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Women’s Health

Women’s Health

If you were to ask women if taking hormones, specifically hormone replacement therapy, is safe, most would say, “well, I think they can cause cancer. So maybe not” or something like that.  And, unfortunately, many health care providers might support that position. So, let’s talk.

First, let’s talk about what hormones are. These are important compounds produced by special glands, called endocrine glands, which are secreted into the blood and go off to specific tissues of other organs to illicit specific responses. For instance, insulin is secreted by the pancreas and allows tissue to absorb glucose from blood into the cells which can then be used to produce energy in that cell. And this is just one action of insulin.

Thus, hormones perform essential functions without which the body would not function well and we would be chronically ill or perhaps not even be able to live.  If your thyroid gland and its hormones are not functioning well, you can have difficulty losing weight and feel cold much of the time. And type I diabetics can’t produce insulin and back before the development of insulin for injection, this diagnosis was universally fatal.

But this blog is about hormone replacement therapy, or HRT.

The Sex Hormones

The sex hormones are estrogen, testosterone and progesterone. Women’s sex hormone producing organs, or gonads, are the ovaries and men’s are the testes and these are the primary sources of these hormones.  The ovary produces all three and the testes produces testosterone and, yes, estrogen as well. Both sexes start the major production of these hormones at puberty, with onset usually between the ages of 10 and 13 years old. The effects of these hormones are what primarily makes us look like women and men instead of girls and boys as we become adults.

Women produce a lot more estrogen than men and men produce much more testosterone than women but both sexes have them and they have many functions in both sexes.  For women, estrogen is important for breast tissue development, vaginal and vulvar health and function, reproduction and bone and brain health. Testosterone is important for muscle development, health and strength, energy and stamina, brain function, sexual desire, mood and bone metabolism.

Aging and menopause

After women begin to ovulate, they produce estrogen and progesterone and continue to do so until menopause, when they quit ovulating and the production of both hormones drop dramatically.  Testosterone production also begins with puberty but it’s production can start dropping earlier, often in the late twenties or early thirties; its production is not so ovulatory dependent. With decreased production of these hormones, symptoms may start to develop even before full menopause.

Perimenopause refers to the years leading up to cessation of ovulation, or menopause, and is often associated with shortened and/or irregular cycles, more variation in production of estrogen and progesterone and as a consequence, a variety of symptoms including hot flashes, mood swings, sleep disturbances and sexual dysfunction.  Hot flashes, vaginal dryness, painful intercourse and lowered libido will often worsen as a woman transitions into menopause.

Hormone Replacement Therapy

If we produce these hormones when we are younger and benefit from all their functions but as we age we produce less of them and thus suffer from the lack of these functions, it only stands to reason that if we had them back, we’d probably feel a lot better.  Right? Well, in the early part of the last century, the administration of estrogen to women for relief of these symptoms started.  In the 1930’s, it was discovered that certain plants produced estrogen, testosterone and progesterone that was biologically identical to what our human body produces. And pharmaceutical companies found other sources or developed synthetic options of sex hormones.

Women benefited from HRT for many years thereafter but in the late nineties a large study, The Women’s Health Initiative, or WHI, found that women who were given oral estrogen with a synthetic progestin (not the progesterone the body produces) had a slightly higher rate of breast cancer. It also showed that women who got estrogen only did NOT have an increased risk over placebo. Unfortunately, many patients and providers did not act on the distinction and stopped HRT.

Since then, multiple studies have supported the benefits and safety of HRT when done properly. Taking estrogen does not cause breast cancer nor does it increase the risk of breast cancer. And the natural form of progesterone does not have the adverse effect of the synthetic progestin used it that study.

When considering hormone replacement, we also must consider testosterone. Although women produce much more estrogen than men, they still produce about a hundred times more testosterone than estrogen. So it must be an important compound and it is. For many women, replacing testosterone is important in addressing symptoms such as fatigue, stamina, muscle preservation, mental alertness, libido and sexual health, moods and night sweats.  Testosterone levels can start dropping in the early thirties and addressing this is important for many women prior to menopause.

We can help!

So if you are suffering from symptoms of hormonal changes and want to know if hormone replacement therapy is an option, make an appointment with a Seven Oaks Women’s Center provider.  She or he can do a thorough evaluation of your condition and discuss options of treatment that may really change your situation.

Women are powerful:  you face obstacles and experience achievements with everyday life, your health, and your family.  March was Women’s History Month, a nationally celebrated month-long event remembering women’s triumphs in history and honoring today’s generations of women. The month of March recognizes the contributions and achievements women have made in the United States throughout our country’s history. As your Seven Oaks Women’s Center, we celebrate women year-long and dedicate ourselves to helping ensure women’s health for all women!

Women’s History Month is relatively new – under 40 years old. What started as Women’s History Week in 1982 rolled into the month-long event and by 1995, Women’s History Month became an annual proclamation.

Several of our nation’s most distinguished institutions displayed thoughtful exhibitions detailing various historical moments featuring women. The Library of Congress, for example, has a powerful exhibition showcasing Rosa Parks. The National Museum of American History’s featured Women’s Month exhibit details woman suffrage and commemorating the 100th anniversary of the 19th Amendment.

As your women’s health center, we are dedicated to keeping our wonderful women healthy and educated on various issues facing women’s health today. Throughout your lives, your body is subjected to various obstacles and issues exclusive to women; as you age and experience new life events, your body changes and so do risks. We are constantly learning of new modes of prevention and treatment, as well as maintaining a healthy body. This month – and all months – we at Seven Oaks celebrate women and women’s health.

Breast cancer remains a very real threat for women across the United States. The Centers for Disease Control and Prevention state that breast cancer is the number one cancer in women, despite ethnicity; the number one cause of death by cancer for Hispanic women; and the second-highest cause of death by cancer in women of different ethnicities.  Mammograms are a tool to detect breast cancer.

Because of these harsh statistics, a detailed screening protocol is in place that most doctors recommend for women starting at age 40, although various organizations have different recommendations and findings. Once a woman turns 40 years old, annual screenings help to catch breast cancer and give time for treatment. The American Cancer Society recommends optional screenings starting at age 40 to 44, then annual screenings from age 45 to 54. Once you turn 55, they recommend switching to mammograms every two years or to continue annually.

In some cases, breast cancer will remain confined to the breast tissue; unfortunately, however, breast cancer may be a type of cancer that spreads outside of the breast tissue to other areas of the body. Being able to catch the cancer cells earlier than later allows for a greater range of treatment and, when all goes to plan, removing the cancer completely.

What is a Mammogram?

A mammogram is a specific type of X-ray to examine the breast tissue.  The doctor takes four images: two of each breast. Yes, the mammogram may be a little uncomfortable, but imperative for detection nonetheless.

Higher Risk

Some women are at higher risk for breast cancer and should start their screenings earlier than age 40. Women with a family history of breast cancer — particularly early-onset breast cancer, women with a family history for particular genetic mutations, and women of Ashkenazi Jewish ancestry may begin their screenings younger than 40 to help prevent this common disease from progressing. Unfortunately, breast cancer can be more difficult to detect in younger women as the breast tissue is more denser. However, despite more difficulty in detection, it is imperative for women with greater risk to start their mammogram screenings earlier than age 40 as evidence exists breast cancer in younger women may be much more aggressive.

Speak with your doctor at your women’s center to discuss your options regarding detection and early detection. You and your doctor will find the best course of action and time intervals regarding breast cancer screenings.

Connect with Seven Oaks Women’s Center for your mammogram needs.

Osteoporosis, according to the World Health Organization (WHO, 1994), is a bone mineral density (BMD) 2.5 SD (standard deviation) or more below the adult peak mean. This debilitating musculoskeletal disease is characterized by loss of bone mass, low bone mineral density, reduced bone strength, and increased bone fragility. Currently there are about 8.5 million women in the United States living with osteoporosis. Osteoporosis, due to the absence of symptoms until a fragility fracture occurs can be considered a silent threat to a woman’s health.


Estrogen deficiency, and the subsequent effect on bone deterioration that occurs with natural menopause (cessation of menses for one year) or surgically induced menopause, (cessation of menses due to removal of ovaries) has been cited as the cause and primary risk factor for osteoporosis. Both natural and surgically induced menopause are risk factors for osteoporosis. Age, female gender, and heredity are also risk factors for osteoporosis.


Osteoporosis, is a chronic disease that can have a negative impact on an individuals’ self-confidence, body image, mental status, physical, social, and economic well-being due to the changes in the quality of life, and potential loss of independence.

Modifiable Risk Factors

Decrease caffeine, decrease salt intake, stop smoking, decrease alcohol consumption, limit or modify protein intake.

Preventive Strategies

Increase physical activity (3-4 times a week for 30-40 minutes).

Weight bearing exercises, such as, walking, running, tennis, dancing, hiking, climbing stairs, etc.

Consult with your health care provider, regarding ongoing steroid use.

Have adequate calcium intake, if not contraindicated. (600-1000mg daily). Calcium rich foods, such as, dairy, green leafy vegetables, beans, citrus, almonds beans. Consult with your primary care provider.

Increase vitamin D intake, (600IU daily), if not contraindicated. Vitamin D rich foods, such as, salmon, tuna, beef, liver, cheese, yogurt. Consult with your primary care provider.

Bone Density Screening

The current recommendation to begin screening is age 65, or age 50 for those individuals with a high clinical risk, such as, frequent fractures and family history of osteoporosis.

Do you need birth control?  Explore your birth control options.  Most often we use birth control to prevent pregnancy, but we can also use birth control for other health issues.

  • Regulate your cycles
  • Shorten your cycles
  • Reduce bleeding
  • Minimize menstrual pain from cramps to headaches
  • Help control acne

Selecting the right option

How do you decide what birth control is best for you? Are you great at taking a daily pill or are you more of a set it and forget it type of person? Options for birth control will vary based on what method will be easiest for your lifestyle and of course your medical history.

Birth control pills have been around for decades and there are many different combinations available. You take birth control pills every day and its best to take them around the same time every day for the greatest efficacy.

Some of the longer-term options include a patch, vaginal ring, Depo-Provera injections, Nexplanon, and intrauterine devices (IUD).


The birth control patch is changed weekly for 3 weeks, think of it as a band-aid but much smaller (1.5”x1.5”) and it stays on when you shower and swim.

Vaginal Ring

Nuva-Ring is a vaginal ring, its inserted like a tampon and stays in place for 3 weeks. It is safe to have intercourse with your Nuva-Ring in place, but it can also be removed for up to 3 hours.


Depo-Provera is an intramuscular (IM) injection that you get at our office every 11-13 weeks. Many women stop having menstrual cycles after their first 3-4 injections, but no need to worry, typically your cycles will return to normal 6-12 months after you stop Depo-Provera.

Implant and IUD

The Nexplanon is an implant placed under the skin in the upper arm of your non-dominant hand. It is effective for 3 years and over 99% effective. The Nexplanon and IUDs are considered a long-acting reversible contraception or LARC. IUDs are over 99% effective and 100% reversible, they are inserted in the uterus right in the office. If you are looking for contraception, but don’t like the idea of hormones then the copper IUD, Paragard, may be a good option for you or condom use.

Your birth control needs to work for you and your plans for a family. It should be personalized to your preferences. Luckily if you find one isn’t working for you, we can change the method quickly and easily!  When it comes to birth control, we know there are a lot of options available and it can be confusing. This should serve as a starting point for your decision and discussion. Make an appointment today with your provider to discuss the options that will work best for you and your needs.

There’s no denying that feeling: you start cramping and, for some of us, that means everything else becomes a blur. While not all women experience cramping during their period, those of us that do envy those that don’t. Some women’s menstrual cramps are so extreme that even the most mundane tasks go uncompleted. Heating pads, warm baths, exercise or curling up in the fetal position – we all have our coping mechanisms.

Menstrual cramps result from your uterus shedding its lining. As your uterus contracts, the muscles may press blood vessels and cut off the oxygen, resulting in cramps. Some women have mild cramping, others have severe cramping. If you have mild cramping, an over the counter pain reliever such as acetaminophen or ibuprofen will help curb the pain so you can carry on with your day-to-day activities. More severe cramping may cause you extreme fatigue and pain that makes you blind to everything else.

Relief: Is it Possible?

If your cramps are causing pain or reducing your functionality, you have a few options to help curb the pain and get back to your life. Heat is something women may overlook as an option, although it’s among the cheapest and most readily available forms of relief. A heating pad on your abdomen or even your lower back can greatly reduce the pain from your cramps as it relaxes the contracting muscles. A lower back massage is another option and one that provides almost immediate relief for many women. Some women experience great fatigue at the same time they’re cramping: there’s no shame in sleeping it off and giving your body what it needs!

Certain factors may increase your risk of cramping: women under 30, women with heavier bleeding during their periods, and women who smoke. This isn’t a catch-all, some women outside of these groups experience extreme cramping.

When to Talk to Your Doctor

If you have severe cramping that prevents you from living your life or doing daily tasks, such as going to work, come see us! Some women have great success in using various prescriptions to help manage their cramps, such as birth control options that change your hormonal structure. If you’re experiencing cramping not related to your period, you may have an underlying issue and, unfortunately, it may be serious. Uterine fibroids, pelvic inflammatory disease, and cervical stenosis may all cause pain and cramping, along with issues not related to your reproductive system, such as a bowel disease (Crohn’s or Ulcerative Colitis).

It’s no secret that we at Seven Oaks take women’s health seriously. We’re here to keep you healthy so you can get back to living your best life! Whether you need medical intervention or some tips on helping to reduce and manage your cramps, we’re here to help you navigate your choices and make the correct decision.

Women everywhere know the word menopause and what it means, even if just a basic definition of the term. Perimenopause, however, may be less known as a word but more commonly referred to due to many women confusing the meanings of the two words. When a woman states she “is going through menopause,” she often means her body is in perimenopause. Fortunately, women today have more options as far as receiving information and, in some cases, relief from perimenopause’s many symptoms.

What is Menopause?

Menopause is the final menstruation which is officially confirmed after missing your period for 12 consecutive months – meaning it’s an event with a defined point in time. Perimenopause (peri derives from Greek and means around, about, surrounding or near) refers to the transition your body goes through leading up to menopause.

It is during perimenopause that those common symptoms creep upon you: ? night sweats, hot flashes, mood swings and changes in sex drive. A few other symptoms hitchhike with perimenopause that aren’t as noticeable upfront: changes in cholesterol levels, loss of bone density and decreased fertility.


Estrogen is a key player in perimenopause and throughout the life of most women. Estrogen levels rise and fall throughout a woman’s menstrual cycle with regularity. Without going to in depth, this rise and fall of estrogen coincides with various aspects of your menstrual cycle. During perimenopause, your estrogen forgets all about rising and falling on a predictable schedule and becomes a little erratic. Because of this change in regularity, the first symptom many women experience during perimenopause is irregular periods.

Hot Flash

Perhaps the most commonly known symptom of perimenopause is the hot flash. This is a sensation that creates a variety of symptoms in different women: flushed face, sweating and/or chills. According to Harvard Health, estrogen is also behind – or at least somewhat responsible for – the dreaded hot flashes.

If you have symptoms that worry you, always feel free to speak with your doctor for more information. Heavy bleeding, severe mood swings or extreme changes in your sexual desire or function may require help from your physician. We can help relieve many of these symptoms or manage the associated effects.

Want to make an appointment? Have questions about insurance?

Call (210) 692-9500

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We proudly serve patients needing gynecology services, obstetrics and overall women's health in the following areas of Alamo Heights, Olmos Park, Castle Hills, Medical Center, Hill Country, Stone Oak, Hollywood Park, Downtown, Bulverde, Spring Branch, Leon Springs, Boerne, Alamo Ranch and many other neighborhoods in the greater San Antonio.