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Ask The Expert Archives Sex & STD's

By Marta Mendez, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Young Woman Editorial Advisory Board | July 13, 2011

Q: Bleeding after intercourse
I recently had my period at the end of December (start 12/29 - end 1/3) and after intercourse on January 8th I started bleeding again. Now it is the 11th. I have never experienced this before. I had taken some antibiotics from 12/20 to 1/3. I don't know if this would effect it. I am also on the birth control pill for the past 2 years. What is your opinion? Should I make it a priority to see the doctor?

A: Postcoital bleeding may result from trauma to the vagina, the cervix or to existing lesions such as cervicitis (inflammation of the uterine cervix). Go to your gynecologist.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Bleeding from sex
I am 17 years old and I have been having sex with my boyfriend for a while. Not too long ago I started to bleed from having sex and I already know my period is not an issue in this case. What could be the problem?

A: Trauma (during sex) to vulva, vagina or cervix or to an existing lesion. Go to your OB/GYN.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

Q: Painful intercourse
I am 25 years old and have two children (vaginal delivered) . I have pain sometimes at the opening of my vagina just with touch much less intercourse. Could you please tell me what this could be?

A: Any genital trauma (vulva, vagina) during deliveries? Episiotomy?

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

Q: Blood spotting after intercourse at mid-cycle
At the mid-cycle of my period I noticed some blood spots after intercourse and my husband noticed some blood on his condom. This happened two times and I would like to know what it could be...it is disturbing and I cannot find any information on this particular subject. My periods are normal and I am in my late twenties.

A: This could be related to coital trauma. If it is persistent go to your gynecologist...

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Artificial pleasures...
Can I pleasure myself with a dildo or let my boyfriend pleasure me that way?

A: It's OK as long as you accept it . There is no medical contraindication.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Sex during menstruation
I am 19 years old and recently had protected sex while I had my period. My period normally lasts for seven days and at the time I had sex I was four days into my period. My boyfriend did use a condom properly and it did not break or tear. I was wondering what the chances are of getting pregnant in this situation.

A: Getting pregnant in your situation? Very unlikely!

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Painful Intercourse
I'm 21 and married. Every time I attempt to have intercourse, it feels so sore its like I already had a day of sex and I can't handle it anymore. Even when I wipe myself it sore. I am on a birth control called Ortho-Cyclen, I also shave my pubic hair. I haven't lost interest in sex or my husband, I just can't handle it. Should I go see a doctor or a therapist and is it that bad? Can you please tell me what's wrong with me?

A: Pain with intercourse, pelvic pain and recurrent vulvar sore my be due to the presence of an actual benign lesion (e.g., vulvovaginitis). My advice to you is that you should discuss this with your doctor (gyn).

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Overweight and Sex
I would like to know if fat affects your sex life. I've been told that when you are overweight fat gets around your sensitive areas and sometimes women therefore somehow can't achieve an orgasm. I understand that being overweight has many complications, but I would really like to know if there's a problem.

A: Don't worry, be happy. There's nothing to be concerned about.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Abdominal Pain, Painful Intercourse
I am a seventeen year old, who, over the last couple of weeks, has experienced different amounts of pain during vaginal penetration. For the most part it is a sharp pain that is on the right side of my abdomen close to my ovaries. Today, it lightly hurt during sex, but afterwards I was in a tremendous amount of pain for about 30 minutes. This pain was mainly a sore constant pain with sharp sudden pains. My boyfriend and I had unprotected sex about two weeks ago and I'm not on birth control. I've only been having sex for a month, and the last time I had my period was 20 days ago. I was wondering what these symptoms could mean. Any input on this would be most appreciated. Thank you for your time.

A: These symptoms and your concerns need to be evaluated personally with your Gyn.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: When do you Ovulate?
I'm a 16 year old female who is ready to have sex with her boyfriend for the first time. I was wondering if you could answer a few of my questions? They are: #1 How many days after you have your period do you ovulate? #2 How effective is ovulation?

A: Ovulation occurs 14 days before menstruation, but this date is only approximate. Each woman may have a different cycle length.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Bleeding During Intercourse
I am a 25 year old woman in her first sexual relationship. We have been sexually active for about 2 months and within the last month I have bled twice during intercourse. I'm not in any pain and only know that I have bled when I notice the sheets in the morning, there is a blood stain about the size of my fist. My partner is very worried, but I think that this is normal for someone just becoming sexually active. As we are becoming more comfortable with each other we are trying new positions and that is usually when I bleed. I am on birth control and had a gyn exam with normal results this past June. Any need to worry?

A: Get a 2nd opinion; bleeding during with intercourse should not happen.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Could I have Caught an STD?
I have been with only 1 guy for the past 8 years. He had had 2 previous sex partners before I came into the picture. Is it possible that he might have given me an STD 8 years ago (like chlamydia) and it is just now showing up?

I hope to hear from you soon. I keep putting off going to the gyn because I am afraid of what they will tell me. My yearly pap is due in about a month and I am scared that I am going to find out something is really wrong with me.

A: Very unlikely.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: What Caused This?
I'm almost 16 years old and a couple of nights ago I was fingered pretty badly and I started bleeding, which I thought was strange because I've been fingered before and I've had sex. Well the next morning I went to the bathroom and I noticed a piece of skin with blood on the end hanging from my vagina. I have no idea what it is. I got pretty scared and I'm still really worried. I was wondering what it is and what I should do about it? Will it go away on its own? Should I go to the doctor?

A: The only way to know is to be seen by an OB and a histological exam of the piece of skin you are worried about.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Pain with Intercourse and Orgasm
I am 35 years old. I have been married for 9 years with no sexual problems. For the last month I have had very bad pain with intercourse and orgasms. When I have an orgasm (orally) the pain shoots up from the clitoris to my stomach area. I also have swelling of the clitoris and area around it. I tried to treat it with yeast infection medicine, but that didn't help. I have had bladder infections before, and this doesn't feel like a bladder infection.

A: Acute infection of the vulva and vagina (vulvovaginitis) may have a variety of causes. Ingestion of sex steroids (pill) and broad spectrum antimicrobials may predispose to overgrowth candida (yeast). Allergies (scented or flavored douches, deodorant soaps or powders, contraceptive foam, jellies, creams) may produce symptoms of vulvovaginitis. You should get a complete general physical and gynecological exam.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


 

Q: What is a normal clitoris?
Can you tell me if there is a normal size for the clitoris? I have difficulty finding it, and so does my husband. We know where it's supposed to be, but it must be very small. My cousin tells me that when she climaxes she ejaculates just like a man. Is this normal? I have never experienced this. Am I normal? Please answer since I could never ask my gynecologist.

A: There's not an exact normal size for the human clitoris. As with many things in the human body, it can vary. There are some diseases in which one of the features is an enlarged clitoris. You shouldn't worry. There's no such thing as "female ejaculation".

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Painful intercourse
I'm in a monogamous relationship with my boyfriend, and a few days ago during intercourse it really started hurting. We stopped, and afterward while I was urinating, I felt a horrible burning sensation. I'm not sure if this is at all related, but yesterday I noticed an orangish-whitish discharge. Could this be a yeast infection? Or is it another type of vaginal infection?

A: Could be yeast, Trichomonas or bacterial vaginosis. Remember that your sexual partner usually must be treated. Go see your OB/GYN!

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Blood-tinged mucous discharge after sex
A day after I had sex I had some blood-tinged mucous discharge, which lasted a few days. I haven't been feeling right and today (about 2 weeks after my period) I started spotting a little. I put in an "Instead" cup and when I pulled my finger out it had dark peach colored little ball-like things all over it. There is no strange odor, but I have been having all kinds of cramping in between my periods. Am I pregnant? Is this a yeast infection?

A: Go see a gynecologist for complete exam.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Sexually abused as a child
I'm a 25-year-old female that was sexually abused at the age of 12. That was when I had my first penetration. I was not sexually active from the age of 15 until now. I had sex twice in the past month and attempted 4 times. The first two times I could not resist the pain caused by the penetration. Therefore, we were not successful. The last two times we succeeded at the penetration process, but the pain was so intense that I could not feel any pleasure. The last time, the pain was still very intense, but not as the first time, and no pleasure. Is this normal? Is the act supposed to be this painful or is there something wrong with me?

A: You should seek counseling. This is most likely related to your past experience. Consult a sexologist.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Chance of pregnancy?
I am 19 years old and I was having sex with my boyfriend. While having sex, I was on day two of my period. The condom broke. Could I be pregnant?

A: It is highly unlikely. To ease your mind, you could take a home pregnancy test.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Unprotected sex during menstrual cycle
I am 20-year-old and had unprotected sex during the third day of my menstrual cycle. What are the chances of my being pregnant? Would my menstruation stop immediately if I'm pregnant? If I am pregnant, how do I know it?

A: Pregnancy is unlikely. A reliable pregnancy test and doctor exam can provide the diagnosis.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Difficulty achieving orgasm
I am a 29-year-old mother of 3 children. I had a partial Hysterectomy (uterus removal) back in 1992. Since having my kids, maybe even before, I have extreme problems achieving orgasm during sexual intercourse. I can have one or multiples, it just takes forever! I can only have one in the missionary position (with the man on top). I think that I have noticed that it's a pressure thing. I need pressure on the clitoris in order to achieve it. In other positions I can achieve one with the use of a vibrator, but it won't happen if this isn't used. Would you have any idea as to why I could be so limited in being able to achieve orgasm during intercourse?

A: Orgasmic dysfunction can be due to organic or psychogenic factors. You should consult a sexologist.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: What are the odds of my being pregnant?
I have very irregular periods. I had sex on days 14 and 15 of my cycle, but he pulled out before he ejaculated. I still haven't started my period this month. What are the odds that I could be pregnant?

A: It is possible. Withdrawal method ("pull out") isn't an effective contraceptive method. Get a pregnancy test.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Burning during intercourse
Last night during intercourse I started burning really bad. That had never happened to me before. I have had no symptoms of an infection. What could it have been from?

A: Vulvovaginitis (VV) is a common cause of painful intercourse. VV can cause a burning sensation within the vagina. Allergy to the semen (uncommon) and some medical conditions (e.g, fibroids) also can cause painful intercourse.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Condom allergies
My boyfriend and I started having sex two months ago. We were both virgins. We have been using two types of contraception: birth control pills and condoms. The problem is that we have used many types of condoms-- latex, non-latex, lubricated, and non-lubricated (different brands as well)-- and all of them cause burning irritation. STDs are not an issue with us. Are birth control pills enough protection against pregnancy?

A: Oral Contraceptives are the most effective method of contraception.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Sore after sex
Just after my boyfriend and I had sex, I started to feel a bit sore and irritated. It feels as though I have been cut during intercourse. I am also finding it hard to urinate without it hurting. I started my period as I would usually, but it is still causing me irritation. I am still finding it hard to urinate without it burning. I looked in the mirror and the outer part of my vagina looks very inflamed, which is where the irritation and pain is coming from. Something like this seems to be happening to me every month just before I start my period. What is it do you think?

A: It could be urinary tract infection (UTI) or PID (pelvic inflammatory disease). Go to your gynecologist.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Pain during intercourse
I have been having pain during intercourse for over 6 months now. I have been with only my boyfriend for over a year. I am his first partner. I have been tested for STDs, yeast, bacteria, all of which were negative. I did have a chronic yeast infection about 3 months ago, but I had that cleared up. The thing is that it is less of a pain than an urge to urinate while we have intercourse. It feels like his penis is causing friction on my anterior vaginal wall. I always urinate before and after sex. The only position that does not hurt as much is the spoon position and even that still hurts a little. I just feel like I'm on fire inside. We don't use condoms, I'm on birth control. An MRI showed that I had a probable arcuate uterus. Could this affect my bladder and other organs to cause pain? I am going to see a urologist in about a week because I also thought of cystitis because I also have painful urination and my urine culture has come back clean many times. What is the treatment for cystitis?

A: The best information will come from the urologist once he checks you out.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Burning following intercourse without condom
I've been on the pill since last May. Before then, my boyfriend would use a condom and we didn't have any problems. Now every time we have sex without a condom, I burn afterwards. It doesn't hurt during, but always after, sometimes worse than others. Do you have any idea what that might be? Thank you for your time.

A: It could be an allergy to the semen.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Bleeding after intercourse
My partner (15) has been experiencing bleeding after intercourse and manual stimulation. The bleeding lasts for about 2 days. I know that it is normal when the hymen is broken, but it was not her first time. What could be causing her to bleed each time?

A: It might be due to trauma to existing lesions (vagina/cervix, e.g., cervicitis, polyps).

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Allergic to semen?
Is it possible for a woman to be allergic to a man's semen? I feel a burning after having sexual intercourse but not necessarily while urinating. After a while it goes away.

A: It's uncommon. but yes it could be possible. Sexual intercourse may cause a burning sensation.

Marta Mendez MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Chronic pain during sex
I am a 21-year-old female. I have been dating the same guy for four years. We have been having sex for the past three years. The past two years I have been experiencing chronic pain during sex. It feels like a brush burn. It stings when I go to the bathroom, and the pain usually lasts two days. I have never been with anybody else so I don't know if my boyfriend is doing something wrong. Please help me. I want to be able to enjoy sex again.

A: The way you describe the pain, it might be inadequate lubrication. You might try something like KY Jelly or Ortho-Gynol Jelly. Make sure that it is water based. If that doesn't work, you need to see your Gynecologist.

R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Bleeding and pain following intercourse
My boyfriend and I recently had intercourse. It felt like he hit something inside my stomach and it hurt. Later I started bleeding. I thought my period was starting, but later realized that I had already menstruated this month. The bleeding hasn't stopped yet, but this is around the time I usually get my period so now the bleeding may be just normal menstruation. I have a doctor appointment coming up to check it out but I still wanted to ask for some reassurance. What do you think it could be? Is it something serious?

A: It is really impossible to say without doing an exam. One of the things that will cause Post Coital Bleeding (PCB) {Bleeding after sex} is an irritation on the cervix, another is HPV infection, another is cervical dysplasia. A pap smear and possibly a colposcopy are indicated. 

R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Possible allergy to semen
I have been having sex with my boyfriend for over a year now, and I have been on birth control pills for about eight months. Many times after he ejaculates inside of me I feel a burning sensation. When we have sex and he doesn't ejaculate inside of me it doesn't burn. I read that it could be an allergic reaction to his semen. If it is an allergy, what can be done to prevent the burning?

A: Use condoms, either male or female variety to keep the semen from coming into contact with the vaginal mucosa. Still use birth control pills for contraception. They work much better than condoms alone for contraception.

R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Painful intercourse
I'm a healthy 25-year-old. I've been having an abnormal amount of pain during intercourse, from the pressure on my cervix. I've had this type of discomfort before (when my cervix is knocked hard), but now it seems exaggerated. What could this be? Endometriosis? Fibroids run in the family.

A: The list of causes of dyspareunia (painful Intercourse) is long. It does indeed include endometriosis and fibroids as well as some of the earlier stages of Interstitial cystitis. A visit to a physician and testing would be needed to make a diagnosis.

R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Pain during and after sex
Sometimes during and after sex, I hurt in my stomach, rectum and vagina. The pains feel like labor pains. Could you give me some idea as to what could be causing this?

A: The causes for this could make up a long list. Endometriosis would have to be on it along with normal response to prostaglandins from the semen being deposited in the vagina. Strained relationship with significant other, lack of lubrication, lack of sufficient foreplay, stress in your life, etc could all be related.

R. Daniel Braun, MD, OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.


Q: Will sex "doggy style" enlarge a woman's hips?
I have heard that sex "doggy-style" will make your hips much larger and they won't go back to how they used to be. Is this true?

A: Nope, sexual positions have nothing to do with how your body develops. Two separate things. Don't worry.

Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.


Q: Pain during and after sex
Just recently I have been in pain during and after sex. I start to burn and sting when I urinate after sex. It kind of feels like I have a cut of some sort in my vaginal area. It also feels like it swells up a little in the middle of sex. What can it be?

A: Are you using any spermicides that might cause a chemical reaction? Is your partner taking any antibiotics ? Do you have a yeast or vaginal infection such as bacterial vaginosis? Does your partner. All of these can contribute to burning. If this is something new, try to identify what has changed in your environment: new soap? new laundry soap? New clothing?
If these symptoms persist, then you need to be evaluated further by your health care provider to help identify the specific cause. Here's a few web sites you might find helpful:
Painful
Vulvodynia
Dyspareunia

Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.


Q: Chronic Pelvic Pain & Sex
I saw my gynecologist yesterday and told her about how painful sex has been for me. When she examined she saw I was ripped. She said it was possible that I have a rare weak tissue disease that will cause me to rip each time I have intercourse. She wants to wait a a while longer before doing a biopsy of the tissues. She also mentioned how it never seems to heal that it keeps getting re-opened and then infected. What is the name of this disease and is it treatable? I was diagnosed with chronic pelvic pain. Could that cause my sexual discomfort?

A: This is rather difficult for me to answer, as I am not entirely clear what your provider is referring to. I think your best bet is to call her and get the specifics about the condition she is describing. Then you can do further research yourself. Vagismus is what comes to mind, but I am not quite sure that is what she is talking about. Did she recommend anything you could do to improve the tissue strength and decrease the pain. It seems to me there would be something you could use in this situation.

I think as far as external pain, this would explain it to me. If you are also having pain inside, perhaps that is related to the position of your uterus. For example, a retroverted uterus can cause pain during intercourse. If your uterus is curled backwards instead of forwards, this can cause more painful intercourse in certain positions. The way to get around this is to try different positions with your partner. For example, you on top will give you better control and also takes the pressure off the uterus. Here are a few links that you mind find helpful:
Painful
Vulvodynia
Dyspareunia

Pat Sonnenstuhl, ARNP, CNM, MS, OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.


 

The Ask the Expert Forum is an archived feature and no longer visited by the doctors.

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TopicIndex

 

Adhesions
Breast Health and Breast Care
Contraception
Electronic Health Records (EHRs)
Endometriosis
Fetal Monitoring
Fibroids
Gestational Diabetes
Gynecologic Oncology
Hysterectomy
Infertility
In Vitro Fertilization (IVF)
Laparoscopy
Malpractice

  Menopause
Osteoporosis

Polycystic Ovary Syndrome
Postpartum Depression
Pelvic Pain
Premenstrual Syndrome/Premenstrual Dysphoric Disorder (PMS/PMDD)
Pregnancy and Birth
Sex-related Issues
Ultrasound
Urogynecology
Uterine (Endometrial) Polyps
Weight Management
Young Women

 

MedicaForums

Atypical endometrial cells
Medica Forums - 5/17/13
Had a case the other day with the above finding on a pap. She was age 36 and had a Mirena in place. How do people feel about the idea of trying to do an EMB with an IUD in place? If not, how do we proceed?
App to compute fetal weight percentiles
Medica Forums - 5/16/13
Hello,

Has anyone tried FetalGrowth app (App Store for iPhone/iPad) ? I'm interested in using a simple and handy tool to calculate fetal percentiles, and I came across this app, which seems it does the job (plots growth charts, as well). I haven't seen anything else, besides this app, so I was wondering if there are people who have already tried it.

Thanks !
Welcome to the new ObGyn.net Forum!
Medica Forums - 5/12/13
Welcome to the new ObGyn.net Forum!

To all the members of OB-GYN-L… Thank you for coming! I’m thrilled that you’ve decided to check out the new Forum site, and look forward to reading about what’s on your mind.

If you’re new to the ObGyn.net community... welcome aboard! You’ve just joined an outstanding group of physicians and health care professionals who have been sharing information, answering questions, and building professional relationships via the site’s listserv for nearly 20 years.

Feel free to poke around on the site to get a feel for things, or take a look at the Help Topics page for instructions on how to use the different features of the site.

A few quick tips:
For those of you who like getting new Forum messages delivered directly to your inbox, the first thing you’ll want to do is click on the ‘Follow this forum’ button on the main page. You’ll have the option of getting notifications immediately, as a daily digest, a weekly digest, or only when you’re not online (which is to say, if you’re on the site when someone posts a message, you won’t be notified of it). You won’t be able to post on the site just by replying to the email, but the message will contain a link that takes you directly to the message you’d like to reply to.

You can also follow individual conversations without following the whole list by going into the topic and clicking the ‘Follow this topic’ button next to the title.

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If you have questions, feel free to respond to this post or send me a direct message by clicking on the envelope icon.

Happy posting!
Retained Placenta (Ronald Ainsworth – February 2013)
Medica Forums - 5/11/13
I helped another physician with removal of a retained placenta last night, we were unsuccessful in removing it vaginally, her cervix was too closed to allow manual removal and we could only get a few pieces out with ring forceps and a large curette, so we did a laparotomy/hysterotomy and were able to preserve the uterus. The placenta turned out not to be an accreta and it was easily removed via that route through a low vertical incision on the uterus. Any thoughts on the appropriate CPT code would be appreciated. The patient came in through the ER five days after home delivery by her husband. She was severely anemic, rcvd 7 units of blood and is still quite ill and in the ICU but improving.

Ronald E. Ainsworth, MD, FACOG
Attendance in L and D
Medica Forums - 4/15/13
Recently, I had the occasion to review a case of a term primigravida with PROM in a private hospital (no housestaff or in house obstetricians). She was seen by an obstetrician soon after arrival, evaluated, and pitocin induction begun.

She did not deliver for around 29 hours after admission, and the delivering obstetrician (a different physician) was physically present during the last 2 hours of labor prior to delivery.

Simply put, while the two involved obstetricians were in communication by phone with the nursing staff throughout labor (separately as their "shifts" did not overlap), no one actually came to the bedside and wrote a note) from admission until around 2 hours before delivery.

Medical staff bylaws call for a daily progress note; this bylaw was easily met.

In reviewing the case, it did not "feel good" that no one came to the bedside.

My questions:

1. Does anyone have or know of any guidelines to mandate such bedside attendance? Of course, we all hope that the involved physicians would not need said guidelines.
2. Does anyone have a suggestion of hospital/nursing protocols? Simply, in this case I would like to have had a charge nurse or bedside nurse simply say, "Hey, no one has been by for a while. What's up?"

Garry
Basic Textbooks for an Ob/Gyn resident
Medica Forums - 4/12/13
Hey, what textbooks would you advise for my son who is beginning residency this summer?

Post here or email privately if better.

Thanks,

Garry
Facelift cost
Medica Forums - 4/8/13
<p>Hello  friends ,

           I want to know how much does a facelift cost on average? Do you know anyone what is facelift cost ? please help me .........
Cosleeping Survey help
Medica Forums - 4/7/13
Hello,

I really need help from OB/GYNs and I'm having a hard time getting it. I find your opinions really valuable. I'm researching recommendations for cosleeping. This is for my dissertation, so your time is truly appreciated! Please complete the full survey. It will help me tremendously.

The study takes about 5 to 10 minutes to complete. Please don't hesitate to contact me at bhamel@pacificu.edu with any questions.

If you are interested in participating, please follow the link provided below:

https://www.surveymonkey.com/s/Cosleeping

Thank you in advance for your time. If possible, please forward this to other OB/GYNs you know.

Sorry if this an innappropriate use of the forum. But it seems like the right place to find the participants I need.
Those Wonderful And Useful EMRs
Medica Forums - 4/7/13
.

Our hospital bought an electronic medical record (EMR) system for the clinics. There is a large hosptial group practice including pediatrics, medicine, FP, OB/GYN, and other specialities and sub-specialities. Furthermore, the hospitalists and the ER doctors are also employed in the same hosptial group practice.

The hospital spent millions of dollars on an EMR. As best I can tell there are only two useful things that the EMR does. One is to automatically calcualte the BMI, which it does very well. THe other is to make records available on any patient to any doctor anywhere in the practice. It does not do this well -- it requires lots of mouse movements and clicks and different documents come up in different formats, making it labor intenisve. But, with enough time, effort, and frustration, one can obtain copies of every document in the sustem, either on a computer screen or on paper.

Swith to the ER now. A paitnet whom I had seen the previous week in consultatio comes into the ER for a non-pregnancy problem. They call me on the telephone in the evening. "No problem", I say. I did a torough evaluation and wrote a detailed note on the patient and her OB and non-OB problems only a few days ago. "Just go to the EMR and you can print out my note with all the details."

Seems, however, that for some reason the EMR is not available in the ER (or on the wards for that matter). When I asked the hosptial administrator about it the next morning, he said that he and the hosptial lawyers were working on the problem.

Apparently the government thinks that the ER doctors and hospitalists have nothing better to do with their time than to print out copies of patients' medical records from the EMR and sell them on the black market. Therefore, we cannot let those nasty doctors have access to the EMR records. Nevermind that the ER doctors are in the same group practice as all the other doctors. Never mind that the patient is willing to sign a release so that the doctor who is taking care of her can see the records of the practice. We have to protect the patient even if it means that vital information is rendered unavailable and that things are made more difficult, complicated, and expensive. It reminds me of the Army in Viet Nam where they would have to "destroy a village in order to save it!" Apparently the EMR makes us destroy a patient in order to save her.

Thank GOD for the EMR. Three million dollars and the only benefit is that we can get a BMI 10 seconds faster.

I think the NEJM got it correct last month when they said in an atricle that the only ones who truly benefit from electronic medical record systems are the people who make and sell them.



Dean Huffman
Decline in Semen Concentration.
Medica Forums - 4/7/13
Decline in Semen Concentration and Morphology in a Sample of 26,609 Men Close to General Population Between 1989 and 2005 in France


http://www.medscape....22498EV&spon=16

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