be considered. Although hormonal contraceptives and IUDs are highly effective at preventing pregnancy, they do not protect against STDs, including HIV. Consistent and correct use of the male latex condom reduces the risk for HIV infection and other STDs, including chlamydial infection, gonococcal infection, and trichomoniasis.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-639d12911f8d9ba51 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_639d12911f8d9ba51\"><a aria-expanded=\"false\" aria-controls=\"639d12911f8d9ba51\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-1\" data-target=\"#639d12911f8d9ba51\" href=\"#639d12911f8d9ba51\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Breast Cancer screening<\/span><\/a><\/h4><\/div><div id=\"639d12911f8d9ba51\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_639d12911f8d9ba51\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p>Mammography is the most widely used screening modality for the detection of breast cancer. There is evidence that it decreases breast cancer mortality in women aged 50 to 69 years and that it is associated with harms, including the detection of clinically insignificant cancers that pose no threat to life (overdiagnosis). Breast self-exam has been shown to have no mortality benefit. No results have been published on the outcomes of incidence or mortality for CBE (clinical breast exam).<br \/>\nTechnologies such as ultrasound, magnetic resonance imaging, and molecular breast imaging are being evaluated, usually as adjuncts to mammography, and are not primary screening tools in the average population.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-1d233adcda69b0d35 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_1d233adcda69b0d35\"><a aria-expanded=\"false\" aria-controls=\"1d233adcda69b0d35\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-1\" data-target=\"#1d233adcda69b0d35\" href=\"#1d233adcda69b0d35\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Osteoporosis Screening<\/span><\/a><\/h4><\/div><div id=\"1d233adcda69b0d35\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_1d233adcda69b0d35\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<h3><span style=\"font-weight: 400;\">Bone Density Test<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A bone density test (DXA) is the only test that can diagnose osteoporosis before a broken bone occurs. This test helps to estimate the density of your bones and your chance of breaking a bone.\u00a0 DXA stands for dual energy x-ray absorptiometry.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can find out whether you have osteoporosis or if you should be concerned about your bones by getting a bone density test. Some people also call it a bone mass measurement test. This test uses a machine to measure your bone density. It estimates the amount of bone in your hip, spine and sometimes other bones. Your test result will help your healthcare provider make recommendations to help you protect your bones.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Are you a postmenopausal woman age 50 and older? Have you recently broken a bone? If you answered \u201cyes\u201d to both questions, you should talk to your doctor or other healthcare provider about getting a bone density test if you\u2019ve never had one.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">What a Bone Density Test Can Do<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A bone density test tells you if you have normal bone density, low bone density (osteopenia) or osteoporosis. It is the only test that can diagnose osteoporosis. The lower your bone density, the greater your risk of breaking a bone. A bone density test can help you and your healthcare provider:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">learn if you have weak bones or osteoporosis before you break a bone<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">predict your chance of breaking a bone in the future<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">see if your bone density is improving, getting worse or staying the same<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">find out how well an osteoporosis medicine is working<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">let you know if you have osteoporosis after you break a bone<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Who Should Have a Bone Density Test?<\/span><\/h3>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">you are a woman age 65 or older<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">you break a bone after age 50<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">you are a woman of menopausal age with risk factors<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">you are a postmenopausal woman under age 65 with risk factors<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">A bone density test may also be necessary if you have any of the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">an X-ray of your spine showing a break or bone loss in your spine<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">back pain with a possible break in your spine<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">height loss of \u00bd inch or more within one year<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">total height loss of 1\u00bd inches from your original height<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-55fb9f74e627472ba fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_55fb9f74e627472ba\"><a aria-expanded=\"false\" aria-controls=\"55fb9f74e627472ba\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-1\" data-target=\"#55fb9f74e627472ba\" href=\"#55fb9f74e627472ba\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">STD Screening<\/span><\/a><\/h4><\/div><div id=\"55fb9f74e627472ba\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_55fb9f74e627472ba\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span style=\"font-weight: 400;\">If you are sexually active, getting tested for STDs is one of the most important things you can do to protect your health. Make sure you have an open and honest conversation about your sexual history and STD testing with your doctor and ask whether you should be tested for STDs.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Below is a brief overview of STD testing recommendations.\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>All adults and adolescents from ages 13 to 64<\/b><span style=\"font-weight: 400;\"> should be tested at least once for HIV.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>All sexually active women<\/b><span style=\"font-weight: 400;\"> younger than 25 years should be tested for gonorrhea and chlamydia every year. Women 25 years and older with risk factors such as new or multiple sex partners or a sex partner who has an STD should also be tested for gonorrhea and chlamydia every year.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>All pregnant women<\/b><span style=\"font-weight: 400;\"> should be tested for syphilis, HIV, and hepatitis B starting early in pregnancy. At-risk pregnant women should also be tested for chlamydia and gonorrhea starting early in pregnancy. Testing should be repeated as needed to protect the health of mothers and their infants.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>All sexually active gay and bisexual men<\/b><span style=\"font-weight: 400;\"> should be tested at least once a year for syphilis, chlamydia, and gonorrhea. Those who have multiple or anonymous partners should be tested more frequently for STDs (i.e., at 3- to 6-month intervals).<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Sexually active gay and bisexual men<\/b><span style=\"font-weight: 400;\"> may benefit from more frequent HIV testing (e.g., every 3 to 6 months).<\/span><\/li>\n<\/ul>\n<p><b>Anyone who has unsafe sex or shares injection drug equipment<\/b><span style=\"font-weight: 400;\"> should get tested for HIV at least once a year.<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-6a44a8d75ab37e6f6 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_6a44a8d75ab37e6f6\"><a aria-expanded=\"false\" aria-controls=\"6a44a8d75ab37e6f6\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-1\" data-target=\"#6a44a8d75ab37e6f6\" href=\"#6a44a8d75ab37e6f6\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Cervical Cancer Screening (Pap Smear)<\/span><\/a><\/h4><\/div><div id=\"6a44a8d75ab37e6f6\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_6a44a8d75ab37e6f6\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span style=\"font-weight: 400;\">Two screening tests can help prevent cervical cancer or find it early\u2014<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The Pap test (or Pap smear) looks for <\/span><i><span style=\"font-weight: 400;\">precancers,<\/span><\/i><span style=\"font-weight: 400;\"> cell changes on the cervix that might become cervical cancer if they are not treated appropriately.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The HPV test looks for the virus (human papilloma<\/span> <span style=\"font-weight: 400;\">virus) that can cause these cell changes.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Both tests can be done in a doctor\u2019s office or clinic. During the Pap test, the doctor will use a plastic or metal instrument, called a <\/span><i><span style=\"font-weight: 400;\">speculum,<\/span><\/i><span style=\"font-weight: 400;\"> to widen your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are sent to a laboratory.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">If you are getting a Pap test, the cells will be checked to see if they look normal.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">If you are getting an HPV test, the cells will be tested for HPV.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">How to Prepare for Your Pap or HPV Test<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You should not schedule your test for a time when you are having your period. If you are going to have a test in the next two days\u2014<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">You should not douche (rinse the vagina with water or another fluid).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">You should not use a tampon.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">You should not have sex.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">You should not use a birth control foam, cream, or jelly.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">You should not use a medicine or cream in your vagina.<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-7fbe45cf0ba17aeba fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_7fbe45cf0ba17aeba\"><a aria-expanded=\"false\" aria-controls=\"7fbe45cf0ba17aeba\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-1\" data-target=\"#7fbe45cf0ba17aeba\" href=\"#7fbe45cf0ba17aeba\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Genetic Cancer Screening and Testing<\/span><\/a><\/h4><\/div><div id=\"7fbe45cf0ba17aeba\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_7fbe45cf0ba17aeba\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<h3><b>What is genetic testing?<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Genetic testing looks for specific inherited changes (variants) in a person\u2019s genes. Genetic variants can have harmful, beneficial, neutral (no effect), or unknown or uncertain effects on the risk of developing diseases. Harmful variants in some genes are known to be associated with an increased risk of developing cancer. These inherited variants are thought to contribute to about 5 to 10% of all cancers.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Cancer can sometimes appear to \u201crun in families\u201d even if it is not caused by an inherited variant. For example, a shared environment or lifestyle, such as tobacco use, can cause similar cancers to develop among family members. However, certain patterns that are seen in members of a family\u2014such as the types of cancer that develop, other non-cancer conditions that are seen, and the ages at which cancer typically develops\u2014may suggest the presence of inherited susceptibility to cancer.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Genes involved in many of the known inherited cancer susceptibility syndromes have been identified. Testing whether someone carries a harmful variant in one of these genes can confirm whether a condition is, indeed, the result of an inherited syndrome. Genetic testing is also done to determine whether family members who have not (yet) developed cancer have inherited the same variant as a family member who is known to carry a harmful (cancer susceptibility predisposing) variant.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">From NCI<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_2 1_2 fusion-flex-column fusion-flex-align-self-flex-start fusion-column-no-min-height\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:0px;--awb-icon-size:20px;--awb-content-font-size:16px;--awb-icon-alignment:left;--awb-hover-color:#f9f9f9;--awb-border-color:#e5e5e5;--awb-background-color:#ffffff;--awb-divider-color:#dddbdb;--awb-divider-hover-color:#dddbdb;--awb-icon-color:#63ABDC;--awb-title-color:#63ABDC;--awb-content-color:#585858;--awb-icon-box-color:#6abf16;--awb-toggle-hover-accent-color:#63ABDC;--awb-title-font-family:&quot;Roboto&quot;;--awb-title-font-weight:900;--awb-title-font-style:normal;--awb-title-font-size:20px;--awb-content-font-family:&quot;Roboto&quot;;--awb-content-font-style:normal;--awb-content-font-weight:400;\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-1124-2\"><div class=\"fusion-panel panel-default panel-e17a5b25824d62211 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_e17a5b25824d62211\"><a aria-expanded=\"false\" aria-controls=\"e17a5b25824d62211\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-2\" data-target=\"#e17a5b25824d62211\" href=\"#e17a5b25824d62211\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Infertility testing and treatment<\/span><\/a><\/h4><\/div><div id=\"e17a5b25824d62211\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_e17a5b25824d62211\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span style=\"font-weight: 400;\">In general, infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. Because fertility in women is known to decline steadily with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex. Women with infertility should consider making an appointment with a gynecologist. Your gynecologist may also be able to help women with recurrent pregnancy loss, defined as having two or more spontaneous miscarriages.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Pregnancy is the result of a process that has many steps.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To get pregnant<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A woman\u2019s body must release an egg from one of her ovaries.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A man\u2019s sperm must join with the egg along the way (fertilize).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The fertilized egg must go through a fallopian tube toward the uterus.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The fertilized egg must attach to the inside of the uterus (implantation).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Infertility may result from a problem with any or several of these steps.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Infertility is not always a woman\u2019s problem. Both men and women can contribute to infertility. \u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Many couples struggle with infertility and seek help to become pregnant, but it is often thought of as only a woman\u2019s condition. However, in about 35% of couples with infertility, a male factor is identified along with a female factor. In about 8% of couples with infertility, a male factor is the only identifiable cause.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Almost 9% of men aged 25 to 44 years in the United States reported that they or their partner saw a doctor for advice, testing, or treatment for infertility during their lifetime.<\/span><\/p>\n<p><b><i>The following tests may be recommended as part of your infertility evaluation:<\/i><\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><b>Male Partner Semen Analysis:\u00a0<\/b><span style=\"font-weight: 400;\">Although the semen analysis is obtained from the male partner, it is an essential part of the infertility evaluation. \u00a0A semen analysis should provide information about the number, movement, and shape of the sperm. A semen analysis is necessary even if the male partner has fathered a child before.\u00a0<\/span><\/p>\n<p><b>Hysterosalpingogram (HSG):\u00a0<\/b><span style=\"font-weight: 400;\">This is an X-ray procedure to see if the fallopian tubes are open and to if the shape of the uterine cavity is normal. A catheter is inserted into the opening of the cervix through the vagina. A liquid containing iodine (contrast) is injected through the catheter. The contrast fills the uterus and enters the tubes, outlining the length of the tubes, and spills out their ends if they are open.\u00a0<\/span><\/p>\n<p><b>Transvaginal Ultrasonography:\u00a0<\/b><span style=\"font-weight: 400;\">\u00a0An ultrasound probe placed in the vagina allows the clinician to check the uterus and ovaries for abnormalities such as fibroids and ovarian cysts.\u00a0<\/span><\/p>\n<p><b>Ovarian Reserve Testing:\u00a0<\/b><span style=\"font-weight: 400;\">When attempting to test for a woman\u2019s ovarian reserve, the clinician is trying to predict whether she can produce an egg or eggs of good quality and how well her ovaries are responding to the hormonal signals from her brain. \u00a0The most common test to evaluate ovarian reserve is a blood test for follicle stimulating hormone (FSH) drawn on cycle day 3. In addition to the FSH level, your physician may recommend other blood tests, such as estradiol, antim\u00fcllerian hormone (AMH), and\/or inhibin-B,\u00a0as well as a transvaginal ultrasound to do an antral follicle count (the number of follicles or egg sacs seen during the early part of a menstrual cycle).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ovarian reserve testing is more important for women who have a higher risk of reduced ovarian reserve, such as women who:\u00a0<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">are over age 35 years;\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">have a family history of early menopause;\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">have a single ovary;\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">have a history of previous ovarian surgery, chemotherapy, or pelvic radiation therapy;\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">have unexplained infertility; or\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">have shown poor response to gonadotropin ovarian stimulation. \u00a0<\/span><\/li>\n<\/ol>\n<p><b>Other Blood Tests:\u00a0<\/b><span style=\"font-weight: 400;\">Thyroid-stimulating hormone (TSH) and prolactin levels are useful to identify thyroid disorders and hyperprolactinemia, which may cause problems with fertility, menstrual irregularities, and repeated miscarriages. In women who are thought to have an increase in hirsutism (including hair on the face and\/or down the middle of the chest or abdomen),\u00a0blood tests for dehydroepiandrosterone sulfate (DHEAS), 17-\u03b1 hydroxyprogesterone, and total testosterone should be considered. A blood progesterone level drawn in the second half of the menstrual cycle can help document whether ovulation has occurred. \u00a0.<\/span><\/p>\n<p><b>Sonohysterography:<\/b><span style=\"font-weight: 400;\">\u00a0This procedure uses transvaginal ultrasound after filling the uterus with saline (a salt solution). This improves detection of intrauterine problems such as endometrial polyps and fibroids compared with using transvaginal ultrasonography alone. If an abnormality is seen, a hysteroscopy is typically done. This test is often done in place of HSG.<\/span><\/p>\n<p><b>Hysteroscopy:<\/b><span style=\"font-weight: 400;\">\u00a0This is a surgical procedure in which a lighted telescope-like instrument (hysteroscope) is passed through the cervix to view the inside of the uterus. Hysteroscopy can help diagnose and treat abnormalities inside the uterine cavity such as polyps, fibroids, and adhesions (scar tissue).\u00a0<\/span><\/p>\n<p><b>Laparoscopy:<\/b><span style=\"font-weight: 400;\">\u00a0This is a surgical procedure in which a lighted telescope-like instrument (laparoscope) is inserted through the wall of the abdomen into the pelvic cavity. Laparoscopy is useful to evaluate the pelvic cavity for endometriosis, pelvic adhesions, and other abnormalities. Laparoscopy is not a first line option in the evaluation of a female patient. \u00a0Because of its higher costs and potential surgical risk, it may be recommended depending on the\u00a0results of other testing and a woman\u2019s history, such as pelvic pain and previous surgeries.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For best results, the infertility evaluation should be individualized based on each woman\u2019s specific circumstances.\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-dfbcc8d95151ad671 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_dfbcc8d95151ad671\"><a aria-expanded=\"false\" aria-controls=\"dfbcc8d95151ad671\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-2\" data-target=\"#dfbcc8d95151ad671\" href=\"#dfbcc8d95151ad671\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Premenstrual Syndrome management<\/span><\/a><\/h4><\/div><div id=\"dfbcc8d95151ad671\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_dfbcc8d95151ad671\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<h3><span style=\"font-weight: 400;\">Diagnosis<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There are no unique physical findings or lab tests to positively diagnose the premenstrual syndrome. Your doctor may attribute a particular symptom to PMS if it&#8217;s part of your predictable premenstrual pattern.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To help establish a premenstrual pattern, your doctor may have you record your signs and symptoms on a calendar or in a diary for at least two menstrual cycles. Note the day that you first notice PMS symptoms, as well as the day they disappear. Also, be sure to mark the days your period starts and ends.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Certain conditions may mimic PMS, including chronic fatigue syndrome, thyroid disorders and mood disorders, such as depression and anxiety. Your health care provider may order tests, such as a thyroid function test or mood screening tests to help provide a clear diagnosis.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Treatment<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">For many women, lifestyle changes can help relieve PMS symptoms. But depending on the severity of your symptoms, your doctor may prescribe one or more medications for premenstrual syndrome.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The success of medications in relieving symptoms varies among women. Commonly prescribed medications for premenstrual syndrome include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Antidepressants.<\/b><span style=\"font-weight: 400;\"> Selective serotonin reuptake inhibitors (SSRIs) \u2014 which include fluoxetine (Prozac, Sarafem), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and others \u2014 have been successful in reducing mood symptoms. SSRIs are the first line treatment for severe PMS or PMDD. These medications are generally taken daily. But for some women with PMS, use of antidepressants may be limited to the two weeks before menstruation begins.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Nonsteroidal anti-inflammatory drugs (NSAIDs).<\/b><span style=\"font-weight: 400;\"> Taken before or at the onset of your period, NSAIDs such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can ease cramping and breast discomfort.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Diuretics.<\/b><span style=\"font-weight: 400;\"> When exercise and limiting salt intake aren&#8217;t enough to reduce the weight gain, swelling and bloating of PMS, taking water pills (diuretics) can help your body shed excess fluid through your kidneys. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Hormonal contraceptives.<\/b><span style=\"font-weight: 400;\"> These prescription medications stop ovulation, which may bring relief from PMS symptoms.<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Lifestyle and home remedies<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">You can sometimes manage or reduce the symptoms of premenstrual syndrome by making changes in the way you eat, exercise and approach daily life. Try these tips:<\/span><\/p>\n<h3><b>Modify your diet<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Eat smaller, more-frequent meals to reduce bloating and the sensation of fullness.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Limit salt and salty foods to reduce bloating and fluid retention.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Choose foods high in complex carbohydrates, such as fruits, vegetables and whole grains.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Choose foods rich in calcium. If you can&#8217;t tolerate dairy products or aren&#8217;t getting adequate calcium in your diet, a daily calcium supplement may help.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Avoid caffeine and alcohol.<\/span><\/li>\n<\/ul>\n<h3><b>Incorporate exercise into your regular routine<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Engage in at least 30 minutes of brisk walking, cycling, swimming or other aerobic activity most days of the week. Regular daily exercise can help improve your overall health and alleviate certain symptoms, such as fatigue and a depressed mood.<\/span><\/p>\n<h3><b>Reduce stress<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Get plenty of sleep.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Try yoga or massage to relax and relieve stress.<\/span><\/li>\n<\/ul>\n<h3><b>Record your symptoms for a few months<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Keep a record to identify the triggers and timing of your symptoms. This will allow you to intervene with strategies that may help to lessen them.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Alternative medicine<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Here&#8217;s what&#8217;s known about the effectiveness of complementary remedies used to soothe the symptoms of premenstrual syndrome:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Vitamin supplements.<\/b><span style=\"font-weight: 400;\"> Calcium, magnesium, vitamin E and vitamin B-6 have all been reported to soothe symptoms, but evidence is limited or lacking.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Herbal remedies.<\/b><span style=\"font-weight: 400;\"> Some women report relief of PMS symptoms with the use of herbs, such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil and St. John&#8217;s wort. However, few scientific studies have found that any herbs are effective for relief of PMS symptoms.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Herbal remedies also aren&#8217;t regulated by the Food and Drug Administration, so there&#8217;s no record of product safety or effectiveness. Talk with your doctor before taking any herbal products, as they may have side effects or interact with other medications you&#8217;re taking. St. John&#8217;s wort, for example, reduces the effectiveness of birth control pills.<\/span><\/p>\n<p><b>Acupuncture.<\/b><span style=\"font-weight: 400;\"> A practitioner of acupuncture inserts sterilized stainless steel needles into the skin at specific points on the body. Some women experience symptom relief after acupuncture treatment.<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-da7f84093648349b6 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_da7f84093648349b6\"><a aria-expanded=\"false\" aria-controls=\"da7f84093648349b6\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-2\" data-target=\"#da7f84093648349b6\" href=\"#da7f84093648349b6\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Menopausal Management<\/span><\/a><\/h4><\/div><div id=\"da7f84093648349b6\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_da7f84093648349b6\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<h3><span style=\"font-weight: 400;\">Diagnosis<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Signs and symptoms of menopause are usually enough to tell most women that they&#8217;ve started the menopausal transition. If you have concerns about irregular periods or hot flashes, talk with your doctor. In some cases, further evaluation may be recommended.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tests typically aren&#8217;t needed to diagnose menopause. But under certain circumstances, your doctor may recommend blood tests to check your level of:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Follicle-stimulating hormone (FSH) and estrogen (estradiol), because your FSH levels increase and estradiol levels decrease as menopause occurs<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Thyroid-stimulating hormone (TSH), because an underactive thyroid (hypothyroidism) can cause symptoms similar to those of menopause<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Lifestyle and home remedies<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Fortunately, many of the signs and symptoms associated with menopause are temporary. Take these steps to help reduce or prevent their effects:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Cool hot flashes.<\/b><span style=\"font-weight: 400;\"> Dress in layers, have a cold glass of water or go somewhere cooler. Try to pinpoint what triggers your hot flashes. For many women, triggers may include hot beverages, caffeine, spicy foods, alcohol, stress, hot weather and even a warm room.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Decrease vaginal discomfort.<\/b><span style=\"font-weight: 400;\"> Try an over-the-counter, water-based vaginal lubricant (Astroglide, K-Y jelly, Sliquid, others) or a silicone-based lubricant or moisturizer (Uber Lube, Replens, K-Y Liquibeads, Sliquid, others).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">You might consider choosing a product that doesn&#8217;t contain glycerin, which can cause burning or irritation if you&#8217;re sensitive to that chemical. Staying sexually active also helps with vaginal discomfort by increasing blood flow to the vagina.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Get enough sleep.<\/b><span style=\"font-weight: 400;\"> Avoid caffeine, which can make it hard to get to sleep, and avoid drinking too much alcohol, which can interrupt sleep. Exercise during the day, although not right before bedtime. If hot flashes disturb your sleep, you may need to find a way to manage them before you can get adequate rest.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Practice relaxation techniques.<\/b><span style=\"font-weight: 400;\"> Techniques such as deep breathing, paced breathing, guided imagery, massage and progressive muscle relaxation may help with menopausal symptoms. You can find a number of books and online offerings that show different relaxation exercises.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Strengthen your pelvic floor.<\/b><span style=\"font-weight: 400;\"> Pelvic floor muscle exercises, called Kegel exercises, can improve some forms of urinary incontinence.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Eat a balanced diet.<\/b><span style=\"font-weight: 400;\"> Include a variety of fruits, vegetables and whole grains. Limit saturated fats, oils and sugars. Ask your provider if you need calcium or vitamin D supplements to help meet daily requirements.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Don&#8217;t smoke.<\/b><span style=\"font-weight: 400;\"> Smoking increases your risk of heart disease, stroke, osteoporosis, cancer and a range of other health problems. It may also increase hot flashes and bring on earlier menopause.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Exercise regularly.<\/b><span style=\"font-weight: 400;\"> Get regular physical activity or exercise on most days to help protect against heart disease, diabetes, osteoporosis and other conditions associated with aging.<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Alternative medicine<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Many approaches have been promoted as aids in managing the symptoms of menopause, but few of them have scientific evidence to back up the claims. Some complementary and alternative treatments that have been or are being studied include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Plant estrogens (phytoestrogens).<\/b><span style=\"font-weight: 400;\"> These estrogens occur naturally in certain foods. There are two main types of phytoestrogens \u2014 isoflavones and lignans. Isoflavones are found in soybeans, lentils, chickpeas and other legumes. Lignans occur in flaxseed, whole grains, and some fruits and vegetables.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Whether the estrogens in these foods can relieve hot flashes and other menopausal symptoms remains to be proved, but most studies have found them ineffective. Isoflavones have some weak estrogen-like effects, so if you&#8217;ve had breast cancer, talk to your doctor before supplementing your diet with isoflavone pills.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The herb sage is thought to contain compounds with estrogen-like effects, and there&#8217;s good evidence that it can effectively manage menopause symptoms. The herb and its oils should be avoided in people who have an allergy to sage, and in pregnant or breast-feeding women. Use carefully in people with high blood pressure or epilepsy.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Bioidentical hormones.<\/b><span style=\"font-weight: 400;\"> These hormones come from plant sources. The term &#8220;bioidentical&#8221; implies the hormones in the product are chemically identical to those your body produces. There are some commercially available bioidentical hormones approved by the Food and Drug Administration (FDA). But many preparations are compounded \u2014 mixed in a pharmacy according to a doctor&#8217;s prescription \u2014 and aren&#8217;t regulated by the FDA, so quality and risks could vary. There&#8217;s no scientific evidence that bioidentical hormones work any better than traditional hormone therapy in easing menopause symptoms. There&#8217;s also no evidence that they&#8217;re any less risky than traditional hormone therapy.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Black cohosh.<\/b><span style=\"font-weight: 400;\"> Black cohosh has been popular among many women with menopausal symptoms. But there&#8217;s little evidence that black cohosh is effective, and the supplement can be harmful to the liver and may be unsafe for women with a history of breast cancer.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Yoga.<\/b><span style=\"font-weight: 400;\"> There&#8217;s no evidence to support the practice of yoga in reducing menopausal symptoms. But balance exercises such as yoga or tai chi can improve strength and coordination and may help prevent falls that could lead to broken bones. Check with your doctor before starting balance exercises. Consider taking a class to learn how to perform postures and proper breathing techniques.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Acupuncture.<\/b><span style=\"font-weight: 400;\"> Acupuncture may have some temporary benefit in helping to reduce hot flashes, but research hasn&#8217;t shown significant or consistent improvements. More research is needed.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Hypnosis.<\/b><span style=\"font-weight: 400;\"> Hypnotherapy may decrease the incidence of hot flashes for some menopausal women, according to research from the National Center for Complementary and Integrative Health at the U.S. National Institutes of Health. Hypnotherapy also helped improve sleep and decreased interference in daily life, according to the study.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">You may have heard of or tried other dietary supplements, such as red clover, kava, dong quai, DHEA, evening primrose oil and wild yam (natural progesterone cream). Scientific evidence on effectiveness is lacking, and some of these products may be harmful.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Talk with your doctor before taking any herbal or dietary supplements for menopausal symptoms. The FDA does not regulate herbal products, and some can be dangerous or interact with other medications you take, putting your health at risk.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Treatment<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Treatments may include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Hormone therapy.<\/b><span style=\"font-weight: 400;\"> Estrogen therapy is the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose and the shortest time frame needed to provide symptom relief for you. If you still have your uterus, you&#8217;ll need progestin in addition to estrogen. Estrogen also helps prevent bone loss. Long-term use of hormone therapy may have some cardiovascular and breast cancer risks, but starting hormones around the time of menopause has shown benefits for some women. Talk to your doctor about the benefits and risks of hormone therapy and whether it&#8217;s a safe choice for you.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Vaginal estrogen.<\/b><span style=\"font-weight: 400;\"> To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal cream, tablet or ring. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissues. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Low-dose antidepressants.<\/b><span style=\"font-weight: 400;\"> Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can&#8217;t take estrogen for health reasons or for women who need an antidepressant for a mood disorder.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Gabapentin .<\/b><span style=\"font-weight: 400;\"> Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can&#8217;t use estrogen therapy and in those who also have nighttime hot flashes.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Medications to prevent or treat osteoporosis.<\/b><span style=\"font-weight: 400;\"> Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures. Your doctor might prescribe vitamin D supplements to help strengthen bones.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options yearly, as your needs and treatment options may change.<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-ffee97fd187e9b908 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_ffee97fd187e9b908\"><a aria-expanded=\"false\" aria-controls=\"ffee97fd187e9b908\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-2\" data-target=\"#ffee97fd187e9b908\" href=\"#ffee97fd187e9b908\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Abnormal Vaginal Bleeding<\/span><\/a><\/h4><\/div><div id=\"ffee97fd187e9b908\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_ffee97fd187e9b908\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<h3><span style=\"font-weight: 400;\">What Is Abnormal Uterine Bleeding?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Abnormal uterine bleeding is when you bleed outside of your normal monthly period. You might hear it called anovulatory bleeding. Your flow could also be heavier or last longer than what\u2019s typical.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When it comes to menstrual cycles, there\u2019s a wide range of \u201cnormal.\u201d But your period shouldn\u2019t be a problem for you month after month. If it\u2019s so heavy or unpredictable that it keeps you from doing some activities or makes you miss work or school, you may have a medical condition that should be treated.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Abnormal Uterine Bleeding Symptoms<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The signs of abnormal uterine bleeding include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Heavy period (menorrhagia)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Bleeding between your periods, after sex, or during menopause<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Long periods (more than 7 days)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Irregular periods<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Doctors check these things when diagnosing abnormal uterine bleeding:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>How often you get your period.<\/b><span style=\"font-weight: 400;\"> It should be fairly regular. The length of each cycle shouldn\u2019t change by more than a week. If it\u2019s shorter than 3 weeks or longer than 5, that could be a sign of a problem.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>How long it lasts.<\/b><span style=\"font-weight: 400;\"> A typical period lasts 4 or 5 days. If yours is often less than 2 days or longer than a week, that could mean something\u2019s wrong.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>How heavy it is.<\/b><span style=\"font-weight: 400;\"> Most women only lose about 2 tablespoons of blood each period. More than 5 tablespoons is thought to be unusually heavy, but that\u2019s hard to judge. Let your doctor know if you need more than one tampon or pad in an hour. Abnormally heavy menstrual bleeding is called menorrhagia.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Whether you have spotting<\/b> <b>between periods.<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Whether you have bleeding after sex.<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">If you could be pregnant or you\u2019re past menopause and have any kind of bleeding, call your doctor immediately.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some spotting is common early in pregnancy, but bleeding can be a sign of a serious condition called an ectopic pregnancy. That\u2019s when a fertilized egg implants somewhere outside your uterus, most commonly in a fallopian tube. It could also mean you\u2019re having a miscarriage.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">After menopause, women who take hormone replacement therapy may still have periods. But any bleeding should be checked out.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Abnormal Uterine Bleeding Causes<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There are a few possible causes behind abnormal uterine bleeding:<\/span><\/p>\n<p><b>Hormone changes. <\/b><span style=\"font-weight: 400;\">Problems with your hormones are the most common reason for abnormal uterine bleeding. When one of your ovaries releases an egg (called ovulation), certain hormones tell your body to build up and then shed the lining of your uterus (called the endometrium). With teenagers and women getting close to menopause, the endometrium can build up too much. That can lead to an irregular or heavy period or spotting between periods.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These things can throw off your hormones, too:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Birth control pills and other medicines like warfarin and hormone therapy<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Fast weight loss or gain<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Emotional or physical stress<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">An intrauterine device (IUD)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Polycystic ovary syndrome (PCOS)<\/span><\/li>\n<\/ul>\n<p><b>Problems with your uterus.<\/b><span style=\"font-weight: 400;\"> Another possible reason for abnormal bleeding is a physical problem with your uterus. Millions of women have fibroids &#8212; noncancerous tumors that grow in the muscles of the wall of the uterus. A polyp is another kind of growth that can form in the lining of your uterus. A condition called adenomyosis is where the cells similar to the ones that grow in the lining of the uterus start to grow in the muscle part of the uterus. Endometriosis can also cause abnormal bleeding. This is when tissue like the kind that lines the inside of your uterus grows outside of your uterus.<\/span><\/p>\n<p><b>Other health conditions. <\/b><span style=\"font-weight: 400;\">These are much less common, but abnormal uterine bleeding also can result from:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Bleeding or clotting disorders or blood-thinning medicines<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cancer of the cervix, endometrium, or uterus<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Illnesses that affect your kidneys, liver, thyroid, or adrenal glands<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Infection of your cervix or endometrium<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Sexually transmitted diseases<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Abnormal Uterine Bleeding Diagnosis<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">It can help to take detailed notes over a few cycles so you can give the doctor specific information about your symptoms. They\u2019ll also ask about your overall health and give you a physical exam. You\u2019ll probably get a pregnancy test, and you may also have:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Blood work.<\/b><span style=\"font-weight: 400;\"> Heavy bleeding can leave your body short of iron. A blood test can see if that\u2019s a problem for you. It can also show if your hormones are out of balance or if you have a blood disorder or chronic disease.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Ultrasound<\/b><span style=\"font-weight: 400;\"> . This uses sound waves to make images of the inside of your uterus so your doctor can look for fibroids or polyps.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Hysteroscopy.<\/b><span style=\"font-weight: 400;\"> The doctor will look inside your uterus with a tiny lighted scope that they put in through your cervix.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Biopsy<\/b><span style=\"font-weight: 400;\"> . The doctor may take out a small piece of tissue and check it under a microscope for abnormal cells.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Magnetic resonance imaging<\/b><span style=\"font-weight: 400;\"> . This test uses radio waves and powerful magnets to make detailed pictures of your uterus. It isn\u2019t used that often, but it can help spot adenomyosis.<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Abnormal Uterine Bleeding Treatment<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Your treatment\u00a0will depend on the cause of the abnormal uterine bleeding &#8212; if a chronic illness or a blood disorder is at the root of your symptoms, treating that can help.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Treatment also can depend on whether you plan to have children. It might not be safe to get pregnant after some treatments, while others can make it impossible. If you\u2019re close to menopause, the doctor may want to take a wait-and-see approach because your symptoms may get better on their own.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Drugs are usually the first thing your doctor will try. They include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Hormones.<\/b><span style=\"font-weight: 400;\"> Birth control pills and other hormone treatments may be able to give you regular menstrual cycles and lighter periods.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Gonadotropin-releasing hormone agonists (GnRHa). <\/b><span style=\"font-weight: 400;\">These stop your body from making certain hormones. They can shrink fibroids for a while, but they\u2019re usually used along with other treatments.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>NSAIDS<\/b> <b>.<\/b><span style=\"font-weight: 400;\"> If you take anti-inflammatories like ibuprofen or naproxen a few days before your period starts, they may help lighten the bleeding.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Tranexamic acid<\/b> <b>.<\/b><span style=\"font-weight: 400;\"> This is a pill that helps your blood clot and can control heavy uterine bleeding.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>IUD. <\/b><span style=\"font-weight: 400;\">For some women, an IUD that releases a hormone called progestin can stop heavy bleeding. Many women who use one don\u2019t get a period at all.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Sometimes surgery can be needed to stop the bleeding:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Endometrial ablation.<\/b><span style=\"font-weight: 400;\"> This uses heat, cold, electricity, or a laser to destroy the lining of your uterus. It may end your periods entirely. You probably won\u2019t be able to get pregnant after having it done, but it can be dangerous if you do. You\u2019ll need to use birth control until menopause.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Myomectomy or uterine <\/b><b>artery<\/b> <b>embolization.<\/b><span style=\"font-weight: 400;\"> If you have fibroids, the doctor may take them out or cut off the vessels that supply them with blood.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Hysterectomy<\/b> <b>.<\/b><span style=\"font-weight: 400;\"> This is when the doctor removes your uterus. You may need a hysterectomy if your fibroids are very large or you have endometrial or uterine cancer. Otherwise, it\u2019s a last resort when other treatments haven\u2019t worked.<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-49682266faee73c64 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_49682266faee73c64\"><a aria-expanded=\"false\" aria-controls=\"49682266faee73c64\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-2\" data-target=\"#49682266faee73c64\" href=\"#49682266faee73c64\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Endometriosis<\/span><\/a><\/h4><\/div><div id=\"49682266faee73c64\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_49682266faee73c64\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<h3><b>Endometriosis Overview: What is Endometriosis?<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Endometriosis is a disease in which the endometrium (the tissue that lines the inside of the uterus or womb) is present outside of the uterus. Endometriosis most commonly occurs in the lower abdomen or pelvis, but it can appear anywhere in the body. Symptoms of endometriosis include lower abdominal pain, pain with menstrual periods, pain with sexual intercourse, and difficulty getting pregnant. On the other hand, some women with endometriosis may not have any symptoms at all.<\/span><\/p>\n<h3><b>Symptoms of Endometriosis<\/b><\/h3>\n<p><b><i>Endometriosis Symptoms<\/i><\/b><\/p>\n<p><span style=\"font-weight: 400;\">Pain is the most common symptom of endometriosis.\u00a0 Women with endometriosis can experience pelvic or lower abdominal pain, pain with menses (dysmenorrhea), pain with intercourse (dyspareunia) and pain during bowel movements (dyschezia).\u00a0 Symptoms can be constant or \u201ccyclical,\u201d meaning that they worsen before and during the period, and then improve. Women may have constant pelvic or lower abdominal pain as well. Other symptoms include infertility, bowel and bladder symptoms (bloating, constipation, blood in the urine, or pain with urination), and possibly abnormal vaginal bleeding.<\/span><\/p>\n<h3><b>How is Endometriosis Diagnosed?<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Some physicians may treat suspected endometriosis based on a woman\u2019s symptoms or physical examination findings to see if they improve without proceeding to surgery.\u00a0 However, to\u00a0formally diagnose endometriosis, a doctor must perform laparoscopy\u00a0(surgery\u00a0in which a doctor looks in the abdomen with a camera through the belly button) to visualize and biopsy suspected endometriosis lesions.\u00a0 Endometriosis lesions\u00a0can vary in appearance. \u201cEndometrioma\u201d is the term for endometriosis within an ovary, and is often nicknamed \u201cchocolate cyst\u201d because the material inside the cyst looks like chocolate syrup.<\/span><\/p>\n<h3><b>How is Endometriosis Treated?<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The most conservative<\/span><b>\u00a0<\/b><span style=\"font-weight: 400;\">therapy for endometriosis\u00a0is with medications. Non-steroidal anti-inflammatory medications, like ibuprofen, may help with the\u00a0pain associated with endometriosis. Medications that control a woman\u2019s hormones may also help with endometriosis pain. Some examples are oral contraceptive pills and gonadotropin releasing hormone (GnRH) agonists, the latter of which put women into a \u201ctemporary\u201d menopause-like state.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Surgery can diagnose endometriosis, and it can also treat endometriosis via removal (excision) or burning (fulguration) of endometriosis lesions.\u00a0 With surgery, removal of scar tissue can alleviate pain and relocate the ovaries and fallopian tubes to their normal position in the pelvis.\u00a0Surgery\u00a0has been shown\u00a0to<\/span> <span style=\"font-weight: 400;\">help some women with endometriosis to become pregnant. If a woman with endometriosis is no longer interested in becoming pregnant, she and her doctor may decide to remove the ovaries and possibly the uterus. A woman cannot become pregnant if she does not have a uterus.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If a woman with endometriosis is having\u00a0trouble getting pregnant, there are different medications and treatments available that can help her to\u00a0become pregnant<\/span><b>.<\/b><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-8f92cb4b320a1bfb8 fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_8f92cb4b320a1bfb8\"><a aria-expanded=\"false\" aria-controls=\"8f92cb4b320a1bfb8\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-2\" data-target=\"#8f92cb4b320a1bfb8\" href=\"#8f92cb4b320a1bfb8\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Treatment for Urinary Incontinence<\/span><\/a><\/h4><\/div><div id=\"8f92cb4b320a1bfb8\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_8f92cb4b320a1bfb8\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span style=\"font-weight: 400;\">Urinary incontinence is an underdiagnosed and underreported problem that increases with age\u2014affecting 50-84% of the elderly in long-term care facilities\u2014and at any age is more than twice as common in females than in males.<\/span><\/p>\n<h3><b>Signs and symptoms<\/b><\/h3>\n<p><i><span style=\"font-weight: 400;\">Types of urinary incontinence<\/span><\/i><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stress: Urine leakage associated with increased abdominal pressure from laughing, sneezing, coughing, climbing stairs, or other physical stressors on the abdominal cavity and, thus, the bladder<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Urge: Involuntary leakage accompanied by or immediately preceded by urgency<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Mixed: A combination of stress and urge incontinence, marked by involuntary leakage associated with urgency and also with exertion, effort, sneezing, or coughing<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Functional: The inability to hold urine due to reasons other than neuro-urologic and lower urinary tract dysfunction (eg, delirium, psychiatric disorders, urinary infection, impaired mobility)<\/span><\/li>\n<\/ul>\n<h3><b>Diagnosis<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Patients with urinary incontinence should undergo a basic evaluation that includes a history, physical examination, and urinalysis. In selected patients, the following may also be needed:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Voiding diary<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cotton swab test<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cough stress test<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Measurement of postvoid residual (PVR) urine volume<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cystoscopy<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Urodynamic studies<\/span><\/li>\n<\/ul>\n<h3><b>Management<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Successful treatment of urinary incontinence must be tailored to the specific type of incontinence and its cause. The usual approaches are as follows:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stress incontinence: Pelvic floor physiotherapy, anti-incontinence devices, and surgery<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Urge incontinence: Changes in diet, behavioral modification, pelvic-floor exercises, and\/or medications and new forms of surgical intervention<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Mixed incontinence: Pelvic floor physical therapy, anticholinergic drugs, and surgery<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Overflow incontinence: Catheterization regimen or diversion<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Functional incontinence: Treatment of the underlying cause<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Absorbent products may be used temporarily until a definitive treatment has a chance to work, in patients awaiting surgery, or long-term under the following circumstances:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Persistent incontinence despite all appropriate treatments<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Inability to participate in behavioral programs, due to illness or disability<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Presence of an incontinence disorder that cannot be helped by medications<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Presence of an incontinence disorder that cannot be corrected by surgery<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-3d3fe022cc1eaa8bd fusion-toggle-no-divider fusion-toggle-boxed-mode\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_3d3fe022cc1eaa8bd\"><a aria-expanded=\"false\" aria-controls=\"3d3fe022cc1eaa8bd\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-1124-2\" data-target=\"#3d3fe022cc1eaa8bd\" href=\"#3d3fe022cc1eaa8bd\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Evaluation and treatment for Pelvic Organ Prolapse<\/span><\/a><\/h4><\/div><div id=\"3d3fe022cc1eaa8bd\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_3d3fe022cc1eaa8bd\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span style=\"font-weight: 400;\">Pelvic organ prolapse is the abnormal descent or herniation of the pelvic organs from their normal attachment sites or their normal position in the pelvis. The pelvic structures that may be involved include the uterus (uterine prolapse) or vaginal apex (apical vaginal prolapse), anterior vagina (cystocele), or posterior vagina (rectocele). Many parous women may have some degree of prolapse when examined; however, most prolapses are not clinically bothersome without specific pelvic symptoms, and they may not require an intervention.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Etiology<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Pelvic floor defects may be created as a result of childbirth and are caused by the stretching and tearing of the endopelvic fascia and the levator muscles and perineal body. Pregnancy itself, without vaginal birth has been sited as a risk factor as well. Studies suggests that vaginal birth and operative vaginal birth increase an individual\u2019s risk for urinary incontinence and pelvic organ prolapse 5-10 years after delivery when compared with cesarean delivery without labor.<\/span><\/p>\n<h3><b>Evaluation<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Note significant medical history (eg, obesity, asthma, long-term steroid use) that may have contributed to prolapse or urinary incontinence. If possible, attempting to correct some of these problems before any surgical treatment may be wise. Recurrences may be more likely if such conditions are not addressed.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Most clinicians routinely use the ICS classification (POP-Q) system, which is classified as follows:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stage 0 &#8211; No prolapse<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stage I &#8211; Descent of the most distal portion of prolapse is more than 1 cm above the level of the hymen.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stage II &#8211; Maximal descent of prolapse is between 1 cm above and 1 cm below the hymen.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stage III &#8211; Prolapse extends more than 1 cm beyond the hymen, but no more than within 2 cm of the total vaginal length.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stage IV &#8211; Total or complete vaginal eversion<\/span><\/li>\n<\/ul>\n<h3><strong>Pelvic Organ Prolapse\u00a0Treatment &amp; Management<\/strong><\/h3>\n<h3><span style=\"font-weight: 400;\">Medical Therapy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Nonsurgical (conservative) management of pelvic organ prolapse is often recommended and should be attempted before surgery is contemplated. Conservative management confers several advantages: it is safe and inexpensive, it is not usually associated with morbidity and mortality, it is minimally invasive, it can lead to a high patient satisfaction, and it may be used for patients awaiting surgery or patients who are not interested in surgical management. Pelvic muscle exercises (PMEs) and vaginal support devices (pessaries) are the main nonsurgical treatments for patients with pelvic organ prolapse.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Surgical Therapy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The recommended management strategy for severe symptomatic pelvic organ prolapse for patients who failed or refused a trial of pessary management is surgery. A variety of surgical approaches are available to correct pelvic organ prolapse.<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-bg-parallax\" data-bg-align=\"center top\" data-direction=\"up\" data-mute=\"false\" data-opacity=\"100\" data-velocity=\"-0.3\" data-mobile-enabled=\"false\" data-break_parents=\"0\" data-bg-image=\"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2020\/11\/Patient-feedback-section-image1.jpg\" data-bg-repeat=\"false\" data-blend-mode=\"overlay\" data-bg-gradient-type=\"linear\" data-bg-gradient-angle=\"180\" data-bg-gradient-start-color=\"rgba(0,0,0,0.24)\" data-bg-gradient-start-position=\"0\" data-bg-gradient-end-color=\"rgba(0,0,0,0.24)\" data-bg-gradient-end-position=\"100\" data-bg-radial-direction=\"center center\" ><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 fusion-parallax-up nonhundred-percent-fullwidth non-hundred-percent-height-scrolling padding-wrapper\" style=\"--awb-background-position:center top;--awb-background-blend-mode:overlay;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:7%;--awb-padding-bottom:7%;--awb-background-image:linear-gradient(180deg, rgba(0,0,0,0.24) 0%,rgba(0,0,0,0.24) 100%),url(https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2020\/11\/Patient-feedback-section-image1.jpg);;--awb-background-size:cover;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last padding-null\" style=\"--awb-padding-top:40px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"--awb-text-color:#63abdc;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:47;line-height:1.2;\"><p style=\"text-align: center;\">Patient Feedback<\/p><\/h2><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-first fusion-animated white-p\" style=\"--awb-bg-size:cover;width:33.3333333333%;width:calc(33.3333333333% - ( ( 4% + 4% ) * 0.333333333333 ) );margin-right: 4%;\" data-animationType=\"slideInLeft\" data-animationDuration=\"0.6\" data-animationOffset=\"top-into-view\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-4 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-three\" style=\"--awb-text-color:#63abdc;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h3 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:27;line-height:1.5;\"><p style=\"text-align: center; font-size: 22px;\"><strong>Marina D.<\/strong><\/p><\/h3><\/div><div class=\"fusion-text fusion-text-3\"><p style=\"text-align: center;\"><span style=\"font-weight: 400;\"><i class=\"fas fa-quote-left\"><\/i>\u00a0\u00a0Dr. Stine is the best Gyn I\u2019ve ever had in all my 53 years! He\u2019s caring and compassionate and listens to me and has the highest professionalism and ethics. His skills in the OR are superb from my personal experience providing me with a newly found quality of life! I have recommended him to my family and will also be taking my daughters to him. That\u2019s how much trust I have in him!\u00a0\u00a0<i class=\"fas fa-quote-right\"><\/i><\/span><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_3 1_3 fusion-one-third fusion-animated white-p\" style=\"--awb-bg-size:cover;width:33.3333333333%;width:calc(33.3333333333% - ( ( 4% + 4% ) * 0.333333333333 ) );margin-right: 4%;\" data-animationType=\"slideInDown\" data-animationDuration=\"0.6\" data-animationOffset=\"top-into-view\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-5 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-three\" style=\"--awb-text-color:#63abdc;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h3 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:27;line-height:1.5;\"><p style=\"text-align: center; font-size: 22px;\"><strong>Valerie S.<\/strong><\/p><\/h3><\/div><div class=\"fusion-text fusion-text-4\"><p style=\"text-align: center;\"><span style=\"font-weight: 400;\"><i class=\"fas fa-quote-left\"><\/i>\u00a0\u00a0Dr. Stine is the absolute best! He is thorough, so comforting and knows his stuff! He truly cares about his patients and takes such great care of us. He is a blessing to all his patients.\u00a0\u00a0<i class=\"fas fa-quote-right\"><\/i><\/span><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-last fusion-animated white-p\" style=\"--awb-bg-size:cover;width:33.3333333333%;width:calc(33.3333333333% - ( ( 4% + 4% ) * 0.333333333333 ) );\" data-animationType=\"slideInRight\" data-animationDuration=\"0.6\" data-animationOffset=\"top-into-view\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-6 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-three\" style=\"--awb-text-color:#63abdc;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h3 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:27;line-height:1.5;\"><p style=\"text-align: center; font-size: 22px;\"><strong>Melissa D.<\/strong><\/p><\/h3><\/div><div class=\"fusion-text fusion-text-5\"><p style=\"text-align: center;\"><span style=\"font-weight: 400;\"><i class=\"fas fa-quote-left\"><\/i>\u00a0\u00a0My experience with Dr. Stine was basically perfect! I know a lot of women, myself included, that are not comfortable with a male doctor. Dr. Stine changed that for me!<br \/>\nI felt so at ease with him, his bedside manner is amazing. His surgical skills are TOP NOTCH! Do yourself a favor and become a patient of his!<br \/>\n<i class=\"fas fa-quote-right\"><\/i><\/span><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-5 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling padding-wrapper req-app\" style=\"--awb-background-position:center top;--awb-background-blend-mode:overlay;--awb-border-sizes-top:0px;--awb-border-sizes-bottom:0px;--awb-border-sizes-left:0px;--awb-border-sizes-right:0px;--awb-border-color:#ffffff;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:5%;--awb-padding-bottom:5%;--awb-background-image:linear-gradient(180deg, rgba(98,189,219,0.67) 0%,rgba(99,171,220,0.61) 100%);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-11 fusion_builder_column_1_5 1_5 fusion-one-fifth fusion-column-first\" style=\"--awb-bg-size:cover;--awb-margin-bottom:0px;width:20%;width:calc(20% - ( ( 4% + 4% ) * 0.2 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-12 fusion_builder_column_3_5 3_5 fusion-three-fifth padding-null\" style=\"--awb-bg-size:cover;--awb-margin-top:20px;width:60%;width:calc(60% - ( ( 4% + 4% ) * 0.6 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-7 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"--awb-text-color:#585858;--awb-margin-bottom:20px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:47;line-height:1.2;\"><p style=\"text-align: center;\">Request an Appointment<\/p><\/h2><\/div><div class=\"fusion-text fusion-text-6 fusion-text-no-margin\" style=\"--awb-margin-bottom:20px;\"><p style=\"text-align: center;\">Have a question about our practice or want to schedule an appointment? Reach out and speak with a member of our team.<\/p>\n<\/div><div class=\"fusion-aligncenter\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-1 fusion-button-default-span fusion-button-default-type\" style=\"--button_accent_color:#585858;--button_border_color:#585858;--button_accent_hover_color:#ffffff;--button_border_hover_color:#298cd0;--button_border_width-top:2px;--button_border_width-right:2px;--button_border_width-bottom:2px;--button_border_width-left:2px;--button_gradient_top_color:rgba(88,88,88,0);--button_gradient_bottom_color:rgba(88,88,88,0);--button_gradient_top_color_hover:#298cd0;--button_gradient_bottom_color_hover:#298cd0;--button_text_transform:uppercase;\" target=\"_self\" href=\"\/advanced-gynecology-of-tampa-bay\/contact\/\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Request an Appointment<\/span><\/a><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-13 fusion_builder_column_1_5 1_5 fusion-one-fifth fusion-column-last\" style=\"--awb-bg-size:cover;--awb-margin-bottom:0px;width:20%;width:calc(20% - ( ( 4% + 4% ) * 0.2 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-6 hundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-equal-height-columns wh2footerlogos\" style=\"--awb-border-sizes-top:0px;--awb-border-sizes-bottom:0px;--awb-border-sizes-left:0px;--awb-border-sizes-right:0px;--awb-border-color:#63ABDC;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-background-color:#f0f3f6;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-14 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last fusion-column-no-min-height\" style=\"--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-border-color:#63ABDC;--awb-border-bottom:15px;--awb-border-style:solid;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-15 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first wh2footerlogo\" style=\"--awb-padding-top:40px;--awb-padding-left:12%;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-image-element in-legacy-container\" style=\"--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><a class=\"fusion-no-lightbox\" href=\"\/advanced-gynecology-of-tampa-bay\/\" target=\"_self\" aria-label=\"Advanced Gynecology Logo\"><img decoding=\"async\" width=\"270\" height=\"100\" alt=\"Advanced Gynecology Logo\" src=\"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2020\/11\/Advanced-Gynecology-Logo.png\" class=\"img-responsive wp-image-1100\" srcset=\"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2020\/11\/Advanced-Gynecology-Logo-200x74.png 200w, https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2020\/11\/Advanced-Gynecology-Logo.png 270w\" sizes=\"(max-width: 1000px) 100vw, 270px\" \/><\/a><\/span><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-16 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last wh2footerlogo\" style=\"--awb-padding-top:40px;--awb-padding-right:4%;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-image-element fusion-image-align-left in-legacy-container\" style=\"text-align:left;--awb-max-width:300px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-2 hover-type-none\" style=\"margin-right:25px;float:left;\"><a class=\"fusion-no-lightbox\" href=\"https:\/\/www.toplinemd.com\/why-topline-md\/\" target=\"_blank\" aria-label=\"TopLine MD-RegisterR_Stacked_Logo_rgb_color\" rel=\"noopener noreferrer\"><img decoding=\"async\" width=\"1576\" height=\"376\" src=\"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color.png\" alt class=\"img-responsive wp-image-1224\" srcset=\"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-200x48.png 200w, https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-400x95.png 400w, https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-600x143.png 600w, https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-800x191.png 800w, https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-1200x286.png 1200w, https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-content\/uploads\/sites\/119\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color.png 1576w\" sizes=\"(max-width: 1000px) 100vw, 600px\" \/><\/a><\/span><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":13,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-1124","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-json\/wp\/v2\/pages\/1124","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-json\/wp\/v2\/comments?post=1124"}],"version-history":[{"count":0,"href":"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-json\/wp\/v2\/pages\/1124\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.toplinemd.com\/advanced-gynecology-of-tampa-bay\/wp-json\/wp\/v2\/media?parent=1124"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}