Answer: Ovarian cysts can form at any time and can be a normal part of the function of the ovary. These cysts, related to ovulation, go away with time. The problem is that cysts may be related to pathologic conditions including malignancy and may need surgery. The critical nature of an ovarian cyst is determined by the characteristics it has as seen in an ultrasound or sonogram, an exam generally performed at a radiology office. If surgery is needed, the approach may be laparoscopic, robotic, or a laparotomy (opening the abdomen) depending on the patient’s history, age, and the clinical impression of the nature of the cyst and the symptoms it may cause.
Answer by James Barter, MD
Question: Lately, I have not heard much about the HPV vaccination for teen girls and boys. Is this vaccination still recommended? What cancers are prevented with the HPV vaccine?
Answer: The Centers for Disease Control recommends that boys and girls initiate the HPV vaccine series at the ages of 11 or 12. In January 2016, 69 National Cancer Institute (NCI)-designated cancer centers issued a call to action to urge HPV vaccination for the prevention of cancer. These centers urge completion of vaccination by 13 years of age. The call to action also encourages young men up to age 21 and young women up to age 26 to get vaccinated if they missed the younger age targets.
The HPV vaccine practically prevents all anal and cervical cancers and some cervical cancer percursors. It also prevents other genital cancers and some HPV related head and neck cancers.
Answer by Ebony Hoskins, MD
Question: I just read an article about the LARC method of contraception. What is that?
Answer: LARC stands for Long Acting Reversible Contraception and is currently the first line recommendation from the American College of Obstetrics and Gynecologists as well as the American Academy of Pediatrics. It includes methods of pregnancy prevention that don’t require daily, weekly, or monthly use. Because they are “user independent,” they have a higher efficacy rate and work better for birth control than the other options. The methods include Nexplanon, a 3-year progesterone only implant that is painlessly inserted on the inner side of the arm, and Intrauterine Devices (IUDs) that are inserted into the uterus. There are currently 4 IUD options available and can last 3, 5, or 10 years. Both Nexplanon and IUDs are terrific for females of any age in need of safe, easy, and effective contraception. These methods, with the exception of the 10-year copper IUD, can help with painful and heavy periods even if not being used for pregnancy prevention.
Answer by Diane Snyder, MD
Question: I have very painful periods. Could it be endometriosis and how is it treated?
Answer: Endometriosis is a common disease that can affect up to 20% of women of reproductive age. The exact cause of this disease is still not clearly known although we think “retrograde menstruation” may be the reason. In endometriosis, during menses, tissue from the lining of the uterus travels backwards through the fallopian tubes and actually implants into the pelvis and the abdomen, the most common locations tend to be on the ovaries or around the uterus. Endometriosis can be associated with painful periods, pain with intercourse and bowel movements, excessive bleeding, as well as infertility because of scarring around the fallopian tubes. Ovarian cancer can also occur at a higher rate in women with a history of endometriosis.
Although many women have menstrual cramps, women with endometriosis typically describe menstrual pain that is worse than usual and increases over time. The severity of the pain is not associated with the extent of endometriosis; women with little endometriosis can have severe pain, and women with extensive endometriosis can have no pain at all. Early diagnosis, by visualization and pathology of resected tissue during surgery, and treatment can minimize the development of complications. Treatment for endometriosis includes medication or surgical removal of all the endometriosis to provide the most relief from the symptoms and complications associated with this disease.
Answer by Albert Steren, MD
Question: I have concerns about my health because of a history of cancer in my immediate family. What can I do to find out more about my risks and reduce my likelihood of developing cancer in my future?
Answer: Mutations or changes in genes passed from parent to child can drastically increase the risk of many diseases including many types of cancer. In the past, there was little, if anything, that could be done to detect these gene mutations. Today, because of the dramatic advancements of the past 20 years, we can test for the existence of these gene mutations.
When you share your family history with your healthcare provider, this information can help guide healthcare decisions and allow for a proactive approach. A good example of this is BRCA gene testing. In many families with women (or men) who have certain conditions, such as breast cancer, ovarian cancer, or even prostate cancer, there exists harmful changes in the BRCA gene which can increase the risks of these cancers by as much as 85%. Although the risk of having the BRCA gene mutation is higher among Ashkenazi Jews (1 in 40) these gene mutations are found in all ethnic groups. We can easily test for these genetic changes using either blood or saliva. These tests, covered by most insurance programs, can help you and your healthcare provider develop risk-reducing strategies and inform good decision-making. A good place for women to start is by having a conversation with your OB/GYN about your individual health history.