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Old 04-24-2006, 05:39 PM
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Lori Ann Lori Ann is offline
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Wink 25 Trade Secrets of Top OB/GYNS (Part One)

What should you do if you have an abnormal Pap test? What's a great way to feel sexier in bed? How do you handle that 1 week of the month when you take on more water than the Titanic?

The doc who has the answers to all those questions is the one who knows you literally inside out: your OB/GYN. Unfortunately, most of us don't get enough time to ask everything we want to know during our once-a-year visit--a good portion of which is spent in a position that's not conducive to conversation. So we did the asking for you.

Here's the best advice from 15 of the nation's sharpest experts.

Tips 1-3
1. Abnormal Pap? Ask for this test.
The sexually transmitted human papillomavirus (HPV) is the culprit in virtually all cases of cervical abnormalities and cervical cancer. So if your Pap is abnormal, ask your doc to check for HPV.

If you test negative for the virus, it's unlikely your abnormal Pap was due to anything serious, and there's no need for further testing, says Carolyn D. Runowicz, MD, director of the University of Connecticut's Comprehensive Cancer Center and a vice president of the American Cancer Society.

If you test positive, however, your doctor should follow up with a colposcopy, a procedure that involves looking at the cervix with a special magnifying scope and probably taking a small sample of tissue to biopsy. To date, there's no treatment for HPV, which often resolves on its own. Many of the abnormalities caused by the virus will clear up over time as well; your doctor should monitor them.

2. Avoid the unkindest cut.
Has your OB/GYN recommended a hysterectomy for your heavy bleeding problems? Don't sign the release form too quickly. "When it comes to reducing heavy abnormal bleeding, we have newer and less-invasive options available," says Andrew M. Kaunitz, MD, professor and assistant chairman of the department of obstetrics and gynecology at the University of Florida Health Science Center Jacksonville.

Ask your doctor about the latest in hormone therapies, technologically advanced outpatient procedures (one uses heat to destroy the lining of the uterus, the usual source of the bleeding), or how you can use birth control pills for continuous menstrual suppression.

3. Get emergency protection before the emergency.
The biggest mistake women make when it comes to emergency contraception: not having it at home. "It's not just for singles," says Sarah de la Torre, MD, an OB/GYN in Seattle. "Married women should keep it on hand, too."

Pills such as Preven and Plan B can cut your risk of unintended pregnancy by as much as 89% if taken in the first 72 hours after intercourse. (These pills don't terminate an existing pregnancy.) The sooner you take them, the more effective they are. So ask your OB/GYN to write you an Rx now, with the option for refills. Then stash the pills and the refill slip in your medicine cabinet. (Most emergency contraceptives last a year or two.)

4. Pick the perfect birth control.
Newly single, travel a lot, hopelessly disorganized at home? Tell your doc about your lifestyle. It will help her advise you on the right birth control method for you.

"Choosing a contraceptive is a huge decision, and yet most women spend more time planning a week's vacation," says Donnica Moore, MD, founder of the women's health Web site DrDonnica.com. There are now more contraceptive choices than ever, so you can find your ideal match.

Want to be übercareful during your postdivorce dating? A condom paired with a diaphragm or cervical cap provides both birth control and protection against sexually transmitted diseases (STDs). Likely to misplace your contraceptives? Try the intrauterine device (IUD). It's good for up to 10 years (and, contrary to popular wisdom, doesn't cause infertility). The IUD is also a good choice for frequent business travelers or anyone who has a hard time remembering to take the Pill. Other matches for the girl on the go and the one who's forgetful: the patch (you wear it for a week at a time) and the ******l ring (which you leave inserted for 3 weeks).

5. Learn the secret of the ouchless mammogram.
Having your breasts compressed for a mammogram--a necessary evil, since a flattened breast provides a clearer image--is no one's idea of comfortable. But you can take the sting out and even get a better image by scheduling your mammogram for the week after your period ends.

"Ideally, you should schedule it for the first or second day after," says Mitchell Essig, MD, an OB/GYN and associate professor at New York University Medical School. That's when the glands in your breasts are the least swollen and sore, and also least likely to obscure surrounding breast tissue.

6. Bail on the bloat.
If you're on the Pill, switching to the Yasmin brand can help reduce a menstrual potbelly caused by water retention, says Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at Yale University School of Medicine. It contains a progestin, the synthetic form of the natural hormone progesterone, that acts as a diuretic.

De la Torre offers these additional fixes: Take vitamin B6; drink more water (it flushes you out); eat a diet rich in fiber, fruits (grapefruit is particularly good), and veggies (they keep things moving, too); stay away from salty foods (they make you retain fluid); limit caffeine; and exercise.

7. Don't supersize.
To avoid a urinary tract infection (UTI), use the lowest absorbency tampon possible. Jumbo tampons can obstruct the bladder and prevent it from emptying completely, says Minkin. (It's easier for bacteria to multiply when urine stays in the bladder for a long time.) Added risk: During your period, the warmth and moisture of blood provides a friendly environment for germs.

8. Give him time to recharge.
If you have a 28-day menstrual cycle and are trying to get pregnant, have sex on days 12 through 16 of your cycle (for a 32-day cycle, have sex on days 16 through 20), but don't do it more than once a day, says Minkin. (Begin counting on the first day you get your period.) The 24-hour rest between the times you make love allows your man's sperm count to return to its normal level.

9. Want to conceive? Avoid these medications.
Taking any aspirin or nonsteroidal anti-inflammatory drugs such as ibuprofen and ketoprofen at midcycle can upset the timing of ovulation, so it's harder to know when you're most fertile. Instead, take acetaminophen-based pain relievers such as Tylenol, recommends Minkin.

10. Take it all off.
"Get into bed naked, with or without a partner," advises de la Torre. "You're under the covers so you're covered up, but bit by bit you're desensitizing yourself to being uncomfortable about being naked. Accepting your body is the easiest way to feel sexy, and confidence is the sexiest attribute."

11. Switch to the cap, reduce UTI risk.
If your diaphragm is giving you recurring urinary tract infections, ask your OB/GYN about switching to the recently FDA-approved FemCap, a rubber barrier that fits snugly over the cervix. It's less effective than the diaphragm, but it's not as likely to cause a UTI. Diaphragms can press against the urethra, the tube that carries urine outside the body. That allows urine to pool in the bladder, which can lead to infection, says Minkin.

12. Rx for a sexy night.
"If you're self-conscious about normal ******l odors and are planning a romantic night, try snacking on fruits such as pineapples and strawberries," advises Lisa Masterson, MD, an OB/GYN in Santa Monica, CA. "They'll sweeten your juices." If you're heading out for a cozy dinner, skip the blue cheese, garlic, and asparagus because they can cause off-putting ******l odors. Not a fruit lover? Dab scented oil in the crease between your inner thighs and buttocks. (Test for sensitivity by putting a dot of oil under your arm first.)

13. For pain-free nursing, get a grip.
The classic breastfeeding pose--baby's head nestled in the crook of mom's arm--is idyllic but far from ideal, at least for beginners, says Deborah Hubbard, a lactation specialist at the University of Iowa Hospitals and Clinics in Iowa City.

Why? It's hard to control baby's head with the crook of your arm. And having adequate control of her head is key to getting her latched on to the breast properly, with her mouth covering most of the areola. Poor positioning is a leading cause of nipple soreness. While sitting, try these holds, which put baby's neck and lower head in your hand, to increase your comfort.

Cross cradle
Place your baby on her side, across your stomach, on a pillow, with her lower arm around your side. To nurse on your left breast, your right hand supports baby's neck and lower head, and your left thumb and index finger are at a 9 and 3 o'clock position on the breast. Wait for baby to open wide like a yawn or cry, and bring her to your breast. Reverse for right breast.

Football hold
Place your baby on her back at your side, on a pillow. To nurse on your right breast, your right hand supports her neck and lower head, your left thumb is on top of the breast, and your fingers are underneath the breast. Wait for baby to open wide, and bring her to your breast. Reverse for left breast. (This is especially good for C-section moms because it keeps the baby off a sensitive abdominal incision.)
Reprint from Prevention Magazine

Lori Ann
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