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This Juneteenth: Honoring the Mothers of Modern Gynecology

June 10, 2022 by drprabajeyalin Leave a Comment

This Juneteenth, we remember the enslaved black women who were abused for the sake of medical advancement. Their stories have been largely left out of mainstream history, but they are an important part of our heritage. Enslaved black women were routinely subjected to painful and dangerous medical procedures without anesthesia, all in the name of “progress,” but it was nothing more than a guise for abuse. We owe it to them to remember their courage and strength in the face of adversity. Today, we honor their legacy.

Juneteenth is celebrated on June 19th, and marks the day in 1865 when Union troops arrived in Galveston, Texas with news that the Civil War had ended and slavery was abolished. This date is significant as it represented what was supposed to be a time of new beginnings. Slave ownership was not limited to plantation owners. The “father of modern gynecology”, Dr. J. Marion Sims, owned slaves and used them as guinea pigs to test his medical theories. He performed numerous, painful surgeries on black women without anesthesia because he believed they were immune to pain. If the patient’s slave owners agreed to provide clothing and pay taxes, he would accept temporary ownership of them until their “treatment” was completed. In Sims’ autobiography entitled, The Story of My Life, with respect to the advantages of temporary slave ownership, he states, “There was never a time that I could not, at any day, have had a subject for operation”. One of his most famous patients was a woman named Anarcha. She underwent at least 30 operations over the course of three years. Sims was quoted as saying that he “treated her almost like a dog” during her time as his patient.

Sims began performing experimental surgeries on enslaved black women without anesthesia, in an attempt to develop a new technique for treating vesicovaginal fistulas. These procedures were incredibly painful and often resulted in infection or death. As a result of his experimentations, Sims developed the vaginal speculum.  This device is still in use today, but sadly came about as a result of the suffering of black women.

In honor of Juneteenth, let us remember the mothers of modern gynecology who were abused in the name of medical progress. Their strength and courage in the face of unimaginable pain and suffering is an inspiration to us all. Let us also use this day as a reminder to stand up against injustice, wherever it may be found. We have come a long way since 1865, but there is still much work to be done. Let us honor the legacy of these women by continuing the fight for equality and justice for all.

Sources:

– “The Story of My Life.” J. Marion Sims, MD. Philadelphia: Lippincott & Co., 1884.

– “A Timeline of the Life of J. Marion Sims.” Vanderbilt University Medical Center. Accessed June 19, 2019.

– “Enslaved Black Women in Early Gynecology.” Smithsonian National Museum of African American History and Culture. Accessed June 19, 2019.

– “Anarcha.” Encyclopedia Britannica. Accessed June 19, 2019.

Vedantam, Shankar, et al. “Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology.” NPR, NPR, 7 Feb. 2017, https://www.npr.org/2017/02/07/513764158/remembering-anarcha-lucy-and-betsey-the-mothers-of-modern-gynecology.

Filed Under: Gynecology, Racial Equity, Uncategorized, Womens Health Tagged With: #doctor, #gynecologist, #gynecology, #juneteenth, #racialequity, #racialjustice, #surgeon, #womenshealth

Gynecologic Conditions That Can Cause Infertility

April 26, 2022 by drprabajeyalin Leave a Comment

If you’ve been trying to conceive for a while and haven’t had any luck, you may be wondering if there’s something wrong with you. Believe it or not, there are several gynecologic conditions that can cause infertility, but also are treatable. In this post, we’ll briefly review a few of the conditions and treatment options. So, if you’re concerned about your fertility, read on!

Endometriosis

Endometriosis is a condition in which the tissue that normally lines the inside of the uterus grows outside of the uterus. This can cause inflammation and scarring, which can lead to infertility. Treatment for endometriosis may include medication, surgery, or both.

PCOS

PCOS, or Polycystic Ovary Syndrome, is a condition that can cause irregular periods, excess hair growth, and insulin resistance. PCOS is one of the most common causes of infertility. Treatment for PCOS may include medication, diet, and lifestyle changes.

Uterine Fibroids

Uterine fibroids are non-cancerous growths that develop in the uterus. They can cause heavy bleeding, pain, and infertility. Treatment for uterine fibroids may include medication, surgery, or both. 

Uterine Septum

Uterine Septum is a condition in which the uterus is divided by a wall of tissue. It’s actual an abnormality that is present since birth and otherwise known as a Mullerian Anomaly. This can cause infertility by preventing implantation as well be the cause for recurrent miscarriages. Treatment for uterine septum may include surgery to remove the septum.

Uterine Isthmocele

A Uterine Isthmocele is a defect on the lower uterine segment at the site of a C-section scar. This can result in menstrual blood accumulating inside the isthmocele leading to an inflamed uterine lining. The defect can be an obstruction to future implantation.

To repair this defect, a Uterine Isthmocele Resection is performed. During this procedure the isthmus, or middle portion of the uterus, is removed.

Hydrosalpinx

Hydrosalpinx is a condition in which the fallopian tubes are blocked by fluid. This can cause infertility and recurrent miscarriages. Treatment for hydrosalpinx may include surgery to remove the blockage.

If you’re struggling with infertility, don’t give up hope. While these gynecologic conditions may represent some of the causes of infertility, many of them are treatable. Once treated, fertility can often be possible. Are you struggling with one of these conditions and interested in exploring your options? Contact my office to schedule an appointment today!

Filed Under: Endometriosis, Fibroids, Gynecology, Infertility, Uncategorized, Womens Health Tagged With: #doctor, #gynecologist, #infertility, #surgeon, #womenshealth

Why Do Black Women Have a Higher Risk of Fibroid Tumors?

April 11, 2022 by drprabajeyalin Leave a Comment

African American women are at a higher risk of developing uterine fibroids than white women. In fact, African American women have about three times the risk of developing fibroids as compared to white women. What is causing this difference? And how can we use this information to help reduce prevalence rates?

Fibroid tumors are noncancerous growths within the uterus. These growths can range in size as small as a pea to as large as a watermelon. Not all fibroids are symptomatic, but for those that are, women can experience heavy menstrual bleeding, bleeding in between menstrual cycles, longer than normal menstrual cycles, back pain, pelvic cramping, among others.

The statistics surrounding black women and fibroids are not good. In collaboration with Hologic, The Black Women’s Health Imperative authored a whitepaper titled, Unmuting Fibroids: Meaningful Action Toward Equity for Black Women. Within this whitepaper, it was cited that 80% of Black women will develop uterine fibroids by age 50, three times the rate of other racial groups. However, most Black women will experience fibroids much earlier than age 50, with 74% of Black women reporting fibroid tumors by their 30’s compared to only 31% of white women in that age bracket.

Furthermore, Black women often have an increased severity of symptoms, and are more than two times as likely to undergo a hysterectomy and seven times more likely to undergo a myomectomy!

Why?

There is still no conclusion as to exactly what causes this disparity, however researchers have identified some possible associations and influencing factors. They are as follows:
A genetic component
Association to Hypertension
Possible environmental factors such as chronic stress

The above can all be associated factors for women of other racial groups as well. Because there isn’t anything very conclusive as to why Black women suffer more prevalently and severely, it is evident that more research is needed.

Hope

Tanika Gray Valbrun, founder of The White Dress Project, began to experience symptoms associated with fibroids as young as age 14. She had 27 fibroids removed! She is using her story to bring awareness of fibroids through the development of The White Dress Project.

Similarly, Sateria Venable, founder of the Fibroid Foundation, sought to bring awareness and generate funding for research to prevent other women from experiencing what she has had to go through, being diagnosed with fibroids at age 26.

Both referenced groups listed above have been champions in getting legislation proposed for additional funding for research. Recently, Senators Cory Booker (D-NJ) and Shelley Capito (R-WV) introduced a Senate companion bill called the Stephanie Tubbs Jones Uterine Fibroid Research and Education Act of 2021. This legislation would provide $30 million to the National Institute of Health for fiscal years 2022 through 2026, establishing a research database for treatment of fibroids. Congresswoman Yvette D. Clarke (D-NY) introduced the legislation to the House in March 2021. It’s a start to hopefully gaining more answers.

Are you suffering from symptoms you feel may be related to fibroid tumors? I encourage you to schedule an appointment today so that we can help determine the best treatment for your individual needs.

Filed Under: Fibroids, Gynecology, Uncategorized, Womens Health Tagged With: #blackmaternalhealthweek, #blackwomen, #doctor, #fibroids, #fibroidtumors, #gynecologist, #womenshealth

Endometriosis: Is Surgery Necessary?

March 8, 2022 by drprabajeyalin Leave a Comment

Endometriosis is a condition that affects many women. It occurs when the cells from the endometrium, the lining of the uterus, grow outside of the uterus and get stimulated by your monthly cycle. Several symptoms can be caused by endometriosis, such as pelvic pain, painful cycles, painful intercourse, and infertility. While there are medications available to help treat endometriosis, some women may need surgery as well. In this blog post, we will explore whether surgery is necessary for treating endometriosis and discuss the different types of surgery available.

There is no one-size-fits-all answer when it comes to treating Endometriosis. No two women are alike, and many factors must be considered when evaluating treatment options. Such considerations are as follows:

·       Severity of Symptoms

·       Extent of Disease

·       Pregnancy Intentions

·       Overall Health and Medical History  

In most situations your doctor will likely suggest conservative, non-invasive treatment options before recommending surgery for diagnosis and treatment. First line therapies are generally non surgical options, such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) and hormonal therapy.  Depending on symptoms and goals of treatment, surgery can be considered. Endometriosis is a disease that can have a direct impact on other organs, leaving surgery as the only treatment option. 

There are different types of surgery available to treat Endometriosis. The type of surgery performed will depend on the severity of the disease and where it is located. The two surgical approaches used to treat Endometriosis are:

·       Laparoscopic (with or without robotic assistance) : An endoscope (small tube with camera on the end) is inserted through a tiny incision. The surgeon can then see inside the pelvis, visualize the Endometriosis and remove it, either by the use of an electric current or laser.

·       Laparotomy: A larger incision is made in the lower abdomen and the surgeon removes the Endometriosis. Previously, this was the only type of surgery available for Endometriosis Excision. It is now only done in rare cases.

Each type of surgery has its own risks and benefits. Your doctor will be able to discuss these with you in more detail and help you decide which surgery is best for you. If surgery is necessary, be sure to discuss all of your options with your doctor so that you can make an informed decision about the best course of treatment for you.

Does Surgery Cure Endometriosis?

Sadly, surgery is not always 100% and does have associated risks. Depending on goals of treatment and post surgical management, some women will experience recurrence of their symptoms. The reasoning behind reoccurrence can vary depending on clinical context. However, one thing you do have control over is choosing an experienced gynecologic surgeon.  You want an experienced surgeon who has an expertise in the surgical management of Endometriosis, improving the success rate of treatment.

If you are experiencing any of the symptoms associated with Endometriosis, please see your doctor. There is no need to suffer in silence. Treatment options are available and getting an accurate diagnosis is the first step on the road to recovery. In need of an experienced gynecologic surgeon? Call to schedule a consultation with me today! We’ll explore your options for treatment and set you on a path for healing!

Filed Under: Endometriosis, Gynecology, Infertility, Uncategorized, Womens Health Tagged With: #doctor, #endometriosis, #gynecologist, #infertility, #surgery, #womenshealth

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