Monthly Archives: May 2012

ASK DR NOVOA – I was recently pregnant but lost the baby. I didn’t believe my doctor so I repeated my pregnancy test about a week after the loss. The test says I am pregnant. Does this mean I am pregnant again?

No. I doubt that you are pregnant.

Both urine and blood pregnancy tests are extremely sensitive and can accurately determine if you are pregnant just a few days before your missed period.

The lowest level of HCG, which is the hormone of pregnancy that can be determined by home pregnancy tests is 20mIU/ml.

However, once pregnant, your level of HCG will double every 2-3 days. So after a few weeks, your HCG level can literally be greater than 10,000mIU/ml.

If there is a loss of a pregnancy, such as a miscarriage, HCG will no longer be produced, but you will continue to test positive on a pregnancy tests from 1-3 weeks depending on how high the HCG level reached.

Eventually HCG will no longer detectable since your body eliminates it just like any other hormone, but until this happens, you may not have a period or ovulate, so you need to realize that getting pregnant again may take a few months.

Therefore, it is best not to test for pregnancy after a miscarriage for at least a month after the loss in order to confuse you about being pregnant again.

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Filed under Blog, Gynecology, Obstetrics, Questions of the Day

ASK DR NOVOA – I have heard that there is a type of breast implant that will make your breast continue to grow and can make your breasts grow up to size of watermelons. Is this true?

Unbelieveably, this is actually true. This type of implant was briefly available in the US but was pulled off the market in 2001. The implants are called polypropylene string implants (PSI). The polypropylene IS NOT CIRCULAR, rather it is yarn-like. Once placed in the breast pocket it causes irritation to the implant pocket which causes the production of serum which fills the implant pocket on a continual basis. This causes continuous expansion of the breast after surgery. The fluid must be removed on a continuous basis to keep the breasts from continuing to increase in size. Continual breast growth will eventually result in “extreme, almost cartoonish breast sizes.”

This type of implant is most commonly used by exotic dancers, such as, Chelsea Charms. Attached is a link on Youtube to see what this type of string implant can do to the breast to eventually make them grow to an incredibly large size.

This is more for FYI since PSI is no longer available in either the US or Europe.

Also, there is no other type of implant currently available that results in the continuous increase in breast size once they have been placed.

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ASK DR NOVOA – I was thinking of getting an epidural when I am in labor, but I was told it will increase my chances of a C/S and can cause permanent damage to my back. Is this true?

Generally speaking, NO and NO.

The epidural, short for epidural analgesia, is a procedure where a small catheter is placed in the epidural space of the back. Once placed, both pain medication and anesthesia can be given over a number of hours or even days.

For most women, it can mean the difference between smiling through their contractions or suffering for hours until they deliver their baby.

In general, greater than 95% of women will request the epidural for pain management. Unlike oral, intravenous or intramuscular medication, which will eventually enter the bloodstream of the baby, the epidural does not cause the transmission of these types of drugs to the baby.

Some studies have suggested that the use of the epidural can increase the length of labor and increases the risk of C/S. However, when your OB follows the recommended guidelines for labor management, there is very little risk of complications.

Many women believe that the epidural causes permanent or chronic back pain. This can occur but is not due to the actual placement of the epidural line, but, rather, on back injury sustained when moving or straining while pushing without sensing pain. The easiest way to understand this is that the epidural can allow you to literally put your foot behind your head without feeling pain. When you can do this, there are no warning signs being sent from your back to your brain saying “Don’t Do This”. Therefore, it is very easy to injure your back without even knowing it while the epidural is working.

If you are interested in statistics, the risk of neurological injury or paralysis from an epidural is 1/250,000. The risk of death is 1/100,000.

Despite this, the epidural is extremely safe and is highly recommended in order to help a woman avoid the intense pain of labor and enjoy her labor with a smile.

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ASK DR NOVOA – I heard that there is a procedure that can stop me from having periods and can be done in the office. Is this true?

Yes.

The procedure is called an endometrial ablation. The most common device used is called Novasure.

The procedure involves the placement of a small device in your uterus which produces an electrical charge and cauterizes (burns) the thin layer of tissue which procedures the menstrual flow each month.

The procedure takes approximately 2 minutes to do and is only done once. It can be done in the office. Down time is minimal and complications are rare.

It completely eliminates menstrual bleeding in approximately 80% of patients; significantly reduces menstrual bleeding in 10% of patients and has a failure (no changes in menstrual bleeding) in 10% of patients.

The procedure is not meant for women wishing to have children in the future. Although it can stop you from having your period forever, it is not considered to be a form of birth control and therefore, you should consider to have your tubes before, during or after having this procedure done.

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ASK DR NOVOA – I have heard to women reach their sexual peak at age 35 while men reached it at age 18. Is this true?

NO.

This is a myth which has been passed on as fact for decades. There is no scientific data to support this comment.

Some may believe that measuring sexual hormones may help determine sexual peak, in reality, there is no set minimal value to determine either a sexual low or high.

A relatively new state of sexual health for men, known as Andropause, has been described as the sexual equivalent to the female Menopause.

Menopause, which generally ranges from age 40-50, with an average age of 50.5, is most often demonstrated by the cessation of the menstrual cycle and decreased libido (sex drive).

For Men, the beginning of the decrease in the sexual hormone Testosterone begins as early as age 30. This is most often marked by a decrease in physical strength and endurance, decrease in sexual drive, decrease in strength of erection, decrease in seminal and sperm count, increase in weight from fat and at the same time decrease in muscle size.

For women, the use of hormone therapy to include estrogen and progesterone can not only help with symptoms of the menopause but increase vaginal wall thickness, sensitivity and lubrication.

What is most interesting is that studies have shown that for both men and women, the off label use of Testosterone has been shown to increase the sexual drive.

So ladies, if your having trouble with your man and he is starting to get soft EVERYWHERE, you may want to suggest that he consider a combination of Viagra and Testosterone. But….. remember that just because he puts high octane in the gas tank, doesn’t mean that he will be a better driver.

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Filed under Blog, Female Sexuality, Questions of the Day

ASK DR NOVOA – I occasionally have this bad vaginal smell and discharge. I clean myself and am always self-conscience since I always think I have it. My Primary Care doctor said its BV. What is BV?

BV, represents Bacterial Vaginosis and is cause by a variety of bacteria in the vagina. What happens is that your vagina has a natural balance of bacteria and yeast. When there is a balance, the discharge is white or clear in color, has no smell and produces no discomfort. When you have too much bacteria, the discharge can be heavy yellow or greenish in color, can have a strong fishy or foul smell and can cause the area to be red, itchy and tender to the touch. When you have too much yeast, the discharge is heavy, white in color, have the consistency of cottage cheese, has no bad smell and may produce an itch.

Although not considered a sexually transmitted disease, BV can occur or worsen by having sex with a partner who has a heavy amount of natural bacteria themselves, especially uncircumsized men.

The treatment is usually easy. If it is the most common bacteria, Lactobacillus, your doctor may recommend either Flagyl or Cleocin.

You should never try to treat BV as if it is a yeast infection because it will make things worse.

BV can recur and if its does, you should ALWAYS see your GYN first because there are over 20 different organisms that can mimic BV. A simple culture test can identify the source of the infection and you can start to feel better after about 3 days with different medications.

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ASK DR NOVOA – I wanted to get filler in my lips to make them look sexier. I am worried though, since I see so many movie stars with clown lips after getting filler. What is the story?

Most absorbable fillers such as Juvederm and Restylane work great when injected into lips. Although a little scary and a bit painful, most now come with lidocaine to numb the lips while the procedure is being done.

The amount of filler injected into the lips will vary between person to person. However, this amount is entirely dependent on the patient since it is done one area at a time and the patient is able to view the procedure.

So if you have ever thought of getting fillers, it does not have to end up making you look fake and it can significantly enhance the look of your lips.

The cost varies but averages about $650 per treatment. Each treatment lasts between 3-6 months.

So, if you are afraid of clowns, avoid going to Hollywood or the Circus. 🙂

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