Finding the Right Gynecologist

finding the right gynecologist The DivaCup

 

Your gynecologist and you share a special relationship – and not just because they are checking out your vagina regularly. Your gynecologist is someone you trust with your health so it is important that you find the right gynecologist for your body and your health concerns.  For this reason, it may not be as simple as calling up the first gyno’s number you see in the phone book. There are many factors that play a part in finding the right gynecologist and the tips below are a great place to start.

Make a “Must-Haves” List

Every gynecologist should meet certain requirements, no matter who you decide on. Every gyno should be certified and educated, experienced with a number of years in the industry under their belt (hehe) and, depending on your body specifically, you can also look for gynos that have a certain expertise. For example, if you are living with endometriosis, you may look for a gyno who focuses on patients with endo.

After these initial must-haves are checked off the list, you should consider the following:

  • Is gender important to you? Everybody has different preferences and experiences, so think about whether you would feel more comfortable with a female or a male gynecologist. This can help you narrow down your list significantly from the get-go.
  • Where are they located? Obviously, you will want to know how close or far your gyno’s office is from where you live and the implications that may have. If you’re willing to have a gyno that is further away, keep in mind that you may not be able to get in for emergency appointments. Take into account your drive time, whether there is public transport stops close by or whether parking will cost you an arm and an ovary.
  • What is included in your health plan? Be mindful that there may be gynos or treatments not affiliated with your benefit package or health plan and ones that are, which may limit your options when it comes to coverage.
  • What are their values? Finding a gyno that shares your views and values is too often overlooked and is actually super important. Whether you are into alternative methods of birth control or really like a gyno with a sense of humor, these are important things to determine before you sign over your vagina to them.

Ask Around

Obviously, walking up to a stranger and asking who they recommend for your vagina may not be the most effective, but getting referrals is an easy way to narrow down your search. You could speak with your regular physician about gynecologists they recommend and get a referral appointment that way, or you could ask family, friends and trusted co-workers if they would recommend their gyno. It’s also important to ask if there is anyone they wouldn’t recommend, which could save you a lot of trouble in the long run.

Do Your Homework

Remember, this is your health so don’t just take someone’s word and leave it at that. Do a little homework and look up your gyno candidates’ credentials, ensure they are properly certified and maybe even look at reviews online from trusted websites.

Make a Consultation Appointment

Narrow down your top choices and make a consultation appointment with each of them. This won’t be an exam, but rather a chance to sit and get to know your potential gynecologist. Don’t leave any stone unturned. Prepare a list of questions you have, from the general to the very specific, and ask each candidate their thoughts. It is important to ask about things that are important to you, whether it is alternatives to the pill or STI testing, so you can get a feel for how you and your potential gyno will groove.

Follow Your Gut

You know yourself better than anyone so don’t feel ashamed of turning down a gyno that seemed perfect on paper but that you just aren’t sure about. There is no shame in putting yourself, your comfort, or your health first. So if something isn’t sitting right with you, keep shopping around. Mindy Lahiri may not actually exist but the perfect gyno for you definitely does.

You Aren’t Stuck

Remember, this doesn’t have to be a permanent relationship. If you end up deciding to go with a gyno and later on find that things aren’t working out the way you had hoped, whether that is because you two have different values or wait times are too long, you are allowed to find a new gyno whenever you see fit.

Are you ready to #GetToYourGyno? Don’t be nervous – you are taking a big step in the right direction for your health. What are some tips you have for finding the right gyno? How did you know when you found her/him? Share your experiences with us on Twitter, Facebook and Instagram!

 

Guest Post: Your Pelvic Floor and The DivaCup

Ah, the magnificent vaginal canal. While many may not use the word magnificent to describe the vagina, we at Diva know how important the vagina is to a women’s health, reproduction, and overall daily comfort. Whether just learning about puberty, or a woman well-versed in all things vagina (and period), there is still lots we can learn from the experts.

Keri Martin Vrbanac is an expert pelvic health specialist who is on a mission to help women find support for their pelvic region (and with The DivaCup). We sat down with Keri, bringing her some case studies that our Consumer Care Team often see from women who are finding some challenges with using a menstrual cup. For some new users, and also some long-time Divas, finding continued success with the cup can take some time as the vaginal muscles (the muscles that hold The DivaCup in place) may require additional support.

The below are just snapshots of the many ways pelvic health physiotherapy can help women find better success with The DivaCup and in turn, better vaginal and pelvic health!

Scenario 1:

I’m a runner and a yoga enthusiast. At 19, I wanted to change my period care routine to a better option so I invested in The DivaCup. I purchased the Model 1 as I am under 30 years old and have not had children. Unfortunately, my experience thus far has not been great. I’m having a really hard time with insertion and rotation. It almost feels as if the cup is too big for me. Please help!

Keri: It is possible that your pelvic floor muscles are hypertonic, or in other words, too tight. Some women with hypertonic pelvic floor muscles may experience pain when using any internal menstrual products or may have pain with intercourse. The only way to know the status of your pelvic floor muscles for sure is to visit a pelvic health physiotherapist in order to have an assessment completed. If it turns out that the floor is too tight, your therapist will educate you on how you can remedy the problem and perhaps return to comfortable use of The DivaCup.

Pregnant person

Scenario 2:

I used The DivaCup for six years before I became pregnant. Fast forward a year and a half and my period has returned. I’m using the Model 2, I am 33 years old and my cup just doesn’t seem to stay in place very well. I am also experiencing leaking; something I have never had an issue with before! I used the Model 1 for a number of years and then switched to the 2 when I turned 30. Could it be that I need the smaller size again?

Keri: There is a possibility that your pelvic floor muscles have become weak following your pregnancy/delivery and are no longer strong enough to hold your cup in place. It is possible for you to strengthen those muscles through proper exercise, but before you begin any form of pelvic floor muscle exercises, you should visit a pelvic health therapist to determine if your pelvic floor is tight or weak, or both. Kegels are not for everyone and in some cases can actually cause more harm than good so consulting with a specialist before incorporating these kinds of exercises is important.

Scenario 3: 

I am 38, don’t have kids and am using The DivaCup model 2. The cup is easy to insert and rotate, but after a few hours, it begins to move up. Around this same time, the cup also starts to leak. I’m sure I am inserting the cup correctly, but when it moves up it makes it difficult to remove. Any advice would be greatly appreciated.

Keri: Your pelvic floor muscles may be hypertonic or too tight. Trying the smaller sized cup may help, but as there is a small difference in the size (Model 1 is 1/8″ (~0.3 cm) smaller), it may be that your muscles need to be elongated or relaxed. Sometimes a smaller pelvis can also affect the tone of the musculature but not always. The only way to know the status of your pelvic floor muscles for sure is to visit a pelvic health physiotherapist to have an assessment completed.

Scenario 4:

I’m 26. I do no have kids and have been using The DivaCup model 1. The cup is amazing. As a nurse I can go an entire shift without worrying about leaks… until I go to bed. While sleeping it seems as though the cup moves lower and begins to leak. Do I need the bigger size? Why is it that it fits fine during the day, even on my painful heavy days, and not at night?

Keri: Just like the rest of the muscles in our body, the pelvic floor muscles will relax when we are resting. Our pelvic floor muscles do not have to work as hard when we are sleeping because we do not require as much support. Position changes throughout the night may cause a shift in the position of the cup as well. Supported sleeping with a pillow between your knees may help maintain a more restful position and prevent frequent position changes.

Scenario 5:

My period has returned after having my fourth child. I’m 39 years old and using The DivaCup model 2. The cup doesn’t seem to want to stay in me. It falls so low that it is essentially falling out. I am really frustrated that I’m not finding success with the cup. All my friends rave about it.

Keri: It is possible that you have a bladder or uterine prolapse which means that one or both of these organs have lowered into the vaginal canal. With less space available, The DivaCup may be pushed downwards. A pelvic health physiotherapist can diagnose a prolapse and work with you to decrease its impact on your life.

Pelvic floor and working out

Scenario 6:

As a gym enthusiast I love lifting weights, I also love The DivaCup, except when it leaks. I find that when I go through my weight routine, the cup begins to move out of place and leak, almost as if the seal has been broken. Could my muscles tense so much that they are breaking the seal?

Keri: Yes, your pelvic floor muscles could be tight OR they could actually be weak. With weight lifting, we increase our intra-abdominal pressure and this in turn causes a downward pressure on our pelvic floor muscles. A pelvic floor physiotherapist can determine the status of your floor and tailor your program to address this issue as well as provide tips for safe exercise and maintaining your pelvic health.

Keri Martin VrbanacKeri Martin Vrbanac

Keri is a Pelvic Health Physiotherapist and the owner of A Body In Motion Rehabilitation in ON, Canada. Keri has been practising physiotherapy since 1997 where she graduated with distinction with her Bachelor of Science in Physical Therapy from the University of Toronto. Keri’s career as a physiotherapist has brought her to Australia, the United States of America and back to Canada where she has settled in Conestogo with her husband and her two amazing little girls! Keri’s passion for pelvic health is contagious and she continues with ongoing education to fuel her passion and remain current. Keri is a member of the Canadian Physiotherapy Association, The Ontario Physiotherapy Association, The International Pelvic Pain Association, The National Vulvodynia Association, and The Association for Continence. You can contact Keri at abodyinmotion@theboardwalkmedical.com.

Endo What? A Documentary on Endometriosis

EndoWhatPosterEndometriosis is a painful and debilitating disease in which endometrial tissue grows outside of the uterus and it affects more women than you think. In fact, an estimated 176 million women around the world have endometriosis. How can this disease be so wide spread and yet barely talked about? The documentary Endo What? is looking to change this by presenting accurate information straight from the experts about this disease. The only film of its kind, Diva International Inc. was proud to partner with the Endo What? team as a sponsor. With its world screening tour continuing throughout March (aka Endometriosis Awareness Month) we thought we would share a bit about the experience! We recently got the chance to speak with Shannon Cohn (Director/Producer) and asked her a few questions:

What was the turning point that led to this documentary’s creation?

We’ve been working on the film for 4 years, but it’s been over 20 years in the making. That’s how long I’ve had symptoms of endometriosis. When my 2nd daughter was born 4 years ago I started thinking about how little things have changed since I first had symptoms at 16. Women still go to an average of 8 doctors for 10 years before they are diagnosed. They are still told it’s in their heads, that pregnancy and hysterectomy are cures, and that pain is normal. All is this is completely false. I thought: What if there were a film to help stop this vicious cycle? A film to put power in the hands of women. This is that film.

Why Endometriosis?

Endometriosis is the most devastating and common disease that most people have never heard of. It affects 1 in 10 women or 176 million women around the world. The only way we’re going to stop the devastating narrative of the disease is to talk about our pain, our symptoms and get the right information out there. Only then can we act on it and make empowered decisions about our health, about our lives. This film and the one that follows are our contribution to changing that narrative once and for all.

What steps went into setting up and creating this documentary?

When I first decided to make this film, I started reading and researching everything I could get my hands on. Books, articles, journals… everything. It became clear to me that 95% of the information out there is incorrect. For example, endometriosis lesions are not simply misplaced uterine tissue. The lesions are similar to uterine tissue, but not exactly the same. Also, thorough excision surgery from a qualified surgeon is the cornerstone of good treatment and the true symptomatic profile is not well known, not well-taught. Endometriosis is not just “killer cramps.” It can just as often present with GI or urinary symptoms. I had a ton of GI symptoms and had multiple colonoscopies & endoscopies, CATscans, MRIs, ultrasounds and nothing ever showed up. I tried every diet under the sun and continued to have symptoms. It turns out it was endometriosis the entire time. Yet it’s incredibly hard to find that information amid the plethora of misinformation, politics and egos vying for attention and notoriety.

We started interviewing the world’s top experts, not just surgeons, but researchers, scientists, nutritionists, therapists and more. It was important to me to take a nuanced, multi-disciplinary exploration of the disease to give women the most complete tool they can use to take control of their health.

What do you hope to achieve with this documentary both long term and short term?

In the short term, I hope the film is widely-seen by women with endometriosis, their loved ones and the medical community including OBGYNs, pediatricians, primary care providers and gastoenterologists.  I hope women are empowered by the film and can starting being proactive in their own healthcare. I hope health care providers start to realize that endometriosis is more complex than they’ve been taught. Beyond that, I hope that we can get a copy of the film to every school nurse so that teenage girls may be treated when they first have symptoms rather than go 10 or 20 years like I did and so many others. Further, we plan to partner with local organizations in countries around the world to get copies of the film to lawmakers & put endo on national agendas.

What challenges have you had to overcome when creating this documentary?

Truthfully, navigating the political minefield surrounding endometriosis has been the biggest challenge. When I first started making the film I was unaware of this reality, but quickly learned there are a lot of politics, egos and power plays involved in endometriosis advocacy and care. Unfortunately, I think this is one reason that the field hasn’t advanced as quickly as it could. We navigate it by continually asking “Would this ultimately benefit a woman with endo?” If the answer is no, then it doesn’t happen. Beyond that, of course there are financial challenges as we funded this film on our own, filming whenever we could and editing as we went along. The endo community rallied in a tremendous way last fall in helping us raise funds to execute a large scale outreach campaign of the film and that’s what is about to happen now. It’s really happening & we couldn’t be more excited. Change is coming. Believe it.

The Diva Team would like to congratulate everyone on the Endo What? team for creating a truly amazing documentary that attests to the struggles women with endometriosis face.

For more information on this important film or to buy tickets to one of the stops on the Endo What? world tour, please visit: www.endowhat.com

shannon-imgShannon Cohn
Director / Producer
For over a decade, Shannon has produced award-winning feature films and TV series for Discovery Channel and NatGeo. Before that, she practiced international law and was part of the legal team that prosecuted Enron. She went to film school at NYU and has a law degree from Vanderbilt. She’s also a woman who lives with severe endometriosis. In her case, that means over 20 years of debilitating pain, miscarriages, multiple surgeries and misdiagnoses. She started thinking about how little things have changed since she first had symptoms at 16. Women still go to an average of 6-8 doctors for 8-10 years before they are diagnosed. They are still told it’s in their heads, that pregnancy and hysterectomy are cures, and that pain is normal. She started thinking. What if there were a film to help stop this vicious cycle? A film to put power in the hands of women. This is that film.

 

Be Heart Healthy

Whether celebrating love (romantic or platonic), or simply focusing on some much needed love of self and self-care, there is no denying that February is all about the heart. Though you may spend much of this month giving and sharing of your heart, how much are you doing for your heart itself?

Did you know that according to the Heart and Stroke Association, heart disease is still the number one killer of women in the United States and is seen to be the cause of 1 out of every 3 deaths of American women? An estimated 43 million women in the US are currently affected by heart disease, which is about 27% of American women. That seems like quite a lot!

So why are we not talking about it more?

This should not surprise us, when an even higher percentage of women in the United States menstruate but menstruation still seems to sometimes be difficult to talk about, and guess what? It’s not only our silence on the two topics that are linked!

Menstruation and Heart Health

Do you know that there may also be a connection between menstruation and heart health? Researchers have been looking into links between menstruation and heart health for some time. There has been much talk about the link between menopause and overall cardiac health as the risk of heart disease is certainly higher for women after menopause. A recent decade long study at University of Oxford even suggested a link between when a woman first starts menstruating and heart disease in later life. In addition to this, Dr. Susan Rako MD in her book, No More Periods?, attributes menstruation to other heart health benefits, including: 1) the reduction in blood pressure during half the normal menstrual cycle and 2) the reduction of stored iron which can also help reduce the risk of stroke or heart attack.

Be Still My Healthy Heart!

So how can you live heart healthy? Well most importantly, make sure that you are doing your regular health checkups and talking with your primary healthcare provider. Also it is never too late to make those small lifestyle changes that can improve not only your cardiac health but your overall health as well. Of course, we are talking about making healthier diet choices and finding more ways to incorporate exercise and activity in your life.

Heart Healthy Eating

We’ve all heard about the heart healthy benefits of EFAs (Essential Fatty Acids like Omega 3 and Omega-6) which can be found in delicious foods like fish, flaxseed, hemp seeds, walnuts, chia, etc. Incorporating some of these into your diet can be easy as well as yummy. Who doesn’t like a good fish fillet for dinner? And if you are vegetarian, adding some flaxseed oil or hemp seed to a smoothie or salad can be a simple fix too.

Try this Heart Healthy Recipe!

OMC (Oh My Cod!)

Ingredients:
1 lb  filet of cod
2 Medium Tomatoes – diced
1 red pepper
1 yellow pepper cut into strips
1 yellow onion – diced
2 cloves of garlic – minced
2 sprigs of fresh parsley – chopped fine
2-3 cilantro leaves – chopped fine
1 Tbsp of capers – sliced to release juices
I tsp of Lime juice,
Virgin coconut oil
Coarse salt and fresh pepper to taste

Instructions:

Preheat oven to 375 C

Sauté onion in coconut oil until the onion starts to yellow. Then add all vegetables and sauté for about 5 to 10 minutes on medium heat adding water as needed. Add herbs and continue cooking for on medium heat until tastes are blended. Add salt and pepper to taste. Apply a 1/3 of the sauce to the bottom of a medium-sized glass baking dish, and then place the cod filets on the sauce, spooning the remainder of the sauce over top and squeeze the lime juice over the filet.

Bake uncovered for 25-30 minutes until the fish has a flaky texture and is opaque white throughout.

Activity and Exercise

The other piece to the puzzle is injecting a bit more activity and movement into your life. More often than not, it becomes all too easy to be more sedentary. If you work at an office job you may be sitting at your desk all day, and even in our off time the entertainment offered by television, the internet, and our smart phones, make it all too simply to sit on the couch instead of getting up and moving around.

Though you may not be able to get out to a gym, some simple things like opting to climb the stairs instead of taking the elevator can make a world of difference. Another great idea, during the work day is to set an alarm on your phone to get up every couple of hours and do 5-10 squats. Roping your colleagues or cubical buddies into joining you can make this a fun way to break up the work day while getting you up and moving.

A fun idea for getting yourself moving while not letting it get monotonous is to make yourself an activity challenge jar. Write yourself some activity challenges on slips of paper and keep them in a jar. You know yourself so make sure your challenges are not too easy but also within your ability while still being slightly challenging. Then 2-4 times a day pull out an activity idea from the jar to do on the spot.

Here are some ideas to get you started, no equipment necessary!

  • Do __# of squats holding each squat for a count of 15.
  • Do __# sit-ups.
  • Hold a plank for __# seconds.
  • Do __# burpees.* Remember the number of repetitions or for holding a position will be unique to everybody and make sure to keep it reasonable, discussing all increased activity with your doctor.

Finding fun ways to get more active and eat better will benefit your health in many ways including the ways of the heart.

You’re in our hearts!

diva team signature

 

Research Opportunities and The DivaCup

PrintA few weeks ago, The Diva Education Team had the opportunity to visit The Feinstein Institute for Medical Research in Long Island, New York. Diva International Inc. has committed to provide menstrual cups for the Feinstein institute’s ROSE Study (Research OutSmarts Endometriosis) in an effort to help advance the care and knowledge of a disease that affects 1 in 10 women.

You may be wondering: What role does The DivaCup play in all of this?

One element of the study includes asking participants to provide a sample of menstrual flow through the use of The DivaCup. The DivaCup easily collects flow, is super comfortable and if women choose, can be used as their preferred femcare option after they’ve submitted the sample.

For those not familiar with endometriosis, approximately 5.5 million women and girls suffer from endometriosis in North America alone. Endometriosis occurs when the endometrium, the tissue that lines the uterus and is shed every month, grows outside of the uterus on other organs or structures in the body. Symptoms can range from painful menstrual cramps to incapacitating abdominal and pelvic pain and infertility. While the severity of endometriosis varies, the more extensive forms of the disorder can cause severe pain and disability. In addition, approximately 40% of infertility is associated with endometriosis.

Pink science equipment microscopeThe team at the Feinstein Institute are welcoming and enthusiastic about the work they are doing. Everyone we met was positive about the study and thankful to have the opportunity to play a part in the research. Bringing years of research and experience together, the team is diverse, dynamic and excited for what can be achieved through the aid of The DivaCup. We met with Peter K. Gregersen, MD and Christine Metz, PhD  the lead investigators on the study, along with the researchers, nurses and medical school interns.  We got to tour the lab (where we saw some fascinating cell samples in the microscope collected from menstrual flow using the DivaCup) and had the opportunity to talk through the many advances the team has already made in the study.

All in all, the trip was both inspiring and educational.

The goal of the ROSE study, which has received funding from the Endometriosis Foundation of America, founded by Dr. Tamer Seckin, is to investigate the cause of endometriosis and bring improved diagnostics and treatments for women living with the disease.

Current diagnosis relies on pelvic exams and ultrasound imaging coupled with laparoscopic surgery. Women with more severe endometriosis often require surgical intervention to relieve symptoms and it is not uncommon for a woman to require repeat surgery. Hormone treatments may be effective in many women, but can have unpleasant side effects. Improved diagnostic methods and better tolerated and more effective medical therapies are needed.

Researchers involved in ROSE are using several approaches to study endometriosis. These include efforts to better understand the genetic basis of the disease and relate this what is occurring at the cellular level in the disease, with particular emphasis on the role of stem cells and the immune system.

They are receiving great feedback and response, but the study is hoping to receive hundreds of samples each year and needs your help! Women both living with and living without endometriosis in both Canada and the United States can participate in the ROSE study to help find answers for those who are suffering.

To learn more about getting involved visit the ROSE Study webpage.

 

Feinstein Empowering®The Feinstein Institute for Medical Research
Headquartered in Manhasset, NY, The Feinstein Institute for Medical Research is home to international scientific leaders in many areas including Parkinson’s disease, Alzheimer’s disease, psychiatric disorders, rheumatoid arthritis, lupus, sepsis, human genetics, pulmonary hypertension, leukemia, neuroimmunology, and medicinal chemistry. The Feinstein Institute, part of the North Shore-LIJ Health System, ranks in the top 6th percentile of all National Institutes of Health grants awarded to research centers. For more information, visit www.FeinsteinInstitute.org.