PREVENTIVE WELLNESS

ANNUAL EXAM

The thought of seeing a gynecologist, especially for the first time, can be a frightening feeling for many women. At MOGA, we realize that this is a sensitive experience, and make every effort to put you at ease. During your annual exam, we will usually check your blood pressure, stick your finger to obtain a small blood sample, and have you provide us with a urine sample for testing. You should avoid sexual activity or douching for 24 hours prior to your appointment. Your physician will ask you some questions about your personal and family health histories. For the physical exam, he or she will first examine the outside of your vagina for abnormalities. Using a speculum to hold the vagina open, he or she will then view the inside of your vagina and cervix. Your MOGA physician will often perform a Pap test as well during this exam. This involves removing a sample of cells from the cervix using a small brush. These will be tested at a lab for cervical cancer and other abnormalities. Additionally, a breast exam will be performed to check for lumps or other abnormalities. This is also your opportunity to ask questions about your gynecological health. Please give these questions some advance thought so that you can make the most of your visit.

SCREENING MAMMOGRAPHY

The American Cancer Society recommends that every woman have her baseline (initial) mammogram at age 35, and begin having annual screening mammograms at age 40. The physicians of MOGA subscribe to this recommendation. MOGA is pleased to offer on-site mammography at our Wolfchase, East (Baptist Women’s Hospital), and DeSoto offices. If your annual exam is at one of these offices, you may want to schedule your mammogram to coincide with the appointment.

What Happens?  The technician will ask you to undress from the waist up, and put on a hospital gown which opens in the front. She will then position you next to the machine, helping you to rest each breast on a metal plate and arrange as much breast tissue as possible between the bottom plate and the top compression plate. The compression will last about ten seconds. During this time, the machine will make both vertical and lateral images. Sometimes, images will need to be re-done for better accuracy. This is simply an effort to get the most accurate results possible, and does not necessarily mean there is a problem.

Can I Make It Less Painful? Breasts are a tender part of your body, and the squeezing by the machine is – although necessary—somewhat uncomfortable. The good news is that there are some things you can do to lessen the discomfort:

• Schedule your appointment about one week after your period starts.
• Cut down on caffeine for two weeks prior to your mammogram.

What About the Results?  Your results will be interpreted by a radiologist. The radiologist will often write a report and send it to your physician. You should also receive a letter by mail giving you the general results. If you do not hear from us within thirty days, please call and let us know. If your results are abnormal, remain calm. Only about 10% of women with abnormal screenings will truly have breast cancer. A digital mammogram or breast biopsy may be necessary for additional study.

How Do I Schedule My Mammogram?  To request an appointment for your mammogram, call the MOGA East (Baptist Women’s Hospital) office at (901) 767-8442, or the MOGA Wolfchase office at (901) 373-9221.

SCREENING BONE DENSITOMETRY

One of our goals at MOGA is the prevention of bone fractures. We have acted upon this concern by offering bone density scanning at our Wolfchase, East (Baptist Women’s Hospital), and Germantown locations. Individuals who easily experience fractures may be suffering from either osteoporosis or osteopenia.

Osteoporosis is a disorder in which the bones increasingly become brittle, porous, and subject to fracture. It is caused by a loss of calcium or other important mineral components, and often results in pain, lessening of height, and skeletal deformities. It is more severe than osteopenia.

Osteopenia is a general reduction in bone mass. It is caused by the disappearance of bone tissue at a rate that exceeds formation.

How do we Test?  Dual Energy X-ray Absorptiometry (DEXA) scanning is a method for measuring bone mineral density (BMD). Our patients lie on an exam table which is attached to an overhead scanner. As it slowly moves, the scanner aims two X-ray beams with differing energy levels at the patient's bones. The scan measures the amount of soft tissue absorption, and thus determines a “T-score.”

DEXA scans are more accurate than x-rays, require less radiation than CT scans, and are less costly than most other related tests. Medicare will cover an initial DEXA scan, along with a repeat scan once every 24 months. If you are diagnosed with osteoporosis and placed on medication for it, Medicare will cover a repeat scan after one year.

DETERMINING THE RISK: What is Your T-Score? The T-score is an indication of the quality of your bone mass, and can indicate your risk for a fracture. Specifically, it is a comparison of a patient’s bone mineral density to that of a healthy thirty-year-old of the same age and ethnicity. This value is used for women who are post-menopausal. Patients with a T-score between -1.0 and -2.5 are normally diagnosed with osteopenia. Patients with a T-score which is less than -2.5 are normally diagnosed with osteoporosis.

What are the Risk Factors?  Patients who exhibit certain risk factors are much more likely to experience loss of bone mass:

• ethnicity: Caucasian and Asian women are at the highest level of risk.
• low body weight.
• lifestyle: Cigarette smoking, alcohol consumption, improper eating habits, and an inactive lifestyle are all factors which place a woman at greater risk.
• menstrual history: Women who began menstruating at age 15 or older are at greater risk.
• diet and nutrition: Women who consume too much protein or caffeine, and who eat less than five daily servings of fruits and vegetables, are at greater risk.
• family history of osteoporosis, hip fracture, or fragility fracture.

Medicare will cover a DEXA scan every two years, and all women over the age of 65 should have one performed accordingly. Women who are at high risk should begin getting one at age 60. For individuals who have certain risk factors, a physician may recommend a scan at an even earlier age. Some of these risk factors include:

To find out if you are currently at a high risk for fractures, call today to request an appointment with one of our physicians.

HPV SCREENING

Human Papillomavirus (HPV) is a virus which exists in over 100 different forms. It is passed from person to person through skin-to-skin contact. About 30 types of HPV infect the genital areas of men and women, and are spread through sexual contact. There about twelve types of HPV which cause genital warts, and there are about fifteen types of HPV which are linked to cervical cancer.

A Pap test collects cells from the cervix and then looks for abnormalities before they have a chance to become precancerous. The American College of Obstetricians and Gynecologists (ACOG) recommends that women have their first Pap test at age 21, and then repeat it every year thereafter. In most cases, this can be amended to every three years after a woman reaches her thirties.

MOGA recommends HPV vaccination and counseling for teenage girls and young women who have not had it. The most commonly-used HPV vaccines are Gardasil and Cervarix. Gardasil is given as a three-dose series: initial, 1-2 months after 1st dose, and 6 months after 1st dose. It is recommended that girls begin receiving Gardasil before they become sexually active. It can be given at age 9, but the recommended age is 11. Cervarix is an alternative product which is prescribed and used by physicians in a very similar manner. Your MOGA physician will provide you with clarifications and recommendations for your particular situation.