There are over 100 different types of HPV. Approximately 40 of the types infect the genital areas of men and women. Approximately 12 types of HPV are known to cause genital warts and approximately 15 types are linked to cancer of the anus, cervix, vulva, vagina and penis.

Since HPV is so common, it is important for both women and men to take preventative measures to minimize their risk of infection. Individuals can help reduce the risk of infection by limiting his or her number of sexual partners, using condoms during sexual intercourse and getting vaccinated.

Gardasil, a vaccine that is approved for females and males ages nine to 26, protects against four strains of the human papillomavirus (HPV). Virginia Women’s Center was the only research site in the Richmond area involved in the clinical trial leading to the approval of the Gardasil vaccine in 2006. In females, Gardasil helps protect against the two types of HPV that cause about 70 percent of cervical cancer cases and two additional types that cause 90 percent of genital warts cases. In males, Gardasil helps protect against 90 percent of genital warts cases.

Gardasil is ideally given to patients before they become sexually active. The vaccine is given in three shots over a period of six months. Routine vaccination is recommended for boys and girls at age 11-12. However, it is also recommended for older teens and young adults who were not vaccinated when younger.

The Centers for Disease Control and Prevention (CDC) announced in June 2013 that a new study shows that HPV in young women (ages 14 to 19) has declined by more than half since the vaccine was introduced in 2006. This is encouraging news despite the fact that only one-third of eligible patients have received all three doses of the vaccine.  Dr. Thomas R. Frieden, director of the CDC said of the results, “They should be a wake-up call that we need to increase vaccination rates. The bottom line is this: It is possible to protect the next generation from cancer, and we need to do it.”

To learn more about Gardasil, visit our Web site or speak with your health care provider.

Schedule outdoor activities wisely

The sun’s rays are the strongest between 10:00 a.m. and 2:00 p.m.; if possible, avoid scheduling outdoor activities during the middle of the day. It is important to remember that UV rays can reach you on cloudy or hazy days and during any season, not just the summer. The sun’s rays can be reflected by sand, water, snow, ice and pavement and they can also go through light clothing, windshields, windows and clouds. If you must be outdoors, seek shade when you can.

Choose the right sunscreen for you

It’s important to select a sunscreen that works well and one you enjoy wearing. The good news is that the U.S. Food and Drug Administration (FDA) has recently put new rules in place to help consumers understand the benefit of one sunscreen versus another. Here are some of the changes:

1. You’ll start seeing the words “broad spectrum” on sunscreen bottles. This means that the sunscreen must provide equal protection against UVA and UVB rays. Both UVA and UVB rays can lead to cancer. You want to select a sunscreen that is labeled “broad spectrum.”
2. Phrases you won’t see anymore: sunblock, waterproof, sweatproof or instant protection. Why these changes?
   • “Sunblock” – this is not accurate since no product completely shields you from the sun’s rays.
   • “Waterproof” or “sweatproof” – this is not accurate. Instead, sunscreens will be required to say how long they offer water resistant protection.
   • “Instant protection” – unless the FDA approves these claims for the specific sunscreen in question, this phrase cannot be used. It takes time for sunscreen to absorb into skin.
3. Sunscreens have to be clear about their sun protection factor (SPF) and what you will be protected against. If a sunscreen has a SPF of 15 or more, the product lowers the risk of skin cancer and skin aging. Sunscreens with a SPF of 15 or less only help prevent sunburn. The American Academy of Dermatology recommends you select a sunscreen with an SPF rating of 30 or higher.

Apply sunscreen correctly

While many of us use sunscreen, we don’t always use it correctly. Sunscreen takes time to absorb into our skin so it is important to apply it at least 30 minutes before going outside. You also need to be sure that you are using enough sunscreen for it to protect your skin. Apply one ounce – about the size of a golf ball – to cover every part of your body exposed to the sun. Be sure to reapply sunscreen again every two hours or after swimming or sweating.

Don extra protection

While sunscreen is important, you shouldn’t rely on it as your only source of protection. When possible, wear long sleeves, long pants and a hat with a wide brim that shades your face, neck and ears. Baseball caps and some sun visors only protect parts of your skin. Also, choose sunglasses that absorb UV radiation to protect the skin and your eyes. Remember to protect your lips by wearing a lip balm that has SPF 30 (or more) protection.

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At Virginia Women’s Center, we follow the guidelines of the American College of Obstetricians and Gynecologists (ACOG) and recommend that women over age 40 have a mammogram annually. As always, there are certain circumstances or family history that might warrant earlier or additional screening. It’s important to keep in mind that guidelines give us solid recommendations, but women’s health care isn’t a one-size-fits-all proposition. One-on-one with your health care provider is the best way to determine what you need and when.

Women’s breasts are always changing. They change during the menstrual cycle, pregnancy, breastfeeding and menopause. Many lumps, tenderness and other changes are benign, normal and simply the result of these hormonal changes. Along with these normal changes, problems can arise. It is important for you to be aware of any changes in your breasts. Tools such as screening mammograms and clinical breast exams, which are procedures that are performed by health care professionals at facilities like Virginia Women’s Center, can help detect breast cancer before it has progressed.

If you’re preparing for a mammogram at Virginia Women’s Center, you may find the following tips helpful:

Scheduling your appointment

• Try to schedule your mammogram for immediately after your menstrual cycle, so you will not have the breast tenderness that can occur at other times in the cycle.
• Virginia Women’s Center offers screening mammograms at our Henrico Doctors’ Forest Medical Plaza, John Rolfe Commons and Mechanicsville locations. You may be able to schedule your annual well-woman exam and mammogram at the same time. You can schedule an appointment on our secure patient portal or by calling 804.288.4084.
• You will need a physician’s order for a mammogram. If you see a VWC health care provider and are planning to have your mammogram at VWC, you do not need a written order (our providers will have access to your electronic health record).

Prior to your appointment

• If you have had a mammogram before at a location other than Virginia Women’s Center or The Ellen Shaw de Paredes Institute for Women’s Imaging, you will need to request that your prior films be sent to us before your visit. You can download the form here.
• Please verify coverage with your insurance. Any payment is requested at the time of service.

On the day of your mammogram

• Your mammogram will take approximately 20 minutes.
• Do not use perfumes, bath oils, powders or deodorant. They contain ingredients that can interfere with the clarity of the image.
• It’s best to wear a two-piece outfit to your mammogram appointment. Then, you will only have to remove your top at the time of the procedure.

If you have any questions about your upcoming mammogram, feel free to contact our office at 804.288.4084.

Additional Resources:

• Screening mammograms at Virginia Women’s Center
• Debunking the myths of mammography
• Breast self-awareness
• Understanding breast density
• Breast health

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A nurse practitioner is a registered nurse who has completed specific advanced nursing education, typically a master’s degree, and is trained in diagnosing common and complex medical conditions. Nurse practitioners can provide a full range of services such as ordering, performing and interpreting diagnostic tests; diagnosing and treating acute and chronic conditions; prescribing medications and treatments; and managing overall patient care. At Virginia Women’s Center, our nurse practitioners are board certified by national professional organizations.

Women’s health nurse practitioners are specially trained and board certified in obstetrics and gynecology and collaborate with our physicians to provide services that include the following:

• Care before and after menopause
• Contraceptive care
• Evaluation and treatment of common vaginal infections
• Health and wellness counseling to patients of all ages, including family planning care and gestational diabetes consultations
• Annual exams, including Pap test
• Pregnancy testing and routine care before, during and after pregnancy
• Screening and referral for other health problems
• STD screening and follow-up

Women with medical conditions, especially those that require surgery, need the services of a physician. But when women have typical health care needs, a nurse practitioner can serve as their health care provider.

Nurse practitioners distinguish themselves from other health care providers by focusing on the health and well-being of the whole person, in addition to specific concerns. They work as partners with their patients, guiding them to make educated health care decisions and healthy lifestyle choices. Their aim is to educate patients on the effects their health choices can have on them, their loved ones and their communities.

To read the biographies of Virginia Women’s Center’s nurse practitioners, visit the staff page on their Website. To learn more about the care that nurse practitioners provide, read their comments here.

Additional links:

American Academy of Nurse Practitioners

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http://www.virginiawomenscenter.com

Just like all aspects of your health, education and regular preventative check-ups can help keep you informed and engaged in your care. However, it’s also important that you pay close attention to your own body so that you can know what is normal for you and seek medical care when your health changes and is no longer normal. With your breast health, this self-awareness is no exception.

Women’s breasts are always changing. They change during the menstrual cycle, pregnancy, breastfeeding and menopause. Along with these normal changes, problems can arise. It is important for you to be aware of any changes in your breasts. Tools such as screening mammograms and clinical breast exams, which are procedures that are performed by health care professionals at facilities like Virginia Women’s Center, can help detect breast cancer before it has progressed.

In addition to regular screening mammograms and clinical breast exams, some women choose to perform a formal step-by-step breast self-exam and others prefer a visual inspection. No matter the technique you choose (both can be performed in the comfort of your own home and without any formal training), it’s important that you are aware of what your breasts normally look and feel like. Should you notice any changes, you can proactively seek medical care.

When inspecting your breasts, stand or sit in front of a mirror. Pay attention for the following changes

• Changes in color or shape of your breast
• Changes in color or texture of your skin
• Changes in nipple shape or texture
• Evidence of nipple discharge
• Dimpling or puckering anywhere on your chest

It’s common for women to be so concerned performing breast self-exams “right” that they become stressed over the technique. Performing a breast self-exam or a visual inspection of your breasts regularly are both ways for you to know how your breasts normally look and feel and to notice any changes. The goal, with or without a formal breast self-exam, is to report any breast changes to your health care provider right away.

In addition to being aware of your own health, it’s important to be knowledgeable about your specific family history, which can shape your health both in the present and the future. Knowing your family and personal health histories can help you and your health care provider determine the best plan for your individual care.

In the end, it’s important to remember that all women are unique and different. In addition to staying on top of preventative appointments and screenings, self-awareness is a key aspect to detecting changes not only in your breasts, but in your overall health.

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As we discussed in this blog post, a woman’s breasts change as she advances through the stages of life and breast density is part of this. For many women, breast density will decrease with age as well as with each pregnancy. However, some women may maintain high breast density throughout their lives because of other factors like family history, body weight and postmenopausal hormone use.

Just like family history, breast density is a risk factor that is taken into account when determining the best breast cancer screening plan for a patient. Because of a recent law passed by the state of Virginia, women who have dense breast tissue will now be informed of this from both the radiologist who interprets the mammogram results as well as the referring provider (in our patients’ case, Virginia Women’s Center). This notification is now required because dense breast tissue may hide cancer or other abnormalities from the radiologists who are interpreting the screening mammogram.

Women who have dense breast tissue may have an increased risk for breast cancer. However, at this time, the amount of this risk is not understood and continues to be debated among health care professionals. Aside from receiving regular mammograms and clinical breast exams, and performing monthly breast self-exams, there are no specific or additional screening recommendations for women with dense breasts.

There are many studies that are evaluating the relationship between breast density and breast cancer, but currently, there are no specific recommendations on how to lower breast cancer risk for women who have dense breasts. However, all women can take steps to lower their overall breast cancer risk by not smoking, limiting alcohol use, exercising regularly, eating a healthy diet and maintaining a normal weight.

Please note: Your health care provider can determine the best breast cancer screening plan for you based on your individual health and family history.

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The kids are out of school, the smells of grilling and sunscreen are in the air and the temperatures in Richmond have surpassed the 90 degree mark. It can only mean one thing: summer is here! As we head into the hot, summer months, it becomes more important than ever to protect yourself and your loved ones from the extreme heat and sun.

Heat illnesses can happen to anyone, but the following individuals are at higher risk for developing them: elderly people (65 +), infants and children and individuals with chronic medical conditions. There are three degrees of heat illness:

• Heat cramps: Intense muscle pains or spasms that may occur during strenuous activity.
• Heat exhaustion: May occur after several days of intense heat without adequate replacement of fluids. Warning signs include: heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea, vomiting or fainting. If left untreated, it can progress to heat stroke.
• Heat stroke: Occurs when the body’s cooling system fails and if not properly treated, can cause severe disability or even death. Warning signs include: an extremely high body temperature (above 103°F, orally); red, hot, and dry skin (no sweating); rapid, strong pulse; throbbing headache; dizziness; nausea; confusion and unconsciousness.

When you choose to do activities outdoors, the following tips can be helpful in preventing heat illnesses.

• Stay hydrated by drinking plenty of fluids, but avoid those with alcohol and sugar
• Wear light, loose-fitting clothing
• Never leave anyone in a closed, parked vehicle

In addition to the extreme heat and humidity, it’s important to protect yourself and your loved ones from the harmful rays of the sun. Remember, there’s no such thing as a healthy tan!

• Avoid outdoor activities during the middle of the day. The sun’s rays are the strongest between 10 a.m. and 4 p.m. When you must be outdoors, seek shade when you can.
• Remember that the sun’s rays can be reflected by sand, water, snow, ice and pavement. Its rays can also go through light clothing, windshields, windows and clouds.
• Wear long sleeves and long pants. Avoid loosely woven fabrics.
• Wear a hat with a wide brim that shades your face, neck and ears. Keep in mind that baseball caps and some sun visors protect only parts of your skin.
• Wear sunglasses that absorb UV radiation to protect the skin around your eyes.
• Use sunscreen lotions with a sun protection factor (SPF) of at least 15. Apply the product’s recommended amount to uncovered skin 30 minutes before going outside and apply again every two hours or after swimming or sweating. Be sure that your sunscreen lotion filters both UVB and UVA radiation.

No matter where your summer plans take you, we hope you enjoy the season with family and friends and take the appropriate measures to ensure everyone has a safe and enjoyable time!

Virginia Women’s Center is an advertiser on Richmondmom.com

Skin cancer is the most common type of cancer in the United States – one in five Americans will develop skin cancer in the course of a lifetime. While it is always important that we remember this valuable information from the National Cancer Institute, as we plan to spend more time in the sun during the summer months, awareness and prevention become even more essential.

Melanoma is one type of skin cancer that begins in melanocytes, cells that make the pigment melanin. It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines.

“ABCDE” can help you remember what to look for in existing or new moles:

• Asymmetry: The shape of one half does not match the other half.
• Border that is irregular: The edges are often ragged, notched or blurred in outline. The pigment may spread into the surrounding skin.
• Color that is uneven: Shades of black, brown and tan may be present. Areas of white, gray, red, pink or blue may also be seen.
• Diameter: There is a change in size, usually an increase. Melanomas can be tiny, but most are larger than the size of a pea (larger than 6 millimeters or about 1/4 inch).
• Evolving: The mole has changed over the past few weeks or months.

The best way to prevent skin cancer is to protect yourself from the harmful rays of the sun:

1. Avoid outdoor activities during the middle of the day. The sun’s rays are the strongest between 10 a.m. and 4 p.m. When you must be outdoors, seek shade when you can.
2. Remember that the sun’s rays can be reflected by sand, water, snow, ice and pavement. Its rays can also go through light clothing, windshields, windows and clouds.
3. Wear long sleeves and long pants. Avoid loosely woven fabrics.
4. Wear a hat with a wide brim that shades your face, neck and ears. Keep in mind that baseball caps and some sun visors protect only parts of your skin.
5. Wear sunglasses that absorb UV radiation to protect the skin around your eyes.
6. Use sunscreen lotions with a sun protection factor (SPF) of at least 15. Apply the product’s recommended amount to uncovered skin 30 minutes before going outside and apply again every two hours or after swimming or sweating. Be sure that your sunscreen lotion filters both UVB and UVA radiation.

Take precautions to prevent skin cancer for you and your child, and have fun outdoors this summer!

Thanks to Virginia Women’s Center, which is a Richmondmom.com advertiser, for this valuable information.