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By James A. Scales, MD
May 21, 2018

Are you considering expanding your family in the near future? Our Texarkana, TX, OB/GYN, Dr. James Scales, can help you identify Pregnant Womenissues that may affect your fertility or pregnancy with preconception counseling.

What is preconception counseling?

Preconception counseling involves a physical exam, blood, or other laboratory tests, in some cases, and a discussion about risk factors that affect you or your partner or spouse. Counseling is usually conducted in our Texarkana office three to six months before you intend to become pregnant and covers these topics:

  • Medical and Reproductive History: During your counseling session, you'll be asked about your reproductive history, including previous pregnancies, surgeries, infections, gynecological conditions, and sexually transmitted diseases. Dr. Scales will also ask you and your partner about chronic diseases you may have or that may run in the family. Because some chronic diseases, such as diabetes or high blood pressure, can affect your pregnancy, it's important to identify these risk factors and create care plans before you even become pregnant.
  • Medications: Some medications can cause side effects that cause birth defects in fetuses. You'll be informed if any of the medications you take may cause birth defects and will be advised to discuss other medication options with the prescribing physician before you try to become pregnant.
  • Genetic Disorders: You'll also be given information about common inherited disorders, such as cystic fibrosis, Tay Sachs disease or sickle cell anemia.
  • Lifestyle Factors: Discussing lifestyle factors, including your job and drug and alcohol use, can help us identify risk factors that may lead to issues with your pregnancy. For example, if you work in a physically demanding job or are routinely exposed to toxins at work, modifications may be needed to increase the odds of a healthy, full-term pregnancy.
  • Weight and Exercise: It may be much easier to get pregnant if your weight falls in the ideal range for your height and frame. If you weigh too much or too little, you'll be given recommendations that can help you lose or gain weight. You'll also receive advice and information about exercise and nutritional requirements and vitamins that can help support a healthy pregnancy.

Thanks to prenatal counseling, you'll have time to address any issues that may affect your ability to become pregnant. If you're interested in scheduling a counseling session, call our Texarkana, TX, OB/GYN, Dr. Scales, at (903) 614-3003.

By James A. Scales, MD
May 15, 2018
Category: Women's Health
Tags: Menopause   OBGYN  

Getting older means overcoming many different obstacles as your life and your body change. But you must deal with one that is uniquely female: menopause and the symptoms that come with it. You know the symptoms commonly associated with menopause—hot flashes, night sweats, mood swings, difficulty sleeping, vaginal dryness—but did you know that they are treatable and that menopause doesn’t have to be insurmountable?

Hormone Therapy

If you have moderate to severe symptoms, hormone replacement therapy (HRT) is an effective treatment for hot flashes and can also help elevate vaginal dryness and mood issues. It has traditionally been administered with pills like birth control, but also like birth control it can now be taken through patches, creams, gels, and vaginal rings. If you have not had a hysterectomy, you could be prescribed estrogen and progesterone, called combination HRT. If you have had a hysterectomy, estrogen alone would be prescribed.

Not all women are candidates for HRT. Those who have breast or uterine cancer, blood clots, heart or liver disease, or have had a stroke would be better candidates for the following options.

Non-hormonal Therapy

Vaginal estrogen is a lower dose of estrogen that comes as a cream, tablet, or ring and is placed in the vagina to treat vaginal dryness if you don’t have hot flashes. Vaginal lubricants and moisturizers are non-prescription options to treat dryness as well. Lubricants can help decrease friction and ease intercourse, but be sure to only use water-soluble products designed for the vagina to avoid irritating tender tissue. Moisturizers can improve or maintain vaginal moisture if you have mild vaginal atrophy and can also keep your pH level low, ensuring a healthy vaginal environment. They can also be used regularly with longer-lasting effects than lubricants.

Prescription antidepressant medications are often used to treat mood problems, like depression, with relatively few side effects. They have also been used to treat hot flashes. However, if you are having mood issues, be sure to talk with your doctor to identify the cause and decide on the best treatment.

Lifestyle Changes

You’d be surprised how far simple lifestyle changes, like eating a healthy diet and regularly exercising, can go in minimizing menopause symptoms. Wearing light-weight pajamas, using layered bedding that can easily be removed, and using a fan in your bedroom can help with night sweats while keeping a regular sleep schedule and nighttime routine can make falling asleep and staying asleep easier.

The onset of menopause is a big change, and dealing with its symptoms can be daunting. But you don’t have to take on this new phase in your life alone. No matter if you are suffering severe symptoms or you just have some questions of what to expect as you get older, our office is here to help. Call to schedule your appointment today.

By James A. Scales, MD
May 01, 2018
Category: Pregnancy Care
Tags: Postpartum Care  

OBGYNS recommend that women come in for a postpartum visit approximately 6 weeks after giving birth. Unfortunately, medical reports state thatPostpartum Care the percentage of women that actually go to these appointments is staggeringly low. Of course, while a woman’s primary focus might be to care for their little one, it’s also important that women are getting the proper care they need to tackle their new role as a mother.

Any woman who has just given birth can tell you just how much pregnancy changes your body. Perhaps it changed it in ways you didn’t even imagine. So it goes without saying that those nine months of changes means that it’s going to take time for your body to bounce back to the way it was pre-baby. If you had a vaginal delivery it’s normal to experience vaginal discharge, urination problems, hemorrhoids, mood swings, hair loss, contractions, and vaginal soreness.

It’s important that you have an OBGYN that you trust to answer your questions and provide you with advice and help when you need it. An OBGYN can also be a wonderful source of emotional and mental support, which can be invaluable for a new mother.

One issue that’s often discussed during the postpartum phase is mood swings. Some women experience the “postpartum blues”, which only lasts a few weeks; however, postpartum depression is characterized by intense feelings of sadness and anxiety that can last up to one year. As you might imagine, postpartum depression can have a profound impact on a woman’s outlook and mood, making it particularly challenging when she has a new baby to take care of. An OBGYN can help provide you with the care you need and, if necessary, offer a referral for a mental health professional that can truly listen to your needs and help you on the road to healing.

Furthermore, if a mother has been diagnosed with a chronic medical condition like diabetes, hypertension, thyroid disorders, or mood disorders prior to pregnancy it’s also important that she has a follow-up visit with her gynecologist after the baby is born to ensure that she is still receiving ongoing maintenance and care for these long-term health problems to keep them in check.

It’s important that all women take postpartum care seriously to ensure that they continue to maintain good physical and mental health. Taking the time to care for yourself is important, even though you have a new baby to take care of. Ensuring that your health is in tip-top shape will allow you to spend more time with your beautiful family.

By James A. Scales, MD
April 13, 2018
Category: OBGYN Care
Tags: Period   Pain  


While we know that dealing with your period each month is never a party, we also understand that every woman experiences their period differently. Some women barely, if ever have any symptoms or problems during this time of the month; while other women experience symptoms that are so painful and debilitating that it takes a toll on their personal and professional lives. If you are dealing with painful periods then it’s time to read on to find out how to relieve these stubborn monthly symptoms.

Painful periods, medically known as dysmenorrhea, don’t refer to the normal cramping and discomfort that can easily be remedied with pain relievers or a heating pad. Dysmenorrhea refers to either lower abdominal pain and cramping that lasts a few days before your period starts (primary dysmenorrhea) or cramping that appears as a result of another condition such as endometriosis (secondary dysmenorrhea).

Fortunately, there are ways to tackle this problem if this is something you are experiencing. While some women find relief from over-the-counter anti-inflammatory medications when they experience menstrual cramps, if you deal with severe pain you may want to consider taking this pain medication a couple days before your period even begins. Nonsteroidal anti-inflammatory medications have the ability to greatly lessen and even stop uterine cramping while also decreasing your flow.

Along with these medications, you can also turn to alternative therapy such as acupuncture to help manage your symptoms, or turn to certain therapeutic exercises such as yoga to ease cramping.

If you don’t experience the relief you need through over-the-counter treatments, you’ll want to turn to your gynecologist for more specific care. Sometimes oral contraceptives are prescribed because they are effective for lessening both blood flow and menstrual cramping due to the hormones within the pills.

It’s important that if you have any questions or concerns about your period that you turn to a gynecologist who can provide you with the proper care and treatment you need. If painful periods are affecting you and aren’t responding to lifestyle modifications or medicines, or if the pain is getting worse, it’s a good time to call your women’s doctor.

If symptoms don’t improve even with other more aggressive measures, a diagnostic procedure known as a laparoscopy may be performed to determine the source of your pain.

By James A. Scales, MD
April 03, 2018
Category: Fertility
Tags: Infertility  

There are many reasons couples have trouble getting pregnant. There are so many factors that can influence fertility and it can be almost impossible to pinpoint the cause without turning to a medical expert for help; fortunately, your OBGYN is a great source for providing a proper evaluation and treatment options to increase your odds of getting pregnant.

So, when should you consider visiting your gynecologist or infertility specialist? If you are at a high risk for infertility, if you are over the age of 35 or if you’ve been trying to get pregnant for a year, then you may want to schedule an evaluation to find out if there is something that could be preventing you from getting pregnant.

During a fertility evaluation, you and your partner will provide details regarding your medical histories, and you will undergo a physical examination. For women, a blood test will be performed to check hormone levels. If you have a history of irregular periods this could also mean that there is an ovulation issue.

X-rays or other imaging tests may also be performed to check the health of the reproductive organs or to determine if there is a blockage in the fallopian tubes. Uterine fibroids can also be detected through these imaging tests, and this common issue can also affect a woman’s ability to get pregnant.

The most effective fertility treatment will really depend on the root cause. If there is an ovulation problem then medication will be prescribed to either stimulate the release of the egg or to treat conditions such as polycystic ovary syndrome, which can make it difficult to get pregnant.

If there is a fallopian tube blockage, then surgery will be performed to remove the blockage. If endometriosis is causing your infertility then a minor surgery may be recommended to remove the excess endometrial tissue.

However, there are situations in which your OBGYN can’t find the cause of your infertility. Even if this happens there are different ways to treat infertility to increase your odds of getting pregnant. Just like with any condition, there is trial and error when it comes to finding the right treatment. Medication may be prescribed (often the same type of medication used to treat ovulation problems).

If a woman is dealing with damaged fallopian tubes, severe endometriosis or other fertility issues that don’t respond to the treatment options above, in-vitro fertilization (IVF) may be recommended.

Your gynecologist will sit down with you to discuss the ideal fertility treatment options that will offer the best chance for success.

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