Constipation During Pregnancy: Tips for Finding Relief and Peace of Mind

Constipation is one of those uncomfortable pregnancy symptoms that no one likes to talk about, but it affects countless women. If you’re feeling bloated, sluggish, and struggling to have a bowel movement, you might be wondering what’s causing your constipation and whether it could harm your baby. Rest assured, while constipation during pregnancy can be a nuisance, it’s not dangerous for your little one. There are plenty of safe, natural ways to find relief and prevent constipation from happening again.

Keep reading to learn why constipation is so common during pregnancy and what you can do to get your digestive system back on track.

What Causes Constipation During Pregnancy?

Several factors can contribute to constipation during pregnancy:

• Hormonal changes: Increased progesterone levels relax the muscles in your digestive tract, slowing down digestion. This allows more time for the colon to absorb water, making stools hard and dry.
• Growing uterus: As pregnancy progresses, your growing uterus puts pressure on your bowels, making it harder to pass stools.
• Low-fiber diet: Not eating enough fiber-rich foods like fruits, vegetables, whole grains, and beans can worsen constipation.
• Iron supplements: Although often needed in pregnancy, iron supplements can be constipating, especially when digestion is already slow.
• Dehydration: Not drinking enough water also allows more fluid to be absorbed from stools, making them harder and more painful to pass.

How to Prevent Constipation During Pregnancy

The best approach to constipation during pregnancy is preventing it before it starts. Try these tips:

• Eat 25-30 grams of fiber daily from fruits, vegetables, whole grains, nuts, and beans. Gradually increase your fiber intake by adding one new high-fiber food every few days to avoid bloating and gas. Some great options include:
  • Berries, pears, raspberries, and apples with the skin on
  • Avocado on whole-grain toast
  • Lentil or black bean soup
  • Oatmeal topped with chia seeds and sliced almonds
• Drink 8-12 cups of water and other fluids each day. Keep a water bottle with you and sip throughout the day. Herbal teas and low-sodium broths can also help you stay hydrated.
• Get regular exercise, aiming for 20-30 minutes most days if approved by your doctor. Walking, swimming, and prenatal yoga are great options that can help stimulate digestion.
• Don’t ignore the urge to have a bowel movement. As soon as you feel the need, head to the bathroom to avoid constipation from worsening.
• Discuss switching to a prenatal vitamin with less iron if constipation persists. Your OBGYN can recommend a brand that meets your needs.

Constipation Relief During Pregnancy

If diet and lifestyle changes aren’t enough to get things moving, there are safe constipation remedies you can try:

Natural Remedies

• Fiber supplements like psyllium (Metamucil) can boost your fiber intake if food sources are lacking. Start with a low dose and gradually increase as needed to avoid gas and bloating.
• Probiotic supplements provide beneficial gut bacteria that may improve regularity.
• Prunes and prune juice act as a natural laxative due to their sorbitol content. Start with a small serving of 2-3 prunes or 1/4 cup of juice and increase as needed.

Over-the-Counter Medications

With your doctor’s okay, certain over-the-counter (non-prescription) products are safe for short-term constipation relief during pregnancy:

• Bulk-forming agents like Fibercon or Metamucil
• Stool softeners such as Colace
• Osmotic laxatives like Miralax which draw fluid into the colon
• Milk of Magnesia – Not to be used regularly but may be used on occasion for more severe constipation

When to Expect Relief

While constipation can be frustrating, relief is possible with the right strategies. Most women see an improvement in their symptoms within a few days to a week of making diet and lifestyle changes. It may take a few days to see the full effect if you’re using a new supplement or medication. Be patient with your body and consistent with what you try. If constipation continues or gets worse despite home treatment, reach out to us for help.

Severe Constipation During Pregnancy

While constipation itself is not usually serious, it can occasionally lead to complications or be a sign of an underlying problem. Contact your doctor right away if you experience:

• Constipation that lasts more than 2 weeks despite treatment
• Severe abdominal pain
• Blood in your stool
• High fever over 101°F
• Vomiting or weakness

These symptoms could indicate a bowel obstruction, rectal bleeding, or other issues that require prompt medical care.

Constipation: Uncomfortable, but Treatable

Dealing with constipation during pregnancy can be frustrating, but remember, you’re not alone in this struggle. By making small, consistent changes to your diet and lifestyle, you can find relief and prevent constipation from recurring. Focus on nourishing your body with plenty of fiber-rich foods, staying hydrated, and getting regular exercise. If you’ve tried home remedies and are still struggling to find relief, don’t suffer in silence.

All of us here at Madison Women’s Health are here to support you. We understand the challenges of pregnancy and are dedicated to helping you find safe, effective solutions for constipation and other common discomforts. Remember, your well-being matters, both for your own comfort and for the healthy development of your baby.

You’re expecting—congratulations! For some women, pregnancy is an exciting time full of magic and wonder. For others —and let’s face it, for most women — pregnancy also brings up questions and worries, including infections during pregnancy.

As your body goes through pregnancy changes, your immunity is lowered, making you more prone to infections. The good news is most common infections during pregnancy are harmless. But some — especially if left untreated — can be dangerous. The key is knowing which infections are most likely, how they can affect you and your baby, and what you can do to prevent them.

In this article, we’ll walk you through the truth about infections during pregnancy—what’s normal, what’s not, and when you need to call your doctor. Arming yourself with the facts will help you have a happy, healthy pregnancy.

Most Common Infections During Pregnancy

The most common infections are urinary tract infections, yeast infections, and bacterial vaginosis (BV).

Talk to your women’s physician or OBGYN provider right away about any concerns. Prevention, early detection and proper treatment of infections will help ensure you both stay as healthy as possible. Some infections can also be prevented with vaccinations.

Urinary Tract Infections (UTIs) During Pregnancy

Pregnancy already puts enough stress on your body — you don’t need an infection on top of it. Unfortunately, urinary tract infections (UTIs) are common during pregnancy for a few reasons. As your uterus grows, it puts pressure on your bladder and ureter, making it easier for bacteria to travel up the urinary tract. Hormone changes also slow the flow of urine, giving bacteria more time to grow.

UTI Symptoms

Some signs you may have a UTI during pregnancy include:

• Needing to pee frequently, even when just a little comes out
• A burning feeling when you pee
• Lower abdominal pain or pressure
• Cloudy, foul-smelling, or bloody urine

If you experience these symptoms, see your doctor right away for a urine test. Left untreated, a UTI can lead to a kidney infection and potentially preterm labor.

UTI Treatment and Prevention

Your doctor will likely prescribe a course of oral antibiotics that are safe during pregnancy to clear the infection. Be sure to take the full course of medication as prescribed to avoid the infection coming back.

To help prevent future UTIs:

• Drink plenty of water to flush out your urinary tract. Six to eight glasses a day is a good target.
• Urinate when you feel the need. Don’t hold it.
• Wipe from front to back after using the bathroom.
• Take showers.  If you prefer a bath, rinse with clean water after washing and avoid sitting in soapy water.
• Wear cotton underwear and avoid tight-fitting clothes that can trap moisture. (Sorry, yoga pants!)

While inconvenient, UTIs are usually not dangerous if caught and treated early. By understanding the signs and taking preventive steps, you can avoid complications.

Vaginal Infections During Pregnancy

Vaginal infections are common during pregnancy and nothing to be ashamed of. The normal changes in your body can make you more susceptible, but the good news is most are easily treatable.

Yeast Infections

The most common vaginal infection is a yeast infection, caused by a fungus. You may notice a thick, white discharge, intense itching, and irritation around the vagina. Yeast infections are usually treated with over-the-counter (OTC) antifungal creams. However, during pregnancy, you’ll need a prescription medication, as some OTC treatments may be unsafe. Oral fluconazole is often used and considered safe for most women in the second and third trimesters.

Bacterial Vaginosis

Another common infection is bacterial vaginosis (BV), caused by an overgrowth of normal bacteria in the vagina. Symptoms include a thin, white or gray discharge, fishy odor, irritation, and itching. BV is treated with oral antibiotics, typically metronidazole. Left untreated, BV may lead to complications, so see your doctor right away if you notice symptoms.

While uncomfortable, neither yeast infections nor BV will harm your baby.

Sexually Transmitted Infections (STIs) in Pregnancy

Sexually transmitted infections (STIs) during pregnancy require close monitoring and treatment. As an expectant mom, you’ll be screened for some of the most common STIs, such as syphilis, HIV, hepatitis B, chlamydia and gonorrhea. If detected and treated early, most STIs won’t harm your baby. However, some STIs can be passed to your baby during pregnancy or childbirth if left untreated.  There are potential serious consequences for your baby.

Syphilis

Syphilis is an STI caused by bacteria. If untreated, it can cause serious health issues for you and your baby. The good news is syphilis can be cured with antibiotics. You’ll be tested for syphilis during your first prenatal visit. If detected and treated, there’s little risk to your baby. However, without treatment, syphilis can lead to premature birth, stillbirth or birth defects. There has been an increase in cases of syphilis in Wisconsin.  Your doctor may recommend retesting for syphilis at 28 weeks and when you are in labor.

HIV

HIV, or human immunodeficiency virus, is a serious but manageable infection. Fortunately, with proper treatment and care, the risk of transmitting HIV to your baby can be very low. You’ll be offered an HIV test in your prenatal visit. If it is positive, your OBYGN will refer you to an expert who can discuss treatment options to keep you and your baby healthy. Be sure to follow your doctor’s recommended treatment plan.

Hepatitis B

Hepatitis B is a liver infection caused by a virus. If you test positive for hepatitis B, your baby will receive vaccinations and treatment to help prevent infection. Work closely with your doctor to monitor your hepatitis B levels during pregnancy and make a plan to reduce risks to your baby.

The most important thing is not to panic if you test positive for an STI during pregnancy. With prompt diagnosis and treatment, the risks to you and your baby can be minimized. Be open and honest with your doctor about any concerns you have regarding STIs or possible exposure.

Gonorrhea and chlamydia can be passed to the baby during birth.  It is important to test and treat for these infections if detected.

TORCH Infections During Pregnancy

You may have heard of “TORCH” infections—they should be on every pregnant woman’s radar. TORCH stands for toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes. They are all infections that can be passed from mother to baby during pregnancy and cause serious health issues.

Cytomegalovirus (CMV)

CMV is a common virus in the herpes family that often causes few or no symptoms in adults. However, if a woman contracts CMV for the first time during pregnancy, it may be transmitted to the baby. It could potentially cause hearing loss, vision problems, and developmental delays. Unfortunately, there is no vaccine for CMV, so prevention is key. Practice good hygiene like washing your hands frequently and avoiding contact with the saliva or urine of young children. If CMV is detected during pregnancy, your OBGYN will request additional ultrasounds to monitor the baby’s growth and development.

Toxoplasmosis

Toxoplasmosis is an infection caused by a parasite found in cat feces. Pregnant women can contract it by cleaning a cat’s litter box, gardening, or by ingestion of undercooked meat or unpasteurized milk. To avoid toxoplasmosis, have someone else change the litter box during pregnancy. Always wear gloves when gardening. Avoid ingestion of unpasteurized milk and undercooked meats.  If toxoplasmosis is caught early, a short course of antibiotics can help prevent transmission to the baby. However, toxoplasmosis acquired early in pregnancy poses the greatest risk, so prevention is best.

Other TORCH infections like rubella (German measles) and herpes can also be harmful during pregnancy. If you experience symptoms like fever, rash, or genital lesions (sores), be sure to talk about them with your OBGYN. We can help reduce the risks to your baby with prompt diagnosis and treatment.

Staying Healthy During Pregnancy

Taking some simple precautions can help you avoid many of these common infections.

Practice good hygiene

One of the best ways to avoid infections during pregnancy is through good hygiene.

• Wash your hands frequently, especially after using the bathroom or touching raw meat.
• Wipe from front to back when using the bathroom to avoid spreading bacteria.
• Drink plenty of water.

Be cautious with cats

Stay away from cat feces, as toxoplasmosis infection can be passed to your baby. Have someone else change the litter box during your pregnancy or wear gloves if you must do it yourself.

Also, avoid unwashed vegetables and undercooked meat, which may contain toxoplasma parasites.

Get tested

Ask your doctor about being tested for STIs like chlamydia, gonorrhea and syphilis. Left untreated, these infections can harm your baby. Get vaccinated for the flu and whooping cough, and ask about the Tdap and flu vaccines. Some viral infections like CMV often cause no symptoms, so talk to your doctor about testing if you’re at high risk.

Monitor symptoms

See your doctor right away if you notice symptoms like frequent urination, abdominal pain, foul-smelling discharge or fever. While infections are common during pregnancy, early diagnosis and treatment are key. Don’t delay if something feels off.

By taking good care of yourself, avoiding harmful exposures and watching for signs of infection, you can lower risks to yourself and your baby.

Dr. Dickmeyer has been providing healthcare for women in the Madison area since 1998 and is a founding member of Madison Women’s Health. Her specialties include minimally invasive surgical techniques, high and low risk obstetrics, pelvic floor disorders and postmenopausal medicine.

Navigating the world of health insurance isn’t easy – or fun. And it’s common to feel overwhelmed or avoid making decisions when it comes to signing up for or changing health insurance. But it’s important that you understand how to get the best health insurance for your particular situation so you don’t get a surprise bill that could negatively impact your finances.

If you’re pregnant or planning to become pregnant, it’s even more critical that you have a clear picture of how your prenatal care, baby’s birth and the new addition to your family might impact your coverage and premiums.

Rest assured, these situations are not uncommon, and there’s flexibility in your health insurance choices.

Continue reading to delve into the frequently asked questions of when and how to change your health insurance plan.

Can I change health insurance at any time?

Most employers that offer group health insurance have an annual Open Enrollment Period, which is usually in the fall. During this time, you get the opportunity to reassess and modify your existing health insurance plan to ensure it aligns with your family’s evolving needs.

In most cases, health insurance changes are only allowed during these annual  enrollment periods. But if life brings about significant changes throughout the year, you can promptly update your plan during a Special Enrollment Period.

You qualify for a Special Enrollment Period if you’ve had certain life events, including the following:

• losing health coverage
• moving out of range of in-network providers
• getting married or divorced
• your spouse passes away
• having a baby or adopting a child
• you turn 26 and no longer have access to your parent’s health insurance
• if your household income is below a certain amount
• you no longer qualify for Medicaid, Medicare, or Children’s Health Insurance Program (CHIP)
• you become a citizen of the US

Can I switch health insurance while pregnant?

You can switch your health insurance while pregnant only during the Open Enrollment Period or if you have experienced one of the other life events listed above.

Pregnancy does not qualify you for a Special Enrollment Period, but giving birth does. After you have a baby, you can switch insurance because the number of dependents you have has changed, allowing you to switch outside of the typical Open Enrollment Period.

If you do experience a qualifying life event while you’re pregnant and qualify for a Special Enrollment Period, make sure to let your insurance know as soon as the event happens, as you typically will have up to 30 days to enroll in your new plan.

You may be asked for documentation related to your qualifying life event, so make sure you have your paperwork in order to avoid delays.

The great news is that all government marketplace and Medicaid plans cover pregnancy and childbirth. This is true even if your pregnancy begins before your coverage starts.

Maternity care and newborn care are considered “essential health benefits.” This means all qualified health plans inside and outside the Marketplace must cover them.

If you’re pregnant without insurance, read up on your options or call Healthcare.gov help line to learn more.

Call 1-800-318-2596 (TTY: 1-855-889-4325).

What are the reasons for switching insurers?

Common reasons for switching insurers include the following:

• changes in life circumstances
• a significant increase in insurance costs for your existing plan
• dissatisfaction with current coverage
• or the availability of better coverage options or different in-network providers or hospitals.

When is the Open Enrollment Period?

The Open Enrollment Period typically occurs once a year, usually in the fall. Exact dates may vary by employer or insurance plan, so it’s crucial to stay informed about the specific Open Enrollment Period for the current year. Check the HealthCare.gov website for exact dates and deadlines.

How do I get health insurance?

Enrolling in new health insurance can be done through various channels, including online marketplaces such as healthcare.gov, your employer (if they offer health insurance), insurance brokers and agents, or directly through the insurance provider.

What do I do after I switch health insurance?

After switching health insurance, take a close look at your new plan’s benefits, coverage details, and any changes in providers.

Most insurance companies have a “Find a Doctor” search on their websites, and many will mail you printed materials to view your options. If you are unable to find your doctor using this approach, you can also call the health plan and ask if the doctor is in network.  If you call, you will have the best luck if you use the provider’s National Provider Identifier, or NPI number. This is like a Social Security Number for medical providers. If your doctor and regular providers are no longer “in network,” you’ll want to choose a new primary care provider and set up any annual or regular appointments you may need.

Note: It’s a good idea before you switch to check out the provider options in case you want to keep your same doctor or if you have a specific hospital you want to use. Keep in mind that Madison Women’s Health does its obstetric deliveries and surgeries out of UnityPoint Health-Meriter Hospital. In rare cases, some health plans will cover you to see a Madison Women’s Health provider, but not necessarily services at Meriter Hospital; so please call Meriter Hospital (608-417-6000) to check on this.

After switching insurance, don’t forget to:

• Contact Madison Women’s Health or other providers right away so we can update your records, especially if you’re pregnant.
• Cancel your other health insurance (if you have individual coverage) and remove any automatic billing that might be associated with your bank account so you don’t get double billed.
• Set up automatic payments to your new insurance if applicable so you don’t have to have to mail in checks every month.
• Put your new insurance card in your wallet and present it at your next doctor visits.

It’s essential to update your healthcare information with providers and pharmacies and familiarize yourself with any new policy requirements before you get care.

How do I cancel my health insurance?

To cancel health insurance that is your own (not through an employer), contact your insurance agent, old insurance provider, or the marketplace through which you obtained coverage. Be sure to follow the cancellation procedures outlined by both the new and old insurer to avoid any gaps in coverage or double billing.

How can I get help with getting health insurance?

For assistance with obtaining health insurance, explore resources such as healthcare.gov (the government health insurance marketplace), local health insurance agents, or community health centers.

What insurance does Madison Women’s Health take?

Madison Women’s Health accepts a variety of insurance plans to ensure comprehensive and accessible healthcare for our patients.

While we may be participating with health plans, we always encourage you to check with your insurance company to confirm that we are an in-network provider for your specific benefit plan.

We are participating providers for the following health plans:

• The Alliance
• Anthem Blue Cross/Blue Shield
• BadgerCare (Wisconsin Medicaid)
• Cigna
• First Health Network (Coventry Health Network)
• HealthEOS (includes Aetna)
• Humana (limited options)
• Medicare
• Quartz Plans
• Tricare
• UnitedHealthcare
• Chorus Community Health Plan (formerly WEA Health Insurance)
• WPS Health Solutions

Other Insurance Plans

We also accept other non-network plans and fee-for-service insurance, such as “Choice” plans or “Point of Service (POS)”, as well as self-pay arrangements. Patients under these plans may pay more out-of-pocket to see our providers.

Medicare Patients

For more information about your Medicare benefits, please visit our Medicare Services page.

Conclusion

If you have any questions about our providers and whether they are covered under your specific insurance benefit plan, we encourage you to contact your insurance company. It may be helpful to use our clinic’s National Provider Identifier (NPI) number, which is 1174851851.  Individual provider NPI numbers can be given out upon request.

Above all, we hope this article will help you understand the ins and outs of switching health insurance.

 

Pregnancy brings a host of changes to your body. One unpleasant surprise is that expectant mothers are more likely to develop yeast infections during pregnancy. Yeast infections are common during pregnancy due to hormonal changes. Fortunately, they’re usually easy to treat and prevent.

In this article, we’ll walk you through everything you need to know about yeast infections when you’re pregnant—what causes them, how to spot the symptoms, safe treatment options, and tips to reduce your risk.

Yeast Infections Are Common During Pregnancy

Yeast infections happen when there’s an overgrowth of fungus, Candida albicans being one of the potential fungii implicated. Thanks to hormonal changes, pregnant women are more susceptible to these overgrowths. The increased estrogen makes it easier for yeast to grow. Changes in vaginal pH levels can disrupt the normal balance. Untreated gestational diabetes also increases your risk, as the extra sugar in your system feeds the yeast.

Vaginal yeast infections pose little risk to your pregnancy or baby. However, some doctors may treat all expecting mothers before delivery to prevent thrush in newborns. In Europe, this preventative treatment is common, though less so in the U.S.

Yeast Infection Symptoms

The symptoms of a yeast infection during pregnancy are the same as when not pregnant. They include:

• itching
• burning
• redness
• thick, white discharge resembling cottage cheese

Diagnosis

The only way to know for sure if you have a yeast infection is through a diagnosis from your doctor.

Self-diagnosis is notoriously unreliable and can lead to improper treatment. Some women mistake normal changes in vaginal discharge during pregnancy for an infection — and then they self-treat unnecessarily. Others may have an underlying condition, like bacterial vaginosis (BV), and mistake it for a yeast infection. If the cause of your discomfort is BV or another infection, using over-the-counter antifungal creams won’t help. That’s why it’s so important to consult your women’s physician or OBGYN provider.

Your OBGYN will perform a wet prep test or a culture test to check for signs of excess yeast. During a wet prep test, your doctor examines a sample of vaginal discharge under a microscope. They’re looking for budding yeast and hyphae, the branching filaments that make up the body of the yeast fungus. A culture test involves taking a swab of the vaginal discharge and growing it in a substance that promotes yeast growth. If yeast colonies develop, it confirms an infection.

These tests are quick, painless, and safe during pregnancy.

Safely Treating Yeast Infections While Pregnant

Antifungal medications

The most common treatments are antifungal creams or suppositories like clotrimazole (Lotrimin) and miconazole (Monistat). These medications are considered safe for pregnant women. They work by destroying the cell walls of the Candida fungus that causes the infection. Treatment may need to last longer than the usual seven days to fully clear up the infection during pregnancy.

The oral antifungal fluconazole (Diflucan) is avoided until after delivery due to possible risks to the baby. However, you can typically use the topical creams and suppositories to relieve your symptoms.

Talk to your OBGYN about the best treatment plan for you based on your medical history. They may want to test a sample to determine the specific type of yeast causing your infection before prescribing medication.

Easing discomfort

In the meantime, you can take steps to relieve discomfort from your yeast infection:

• Apply a cold compress to your vulva to reduce inflammation and itching. Do this for 10-15 minutes at a time, a few times per day.
• Soak in a warm bath with baking soda, oatmeal bath product, or Epsom salt. The water will help reduce irritation, while the add-ins can help relieve itching.
• Use unscented baby wipes instead of toilet paper, which can further irritate the area.
• Wear cotton underwear and loose, breathable clothing. Avoid pantyhose and tight-fitting pants or shorts.
• Ask your OBGYN about using hydrocortisone cream to help with inflammation. Low-dose steroids are often considered safe during pregnancy.

Preventing Yeast Infections During Pregnancy

Check your wardrobe

Yeast thrives in warm, wet areas. Tight-fitting synthetic fabrics trap heat and moisture, creating the perfect environment for yeast overgrowth. Cotton underwear and loose pants or dresses will keep you more comfortable and help prevent infection.

Change damp clothing right away. Any damp area such a bathing suit or sweaty workout clothes should be removed as soon as possible.

Practice good hygiene

Wash the vaginal area with water. Harsh soaps can irritate sensitive skin and disrupt the natural balance of good bacteria. After using the toilet, be sure to pat instead of rub dry, and always wipe from front to back.

What about probiotics?

While some women add yogurt with probiotics to their diets, there is no good data supporting the use of probiotics to prevent vaginal yeast infections.

See Your Doctor For Any Infection

Follow these preventive tips, practice good self-care, and maintain open communication with your OBGYN to help reduce your chances of developing a yeast infection during pregnancy.

Don’t self-diagnose or treat a yeast infection during pregnancy. See your doctor right away. It could be a simple yeast infection, or it could be something else that needs a different treatment.

Take comfort in knowing that yeast infections pose no harm to your baby, and effective treatment options are available should an infection occur.

We’re here to support you through all the ups and downs of pregnancy and want you to feel as comfortable as possible! If you have concerns, please let us know.

Dr. Dickmeyer has been providing healthcare for women in the Madison area since 1998 and is a founding member of Madison Women’s Health. Her specialties include minimally invasive surgical techniques, high and low risk obstetrics, pelvic floor disorders and postmenopausal medicine.

What Are STIs and Why Should You Get Tested?

STIs, or sexually transmitted infections, are infections passed between partners during sexual contact.

While “STDs” or “sexually transmitted diseases” used to be the common term, STI is now preferred because these infections can often be cured or managed with treatment.

As a sexually active woman, STI testing should be an important part of your self-care routine. Many STIs don’t show symptoms, so the only way to know if you have one is through testing. If detected and treated early, most STIs can be cured or managed well with antibiotics or antiviral medication. However, without treatment, STIs can lead to long-term health issues like infertility, cancer, liver disease, and even death.

You should get tested after every new partner, or at least once a year. Getting tested and encouraging your partners to get tested too shows you care about your health and the health of your community. Testing is often free or low-cost at clinics. Home test kits are also available, though less accurate.

The Most Common STIs: Symptoms, Testing, Treatments

The most common STIs are chlamydia, gonorrhea, herpes, HPV, syphilis, and trichomoniasis.

These infections are common, but the good news is that most are curable if caught early. At Madison Women’s Health, we recommend our patients get tested for chlamydia, HPV, gonorrhea, and trichomoniasis as part of their annual exam or Pap test.

Early detection of these infections is key to preventing long-term health issues.

Chlamydia

Chlamydia is a common STI that is caused by bacteria. It is often asymptomatic, meaning you may not notice any symptoms. If symptoms do appear, you may experience abnormal discharge from the vagina or penis, pain during urination or sex, and lower abdominal pain.

If left untreated, chlamydia can lead to pelvic inflammatory disease, which may cause permanent damage to your reproductive organs.

Chlamydia is diagnosed with a urine test or swab and cured with a round of antibiotics. To avoid reinfection, sexual partners should also be treated.

HPV

The human papillomavirus or HPV is an extremely common viral STI. There are over 100 strains of HPV, some of which are low-risk and cause genital warts, while high-risk strains may lead to cervical cancer in women. HPV often has no symptoms, so the only way to detect it is through routine Pap smears and HPV testing.

While there is no cure for HPV, the good news is most infections clear up on their own. However, certain high-risk HPV infections require close monitoring or procedures like colposcopy to check for precancerous cell changes.

Treatment for HPV warts includes freezing, laser therapy or topical creams.

The Gardasil vaccine protects against cancer-causing HPV strains. The CDC recommends all girls and boys get vaccinated by age 26. When administered to children, it is a two-vaccine series. The Gardasil vaccine is also available for men and women through age 45. A three-vaccine series is administered to adults.

Hepatitis C

Hepatitis C is a viral infection that causes inflammation of the liver. It is often asymptomatic for years but can eventually lead to serious liver damage if left untreated. Common symptoms include fatigue, nausea, muscle aches, and jaundice (yellowing of the skin).

Hepatitis C is most commonly spread through contact with contaminated blood, though it can also be transmitted sexually. Treatment typically involves antiviral medications to clear the infection, slow damage to the liver or, in some cases, even cure the infection.

Gonorrhea

Gonorrhea is a common bacterial STI that can affect both men and women. Symptoms in women include unusual discharge from the vagina, pain during sex or urination, and bleeding between periods. In men, symptoms include discharge from the penis, pain during urination or soreness in the testicles.

Gonorrhea can usually be cured with antibiotics, though treatment may require a longer course of medication if it has been present for some time. Without treatment, gonorrhea can lead to pelvic inflammatory disease, infertility and pregnancy complications.

Trichomoniasis

Trichomoniasis usually causes symptoms like itching, burning, redness or soreness in the genital area and an unpleasant-smelling discharge. Diagnosis and treatment are the same as for chlamydia and gonorrhea—trichomoniasis is tested using a genital swab or urine sample and treated with a prescription medication.

If left untreated, it may lead to pregnancy complications, so testing is especially important for pregnant women.

Syphilis

Syphilis is highly contagious. It is caused by a bacteria, which produces a painless sore on the genitals, rectum, or mouth. There has been an uptick in the number of cases of syphilis in the past decade. Syphilis is typically treated with penicillin.

HIV

HIV can cause major health problems and even death by weakening the body’s immune system. Traditionally, the only way to prevent transmission of HIV was to use condoms. Now, a medication is available to use prior to exposure to HIV: PrEP. PrEP stands for pre-exposure prophylaxis.

If your partner is HIV positive, a medication called Cabotegravir can help prevent you from getting HIV-1 through sex. It is administered either by injection or a daily pill. This medication must be taken as directed for it to be effective.

Prevention 101: Safe Sex and Vaccinations

Use Protection Every Time

Condoms are your best defense against STIs. Use them for any sexual contact—not just intercourse. Don’t rely on the pull-out method or any other method that doesn’t provide a physical barrier.

Get Tested Regularly

Many STIs don’t show symptoms, so the only way to know for sure if you have an STI is through testing. The CDC recommends getting tested at least once a year, or more often if you have multiple partners.

Tests for STIs include:

• Blood tests: Check for HIV, syphilis, and hepatitis.
• Urine tests: Screen for chlamydia and gonorrhea.
• Swab tests: A sample is taken from the cervix or urethra to test for chlamydia, gonorrhea, herpes, and HPV.
• Physical exams: Doctors check for signs of infections, genital warts, and discharge.

At-home tests are available for some STIs but may be less accurate than tests done by a doctor. See your doctor for the most reliable results. Testing is often free, confidential, and can provide peace of mind.

Consider Vaccination

Vaccines are available for some viral STIs, including HPV, hepatitis A, and hepatitis B. The HPV vaccine is recommended for all preteens at age 11-12, but can be given up to age 26. It protects against the HPV strains most likely to cause genital warts and cervical cancer. Hepatitis vaccines are also routinely given to infants but should be considered for at-risk adults.

Where to Get Tested for STIs in Madison

Getting into a regular habit of STI testing — especially if you have new or multiple sexual partners — is one of the best ways to take control of your reproductive and sexual health. There are several options for confidential and low-cost (or free) testing right here in Madison.

• Madison Women’s Health: As a women-owned clinic focused on caring for the community, Madison Women’s Health provides discreet STI testing for people of all genders. We offer screening for common infections like chlamydia, gonorrhea, herpes, HPV, syphilis, and HIV.
• First Care Clinic: First Care Clinic’s medical professionals can provide STI testing for women, free of charge.
• Public Health Madison & Dane County (PHMDC): For those without health insurance, PHMDC provides low-cost STI testing through their Sexual Health Clinic. They offer screening for chlamydia, gonorrhea, syphilis, herpes, and HIV, with results available during your visit or within a few business days. The clinic staff understands that anyone can be at risk for an STI, so they aim to provide judgment-free care for people of all backgrounds.
• At-home test kits: While convenient, at-home STI test kits may not be as accurate as testing done by a healthcare provider. Results can be difficult to interpret without professional guidance. However, for those unable or unwilling to visit a clinic, at-home tests do provide an option for screening. Look for test brands that analyze samples at a certified lab for the most reliable results. Be aware that at-home tests typically do not screen for all STIs. No test is 100% accurate, so follow-up testing at a clinic is recommended if you receive a positive result.

For the most reliable results, get a full STI screening that includes:

• A pelvic exam for women, which allows the doctor to check for any abnormalities.
• Urine, blood, and swab samples to test for chlamydia, gonorrhea, syphilis, herpes, HIV, and hepatitis B and C.
• A Pap smear to screen for HPV and cervical cancer. The latest HPV tests can detect 14 high-risk HPV strains.
• Additional testing for symptoms like genital sores, rashes, or discharge.

How to Bring Up STI Testing With Partners

Bringing up STI testing with a new partner can feel awkward, but it’s an important conversation to have. At Madison Women’s Health, we strongly advise all our patients to get tested regularly, especially for those who have multiple partners or are starting a new relationship.

The good news is, there are some tips to make this talk a little easier.

Frame it around health and caring for each other.

Let your partner know you want to make sure you’re both safe and healthy before becoming intimate. This approach feels more positive and less accusatory. You might say something like, “I care about you and our health, so I think we should both get tested for STIs before we have sex.”

Discuss getting tested together.

Offer to accompany your partner to get tested, and get tested yourself at the same time. This shows you’re in it together and can help put them at ease.

Be open and honest about your concerns.

Don’t be afraid to voice why STI testing is important to you, especially if you’ve had experiences with STIs in the past or a previous partner. However, be sensitive about how you frame it. Focus on the present and future, not on past relationships. Let your partner know you want to build trust and intimacy in a healthy way.

Talk about the specifics of what you want tested.

Discuss which STIs in particular concern you, based on your risks and experiences.

Discuss what you’ll do if there are positive results.

This is an important part of the conversation, even if it’s uncomfortable. Talk about the treatment options, the need to notify past partners, and using protection like condoms during treatment and recovery. Having a plan in place will make dealing with positive results much easier.

Do it with empathy, honesty and care for your partner and relationship.

Turn it into an opportunity to build trust and set a foundation of good health and open communication.

While it may feel awkward, the benefits to your peace of mind and intimacy will make this difficult conversation worth it.

Conclusion

Getting tested for STIs should absolutely be part of your regular self-care routine. Your sexual health and well-being deserve the same level of care and attention as your physical and mental health. While it can feel uncomfortable or embarrassing, STI testing is a critical way for you to take control of your health and your body.

Knowing your status gives you the power to make informed choices about safe sex practices and to get treatment right away if needed.

Make that appointment today—your future self will thank you!

Dr. Dickmeyer has been providing healthcare for women in the Madison area since 1998 and is a founding member of Madison Women’s Health. Her specialties include minimally invasive surgical techniques, high and low risk obstetrics, pelvic floor disorders and postmenopausal medicine.

What is a Hysterectomy?

Hysterectomy is the surgical removal of the uterus. Although it is the second most common surgery unique to women, choosing to undergo a hysterectomy can be a deeply personal and challenging decision. Physicians recommend the procedure after other treatment options have been discussed and are unsuccessful or are not preferred by the patient.

In this article, we will explain how hysterectomies are done and what to expect during the recovery period.

Reasons for a Hysterectomy

Common reasons women undergo a hysterectomy include:

• Endometriosis
• Heavy periods
• Uterine fibroids
• Cancer or pre-cancer of the uterus, ovaries or cervix
• Uterine prolapse
• Gender affirming surgery

Types of Hysterectomies

Total hysterectomy involves removing the uterus and cervix. A supra-cervical hysterectomy (previously described as partial), removes the uterus while leaving the cervix place. The fallopian tubes are also typically removed at the same time, and this is a separate procedure called salpingectomy. Ovaries are not removed during hysterectomy unless indicated by age or a separate problem. A hysterectomy alone does not induce menopause!

Surgical Techniques

There are different ways to perform a hysterectomy. Your surgeon will recommend a technique based on the size and shape of your uterus, the reason for your hysterectomy, and any previous deliveries/surgeries. Depending on these factors, the surgery will typically take 1-3 hours under general anesthesia (with a breathing tube).

• A vaginal hysterectomy is performed through an incision in the vagina. The uterus is removed vaginally with no abdominal incisions. This is often an option for women who have had a vaginal delivery.
• Laparoscopic hysterectomy (traditional or robotic) is the most common route performed in the US. The surgeon inserts a laparoscope (camera) through 3-4 small incisions in the abdomen. The uterus is most commonly removed through the vagina with that being the largest incision for the case (although this can vary with the size of the uterus).
• An abdominal hysterectomy requires a larger incision in the lower abdomen. It is much less common now and reserved for cases when the uterus is large or if the physician needs to examine the surrounding tissue.

Recovery

After a hysterectomy, patients will spend 6-24 hours in recovery at the hospital. They manage pain with ibuprofen, Tylenol, and a stronger narcotic pain medication. The stay may be extended based on specific circumstances, but most patients go home the same day of the procedure.

The standard recovery time is around 6 weeks. During those 6 weeks, women shouldn’t lift anything heavier than 15 pounds. They should also remain on pelvic rest for 6-8 weeks, which means no intercourse or inserting anything into the vagina. Women often feel fatigued or worn down for about a month after the procedure.

It’s important to follow recovery directions, especially lifting restrictions. Lifting restrictions are in place to prevent vaginal cuff dehiscence, which is when the vaginal incision opens. Vaginal cuff dehiscence is an emergency situation because it creates an open hole into the abdominal cavity.

Signs of overdoing it after a hysterectomy surgery include increased soreness or vaginal bleeding.

Risks and Potential Complications

Complications with this type of surgery are rare. Like any surgery, however, some risks exist.

Risks of a hysterectomy include:

• Bleeding: It’s normal to lose blood during this surgery—maybe even enough to fill a soda can.
• Infection: Antibiotics are given prior to surgery to reduce the risk of infection. It is important to monitor for fevers after surgery.
• Risk of injury to surrounding areas: There is less than a 1% chance of injury to surrounding tissue or organs.
• Complications with anesthesia: This can include postoperative nausea, developing a blood clot, and other risks that are reviewed with you by the anesthesia team.

Life after a Hysterectomy

Most women do not miss their uterus and the symptoms that lead to hysterectomy. After the initial recovery period, they are able to focus on the important things in their life, rather than bleeding and pain. If a hysterectomy was required prior to completing childbearing, this can be a significant loss for women. At Madison Women’s Health, we can connect you to mental health specialists to help you during this transition and help you navigate ways to parenthood.

Hormones & Sex

Hormone replacement is not necessary after a total hysterectomy. Women will continue to ovulate. They may even experience PMS symptoms. Menopause (cessation of ovulation) will occur in the same fashion as if they had their uterus, just without the bleeding symptoms.

After 6-8 weeks of pelvic rest, it is typically ok to have sexual intercourse after a hysterectomy if your surgeon has done an exam and given the go-ahead. A lot of research has also shown that hysterectomy does not negatively impact orgasm/sex life.

Conclusion

Even though hysterectomy is a common procedure, deciding if or when to have this surgery is a big step. Your OBGYN can help you determine if it’s the best choice for you. At Madison Women’s Health, we are on your side as you consider and prepare for the surgery — and we’re with you through recovery.

Dr. Ashley Durward has been providing healthcare to women in Madison since 2015 and joined Madison Women’s Health in 2019, specializing in high and low risk obstetrics, contraception and preconception counseling, management of abnormal uterine bleeding, pelvic floor disorders, and minimally invasive gynecologic surgery.

Uterine fibroids are benign smooth muscle tumors that grow in the uterus. They can be asymptomatic or present with a variety of symptoms. They are a common gynecological condition affecting many women during their reproductive years and perimenopausal years. Let’s explore the symptoms, causes, and treatment options for fibroids, and talk about how they may affect fertility and pregnancy.

What are Fibroids?

Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop within the muscular walls of your uterus. These smooth muscle tumors can vary from small pea-sized nodules to large masses that can fill the entire abdominal cavity. Up to 80% of women will be diagnosed with having fibroids over the course of their life. The symptoms of fibroids can differ based on their size, location, and number.

Fibroids can be intramural (in the muscle), submucosal (near the lining of the uterus), or subserosal (on the outside of the uterus). Intramural and submucosal fibroids cause the most bleeding and cramping symptoms. Some large subserosal fibroids cause no symptoms.

While fibroids are typically benign (non-cancerous), it’s essential to consult with your OBGYN for an accurate diagnosis and appropriate management.

Symptoms of Fibroids

The most common symptoms of uterine fibroids include heavy menstrual bleeding and cramping during periods (dysmenorrhea). You might find yourself needing to change pads or tampons every 1-2 hours. Some women with fibroids experience painful periods, with cramps radiating down their legs and to their back. Others may feel pelvic pressure or fullness and endure discomfort during intercourse. Some even have changes in their bowel and bladder function.

It’s worth noting that many women with fibroids don’t experience symptoms and may only discover them during routine pelvic examinations or while seeking medical attention for unrelated concerns.

Causes and Growth Factors

Hormones, particularly estrogen and progesterone, play a significant role in fibroid growth. As a result, women of reproductive age are more prone to developing fibroids and pregnancy can trigger their growth due to changes in hormone levels. Birth control, like oral contraceptives, can help manage fibroid symptoms by stabilizing hormone levels and lessening bleeding/cramping symptoms.

Who is at Risk for Developing Fibroids?

Having a family member with fibroids increases your risk. Studies also suggest that black women may have a 2-3 times higher incidence of fibroids than white women. It is essential to note that fibroids can affect women of all races and ethnicities.

Treatment Options

Several treatment options for uterine fibroids are available, ranging from non-invasive approaches to surgical management.

Medical management

• NSAIDS (nonsteroidal anti-inflammatory drugs) lessen bleeding and are best for treating cramps.
• Hormonal birth control, such as combination oral contraceptives, can keep your hormone levels steady and lessen bleeding/cramping associated with fibroids. These will not cause fibroids to shrink.
• Levonorgestrel IUDs can lessen the heavy menstrual bleeding seen with fibroids, depending on fibroid location.
• GnRH altering drugs can lessen the heavy menstrual bleeding seen with fibroids, while also shrinking their size. Sometimes these are used for treatment alone or in preparation for surgery.

Surgical intervention

• Uterine artery embolization (UAE)/uterine fibroid embolization is performed by an Interventional Radiologist. They use a catheter through your leg to obstruct blood flow to the uterus/fibroids, which can shrink them over time.
• High intensity focused ultrasound is a procedure performed laparoscopically. A special probe uses high ultrasound energy essentially to shrink fibroids with time.
• Myomectomy involves removing fibroids while leaving the uterus in place. This can be done through a camera through the cervix (for submucosal fibroids), laparoscopically (through small incisions on the abdomen), or with laparotomy (reserved for very large fibroids that cannot be removed through minimally invasive techniques).
• Hysterectomy, or surgically removing the uterus, is a consideration if you are done childbearing.

Fertility and Pregnancy with Fibroids

Good news—getting pregnant with most types of uterine fibroids is possible. While fibroids can cause fertility issues or increase the risk of pregnancy complications in some cases, most women have no extra trouble conceiving or carrying a pregnancy to term. However, large or multiple fibroids may occasionally interfere with the implantation of a fertilized egg or fetal growth and women may benefit from removal prior to trying to conceive.

If you’re planning to conceive or are already pregnant, it’s essential to discuss your fibroids with your healthcare provider for proper monitoring and management. Regular prenatal care and open communication with your OBGYN providers can help address any concerns and ensure the best possible outcomes for both you and your baby.

Risk of Cancer: Very Low

The risk of a fibroid containing cancer is low. Some experts estimate that 1 in 750 could become malignant (cancerous) while others say it is even lower, at 1 in 2000+ cases. A better estimate can be made based on age, fibroid size, imaging, and concurrent symptoms.

Conclusion

It is important to remember that you are not alone in dealing with fibroids—many women navigate this journey. There are effective treatment options available for your specific situation, whether it’s a conservative approach with fertility preservation or more involved surgical procedures.

By working closely with your OBGYN, you can find the best way to alleviate symptoms and improve your overall well-being. Madison Women’s Health is here to support you every step of the way.

Dr. Ashley Durward has been providing healthcare to women in Madison since 2015 and joined Madison Women’s Health in 2019, specializing in high and low risk obstetrics, contraception and preconception counseling, management of abnormal uterine bleeding, pelvic floor disorders, and minimally invasive gynecologic surgery.

Regular health check-ups play a crucial role in maintaining overall well-being. For women, well-woman exams are an essential part of preventative care. They’re designed to address various aspects of women’s health and provide a comprehensive evaluation of their physical and emotional well-being.

Well-woman visits are different from an “annual physical exam.” In this article, we will explore why they’re different, what to expect from a well-woman exam and the differences in insurance coverage between the two types of healthcare check-ups.

What is a well-woman visit?

Simply put, the goal of a well-woman visit is to keep you well.

It is a regular appointment with a healthcare provider that focuses on preventive care for women of all ages—starting from the time a woman is sexually active and continuing until the age of Medicare eligibility.

These visits are an opportunity to discuss and evaluate various aspects of a woman’s health, including physical, emotional, and reproductive well-being. They’re tailored to meet the specific needs of women at different stages of life, providing personalized care and health education.

By identifying and addressing potential health concerns early on, well-woman visits aim to prevent the development of more serious conditions. These visits also help healthcare providers establish open and trusted relationships with their patients, fostering effective communication and personalized care.

While well-woman visits focus on preventive care, they are not intended to manage existing medical conditions such as hypertension, thyroid disorders, or diabetes.

How is a well-woman visit different from an annual exam?

Many patients often refer to their visits with their OB/GYN as their ‘annual exam’, but the more accurate term is the ‘well woman exam’ or ‘well woman visit’.  While we encourage regular visits to ensure you remain healthy, it does not always mean it has to be done annually.

Check with your insurance to understand how frequently you can obtain preventive services. A well-woman visit has a specific insurance billing code, which determines the topics and services insurance will cover. It is a specialized appointment dedicated to addressing women’s specific health needs. It encompasses a broad range of preventive services, including reproductive health screenings, counseling, and education.

Medicare, which is mostly for adults ages 65 and older, provides a limited gynecologic exam, as well as an “annual wellness visit” that is available to both male and females.

How often should I schedule a well-woman visit?

Most insurance plans cover these visits once a year or every other year. Read more about when to see your OBGYN.

Will my appointment be covered by insurance?

The Affordable Care Act requires insurance plans to cover 100% of the cost of preventative care, such as a well-woman visit. Preventative care includes screenings and assessments, but not the management of existing medical conditions.

Discussions of problem-oriented issues may not be fully covered by your insurance.  While not a complete list, some of the more common issues are:

• Back pain
• Sleeping problems
• Mental health concerns, like anxiety
• Abnormal bleeding
• Perimenopausal symptoms
• Dermatologic concerns
• Hair loss
• Pain with intercourse

What items are included in a well-woman visit?

During a well-woman visit, a physician conducts various screenings and assessments to monitor and address specific health concerns. Common components of a well-woman visit include:

• Monitoring BMI (Body Mass Index) and vital signs
• Reviewing menstrual history
• Cervical cancer screening, commonly known as a Pap smear
• Checking immunization status and providing necessary vaccinations
• Conducting mood screenings and assessing domestic violence risks
• Discussing wellness issues such as exercise and diet
• Breast cancer screening, recommendations for mammography and breast exam (if not declined)
• Colon cancer screening (depending on age)
• Screening for sexually transmitted infections (STIs) if needed
• Bone density testing if needed to assess osteoporosis risks
• Screening for alcohol / substance abuse and smoking habits
• Discussing birth control / contraception options
• Cholesterol and glucose screening (note: lab tests may or may not be covered by insurance)

What is typically not included during a well-woman visit?

While you are welcome to ask your physician questions and discuss medical issues, topics related to managing existing medical conditions are not considered preventative care and are not required to be covered by insurance during a well-woman visit.

Instead of discussing existing conditions at your well-woman exam, we recommend that you schedule a follow-up visit to discuss problem-oriented conditions like the ones listed previously.

Understanding the Affordable Care Act, preventative care and your insurance

No one likes surprise bills! That’s why it’s so important to be familiar with the specific details of your insurance plan and what is covered for different kinds of health checkups.

The Affordable Care Act (ACA) expanded access to preventive services. Under the ACA, preventive care services for women are required to be covered by most insurance plans without charging a copayment, coinsurance, or deductible. Check with your insurance provider to confirm the coverage details related to well-woman visits.

Learn what your insurance plan includes by:

• calling the 1-800 number on the back of your insurance card
• looking at your plan book during open enrollment period
• emailing your insurance company

If you have any concerns about the cost of services, ask your clinic for an estimate of fees for the specific components of your well-woman visit. By law, healthcare providers are required to provide estimates of fees upon request. This transparency helps you to make informed decisions and ensures that you have access to the necessary healthcare services as mandated by the ACA.

For example, if you have questions about menstrual irregularity, you could ask what an ultrasound or blood tests will cost. If your insurance doesn’t cover the tests or care you need, we will work with you to create a payment plan.

Common questions patients ask during well-woman appointments:

• What screenings or tests do you recommend for my age and health condition?
• Are there any lifestyle changes I should consider to improve my overall health?
• Can you provide more information about contraception options and their suitability for me?
• Are there any additional preventive measures or vaccinations I should consider?
• What resources or support groups are available for specific health concerns I may have?
• How can I maintain a healthy weight and lifestyle?

Our goal is to help you stay well

Well-woman visits are vital for women’s preventive care. They offer an opportunity to monitor your overall health and receive important screenings. By prioritizing regular well-woman visits, you can take proactive steps toward maintaining your well-being and leading a healthy life.

When we established Madison Women’s Health, we set out to provide “a different kind of care,” the kind of care we always wanted for ourselves as women. As the only women-owned clinic in Madison, our level and style of care goes beyond the ordinary—we understand that each patient is unique and deserves personalized attention. Our approach sets us apart from other clinics, and we’d like to share with you what makes us different.

We take more time to listen to our patients

Truly understanding our patients’ needs starts with attentive listening. Because our clinic is smaller than most, we can make longer appointments to spend more time with each patient. This means we can delve deeper into their concerns, answer their questions, and provide comprehensive care. Whether it’s a well woman exam or a more complex issue, we ensure that our patients feel heard and valued.

We get to know each patient, their moods, stressors, and the demands of their lives. This understanding allows us to offer comprehensive care that addresses not only physical needs but also mental and emotional well-being.

In addition to longer appointments, we also accommodate our patients’ schedules. We know that life can be unpredictable, and sometimes a medical issue arises when it’s least expected. We strive to be flexible and understanding, providing solutions that work for each individual’s circumstances.

At our clinic, nurse practitioners play a crucial role in patient care. Patients have direct access to them, ensuring that they receive the attention they need promptly. Our nurse practitioners exclusively see Madison Women’s Health patients, so when urgent issues arise, patients don’t have to be diverted to other healthcare facilities. This ensures continuity of care and allows us to be there for our patients when they need us most.

We individualize and personalize our patients’ care

Our commitment to personalized care extends beyond listening. We take the time to get to know our patients and their unique circumstances. We understand that preferences and needs differ from person to person, so we tailor our care accordingly.

For instance, one patient in her first trimester of pregnancy was experiencing severe nausea and dehydration. Our nurse promptly got permission to administer an IV to help her feel better right away. She and the patient discussed other ways to manage nausea—but also let the patient know she could return to the clinic for IV fluids when needed. We’re here to support our patients when they need us the most.

If a patient has a particular provider they want to see but struggles to find an appointment, we offer telehealth visits when that provider is on-call—increasing flexibility for the patient. Moreover, we provide office procedures to spare our patients the extra time it takes to go to the hospital for certain treatments.

Encouraging a healthy lifestyle is another aspect of our personalized care. We understand the importance of staying active and eating well for maintaining good health. We lead discussions about various ways to incorporate physical activity into daily routines and offer guidance on making healthier food choices and managing weight effectively.

Our dedication to personalized care is evident throughout the entire patient journey. We have been privileged to take care of some patients for over two decades, witnessing and supporting them through various phases of life. It’s almost like caring for family because we know them that well.

Women taking care of women

We understand the unique challenges that women face in their lives. As female physicians, specialists and nurses, we can empathize with our female patients on a deeper level. From first periods and pregnancy to childbirth, infertility and loss—we’ve been there. We understand the frustrations of weight changes and body image struggles. We’ve lived through the ebb and flow of daily hormone fluctuations, and we understand what it’s like to reach menopause.

Stress is a common factor in many women’s lives—it’s important to talk openly about how to address it. Taking care of one’s mental and emotional health is just as important as physical health. Through open discussions and compassionate guidance, we work together with our patients to find effective ways to manage stress and improve their overall quality of life.

We believe that empowered women empower other women. We consider it a gift to be able to work in these roles and help our patients live their best lives.

We believe our experience as women and mothers gives us valuable insight into the challenges our patients may face. At the same time, we support male residents and anesthesiologists, and we also educate male students and residents, fostering a collaborative and supportive environment.

Collaboration and warmth in patient care

Our clinic is more than just a medical facility—it’s a warm and personalized environment. Our providers collaborate with each other and specialists in the area to bring fresh ideas and expertise to complicated cases. We make it a priority to take as much time as we can in each visit. We want to get to know our patients, listen to them, and accommodate their preferences, especially during pregnancy and labor.

Speaking of labor, we offer a different level of presence during this important process. Our team stays with the patient throughout the labor, ensuring they feel supported and cared for every step of the way. Our ample nursing staff guarantees that patient needs are addressed quickly. Even after delivery, our nurses call postpartum patients 1-2 weeks later to check-in and provide any necessary support.

Providing compassionate care tailored to women since 2010

Our passion for helping women meet their goals drives us to offer a level of care that goes beyond the clinical aspect and into the realms of genuine support and understanding.

We take the time to listen, understand, and personalize care according to the unique needs of each person. Being women-owned and operated, we offer a warm and compassionate environment where we empower our patients to live healthier and happier lives. Our collaborative approach and dedication to excellence set us apart and make us the best choice for an OBGYN and women’s health care clinic in Madison.

We look forward to welcoming you to our clinic and providing you with the exceptional care you deserve.

Experiencing a miscarriage is an emotionally challenging, often devastating experience for women and their partners. A miscarriage, also called early pregnancy loss, is the loss of a pregnancy within the first 12 weeks. Everyone reacts differently after an early pregnancy loss. It’s important to give yourself time to grieve and to recognize that the loss was not your fault.

When you feel ready to start trying to conceive again, you may have many questions like  —  Why did I have a miscarriage this time? How soon can I get pregnant after a miscarriage?  Can I prevent another miscarriage from happening?

Let’s start with one of the most common questions our providers are asked:

Why did the miscarriage happen?

As advanced as modern medicine is, we still don’t know the exact cause of most miscarriages. About half the time, the miscarriage happened because the embryo didn’t form correctly. This is called a chromosomal abnormality. It can mean that the embryo had either too many or too few chromosomes or even though there is the correct number of chromosomes, something about one or more of them is not normal.

Other times, we simply do not have an answer.

What we do know, however, is the following activities do NOT cause miscarriage:

• working
• exercising
• falling
• feeling upset
• or having sex.

Will I have a successful pregnancy after a miscarriage?

After an early pregnancy loss, it’s common to worry if it will happen again. Getting your hopes up again after a loss feels risky. But we have some good news for you — most women (about 85%) go on to have a successful pregnancy after a miscarriage.

Recurrent miscarriage, which means two miscarriages in a row, happens to less than 5% of women. Three miscarriages in a row are even more rare, occurring less than 1% of the time.

Are special tests recommended before trying to conceive after a miscarriage?

If you have had two miscarriages in a row, then we recommend evaluation which will include genetic testing for you and your partner. Tests can help us discover the reason for recurrent miscarriages about 50% of the time.

How long do pregnancy symptoms last after miscarriage?

After a miscarriage, you may still have some pregnancy symptoms, like nausea and vomiting, breast tenderness, and fatigue. These symptoms are related to the amount of beta HCG (pregnancy hormone) that is still in your bloodstream, and they usually go away after about two weeks. If you’re still experiencing pregnancy symptoms after two weeks, it is important to contact your doctor.

Pregnancy symptoms typically stop sooner for women who have a DNC (dilation and curettage), which often causes beta HCG levels to drop more quickly.

Bleeding and cramping can also vary greatly from woman to woman. It could feel like a heavy period at first. But heavier bleeding should only last a few days at most. Although Some women may experience lighter bleeding for up to a month. As long as the bleeding appears to be decreasing, this is normal. If bleeding or cramping increases instead, call your doctor.

About 90% of the time, a woman’s body will resume its typical cycle within 8 weeks.

How soon after a miscarriage can I start trying to get pregnant?

You may have been told that you should wait a certain number of months or menstrual cycles before trying to conceive. However, there aren’t any large, quality studies that suggest it’s beneficial to wait after a first-trimester miscarriage. (Second- and third-trimester losses require a more personalized plan.)

Instead of recommending patients wait a specific number of months or cycles, we track beta HCG levels after any kind of pregnancy loss. When these levels return to pre-pregnancy levels, your body is ready to try to conceive again.

If you experience a first-trimester loss, talk to your OBGYN about whether you want to track labs early in the next pregnancy. For example, your doctor might track your beta HCG levels to indicate whether the pregnancy is likely to be viable. If the beta HCG level doubles every 48 hours, then there is a good chance that the pregnancy is on the right track.

When will you begin ovulating or menstruating after a miscarriage?

The body usually reacts to a miscarriage as if it’s a “period.” Some women’s bodies will resume ovulation right away, meaning they do not miss an ovulatory cycle after having a miscarriage. Others may miss one ovulation cycle. Sometimes the stress of miscarriage or surgery might affect ovulation and push it out a week or so.

Can you test false-positive for pregnancy after a miscarriage?

Pregnancy tests measure the amount of HCG in a woman’s blood or urine. Once beta HCG numbers are normal (close to zero), you would not get a positive pregnancy test. However, it could take about 2-4 weeks for those numbers to return to pre-pregnancy levels. While waiting for the beta HCG level to return to normal, you might get a positive pregnancy test. For that reason, we don’t recommend testing at home.

If you get a positive pregnancy test after a confirmed miscarriage, it may be due to testing too early. If beta HCG levels stay the same and do not decrease, your OBGYN may check to see if tissue is still present in your uterus. Sometimes, a prescription can help the tissue pass, but other times it may need to be removed with surgery (D&C).

What can I do to improve the chances of a healthy pregnancy after a miscarriage?

Remember, a miscarriage is not your fault. There’s nothing you can do to prevent a first-trimester loss.

While you can’t prevent a miscarriage, you can prepare your body for a healthy pregnancy. Be physically active. Nourish your body with whole foods and a balanced diet of carbohydrates, fats and protein. Read more about preparing for pregnancy.

We’re here for you

We’ve talked a lot about how to know if your body is physically ready for pregnancy after miscarriage. But it’s just as important to consider your mental health. Give yourself time to grieve after a miscarriage and seek therapy to help you process your loss. And when the time is right, we’ll be here for you to try getting pregnant again.

Dr. Beth Wiedel has been providing healthcare to women in Madison since 2002 and is a founding partner of Madison Women’s Health.  She shares the vision of all the partners of being a strong healthcare advocate for her patients, emphasizing compassion and communication throughout her practice.