Contraceptive Management and Menopause

by Bethany King WHNP

Votiva Vaginal RejuvenationContraception management is a large and very important topic for discussion and can only be briefly covered in the following paragraphs. Contraceptive options, both hormonal and non-hormonal, are used by approximately 60% of all reproductive age women. Most often, women use contraception to prevent pregnancy or to have healthier pregnancies by delaying childbearing until ready. It can also be used to help time and space births and achieve one’s desired family size. However, the term “contraceptive management” is misleading as hormonal options for contraception are also commonly used to treat very heavy menstrual periods, painful menstrual periods, and pelvic pain. In this regard, contraceptive management is often used to treat women who may not be sexually active or desiring fertility.

Contraceptive methods include the pill, flexible rod implants (i.e. Nexplanon), injections, hormone and non-hormonal intrauterine devices (IUD), patches, vaginal diaphragms, and condoms. With consistent and correct use, unintended pregnancies can be dramatically decreased by about 99.98%. Current medications, health diseases, as well as weight can adversely affect the efficacy of contraceptive options and it is important to discuss this in detail with your health care provider. It is also important to understand that contraceptive options do not prevent sexually transmitted illness such a gonorrhea, chlamydia, HIV, herpes, syphilis, hepatitis, and human papilloma virus (HPV). If you are concerned about possible exposure or symptoms, testing is recommended.

As mentioned above, hormonal contraceptive methods can also provide a number of gynecologic health benefits such as treatment for excessive menstrual bleeding, menstrual pain, menstrual cycle irregularity, menopause symptoms during perimenopause, acne, and excessive hair growth. Treatments are highly individualized. Appropriate contraception counseling with your provider is extremely important when considering hormonal or non-hormonal methods for contraceptive or non-contraceptive purposes.

McDowell Mountain Gynecology Supplements

As women age beyond reproductive years, it is the natural progression to be faced with changes associated with perimenopause and menopause. The average age of menopause is between the ages of 45-55 y/o, with a median age of 51 y/o. Menopause is defined by the lack of a menstrual period for 1 year. Symptoms of menopause or “perimenopause” can begin up to 10 years prior to menopause! Menopause is associated with a decreased production in ovarian estrogen and other hormones which is often accompanied with vasomotor symptoms such as hot flashes, night sweats as well as symptoms of mood irritability, mental fogginess, vulvovaginal atrophy, vaginal dryness or painful intercourse. As you can imagine, all of these symptoms can interfere with quality of life and vitality as we age! A detailed medical history and a trusting provider-patient relationship can help women transition better into menopause. Both hormonal and non-hormonal treatment options are available. Hormonal options include low dose oral tablets, topical creams and gels, lozenges, hormonal pellets, and vaginal estrogen or DHEA. Based on the patient’s symptoms and needs, bioidentical hormone therapy may be a preferred option. If a woman has not undergone a hysterectomy, it is imperative that estrogen therapy be combined with low dose progesterone for uterine protection. Non-hormonal options include mood stabilizing medications such as SSRIs, SNRIs; non-pharmacologic and over the counter options; and cognitive-behavioral therapies. Just like contraceptive management, menopause symptom management is highly individualized and counseling with your provider is recommended.

If you would like more information or want to discuss an individualized treatment plan with our providers, call McDowell Mountain Gynecology for an appointment today! 480.483.9011

Bethany King WHNP and our providers are excited to take care of your Women’s Health needs!

What You Need To Know about Labial Reduction in Arizona?

Labial Reduction

When you decide to undergo any type of cosmetic surgery, it can be one of the most personal – and often private – decisions that you make. This is especially the case with a labial reduction in Arizona because many women feel they have no one to talk to because the subject is so personal. Following are some of the most frequently asked questions we receive about labial reduction, otherwise known as labiaplasty.

What is a labiaplasty procedure?

A labiaplasty is a surgical procedure that is performed to reduce the size of the labia, which are the inner and outer folds of the vulva, at either side of the vagina.

The purpose of the procedure is to create a neater and more symmetrical appearance to the inner and outer labia. The labia are not removed in this procedure, as they are needed to protect the delicate inner areas.

Why would a woman need labial reduction in Arizona?

Approximately a third of women choose to have the labiaplasty procedure for aesthetic reasons because they aren’t happy with the appearance of their labia. Other reasons for surgery include discomfort when inserting a tampon, inflammation, and pain during sex, or general chafing when performing day-to-day activities.

How long does the procedure take?

Although the surgical procedure is quite complex, it is relatively quick and usually takes just 15 minutes to an hour. The procedure is typically performed under general anesthesia.

What is the recovery and downtime like following labia reduction in Arizona?

Many patients take one week off from work, but some patients have been known to take up to three weeks off. The length of your recovery will depend on the type of work you do and your recovery rate. Patients typically experience swelling and discomfort for the first week following the procedure, but it typically begins to subside after the second week.

You will be able to bathe or shower after the procedure, but you must avoid using tampons, exercising, and engaging in sexual intercourse for 3-4 weeks or until the area is fully healed. You will also need to refrain from driving for at least a week until you get the all-clear from your surgeon.

What is the difference between labia reduction in Arizona and vaginoplasty?

A common misconception is assuming that a labiaplasty is the same as a vaginoplasty. A labiaplasty is a procedure that reduces the size of the labia, whereas vaginoplasty usually refers to tightening of the vagina.

What are the risks and complications associated with labiaplasty surgery?

 All surgical procedures come with some level of risk and this usually includes inflammation and infection. The best way to avoid risks and complications is to choose an experienced and qualified surgeon who performs the procedure on a regular basis.

Have we answered all of your questions?  To find out more about a labial reduction in Arizona, call our office today to schedule a consultation. We can discuss your goals with regard to the procedure openly and honestly and put you completely at ease.

10 Things You Didn’t Know About Having A Dilation and Curettage in Arizona

Dilation Arizona

Dilation and curettage in Arizona are performed to remove tissue from inside the uterus. Doctors perform dilation and curettage (D&C) to diagnose and treat certain uterine conditions – such as heavy bleeding – or to clear the uterine lining after a miscarriage or abortion.

It is considered an outpatient procedure, and most patients who do not develop any complications leave the hospital within a few hours. There are also different ways to undergo this surgery and different uses for it that are not limited to miscarriage.

Here, we list 10 facts about dilation and curettage in Arizona that not all women know.

1. It’s not just for miscarriages. The most well-known requirement for a D&C procedure is a miscarriage. It can also be performed to determine the reasons behind symptoms like irregular bleeding and pain.

2. It can be a treatment option. D&C procedures do not only have diagnostic purposes – they are also treatment options. It can enable a doctor to remove a molar pregnancy, a case in which a tumor grows in place of a normal pregnancy. It is also done postpartum in women whose placenta does not fully clear after birth.

3. Preparation starts one day prior. Being a one-day procedure, one would think that it is okay to relax and only start worrying upon admission to the hospital. The procedure itself may take 10-15 minutes, but preparing for it starts the day before.

4. There are different kinds of anesthesia. The anesthesia used to perform a dilation and curettage in Arizona varies greatly. Some women request general anesthesia and are therefore unaware of what is going on. Others go for spinal or epidural anesthesia. In rare cases, women could be given local anesthesia.

5. No driving is allowed. Although this a short procedure, its effect lasts for some time. As with any invasive surgery, there are feelings of tiredness afterward. Also, anesthesia could cause a person to be drowsy and unfocused, even after the anesthesia wears off and they wake up, so no driving is permitted.

6. It takes some time. After the procedure is performed, some women need some time to wake up from the anesthesia. Even after that, leaving the hospital is not easy. After such a tiring procedure, women are usually too tired and need all the rest they can get.

7. The risk for possible infections. One of the rare complications that could result from a D&C is an infection. It could be due to exposing a vulnerable place of the body, an inner organ, to the environment.

8. The risk of internal damage. Another RARE complication is the chance of uterine perforation. Cuts or tears are also possible and are usually treated at the moment to stop any bleeding.

9. After effects can be painful. After the surgery, there are some scary symptoms that may crop up. They make women feel bad, but they are normal byproducts of the operation and should not cause alarm.

10. Remove the everything after: Feelings vary from woman to woman, depending on the situation. If the surgery is performed after a miscarriage, a woman may still be grieving the lost baby. The exhaustion and trauma of having to go through surgery when a woman already feels horrible are not to be underestimated.

If you would like more information – or have questions – regarding dilation and curettage in Arizona, call our office today to schedule a consultation.  We’ll answer your questions, address your concerns and put your mind at ease.

Breast Cancer Screening

Breast Cancer Screening

Breast cancer is the most commonly diagnosed cancer in women in the U.S. and the second leading cause of cancer death in American women. It accounts for 30% of all new cases of cancer diagnosed in women. A woman’s lifetime risk of developing breast cancer is 12% (1:8). Breast cancer mortality (death) rates have decreased significantly in the past 50 years. This is attributed to early detection and improvements in breast cancer treatment. Regular screening mammography starting at age 40 y/o reduces breast cancer mortality in average-risk women.

While screening provides improved health outcomes, there can also be adverse consequences. Screening can be harmful through false-positive test results and over-diagnosis of benign lesions. Additionally, cost of testing, anxiety, discomfort/pain, inconvenience, overdiagnosis and overtreatment are potential risks. Many women are concerned about the risk of radiation exposure from routine screening. The risk of radiation induced cancer is 2 per 100,000 women. The potential mortality benefit from early detection is 60 fold the risk of radiation exposure. In other words, the benefit of detecting breast cancer far outweighs any risk from radiation exposure. Balancing the benefits and risks of screening has led to controversy of opinion about uniform guidelines for breast cancer screening.

Breast cancer risk assessment is particularly important for identifying women who may benefit from more intensive breast cancer surveillance. Risk assessment and identification of women at high risk for breast cancer in the office setting allows for adequate referral to health care providers with expertise in cancer genetics and counseling, testing for germline DNA mutations (i.e. BRCA), discussion of risk reduction options, and the opportunity to identify other family members at increased risk.

The main risk factors for breast cancer are female sex and advancing age. Other factors have been found to be associated with increased risk, but most women diagnosed do not have identifiable risk factors. Other risk factors include family history of breast cancer, known gene mutation, prior breast pathology showing atypical hyperplasia or lobular carcinoma in situ, early menarche, late menopause, nulliparity, estrogen and progesterone hormone therapy, ethnicity (i.e. Ashkenazi), obesity, alcohol consumption, smoking, and dense breasts.

Currently self breast exams are no longer considered beneficial. Instead, breast self-awareness is recommended. This is defined as a woman’s awareness of the normal appearance and feel of her breasts. It means that a woman should be attuned to noticing a change or potential problem with her breasts. Additionally, women should be educated about signs and symptoms of breast cancer and advised to notify their health care provider if they notice a change. It is recommended that a practitioner performs a breast exam in intervals of every 1-3 years for women 25-39 y/o and yearly for women 40 y/o and older. A clinical breast exam by a practitioner will detect 2-6% more cases of invasive cancer than mammography alone.

Women at average risk of breast cancer should be offered screening mammography at 40 y/o. If they have not initiated screening in their 40s, they should begin screening mammography no later than 50y/o. Screening should be performed every 1-2 years based on patient health and risk factors. Biennial (every 2 years) screening mammography may be a reasonable option for women after 55 y/o. Women should continue screening mammography until at least age 75y/o. Age alone should not be the basis to continue or discontinue screening. Women should continue screening mammography as long as their overall health is good and they have a life expectancy of at least 10 years.

If you have concerns or questions regarding your breast health, please call today to schedule an appointment with Dr. Rachel Spieldoch or a provider at McDowell Mountain Gynecology at 480-483-9011.

Mcdowell Mountain Gynecology is now offering vaginal laser with Selene Touch!

Selene TouchSeleneTouch offers women a minimally-invasive, pain-free, fast, safe and effective solution for many feminine health conditions.

SeleneTouch is an in-office solution requiring no down-time, no anesthesia and minimal sexual interruption.


50% of post-menopausal women, after childbirth, hormonal changes and medications, experience a diverse range of symptoms and side effects including: dryness, itching, and painful intercourse, which affect Quality of Life.

The SeleneTouch micro-ablative laser energy is dispensed in a controlled and uniform distribution into the vaginal wall tissue. The superior design allows the SeleneTouch laser to ablate small micro spots of tissue, while leaving the adjacent tissue intact, thus promoting faster tissue regeneration. This natural tissue regeneration process promotes the restoration of pre-menopausal metabolic activity including new collagen, elastin, and vascularization of the vaginal mucosa.

Increased collagen production, thicker vaginal mucosa and natural restoration of the ablated vaginal tissue allow post-menopausal women to return to their normal lifestyle with comfort, confidence and improved Quality of Life.


The design allows the laser to ablate small micro spots of tissue, while leaving the adjacent tissue intact, thus promoting faster regeneration.

Selene Touch

To learn more about this revolutionary procedure contact McDowell Mountain Gynecology for your consultation today! 480-483-9011.


What Are the Risks and Complications of Dilation and Curettage?


The dilation and curettage procedure (D&C) involves dilating the uterine cervix so that the lining tissue of the uterus can be removed by scraping or suction. It is a safe, minor procedure that is performed for a variety of reasons in a hospital or ambulatory surgery center or clinic. (more…)

Everything You Need to Know About Your Colposcopy in Scottsdale


Colposcopy is a procedure to closely examine your cervix, vagina and vulva for signs of disease. During colposcopy in Scottsdale, your doctor uses a special instrument called a colposcope. (more…)