What is Menopause?

With over 30 years of experience, Dr Keith Reisler provides women in Plano, TX with care specific to them. Areas of concern for Keith Reisler MD include pregnancy and menopause.

Menopause refers to the time period when the levels of estrogen and progesterone, hormones controlling many aspects of a woman’s bodily functions, are significantly lower than earlier in life. The exact age a woman begins menopause varies, because the premenopausal, transitional period, begins between 45 and 55 years old. The transitional period lasts between seven and 14 years, and during this time, estrogen and progesterone production fluctuate. Menopause formally begins at least 12 months after a woman’s last period.

Menopause symptoms vary between individuals, and they manifest unpredictably, so a woman may experience symptoms at different severities, and at random times. The most noticeable change is a change in the menstrual cycle, where periods no longer occur periodically, and their flow is greater or lesser than normal. Some women may also experience hot flashes, a sudden feeling of heat in the upper or whole body, that may also result in sweating and shivering. Combined, menopausal symptoms may cause a reduction in sleep quality that a doctor can address with medication or lifestyle changes.

An Overview of a Hysteroscopic Resection

Serving women in Plano, TX, Dr Keith Reisler has decades of experience meeting their specific needs. In addition to his work in pregnancy care and menopause Keith Reisler MD performs a procedure called a hysteroscopic resection. A hysteroscopic resection is a minimally-invasive surgical procedure with benefits absent from other surgeries that fulfill the same purpose.

A hysteroscopic resection, also called a Transcervical Resection of Fibroids (TCRF), is a procedure where the surgeon removes fibroids, growths inside the uterus. An instrument called a hysteroscope removes the fibroids gradually. Inserted into the body through the cervix and offering a visual of the uterus via an attached camera, a TCRF is minimally-invasive because no surgical incisions occur.

To prepare for the TCRF, the patient will undergo an ultrasound, to locate the fibroid. If it is large, the surgeon will remove it in two separate surgeries, spaced between six and eight weeks apart. Performed while under general anesthesia, the patient usually experiences little to no pain and an average recovery time of one or two days.

Factors That Increase Pregnancy Risk

Dr. Keith Reisler is an MD and a fellow of the American College of Obstetrics and Gynecology. Based in Plano, TX, Dr. Keith Reisler believes in complete collaboration between doctor and patient to make the most appropriate medical decisions for the patient during pregnancy. Keith Reisler, MD, a board-certified obstetrician and gynecologist, believes in providing comprehensive services that encompass diagnosis and treatment of all gynecologic problems, including high-risk pregnancy care.

A pregnancy is categorized as high risk when potential complications exist or arise that could impact the baby, mother, or both. Factors that make a pregnancy higher risk include the following.

Pregnant women with infectious diseases, diabetes, high blood pressure, and autoimmune diseases such as lupus and multiple sclerosis (MS) are at risk of complications and need special care. For example, chronic high blood pressure puts the patient at an increased risk for preterm delivery, a low birth weight infant, and preeclampsia during pregnancy.

Problems can also arise that are pregnancy-specific, including fetal problems like structural anomalies and growth abnormalities. Compared to older women, pregnant teenagers are more prone to develop pregnancy-related anemia and high blood pressure. These complications can induce preterm labor and delivery.

Alcohol consumption during pregnancy also increases the risk of sudden infant death syndrome, miscarriage, stillbirth, and fetal alcohol spectrum disorders (FASDs). Children with FASDs may be born with abnormal facial features and other complications.

Benefits of Invasive Hysterectomy

Keith Reisler, MD, is an obstetrics and gynecologist physician and practices at his clinic, Keith Reisler, MD PA. Dr. Keith Reisler has been a member of several professional associations such as the American Association of Gynecologic Laparoscopists. Operating out of Plano, Tx., Keith Reisler, MD, did his ObGyn residency training at the University of Texas Southwestern Medical School/Parkland Hospital. He has specialized training in minimally invasive procedures such as laparoscopy and laparoscopic hysterectomy.

In minimally invasive surgical procedures, doctors employ advanced techniques and robotics to operate. It gives doctors greater vision and control during surgery for less invasive, safer, and precise surgical outcomes. Minimally invasive surgery is generally less risky as the surgical incisions are smaller. Typically, in traditional open surgery, to access the body part or organ being operated on requires larger incisions. A traditional open hysterectomy, for example, requires a six to 12-inch incision.

Patients have less discomfort and pain than those who undergo open surgery. Often, there is less trauma during minimally invasive surgery, which might explain having less pain. In addition, smaller open wounds reduce the risk of bacteria and infection.

Contraceptives as Treatments for Endometriosis

The former chief of a department of obstetrics and gynecology and an American Board of Obstetrics and Gynecology Diplomate, respected physician Dr. Keith Reisler specializes in the diagnosis and treatment of mild to severe gynecological disorders. Plano, TX gynecologist Keith Reisler, MD is a leading expert in effective endometriosis treatments, including operative laparoscopy and hysteroscopy as well as hormonal contraceptives.

Endometriosis, a painful condition caused by the growth of uterine tissue outside of the uterus, affects approximately 10 percent of American women. While there is no cure, symptoms such as intense cramping and long and heavy menstrual cycles can be minimized with hormonal contraceptives, including the three medications below.

Progestin-only pills - These contraceptives are composed of a synthetic form of progesterone, which thins the uterine lining over time. Progestin pills can also reduce or eliminate menstrual cycles completely, helping patients avoid painful periods.

Mirena IUD - The Mirena IUD can reduce pain and blood flow during the menstrual cycle. Since IUDs can be effective for up to five years, Mirena may be a long-term solution for women experiencing heavy periods.

Depo-subQ Provera 104 - Depo-subQ, an injectable form of birth control, is FDA approved for treating several endometriosis symptoms, including painful periods and dyspareunia, or pain during or after sex. One shot is effective for up to three months and has minimal side effects.

How Frequently Should You See Your OB/GYN?

Keith Reisler, MD, studied medicine at the State University of New York Downstate Medical School. For three decades, Keith Reisler, MD, has functioned as an obstetrician and gynecologist (OB/GYN) at a private practice in Plano, TX.

When it comes to visiting an OB/GYN, there is no set frequency that can be applied to all patients. In the past, women have been advised to make annual visits to receive pelvic examinations and Pap tests. However, the United States Preventive Services Task Force, in partnership with the American Cancer Society and the American Congress of Obstetricians and Gynecologists (ACOG), issued a statement in 2012 stating that women between the ages of 30 and 65 who have received negative Pap test results in the past only require a combination Pap and HPV test once every five years but should continue to have a gynecological exam yearly. Some newer studies have indicated that some precancerous cells can be missed with every 5 year Paps and Dr Reisler still advises yearly Pap smears and insurance will cover this. Either way patients should still have a gynecological exam yearly.

Meanwhile, women over the age of 65 do not require Pap tests at all, assuming there is no history of cervical cancer or precancerous cell development. Furthermore, women over 65 must have received either three consecutive negative Pap tests or two Pap and HPV tests within a 10-year period. Once again Dr Reisler thinks this should be individualized and some women may want to continue more frequent Pap smears.

With that said, there is still value in annual visits to the OB/GYN. These benefits include discussions about diet and exercise, sexual practices, pelvic prolapse, and the onset of menopause symptoms. Individuals should express any questions or concerns with their OB/GYN to determine what schedule would best suit their needs.

About the AAGL Foundation

Working out of his own obstetrics and gynecology practice in Plano, TX, since 1988, Dr. Keith Reisler offers comprehensive women’s health care services. Outside of his daily clinical work, Keith Reisler, MD, keeps up with advances in his field and networks with colleagues through membership in multiple organizations. The American Association of Gynecologic Laparoscopists (AAGL) is an organization that allows physicians such an opportunity.

Founded more than 25 years ago as the charitable arm of the AAGL, the Foundation of the AAGL was established to advance the profession by providing funding for educational and professional development opportunities in minimally invasive gynecological treatments, and to encourage emerging technologies in the field. Specifically, the foundation offers scholarships, research grants, and funded teaching fellowships.

One of the foundation’s most prominent funds is the Fund for the Future, which awarded more than $250,000 in 2016-2017. The fund disseminates money to educational centers focused on teaching the most up-to-date techniques in the field. To learn more about the Foundation, visit aagl.org/service/foundation.