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WPMG Newsletter -- Volume 7 Issue 3 -- July 1, 2010 Index El Camino Women’s Hospital Awarded 5 Stars! Pertussis is Epidemic in California Intimacy and Sexuality in Women Screen for Decreased Sexual Desire New Website on Health-Care Insurance Options Announcement for Users of Vagifem®
El Camino Women’s Hospital Awarded 5 Stars!
WPMG is proud to be associated with the Women’s Health Program at El Camino Hospital, which just received two awards from HealthGrades, the leading independent healthcare ratings company. El Camino earned a 5 star (highest) rating in Maternity Care, placing it in the top 10% of hospitals nationwide. Only 150 hospitals in the U.S. have earned a 5 star rating. El Camino also received a 5 star rating for the 4th year in a row for Women’s Health. ECH is the only hospital in California to garner this prestigious ranking. Having achieved these accolades, El Camino Hospital joins an elite group of only 19 hospitals in the entire country to be honored with 5 star awards in both of these women’s health categories and reflects the hospital’s continuing commitment to the health and well-being of Silicon Valley women. Go El Camino! It’s no wonder we have so many satisfied patients who get their care with us.
Pertussis is Epidemic in California
In 2010, California is on pace to have the highest number of pertussis (whooping cough) cases in 50 years. The number of whooping cough cases so far this year is more than four times the number for the same period last year. Young infants are most vulnerable to the devastating effects of pertussis. Thousands of infant hospitalizations are anticipated. Already several newborns have died. In most cases, infants catch pertussis from a family member or household contact. So, it is important to make sure that everyone is protected from pertussis by vaccination – children, adolescents, and adults, especially those with close contact with infants. Neither vaccination or illness from whooping cough provides lifetime immunity. WPMG has Tdap vaccinations available and strongly recommends everyone be up-to-date with vaccinations, but especially anyone exposed to infants, including moms, dads, grandparents, siblings, and child care providers. We will provide vaccinations even to people who are not our regular patients. Information for pregnant women can be found at http://eziz.org/PDF/IMM-887WC_Pertussis_Preg.pdf
Intimacy and Sexuality in Women
We’d like to talk about a subject that’s been ignored for too long. Intimacy and sexuality is an important component of one’s quality of life and often a necessary ingredient for healthy relationships. The doctors at Women Physicians Ob-Gyn recently hosted a Sexuality Round Table inviting a broad range of other health care providers in our community, including urologists, psychologists, sex therapists, and pelvic floor physical therapists. This confirmed what we had learned from our patients. At least 40% of women admit to having some sort of sexual problem and about 20% are significantly concerned about it, yet only half of those have ever discussed it with their doctors. If you have been suffering in silence, it’s time to speak up. Due to the complexity of the subject, we would encourage you to make a separate consult appointment since the annual exam doesn’t include enough time to do it justice.
What’s normal? The frequency of sex varies with age, cultural norms, and circumstances. There is no right or wrong. According to Dr. Brizendine’s books, The Female Brain and The Male Brain, men are wired to have a stronger sex drive than women. Frequency is only a problem if one or both partners feels it is a problem.
What are typical problems? The 4 most well defined sexual problems are low desire or low libido, decreased arousal, decreased orgasm, and pain. The most common is low desire, also called hypoactive sexual desire disorder (HSDD), which occurs in 25% to 35% of women. The 4 problems are all very intertwined. For example, if intercourse is painful, it will quickly result in a decreased desire and decreased arousal. Likewise, if a woman doesn’t experience orgasm, she is less likely to experience normal desire. Low libido means no thoughts about sex, fantasies, initiation of sex, and possibly even rejection of advances.
What are causes of low libido? It’s important to explore all the possible causes of decreased desire. Sometimes this may be the relationship itself. If there are any underlying hostilities, even as simple as conflict regarding not taking out the garbage, the interest in sex can decrease. It’s said that foreplay starts 24 hours before sex, meaning women are turned on when their partner is attentive all day long, and not just at the time of intimacy. A woman’s overall stress and mood is also very important. If there are many distracting situational issues going on, most women will not place sex as a priority. Depression and anxiety often interfere with sexual function. Pain can be a major turn-off. After only 1 or 2 encounters a woman may become fearful and averse to sexual advances. It is important to review medications carefully. The most obvious culprits are the SSRIs like Prozac, Zoloft, Paxil, Celexa, or Lexapro which decrease interest in 70% of users. The newer combination SSRIs/SNRIs (Effexor, Cymbalta, Pristiq), though less likely to adversely affect sexual function, may still present a problem. SNRIs like Wellbutrin can sometimes improve libido, but not always. Other meds like diuretics and antihypertensives can also affect libido. Hormone changes affect interest in sex. Decreased estrogen of menopause can result in vaginal dryness and pain with intercourse. Sleepiness and need for sleep may take priority over interest in sex. The decreased androgens associated with surgical removal of ovaries can directly contribute to decreased libido. Body image affects how one feels in a sexual relationship. If women do not feel comfortable with their appearance, they may avoid being seen without clothes. This often happens after childbirth or as women get older and put on unwanted weight or lose muscle tone.
What can you do to improve your sexual function? One of the first important steps is communication with your partner. Tools like the book Hot Monogamy or the website http://www.sexbrainbody.com, which includes a sexual satisfaction check-up under resources, can be good places to start. It is helpful to increase focus on sex and think of it as a priority. The more you think about it, the more interested you will be in it. Spend time thinking of ways to make it more enjoyable or to break down the barriers that are interfering with your pleasure. Learn to be in the moment during sex. Don’t try to multitask. Make sex separate from your feelings of anger, stress, or fatigue. Consider how to increase stimulation and interest. Sometimes exercise, sexy clothes, books, and videos can increase stimulation. Be creative. Sexy dancing or sensual massage or showers may be a good starting point. Lotions, smells, and soft materials may all enhance your senses. Other helpful self-help websites include http://www.sexandahealthieryou.org/sex-health/index.html, http://www.acog.org/publications/patient_education/bp072.cfm . If you need a jump-start, don’t hesitate to see a sexual counselor who is specially trained in evaluating and treating sexual difficulties.
When should you see a doctor? If you have a good relationship with your doctor and your doctor is knowledgeable in the field of sexual function (as the doctors are at WPMG), make a consult appointment to discuss your concerns regarding sexual function. Your doctor may be able to discontinue medicines that are contributing to your problem or discuss changes in medicines that might help. Your physician can determine if lack of estrogen is causing vaginal dryness, and explore options for treatment. Prescriptions for androgens (male hormones) may be helpful but these are not FDA-approved for this purpose, so you will need a full discussion of the risks and benefits. The FDA is also considering a new medicine for treatment of HSDD, though a recent advisory committee felt the benefits did not justify the risks. WPMG will stay up-to-date with any new medicines that become available. For many couples, sexual counseling or pelvic floor therapy is the treatment of choice. We can refer you to specialists that are most likely to be able to meet your needs.
Are you concerned about your lack of sex drive?
Screen for Decreased Sexual Desire
1. In the past was your level of sexual desire or interest good and satisfying to you? Yes/No 2. Has there been a decrease in your level of sexual desire or interest? Yes/No 3. Are you bothered by your decreased level of sexual desire or interest? Yes/No 4. Would you like your level of sexual desire or interest to increase? Yes/No 5. Please check all the factors that you feel may be contributing to your current decrease in sexual desire or interest:
A. Any surgery, depression, injuries, or other medical condition [] B. Medication, drugs, or alcohol you are currently taking [] C. Pregnancy, recent childbirth, menopausal symptoms [] D. Other sexual issues you may be having (pain, decreased arousal or orgasm) [] E. Your partner’s sexual problems [] F. Dissatisfaction with your relationship or partner [] G. Stress or fatigue []
If your answers to the first four questions are “yes”, it’s time to make an appointment with your doctor at Women Physicians Ob-Gyn.
New Website on Health Insurance Options
On July 1, the new website, www.HealthCare.gov, went live. This year's health-care overhaul bill mandated creation of the site to allow users the ability to see what their private and public health care options are. These options will change as different phases of the health-care bill come into effect over the next four years. At present, the site is most useful to small business owners and individuals looking for health insurance. The site will become even more user friendly inOctober when price/plan feature comparison charts will be readily accessible.
Announcement for Users of Vagifem
Many postmenopausal women use Vagifem® for vaginal dryness. The manufacturer, NovoNordisk, is discontinuing the current dose of 25 micrograms and replacing it with a dose of 10 micrograms. This is not because the safety of the current dose has been questioned, but rather because of a general philosophy of always using the lowest possible dose of estrogen to meet an individual's needs.
When you go to renew your current prescription of Vagifem®, your pharmacist will need to contact us to get a new prescription for the 10 microgram dose. We are supportive of using this new dose, and encourage you to try it. Please allow ample time for us to call or fax your pharmacy with a new prescription. This will be especially true for the mail-order pharmacies where there may be a delay for new prescriptions compared to refills.
If the lower dose is not sufficient to meet your needs in terms of vaginal dryness, please make an appointment so we can discuss alternatives.
inspiring and empowering 24 hours at Cuesta Park on May 22/23. This team event fights back against cancer by celebrating survivors, remembering loved ones, and raising money for cancer research and services. Thanks to all of our committed donors and teammates, we were the #1 fundraising team, raising almost $16,016.82. Dr. Sutherland was the #1 individual fundraiser, raising $6,845.00. Our teammate, Mary Ding, was in the top 3 fundraisers with $4,761.82. Go team!
We also had a lot of fun. Our booth raised awareness of cervical cancer and the HPV vaccine to prevent cervical cancer. Since golf balls look a little like an HPV virus, we had a “Guess the number of golf balls” game with 559 golf balls in a wire container. The winner got, you guessed it, golf balls. Thanks to all our teammates who brought lots of healthy snacks to our booth to keep the team going all night and day.
Excellent bands and entertainment were provided all day, thanks to our office manager, Randy Kensing, who was the Entertainment Chairman for the event. Our team member, Judy Scott, did an outstanding job as the Co-chairman for Registration which ran very smoothly. Dr. Sutherland, as Fight Back Chairman, would like to extend special thanks to our team members, Brenda Ziegler, Stephanie Kensing, and Jayna Sutherland who helped at the Fight Back booth. A special thanks also goes to Beth Marer-Garcia who wore the grape outfit as a Fight Back message to Eat Right! And a very special thanks to Kimberly and Madison Brown, Dr. Christine Litwin, and Barbara Dehn who all helped with the Fight Back skit, which got great reviews.
We are always looking for new team members to join us in this great event. Each team member is asked to raise $100 and to walk for an hour around the track at beautiful Cuesta Park. If you are interested in joining our team, forming your own team, or serving on the Steering Committee, please contact Dr. Sutherland at 650-988-7550 or go to www.RelayForLife.org/mountainviewca.
For more pictures, visit the Women Physicians OB/GYN Facebook page. We invite you to become our fan!
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Information on this website is for educational and reference purposes only and should not be interpreted as specific medical advice.
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