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        | FAQ |  
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        | 1. 
 | At what age should I have my first gyn exam? Unless there is a medical problem, you should have your first pelvic exam around the age of 21 years or sooner if you begin sexual activity. |  
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        | 2. | When should I get my first mammogram? |  
        |  | Women age 40 and older should have mammograms every one or two years.   However, the likelihood of developing breast cancer is higher if a close   blood relative has been diagnosed with the disease, especially if they   were diagnosed before the age of 50. Likewise, women who began having   their periods before the age of 12 or who went through menopause after the age of 55 are at higher risk, as are women who had their   first child after age 30 or who never had a child. If you believe you   may be at a higher risk, ask your physician when you should start being   examined. |  
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        | 3. | What do I do if I missed one or two days of birth control pills? |  
        |  | First, read the instructions that came with your pill. Generally   speaking, if you miss one pill, take two pills the next day. If you miss   two pills, take two pills on each of the next two days. It’s best to   use a backup contraception method such as condoms for the remainder of the month. |  
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        | 4. | Is the patch safe? |  
        |  | The Orth Evra patch releases a higher estrogen level than what is   received from oral birth control pills. Please discuss with your doctor   whether the patch is a good choice for you. |  
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        | 5. | Can I have a pap smear if I have my period? |  
        |  | You should try to schedule your annual exam for when you are not having   your period. However, you can have a pap smear during your period as   long as the flow is not very heavy. |  
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        | 6. | How much calcium do I need? |  
        |  | Adults under the age of 50 should get 1,000 mg of calcium every day.   Over the age of 50, the amount goes up to 1,200 mg. The best way to get   your calcium is in your food. |  
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        | 7. | I have gone through menopause but am experiencing spotting or staining. What should I do? |  
        |  | Call the doctor’s office and speak with the nurse or doctor about your symptoms |  
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        | 8. | What should I do if I think I have a vaginal infection or a urinary tract infection (UTI)? |  
        |  | Call our office to schedule an exam. |  
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        | 9. | Should I be tested for HPV? |  
        |  | If you are sexually active, you are at risk of exposure to human   papillomavirus (HPV, or genital warts). Please discuss HPV testing with   your doctor during your visit. When your Pap smear is performed the   cells can be tested for HPV. |  
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        | 10. | Should I get the HPV vaccine? |  
        |  | The HPV vaccine is recommended for adolescent girls who are not sexually   active. Females who are sexually active may also benefit from the   vaccine. The HPV vaccine is not recommended for pregnant women. |  
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        | 11. | When should I schedule my first prenatal visit? |  
        |  | If you’ve tested positive with a home pregnancy test, give us a call. We   will schedule an appointment for you approximately eight weeks from   your last menstrual period. |  
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        | 12. | What foods should I avoid during pregnancy? |  
        |  | During pregnancy you should avoid fish that contains Mercury (including   swordfish, tile fish, mackerel and shark). Also avoid saccharine,   alcohol, deli meats, unpasteurized cheeses, and meat, poultry and fish   that have been under-cooked. |  
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        | 13. | Is it safe to have sex during pregnancy? |  
        |  | For most women, there is no medical reason not to have sex during   pregnancy. Unless your pregnancy is classified as high risk or if there   are other safety concerns, you and your partner can have sex without   fear of harming your baby. |  
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        | 14. | Is it safe to exercise when I’m pregnant? |  
        |  | It is safe to exercise in moderation during pregnancy, unless your   obstetrician advises against it. Some exercises can help with   childbirth. |  
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        | 15. | What medications can I safely take when I am pregnant? |  
        |  | Prenatal vitamins, which are now available without a prescription, are   safe to take during pregnancy. For any other medications, vitamins,   herbal remedies or supplements, check with your physician. |  
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        | 16. | What medications can I take for a cold during pregnancy? |  
        |  | If you are pregnant and you get a cold, check with your physician before   taking any over-the-counter cold or cough medications, especially if   they contain aspirin or ibuprofen. In most cases, it is safe to take   Tylenol (acetaminophen) for minor aches and pains. Saline nasal sprays   or steam inhalation may help with congestion. Remember to drink lots of   fluids. |  
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        | 17. | Should I get the flu shot when I am pregnant? |  
        |  | We recommend that you get a flu shot if you are pregnant during flu   season. It’s safe to get a flu shot even if you are in the first   trimester. |  
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        | 18. | What do I do if I am exposed to someone with Fifth disease? |  
        |  | Most pregnant women experience no serious complications if they are   exposed to the Fifth disease virus. However, anemia or miscarriage is   possible, especially in the early stages of pregnancy. If you suspect or   know you’ve been exposed to the Fifth disease virus, contact your   health care provider. If you have the virus, your physician may decide   to monitor you more closely. |  
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        | 19. | Is it safe to get my hair colored during pregnancy? |  
        |  | Since very little of the chemicals in hair dye are absorbed into your   system, it’s probably safe to dye your hair during pregnancy. However,   if you’re concerned, you might consider waiting until the second   trimester, when your developing baby is less vulnerable. You might also   consider streaking, highlighting, frosting or other options in which the   chemicals have little or no contact with your scalp. |  
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        | 20. | Is it safe for me to be around paint fumes? |  
        |  | Exposure to paint fumes has not been shown to harm developing fetuses.   However, you may wish to avoid prolonged exposure if the smell bothers   you. |  
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        | 21. | What is infertility? |  
        |  | Infertility is a disease or condition of the reproductive system often   diagnosed after a couple has had one year of unprotected, well-timed   intercourse, or if the woman has been unable to carry a pregnancy that   results in a live birth. |  
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        | 22. | Is infertility a "women's problem?" |  
        |  | Infertility is a medical problem. Approximately 35% of infertility is   due to a female factor and 35% is due to a male factor. In the balance   of cases, infertility results from problems in both partners or the   cause of the infertility cannot be explained. |  
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        | 23. | How long should we try before we see a doctor? |  
        |  | Experts often advise you not to be concerned unless you have been trying   to conceive for at least one year, unless you do not menstruate   regularly. However, if you are over 30 years old, have a history of   pelvic inflammatory disease, painful periods, miscarriage, irregular   cycles, or if your partner has a known low sperm count, it is often   recommended by doctors that you may want to seek help sooner. Many   couples have a hard time admitting that there may be an infertility   problem. After each menstrual period, they hope that "maybe it will work   this cycle". When these hopes are dashed month after month, a woman   often consults her regular Ob/Gyn or a fertility specialist. |  
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        | 24. | What is a Fertility Specialist? |  
        |  | A fertility specialist, or Reproductive Endocrinologist, is a medical   doctor who has been specially trained in the complex issues that can   contribute to infertility. In addition to being trained as an Ob/Gyn, a   Reproductive Endocrinologist must complete highly specialized training   for all aspects of infertility. Below are the school and training   requirements that an Ob/Gyn and Reproductive Endocrinologist must   complete.   To become Board Certified in Ob/Gyn, the doctor must: |  
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          graduate from college & medical schoolcomplete 4-year residency in Ob/Gyn pass written exam in Ob/Gyncomplete 2-year practice experiencepass oral exam in Ob/Gyn |  
        |  | To become Board Certified in Reproductive Endocrinology, the doctor must: |  
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            complete all requirements for Ob/Gyn board certification (see above) attend 2 or 3-year fellowship in reproductive endocrinology pass written exam in reproductive endocrinology pass oral exam in Ob/Gyn complete 2-year practice experience pass 3-hour oral exam in reproductive endocrinology |  
        |  | Currently in the Unites States, there are only about 1000 Board   Certified Reproductive Endocrinologists. These physicians have completed   fellowships and passed exams to become Board Certified in Reproductive   Endocrinology. |  
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        | 25. | At what time of the month is a woman most fertile? |  
        |  |  The most fertile time of the month is just before or at ovulation.   Ovulation usually occurs two weeks before a period starts, so it is   necessary to count backwards from the anticipated start of the next   period in order to find the most fertile time. Take the number of days   in the usual cycle (from the beginning of one period to the beginning of   the next) and subtract 14. For example, a woman with a 32 day cycle    would likely ovulate around day 18 (32-14=18), while a woman with a 28   day cycle would ovulate around day 14 (28-14=14).
 Because the sperm live longer than the egg does, it is best to have   intercourse before ovulation rather than afterwards, so a woman who   ovulates on day 14 would have a good chance of conceiving if she has   intercourse on either day 13 or 14. For women with irregular cycles, one   way to decide on the potential fertile period is by taking the shortest   cycle and subtracting 16, then taking the longest cycle and subtracting   12. This would give the fertile time and allow for even more   fluctuation in cycle length than usual. For example, the fertile period   for a woman whose cycles vary from 27 to 33 days should be sometime   between day 11 (27-16=11) and 21 (33-12=21).
 Alternatively, women with irregular cycles may want to use an   ovulation predictor kit, which can be purchased over the counter at drug   stores. One important fact to note is that, if a woman is using a basal   body temperature chart, that the temperature will rise after ovulation,   and therefore after the most fertile period. The couple should   therefore not wait until the temperature has risen to start to have   intercourse, as they will have missed the most fertile time. |  
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        | 26. | How can a woman tell when she ovulates? |  
        |  | The simple, inexpensive way of finding out the approximate time when you   ovulate is to take your basal temperature (that is, your body   temperature at rest) every morning and record it on a chart. You can buy   a Basal Body Thermometer at your drug store. Save all your charts so   you can review them with your doctor. Three or four months of charting   should be adequate. |  
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        | 27. | Are there any other ways to detect ovulation? |  
        |  | Yes. You can buy an ovulation predictor urine test at your drug store.   Also, your body may signal when you are about to ovulate; many women   feel twinges in their lower abdomen (your ovaries are on the right and   left sides of your lower abdomen). Other women notice clear, stretchy   vaginal discharge just at their fertile time. Your doctor can also   request an ultrasound or appropriate blood tests to determine ovulation. |  
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        | 28. | How often should we have intercourse? |  
        |  | It is a good idea to have intercourse every other day around the time   you ovulate. (Day 10, 12, 14, and 16.) Remember, every woman is   different, and may not ovulate exactly on "Day 14." And, just because   you ovulated on "Day 14" this month, doesn't mean you will next month.   It is preferable to have intercourse every other day rather than every   day so that sufficient sperm will be available. To increase your chances   of the egg becoming fertilized, it is generally recommended that you do   not douche or use lubricants immediately before having intercourse. |  
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        | 29. | What tests MIGHT our fertility specialist perform? |  
        |  | Your doctor will likely do the following: |  
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            Blood tests to check all hormone levels in the woman; thyroid, prolactin, and androgen levels Complete semen analysis on the male partner Hysterosalpingogram (HSG), an x-ray to evaluate if the woman's fallopian tubes are open Endometrial biopsy, to check the quality of the uterine lining (if appropriate) Laparoscopy, outpatient surgery to check for endometriosis or pelvic scarring in the woman |  
        |  | If you have not had these tests done, ask your doctor about them. |  
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        | 30. | How is a semen analysis done? |  
        |  | The lab will provide instructions to abstain from sex for a certain   period of time before the test, and it will give you a small jar to use   for the specimen. Generally, after masturbating and ejaculating into the   jar, you must take the whole specimen immediately to the lab. You may   be asked to produce a specimen at the lab, where they will provide a   private room. |  
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