Women’s Healthcare–pelvic organs

 

 

Women’s health is really designed for all people who need it. 

Women’s health is for anyone of any gender in need of inclusive healthcare related to pelvic organs, mental health, reproductive health and family planning.

Being a man or a woman has a significant impact on health, as a result of both biological and gender-related differences. The health of women and girls is of particular concern.

Pap/Pelvic Exam

A pelvic exam involves a physician looking at a woman’s vulva, uterus, cervix, fallopian tubes, ovaries, bladder, and rectum to spot signs of illness.

A pelvic exam is a way for doctors to look for signs of illness in organs in a woman’s body before, during, and after menopause. The word “pelvic” refers to the pelvis. The exam is used to look at a woman’s:

        • Uterus (the womb)
        • Vagina (the muscular canal which extends from the cervix to the labia)
        • Cervix (opening from the uterus to the vagina)
        • Fallopian tubes (tubes that carry eggs to the womb)
        • Ovaries (glands that produce eggs)
        • Bladder (the sac that holds urine)
        • Rectum (the chamber that connects the colon to the anus)

A woman’s body size determines the sensitivity of the pelvic exam to identify an abnormality. Unfortunately, it is more difficult to examine patients who are heavier. Sometimes a doctor may order an ultrasound to confirm the findings on a pelvic exam.

You can expect to feel a little discomfort, but you should not feel pain during a pelvic exam. The exam itself takes about 10 minutes. If you have any questions during the exam, be sure to ask your doctor.

During a typical pelvic exam, your doctor or nurse will:

    1. Ask you to take off your clothes in private. (You will be given a gown or other covering.)
    2. Talk to you about any health concerns.
    3. Ask you to lie on your back and relax.
    4. Press down on areas of the lower stomach to feel the organs from the outside.
    5. Help you get in position for the speculum exam. (You may be asked to slide down to the end of the table.)
    6. Ask you to bend your knees and to place your feet in holders called stirrups.
    7. Perform the speculum exam. During the exam, a device called a speculum will be inserted into the vagina. The speculum is opened to widen the vagina so that the vagina and cervix can be seen.
    8. Perform a Pap smear if indicated. Your provider will use a plastic or wooden spatula and small brush to take a sample of cells from the cervix. A sample of fluid may also be taken from the vagina to test for infection.
    9. Remove the speculum.
    10. Perform a manual exam with their fingers. Your provider will typically place two fingers inside the vagina and use the other hand to gently press down on the area they are feeling. Your doctor is noting if the organs have changed in size or shape.
    11. Sometimes a rectal exam is performed. Your doctor inserts a gloved finger into the rectum to detect any tumors or other abnormalities.
    12. Finally, your doctor will talk to you about the exam. (You may be asked to return to get test results.)

As mentioned above, during a pelvic exam, a sample of cells may be taken as part of a regular test called a Pap smear, or Pap test, to screen for cervical cancer or cells that look like they might lead to cancer. This sample may also be screened for HPV as well. The sample is placed in a solution and sent to a lab where it is examined. Tests also may be taken to screen for sexually transmitted diseases or other infections.

Progesterone

Progesterone is 1 of 2 female sex hormones, the other being estrogen. Its main functions are regulating menstruation and supporting pregnancy in the female body.

Progesterone is produced in the corpus luteum, a temporary mass of cells that form in the ovaries following the release of an egg. In fact, progesterone is present in oral contraceptives because it can trick the body into not ovulating.

The adrenal glands and the placenta can also produce progesterone.

What does progesterone do to my body?

Progesterone does several things, including:

        • Thickening the lining of your uterus for implantation.
        • Regulating bleeding during menstruation.
        • Supporting a pregnancy once conception occurs.
        • Helping to improve your mood.
        • Supporting thyroid function.
        • Supporting lactation.

How does your body produce progesterone?

A gland called the corpus luteum produces progesterone. Your corpus luteum is a temporary gland that develops after you ovulate (release an egg from your ovary). It’s responsible for maintaining progesterone levels after conception and fertilization to support a pregnancy.

Your adrenal glands and placenta also make progesterone.

What are the common disorders associated with progesterone?

Low progesterone can affect your body in several ways, sometime causing noticeable symptoms. High progesterone levels don’t typically have a negative impact on your health. In rare cases, it can be a sign of ovarian or adrenal cancer.

Symptoms of low progesterone in people who aren’t pregnant include:

Low progesterone in pregnancy

Since progesterone maintains your uterine lining during pregnancy so a fetus can grow, low levels can make it hard for you to stay pregnant. You need progesterone levels to stay high until you’re ready to give birth.

If you have low progesterone, you’re at risk for pregnancy complications such as:

How do healthcare providers test progesterone levels?

Progesterone is a hormone that supports menstruation and pregnancy. It typically rises during pregnancy and while using some birth control medications. Low levels can affect menstruation and fertility.

A blood test (a PGSN or progesterone test) can be used to test progesterone levels. It’s most commonly used to determine ovulation.

What are normal levels of progesterone?

Progesterone levels fluctuate throughout your menstrual cycle. Levels rise after ovulation and continue to rise if pregnancy occurs. Your healthcare provider is the best person to determine what your progesterone level should be depending on where you are in your menstrual cycle or if you’re pregnant.

Progesterone levels are measured in nanograms per milliliter (ng/mL). The chart below lists what are considered normal levels of progesterone for an adult female during different

Stage Progesterone level (ng/mL)
follicular stage of the menstrual cycle < 0.7
luteal stage of the menstrual cycle 2 to 25
first trimester of pregnancy 10 to 44
second trimester of pregnancy 19.5 to 82.5
third trimester of pregnancy 65 to 290

  1. The Follicular Phase follows just after menstruation. It’s called the Follicular phase because your pituitary gland releases a hormone called Follicle Stimulating Hormone (FSH), which stimulates the follicles in your ovaries to mature. It is the longest phase of your menstrual cycle. During ovulation, your ovary releases the egg that matured during the follicular phase.

  2. The luteal phase of your menstrual cycle occurs right after ovulation (when your ovary releases an egg). It lasts about 14 days and ends when you get your period. The luteal phase prepares your uterus for pregnancy by thickening your uterine lining. A disorder involving your luteal phase can affect getting and staying pregnant.

When should you take progesterone?

Some women or people AFAB need to take progesterone supplements. Your healthcare provider may prescribe progesterone if you:

        • Have symptoms of perimenopause (the transition to menopause).
        • Need to regulate your menstrual cycle.
        • Need to prevent pregnancy (minipill).

Progesterone during perimenopause

As you begin to transition into menopause, your ovaries no longer produce high levels of estrogen and progesterone. Changes in these hormone levels can cause uncomfortable symptoms. Common symptoms include:

Your provider may recommend estrogen progesterone hormone therapy (EPT) to relieve these symptoms. Also called combination therapy, this form of hormone therapy combines estrogen and progesterone.

Does progesterone make you gain weight?

Weight gain isn’t a direct side effect of progesterone. While hormones in general can affect your hunger levels and weight, having too much or too little progesterone alone isn’t usually a cause of weight gain.

Does progesterone make you tired?

Yes, progesterone levels may make you feel more tired.

Progesterone is a hormone that plays an important role in your reproductive system. Hormones are chemical messengers that tell your body how to work. In women or people assigned female at birth (AFAB), progesterone supports menstruation and helps maintain the early stages of a pregnancy.

What is the main purpose of progesterone?

The main function of progesterone is to prepare the endometrium (lining of your uterus) for a fertilized egg to implant and grow. If a pregnancy doesn’t occur, the endometrium sheds during your menstrual period. If conception occurs, progesterone increases to support the pregnancy.

10 Signs You May Have Low Progesterone

One of the most common patterns of hormone imbalance that I see in my practice treating women is low progesterone. In this article, I’ll explain why progesterone is so important for women’s hormone balance, and some of the common signs that suggest you may have this pattern.

What does progesterone do for you?

Progesterone is the hormone that is produced in the second half of the menstrual cycle, after ovulation occurs. I call progesterone the “calming, cooling hormone.” It’s like the “yin” to estrogen’s “yang”; both are important, and they work best when in balance with one another.

Ovuation is the key event that is required for optimal progesterone levels. After an egg is release from the follicle inside the ovary, the little structure that is left behind is called the corpus luteum. This structure is responsible for producing progesterone.

Progesterone has the following important functions:

        • Helps to grow and maintain the lining of the uterus by increasing blood flow and oxygen to this area
        • Supporting and regulating your mood, especially in the second half of your menstrual cycle
        • Maintaining a regular menstrual cycle length (no less than 21 days, and no longer than 35 days)
        • Maintaining a predictable period schedule
        • Normalizes period bleeding (not too heavy or too light)
        • Calming the mind and mitigating anxiety
        • Calming the nervous system and enhancing your capacity to manage stressors
        • Supporting quality sleep
        • Promoting fertility, implantation and supporting early pregnancy
        • Progesterone also appears to have some neuroprotective brain benefits, especially after concussions.

The corpus luteum typically lives for about 10-14 days. If fertilization does not occur, it will disintegrate, progesterone levels will drop, and a period will occur. If fertilization and implantation DO occur, then pregnancy hormones will help to maintain the corpus luteum. This way, progesterone levels are kept elevated in order to support the early stages of pregnancy.

10 signs that you might be low in progesterone

The following signs may indicate low progesterone. These symptoms can also overlap with other hormone concerns, such as thyroid problems, elevated estrogen, or iron deficiency, so it’s important to seek help in evaluating your hormones thoroughly.

1. Irregular or skipped periods.

As I explained above, you need to ovulate in order to produce progesterone. If your period is irregular, unpredictable, or you skip periods, this is a sign that you aren’t ovulating. You should speak to your health care provider if you haven’t had a period in 3 or more months, or if your period comes every 35 days or longer.

2. You experience spotting before your period.

Progesterone helps to maintain the integrity of the uterine lining. A little bit of spotting just before your period is normal, because your progesterone is naturally dropping at this time. But if you are having 2 or more days of spotting before your period “officially arrives”, this may indicate low progesterone.

3. You’re not ovulating (or, you’re not ovulating regularly).

Once again: you must ovulate in order to produce progesterone. No ovulation = low progesterone.

Did you know that just because you are getting a period monthly, doesn’t necessarily mean that you are ovulating every single month? This may seem counterintuitive to point #1, but it’s true. This is why for my fertility patients, I educate about the physical signs of ovulation to watch for, basal body temperature tracking, and the “fertile window.” If you are actively monitoring using BBT or ovulation predictor kits but not getting a rise in temperature or a positive test, then you may not be ovulating.

4. Moodiness: you feel really irritable, anxious, angry, tired or depressed in the day(s) leading up to your period.

Progesterone is calming to the brain. It mitigates anxiety, and helps you manage stressors more effectively. Low progesterone is associated with more aggression and fatigue in the PMS time.

5. Other PMS symptoms: in the days before your period, you feel extra bloated, have breast tenderness, headaches, and/or water retention in your arms and legs.

These physical symptoms of PMS are associated with low progesterone.

6. You have problems getting good quality sleep, especially in the second half of your menstrual cycle or during your PMS phase.

Studies show that women with more severe PMS have decreased parasympathetic brain activity (the “rest and digest” state) in the luteal phase. This contributes to worsened sleep, whether that is difficulty falling asleep or staying asleep. In fact, prescription bioidentical oral progesterone is always given at night, because it makes you sleepy.

7. You get acne breakouts before your period.

Are you in your 30’s and suddenly breaking out like a teenager? You’re not alone. Acne breakouts before the period can, in fact, return later in life! This can be a sign of low progesterone. For more on this specific topic, check out my other article about hormonal acne.  

8. You are in your 40’s.

During a woman’s lifespan, peak progesterone production occurs in the late 20’s and early 30’s. If you’re in your late 30’s and feel like your PMS symptoms are worsening, it may be related to lower progesterone production.

Did you know that symptoms of perimenopause start 7-14 years before menopause? This means that perimenopause can start in the early 40’s, or even earlier. Can you guess the first hormone that tends to decline in perimenopause? If you guessed progesterone, you’re right. This is always one of the first hormone that I discuss supporting for my patients in their 40’s.

Menstruation

In the middle of a person’s menstrual cycle, a rise in levels of luteinizing hormone leads to ovulation.

Progesterone helps prepare the body for pregnancyTrusted Source by stimulating glandular development and the development of new blood vessels. This provides a good environment for implantation by a fertilized egg.

If the egg isn’t fertilized, the corpus luteum breaks down, leading to a drop in progesterone levels. This decrease causes the endometrium (tissue lining) to break down, resulting in the beginning of a menstrual period.

Progesterone and menstruation

Ovulation (when your ovary releases an egg) occurs around the middle of a person’s menstrual cycle. The corpus luteum forms from the empty egg follicle and begins producing progesterone. Your corpus luteum is a temporary gland that helps support the beginning of a pregnancy if conception occurs during that cycle. Progesterone works by thickening your uterine lining and creating a good environment for a fertilized egg to implant.

At about 10 weeks, the placenta then takes over the production of progesterone and other hormones. The corpus luteum gets smaller and stops functioning.

In males, adrenal glands also produce progesterone. Its function is associated with sperm development.

What does Progesterone’s do?

If an egg isn’t fertilized during that cycle (meaning you don’t get pregnant), the corpus luteum breaks down, which decreases progesterone levels. Decreasing progesterone levels means your uterine lining thins and breaks down, causing the beginning of your menstrual period.

Pregnancy

Progesterone is critical in supporting a pregnancy because it thickens your uterine lining. A thick uterine lining helps a fertilized egg grow into an embryo, and then to a fetus.

Progesterone levels continue to rise during pregnancy. High progesterone levels prevent your body from ovulating while you’re pregnant. It also suppresses uterine contractions, which helps you avoid preterm labor. Finally, progesterone helps your breasts prepare for breastfeeding (chestfeeding).

Because progesterone is so important in maintaining the early stages of pregnancy, low progesterone levels may make it hard for you to conceive and may put you at higher risk for miscarriage.

Because progesterone is so important in maintaining the early stages of pregnancy, low progesterone levels may make it hard for you to conceive and may put you at higher risk for miscarriage. What does progesterone do to my body? Progesterone does several things, including: Thickening the lining of your uterus for implantation and too little progesterone can cause complications with pregnancy or produce side effects similar to menopause.

 An egg is fertilized by sperm and conception occurs, the corpus luteum doesn’t break down and continues to make more progesterone. Your uterine lining is thick and rich in blood vessels, which provides nutrients for the fertilized egg (now an embryo). Once the placenta forms, it’ll take over progesterone production.

During pregnancy, progesterone levels increase each trimester, reaching their highest level in your third trimester (weeks 28 to 40 of pregnancy). Progesterone levels decline in the years leading up to menopause, when ovulation stops.

Miscarriages

If you’re pregnant, you may be concerned about the risks of a miscarriage or pregnancy loss. (It’s called “miscarriage” when the pregnancy ends before the 20th week). Most of the time, this happens for reasons you have no control over. In fact, it’s often difficult to pinpoint the exact cause. Learning what causes it may help put your mind at ease and help you improve your chances for having a healthy, full-term pregnancy.Here’s an overview of some of the most common causes of pregnancy loss.

When a miscarriage happens in the first 12 weeks, more than half the time it’s because of a problem with the baby’s chromosomes. Chromosomes contain the genes that determine your baby’s unique traits, such as hair and eye color. A baby can’t grow normally with the wrong number of chromosomes or with damaged ones.

An abnormality in a unborn baby’s chromosomes could cause one of several problems. Among the most common are:

    • Blighted ovum(anembryonic pregnancy). No embryo develops.
    • Molar pregnancy. Both sets of chromosomes come from the father, while none come from the mother. The placenta doesn’t grow normally, and the fetus doesn’t develop.
    • Partial molar pregnancy. The father gives two sets of chromosomes in addition to the set from the mother. The embryo may start to develop but soon stops.

Several other chromosomal abnormalities can cause the loss of a pregnancy. These include trisomy 13, 18, 21 (Down syndrome), monosomy (Turner’s syndrome), and other sex chromosome issues.

Here are some other things to keep in mind about abnormal chromosomes:

          • There’s no way to prevent chromosome problems from happening.
          • As you get older, especially after age 35, your risk for chromosome problems specifically, and pregnancy loss in general, goes up.

Miscarriages from chromosome problems usually don’t happen again in future pregnancies.

A pregnancy loss often results from a problem with the mother’s health. Some of these include:

Your habits as the mom-to-be can increase the risk of a pregnancy loss. Here are some habits that are dangerous for a developing baby:

In addition to secondhand smoke, certain substances in your environment at home or at work could put your pregnancy at risk. These include:

          • Lead in old water pipes or paint in homes built before 1978
          • Mercury released from broken thermometers or fluorescent light bulbs
          • Solvents such as paint thinners, degreasers, and stain and varnish removers
          • Pesticides for killing insects or rodents
          • Arsenic found near waste sites or in some well water

Be sure to talk with your doctor about this. You may find your risks are not as great as you think.

Several prescription and over-the-counter medications can raise your chances of miscarriage and pregnancy loss, including:

Several types of food poisoning during pregnancy can raise your risk for miscarriage or pregnancy loss.

        • Listeriosis. Typically found in unpasteurized soft cheeses such as blue, Brie, or queso fresco, and raw or undercooked seafood
        • Salmonella. Usually found in raw or undercooked eggs
        • Toxoplasmosis. Most often caused by eating infected raw meat

Some food poisoning illnesses, including listeriosis and toxoplasmosis, can infect your unborn baby even if you don’t have symptoms yourself.

Follow your doctor’s guidelines about cooking and foods to stay away from while you’re pregnant.

You may worry that certain activities or emotions might raise the risk to your pregnancy. But if your pregnancy isn’t considered high-risk, the following things are generally safe:

        • Working
        • Sitting or standing for reasonable amounts of time
        • Exercise (talk with your doctor about what level of exercise is right for you)
        • Having sex
        • Air travel
        • Eating spicy food
        • Having an emotional shock or scare
        • Stress or depression

Although there’s no sure way to prevent miscarriage or pregnancy loss, you can take steps to help ensure a healthy pregnancy:

      • Have a pre-conception checkup.
      • Have regular prenatal visits so your doctor can help prevent and treat any problems early. Make taking care of existing health problems a priority. Your efforts will give your baby the best chance for health.
      • Curb dangerous lifestyle habits. If you can’t stop on your own, talk with your doctor about getting help to stop.
      • Ask your doctor about your risk from the environment and how to protect yourself.
      • Ask your doctor whether you should see an obstetrical specialist, such as a perinatologist, especially if you have more than one miscarriage. These doctors specialize in complicated pregnancies.
      • Take a daily multivitamin.
      • Limit caffeine.
      • Eat a healthy, balanced diet.
      • Avoid certain foods that can carry bacteria.
      • Maintain a healthy weight.
      • Be aware that you can do everything “right” and still have a miscarriage. Try not to add guilt or self-blame to your emotional burden. Between working with your doctor and making healthy lifestyle changes, you can rest easy knowing you’ve done everything you can to have a healthy pregnancy

Treatments

You need surgical treatment if you have a miscarriage along with heavy bleeding or signs of an infection. After a miscarriage, if you are blood type Rh negative, you also may get a shot of medicine called Rh immunoglobulin.

The positive or negative sign next to the blood groups is known as the Rhesus (Rh) factor. The Rh factor is an inherited protein that can be found on the surface of the red blood cell.

The Rh factor is one of the proteins on [Red Blood Cells] RBCs used to indicate whether the blood of two different people is compatible when mixed – such as blood of a mother and her baby at birth.

Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Health care professionals perform dilation and curettage to diagnose and treat certain uterine — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.

In a dilation and curettage, small instruments or a medication is used to open (dilate) the lower, narrow part of your uterus (cervix). Next, a surgical instrument called a curette, which can be a sharp instrument or suction device, is used to remove uterine tissue.

Menopause

This is the conclusion of the natural transition in a woman’s reproductive life. It’s the point where progesterone and estrogen production decrease permanently to low levels. The ovaries stop producing eggs, and a woman is no longer able to become pregnant, naturally. Menopause is officially marked by the total cessation of the menstrual cycle for 12 months or more. In other words, not having a period for at least 12 months in a row.

On average, menopause occurs around age 52 in the United States but varies from woman to woman.

Menopause-associated symptoms may never occur or can last for several months or even years, depending on the individual. Except for irregular periods, all the following common signs and symptoms can be prevented or effectively treated, naturally.

Hormone imbalance cause uterine and psych problems.

Low levels of progesterone can cause irregular menstrual periods, abnormal uterine bleeding, spotting, mood changes and headaches, and could affect your ability to get pregnant.

Menopause is a point in time 12 months after a woman’s last period. The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or other symptoms, are called the menopausal transition or perimenopause. The menopausal transition most often begins between ages 45 and 55.

Menopause is a natural part of the aging process during which a woman transitions from her years of potential childbearing to her fully mature years free of this responsibility.

It’s important to recognize that a woman’s reproductive years are only one stage of her life. Before menarche, a young girl’s first period, she is unable to bear children. After menopause as well, the potential for childbearing ceases. One of the first observational changes that signal this change during menopause is the gradual tapering off and final ceasing of menstrual periods.

With the information you need to optimize your health through this period of transition and beyond, there’s no limit to what your body can do… and when it comes to menopause, your mindset can make a big difference.

Research shows that what you believe about menopause can affect your experience. Women with more negative attitudes towards menopause generally report more symptoms during their menopausal transition.

The 4 Stages of Menopause

There are four stages of the menopausal transition: premenopause, perimenopause, menopause, and postmenopause. In addition, some women may also experience early or “premature” menopause, which occurs before the natural aging process.

Because the risk of cancer increases with age, having regular pelvic exams may help in early detection of certain cancers in both menopausal and postmenopausal women.

The U.S.Preventive ServicesTask Force recommends that women between the ages of 21 and 65 have a Pap test every three years, or a human papilllomavirus (HPV) test or a combination of a PAP and HPV test every five years, starting at age 30.

Women over age 65 can stop getting screened if they’ve had at least three consecutive negative Pap tests or at least two negative HPV tests within the previous 10 years, according to the guidelines. But women who have a history of a more advanced precancer diagnosis should continue to be screened for at least 20 years.

And women of any age who’ve had a hysterectomy with removal of the cervix and no history of cervical cancer or advanced precancerous abnormalities do not need to be screened, according to the guidelines.

Still, even though you may not need a Pap test every year, you should still have an annual gynecological exam to protect your health.

Women’s inclusion in clinical research

Women’s health is a relatively new area of study. When you consider the great span of medical science, most medical research has been historically centered around biological male bodies. For some, that may be a little shocking to learn. But it’s only within the last several decades that women have been truly included in clinical research — the methods used to study and advance medical treatments.

In 1993, the National Institutes of Health (NIH) passed the Revitalization Act that required the inclusion of women and racial/ethnic minorities in NIH-funded clinical research. The reason is that prior to that passing, women and ethnic minorities were largely excluded from clinical trials even in their earliest stages.

And it wasn’t until 2016 that the NIH passed a policy stating sex was a biological variable that needed to be factored into studies of both animals and humans. This meant that biological sex differences needed to be considered from the earliest stages of developing research questions and designing studies, all the way through analyzing the results and reporting on published work.

Translation: The NIH determined the sex you’re assigned at birth has a direct impact on your overall health and, therefore, should be taken into consideration when we make decisions about how we develop and advance medical treatments.

And yet, research continues to show that women and people assigned female at birth (AFAB) are still underrepresented in the earliest phases of clinical trials, where men make up 64.1% of the subjects studied.

“Women are just the tip of the iceberg,” says Dr. Ferrando. “Ethnic minorities, individuals of color, are really underrepresented in research. A lot of studies also exclude individuals who are trying to conceive or have the potential to become pregnant.”

How sex impacts your health outcomes

“We know physiologically, biologic females and biologic males are different in some respects,” says Dr. Ferrando.

For example, women and people AFAB have an increased risk of breast cancer and Alzheimer’s disease when compared to men and people assigned male at birth (AMAB). Other conditions that affect women and people AFAB differently include:

One 2019 study of 6.9 million Danish people found that women were diagnosed much later than men for more than 700 conditions. On average, researchers found that women were diagnosed with cancer two-and-a-half years later in life than men with the same diagnosis. And for metabolic diseases like diabetes, women received a diagnosis four-and-a-half years later than men.

The researchers couldn’t determine the direct cause for any delay in diagnosis, and the study looked only at people who were hospitalized who had access to a single-payer healthcare system. But we know that women, especially women of color, have a long history of dealing with healthcare disparities, leading to an increase in undiagnosed or misdiagnosed conditions.

That’s why it remains so important for women to continue to advocate for themselves in the healthcare space. By being direct about how you’re feeling, the symptoms you’re experiencing and the concerns you have when speaking with a healthcare provider, you can help minimize the potential for misdiagnosis.

And that’s also why it’s important to start asking ourselves who else has been left out of the same conversations?

References:

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