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Recognizing National Infertility Awareness Week

Recognizing National Infertility Awareness Week

This month we’re standing with the N.I.A. to recognize infertility awareness with a focus on preconception counseling, because that’s where education begins.  With preconception counseling at W.H.O.C., Dr. Cothran follows your journey from planning to your first positive pregnancy test or, if needed, referral to a specialist after 12 months of trying without success. Whether you anticipate fertility may be an issue or not, you’ll want an experienced women’s health expert on your team as you consider your first or next pregnancy.

Why Preconception Counseling Is Important in Infertility

Preconception counseling is an important step in your overall health and wellness. It begins about 3 to 4 months before you’re hoping to become pregnant, or when you decide to stop contraception, and it includes evaluation of the following:

  • Overall family plan and emotional well being
  • Medical history and current medications
  • Update of important immunizations
  • Fitness and body mass index
  • Diabetes mellitus and hypoglycemia before conception
  • High blood pressure and borderline H.B.P.
  • Folic acid and other supplements
  • Nutritional guidelines before pregnancy
  • Screening for genetic counseling if needed
  • Vocational issues and ergonomic considerations
  • Optimizing the likelihood of pregnancy

As more women decide to put off starting a family until they’re established in their careers, preconception counseling can help you sort through a range of lifestyle-impacting changes. It can help you avoid preventable complications and prepare for smooth transition through the trimesters of pregnancy. Dr. Judy counsels with compassion and non-judgement, and patients often comment on the ease of discussing sensitive issues after their visits.

Clinical infertility is diagnosed after 12 months of trying to conceive without success. It can be a stressful experience with impact to your relationships. Dr. Cothran guides you through the referral process and counsels you on what to expect.

The goal of preconception counseling is to ensure you’re as healthy as possible before you become pregnant. Partner with Dr. Cothran for women’s health in a caring atmosphere.

A Bouquet of Honors for Breast Cancer Awareness

A Bouquet of Honors for Breast Cancer Awareness

Breast Cancer Awareness Brings Autumn’s Bouquet

Among the multi-colors of Autumn this month is a beautiful streak of pink. For Breast Cancer Awareness Month, we honor victors in the battle against breast cancer, and cherish the memory of brave heroes we’ve lost. Women’s Health of Chicago supports survivors, many who’ve fought breast cancer multiple times, and now serve as activists, mentors, and tireless examples of how the battle might be won for all. While an update on the war against this disease is mixed with highs and lows, one thing remains constant: early detection is still our best weapon in the fight.

As an obstetrics and gynecology specialist, I’ve walked through diagnosis and treatment of this disease with close friends and patients.  Very few people I know remain untouched in some way by the fight for a cure. It’s a personal battle for me and many in my genetic family and patient family.

Rates of Detection and Survival in the Battle Against Breast Cancer

The survival rate for breast cancer has been growing since 1989. Survival rates among women under the age of fifty are even more encouraging than the national average. Treatment advances, earlier detection, and increased awareness are credited for this increase.

Float pink balloons for breast cancer awareness at women's healthThanks to awareness and screening, rates of detection have been on the rise.  Earlier detection uncovers more cases of breast cancer annually – about 307,000 this year or one in eight women.  Cures for Stage I Breast Cancer approach 95% nationally, and that’s great news.  Not only does early detection increase rates of survival, women who maintain a recommended mammography schedule undergo less invasive treatment at lower cost. Consult your gynecologist for advice on how regularly you schedule a mammogram based on your age, family history, and genetic risk factors.

Unfortunately, advances in detection and treatment haven’t impacted all women evenly.  Black women receive breast cancer diagnoses at younger ages and survival rates are lower than those for white women.  The data suggests that breast cancer may exact a greater economic and family toll on black women than even Asian or Latino women. The median age at diagnosis is 58 for black women and 62 for white women.

The data for the report was obtained from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute, a program that has been collecting information on cancer patients since 1973.

Feel Something, Say Something

In addition to mammograms, we stress the importance of patients trusting their own familiarity with their bodies. Whether it’s a lump or an inclination that something is wrong, follow through and get it checked. You may learn your concern is unfounded, or examination may lead in a totally different direction.  However, act on this instinct, because it’s a common trait among women who discover breast cancer early.

A Strong Network of Support

No one should battle this disease alone. Agencies and support groups are working to raise funds to increase breast cancer awareness and research.  Learn more about how you can donate, get involved, or find your own support group, by reaching out to the American Cancer Society, the National Breast Cancer Foundation, or Susan G. Koman for the Cure.

What You Should Do During Breast Cancer Awareness Month

Breast cancer awareness inspires and motivates women to action. No matter your age, if it’s been longer than 12 months since your last mammogram, schedule your physical examination and mammogram as soon as possible. If you’ve had your mammogram, encourage a loved one or co-worker to schedule their annual exam. You could be the difference in another life saved.

The Best Mother’s Day Gift

The Best Mother’s Day Gift

Happy Mother’s Day!

It’s the time of year we all pause to give thanks and express our love and appreciation for our mothers. We honor those mothers we’re fortunate to have close by and the moms we appreciate across the miles.  We cherish memories of mothers to whom we’ve had to say good-bye, at least on this side of life.  And for too many of us, Mother’s Day’s day is a painful holiday, reminders of unfulfilled desires to experience motherhood ourselves, or punctuated by lingering grief and loss.

There are many reasons Mother’s Day is a meaningful season for us at Women’s Health of Chicago.  We’ve devoted to helping women plan motherhood through preconception counseling, and supporting patients tackling the toughest fertility challenges . We’ve counseled mothers on the sensitivity of a teen’s first visit to a women’s health specialist, and educated thousands of young women on the risks of sexually transmitted diseases.  I’ve had the pleasure and gratification of caring for generations of mothers in the same family. Truly, I’ve been sincerely moved by the depth of the bond shared between mother and daughter.

Mother’s Day Health Alert

However, it’s important during this season to remind all women that while you’re selecting greeting cards and making plans for Mother’s Day dinner, please take time to make sure your mom and all the important mothers in your life have had an annual physical exam and mammogram in the past 12 months.  Sure, load up on beautiful flowers, delicious treats, picnic fun and the gathering of family to honor the matriarch who’s made it all possible.  We’ve traded a few ideas in our office for handmade gifts designed for lasting memories, all in additionHappy Mother's Day from Women's Health of Chicago to the best gift of all.

Best Mother’s Day Gift

There is no better Mother’s Day gift than gently reminding, and harassing if necessary, your beloved mothers to schedule their annual physicals and mammograms.  Remember, early detection is the best weapon we have in the fight against breast cancer, and a host of other diseases that are nearly 100% curable if detected in early stages.  The rate of Type II Diabetes is at epidemic proportions in the U.S. and there’s so much we can do if it is detected early.  There are too many reasons to list here to remain vigilant about maintaining and supporting the maintenance of good health in our mothers, but perhaps LOVE is the only reason you need.

Say Happy Mother’s Day in a way that can really count. Make an appointment today for someone you love at Women’s Health of Chicago.

The Fight Against Pelvic Pain

The Fight Against Pelvic Pain

Pelvic pain, and related painful syndromes, which can be more difficult to describe, require thorough diagnostic protocols to determine the cause in each specific case. Therefore, it’s important that your primary care physician have a good relationship with a women’s health specialist who is following your overall health as well as your OB-GYN needs. That’s why I make a point to know the primary care physician and other related specialists treating my patients. Holistic, collaborative care is the best way to keep you living a vital and healthy lifestyle.

Managing pelvic pain with non-surgical options

When diagnosed with pelvic organ prolapse, you’ll have a number of surgical and non-surgical options to consider. To select the best option for you, we’ll consider a number of elements in your medical history, current physical condition and immediate support system. Either way, it’s is important to understand all options before deciding which treatment is best. Many women do very well with nonsurgical treatments for prolapse. Here is a quick synopsis of some of them.

First, We Advise Close Observation

A first option for pelvic organ prolapse might be observation or expectant management, which simply means periodic checkups and no active treatment at all. There is no evidence that this is likely to cause more problems than treating prolapse, until organ prolapse becomes severe enough to cause poor bladder elimination, bowel evacuation or irritation around the prolapsing tissues.
Although data show that prolapse is likely to worsen over time for most women, there is no current method to accurately predict who is likely to develop worsening prolapse, so treatment may simply not be necessary for women with lesser degrees of prolapse. The key is to diagnose it early and follow it closely.

Physical Therapy for Pelvic Pain

Another early treatment option includes pelvic floor physical therapy. In this instance, treatment is designed to reduce pelvic pain by improving the muscular support of and blood flow to the pelvis. Many women find this treatment eliminates their symptoms all together. Many times this will improve bladder and bowel symptoms as well. Working with a trained pelvic floor physical therapist is more likely to result in improvement than observation or home “Kegel” exercises alone. In the event you choose this route, I’ll follow-up closely to support your commitment to a regular schedule of therapy, and to track how effectively it relieves your pain.

What Is a Pessary?

Pessary Device from WebMDFinally, the oldest and best known non-surgical treatment of prolapse is a device called a pessary. A pessary is a device worn inside the vagina which supports the bladder, vagina or uterine apex, and rectum. There are many types of pessaries available, the most commonly used is a “Ring with Support”, which somewhat resembles a diaphragm used for birth control, except that it is a bit stiffer and flat rather than dome-shaped, and has perforations in the support membrane to allow for circulation of vaginal fluids and let the tissue “breathe.” Another common pessary includes a dome with ballast type called a Gellhorn. The appropriate type of pessary is best determined by the physician or healthcare provider trained in the proper assessment and fitting of the pessary. Once this is done, instructions regarding self-care and/or intermittent visits with office care of the pessary will be given.

Effectiveness of Pessaries

Many women achieve satisfactory treatment of prolapse with a pessary, and choose to continue this course of therapy indefinitely to relieve pelvic pain. While it is natural to develop some increase in vaginal discharge, as long as it is not disagreeable and manageable, this is usually acceptable. Sometimes, the pessary can cause irritation or erosion of vaginal tissues due to rubbing against the vaginal tissues. Often this can be corrected by increasing the amount of lubricant, or occasionally leaving the pessary out for a short period of time. A small number of women will develop a vaginal infection and become unable or unwilling to use a pessary. Normally, however, when properly fitted a pessary should be a “silent passenger”, and a woman wearing a pessary should be totally unaware of it.

You can learn more about pessaries at WebMD.

There’s much more to learn, and at Women’s Health of Chicago, WebMD we’ll make sure you’re thoroughly educated and well prepared to manage your pessary, or any other non-surgical treatment you elect.

The Fight Against Breast Cancer: A New Milestone

The Fight Against Breast Cancer: A New Milestone

Last October, Tara Parker-Pope’s article in the New York Times “Well” Section highlighted a troubling milestone in the decades-long rise in breast cancer in African American Women.  In fact, incedence of breast cancer has been on a steady rise for the past quarter century due to a complex array of trends, both nationally, and in African American communities.

A Breast Cancer Milestone We Can Reverse!

Here’s an excerpt from Tara Parker-Pope, A Grim Breast Cancer Milestone for Black Women, New York Times, Well, October 29, 2015.

“It is a crisis,” said Marc Hurlbert, chief mission officer for the Breast Cancer Research Foundation. “The increasing incidence is unfortunate because the mortality rate for black women is already so much higher, and now if more women are getting breast cancer, then unfortunately, the number of black women dying from the disease will go up.”

Over all, the report painted a grim picture of the state of breast cancer in African-American women, showing that advances in diagnosis and treatment that have sharply improved survival rates from breast cancer and saved countless lives have largely bypassed African-American women. By virtually every measure of the disease — age of diagnosis, age of death, stage of diagnosis — black women are at a significant disadvantage compared with white women, the data show.  (End excerpt.)

The Importance of Early Detection

Breast Cancer Milestone in the African American CommunityI’m particularly sensitive to this statistical milestone as a women’s health specialist fighting against this trend by empowering women to schedule annual mammograms with their physical exam. My message is simple: take early detection of breast cancer seriously.  My work in under-served communities brings me face to face with the real-life dynamics complicating even the simplest steps toward early detection. Yet, I’m hopeful that by keeping the message front and center, we might reverse this troubling trend and the higher rates of mortality that accompany it.

No matter your age, if it’s been longer than 12 months since your last mammogram, you should schedule your physical examination and mammogram as soon as possible.  There’s no better way to celebrate your birthday than to schedule your annual check-up and mammogram at around the same time.

(Excerpted and paraphrased from Tara Parker-Pope, A Grim Breast Cancer Milestone for Black Women, New York Times, Well, October 29, 2015.)

The reasons for the increase in breast cancer rates are complex and are thought to be driven largely by rising obesity rates among African-American women. Researchers also believe that changes in reproductive patterns may play a role, as more African-American women delay childbirth and have fewer children. Both are recognized risk factors for breast cancer.

Black women are given breast cancer diagnoses at younger ages and die from the disease at younger ages than white women, suggesting that the disease may exact a greater economic and family toll on blacks by stealing more of a woman’s most productive years. The median age at diagnosis is 58 for black women and 62 for white women. The median age for breast cancer death is 62 for black women and 68 for white women.

The data for the report was obtained from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute, a program that has been collecting information on cancer patients since 1973.

For more background on breast cancer trends in the African American community, read a previous article by Tara Parker-Pope, New York Times article.


For more information about the research behind this milestone, read her full article here.

Don’t put off scheduling your next annual physical and mammogram. At Women’s Health of Chicago, we can do both right here in the same office, often without having to schedule a separate appointment.  It could be a matter of life and death for our sisters and loved ones.  Spread the word!

PCOS – What You Should Know About One of the Most Common Women’s Health Issues

PCOS – What You Should Know About One of the Most Common Women’s Health Issues

PCOS – A Diagnosis So Common It’s Been Called an Epidemic

Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing age, affecting between 6.5 and 8 percent of women worldwide.  Its prevalence is strikingly similar across all cultures from southeastern United States to the Greek Isles of Lesbos and Spain. Here, its diagnosis is so common some experts have referred to it as an epidemic.

PCOS occurs when a woman’s body overproduces sex hormones called androgens. The hormone imbalance prevents the ovaries from breaking open and releasing mature eggs. Fluid-filled sacks accumulate in the ovaries and can create numerous tiny cysts.

PCOS can have significant impact on women’s blood sugar levels, high blood pressure, cholesterol levels and heart health overall. So, it’s important to be diagnosed, treated properly and cared for by an experienced and sensitive OB-GYN.

How to Know You May Have PCOS

Women affected by PCOS may have irregular menstrual cycles, periods that occur too frequently or infrequently, abnormally heavy or unpredictable periods.  Some may have regular cycles at first and subsequently experience irregular menstrual cycles associated with weight gain.  Many obese women with PCOS report menstrual cycles that return to normal after relatively small amounts of weight loss.

Here are the most common symptoms.Judith Cothran, MD explains what you need to know about PCOS, a common syndrome effecting millions.

  • Infertility – PCOS is one of the most common causes of female infertility.
  • Obesity – Up to 80% of women with PCOS are obese.
  • Hair Growth – This condition, called hirsutism, affects more than 70% of women with PCOS and can cause excess hair growth on the face, chest, abdomen or upper thighs.
  • Acne or oily skin – severe acne that occurs after adolescence and does not respond to usual treatments.
  • Darkened skin – Patches of thickened, velvety, darkened skin, called acanthosis nigricans.
  • Cysts – multiple small cysts on the ovaries can occur.

Some women also experience repeated miscarriages, and gestational diabetes during pregnancy.

PCOS and the Risk of Diabetes Type II

Along with infertility, one of our biggest concerns related to women suffering from PCOS is insulin resistance.  Insulin resistance, in which the body’s cells do not respond to the effects of insulin, leads to increased levels of glucose in the blood. This often causes the body to produce more insulin as it tries to move more glucose into cells.  Insulin resistance can lead to diabetes mellitus or Type II Diabetes, and any of the symptoms above can be an early indicator.

Cardiovascular disease can be a result of PCOS closely associated with insulin resistance and Type II Diabetes.  These are lifelong consequences that should be watched carefully by your women’s health specialists in collaboration with your primary care physician.

Women with PCOS are also likely to develop a condition called endometrial hyperplasia, in which the lining of the uterus (the endometrium) becomes too thick.  This condition increases the risks of endometrial cancer.

PCOS causes a wide variety of symptoms and it may be hard to know when to call your doctor. However, early diagnosis and treatment will help prevent the consequences of serious health problems.

Here are a few signs that it’s time to see your doctor right away.

  • Passing clots during your period or suffering severe bleeding (soaking through your normal pads or tampons every 2 hours.)
  • Normal periods, but you have been trying unsuccessfully to get pregnant for more than 18 months.
  • Depression or mood swings, these can be the direct result of hormonal imbalances and the emotional stress triggered by weight gain or skin problems

It’s just one more reason it’s important to make and keep your annual appointment with a caring OB-GYN, like Dr. Judith Cothran of Women’s Health of Chicago. There are a number of treatment options depending on your particular needs, so call for your appointment today and get the personalized care you deserve.