R. Scott Thornton - Ask Your Gynecologist: Answers to Over 200 (Sometimes Embarrassing) Questions Women Ask through Every Age and Stage of Their Lives

Copyright 2013 by R. Scott Thornton and Kathleen Schramm

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10 9 8 7 6 5 4 3 2 1

eISBN: 978-1-62873-839-1

Library of Congress Cataloging-in-Publication Data

Thornton, R. Scott.

Ask your gynecologist : answers to over 200 (sometimes embarrassing) questions women ask through every age and stage of their lives/by R. Scott Thornton, MD and Kathleen Schramm, MD.

pages cm

Includes bibliographical references and index.

ISBN 978-1-62636-419-6 (alk. paper)

1. GynecologyMiscellanea. 2. Generative organs, FemaleMiscellanea. 3. WomenHealth and hygieneMiscellanea. I. Schramm, Kathleen. II. Title.

RG121.T486 2013

618dc23

2013031956

ISBN: 978-1-62636-419-6

Printed in the United Sates of America.

Disclaimer

This book is intended as a reference volume only, not a definitive medical manual. The information is provided to help you make decisions regarding your health, but it is not intended to replace your medical doctors. This book should help you engage your doctors in meaningful discussion, but not replace their advice. If you suspect that you have a medical problem, you are encouraged to seek a professional healthcare provider. Prescribed medications and treatments should not be changed or discontinued without consulting the prescribing doctor and no new medication or treatment should be started without consulting a qualified healthcare provider.

Mention of specific brand name products, authorities, companies, and organizations does not imply endorsement of these by the authors or publisher. In addition, mention of specific companies, organizations, and authorities does not imply that these entities endorse the authors or the publisher. The brand names for drugs mentioned in this book are registered trademarks of their respective companies. The Internet addresses provided in this book are accurate as of the time this book went to press.

Acknowledgments

The authors would like to thank the following colleagues who have reviewed our book to ensure that its content is accurate and up-to-date:

Martin F. Freedman, MD

Co-Director

Division of Reproductive Endocrinology and Infertility

Temple University School of Medicine

Enrique Hernandez, MD, FACOG, FACS

The Abraham Roth Professor and Chair

Department of Obstetrics, Gynecology, and Reproductive Sciences

Section Chief, Gynecologic Oncology

Temple University School of Medicine

Beth Baughman DuPree, MD, FACS

Medical Director of the Holy Redeemer Breast Health Program

Adjunct Assistant Professor of Surgery at the University of Pennsylvania

Dr. Charles Lockwood, MD, MHCM

Dean, College of Medicine

Vice President for Health Sciences

Professor, Obstetrics and Gynecology

Ohio State University, Wexner Medical Center

The authors would also like to thank our agent Rita Rosenkranz (www.ritarosenkranzliteraryagency.com) for her encouragement and support in finding a home for our book and Emily Houlihan, our editor at Skyhorse Publishing, for polishing our text as needed.

Foreword

Having practiced obstetrics and gynecology for decades, I can tell you that our world can be a frightful place for any woman who doesnt know what to expect. Having come from a large extended family, I answer questions weekly from third cousins once removed about every aspect of their obstetrical and gynecologic concerns from pregnancies to ovarian cysts. However, not every woman has such a resource! One alternative to having a gynecologist for a relative is the Internet. But I have found that the explosion of data pouring out from the Internet can be paralyzing. Whom do you trust? Are you looking in the right place? Why are there so many different answers? These are only a few of the obstacles that women face before gathering the courage to make an appointment with their gynecologist.

I have known Dr. Scott Thornton since my medical student days. He was my chief resident and a terrific mentor: wise, well informed, and unflappable. Dr. Kathleen Ann Schramm adds her unique perspective as a psychiatrist. Together, they make a perfect team to render obstetrics and gynecology understandable to the lay audience, to serve as every womans family doctor.

Over the years, I have dedicated much of my time to writing, reviewing, and editing numerous journals and textbooks to educate current and future physicians and I do it now on a daily basis as a dean. I have also spent countless long and sleepless nights caring for women with complicated and high-risk pregnancies. Needless to say, I have a little bit of experience in this field. Despite being an OB/GYN veteran, I never appreciated how critical the information in this book will be to women until I read it.

Throughout this book, Scott and Kathleen review the very basic to the very complex while keeping it easily digestible for those who do not have an RN, PA, CNM, MD, or DO behind their names. They give you honest and accurate information and advice on a variety of problems from yeast infections to breast cancer. Even more importantly, they keep you well apprised of some of the controversies in our field that could be important to you as you seek advice from your physician. Ultimately, you are getting an insiders view of the field of gynecology from a great physician team. Forget trying to find a doctor to join your family, as you now have a trusted gynecologist at your beck and call.

Dr. Charles Lockwood, MD, MHCM

Dean, College of Medicine

Vice President for Health Sciences

Professor, Obstetrics and Gynecology

Ohio State University, Wexner Medical Center

Authors Note

Throughout Ask Your Gynecologist , we often include complementary and alternative medical (CAM) treatments for various gynecologic disorders. Complementary and alternative options are gradually gaining acceptance, not just with the public, but also with traditional medical practitioners. In some cases, their use is long overdue, but in other cases we seem to be putting the cart before the horse. In other words, herbs and supplements are often utilized without well-designed studies demonstrating their efficacy and safety. Keep in mind that the FDA (Food and Drug Administration) does not approve or regulate the manufacturing or sale of herbs and supplements.

The United States Pharmacopeia does enforce some standards in the manufacturing process. Companies that produce herbs meeting their requirements have the USP Dietary Supplement Verified seal of approval on their label. Looking for herbs with this stamp can help reassure you that you are buying a product with some quality.

You can join www.ConsumerLab.com, which conducts independent research on herbs and supplements. Also, if a label or advertisement says that a product has been scientifically tested, consider contacting the company for a copy of the study. Your doctor can review the study and help you determine the value of the research, the potential benefits of the herb or supplement for your condition, and the likelihood of adverse reactions based upon the study. Many doctors remain open to CAM treatments, even those that do not appear in traditional medical journals, but they will usually demand reasonable evidence of efficacy and safety based upon well-designed research. Just like traditional FDA-approved medications, herbs and supplements can have the potential for side effects and adverse reactions; you cant assume that a product is effective or safe just because it says so on the label or is available over the counter.