Health hotline: Hotline callers seek advice on a variety of women's reproductive health issues

Published: Sunday, Aug. 9 2009 12:00 a.m. MDT

Questions about the symptoms of endometriosis, ovarian cancer, breech births and hormone therapy were among the topics Deseret News readers asked on Saturday during the paper's monthly hotline call-in program.

Dr. Kathryn Walker with Sandy OB/GYN at Alta View Hospital told one caller concerned about her daughter's irregular menstrual periods that a possible solution may involve changing the birth-control pills she currently takes to regulate her cycle.

"Sometimes it can help if you skip the placebo pills," included with each birth control packet, Walker said. The woman was worried about the possibility that her daughter has endometriosis because her periods are painful, but Walker said other symptoms are involved with the condition beyond mere pain.

A question about the risk of ovarian cancer came from a woman with a family member who had the disease. Walker said there is no early detection test at this point for ovarian cancer, but scientists are working on a blood test that is not yet available.

Because of that, "we tend to catch ovarian cancer at a much later stage, and it's commonly diagnosed at the two most severe stages" because symptoms are vague and non-specific, she said. They include bloating with additional pain that seems to become chronic for a few months, but other conditions can cause similar symptoms.

One caller asked about a doctor's recommendation for an "external version" procedure to try to turn a fetus that is in the wrong position for delivery while still inside the mother's womb.

Such a procedure is common before the baby is full-term, Walker said, noting that movement is most often successful when the baby is not too large.

An obstetrician puts hands on the woman's abdomen and gently pushes in such a way to try to turn the baby's head down in order to facilitate a vaginal delivery.

"There is a little bit of risk," Walker said. "The mom can go into labor or there may be some fetal distress, so we want them in a place where we can monitor what's happening" as the procedure is done. "We can turn them about 50 percent of the time," which allows the mother to avoid a C-section delivery.

While Walker is certified in vaginal breech delivery, she said fewer physicians are willing to perform the procedure because of fear about potential complications and consequent litigation.

"It's becoming a lost art," which forces mothers to endure a C-section, creating additional expense and recovery time, she said.

Breech positioning occurs in about 1 of 25 births, according to the American Pregnancy Association.

A question about hormone therapy included a recommendation that women who are taking hormones but don't deal regularly with hot flashes or other symptoms may want to consider tapering off their medication.

"It's an individualized thing so there's no overall recommendation that works for everyone. You have to consider quality of life vs. the potential risks," Walker said.

Sponsored by the Deseret News and Intermountain Healthcare, the two-hour call-in program features a different topic on the second Saturday of each month.

e-mail: carrie@desnews.com

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