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Notes on Women's Health
Notes on Women's Health

Tag: CT

Placenta Pills: Is There Any Benefit?

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If you’ve been keeping up with the Kardashians, you may have heard the belief that consuming human placenta can offer a new mother various health benefits, such as help with treatment of postpartum depression.

While a quick look online finds a placenta cookbook on Amazon.com, a more mainstream approach is “encapsulated” placenta, which is when placental tissue is dried, ground up and then packaged into clear gelatin capsules like a vitamin supplement. Read More

Weight Loss After Pregnancy: Staying Healthy as You Get Your Body Back

Post-Pregnancy-ExercisingIt seems like you only need to go as far as the nearest supermarket checkout line to see photos of celebrity moms flaunting their post-pregnancy figures – a few months or even weeks after giving birth.

One week it’s Blake Lively or Duchess Catherine, the next it’s Halle Berry or Christina Aguilera. But while speedy celebrity transformations are certainly impressive, are they healthy? What are the effects of rapid weight loss on the new mother – and, indirectly, the new child?

What are the best ways to lose weight after pregnancy? These are questions we hear regularly at our practice … and here are a few answers. Read More

A primer on emergency contraception pills

Thoughtful woman sitting on floor using laptop in living roomYou’ve heard about emergency contraception pills but do you really understand exactly what they do?

First, the simplest way we describe these pills to our patients is to call them emergency contraception that prevents pregnancy after unprotected sex. They are not traditional birth control. And they do not cause abortion because they work before a pregnancy occurs.

According to the American College of Obstetricians and Gynecologists, fertilization, the union of an egg and a sperm, occurs in the fallopian tube. During the next few days the fused egg and sperm move through the fallopian tube to the lining of the uterus, where it implants as a cluster of cells that will become the fetus and placenta. Emergency contraception pills do not work at this point. Read More

Your daughter’s all-important first visit to our office

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“When should my daughter first see a gynecologist?” is a question our patients often ask during their visits to us, followed by an almost always immediate second question: “What kinds of things do you do to calm the nerves of the first visit?”

The optimum time for a first visit to our office is between ages 13 and 15. As for the second answer, because it can be scary for your daughter as young girls often feel embarrassed or nervous discussing their bodies, we make the visit as pleasant and comfortable as possible, and consider this a get-to-know-you session, where we begin building relationships and talk about health, education and prevention.
In most cases young girls visit our nurse practitioner Laury Berkwitt, who specializes in women’s health, is a mother of two, and is passionate about caring for young women and adolescents. She knows how to speak to young girls and is able to get them to open up, talk and ask questions. Read More

Mammograms: Making Sense of Conflicting News

In the past few months there’s been a lot of conflicting information about mammograms in the press. Not surprisingly, we get asked a lot of questions by our patients: Are mammograms useful? At what age should I start getting tested? What are the risks? What if I test positive?

Recent News: A Quick Summary

A few months ago, there was a cost analysis of whether women should start regular mammograms starting at age 40 or age 50. Why was this a concern? Because the American Cancer Society recommends that women start mammogram screening every year starting when they turn 40, while the U.S. Preventive Service’s Task Force recommends that women get a mammogram every other year starting at age 50.

A few weeks later, a Canadian study reported that mammograms did not reduce breast cancer deaths. This study was criticized by U.S. radiologists as being flawed and misleading.

The Latest Word

Even more recently, the American Medical Association published the results of studies that attempted to put all the previous research into perspective. For the first study, researchers at Harvard examined all the research done on mammograms since 1960. They concluded that while mammograms have benefits, these benefits have been “oversold,” while the potential harms have been minimized.

Who Should Get Screened, And When?

The researchers also found that annual mammograms can reduce the risk of dying from breast cancer by about 19 percent; but the benefit varies based on a woman’s age and her underlying cancer risk. For example, breast cancer becomes much more common as a woman ages. Here are the statistics:

chart

As for women age 75 and older, the study found that there have been no tests to see whether women of this age benefit from regular mammograms. This means that there’s no way to know how much regular mammograms might extend the life of a woman in this age range.

The Risk of Overdiagnosis

The Harvard study also evaluated overdiagnosis, in which women are treated for a cancer that would never have been life-threatening. The researchers found that about 19 percent of women who are diagnosed with breast cancer as a result of a mammogram undergo unnecessary surgery, chemotherapy or radiation.

So What’s the Bottom Line?

The researchers concluded that mammography is a useful but not perfect screening test. So if you’re trying to make a decision about mammography, be sure to discuss the risks, benefits, uncertainties, alternatives, and your own health history and preferences.

About the practice

Dr. John Garofalo, M.D., is a gynecologist located in Fairfield County, Connecticut. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.

Laury Berwitt is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for 10 years, caring for women of all ages.

Laury and Dr. Garofalo offer mammography and related consultation services as part of well woman care.

For more information, go to www.garofaloobgyn.com. John Garofalo, MD and Laury Berkwitt, APRN can be reached for personal consultations by calling 203.803.1098.

Genetics Testing

Details of a Genetics Testing Consultation

In the last post, I mentioned that I often talk with my patients about their options in genetics testing during the first prenatal appointment, but it actually goes much further. The genetics testing consultation is a separate appointment altogether.

If you were my patient, here’s what we’d discuss in this special consultation:

  • A detailed health history of both mom and dad to find out if you are at risk of having a baby with a disorder.
  • An overview of the tests available to you, the risks of each, and the reasons you may or may not want to proceed with each test.
  • Options available to you should you discover that your baby may have a genetics disorder.

Understanding Genetics Disorders

You may remember that genetics are the traits passed from both parents to the child. The mother’s egg and the father’s sperm each have 23 chromosomes, which pair up within each cell of the fetus. Each of the 46 chromosomes contains a number of paired genes, some recessive and some dominant, which define a number of traits. These traits range from the color of the baby’s eyes to blood type.

A genetics disorder can result from a missing or damaged chromosome or gene or when inherited from a parent. Disorders could include Huntington’s Disease, Tay-Sachs disease, cystic fibrosis, hemophilia, Down syndrome, and others.

Types of Tests Available to You

Read More

Essure permanent birth control: risks and benefits

(PART 2)

In my last blog I wrote about Essure, a relatively new procedure that offers a highly effective option for permanent birth control. One of the best ways to evaluate whether or not a medical procedure is right for you is to look at it in terms of its risks and benefits. Here are some more questions and answers that I hope will help you with your decision.

Is the Essure procedure effective?

While no form of birth control is 100% effective, fewer than one in 100,000 pregnancies occur when tubal blockage has been confirmed by the three-month test. The Essure procedure is the only birth control method with zero pregnancies in clinical trials.

Is the Essure procedure safe?

Studies have shown that the Essure procedure is safe. However, as with most birth control methods, there are risks. In some cases one or both Essure coils may not place properly in the Fallopian tubes and may have to be re-applied.

Is the Essure procedure painful?

In most cases the pain of an Essure procedure is far less and shorter-lasting than the pain often associated with Read More

Essure Permanent Birth Control: Questions and Answers

(PART 1)

Lately I’ve been getting a lot of questions from my patients about the Essure birth control procedure. Maybe it’s because of the recent publicity from Olympic gold medalist Picabo Street, who announced earlier this year that she’d undergone the procedure. In any case, I thought I’d answer some of the most common questions I’ve heard. I’ve also included some useful links at the bottom of this blog. Read More

da Vinci surgery, uterine fibroids and myomectomy

da Vinci myomectomy

da Vinci myomectomy

In my last blog I wrote about hysterectomy (surgical removal of the uterus) and how this surgery is well-suited for surgery using the da Vinci approach. One of the main reasons a woman might consider a hysterectomy is the presence of uterine fibroids, which are non-cancerous tumors that grow out from the muscle layer and connective tissue in the uterus. Uterine fibroids (also called leiomyomas or myomas) are very common, especially during a woman’s middle and later reproductive years: about 20-40% of women will be diagnosed with uterine fibroids at some point in their lives.

In most cases uterine fibroids are harmless. But sometimes they can cause heavy and painful menstruation, painful sexual intercourse, and urinary frequency and urgency. Uterine fibroids that are located inside the uterine cavity can make it difficult or impossible to conceive a child, and they can cause complications in pregnancy, including bleeding, miscarriage, premature labor, or interference with the position of the fetus.

If you or someone you know has problems with uterine fibroids, there are several options for treatment. Read More

da Vinci Surgery and Hysterectomy

In my last blog, I mentioned that da Vinci surgery provides precision that’s crucial when working in close proximity to delicate organs like the bladder. In addition, the camera technology provides a great deal of detail. If you’re facing the prospect of surgery and you think of the kind of surgery you’d prefer to have, hopefully words like detail and precision are ones that come to mind.

This combination of detail and precision makes da Vinci very well suited for a variety of surgery types and procedures, including several that I do regularly as part of my medical practice. For this blog I thought I’d talk about da Vinci surgery and hysterectomy. Read More