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Author: Manisha Purohit, M.D., FACOG

According to large sample data, approximately 75 percent of all women experience hot flashes. For many women, episodes of hot flashes can last for up to five years. In addition to medication and other therapies, you can use these four at-home remedies for hot flashes. [continue reading…]

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Author: Manisha Purohit, M.D., FACOG

In the past, women who regularly experienced disruptive hot flashes had just one option: estrogen therapy. Today, new non-hormonal treatments for hot flashes are making their way onto the market after receiving FDA clearance this past summer. This is great news, as an alternative treatment for hot flashes has been long overdue. After all, many physicians and patients have expressed concerned about the use of estrogen and progesterone to reduce hot flashes. [continue reading…]

Author: Cynthia Cabello, WHNP-BC

Did you know that the people wearing the scrubs and lab coats aren’t the only ones directing the course of your appointment? Next time you visit your women’s health care provider, remember that you also have a say in how your appointment goes. Your visit with a physician or women’s health nurse practitioner is your opportunity to ask questions.

Whether out of fear, shyness, or embarrassment, many women do not ask all of their questions about sexual topics. At Arizona Associates for Women’s Health, we encourage our patients to ask any and every question they have.

Next Time You Have A Question…

Please remember:

  • Nothing makes us uncomfortable. I’ve been working in health care since 1998. Some of my colleagues have been women’s health care providers for a longer time. We’ve heard it all. And even if we haven’t, no question you want to ask or conversation you want to have is going to make us uncomfortable.
  • Your health care provider will not be judgmental. It is neither our job nor our desire to comment on the moral or ethical components of any sexual topic.
  • Your provider does not think you’re stupid. In fact, we like hearing your questions. We want to see you achieve your health goals, and asking questions and obtaining information is a fundamental part of that process.
  • Your provider has your best interests in mind. That’s right – we are your advocates. We want to see you succeed.

Sensitive Sexual Topics

Below are a few sensitive sexual topics that some women have difficulty bringing up with their health care provider. Please know that these topics – and any other you may be dealing with – are completely okay to bring up in your next appointment. If you have a concern or need information, we want to hear from you.

  • Comfort During Sex
  • Sexual Abuse
  • Sexual Orientation
  • Sex Therapy
  • Taboo Sexual Relationships

How Do You Start the Conversation?

During your appointment, your women’s health care provider will ask you if there’s anything you want to discuss. This is your opportunity to bring up anything that’s on your mind. If it’s an uncomfortable subject for you, prepare in advance by writing down your question. Many patients find this helps them articulate the issue and ask the question the way they intended.

You can even begin the question by saying something like, “This is a little uncomfortable for me, but I wanted to ask you about ___________.” 

Schedule With a Women’s Health Care Provider

Have a question that you want to ask your women’s health care provider? Contact us to schedule an appointment with a Valley-area provider.

Please consult with your provider before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

Author: Holly Todd, WHNP-BC

According to a major study by the Guttmatcher Institute, “More than 99% of women aged 15–44 who have ever had sexual intercourse have used at least one contraceptive method.” The majority of these women are using “the Pill,” a daily hormone-combination drug that prevents pregnancy. The pill has one major problem though…

You have to remember to take it at the same time every day.

And missing a day can be risky, as a skipped dosage could weaken the therapy’s effectiveness and lead to pregnancy. Many women who don’t want to have to remember a pill every day have turned to NEXPLANON, an implantable contraceptive that’s placed in the upper arm.


NEXPLANON is a small implant (just 1.6 inches) that is inserted just under the skin on the inside of the upper arm. The NEXPLANON device can stay here for three years. It works by gradually releasing a progestin hormone called etonogestrel. This hormone offers continuous pregnancy prevention. You don’t have to do anything else. It just works.

If you want birth control for longer than three years, you simply have your health care provider remove the old device and place a new one in your arm after the three-year mark. If you decide you want to get pregnant while you have the device, simply have your health care provider remove it, and you may become pregnant as early as one week following removal of the device.

As far as effectiveness is concerned, patients should have no worries. NEXPLANON is over 99 percent effective – just like the pill.


Inserting the device is a simple, in-office procedure with very little or no pain. The area is numbed before the device is inserted. It’s normal to feel some soreness in the arm for a few days following the birth control implant. After this goes away, you don’t have to even think about the device for the next three years.

Is NEXPLANON Right for Me?

If you want a birth control option that doesn’t require any thought, action, or planning on your part, NEXPLANON could be a great option. NEXPLANON isn’t right for everyone, including women who have blood clots, diabetes, high cholesterol, high blood pressure, and some other health issues. Your provider at Arizona Associates for Women’s Health can tell you more.

NEXPLANON In Arizona: Schedule An Appointment

To learn more about NEXPLANON and other birth control implants, contact us to schedule an appointment. Read more about birth control here.

Please consult with your provider before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

Author: Andrew Adamson, D.O.

According to the Centers for Disease Control, there are 20 million new sexually transmitted infections in the U.S. each year (with a total 110 million infections). Half of these infections occur in people under the age of 24, with HPV (human papillomavirus) being the most common sexually transmitted infection.

All sexually active women should know at least the basics about sexually transmitted disease. Ask your women’s health care provider if you have questions.

Who’s At-Risk for STDs?

Anyone who is sexually active is at some risk for sexually transmitted disease. Risk factors include:

  • Unprotected sex
  • Multiple sexual partners
  • Having a history of STIs
  • Substance abuse
  • Needle sharing
  • Victims of forced sexual intercourse
  • Being an adolescent female

How Can I Do In Preventing STDs?

Abstinence is the only effective method for preventing STDs. People in long-term monogamous relationships are also at a lower risk for sexually transmitted disease. The use of a latex condom can lower risk for some – but not all – STIs.

What Should I Do If I Think I Have an STD?

Symptoms of sexually transmitted disease may include:

  • Pain during sex
  • Pain in the lower abdomen
  • Painful or burning urination
  • Sores or bumps in the genital, oral, or rectal areas
  • Sore or swollen lymph nodes (groin or elsewhere)
  • Unusual vaginal bleeding
  • Unusual vaginal discharge
  • Rash

If you experience any of these symptoms, schedule an appointment with your women’s health care provider.

Common STIs

Some of the more common sexually transmitted infections in the U.S. include:

  • Bacterial Vaginosis
  • Chlamydia
  • Genital Herpes
  • Gonorrhea
  • HPV Infection
  • Human papillomavirus (HPV) and Oropharyngeal Cancer
  • Pelvic Inflammatory Disease
  • Syphilis
  • Trichomoniasis

These infections generally fall into three categories: bacterial, parasitic and viral. Some sexually transmitted infections, such as bacterial STIs, can be cured (typically with antibiotics). Viral STIs, however, are not curable. These include herpes, genital warts, and HIV.

Schedule An Appointment With a Women’s Health Care Provider

To schedule an appointment with a Valley-area women’s health care provider, contact Arizona Associates for Women’s Health.
Please consult with your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

Author: Stephen David Frausto, M.D., FACOG

There was a growing trend in obstetric health care to elective inductions before 40 weeks gestation. As Emily Oster writes for Slate, “In 1990, fewer than 10 percent of births followed medical induction of labor; by 2009, this number had risen to 25 percent. This increase has occurred across the board, not just for babies who are overdue. In 1990, only 7 percent of births at 39 weeks of pregnancy were induced, but 23 percent were induced by 2009.”

The facts are indisputable. Elective inductions were on the rise. Recent recommendations from the American College of Obstetricians and Gynecologists and World Health Organizations encourage elective inductions be delayed until after 39-40 weeks gestation.

Hospitals and physicians have adopted policies to ensure compliance with these recommendations.

Even though the last weeks of pregnancy can be difficult for moms with increased aches and pains and difficulty sleeping, these few weeks are very important for the developing infant.

Elective Induction vs Induction for Medical Indications. 

There are a number of valid medical reasons to induce before 40 weeks. If your obstetrician has reason to believe that carrying to full term could put you or your baby’s health at risk, then an induction for medical indications may be the right decision. Your obstetrician will discuss the risks and benefits of this early induction.

At 41 weeks gestation risks to the infant increase and an induction at this stage is medically indicated.

An elective induction because the mom is tired, sick of being pregnant, obstetrician going on vacation or her mother is scheduled to fly in for the birth are not valid reasons to deliver before 40 weeks gestation.

All those annoying “Braxton Hicks” contractions you feel in the last weeks of pregnancy really do serve a purpose. Be patient, and try to enjoy those last weeks.

Please do not request an induction prior to 40 weeks if there are no medical indications.

Your obstetrician is looking out for the health of your infant.

Why Not Induce Before 40 Weeks?

  • Babies inducted before 39 completed weeks are at increased risk for “breathing problems, infection, and admission to a neonatal intensive care unit (NICU),” reports Childbirth Connection.
  • Women who are induced are more likely to request an epidural for pain. Epidurals include their own set of risk factors.
  • Induction may increase risk of having to have cesarean section.

Should I Be Wary of Having An Induction?

Not necessarily. As I stated above, there are plenty of valid reasons to be induced prior to 40 weeks. If you’re looking for an obstetrician to provide care throughout your pregnancy, don’t be timid in asking for their opinion about induction before 40 weeks. You have a right to know how your obstetrician approaches this issue – and any other issue – that could affect you and your baby’s health.

On the other end of the spectrum, if your baby has made no attempt to enter the world on her own at 41 weeks, your obstetrician may suggest an induction. This medically indicated induction at this stage could actually help lower certain risk factors.

Looking for a Valley-Area Obstetrician?

To schedule an appointment with an obstetrician in the Valley area, contact Arizona Associates for Women’s Health. Offices in Mesa and Tempe, AZ. Learn more about our obstetric services.

Please consult with your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

Author: Manisha Purohit, M.D., FACOG

Every year, “more than one million women have an episode of PID,” reports womenshealth.gov. Pelvic inflammatory disease (PID) is an infection of the female pelvic organs, which include the uterus, fallopian tubes, ovaries, and cervix. While PID is most commonly caused by bacteria associated with chlamydia and gonorrhea, sexually transmitted infections aren’t the only cause of PID. Other infections unrelated to sexual activity can also cause PID.

If you’ve recently seen a provider for pelvic inflammatory disorder or any kind of pelvic infection, it’s essential that you follow your provider’s recommendations and seek follow-up care with a provider.

When Should I See My Provider?

Common symptoms associated with pelvic infection include:

  • Pain in the lower abdomen
  • Fever
  • Bleeding between periods or during sexual activity
  • Painful urination
  • Painful sex
  • Unusual or foul-smelling vaginal discharge

If you experience any of the symptoms (whether you’ve been diagnosed with pelvic infection or not), you should contact your provider immediately. When it comes to STIs, the sooner you can get treatment, the better. Do not assume that an STI will get better on its own, or that symptoms will go away with time. Acting fast is important; as infections may be easier to treat the sooner they are identified, resolving the symptoms faster.

Seeking Follow-Up Care for Pelvic Infection

Once you see your gynecologist, you may be given oral or an intramuscular antibiotic to clear up the infection. (In severe cases, intravenous treatment may be necessary.) It is not uncommon for symptoms to fully resolve before the antibiotic therapy is complete. However, it’s essential that you complete the full course of antibiotics, as failure to do so could have serious health consequences. While you may feel better, the bacteria may not have been fully eradicated if you haven’t finished the antibiotics.

Your provider’s office likely scheduled a follow-up appointment after your initial treatment. It is very important to attend this follow-up appointment so your provider can monitor your treatment and recovery. If you are unable to make this follow-up appointment for any reason, let your provider’s office know in advance, and reschedule for the next available time.

Schedule Follow-Up Care for Pelvic Infection

If you’ve recently received treatment for a pelvic infection, schedule a follow-up appointment with your gynecologist. If you do not have a provider, contact us to schedule an appointment with a Valley-area OB/GYN. Learn more about care for gynecologic issues at Arizona Associates for Women’s Health.

Please consult with your provider before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

Author: Stephen Frausto, M.D., FACOG

It’s often the case that I see patients once they have already come to believe they have a fertility problem. (I say, “come to believe,” because, in many cases, infertility isn’t actually the problem. Rather, it’s just a matter of timing or frequency!)

While there’s oftentimes something to be done for infertility, the best medicine for any health condition is preventive medicine. By taking proper precautions and adopting healthy behaviors early on, you may avoid infertility problems later in life when you want to become pregnant. Of course, it’s important to add a disclaimer to that statement: many causes of infertility are unknown. And for some health issues that affect fertility – like endometriosis – there are few or no verified preventive measures.

Prevent Infertility With These Tips

  1. Exercise regularly.
  2. Quit smoking.
  3. No alcohol or drugs.
  4. Maintain a healthy weight
  5. Tell your doctor that you’re trying to become pregnant – especially if you’re taking prescription medications. Some drugs may inhibit your ability to become pregnant, which your physician may have not considered if you did not tell him or her of your intent.
  6. Caffeine consumption may make it more difficult to become pregnant. Consider cutting back on coffee and soda.
  7. Find healthy ways to cope with stress.

There are things that men can do, as well, to prevent male infertility. Talk to your gynecologist at Arizona Associates for Women’s Health in Mesa or Tempe to learn more about how you can take charge of your fertility.

Schedule An Appointment With a Mesa/Tempe OB/GYN

Are you having difficulty becoming pregnant? See this page for information about how many months of unprotected sex you should attempt before seeking fertility care. You can also use this brief online questionnaire to have someone from Arizona Associates for Women’s Health contact you. To schedule an appointment, call 480-257-2700, or schedule online.

Please consult with your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

Author: Andrew Adamson, D.O.

In one of my last blog posts, I wrote about the symptoms and treatment of osteoporosis – a bone disease that affects at least one in 10 women over the age of 50 (and one in five over the age of 70). But one important topic I didn’t touch on is vitamin D. This vitamin, which is obtained through sun exposure, plays a key role in bone health. Having a vitamin D deficiency can put you at risk for some serious health problems, including osteoporosis.

What does vitamin D do?

Vitamin D helps your body absorb calcium. Calcium, of course, is one of the primary minerals involved in building and strengthening the bones. So, without adequate vitamin D intake, your bones may not be able to get the calcium they need for preventing fractures and bone density loss.

You may have noticed that the milk you buy at the grocery (whether dairy, soy, almond, or other) is fortified with vitamin D. Many brands add vitamin D to their calcium-rich food products so that they can claim a good-for-your-bones product!

What’s the best way to get vitamin D?

The best way to get your daily vitamin D is to spend time under the sun. There are very few foods in nature (e.g. fatty fish, mushrooms grown with certain lighting techniques…) that offer sufficient vitamin D. If regular sunshine isn’t an option because of your work, lifestyle, season, or location, consider taking a vitamin D supplement. Many multivitamin pills already include vitamin D.

Am I getting enough vitamin D?

The RDA (that’s “recommended dietary allowance”) of vitamin D for adults is 600 IU per day (800 IU/day for adults over the age of 70). Creating a correlation between 600 IU and actual time spent under the sun can be complicated, as there are many factors involved, including skin type and the strength of the sun’s rays. The Vitamin D Council offers some helpful tables and example scenarios on this topic here.

Have Questions? Schedule An Appointment

Are you concerned that you – or your mom – could be at risk for a vitamin D deficiency? If so, schedule an appointment with us at Arizona Associates for Women’s Health. Vitamin D deficiency and bone health are important components of comprehensive care for women. You can call 480-844-4702 or schedule with a Mesa gynecologist online.
Please consult with your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.



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