Uterine fibroids are noncancerous growths that develop in the muscle tissue of the uterus. Also known as myomas or leiomyomas, these growths are the most common abnormality that occurs in the female reproductive system. Some fibroids may not cause any symptoms whatsoever, but in other cases, women may experience issues including discomfort during sex, heavy and painful periods, complications during pregnancy and labor, and infertility.

When uterine fibroids affect your quality of life, you can discuss the option to have them removed with one of our providers. Though in certain cases a full hysterectomy may be recommended, very often a less invasive procedure known as a myomectomy can be performed to remove them through robotic surgery. Because a myomectomy keeps the uterus intact, it is frequently a preferred option if you still wish to have children.

Fibroid Removal Through Robotic Myomectomy

There are several surgical methods available to remove fibroids, and the type of procedure performed depends on the type, size, and location of the fibroids themselves. In these more traditional, open surgery procedures, doctors create an incision in the abdomen or through the vaginal wall to access the uterus. Handheld surgical tools are then used to remove the fibroids.

A robotic myomectomy is different, mainly because the surgical instruments are attached to robotic arms instead of the surgeon’s hands. Instead of directly making incisions and handling surgical instruments, the conducting surgeon sits at a separate computer console and controls the instruments remotely.

The other steps involved in a robotic myomectomy are largely the same as other procedures. You’ll still be placed under general anesthesia to sleep through the procedure. Your vital signs will still be monitored by nurses and technicians. The doctor will still direct small incisions to create as little scar tissue as possible, and a camera will still provide close-up views of the area. Once your fibroids have been fully removed, your incisions are closed up and bandaged in the same way.

The Robotic Myomectomy Difference

What sets robotic myomectomy apart from traditional methods is that it allows doctors to make very small, precise movements. This careful precision allows them to remove fibroids that would be more difficult to treat by other means. Although robotic surgery may take longer to complete than a laparoscopy, its other advantages include a lower level of blood loss, a shorter hospital stay (in several cases, patients are able to go home the same day), and less abdominal bleeding during the postoperative period.

After a robotic myomectomy, most women find their challenging symptoms such as heavy menstrual bleeding and cramping are resolved. They also retain good pregnancy outcomes within a year of surgery. (Though regardless of the kind of fibroid removal you undergo, we recommend you wait several months before trying to become pregnant to give your uterus time to fully heal.)

If you have uterine fibroids, or any other gynecological concern, turn to the providers at Avant Gynecology. Our team offers a wide range of services, including surgical interventions, to help you feel like yourself again. Make an appointment online or by calling (404) 352-2850.

Congratulations to Dr. Lynley Durrett and Dr. Obiamaka Mora for receiving Top Doctors honors in Atlanta magazine’s July issue!

Dr. Durrett has been practicing obstetrics and gynecology for more than 20 years and has been annually recognized as a Top Doctor in the publication since 2010.

Dr. Mora joined McDaniel and Durrett Gynecology in 2012 and oversaw the transition to Avant Gynecology in 2018. She has been recognized as an Atlanta Top Doctor in the publication for three years.

Both Dr. Durrett and Dr. Mora are currently seeing and accepting new patients at the Buckhead office located on the Piedmont Hospital campus.

“Receiving this type of recognition from my physician peers means so much to me,” says Dr. Durrett. “My ultimate goal is to be the best gynecologist I can be for the sake of my patients. I’m grateful for the honor, but more importantly, thankful for the privilege to serve.”

Dr. Mora echoes those sentiments. “Women’s health is my passion,” she says, “and I wouldn’t be able to accept an acknowledgment such as this without a patient population willing to trust me with their health and well-being.”

Drs. Durrett and Mora’s professional expertise include minimally invasive and robotic techniques with interests in vaginal prolapse treatment, pelvic reconstructive surgery, bio-identical hormone replacement therapy, symptomatic fibroid management, and endometriosis management. They are also both members of the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA).

Make an appointment with Atlanta’s Top Doctors at Avant Gynecology on our website or by giving us a call at (404) 352-2850.

Avant Gynecology is delighted to announce that two of our physicians appear on both Top Doctor lists featured in The Atlantan magazine and Atlanta magazine.

Those physicians are: Dr. Obiamaka Mora and Dr. Lynley Durrett.

The Atlantan magazine uses a database of top doctors compiled by Castle Connolly Medical Ltd., an established healthcare research company based in New York. The publication features a total of 1,060 physicians representing the following counties: Bartow, Henry, Paulding, DeKalb, Fulton, Clarke, Cherokee, Cobb, Coweta, Dawson, Fayette, Forsyth, Gwinnett, Newton, and Oconee.

Atlanta magazine creates its list from a roster of doctors selected by Professional Research Service’s (PRS) database. A total of 1,098 physicians appear on the publication’s 2022 list. These doctors represent the following counties in Georgia: Carroll, Cherokee, Clayton, Cobb, Coweta, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Hall, Henry, and Rockdale. PRS creates its list by conducting an online peer-review survey of physicians in the metro Atlanta area. Physicians are asked to nominate fellow physicians they deem the best in their field of practice. Many votes were cast honoring excellence in all fields of medicine. The featured doctors were screened and selected through the verification of licensing and review of any infractions through applicable boards, agencies, and rating services.

Avant Gynecology would like to thank Dr. Mora and Dr. Durrett for their accomplishments and tireless work to provide optimal compassionate care to patients of all ages, races, sexual orientations, and religious beliefs.

Dr. Lynley Durrett received her Bachelor of Arts from Furman University in Greenville, South Carolina and her Medical Degree from Mercer University in Macon, Georgia. She is board certified in the practice of obstetrics and gynecology and a fellow of the American Congress of Obstetricians and Gynecologists (FACOG). Dr. Durrett’s professional expertise includes minimally invasive and robotic surgery techniques with interests in vaginal prolapse treatment, pelvic reconstructive surgery, symptomatic fibroid management, endometriosis management, managing urologic conditions, and bio-identical hormone replacement therapy.

Dr. Obiamaka Mora completed a combined bachelor’s degree/medical degree program. She received her Bachelor of Science from Kent State University in Rootstown, Ohio and her medical degree from Northeastern Ohio Medical University in Rootstown, Ohio. She completed a fellowship in advanced pelvic surgery in Atlanta, Georgia. She is board certified in the practice of obstetrics and gynecology and a fellow of the American Congress of Obstetricians and Gynecologists (FACOG). Her professional expertise includes minimally invasive and robotic surgery techniques with interests in pelvic reconstructive surgery, symptomatic fibroid management, endometriosis management, and bio-identical hormone replacement therapy.

Vitamins play an important role in all of our health, regardless of gender. Part of practicing optimal health maintenance includes understanding which particular vitamins your body needs most, and how they benefit your overall well being.

Some vitamins especially benefit women, whose nutrient needs change throughout their lifespan. For example, pregnant and breastfeeding women may temporarily require more of certain vitamins, while women in menopause or postmenopause may benefit from other boosts.

The key thing to keep in mind about vitamins is that they are organic substances we need, but are mainly produced by other plants or animals. Medical experts at WebMD emphasize that “the best thing to do is to keep up a balanced diet. But supplements can be a good way to fill in the gaps when they happen.” Make sure to talk with your doctor about which vitamin supplements they recommend if it’s difficult for you to acquire enough essential vitamins through food.

Here’s a closer look at three key vitamins that may be important for you.

Three Recommended Vitamins for Women

Folate/Folic Acid (Vitamin B9)

Sometimes referred to as vitamin B9, folate/folic acid is the nutrient in charge of healthy cell growth. It also supports formation of red blood cells, so medical experts believe it may be the key to preventing birth defects of the brain and spine. To safeguard against these potential neural tube defects (NTD), women are encouraged to begin taking folic acid supplements for at least three months before conception. The CDC further recommends that anyone who could become pregnant take at least 400 micrograms (400 mcg) of folate every day.

But folic acid is important for all women, regardless of their age, pregnancy status, or desire to conceive. Studies have shown that maintaining healthy levels of folic acid may play a role in preventing cardiovascular disease and stroke, dementia and Alzheimer’s disease, depression, and several types of cancer.

Vitamin B12

Like folic acid, vitamin B12 may prevent neural tube birth defects, but is important for so much more. The biggest and most structurally complex of all the vitamins, B12 helps your body maintain nerve tissue health, produce red blood cells, and improve brain function. It may also prevent osteoporosis and macular degeneration.

Vegans may find it challenging to get enough vitamin B12 in their diets, as the highest levels are commonly found in animal products such as meat, eggs, and milk. Talk to your doctor about which supplements may help you maintain a vegan lifestyle while getting enough of this essential vitamin.

Vitamin D

Calcium is the mineral responsible for creating healthy bones, but your body can only absorb this important nutrient if vitamin D is present. Essentially the body’s building block for maintaining bone health, vitamin D also supports the immune system, and improves muscle function.

These benefits are particularly important to women’s health when it comes to osteoporosis prevention. But vitamin D supplements can be very beneficial for other postmenopausal care, as studies have linked it to the prevention of heart disease, diabetes, cancer, weight gain, and depression that can become more common as you age.

Sometimes referred to as the “sunshine vitamin,” vitamin D is mainly produced when exposure to the sun transforms a chemical in your skin. Based on where you live, your sunscreen usage, melatonin levels, and time of year, it can be tricky to navigate the proper amount of sun exposure to help your body make vitamin D. Talk to your doctor or health specialist for personalized advice.

Other Vitamins Essential for Women’s Health

The experts at Medical News Today have compiled a handy reference for recommended vitamin intake for women at every age, combining data from the Food and Nutrition Board and the Office for Dietary Supplements. But you and your doctor should work closely together to monitor your personal vitamin levels, individual health requirements, and dietary or supplemental recommendations.

Our experienced experts at Avant Gynecology are also happy to discuss your nutritional needs in detail if you have any further questions. Schedule your appointment today by visiting our website or giving us a call at (404) 352-2850.

Though the mental health effects of the COVID-19 pandemic are still felt by people all over the world, women face additional and distinct mental health challenges that can impact their overall wellbeing every day. Let’s look at some of the ways in which women’s mental health is unique and how you can nurture your own good mental health.

Women’s Mental Health is Unique

Taking care of your mind is important for everyone, but mental health can impact women in unique ways. For example, women are much more likely to develop anxiety and depression, which could lead to further problems with their physical health, too. “Unlike their depressed male counterparts,” Everyday Health warns, “women tend to develop problems with alcohol abuse within a few years of the onset of depression.”

Natural hormonal changes may also impact women’s mental health, including perinatal depression, perimenopause-related depression, and premenstrual dysphoric disorder. This is why paying attention to your moods, anxiety, and stress levels — as well as prioritizing self-care — is important as your body goes through changes.

Practice Self-Care

This piece of advice is commonly stated, but not everyone is clear on what self-care is, or how to fold nurturing their mental, physical, and emotional wellbeing into their daily lives. It’s easy enough to advise someone to simply go for more short walks, or get enough sleep, but self-care can be understandably difficult to accomplish.

For example, many women have time-consuming jobs, childcare and households to manage, or feel guilty for taking care of themselves. But even if you aren’t experiencing immediate distress, regularly practicing self-care helps you prepare for and overcome potential future stressors.

Physical:

The mind and body are intertwined, so it’s important to take good care of both. Physical self-care can include:

  • Getting enough sleep
  • Exercising regularly doing something you enjoy
  • Eating nutritious food
  • Regularly visiting healthcare providers
  • Drinking lots of water

Mental:

As the name implies, this category of self-care focuses more on your mental health. This can include anything that stimulates your brain and helps you practice self-compassion. Examples of mental self-care include:

  • Participating in fun, relaxing activities
  • Practicing gratitude
  • Cultivating a positive mindset
  • Getting outside
  • Setting healthy boundaries

Emotional:

“Negative” emotions are valid and normal, but it’s important to practice healthy coping mechanisms while you experience them. Emotional self-care allows you to feel your emotions while expressing them in ways that are nurturing to your mind and body. You can do this by:

  • Connecting with friends and family for support
  • Surrounding yourself with motivating quotes
  • Engaging in rejuvenating activities
  • Practicing relaxation techniques or meditation
  • Interacting with a pet

Seek Professional Support

Women have a significant risk of experiencing mental illnesses, including eating disorders, postpartum depression, and body dysmorphic disorder (BDD). This makes it very important to reach out for support if you feel like your symptoms are becoming overwhelming. If you’re experiencing the following symptoms for more than two weeks, consider speaking to a mental health professional:

  • A sudden change of appetite
  • Struggling to concentrate
  • Having trouble sleeping
  • Loss of interest in previously enjoyable activities
  • Difficulty performing everyday tasks
  • Difficulty getting out of bed in the morning

Mental health is an essential part of gynecology, and our team of professionals want to help you overcome any obstacles affecting your overall wellbeing. To discuss potential treatment options for mental health challenges, schedule an appointment online or by calling us at (404) 352-2850.

 

Vaginal prolapse occurs when the pelvic muscles and connective tissues weaken, allowing other organs (including the uterus, bladder, or parts of the lower intestine) to drop beyond their normal position and into the vaginal canal. Characterized by feelings of fullness, pressure, or pain in the vagina, the condition affects up to 50% of women at some point in their lives.

In addition to vaginal discomfort, prolapse can cause several frustrating symptoms that disrupt daily life, including painful intercourse, urinary or fecal incontinence, and constipation. Vaginal childbirth and menopause are common causes of the condition, but other risk factors include extreme physical activity and genetics.

Just because vaginal prolapse is common doesn’t mean you have to live with it. Fortunately, there are ways to repair a prolapse through the following treatments.

Pessary

Prior to pursuing surgical treatments, you may be advised to try a pessary. This device resembles a diaphragm, and is placed in the vagina to lift the bladder or provide compression to the urethra to stop the leakage of urine. While the treatment is a low-risk, nonsurgical option, it does require ongoing care, including routine removal and cleaning. Moreover, the treatment may not be ideal for patients with very weak pelvic floor muscles.

Obliterative Surgery

Also known as colpocleisis, obliterative surgery involves stitching the vagina shut. This approach has yielded positive outcomes for women aged 70 or older, but it does prevent vaginal intercourse. For this reason, obliterative surgeries are often reserved for women who cannot withstand more extensive procedures.

Reconstructive Surgery

For patients wishing to have penetrative vaginal intercourse, reconstructive surgery aims to reconstruct the vaginal canal. The American College of Obstetricians and Gynecologists outlines the following types of reconstructive procedures to address vaginal prolapse:

  • Native Tissue Repair: In this treatment, the patient’s own tissues are used to correct the prolapse. A surgeon will attach the prolapsed area to a pelvic ligament or muscle for support.
  • Colporrhaphy: Performed through the vagina, a colporrhaphy resolves a prolapse of either the front or back wall of the vagina. Stitches are placed to provide support to the surrounding organs, including the bladder and rectum.
  • Sacrocolpopexy: This approach lifts the vagina into its original position through the insertion of a synthetic mesh, which attaches to the vaginal walls and tail bone. The procedure may be performed through an abdominal incision or laparoscopically.
  • Sacrohysteropexy: This procedure is ideal for patients experiencing vaginal and uterine prolapse who wish to avoid a hysterectomy. It involves the placement of a surgical mesh that runs from the cervix to the sacrum to reposition the uterus.
  • Vaginal Mesh: If the patient’s pelvic tissues aren’t strong enough to support the prolapse on their own, they may be recommended for vaginally placed mesh. While the treatment may repair any type of prolapse, it presents higher risks and is therefore reserved for only select patient populations.

As with any procedure, the decision to pursue surgical treatment for prolapse is best made after an in-depth discussion that examines symptoms, risks, and benefits with your doctor. Our providers are ready to discuss both surgical and non-surgical options to address vaginal prolapse and restore your quality of life. Schedule an appointment by calling (404) 352-2850 or booking one online.

Endometriosis is a gynecological condition affecting about 11% of women in the United States. These women often struggle with severe menstrual cramps and reproductive complications. If you are experiencing similar problems, and are wondering if you should seek treatment, here’s more information on the topic:

What is endometriosis?

The uterus has an inner lining of tissue called the endometrium, and it is released during each menstrual cycle. Endometriosis is when similar tissue grows on the outside of the uterus — often around the ovaries, fallopian tubes, and pelvis. This tissue is normally “programmed” to shed through your vagina during childbirth or your period, but, when it grows outside the uterus, it becomes trapped and can therefore cause severe pain.

Endometriosis can distort the fallopian tubes and inflame ovaries, hindering the ovulation process. Approximately 20-40% of infertility cases are also related to endometriosis.

Symptoms of Endometriosis

There are many other symptoms of endometriosis on top of extreme menstrual pain and infertility, and these include:

  • Painful menstrual cramps that worsen over time
  • Lower abdomen or intestinal pain
  • Experiencing pain during sex or afterward
  • Bowel movements and urinating are more painful during periods
  • Heavy flow on periods
  • Spotting or bleeding before or in between periods
  • Difficulty conceiving

In some cases, endometriosis can be asymptomatic — you may not notice you even have it. But, if you do experience any of the above symptoms, it is always important to discuss them with your doctor and assess your condition.

Who is at risk?

Risk factors for endometriosis are still being researched, but women with abnormal cycles may experience higher risk than others. For example, you’re twice as likely to have endometriosis if you have a less than 25-day cycle or your period lasts for more than 7 days.

Other common risk factors include having endometriosis in your family history, including a sister, daughter, mother, or grandmother. This risk is further heightened if you started your period at an early age or if you have been diagnosed as infertile.

Diagnosis

Unfortunately, diagnosis of endometriosis cannot be based on symptoms and outward evaluation. Instead, your doctor might first assess your family history and may do a pelvic exam or ultrasound to detect any cysts or scars.

For an official diagnosis, your doctor will perform a laparoscopy, making a small incision in your abdomen and inserting a small tube equipped with a camera. This process collects images of any tissue outside of the uterus. A biopsy (sample of the tissue) may also be taken.

Treatments

Endometriosis can either be treated with prescription medication or with surgery. Your best option will depend on your individual case, symptoms, and whether or not you want to have children. Hormonal birth control, for example, is a common option for those not looking to conceive, as it helps relieve pain symptoms and regulate your menstrual cycle.

Surgery is often best for those struggling with fertility or if over-the-counter medication fails to relieve your pain or uncomfortable symptoms. This surgery entails removing the tissue outside of the uterus under general anesthesia.

Others have found that alternative treatments like acupuncture, physical therapy, and/or herbal medicine can help relieve symptoms.

If you are experiencing endometriosis symptoms or complications, our physicians will provide personalized care to confirm a diagnosis and determine your next steps towards comfort. To schedule an appointment, visit us online or call us at (404) 352-2850.

On Sunday, January 30th, 2022, Avant Gynecology’s Drs. Lynley Durrett and Obiamaka Mora returned as guests on The Weekly Check-Up on News/Talk WSB Radio.

During the show, Drs. Durrett and Mora spoke about several women’s health topics with host Ashley Frasca. Some topics of discussion included mental wellbeing during the COVID-19 era, the importance of regular gynecological exams with personalized testing, hormone therapy and its alternatives, and menopause symptom management. They also talked about ThermiVa, the use of Tamoxifen and Raloxifene, Uterine fibroids and treatment with the Acessa procedure or myomectomy, urinary incontinence, libido, and heavy bleeding. They fielded calls from callers throughout the segment.

You can listen to the entire show below.

Have questions? Schedule an appointment with our team of specialists.

While January is nationally slated as Cervical Health Awareness Month, this serious disease was once “the leading cause of cancer death for women in the United States,” and still affects thousands of women annually. It’s why we believe cervical cancer deserves attention regardless of the date on the calendar.

Fortunately, it can often be prevented with both vaccination and screenings — two key elements to reducing your risk.

What Is Cervical Cancer?

Cervical cancer occurs when healthy cells mutate in the lower area of the uterus which connects to the vagina, known as the cervix. Symptoms may include prolonged bleeding during your period, or bleeding in between periods, as well as unexplained pelvic pain — sometimes during or after intercourse. In its precancerous phase, symptoms may not manifest at all.

Although research is still ongoing regarding the direct causes of cervical cancer, strains of the sexually transmitted infection (STI) human papillomavirus (HPV) appear to play a large role. Other risk factors include smoking, age, a decreased immune system, and having had other STIs.

How to Prevent Cervical Cancer

HPV Vaccination

Even though there isn’t an absolute guarantee, the CDC notes that up to 93% of cervical cancers can be prevented through both HPV vaccination and screenings. Just as others do, the HPV vaccine works by producing antibodies which will bind to the virus and render it ineffective.

HPV is the most common STI, affecting 43 million Americans in 2018 — many of them young adults, or people who have only had sex with one person. Oftentimes, you may not know you even have it, as it may not present symptoms, and frequently goes away on its own. While this may not sound as alarming as other STIs, HPV’s potential to cause cancer over time makes it a condition that calls for proactive prevention.

All people ages 9 to 45 can get the HPV vaccine to protect against genital warts and/or different types of HPV that can cause cancer,” advises Planned Parenthood. And though it may seem surprising or uncomfortable for parents and guardians, they also suggest “that children get the vaccine at age 11 or 12, so they’re fully protected years before they become sexually active.” This vaccine can easily be incorporated into the same appointment when other preventative shots are given.

Regular Pap Testing

The Papanicolaou (Pap) test is another helpful step in cervical cancer prevention. According to the American Cancer Society, “The cervical cancer death rate dropped significantly with the increased use of the Pap test.” This is because early detection of any pre-cancerous cells can lead to a greater chance of effective treatment and cure. Most doctors advise Pap tests for women at a minimum of three-year intervals starting at the age of 21, but some risk factors such as a family history of cervical cancer may affect your personal timeline.

During your Pap test appointment, your doctor can also give you an HPV test, which screens for the presence of HPV. This may be particularly helpful if you have not been vaccinated against HPV.

According to the National Cancer Institute Cancer Trends Progress Report, 73.5% of women aged 21-65 reported being up-to-date with their cervical cancer screenings in 2019. We’d like to help include you among that number if you aren’t already. If you’re due for a Pap test, would like to discuss the HPV vaccine, or want to know more about cervical cancer and its prevention, schedule an appointment with us online or call (404) 352-2850.

Annual gynecological exams are an important part of preventive wellness for women, giving you the opportunity to discuss any health changes or evolving needs with our practitioners. During these yearly visits, you’ll also receive a Pap smear, a special type of screening that can detect abnormal cervical cells. Here’s what you should know about the test.

What Is a Pap Smear?

During a Pap smear, your provider will gently remove cells from the cervix with a specifically designed brush. Though you may experience brief, minor discomfort, this brushing is typically done within 15 seconds or less.

Once the cells are extracted from the cervix, medical experts will inspect them under a microscope most specifically for signs of cervical dysplasia, or precancerous changes. The National Cancer Institute further notes that Pap smears can also detect other abnormalities in the cervix, including infections and inflammation.

Why Is the Annual Pap Smear So Important?

The sooner abnormal cervical cells are detected, the earlier doctors can determine the cause and treat the condition before cancer develops. For instance, an abnormal Pap smear may necessitate repeat testing within shorter time intervals or call for a biopsy to determine the root issue and inform treatment decisions.

Annual testing ensures any changes are detected as early as possible. As Johnathan Lancaster, MD, PhD, and chair of the department of women’s oncology at H. Lee Moffitt Cancer Center and Research Institute explained to Everyday Health, “Like all medical tests, Pap smears are not 100% accurate. This reinforces the importance of having regular Paps, so that even if one Pap misses an early abnormal change, it’s likely to be picked up at the next Pap.”

Fortunately, cervical cancer is largely preventable through both screenings and vaccinations. While it was once the leading cause of death for women in the U.S., the Pap test has drastically decreased cervical cancer rates by helping doctors find changes early, when they’re most treatable.

Going for an annual Pap smear also allows you and your doctor to discuss human papillomavirus (HPV), the leading cause of cervical cancer, and whether or not you are at risk or should be tested.

How to Prepare for Your Pap Smear

Women 21 and older should be receiving routine Pap smears as part of their annual gynecological exam. If you’re due for yours, here are a few tips to consider:

  • Try to plan your appointment around your menstrual period. Blood and tissue swelling could make it more difficult to get an accurate assessment of cervical cells.
  • Ask if you can empty your bladder before the test. You may need to provide a urine sample during your appointment, so speak with a nurse first.
  • Avoid intercourse, vaginal medications, or putting any substances (including spermicidal creams) two days prior to your appointment to avoid obscuring abnormal cells.

At Avant Gynecology, we aim to make women’s annual care as comfortable as possible with an inviting atmosphere and gentle, caring practitioners who are ready to answer any questions you may have. If you’re due for an annual exam, contact us at (404) 352-2850 or schedule an appointment online.