Menopausal Hormonal Therapy

Instructions/Activity:
Pelvic rest for 6 weeks. (No douching, tampons, or sexual intercourse.)
No vigorous exercise for 6 weeks.
If you have had a C-section, no heavy lifting greater than 10 lbs. For 6 weeks.
No driving for 1-2 weeks (if you have had a C-section) or while take Percocet.
If you have had a 4th degree tear, nothing in the rectum (suppositories, etc.) for 6 weeks.
Also, please use a stool softener for 2-3 weeks after your delivery, such as Colace (which is sold over the counter)
For C-section patients, keep your incision clean and dry. Let the water/soap run down on the incision in the shower. Do not apply soap on a towel and directly scrub your incision. Do not apply any creams/lotions/Neosporin to your incision. Your steri-strips may fall off on their own, otherwise we will inspect and/ or remove them at your 1-2 week appointment. 

Your next appointment should be:
~ In six weeks for a vaginal delivery, unless otherwise specified at the time of discharge.

~In 1-2 weeks, if you had a C-section, for an incision check. You will then have another appointment 4 weeks later for your 6 week post partum exam.

Call the office if you have...

Signs of mastitis including: reddened, hard, and exquisitely tender areas to the breast accompanied by a fever greater than 100.4.
Excessive vaginal bleeding greater than 1 soaked pad per hour. (You will have vaginal bleeding for 4-6 weeks after delivery. This may slightly increase 2-3 weeks after delivery, but will then taper off.)
An exquisitely tender abdomen accompanied by a fever greater than 100.4.
Any signs or symptoms of post partum depression.
For C- section patients
~ Any opening of your incision
~Any drainage from your incision that is excessive, or any pus coming from the incision.

Medications:
Percocet, 1-2 tablets every 4-6 hours as needed for pain.
Ibuprofen 600 mg every 6 hours as needed for pain.
For constipation: Colace, Milk of Magnesia
Continue your prenatal vitamins as long as you are breast feeding or for 30 days after delivery.
For hemorrhoids, use Tucks pads, Preparation H, Proctofoam as needed.
For cracked/sore nipples you may use Lanolin cream. 





Episiotomy and Laceration Care

“Sitz Baths” (simply sitting in a tub of warm water 15 minutes, 2-3 times per day) can help to relieve discomfort resulting from lacerations. Additionally, Tucks pads. Witch Hazel and Lanacaine, may be applied to the external vaginal area as needed. You may also use oral pain medications as described above. Stitches will dissolve in 1-6 weeks. You will be more comfortable if you are not constipated; please follow directions above to prevent/treat constipation.


Hemorrhoids

Sitz baths, as described above, can help alleviate hemorrhoid pain as well. You can aso use topical agents such as Tucks pads, Witch Hazel pads, or Preparation HC. Actively prevent constipation.

Reasons to Call Your Physician
Fever greater than 101
Cesarean incision that is red, draining or increasingly painful
Signs of a breast infection: red and painful area on your breast, especially if associated with fevers greater than 101 and/or flu-like symptoms
Foul- smelling vaginal discharge
excessive vaginal bleeding (see above section on vaginal bleeding)
Swollen, red, painful area on your leg
Chest pain
Persistenly painful urination or inability to urinate
Worsening vaginbal or rectal pain
Persistent headache not relieved with pain medication, changes in vision, and severe right sided painThe more you understand your body and how it functions, the better equipped you'll be at taking care of yourself to achieve optimal health. We've included the Patient Education section on our website to provide you with valuable, practical wellness information which you can incorporate into your lifestyle to improve the quality of your life. We hope you will turn to these pages whenever you have a question about health related issues and urge you to contact our practice at any time to make an appointment with one of our doctors. 

Hormone replacement therapy is a medical intervention designed to boost a woman's hormone levels. As women get closer to menopause (the average age at onset is 51), their naturally occurring hormone levels ­- particularly estrogen and progesterone ­ decrease considerably. This deficiency can bring on uncomfortable symptoms such as hot flashes, night sweats, painful intercourse due to vaginal dryness, mood swings and problems sleeping. The prospect of osteoporosis ­- a loss of bone density ­- also increases. Menopausal hormone therapy (MHT) works to reestablish those hormone levels, which can curtail the negative side effects and help to prevent osteoporosis.

Estrogen/progesterone therapy is appropriate for women who have reached menopause naturally. These therapies work best for women who are having severe menopausal symptoms or those who are genetically predisposed to osteoporosis. Women who have a history of breast cancer, heart or liver disease, and blood clots are not good candidates for MHT. Both treatments are available in a variety of forms: pills, patches, and gels. For those with predominantly vaginal symptoms, topical creams and intravaginal rings can be prescribed.

Health professionals recommend that all women use the lowest dosage possible, for the shortest amount of time possible. Long­-term, high-­volume doses have been associated with an increased risk of breast cancer and heart disease. Talk to your doctor about whether hormone replacement might be right for you.