Optimum Health At Every Age | Dr. Gloria Ivey-Crowe

The health system has changed considerably over the past two years. The Affordable Care Act (ACA) has allowed more people to obtain health insurance, albeit at the expense of higher deductibles. I dare to say most people may frown when hearing about the Affordable Care Act, but there have been some small perks for most insured patients; no copay for annual visits, free contraception, and most importantly, an affordable plan and increased access to health care. This change has impacted all medical practices that do not provide concierge services or have a large percentage of insured patients, leading into a large revenue loss for many practices. In some instances, this loss of revenue may cause scheduling adjustments, closure of practices, personnel
changes, as well as outsourcing of tasks. More work needs to be done at a higher level with the insurance companies, but that is a discussion for another day.

Review the following list of routine services that are performed based on your age and then call your health care provider to schedule an appointment. Remember that your personal medical history and family history are helpful when deciding on appropriate tests and immunizations are recommended based on age and possible risk of exposure.

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By Dr. Gloria Ivey-Crowe

It’s A Mood Thing! | Dr. Gloria Ivey-Crowe

LoudounJanFeb2016HR_Page_15Why is it that people around us can tell when it’s “that time of the month?” Do we look different, smell different, act different or what? If we took a poll and asked people the answer to that question most would respond: SHE ACTS DIFFERENTLY. Ever wondered why that is or what is actually happening during this time? No, your body has not been taken over by “Body Snatchers” and invaded by an alien. Most women admit they don’t feel like their usual selves and feel as though they are someone else. They don’t like what they are feeling, but still can’t seem to stop the behavior or outbursts. Why is that?

Let’s talk a little anatomy and physiology. Yeah, we had to learn it, but I’m going to give you the Cliff Notes. An average menstrual cycle is 21-30 days. Most fall in the average of 28 days with two phases: follicular and luteal. During the first or follicular part of the cycle, the follicle or egg starts to develop and the uterine lining grows anticipating implantation. The second phase or luteal phase is when the egg is released or ovulated. If the stars are in alignment, the egg and sperm meet and become one, traveling down the yellow brick road to the uterus where implantation occurs. 9 months later, you get a baby!

Both of these phases are controlled by a combination of Estrogen, Progesterone or Testosterone. Most problems with bleeding, mood, irregular cycles, infertility, no cycles, can be traced back to problems with the levels of your hormones. However, we commonly associate our moods to that time of the month. So what’s really going on here?

There is a condition we know as PMS (premenstrual syndrome) and PMDD or premenstrual dysphoric disorder. Most women are familiar with PMS. PMDD is a more serious form of PMS. Both are characterized by symptoms that usually occur 7 to 10 days before the start of the menstrual cycle and a few days when it starts. Women feel bloated, have mood changes, breast tenderness, fatigue, sleep changes such as insomnia and eating changes. You are not alone when you feel like you just got to have some chocolate or CARBS! Physical symptoms may also include joint or muscle pain, headache, weight gain due to fluid retention, acne and changes in bowel habits such as constipation or diarrhea.

Mood changes are common and no doubt is what puts folks on alert that your cycle is coming. The mood changes may be irritability, labile moods,
sadness, anxiety, depression, anger or any combination of these. These changes are occurring in most instances during the luteal phase when the predominant hormone is progesterone. Hence why some women will get relief with the use of progesterone supplements during this time.

Sadness, feeling down, overall dysphoria and even depressed moods can be related to hormones or low levels of serotonin. Serotonin is a neurotransmitter released in the brain. Low levels of serotonin may be associated with dysphoria, sadness or depression, so we can use supplements such as St. John’s Wort and SSRI’s. SSRIs or selective serotonin uptake inhibitors are a class of meds which make serotonin last longer.

Common medications in this class are Prozac, Zoloft, Effexor, Lexapro, Celexa, etc. A common one is Serafim or Prozac, dosed in smaller amounts than what is used for depression and has been very helpful with the control of mood swings and premenstrual emotions.

There is help. SSRIs, progesterone creams and even birth control pills can regulate the imbalance. St John’s Wort, Chasteberry and essential oils all may be helpful, and exercise is always beneficial. For those who become totally debilitated by this time of the month, PMDD is the likely diagnosis and a combination of natural supplements, antidepressants, exercise and meditation may prove helpful.

By: Dr. Gloria Ivey-Crowe
Women Physicians of
Northern Virginia
44110 Ashburn Village Blvd
Suite 237
Ashburn, VA

Are You Achieving Your Health Goals? | Dr. Gloria Ivey-Crowe

LoudounNovDec2015HighResNoBleeds_Page_112015 will soon be over and we will be ushering in 2016: did you meet your financial, personal or health & fitness goals? If not, there are still a couple of months left for you to continue to work on those goals. Many of you may have health dollars left in your flexible spending and health savings accounts, which means NOW is the time to review your health calendar, plan accordingly and spend wisely. There is still time left to invest in yourself and enroll in a fitness center or schedule health and wellness consults or even go to a health spa. Plan how to spend those dollars wisely, or, if you didn’t set aside any or enough money in 2015 in those accounts, make the adjustments for 2016.

The health system has changed considerably over the past two years. The Affordable Care Act (ACA) has allowed more people to obtain health insurance, albeit at the expense of higher deductibles. I dare to say most people may frown when hearing about the Affordable Care Act, but there have been some small perks for most insured patients; no copay for annual visits, free contraception, and most importantly, an affordable plan and increased access to health care. This change has impacted all medical practices that do not provide concierge services or have a large percentage of insured patients, leading into a large revenue loss for many practices. In some instances, this loss of revenue may cause scheduling adjustments, closure of practices, personnel changes, as well as outsourcing of tasks. More work needs to be done at a higher level with the insurance companies, but that is a discussion for another day.

Review the following list of routine services that are performed based on your age and then call your health care provider to schedule an appointment. Remember that your personal medical history and family history are helpful when deciding on appropriate tests and immunizations are recommended based on age and possible risk of exposure.

Women In Their 20s:
• Yearly medical examination (height, weight, blood pressure and breast health).
• Laboratory work: Complete Blood Count (CBC), Cholesterol, Triglycerides, HIV, Thyroid, Electrolytes, Liver Panel, Urine.
• Pap included along with required gonorrhea/Chlamydia testing until age 26
• Possible Gardasil vaccination.
• Dental Evaluation.
• Monthly Breast Examinations.

Women In Their 30s:
• Yearly medical examination (height, weight, blood pressure, breast and skin health).
• Laboratory work: Complete Blood Count (CBC), Cholesterol, Triglycerides, HIV, Thyroid, Electrolytes, Liver Panel, Urine.
• Dental Evaluation.
• Tetanus Booster every 10 years.
• Monthly Breast Examinations.

Women In Their 40s:
• Yearly medical examination (height, weight, blood pressure, breast and skin health).
• Mammogram.
• EKG.
• Laboratory work: Complete Blood Count (CBC), Cholesterol, Triglycerides, HIV, Thyroid, Electrolytes, Liver Panel, Glucose, Urine.
• Dental Evaluation.
• Glaucoma testing.
• Tetanus Booster every 10 years.
• Monthly Breast Examinations.

Women In Their 50s:
• Yearly medical examination (height, weight, blood pressure, breast and skin health).
• Mammogram.
• EKG.
• DEXA Bone Scan every 3 to 5 years. Sigmoidoscopy/Colonoscopy yearly. Fecal Occult Blood Testing.
• Laboratory work: Complete Blood Count (CBC), Cholesterol, Triglycerides, HIV, Thyroid, Electrolytes, Liver Panel, Glucose, Urine.
• Dental Evaluation Glaucoma Testing
• Tetanus Booster every 10 years.
• Monthly Breast Examinations.

Women In Their 60s:
• Yearly medical examination (height, weight, blood pressure, breast and skin health).
• Mammogram.
• EKG.
• Yearly Fecal Occult Blood Testing.
• Pneumococcal Vaccine. Glaucoma Testing.
• Laboratory Work – Complete Blood Count, Cholesterol, Triglycerides, HIV, Thyroid, Electrolytes, Liver Panel, Panel, Glucose, Urine.
• Dental Evaluation.
• Monthly Breast Examinations.

Dr. Gloria Ivey-Crowe
Women Physicians of Northern Virginia
Visit one of our convenient offices:
44110 Ashburn Village Blvd
Suite 237 | Ashburn | VA
1830 Town Center Drive
Reston | VA
703 834 1071
www.womenphysicians.org

Is It Hot In Here? | Dr. Gloria Ivey-Crowe

LWM_MJ15_web_Page_14That’s a common question asked by many women who are on a journey to their “climacteric.” No, not towards the climax but the “change of life” for women. The climacteric, menopause, change of life, or whatever you call it, happens to all women at some point in their lives. Menopause is defined as having no menstrual cycle for twelve months, and all other symptoms can vary for each woman, such as temperature changes, moodiness and irritability. Picture the women sitting in a room or meeting and without warning, she starts sweating profusely and complaining it is hot. She’s the person in church frantically fanning, experiencing her own “private summer” while everyone else is unaffected. She is kicking the covers off at night and opening windows when it is already below freezing.

At 20 weeks of life, while in our mother’s womb, we have our maximum number of eggs. During a normal menstrual cycle, intricate reactions between our hormones (estrogen, progesterone, and testosterone) prime the lining of the uterus (endometrium) to nourish a fertilized egg. For most women, an egg is released during ovulation around cycle day 14. The egg is viable for about 12-24 hours and awaits fertilization by a sperm. If fertilization does not occur, the thick uterine lining is not needed and with proper signaling, it is sloughed off and bleeding occurs. Hence your 5-7 day menstrual cycle.
The age at which menopause occurs is affected by multiple factors: genetics, surgery, medicines, toxins, and radiation. The average age is 51 years old. Women in the same family tend to complete menopause around the same time. However, the manner and number of years prior to completion can vary within the same family. Women undergoing removal of their ovaries will experience a surgical menopause. Medications such as Lupron (used for endometriosis) and Tamoxifen (adjunct for breast cancer) can cause a medical menopause. Large doses of toxins used to treat cancers such as chemotherapy and radiation may also cause menopause.

If the ovaries stop working before age 40 without any of the above situations present, it is referred to as premature ovarian failure (POF). This may be due to genetic or chromosomal factors such as Turner’s or Fragile X syndrome, autoimmune disorders such as Addison’s disease, Lupus, Type 1 diabetes, Sjrogen’s, hypothyroidism, Graves, or rheumatoid arthritis.

The production of female hormones comes from ovaries (65%) and the remainder divided between the skin and adrenals. Ovarian hormones are responsible for wrinkle free skin, vaginal lubrication, bone protection, clarity of thoughts, mood, memory, regular cycles, temperature regulation and libido. It’s easy to see that a loss of these hormones will lead to some degree of deficits.

The transition to menopause for most women is gradual and may occur over 2-8 years as symptoms wax and wane over this period of time. The more common symptoms are hot and cold flashes, night sweats, sleep disturbances ranging from frequent awakenings to insomnia, headaches, migraines, memory lapses, fogginess of thought, irritability, fatigue, pain with intercourse, vaginal itching, vaginal dryness, weight gain, lack of interest in sex, dry skin, urinary frequency, urinary incontinence, irregular cycles, wrinkles, acne, and hair loss. Our risk for heart disease and stroke increases with the loss of estrogen.

The diagnosis of menopause can be accomplished with blood or saliva tests measuring hormone levels of FSH, LH, estradiol, progesterone and testosterone. High levels of FSH and LH >20ng/ml along with no cycle for 12 months is diagnostic for menopause. Low levels of estradiol, progesterone and testosterone are also found in menopause.

The treatment for menopause is varied and may consist of herbs, essential oils, plant-based formulations, bio-identicals, pellets or other non-hormonal pharmaceuticals. Your healthcare provider can do some initial testing and make recommendations for specific therapies. For those who want to do nonconventional therapies, compounding pharmacies may be helpful.

Whether you decide to weather the storm alone or seek professional help with your symptoms, know that you have options. Know the triggers such as: hot weather, smoking, spicy foods, caffeine, stress, eating sugar, alcohol or tight clothing. Relief is around the corner! Ask for it!

By: Dr. Gloria Ivey-Crowe
Women Physicians of Northern Virginia
703.834.1071
www.womenphysicians.org

Woman’s Health Month – Dr. Gloria

woman healthDID YOU KNOW April/May is recognized as WOMAN’S HEALTH MONTH. Our lives should be governed by forever seeking a state of GOOD HEALTH &WELLNESS. So what’s all the hype about WELLNESS! Is it just making sure the scales say the right number and I’m fit? My BMI (basal metabolic index) is the right number (<29)? Is it the goal that every time I go for my yearly visit, my labs fall within normal ranges? Or is it, I run 3 miles everyday or exercise 5 days a week for 1-2 hours? Is it I’m a VEGAN and have nothing to do with meat? I know, I know its that I’m GLUTEN FREE! WELLNESS is all this and more. Not only is it a PHYSICAL state of well being, I would argue that its a LIFESTYLE, MENTAL and SPIRITUAL state of well being.

A woman’s overall HEALTH & WELLNESS is affected by many factors: home, work, nutrition, exercise, spiritual, genetics and emotions to name a few. Let’s tall about a few
of these factors as we strive to make everyday about our health and wellness. The importance of each of these factors varies from individual to individual. Let’s first talk about the factor that we can’t control: GENETICS. Your genetics is determined by the chromosomes or genes that you have inherited from your parents. We have 23
pairs, one pair which determines our sex and the other 22 pairs which determine a myriad of traits and characteristics which determine how we look, feel, and propensity to disease just to name a few. Common diseases that impact our health and wellness and where genetics is a factor include: DIABETES, HYPERTENSION, CHOLESTEROL, DEPRESSION, CANCER. Now of course, some of the aforementioned diseases can be altered by diet and exercise for the sake of GENETICS we are referring to those diseases that we have a propensity to because of the genetic link that has been proven and identified and that no amount of exercise, change in
nutrition can stop it from being manifested as part of your medical history. Diabetes may be Type 1 or Type 2. Type 1 you have a deficiency in the production of cells that secrete insulin. Insulin is responsible for lowering your sugar and therefore allowing your body to metabolize carbohydrates ingested.

 

Read more in the May/June 2014 Issue of Virginia Woman Magazine!

– Dr. Gloria Ivey-Crowe

Woman to Woman at Every Age – Dr. Ivey-Crowe

March winds are signaling spring is near. March also marks that we are  three  months  into 2014, attempting to remain on task with our resolutions for the year. Hopefully, those resolutions included either staying or getting back on track with our health care needs, as well as our physical, spiritual and mental fitness.

At each visit with your health care provider, patients  are asked by the front  desk  staff,  nursing  staff  and their health  care providers, “are you getting  any blood  work  done  today?” or “when is the last time you were tested for….?” Most patients will respond with, “I’m not sure,” or, “what should I be getting done for my age?” or, “whatever the doctor feels I need”.

As women continue to strive towards being empowered with taking charge of their health, this article will provide recommendations for age-based testing. Together, with your history and individual risk factors, your healthcare provider will decide on the appropriate testing.   This is recommended testing and is not considered to be all-inclusive.

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Annual County Fair Held in Loudoun County at the End of July

Annual County Fair Held in Loudoun County at the End of July

The Annual Loudoun County Fair is only a few days away. Residents of Leesburg as well as regular visitors will once again get to enjoy a yearly treat of entertainment and fun activities for one entire week. Starting on Monday, July 29, with pre-fair activities on July 28, the Loudoun County Fairgounds will open its gates to welcome fair enthusiasts for a day of shows, games, and lots of fun.

On opening day, July 29, some of the highlights of the fair will include the Fair Dedication & Opening Ceremony, Corn on the Cob Eating Contest, and Stoney Roberts Demolition Derby.

Tuesday, July 30, will feature events like sheep showmanship, the egg toss contest, swine showmanship, k9’s in Flight-Frisbee Dog Entertainment, Fast Action Motor Sports, and the 1st Virginia Cowboy Mounted Shooting Demonstration.

On Wednesday, July 31, some of the events will include an open pet show, an Oreo stacking contest, “Life on the Farm” with Farmer Tom, Ownership Sheep Breed Show, and live entertainment with Chris Winward.

On Thursday, August 1, there will be bingo for senior citizens as well as Horse Demonstration, Poultry Showmanship, Rabbit Show, and the Pie Eating Contest.

Everyone will enjoy Friday, August 2, with shows such as Bunny Dress Up, Round Robin Competition, Watermelon Eating Contest, and the Livestock Auction.

The last day of the fair will host shows including Livestock Obstacle Course, Wildlife Ambassador’s Children’s Show, Super Farmer Competition, and Kiss-a-Pig Contest.

The Loudoun County Fair will be open to all with an admission of $10 for adults and $5 for children between 6 and 12 years of age. Weekly passes will cost $25 per adult and $10 for children between 6 and 12. Children below 6 are free of charge.

Dorri Scott
Publisher,
Loudoun Woman Magazine

Got Pap? Five Minutes Could Save Your Life!

Got Pap?

The pap smear is a screening test for cervical cancer. It takes five minutes and can save mil- lions of women’s lives. The incidence of cervical cancer has decreased more than 50% in the past 30 years because of wide spread screening with the Pap smear. In
1975, the rate was 14.8 per 100,000 women in the United States. In 2006, it had been reduced to 6.5 per 100,000 women. Death from cervical cancer has also decreased significantly. The American Cancer Society estimated that in 2009, there were about 11,000 new cases of cervical cancer and about 4,000 deaths from the disease.

Of the 11,000 new cases that were diagnosed, it is estimated that 50% of those women had never had a Pap smear done and another 10% had not been screened within the past 5 years. Over the past 10 years, a lot of in- formation regarding the causes of cervical cancer,

Human Papilloma Virus (HPV), vaccines, screening intervals has been in the media. So who should we listen to? Your health care provider should be able to provide you with the most recent and up-to-date information on most topics.

SCREENING INTERVAL

In the past, the recommendation was that women have a Pap smear and pelvic examination each year. There were no caveats as to whether or not she had reached a certain age or whether she was sexually active. However, over the

past 5 years, with the additional knowledge that has been gained with causative factors for cervical cancer to include exposure to the Human Papilloma Virus, new guidelines have been recommended. The first Pap smear should be done 3 years after the onset of sexual intercourse or by age 21. The incidence of cervical cancer is very rare in adolescents and therefore one of the reasons why this testing can be delayed until 21 years of age. The intervals thereafter, are based on results obtained whether the patient is being followed for an abnormal result or whether the patient has a history of a prior abnormal result. The interval can be increased to every three years in the woman who has had three consecutive normal Pap smears, is not being fol- lowed for any abnormal results, has no history of prior abnormal results and has no other medical problems that require more frequent surveillance or is not receiving contraceptive prescriptions that may require an annual exam.

Women can stop Pap smear screening in the following situations:

1. Hysterectomy – removal of the uterus for benign conditions such as abnormal bleeding, fibroids, endometriosis, chronic endometritis or adenomyosis.

2. Age 70 – the incidence of cervical cancer decreases with age

Although, the women above may not require a Pap smear, a pelvic examination is still necessary to evaluate for the presence of vaginal or vulvar cancer and to assess the ovaries.

It’s a quick test, takes only 5 minutes and can save our lives. Why aren’t more of us going to our health care providers and having it done.

Is it fear, pain, embarrassment or all of the above? Whatever your reasons remember the Pap test saves lives and can diagnose precancerous conditions. Check your calendar and call your health care provider today to schedule your Pap test. WE GOT YOUR PAP!!

Call (703) 834-1071
for an appointment www.womenphysicians.org

Dr. Gloria Ivey-Crowe received her M.D. degree from George- town University School of Medicine. Residency training in Obstetrics & Gynecology at Georgetown University Hospital. Undergraduate Education Bachelor of Science in Biology from American University and also Bachelor of Science as a Physician Assistant from Howard University.

Dr. Ivey-Crowe enjoys reading, knitting, crocheting, and listening to jazz. She has three children.

PROFESSIONAL PHILOSOPHY

I want women to take charge and be proactive in their health care. I want them to feel very comfort- able when they come to our offices and see any one of our providers. We give our patients that personal touch, a listening ear, education, sound advice and options regard- ing their healthcare.

See our next issue for Part 2: HPV, Vaccines and Cervical Cancer

– GLORIA J. IVEY-CROWE, MD
Women Physicians of Northern Virginia

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