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Posts for category: Obstetrics Gynecology Care

By Francisco Anguiano, MD
July 13, 2021
Tags: Maternal Age  
Maternal AgeIn the US, more and more women are deciding to have children later in life. Of course, as women wait until their mid-to-late 30s or even 40s to have children some certain risks and complications are more likely to occur during pregnancy. Women who become pregnant at or over the age of 35 years old are considered advanced maternal age (or a geriatric pregnancy). In these pregnancies, your OBGYN may deem you high risk, as certain issues are more likely to occur in older pregnant women over the age of 35.

Okay, so you just turned 35 years old. Should you be concerned about getting pregnant?

Well, not necessarily. It isn’t like everything changes overnight. OBGYNs have been providing care to pregnant women of all ages so they know that when it comes to assessing risk everyone’s needs are different. Just because a woman is 35 years old doesn’t necessarily mean that she will face challenges during pregnancy.

A lot of it has to do with her genetics, medical history, and current health. Women in their 30s and 40s who are in great health may not ever face complications or problems, but it’s still important to recognize these risks ahead of time so that you and your OBGYN can find ways to prevent them from happening.

Your Health is Key to Conception (and a Healthy Pregnancy)

Your health is going to play one of the biggest factors in conceiving after age 35; however, it is important to note that the number of eggs your body produces does decrease with age. The decline occurs in the early 30s with a more serious decline after 37 years old. So, does this mean that you won’t be able to conceive naturally?

Not necessarily. Some women can still easily become pregnant in their early 40s; however, if you’ve been trying to conceive for several months and you’re having trouble, it may be time to talk with your OBGYN.

Possible Complications in Advanced Maternal Age

Women who get pregnant after 35 years old are more at risk for developing certain complications such as high blood pressure or gestational diabetes. Pregnant women over 35 years old are also more likely to face ectopic pregnancies, Down syndrome and other genetic disorders, stillbirth, and preeclampsia.

It’s important to speak with your OBGYN if you are trying to conceive, as certain tests can be performed to check for chromosomal and genetic abnormalities. You may also need to come in more regularly for checkups throughout your pregnancy.

If you are thinking about becoming pregnant and you are over the age of 35, it’s a good idea to speak with your OBGYN to find out if there are certain things you can do before becoming pregnant to keep you healthy and less likely to face complications. Your OBGYN is going to be an integral part of the care you receive both before, during, and after your pregnancy.
By Francisco Anguiano, MD
June 24, 2021
Tags: Vaginal Agenesis  
Vaginal AgenesisVaginal agenesis is a rare congenital condition that impacts the development of a baby’s reproductive system. As a result, a baby girl may be born without certain reproductive organs or a vagina. While this condition may be diagnosed after your child is born, often this condition isn’t recognized until puberty. While young women with this condition will still go through puberty, they will not have a period and the majority will not be able to get pregnant. An OBGYN may be the first person to diagnose this condition and they will become a valuable part of you or your daughter’s treatment plan.
 
What causes vaginal agenesis?

While the genetic cause is still unknown, research has found that 90 percent of children with Mayer-von Rokitansky-Kuster-Hauser’s Syndrome (MRKH) also have vaginal agenesis. This congenital disorder may vary from child to child. Some young girls may not have a vagina or uterus while other girls may have part of a uterus but no vagina.

We understand that this can be distressing for both the patient and their family. Despite this genetic abnormality, the patient is still considered female. Of course, this can be confusing and a lot to process, which is why an OBGYN can be a great doctor and specialist to turn to for help, support, and care during this time.

While most patients with vaginal agenesis will not be able to carry a child, if they do have a uterus then they can become pregnant when they choose to have a family. This is something that your OBGYN can discuss once the patient becomes an adult.
 
Are there treatment options for vaginal agenesis?

Additional testing may need to be performed by your gynecologist before deciding which type of treatments are best for the patient. In most cases, treatment won’t be necessary until the late teens or 20s.
Two of the most common treatment options for vaginal agenesis include,
 
Self-dilation: Instead of turning to surgery to create a vagina, this device can be placed inside the vagina for hours a day to help stretch the skin and create a vagina.

Surgery: If patients don’t see results with self-dilation then surgery is often the next step. There are a variety of techniques that can be used during a vaginoplasty, and your gynecologist will fully discuss them with you, so you decide together on the ideal surgical technique to provide the optimal results.
 
Your OBGYN will take an active role in providing you and your teen with any needed care, treatment, and support. Your gynecologist can address your concerns, answer your questions and be an advocate for your health.
By Francisco Anguiano, MD
April 20, 2021
PostpartumThe postpartum period is defined as the first six weeks after delivery. During this time, new moms are dealing with everything from breastfeeding and changes in sleep to the ups and downs that come with the hormonal changes. You must have an OBGYN that you trust to provide you with regular postpartum care and to be a caring, knowledgeable medical professional that you can turn to when you’re feeling depressed, anxious, or just not 100 percent.
 
Tips for Adjusting to Motherhood

Every journey through motherhood is going to be different for every woman, so you want an OBGYN that understands your specific needs. Here are some ways to make the first six weeks a little easier for both you and your baby,
  • They say to sleep when your baby sleeps, and if you have this opportunity it’s best to take it. While newborns sleep about 14-17 hours within a 24-hour period, they only sleep for about 2-3 hours at a time before needing to be fed.
  • During this time, it’s important to turn to friends and family for help cooking meals or running errands, so you’re not exhausted and running on fumes. Remember, that you don’t have to do it all. Your focus is on healing and caring for your baby. The rest can wait.
  • Eat a healthy diet that helps support and nurture your healing body. This includes eating proteins, whole grains, and vegetables. It’s also important that you are getting enough water and staying hydrated, which will help with breastfeeding.
  • Your OBGYN will be able to tell you when it’s safe to exercise again. While this doesn’t necessarily mean jumping right back into CrossFit (unless you want to), find low-impact activities such as a brisk walk that can help you get out of the house and also provide energizing benefits.
What are the signs of postpartum depression?

Most women experience “baby blues” during the postpartum period. Between the massive changes in hormones to the lack of sleep, it’s very normal for new moms to experience mood swings, anxiety, irritability, and sadness; however, the baby blues are not the same as postpartum depression. These symptoms last longer than two weeks. Know the signs of postpartum depression,
  • You’re experiencing crying spells, or you’re consumed by sadness or guilt
  • You don’t have any interest in activities or things that once made you happy
  • Changes in sleep patterns such as sleeping too little or sleeping too much
  • You have thoughts of harming yourself or others
  • You have trouble bonding with your baby
  • You don’t want to eat
  • You’re having panic attacks
If these symptoms last longer than two weeks or continue to get worse, you must talk with your OBGYN right away about postpartum depression.
 
We understand that the postpartum experience is different for every woman. That’s why an OBGYN can provide you with the nuanced care you need to help guide you through everything, from bodily changes to “baby blues." An OBGYN can be an asset to new mothers.
By Francisco Anguiano, MD
April 07, 2021
Tags: HPV   Human Papillomavirus  
HPVHPV stands for human papillomavirus, a sexually transmitted infection that is found in nearly 79 million Americans at this very moment. About 80 percent of men and women who are sexually active will be infected with HPV at some point during their lifetime. While some people with HPV will never know they have it, other strains of HPV can lead to serious health complications including cervical cancer.
 
Is an HPV test the same as a pap smear?

No, these are two different tests. A pap smear looks for suspicious cellular changes in the cervix to spot precancerous and cancerous cells early. An HPV test, on the other hand, specifically looks for a current HPV infection but won’t be able to detect cervical cell changes. Women should turn to their OBGYN to get both a Pap smear and an HPV test.
 
How often should I get tested for HPV?

Even if you’ve been vaccinated for HPV or you’ve already gone through menopause, it’s still a good idea to get regular pap smears. Women between the ages of 21 and 29 should get a pap smear every three years (if they’ve only had normal pap smear results in the past). Women who’ve had an abnormal pap smear may need to come in once a year. A pap smear should be performed regardless of whether or not you suspect that you might have HPV.

Women between the ages of 30 and 65 should get a pap smear every three years, an HPV test every five years, or both tests together every five years.
 
How is HPV treated?

Many strains of HPV are shed by the body over time so they don’t require treatment; however, other strains of HPV can lead to genital warts and cervical cancer. Cryosurgery or laser treatment may be used to remove abnormal cells from the cervix or genital warts.
 
Should I get vaccinated against HPV?

The CDC recommends that both men and women between the ages of 11 to 26 should get vaccinated for HPV, as this vaccine can protect against many of the strains that can lead to cervical cancer. Since the vaccine is only administered to people who’ve never had HPV before, it’s a good idea to talk with your OBGYN about getting your teen vaccinated before they become sexually active.
 
You must be getting regular pap smears and HPV tests from your OBGYN if you are sexually active. These screening tools are the most effective ways to detect this common STI. Call your OBGYN if it’s time to schedule your next pap smear or if you are interested in STI testing.
By Francisco Anguiano, MD
March 09, 2021
Tags: Miscarriage  
MiscarriageWe understand the turmoil and grief that comes from a miscarriage. It’s important to know that you are not alone. Miscarriages are incredibly common. In fact, about 15-25 percent of pregnancies end in miscarriage. Recovering from a miscarriage both physically and mentally takes time, and your OBGYN can provide you with the tools, advice, and support you need to recover from this sudden loss.

Bleeding after Miscarriage

Whether you had to go through a D&C or you had a natural miscarriage, it is completely normal to bleed immediately after. The bleeding will be heavy for several hours, and it’s normal for it to contain tissue and clots. The bleeding will lighten and go away after 1-2 weeks. Only wear pads, not tampons, while bleeding.

Getting Your Period

It is normal for the first period after a miscarriage to be a little different than what you’re normally used to. Your period could be unusually heavy, or you may only experience spotting. It can take one cycle before your period returns to normal and it should be normal by the second cycle after your miscarriage. If you are still dealing with irregularities after your second cycle, you should talk with your OBGYN.

Having Sex

Most OBGYNs will give you the go-ahead to have sex again after about two weeks, but your OBGYN will need to have you come in for a follow-up to make sure that you’re not still bleeding. If you are, your doctor may ask you to wait a little longer.

Addressing Your Emotions

Your OBGYN has worked with many women who have experienced miscarriages, and they understand that what you are going through is traumatic and stressful. Some ways to support your emotional health during this time include,
  • Spend more time with friends and family
  • Ask for help and support when you need it
  • Talk to other women who have also experienced miscarriages (there are support groups that can help)
  • Talk to your OBGYN if you are experiencing symptoms of anxiety or depression (they can provide counseling referrals)
  • Get adequate nutrition and maintain a healthy, nourishing diet
  • Get regular exercise
  • Turn to meditation or other outlets for stress relief
  • Make sure you are getting good sleep every night
Many women who have experienced a miscarriage worry that they may experience another one, but it’s important to note that women who have had a miscarriage in the past are not at a higher risk for future miscarriages. Many women go on to have healthy pregnancies and healthy babies after a miscarriage.

Remember that you do not have to go through the recovery process alone. Many women seek solace in their OBGYN after a miscarriage. When you are ready, they can also guide you through the steps of getting pregnant again and providing you with the support system and compassionate care you need.


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