Palo Alto Women's Health Center: Lydia Appiah-Dwamena, MD

You have a vast array of choices when it comes to birth control. How do you decide which is best for your needs? Board-certified OB/GYN Lydia Appiah-Dwamena, MD, of Palo Alto Women’s Center in San Antonio provides guidance when it comes to this important decision. If you need insertion of a device or a prescription, she’s also available to help. Call the office or schedule online to evaluate your birth control options. Birth Control Q & A What are the types of birth control? You have more choices than ever when it comes to birth control. Consider four major categories: Hormonal methods that prevent ovulation by altering your hormone production include the pill, implants such as Nexplanon® and DepoProvera® shot Barrier methods that stop the sperm from meeting the egg include condoms and diaphragms Intrauterine devices that are inserted into your uterus and either change your hormones to alter your cervical mucus or use copper to repel sperm Natural methods, such as cervical mucus monitoring, that have you avoid intercourse on your most fertile days Permanent methods of birth control, such as tubal ligation or vasectomy, are also an option. But these aren’t reversible, so you must be sure you’re done having a family. What should I consider when deciding on a birth control method? Not every birth control is right for every woman. Consider issues such as: Your level of sexual activity Reversibility Convenience Effectiveness Comfort Side effects You should also consider your partner’s comfort, your moral beliefs, and a method’s reversibility when weighing family-planning options. Your health history is another factor to keep in mind when settling on a birth control method. For example, women with a history of blood clots shouldn’t take the pill. Can birth control protect against sexually transmitted disease? The only methods of birth control that protects against sexually transmitted diseases are male and female condoms. The condom isn’t the most reliable when it comes to preventing pregnancy, however, so if you’re concerned about STDs, you should use dual protection: condoms to guard against disease; and a more reliable method, such as an IUD, prevent pregnancy. Do all methods of birth control require a prescription? While hormonal methods of birth control do require a prescription, many other options do not. Condoms, spermicides, and sponges are available in most drug stores. The emergency contraceptive pill is also available without a prescription, but don’t use it as your regular form of contraception as it’s not as effective as other methods. If you want to know more about your different options for birth control, call the office or book online to schedule a consultation today.

Pregnancy is an exciting time in your life but also a time full of questions and concerns. OB/GYN Lydia Appiah-Dwamena, MD, is a board-certified obstetrician and gynecologist who offers expert, compassionate pregnancy care for women at Palo Alto Women’s Health Center in San Antonio. Whether this is your first or third child, each pregnancy is different, and you deserve the best support and screenings. Call the office or book online to schedule your prenatal visits today. Pregnancy Q & A Why is prenatal care important? The medical care you receive prior to and during your pregnancy is referred to as prenatal care. Dr. Appiah-Dwamena customizes your care according to your medical history and any existing concerns, such as multiple fetuses or advanced maternal age. Personalized care can make all the difference in your pregnancy and delivery. The care offered at Palo Alto Women’s Health Center is designed to detect potential problems in the earliest stages and find solutions so you get the best possible outcome. You can also get all your questions answered about exercise, weight gain, medications, vitamins, and nutrition when you undergo prenatal care. Dr. Appiah-Dwamena is a trusted resource you can turn to throughout the nine months of pregnancy to help you achieve peace of mind and optimal health. What should I expect at prenatal care visits? At your initial visit, Dr. Appiah-Dwamena gathers information about your medical history, previous pregnancies, and your family medical history. She’ll also talk to you about your lifestyle and support network. The Palo Alto team obtains basic information, such as your weight, height, blood pressure, and other vitals. They may schedule you for specific blood tests and a urine test to check for infection. You undergo a clinical breast exam and a pelvic exam -- along with a Pap smear. They may also screen you for sexually transmitted diseases as a precaution. Dr. Appiah-Dwamena assesses your baby’s heart rate and uses ultrasound to estimate your due date. At future visits, your blood pressure and weight continue to be monitored. You’ll undergo other specific screening tests to ensure your pregnancy is progressing normally. Screenings include those for: Gestational diabetes Preeclampsia Chromosomal abnormalities or developmental challenges in your baby Use your prenatal visits to ask any questions or voice any concerns you have about your or your baby’s health or comfort. Reach out to Palo Alto Women’s Health Center if you have concerns at any point in your pregnancy. How often will I have prenatal visits? Your prenatal care schedule is customized to your health and needs. However, expect to meet with the doctor: Once per month during weeks 4-28 Once every two weeks during weeks 28-36 Once per week during weeks 36-40 If you have special considerations, such as diabetes or a baby with developmental difficulties, you may need more frequent visits. Stick to the schedule Dr. Appiah-Dwamena creates to do everything possible to have a healthy pregnancy and delivery. As soon as you know you're pregnant, schedule your first prenatal visit using the online tool or call the office.

Abnormal menstrual bleeding isn’t just inconvenient, it can be a sign of a serious health issue. At Palo Alto Women’s Health Center in San Antonio, board-certified OB/GYN Lydia Appiah-Dwamena, MD, evaluates your symptoms and determines the cause to find the right treatment for disruptive periods. If you experience exceptionally heavy periods, infrequent periods, extra long periods, or spotting, call the office or schedule online to find relief. Abnormal Bleeding Q & A What defines abnormal menstrual bleeding? While every woman’s period is different, your menstrual cycle shouldn’t interfere with your normal daily life. Most women’s periods last about five days and occur every 21-35 days. Your bleeding may be considered abnormal if it: Regularly lasts longer than five days Occurs more or less frequently than normal Features spotting between periods Happens regularly after sexual intercourse Is very heavy and is hard to control with feminine hygiene products Extreme cramping, fatigue, or other disabling symptoms also warrant a visit to Palo Alto Women’s Health Center. Is abnormal menstrual bleeding always treated? Abnormal bleeding is extremely disruptive. As a result of your cycle, you may experience: Anxiety Sleep disruption Embarrassment Plus, abnormal bleeding may be a sign of serious health issues. If you ignore abnormal bleeding, you delay treatment, and your condition may develop into something more serious with additional complications. Abnormal bleeding can also cause iron-deficient anemia that has other health ramifications. Get treated to avoid this additional health issue. What are the causes of abnormal menstrual bleeding? Abnormal bleeding can be a symptom of a variety of medical concerns. Dr. Appiah-Dwamena performs a comprehensive exam and screening tests to determine the cause. Common issues causing your bleeding may be: Uterine fibroids or polyps Endometriosis Problems with an IUD Miscarriage or ectopic pregnancy Hormonal disruption (such as during menopause) Bleeding disorders Certain types of cancer Determining the cause of abnormal bleeding is the first step in finding relief. You’ll undergo blood tests to check hormone levels and rule out certain blood conditions. Dr. Appiah-Dwamena may recommend an ultrasound to look for uterine polyps or fibroids. What is the treatment for abnormal menstrual bleeding? How Dr. Appiah-Dwamena addresses your abnormal bleeding depends on the cause. Usually, she can find a minimally invasive solution, such as changing birth control methods or altering lifestyle habits. Whatever the issue, the team at Palo Alto Women’s Health Center works with you to address abnormal bleeding and find an appropriate treatment plan. Call the office or schedule using the online tool to take your life back and eliminate the hassle, frustration, and possible health dangers of abnormal menstrual bleeding.

The average age of menopause in the United States is 51, but you may notice changes associated with this shift in your fertility much sooner. Get supportive care for all stages of menopause from board-certified OB/GYN Lydia Appiah-Dwamena, MD, of Palo Alto Women’s Health Center in San Antonio. Whether you’re experiencing disruptive symptoms of perimenopause or are in the process of menopause and have questions about changes in your health, seek the caring, compassionate support offered at the office. Call today or book an appointment online to make your transition through menopause smooth and healthy. Menopause Q & A What is menopause? Menopause is a time of transition in your hormone production and reproductive cycle. Clinically, it’s diagnosed as going 12 months without a period or ovulation. Most women experience menopause naturally during the ages of 45-55. Some women may have a medical condition or undergo a hysterectomy or cancer treatment that brings about the transition sooner. Many women sail through menopause with relative ease. Others, however, experience extreme fluctuations in hormones that are disruptive to their daily life and health. What are common indications that I’m in menopause? Not all women experience menopause symptoms. If you do, they can range in severity from mild to life-disrupting. You may have just one or two indications or experience a variety of symptoms. Usually, menopause symptoms begin several years before menopause, in a period known as perimenopause. Symptoms that indicate your menopause transition is occurring include: Hot flashes and night sweats Vaginal dryness Loss of libido Sleep disruptions Mood swings Depression or anxiety Joint or muscle ache Headaches Racing heartbeat Problems with bladder control Women going through menopause often experience weight gain, fatigue, and trouble with concentration, too. If you have any of these symptoms and they interfere with your daily life, contact Palo Alto Women’s Health Center to learn about options for treatment. What are the options for treating menopause symptoms? Menopause is a natural process, so treatment focuses on making you comfortable as your body changes. Dr. Appiah-Dwamena may offer HRT, or hormone replacement therapy, to help you restore hormonal balance and ease uncomfortable symptoms. Hormone treatment can be administered as a cream, oral pills, pellets inserted under the skin, or as injections. The method of delivery and the exact dosage depends on your symptoms and health history. Not every woman opts for hormone replacement therapy. You may benefit from lifestyle changes, laser treatments to resolve vaginal symptoms, and medications to relieve anxiety or depression. Dr. Appiah-Dwamena works with you to determine the best treatment plan for you. You’ll also learn about health changes that occur with menopause, such as an increased risk of osteoporosis, heart disease, and urinary issues, and how to manage them. If you’re transitioning into menopause, seek the support of the experts at Palo Alto Women’s Health Center. Call the office or book online.

When irregular cells are treated and cured before they develop into cancer, most cases of cervical cancer can be prevented. Regular Pap smears screen for abnormal cells that may indicate cervical cancer. At Palo Alto Women’s Health Center, board-certified OB/GYN Lydia Appiah-Dwamena offers Pap smears and any necessary follow-up to women in San Antonio. Get on a regular schedule of testing. Call the office or book online today. Pap Smears Q & A What is a Pap smear? A Pap smear is a minimally invasive screening test that evaluates you for irregular cells and potential risk of cervical cancer. Usually, you undergo a Pap smear during your well-woman pelvic exam. Dr. Appiah-Dwamena uses a swab to collect a small sample of cells from your cervix. During the smear, you feel a little pressure, but the procedure doesn’t hurt. The cells are sent to a lab for analysis. The administrative team at the office contacts you about the results within 3-7 days. How often should I get a Pap smear? You should have your first Pap smear around age 21. After that, you should plan one every three years. Women who are 30-65 may move to a schedule of every five years if screening is combined with testing for human papillomavirus -- the major cause of irregular cervical cells. If you have a history of cervical cancer or a family history of the disease, you may opt for a more frequent schedule. Talk to Dr. Appiah-Dwamena about what’s most appropriate for you. What is an abnormal Pap smear? An abnormal Pap test is not a diagnosis of cancer. Your Pap smear may be declared “abnormal” due to: Inflammation Cellular changes during aging and menopause Yeast infection Herpes Human papillomavirus (HPV) Recent sexual activity But an abnormal Pap smear shouldn’t be ignored. It can indicate irregular, precancerous cells. What happens if I have an abnormal Pap smear? Dr. Appiah-Dwamena may recommend you have a repeat Pap test within a few weeks if your first one comes back as “abnormal.” Often the abnormal cells disappear all by themselves. Additional diagnostic tests can help the doctor determine the reason for your abnormal results. A colposcopy is a screening test that uses a special magnifying lens to get a better look at cervical cells. Dr. Appiah-Dwamena may take a small sample of the cells – a biopsy – during this exam. If your abnormal Pap smear results do reveal precancer or cancer, you’ll undergo a procedure to have them excised. LEEP (loop electrosurgical excision procedure) and freezing are ways to remove the cells. Protect your cervical healthy by scheduling a Pap smear. Call Palo Alto Women’s Health Center or book online right away.

Ultrasound is a powerful imaging test that examines a developing fetus and your reproductive organs. Palo Alto Women’s Health Center in San Antonio offers in-house ultrasound. Board-certified OB/GYN Lydia Appiah-Dwamena, MD, recommends these screening tests to help diagnose or evaluate issues such as pelvic pain, pregnancy, and infertility. Call the office or schedule online to take advantage of expert ultrasound services. Ultrasound Q & A How does ultrasound work? An ultrasound is a noninvasive test that uses sound waves to obtain a picture of your pelvic organs. It uses no radiation so it’s completely safe for a developing fetus and your internal organs. During an ultrasound, you’re dressed in a hospital gown, and Dr. Appiah-Dwamena spreads a gel on your abdominal or pelvic area to help the ultrasound wand glide easily and the sound waves to transmit smoothly. As the wand glides across your body, it transmits high-frequency sound waves into the body. As the waves hit an object – such as a fetus or an organ – they bounce back, and a computer collects them to create an image. Why would I need a gynecological ultrasound? Ultrasounds are commonly recommended to evaluate a growing baby in your womb. Dr. Appiah-Dwamena uses the screening test to evaluate fetal growth, gender, and possible health concerns. Ultrasounds have other important applications. These include evaluation of your: Uterus Fallopian tubes Cervix Ovaries Bladder If you come to Palo Alto Women’s Health Center with pelvic pain, bloating, irregular menstrual bleeding, or infertility, Dr. Appiah-Dwamena may recommend an ultrasound as part of your comprehensive medical evaluation. What types of ultrasounds are available? Depending on your symptoms, you may undergo either an abdominal or transvaginal ultrasounds. An abdominal ultrasound involves the wand passing over your belly and lower pelvic region. Transvaginal ultrasounds obtain images of the lining of the uterus, ovaries, and muscular walls of the uterus via a sterile ultrasound wand inserted into the vagina. You may also undergo a saline-infused ultrasound, or sonohysterogram. This test involves injecting a small amount of a salt solution into your uterus to see the lining of the uterus more clearly. What symptoms indicate the need for a gynecological ultrasound? Dr. Appiah-Dwamena may recommend an ultrasound to evaluate the following: Irregular menses Abnormal vaginal bleeding Suspected ovarian or uterine cancer Examination of the endometrium, or uterine lining An ultrasound can also help Dr. Appiah-Dwamena diagnose a mass or cyst detected by palpitation during a pelvic exam. For more information about obstetric and gynecological ultrasounds, call Palo Alto Women’s Health Center or book an appointment online.

Infertility affects between 10 and 15% of couples. If you’ve been unable to become pregnant despite a year of actively trying, it is time for a work-up at Palo Alto Women’s Health Center in San Antonio. Board-certified OB/GYN Lydia Appiah-Dwamena, MD, works closely with you and your partner to determine the reason for your inability to get pregnant and help you go on to have a family. Call the office or schedule online to work toward a solution to your fertility challenges. Infertility Q & A When is infertility diagnosed? If you haven’t been able to get pregnant despite having regular, unprotected sex for an entire year, you’re diagnosed with infertility. Women older than 35 are diagnosed after six months of actively trying. At Palo Alto Women’s Health Center, the staff understands how frustrating and debilitating infertility can be. Dr. Appiah-Dwamena works with you to identify the reason you’re having trouble getting pregnant and offers solutions. What are the causes of infertility? Infertility isn’t always the woman’s fault. About one-third of cases can be attributed to the man, one-third to the woman, and one-third goes undiagnosed or is a combination of male and female factors. You undergo an extensive evaluation to determine the cause of infertility. Even in cases in which the cause for infertility is undetermined, women usually go on to have a healthy pregnancy. What tests evaluate infertility? Dr. Appiah-Dwamena has a woman undergo a number of screening tests if infertility is diagnosed. These include blood tests to check for hormonal issues or infection, ultrasound to look for organ abnormalities and check ovulation, and a comprehensive health exam. You may also undergo a hysterosalpingogram, which examines your uterus and fallopian tubes for abnormalities. If the test reveals blocked fallopian tubes, Dr. Appiah-Dwamena may be able to unblock them during the test. The man may also be evaluated for sperm quality and quantity. What methods address female infertility? Dr. Appiah-Dwamena may recommend certain lifestyle changes to help boost your fertility, including proper nutrition and weight loss if you’re overweight. Some women may benefit from oral or injectable hormones to stimulate ovulation. These drugs are the main treatment for women who are infertile due to issues with ovulation. Minimally invasive surgery can remove endometriosis, or an overgrowth of the uterine lining, uterine scar tissue, or fibroids that may be interfering with your fertility. Palo Alto Women’s Health Center also offers intrauterine insemination as a solution for some cases of infertility. During this procedure, Dr. Appiah-Dwamena places healthy sperm from your partner directly into your uterus around the time of ovulation. For more information about infertility evaluation and treatments, call Palo Alto Women’s Health Center, or book an appointment using the online tool.

Prevent major gynecological health issues with expert preventive care provided by board-certified OB/GYN Lydia Appiah-Dwamena, MD, of Palo Alto Women’s Health Center. Regular screenings and annual well-woman exams are part of essential preventive gynecological care offered to women in San Antonio. Call the office to receive comprehensive care for women from puberty to adulthood. Alternatively, use the online scheduler to make your appointment. Preventive Care Q & A What is preventive gynecological care? Preventive gynecological care includes well-woman exams and essential screenings, such as Pap smears and mammograms, to maintain optimal gynecological health. At Palo Alto Women’s Health Center, you also receive education about lifestyle habits such as proper nutrition, exercise, and substance use that maximize your long-term wellness. What is a well-woman exam? A well-woman exam is an annual visit with Dr. Appiah-Dwamena to discuss and evaluate your overall health and reproductive organs. The visit gives you a chance to ask any questions about your sexual and pelvic health. Plus, you update any health changes with Palo Alto Women’s Health Center so the office can best serve you. You’ll also undergo a pelvic exam and clinical breast exam as well as get recommendations for screenings, such as mammograms. What role do screenings play in a well-woman exam? As you move through the different stages in your reproductive life, your screening needs change. Starting at age 21, you’ll undergo regular Pap smears to detect abnormal cells that may develop into cervical cancer. This simple, noninvasive test occurs during your regular pelvic exam. Cervical cancer is highly treatable when caught early. Screenings for sexually transmitted diseases (STDs) are another important part of your gynecological health. Request testing if you’re sexually active, especially if you have multiple partners or your partner does. After age 40, you have the option for yearly mammograms to screen for breast cancer. From age 45-54, you should definitely go in for this screening test. After age 54, you have the option to switch to having a mammogram every two years. Other screening tests may include standard blood tests and urine tests. Dr. Appiah-Dwamena makes recommendations unique to your specific health needs. What happens during a preventive pelvic exam? During a pelvic exam, Dr. Appiah-Dwamena checks your internal and external genitalia. You lay on an exam table with your feet up in stirrups. An instrument called a speculum is inserted to separate the walls of your vagina to perform the Pap smear and check for any visual abnormalities. Dr. Appiah-Dwamena also involves a manual examination of your uterus and other reproductive organs to check for enlargement or unusual growths. If she finds anything unusual, she may refer you to other screening tests such as ultrasounds or colposcopy. Maintaining optimal gynecological health contributes to your overall well-being. Call Palo Alto Women’s Health Center or book online to schedule your preventive care.