Placenta Pills: Is There Any Benefit?

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If you’ve been keeping up with the Kardashians, you may have heard the belief that consuming human placenta can offer a new mother various health benefits, such as help with treatment of postpartum depression.

While a quick look online finds a placenta cookbook on Amazon.com, a more mainstream approach is “encapsulated” placenta, which is when placental tissue is dried, ground up and then packaged into clear gelatin capsules like a vitamin supplement. Read more…

Jun 19th, 2015 | Filed under In the News, Pregnancy Care

Weight Loss After Pregnancy: Staying Healthy as You Get Your Body Back

Post-Pregnancy-ExercisingIt seems like you only need to go as far as the nearest supermarket checkout line to see photos of celebrity moms flaunting their post-pregnancy figures – a few months or even weeks after giving birth.

One week it’s Blake Lively or Duchess Catherine, the next it’s Halle Berry or Christina Aguilera. But while speedy celebrity transformations are certainly impressive, are they healthy? What are the effects of rapid weight loss on the new mother – and, indirectly, the new child?

What are the best ways to lose weight after pregnancy? These are questions we hear regularly at our practice … and here are a few answers. Read more…

Low Libido in Women: What to Do When Your Sex Drive Fades

ggggggReduced libido: a fact of life for many women

If you’re experiencing low libido, fear not … you’re not alone! In a recent U.S. study of more than 2,000 women between the ages of 30 and 70, more than a third had low sexual desire. It’s one of the most common concerns we hear from our patients. And it’s no wonder: As women navigate their middle years, they often find themselves deep into a long-term relationship, a career, raising teens, and taking care of aging relatives.

All of these situations can cause stress, which can have a negative effect on your sex life. And that’s just for starters. Read more…

Feb 18th, 2015 | Filed under In the News, Menopause, Patient Education

In the News: AAP Recommends LARCs for Sexually Active Adolescents

garOctober 30, 2014 – Earlier this month, the American Academy of Pediatrics (AAP) recommended that the first-line contraceptive choice for sexually active adolescents is a long-acting reversible contraceptive (LARC). This is a new recommendation for the APP, which is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. Read more…

Discovery to Cure

Discovery to CureOn September 28, we are forming a team of walkers to support Discovery to Cure and New Treatments for Women’s Reproductive Cancers

Hundreds of walkers will be strolling through the Yale University campus for two miles with tour guides along the way to point out the sites on a beautiful fall day. The walk begins with registration at 10:00 A.M. and will end at approximately noon followed by door and raffle prize drawings. All registered walkers will be entered and must be present to win door prizes.

Join our office team at The Yale Commons (enter through Woolsey Hall) at 168 Grove Street (corner of College Street), New Haven. This is a family friendly event (sorry, no pets). Only people who are pre-registered by September 14th will be guaranteed the customized t-shirts. Registration is $20 for adults. Children under 16 are free.

This is a fundraiser for a great cause. Please plan to ask your friends and family to contribute towards your walk and personal fundraising goals!!

Follow This Link to visit my personal web page and help me in my efforts to support Discovery to Cure.

Sep 8th, 2014 | Filed under Conditions and Treatments
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A primer on emergency contraception pills

Thoughtful woman sitting on floor using laptop in living roomYou’ve heard about emergency contraception pills but do you really understand exactly what they do?

First, the simplest way we describe these pills to our patients is to call them emergency contraception that prevents pregnancy after unprotected sex. They are not traditional birth control. And they do not cause abortion because they work before a pregnancy occurs.

According to the American College of Obstetricians and Gynecologists, fertilization, the union of an egg and a sperm, occurs in the fallopian tube. During the next few days the fused egg and sperm move through the fallopian tube to the lining of the uterus, where it implants as a cluster of cells that will become the fetus and placenta. Emergency contraception pills do not work at this point. Read more…

Your daughter’s all-important first visit to our office

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“When should my daughter first see a gynecologist?” is a question our patients often ask during their visits to us, followed by an almost always immediate second question: “What kinds of things do you do to calm the nerves of the first visit?”

The optimum time for a first visit to our office is between ages 13 and 15. As for the second answer, because it can be scary for your daughter as young girls often feel embarrassed or nervous discussing their bodies, we make the visit as pleasant and comfortable as possible, and consider this a get-to-know-you session, where we begin building relationships and talk about health, education and prevention.
In most cases young girls visit our nurse practitioner Laury Berkwitt, who specializes in women’s health, is a mother of two, and is passionate about caring for young women and adolescents. She knows how to speak to young girls and is able to get them to open up, talk and ask questions. Read more…

Child’s obesity linked to how much – or how little – mom gained during pregnancy

home_pregnancy (2)If you gain too much or too little weight while pregnant, a new study has found that your child has a greater risk of being overweight or obese. The study caught our attention since weight  – “How much or how little should I gain?” – is one of the first questions many of our patients ask us.

The researchers studied 4,145 women and their children, ages 2 to 5, all members of Kaiser Permanente health care plans in Northern California. The women participants were racially diverse and all had a normal body mass index (BMI) before pregnancy, which according to guidelines established by the Institute of Medicine (IOM) means they should gain between 25 and 35 pounds during pregnancy. Read more…

In the News: The Dangers of Power Morcellation for Uterine Fibroid Removal

The FDA speaks out

Earlier this month, the U.S. Food and Drug Administration issued a memorandum that discouraged surgeons from using a common procedure called power morcellation to remove uterine fibroids. Power morcellation uses a medical device to divide uterine fibroids into smaller pieces that can be removed through a small incision in the abdomen, such as during laparoscopic surgery.

Why was the FDA announcement necessary?

New data from the Center for Devices and Radiological Health show that power morcellation can spread undetected cancers more often than previously realized. According to the data, one in 350 women who undergo a hysterectomy to treat fibroids or who have fibroids removed have undiagnosed uterine sarcoma — a type of cancer that can be aggressive. If power morcellation is performed in women with this kind of uterine cancer, the procedure can spread the cancer around the abdomen and pelvis.

The agency’s review occurred following wide media coverage of Dr. Amy Reed, a 41-year-old Boston anesthesiologist who underwent a power morcellation hysterectomy in October 2013 to treat what she was told were likely benign uterine fibroids. Follow-up tests found that Reed had uterine leiomyosarcoma, a very aggressive tumor. Imaging tests showed that the cancerous tissue had been spread throughout her abdominal cavity, giving her stage 4 cancer.

The FDA stopped short of ordering the devices needed for this procedure off the market because, according to a spokesperson, “there still may be individual patients who benefit from the procedure.”

Uterine fibroids: A bit of background information

Most women will develop uterine fibroids at some point in their lives. Most uterine fibroids do not cause problems. However, uterine fibroids can cause unpleasant or even painful symptoms, such as:

• heavy or prolonged menstrual bleeding,
• pelvic pressure or pain, and
• frequent urination

Between 500,000 and 600,000 women undergo hysterectomies in the United States every year. Up to 40 percent of these procedures are to treat painful fibroids.

What do I think?

I’ve had concerns about power morcellation for some time: I think it’s an expensive and dangerous technique that does not improve surgical outcome. While I’m in full support of the FDA’s safety advisory, I think they should have gone even further and taken the devices off the market until a solution is found. Fortunately, there are some good alternatives to power morcellation, including a small lower abdominal incision, manual extraction though a laparoscopy incision, and manual morcellation via posterior colpotomy (an incision in the back of the vagina). I believe that posterior colpotomy is the best option in many cases because it is safe and associated with minimal postoperative pain and excellent cosmetic outcomes.

If you’re considering treatment for uterine fibroids, be sure to discuss with your physician all the available treatment options, including the benefits and risks. If you’re in the area, give me a call to set up an appointment.

Additional information on uterine fibroids

Extensive information on uterine fibroids can be found at:

FDA Safety Communication: Laparoscopic Uterine Morcellation, April 2014
National Institutes of Health: Uterine Fibroids Fact Sheet, March 2013
John M. Garofalo, M.D.: Uterine Fibroids

About the practice

Dr. John Garofalo, M.D., is a gynecologist located in Fairfield County, Connecticut. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.
Laury Berwitt is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for 10 years, caring for women of all ages.

For more information, go to www.garofaloobyn.com. John Garofalo, MD and Laury Berkwitt, APRN can be reached for personal consultations by calling 203.803.1098.

Mammograms: Making Sense of Conflicting News

In the past few months there’s been a lot of conflicting information about mammograms in the press. Not surprisingly, we get asked a lot of questions by our patients: Are mammograms useful? At what age should I start getting tested? What are the risks? What if I test positive?

Recent News: A Quick Summary

A few months ago, there was a cost analysis of whether women should start regular mammograms starting at age 40 or age 50. Why was this a concern? Because the American Cancer Society recommends that women start mammogram screening every year starting when they turn 40, while the U.S. Preventive Service’s Task Force recommends that women get a mammogram every other year starting at age 50.

A few weeks later, a Canadian study reported that mammograms did not reduce breast cancer deaths. This study was criticized by U.S. radiologists as being flawed and misleading.

The Latest Word

Even more recently, the American Medical Association published the results of studies that attempted to put all the previous research into perspective. For the first study, researchers at Harvard examined all the research done on mammograms since 1960. They concluded that while mammograms have benefits, these benefits have been “oversold,” while the potential harms have been minimized.

Who Should Get Screened, And When?

The researchers also found that annual mammograms can reduce the risk of dying from breast cancer by about 19 percent; but the benefit varies based on a woman’s age and her underlying cancer risk. For example, breast cancer becomes much more common as a woman ages. Here are the statistics:

chart

As for women age 75 and older, the study found that there have been no tests to see whether women of this age benefit from regular mammograms. This means that there’s no way to know how much regular mammograms might extend the life of a woman in this age range.

The Risk of Overdiagnosis

The Harvard study also evaluated overdiagnosis, in which women are treated for a cancer that would never have been life-threatening. The researchers found that about 19 percent of women who are diagnosed with breast cancer as a result of a mammogram undergo unnecessary surgery, chemotherapy or radiation.

So What’s the Bottom Line?

The researchers concluded that mammography is a useful but not perfect screening test. So if you’re trying to make a decision about mammography, be sure to discuss the risks, benefits, uncertainties, alternatives, and your own health history and preferences.

About the practice

Dr. John Garofalo, M.D., is a gynecologist located in Fairfield County, Connecticut. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.

Laury Berwitt is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for 10 years, caring for women of all ages.

Laury and Dr. Garofalo offer mammography and related consultation services as part of well woman care.

For more information, go to www.garofaloobyn.com. John Garofalo, MD and Laury Berkwitt, APRN can be reached for personal consultations by calling 203.803.1098.