Deborah Wilson, MD and Associates

Practice Highlights

Given that there have been many changes in our practice over the past year, we wanted to give you some highlights regarding our current offerings.

Dr. Alexandra Kidd is taking new patients and is also happy to see established patients for annual examinations or problems. She is a skilled and experienced laparoscopic surgeon with years of experience. She also has special interests in menopause and hormone therapy, cervical dysplasia, sexually transmitted disease, and birth control issues. So far, the patients who have seen Dr. Kidd are thrilled with her enthusiasm and her expertise. We welcome Dr. Kidd to the practice and encourage you to make an appointment with her yourself or refer a friend. You will not be disappointed.

Dr. Debra Wickman has done a fellowship in sexual medicine. She is happy to see patients who are experiencing challenges in the area of sex and intimacy. She also sees general gynecology patients and is an expert in office-based procedures such as Essure permanent birth control, endometrial ablation for heavy bleeding, and labial reduction.

Barbara Passaretti RN, BSN has joined Skintique MD. We are very excited to have her on our team as she is a highly skilled injector and has advanced training and certification in dermal fillers including Dysport, Restylane, Perlane, and Radiesse.

Skintique After Hours is a division of our practice that offers sexual aids and lubricants to enhance intimacy and sexual pleasure. Log onto http://www.skintiquemd.com/Skintique_MD_After_Hours.html for our exciting offerings! Life is short...why not have a wonderful sex life for all of it!

We do take drop-in patients during office hours. If you have an emergency, we will see you. Guaranteed. We are generally in the office 6 days per week. It is, of course, best to call the office for an appointment, but if you need to be seen unexpectedly we are there for you.

We are open most Saturdays for new appointments, annuals or problems. Saturday is a great time for working women to take care of their gynecologic needs.

2010 Top DocDr. Wilson is now teaching laparoscopic hysterectomy nationally. Her monthly courses for physicians wanting to learn her techniques are booked months in advance. Dr. Wilson was voted "Top Gynecologist in Phoenix" by her colleagues in a Phoenix Magazine survey in 2010. If you are in need of surgery and want a true expert, please make an appointment for a consultation. Dr. Wilson is happy to offer second opinions regarding hysterectomy, especially if you (or a friend or family member) have been told that you need a large incision to accomplish a hysterectomy. Dr. Wilson can usually offer these patients a minimally invasive alternative that will result in less post-operative pain, minimal blood loss and faster return to normal activities.

Robin Parry, RN, FNP is offering testosterone pellets for men who are aging and experiencing symptoms of low testosterone such as fatigue, low sex drive and decreased muscle mass. Send your favorite man in for a consultation with Robin!

We offer in-office endometrial ablation for patients who bleed heavily and want to decrease or stop their bleeding, Essure permanent birth control for patients desiring sterilization and labioplasty (surgical reduction of large labia) for patients who are uncomfortable with the size of their labia. In-office procedures are faster, more comfortable and more efficient. Call for an appointment for a consultation.

We are glad to see young patients who need non-traumatic first examinations, birth control guidance or instruction regarding tampon use.

We specialize in menopausal patients and their unique issues. Many of us are menopausal ourselves and we appreciate the special concerns menopausal women have. We offer Balance Hormone Pellets to our patients who are suffering with severe menopausal symptoms such as hot flashes, night sweats, insomnia, and low (or nonexistent) sex drive. We believe that women should experience vitality and aliveness for ALL of their years. We also believe that women should be able to fully enjoy sex and intimacy after menopause. Come in for a consultation with any of our practitioners if you are suffering with menopausal symptoms or lack of libido...we can help.

HOTFLASH!
By Belinda Barclay-White, MD, Arizona Breastnet

Many of you asked me this week about the much publicized new study indicating women who take estrogen and progestin hormone replacement therapy not only had a significantly increased risk for invasive breast cancer (we knew that from the 2002 WHI study), but also had more lymph node involvement and were twice as likely to die of their disease.

This study evaluated 90,000 women over 11 years. 81 women, or 23.7% had positive nodes if they were on combined therapy versus 43 women, or 16.2% who tested positive on the placebo (no therapy). Twice as many women taking estrogen and progestin died from breast cancer (2.6 per 10,000 per year compared to 1.3 per 10,000 per year if on a placebo.)

Women on estrogen alone had no significant increase in breast cancer rates compared to women on no hormone replacement. Estrogen users did have a decreased risk for heart attack and osteoporosis.

While researching these numbers, I was amazed to come across the E3N French cohort study completed in January 2008! This study never reached our medical journals, at least not the breast journals I read, and I have been anxiously awaiting a study that separated progestin, or synthetic progesterone from bioidentical progesterone.

This study looked at close to 80,000 postmenopausal women over an average time of 8 years. It showed no increased risk in women on estrogen alone and NO INCREASE IN WOMEN ON ESTROGEN AND BIOIDENTICAL PROGESTERONE. It showed a significantly increased risk for breast cancer in women taking estrogen and synthetic progesterone (progestin). Many of our doctors do not distinguish between progestin, which is known to be more like testosterone and progesterone, which is what our body produces naturally.

Discuss this study with your doctor if you are on a combination HRT. Unfortunately, women need progesterone to protect the uterus from the effects of estrogen which can cause irregular bleeding at the least and cancer of the uterus if taken alone.

The decision to take HRT is a personal one. Menopausal symptoms and quality of life after menopause have to be weighed against the small but significant risk of HRT. If you are on HRT or considering your options I hope this information has been helpful.

Why, Why Am I So Dry?

As women age and enter menopause, the ovaries produce less and less estradiol and testosterone. The plummeting levels of hormones produce hot flashes, night sweats, insomnia, decreased libido, and reduce significantly the amount of lubrication the glands in the vagina produce. This makes sex not so fun and in some instances actually painful. For many women, intercourse becomes impossible.

Let's face it, sex drive and sexual function in general are there for one evolutionary purpose — procreation. We are not meant to procreate after the age of 45 (or so). So nature does not think we need our hormones. But wait, we still enjoy sex and we don't want to give it up!

In order to compensate for the lack of hormones we must take steps to counteract the natural processes such as vaginal dryness, decreased vaginal elasticity and lack of libido.

Adding hormones to the system goes a long way towards replacing sex drive and increasing elasticity. But even the best hormones we have to offer do not seem to replace the vaginal lubrication we all counted on in our younger days.

The bottom line is that most women who are either peri-menopausal or menopausal need extra lubrication in order to truly enjoy sex. There are many lubricants on the market and the technology has advanced greatly in the last few years. In other words, we have come far from the days when "K-Y jelly" was the only option.

Now we have lots of choices in lubricants — water based, silicone based, flavored, "hot", etc. Some lubricants are even especially made for sex toys!

We have researched and discovered a line of lubricants called "Pink". Our "testers" cannot say enough about how wonderful these lubricants are and what a difference they make. Here are a few of the comments:

  • "I can't believe how sensual the silicone Pink makes me feel. It is like liquid velvet. My husband and I won't travel without it!"
  • "My partner and I struggled with intercourse for years. I always felt dry, which made sex so painful I didn't have any interest in it at all. When we discovered Pink, our wonderful sexual connection was rejuvenated."
  • "We have used lubricants for years, but Pink is by far the best we have tried. It is slippery, but not too much. We like the Hot Pink the best."

pink

Water based Pink is non-sticky and creates a delightful glide which is sexually stimulating to men and women. It lasts longer than other water based lubricants that tend to dry out. It is safe for use with condoms and toys.

The silicone based Pink is even more slippery, and does not dry out at all. It has a delightful, sensual feel to it that is again very stimulating to men and women. Because it does not dry out, no re-application is needed even during long love-making sessions. Silicone based lubricants should not be used with condoms or silicone sex toys, however.

Hot Pink is silicone based pink with a little tingle that many people find,.....well, hot! It is exothermic, which means that it throws off a little heat. Try it!

Frolic is specifically designed for use with toys. This unscented, water-based and glycerin free formula provides incredible thickness to get the lubrication where you need and not everywhere else. The infused Grapefruit Seed extract provides anti-bacterial, anti-fungal, and anti-viral properties.

Come by either office and try all 4 varieties of Pink. We think you will find that the addition of lubricants makes love making much more pleasurable and stimulating!

Robin Parry, FNP-CAre Your Periods Irregular?
By Robin Parry, FNP-C

Polycystic ovarian syndrome is an endocrine disorder that affects many women. The symptoms of PCOS can vary from woman to woman. Some of the symptoms of PCOS include:

  • Infertility (not able to get pregnant) because of not ovulating. In fact, PCOS is the most common cause of female infertility.
  • Infrequent, absent, and/or irregular menstrual periods
  • Hirsutism (HER-suh-tiz-um) – increased hair growth on the face, chest, stomach, back, thumbs, or toes
  • Cysts on the ovaries
  • Acne, oily skin, or dandruff
  • Weight gain or obesity, usually with extra weight around the waist
  • Male-pattern baldness or thinning hair
  • Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black
  • Skin tags – excess flaps of skin in the armpits or neck area
  • Pelvic pain

How do I know if I have PCOS?
There is no single test to diagnose PCOS. Your healthcare provider will take the following steps to find out if you have PCOS or if something else is causing your symptoms.

Medical History. Your healthcare provider will ask about your menstrual periods, weight changes, and other symptoms.

Physical Exam. Your healthcare provider will want to measure your blood pressure, and also check the areas of increased hair growth. You should try to allow the natural hair to grow for a few days before the visit.

Pelvic Exam. Your healthcare provider might want to check to see if your ovaries are enlarged or swollen by the increased number of small cysts.

Blood Tests. Your healthcare provider may check the androgen hormone and glucose (sugar) levels in your blood.

Vaginal Ultrasound (sonogram). Your healthcare provider may perform an ultrasound to take evaluate the pelvic area. It might be used to examine your ovaries for cysts and check the endometrium (en-do-MEE-tree-uhm) (lining of the womb). This lining may become thicker if your periods are not regular.

How is PCOS treated?
Although there is no cure for PCOS, it needs to be managed to prevent problems. Treatment goals are based on your symptoms, and there are many factors to consider with treatment, including whether or not you want to become pregnant. (womenshealth.gov)

Minimally Invasive Hysterectomy is Officially the Procedure of Choice

AAGLThe American College of Obstetrics and Gynecology and Advancing Minimally Invasive Gynecology Worldwide Society agree that minimally invasive approaches should be the procedures of choice for hysterectomy. The recommendation is that doctors either learn how to perform minimally invasive hysterectomy, get someone to help them, or just refer to a Gynecologist who has the skill to perform the surgery.

Currently, more than 600,000 hysterectomies performed annually in the United States are done through a large abdominal incision despite the availability of less invasive laparoscopic and vaginal approaches which are associated with a decreased complication rate, faster recovery, and lower cost.

An official strongly worded statement advised that abdominal hysterectomies be limited to only a few specific, defined circumstances.

Dr. Wilson and Dr. Kidd are experts in minimally invasive surgery. Dr. Wilson teaches laparoscopic hysterectomy nationally and was voted the top Gynecologist in the Phoenix area by her colleagues last year. Dr. Kidd and Dr. Wilson believe that almost any woman is a candidate for a minimally invasive approach to hysterectomy.

If you need gynecologic surgery or a friend or family member needs surgery, please advise them to seek a Gynecologist who is experienced and comfortable with minimally invasive surgery. The incisions are smaller, the recovery faster and less painful, and the complication rate is lower.

In this day and age, there is very little place for abdominal hysterectomy.

Debra Wickman, MD, FACOGDebra Wickman, MD, FACOG

I attended University of Washington for medical school and residency, and have been Board-certified in Obstetrics and Gynecology for over ten years. When I finished my training, I felt proficient in dealing with the range of medical problems in providing health care to women. However, I soon discovered that there was a significant gap in my knowledge about female sexual function, and how to help women with those issues that affect their physical health, mental well-being, and relationship dynamics. I spent a year at UCLA and completed a fellowship in female sexual medicine in an effort to bridge that gap.

The past ten years have seen a great deal of progress in the field of female sexual medicine. We have a society – the International Society for the Study of Women's Sexual Health, that addresses the needs of providers in this field – and it is really a multidisciplinary field, with physicians (gynecologists, urologists, psychiatrists, family doctors, internists), psychologists, sex therapists, nurse practitioners, physician assistants, pelvic floor physical therapists, all devoted to helping women improve their sexual health. We have seen more research in testosterone use for women, and now have a better sense of what serum levels are associated with better sexual response and sense of well-being for women. We know that greater than 40% of women in the United States report distress about some aspect of their sexual function – most commonly low desire. The media has also been helpful in normalizing discussion about sexual issues – shows like "Sex and the City" have broached topics from oral sex to vibrator use, and eased some of the discomfort women may have had in asking for help with their problem, or answers to their questions.

There are many products available to help with sexual function in women. Vaginal moisturizers and lubricants are important for comfortable activity. Sexual accessories like clitoral stimulators and vibrators are helpful to develop/maintain the orgasm reflex. It is a myth that a woman may get "addicted" to the vibrator, and it can actually be an essential part of sexual interaction for women and couples. We are adding a new feature to our Practice – in that now you can purchase products that we recommend, in the office, or on-line. We will continue with educational features in our newsletters, and I will be happy to discuss products or answer questions regarding your own personal difficulties. Please make an appointment for a consultation.

Skintique After Hours

Pink ProductsWe offer sexual aids such as lubricants and stimulators to increase your sexual pleasure. You may purchase these discreetly on line or in the Skintique office.

Q. Why offer these products?

A. Because women want to be able to purchase sexual enhancement products from a reputable source with the knowledge that the products are tested and reliable. We encourage women to fully express their sexuality, either alone or with a partner. Lubricants and stimulators are helpful in enhancing sexual pleasure.

Q. Why would a woman want to use a stimulator or vibrator?

A. Frankly, because it feels good. Orgasm is easier to achieve with vibrators and intercourse or masturbation are more pleasurable with lubricants, especially for the peri-menopausal or post-menopausal woman. Many couples (or single women masturbating) find toys and lubricants fun and stimulating.

Isla

Q. How do I know what to buy?

A. Our Director of Skintique MD can help you with these decisions.

Infertility (C) Rogers FamilyInfertility

It is estimated that infertility affects as many as 1 in 6 couples. According to the American Society of Reproductive Medicine, one-third of infertility cases are female factor related, one-third are male factor, and the remaining third involve problems on both sides, or unexplained causes. Understanding what causes infertility is the first step towards finding the right treatment plan. Some infertility evaluation and diagnosis topics include:

  • Menstrual
    • Menstrual Irregularities
    • Menopause/Perimenopause (early)
  • Ovarian
    • Polycystic Ovarian Syndrome (PCOS)
    • Premature Ovarian Failure Syndrome (POF)
    • Diminished Ovarian Reserve
  • Uterine
    • Endometriosis
    • Fibroids
    • Recurrent Miscarriage
  • Genetic Factors
  • Male Factor

If you, or someone you love, have been trying to conceive unsuccessfully for over 6 months, you should consult your practitioner. Consult your practitioner sooner if:

  • Your menstrual cycles are infrequent
  • You have a history of irregular or painful menstrual cycles, pelvic pain, endometriosis, pelvic inflammatory disease (PID) or repeated miscarriages
  • Your male partner has a low sperm count or a history of testicular, prostate or sexual problems

Susan MenolaSkintique MD — Dr. Wilson and Associates' very own skin care department.

Visit us on-line at www.skintiquemd.com or call 480.860.9383 for a free consultation!

It's a New Year and we have a lot of new and exciting news to share with you..

First, I would like to announce that Barbara Passaretti RN, BSN has joined Skintique MD. We are very excited to have her on our team as she strives to provide the highest level of care possible to help her clients achieve their fullest potential in the treatments they choose.

RestylaneBarbara brings with her (20)+ years nursing experience and is a speaker and consultant in medical ethics. She is a highly skilled injector and has advanced training and certification in dermal fillers and neurotoxins including Dysport, Restylane, Perlane, and Radiesse.

Her philosophy in medical aesthetics is a results-driven approach individualized for each client's priorities and needs. She is a member of the National Medicis Nurse Advisory Board and conducts injector training for physicians and nurses. Please call Barbara for a free consultation at 480.860.9383.

What's new on www.skintiquemd.com? Visit Skintique MD After Hours to Enhance Lovemaking.

Dr. Wilson and Dr. Wickman address some common and frustrating issues we encounter as we go thru life. We also have products and solutions that can help you enjoy and have fun with your sexuality.

Introducing our new Lumenis Acupulse FX Fractional Treatment

Results 5 days after treatment:Introducing our new Lumenis Acupulse FX Fractional TreatmenOur practice prides itself in offering leading-edge technology to enhance the results of the aesthetic services we provide. Total FX provides a low-density Co2 "fractional" laser resurfacing procedure ideal for smoothing fine lines, uneven pigment and tightening sagging skin. Most patients achieve remarkable results with only a single treatment and typically experience only 3-5 days healing time - in essence a long weekend. Special advanced technology gives the laser the added benefit of stimulating the formation of new, underlying collagen2, which provides better elasticity and support for the skin and continued improvement in skin texture for up to six months after treatment. Total FX has already helped thousands of patients. And it is now available exclusively at Skintique MD.

Does the DaVinci Robot Approach to Surgery Offer Any Advantages to the Patient?

In short, the answer is no.

Laparoscopic surgery is a skill that takes extensive training, practice, and talent to perform.It involves intricate hand-eye coordination and an ability to "feel" tissue through instruments instead of directly through fingers. As with any other technical skill, some people are simply better at it than others.

Mininmally Invasive SurgeryA laparoscopic hysterectomy generally involves 3 small incisions. Most laparoscopic hysterectomies take significantly less than an hour to perform unless there are adhesions or other complicating factors.

A robotic hysterectomy requires at least 4 incisions, the incisions are larger, and the operating time is much longer. Using the robot also adds significantly to the cost of the procedure.

The DaVinci robot is useful in cases of cancer, where intricate node dissection is necessary.

For a benign hysterectomy, it is simply not necessary.

Some surgeons who have difficulty mastering laparoscopic technique find it useful to help them suture and dissect tissue. It allows these surgeons to offer patients a minimally invasive option as an alternative to a larger incision and this is a good thing.

In this practice, we choose not to offer robotic hysterectomy because the surgeons simply do not need the robot to perform a minimally invasive, effective, successful surgical procedure with minimal operating time and fewer, smaller incisions

If you have further questions about laparoscopic surgery, please feel free to schedule a consultation with either Dr. Wilson or Dr. Kidd.

Circle L Ranch Animal Rescue Benefit Concert 02/17/11

Join us February 17from 6pm - 9:30pm for a concert featuring Rhythm Edition and two additional original acts at the Mesa Community College - Kirk Student Center - Navajo Room.

To learn more, visit us on Facebook and share with your friend.

Proceeds benefits Circle L Ranch and Lucky Paws animal rescue shelters.

Circle L Ranch and Lucky Paws Shelter