What is Menopause?
What to expect Hot flashes Sleep problems Vaginal/urinary tract changes Bone/other body changes Emotional changes Sexuality
The Gynecologic Visit
Staying Healthy Food Nutrition Exercise
Urinary Incontinence Loss of voluntary bladder control resulting in urinary leakage
Urinary Problems Inability to store urine Bladder cannot stretch Urethra is unable to close
Different Types of Incontinence Urge Stress Mixed
Patient Evaluation Voiding symptoms Storage symptoms Associated medical conditions Voiding diary
Urge Incontinence Treatments Lifestyle changes Behavior modifications Medications Neural stimulation
Stress Incontinence Solutions Pelvic floor exercises Medication Surgical procedures
Breast Health Keiva L. Bland, MD Sinai-Grace Hospital
Breast Anatomy
Screening recommendations Screening Mammography Yearly starting at age 40 If there is a positive family history for breast cancer, then start 10 years earlier than that person s age of diagnosis Clinical Breast Exam Every 3 years age 20-39 Yearly after age 40 Breast Self Exam monthly after age 20
Breast Self Exam Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Here's what you should look for: Breasts that are their usual size, shape, and color. Breasts that are evenly shaped without visible distortion or swelling. If you see any of the following changes, bring them to your doctor's attention: Dimpling, puckering, or bulging of the skin. A nipple that has changed position or become inverted (pushed inward instead of sticking out). Redness, soreness, rash, or swelling breastcancer.org
Breast Self Exam Raise your arms and look for the same changes. While you're at the mirror, gently squeeze each nipple between your finger and thumb and check for nipple discharge (this could be a milky or yellow fluid or blood). breastcancer.org
Breast Self Exam Feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few fingers of your hand, keeping the fingers flat and together. Cover the entire breast from top to bottom, side to side from your collarbone to the top of your abdomen, and from your armpit to your cleavage. breastcancer.org
Breast Self Exam Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. breastcancer.org
Common Breast Issues Pre-menopause Pain Lumps Discharge Skin changes/rashes Post-menopause Pain Lumps Discharge Skin changes/rashes The issues are essentially the same; their causes can be different, however.
Breast Pain Causes can include: Hormone changes Menstrual cycles Perimenopausal Cysts Infection Abscess Cellulitis Mastitis Caffeine!!!!
What Can You Do For Good Breast Health? If you have breast pain (and no mass): Eliminate caffeine. Apply heat to the breast twice a day for 20 minutes at a time. Take Motrin or Aleve (if you don t have reason that you can t take it) for a week. If no relief, seek attention.
Breast Lumps Fibroadenomas Cysts Abscess Cancer
What Can You Do For Good Breast Health? If you have a breast lump: Get it evaluated by a physician as soon as possible to establish the nature of the mass. Only 1 in 5 masses is cancerous. Do self breast exams to become familiar with your lumps so that you will notice any changes in the mass. Notify your physician if there are any changes in the mass.
Nipple Discharge Hormones Clear, yellow, whitish Intraductal papilloma Bloody Usually not cancerous Duct Ectasia Greenish
What Can You Do For Good Breast Health? If you have a nipple discharge: Take note of the following: When does it or did it come? Spontaneously or do you have to express it? During your period? Have you started any new medications? What color is it? Does it occur in just one breast or both? Have it evaluated by a physician
Skin Changes Any Skin Changes (except for pimples) On The Breast Should Be Evaluated By A Physician!!! Redness Scaliness Swelling Dimpling Why? Because you want to tell the difference between cellulitis (skin infection and common) and inflammatory breast cancer
Breast Skin Changes
Other Factors Affecting Breast Health Smoking Increases your risk for abscesses and duct ectasia Caffeine Contributes to breast pain and fibrocystic changes Alcohol Can increase your risk for breast cancer
Take Home Message Do breast self exams to become familiar with your breasts. Get your mammogram screenings regularly. Avoid caffeine, smoking, and alcohol. Report any abnormal findings to your physician.
Thank You!!!! Any Questions?