Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Depot medroxyprogesterone acetate (DMPA) is a synthetic long-acting form of
the hormone progesterone. DMPA is similar to the birth-control minipill in that
it does not contain estrogen. Like other progesterone-based contraceptives, DMPA
acts by preventing the release of the egg from the ovary (ovulation) and by
promoting thick cervical mucus that impedes the sperm's progress. Its
effectiveness in preventing pregnancy is close to 100%.
DMPA must be injected by a health-care professional every three months (12
weeks). It is administered as a deep muscle (intramuscular) injection. A
lower-dose formulation of the drug that is injected beneath the skin
(subcutaneously) is also available. The injection must be administered within the
first five days of a woman's menstrual period. She is then protected from
pregnancy within 24 hours of receiving the injection.
A woman may stop having periods altogether after using DMPA for one year.
After two years of use, 70% of women will have no menstrual bleeding. Menstrual
periods stop because the DMPA causes the ovaries to go into a "resting" state.
When the ovaries do not release an egg every month, the regular growth of the
lining of the uterus does not occur and no uterine lining is shed during the
subsequent menstrual cycle.
A woman's menstrual periods should begin again within six to 18 months after
she stops taking the injections. A woman can also become pregnant, usually
within 12 to 18 months, once she stops using DMPA. If a new mother does not
breastfeed her baby, she can resume the injections right after childbirth.
Mothers who are breastfeeding can safely begin the injections six weeks after
childbirth. The injections do not reduce the flow of her breast milk, and no
harmful effects on the baby have been noted.
The most common side effects of DMPA injections are irregular menstrual
cycles, cessation of menstrual periods, and weight gain. Other side effects may
include nervousness, dizziness, stomach discomfort, headaches, fatigue, or
breast tenderness. It is important that a woman realize that once she has been
injected with DMPA, any side effects she may experience cannot be neutralized or
eliminated. She has to tolerate these side effects until the medication wears
off, typically three months later.
DMPA has also been shown to have a negative effect on bone mineral density,
especially with longer-term use; however, studies have shown that her previous
bone density is usually restored when the drug is discontinued.
Women may be able to use DMPA when avoidance of estrogen is prudent for
medical reasons (see oral contraceptives). A qualified health-care provider
should be able to help make the proper distinction. DMPA should not be used by
women who have a history of breast cancer, blood clots, liver disease,
unexplained vaginal bleeding, or stroke. A woman on DMPA should contact her
health-care professional if she experiences a heavy menstrual flow, severe
abdominal pain, headaches, or depression.
DMPA injections are over 99% effective if the injections are received
according to the correct schedule. A woman using injection contraceptives has
the advantage of being capable of becoming pregnant at a later time, if desired,
simply by discontinuing use. DMPA does not increase a woman's risk of cancer,
including breast cancer, and greatly reduces her risk of developing
uterine
cancer.
Injectable hormonal contraceptives do not protect against sexually
transmitted infections.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including: over age 50, endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Ovarian cysts are fluid-filled, sac-like structures within an ovary. Causes of ovarian cysts are numerous. Symptoms of an ovarian cysts may be pain in the belly or pelvis. Treatment of an ovarian cysts depends on type of cyst.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
Amenorrhea is a condition in which there is an absense of menstrual periods in a woman. There are two types of amenorrhea, 1) primary and 2) secondary. Treatment of amenorrhea depends on the type (primary or secondary). In prmiray, surgery may be an option and in secondary amenorrhea medication or lifestyle changes may be treatment options.
There are a number of different methods of birth control to include: barrier methods, IUDs, hormonal methods, natural methods, and surgical sterilization. Birth control methods can be reversible or permanent. In simple terms, all methods of birth control are based on either preventing a man's sperm from reaching and entering a woman's egg (fertilization) or preventing the fertilized egg from implanting in the woman's uterus (her womb) and starting to grow.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
There are four phases to the sexual response for men and women. Couple do not usually reach each phase at the same time, and they are dependant from individual to individual. The four phases of the sexual response cycle include phase 1, excitement; phase 2, plateau; phase 3 orgasm; and phase 4 resolution.
Reproductive health encompasses the beginning of menstruation for women, choosing the right birth control method for you and your partner, preventing contracting sexually transmitted diseases (STDs), and for women, ending with the menopausal transition.
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