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For many women, taking time off work to see a gynecologist can be stressful and inconvenient. Whether you need routine care, contraceptive advice, or help managing a health condition, finding a gynecologist with evening hours can make it easier to stay on top of your reproductive health. With extended evening availability, you can access the care you need without disrupting your work schedule or daily routine.
Evening appointments are a game-changer for women who need gynecological care but struggle to find time during traditional office hours. These flexible hours make it easier to prioritize your reproductive health, whether it’s for an annual exam, birth control counseling, or managing a specific health concern.
At My Virtual Physician, we offer flexible telehealth appointments with board-certified gynecologists, including evening hours to fit your busy schedule. Whether you need routine care, contraceptive advice, or help managing reproductive health concerns, our virtual platform allows you to receive personalized care from the comfort of your home, at a time that works best for you.
Finding a gynecologist with evening hours doesn’t have to be a challenge. By using online resources, considering telehealth options, and verifying your doctor’s credentials, you can ensure your reproductive health remains a priority without disrupting your day.
To schedule an evening appointment, visit My Virtual Physician today and take advantage of expert gynecological care that fits your schedule.
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Syphilis is primarily a sexually transmitted disease caused by the bacterium Treponema pallidum (because syphilis is in the genus Treponema, it can also be called a “treponemal disease”; however, there are other treponemal diseases that are not syphilis). It is transmitted through the mucous membranes, broken skin, and direct mother-to-child infection during pregnancy. As such, unprotected sex (anal, oral, vaginal, or any other permutation that results in the exchange of bodily fluids) increases an individual's risk of contracting the disease. Similarly, risky sexual behavior and increased number of sexual partners also increase an individual’s risk of contracting syphilis (and other sexually transmitted diseases).
Syphilis typically presents in three distinct symptomatic stages, (described below) marked by potentially long periods of symptom-free remission between stages. If left untreated, the final stage is usually ultimately fatal. However, it can take up to several decades from the point of initial infection until an individual enters the third and final phase of the disease.
As mentioned above, syphilis commonly presents with three distinct symptomatic stages. These are commonly known as Primary, Secondary, and Tertiary syphilis. Each stage is marked by its own set of typical signs and symptoms of the underlying disease.
● Primary Syphilis usually presents as a single round, painless, firm lesion called a chancre. It usually appears around the genitals or anus, but can occur elsewhere on the body. It usually appears within three weeks of the time of the initial infection. Even if left untreated, the chancre will usually heal within three to ten days.
● Secondary Syphilis usually presents as a more diffuse non-itchy rash across the skin. One of the distinct features of secondary syphilis is that this rash often can involve both the palms of the hands and the soles of the feet. Even if left untreated, this phase will also usually resolve on its own.
● Tertiary Syphilis may occur multiple decades after the initial infection, if left untreated. It can cause diffuse damage throughout the individual’s body to multiple different organ systems, from bone to skin and so forth. However, what often ends up claiming the lives of the afflicted individuals is the damage done to their brain and cardiovascular system. If there is clinical suspicion of syphilis, the individual will still require additional laboratory testing to confirm the diagnosis.
Individuals infected with syphilis can still be accurately tested even if they do not have any active symptoms suggestive of syphilis. This is done by a combination of two blood tests:
1. A nontreponemal test, such as the Venereal Disease Research Laboratory (VDRL) or Rapid Plasma Reagin (RPR) test.
2. A treponemal test, such as the Treponema pallidum Passive Particle Agglutination assay (TP-PA), Enzyme Immunoassays (EIA), Chemiluminescence Immunoassays (CIA), or rapid treponemal assays.
A positive result for both the nontreponemal and treponemal tests is required for a diagnosis of syphilis. Additionally, if there is access to drainage or fluid from an open lesion, urinary discharge, or the tissue from a lesion, darkfield microscopy can be used to look for visual confirmation of the presence of Treponema pallidum (which appear as little white spirals under the microscope, hence their alternate classification as a “spirochete” bacteria).
As dismal and dire as untreated syphilis is, the good news is that syphilis is easily treatable and curable if caught before entering the tertiary syphilis stage of the disease. The mainstay of treatment is an injection of a long-acting form of penicillin called benzathine penicillin G. Because syphilis can be transmitted directly from mother to child during pregnancy, treatment with benzathine penicillin G is highly recommended for infected pregnant women to prevent congenital syphilis in the child. There is even evidence supporting additional treatment for pregnant women. However, because of the additional risks, this issue should be discussed with the woman’s obstetrician to decide on the best treatment plan and course of action.
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From a purely brass-tacks scientific perspective, syphilis is just the name given to a three-stage disease caused by the bacteria Treponema pallidum. It is essentially transmitted through mucous membranes or broken skin, which is why the overwhelming method of transmission is unprotected sexual contact and the risk goes up rapidly in proportion to riskier sexual practices and increased number of sexual partners. It is also worth noting that the sexual partners of people with a high number of sexual partners are also more likely to have an increased number of sexual partners themselves, thus compounding the increased risk of exposure to syphilis.
Syphilis can also be transmitted directly from an infected mother to her unborn child. The untreated disease usually progresses through three distinct stages, punctuated by periods of spontaneous remission (often mistaken for an actual resolution of the disease) in between. The first stage is usually a single, painless, firm lesion on the skin called a chancre (most commonly on the genitals or anus, but it can occur elsewhere). The second stage is usually a more disseminated rash across the skin, notable for its presence on the palms and soles of the feet. The third and final stage is usually characterized by diffuse systemic involvement, but most notably including severe damage to the central nervous system and cardiovascular system. This third and final stage may occur decades after the initial infection, and often results in the death of the individual.
The exact geographic origin of syphilis is still a widely debated subject. Some theories posit that it originated in the Americas and was brought back to Europe by Christopher Columbus’ crew. Others posit that it originated in Africa or the Old World. And others suggest that it was endemic globally. There is good evidence of treponemal disease (syphilis) in Native Americans prior to 1492, thus making the American origin plausible. However, there is also some evidence of treponemal disease in Europe prior to 1493 (when Columbus’ crew returned), although this evidence is not as strong and is disputed by many. There is also evidence that syphilis originated in either cattle or sheep and made a zoonotic transmission to humans. This, of course, raises the possibility of --to put it delicately-- let’s just say a rather unorthodox approach to “animal husbandry”. Although it is also plausible that the jump to humans could have happened through less disturbing means, such as butchering the carcasses of infected animals with broken skin.
Over the centuries, what we now call “syphilis” has gone by many names and has often been conflated and confused with other sexually transmitted diseases -- and even diseases such as leprosy and leishmaniasis. Our current name “syphilis” actually originated from a set of fictional novels written in 1530 by the Italian poet Girolamo Fracastoro called, “Syphilis sive Morbus Gallicus”. In these books, Fracastoro ascribes the origin of the disease to a curse placed on the people of ancient Greece because a shepherd named Syphilis refused to worship the god Apollo. As one might expect, there is rampant speculation about many prominent historical figures who are believed to have had syphilis, ranging from Leo Tolstoy and Friedrich Nietzsche, to Al Capone and Adolf Hitler.
The actual bacterium responsible for syphilis (Treponema pallidum) was not identified until 1905 by Fritz Schaudinn and Erich Hoffmann in Germany, and the first (moderately) effective treatment for syphilis did not come until 1910. It was an arsenic-based drug called arsphenamine and, while it was effective in the treatment of syphilis, it carried considerable downsides and adverse side effects -- as one would expect from a drug derived from arsenic! The real game changer for the successful treatment of syphilis came with the discovery of penicillin. Even though penicillin was discovered by Alexander Fleming in 1928, it was not mass produced and introduced to the American market until 1943.
While syphilis is a potentially fatal disease, the good news is that it can now be easily tested for and successfully treated with a single injection of long-acting penicillin. Recognizing the disease early is important and we will cover that in the next blog post.
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Both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have recently reported drastically increased rates of syphilis and, correspondingly, congenital syphilis recently. The WHO estimates that 7.1 million people globally acquired syphilis in 2020. The table below from the CDC shows a 78.9% increase in syphilis cases generally over the 5-year period from 2018 to 2022. Even more concerning, over that same 5- year period there was a 183.4% increase in congenital syphilis (that is, syphilis transmitted from an infected pregnant woman to her unborn child), and a 937% increase from a decade ago.
Among the greatest risk factors for syphilis are high risk sexual behaviors and a high number of sexual partners. However, what is surprising about the data is that the incidences of chlamydia and gonorrhea have remained relatively flat over that same 5-year time period. This would seem to suggest that there has not necessarily been an increase in risky sexual behaviors, but rather that the prevalence of syphilis has been increasing within the general population.
There are many potential reasons for this. One of the most commonly cited explanations by health organizations is insufficient testing for syphilis. One much less credible explanation given is a shortage of long-acting penicillin (trade name Bicillin) over the past year. While that might explain a rise over the past year, it does little to explain the rising trend over the 10 years prior. Moreover, there are other alternative treatments for syphilis, such as doxycycline.
One thing that is important to know about the disease course of syphilis is that it often has long periods where the infected individual may have no symptoms at all, and these periods can be up to decades long! Consequently, infected individuals who are asymptomatic are less likely to seek medical attention for testing and treatment. This, in turn, means that infected individuals could potentially be unwittingly transmitting the disease to others for years at a time before their syphilis symptoms recur and prompt seeking medical treatment. Syphilis is further complicated
by the fact that it can present in all manner of symptoms that one might not necessarily associate with a classic STD, thus leading to failure to successfully recognize and treat it. For this very reason syphilis is often colloquially called “the great imitator” amongst the medical community.
Greater awareness amongst both the general population and medical providers, combined with developing better and more frequent testing protocols would likely go a long way towards stemming the rising tide of syphilis. Successfully squelching syphilis need not be a Sisyphean task.
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Every girl is taught from a very young age that wiping after using the bathroom should always occur from front to back. But for some women, that’s as far as the vaginal health lesson goes. One piece of evidence that supports that we need better vaginal health education is that one in five women in America is still using douching for vaginal cleansing, a practice that can actually be harmful to a woman’s reproductive system.
How would you know any better? If you’re like most women, you’ve kind of just figured out what works for you and what causes problems. Or maybe you’re still having problems and didn’t realize the cause. Either way, we’re going to cover 5 tips to keep your vagina healthy and happy.
Many products in the period aisle have both a scented and unscented version. There’s a reason for that. While it sounds like a good idea to freshen up your natural vaginal scent with a perfume-infused tampon, pad, or liner, it can wreak havoc on your natural pH balance and cause irritation. So our first tip is to always go for the unscented version. Your vagina is self-cleaning but when you begin adding extra chemicals and scents, it can interrupt the natural process.
Related: How Your Body’s pH Levels Can Affect Your Health
Have you ever been taught how to wash your vagina? Probably not, but if you have, you might want to unlearn it. The vagina is self-cleaning. That means you do not need to wash inside the vagina, ever. Never use soap or insert any products, like douches, into the vagina for regular washing. The vulva, on the other hand, is the visible portion of a woman’s genitalia and it does require regular washing during showering with plain water or a very mild, pH-neutral soap.
If you are using a lubricant for sex, be sure to check the ingredients. Using a lubricant with unnatural added chemicals, flavors, or dyes can throw off your vagina’s healthy status quo. For example, some lubes contain a chemical called glycerin, which is a sugar-based food source for bacteria. Another chemical that should be avoided is petroleum which can affect pH. Here’s a list of chemicals to avoid and why:
Instead, opt for a natural lubricant like silicone-based or coconut oil. Be sure to verify compatibility before using with any sexual pleasure toys or condoms.
Everything you put into your body can affect your overall health so of course, optimizing your food choices can improve your vaginal health. But which foods keep your sensitive lady parts happy and functioning and which ones can be irritating and throw things off-kilter?
Eating fermented foods with probiotics, like yogurt, sauerkraut, or kefir, can help maintain healthy flora by keeping the right kinds of bacteria in the body. One thing to keep in mind with these foods is the sugar content. Avoiding too much added sugar is important for vaginal health because bacteria feed on the sugar.
Vaginal dryness can sometimes be improved with the addition of healthy fats. Here are some foods to try:
Alcohol and nicotine can also negatively impact your sex drive as well as your vaginal health. Limiting their consumption may help improve any vaginal issues.
Our final tip for optimal vaginal health is to stay on top of your regular annual screenings and exams. Women who are sexually active with multiple partners should be tested annually for STIs and all women should have an annual wellness checkup. Never ignore signs or symptoms. If you’re having discomfort or irregularities, your vagina is trying to tell you that something is wrong. Seeing your online OBGYN regularly is critical to maintaining your reproductive health.
Related: The Importance of STD Screening with a Virtual Doctor
Keeping your vagina happy can improve your overall outlook on life. If you’re experiencing discomfort “down there,” it can be a big disrupter. Following the tips provided above should help to maintain optimal vaginal health.
If you’ve tried these tips and are still experiencing odor, discomfort, discharge, irritation, irregular bleeding, or other symptoms, book an appointment online today with My Virtual Physician’s board-certified OBGYN, Dr. Howard, so we can help to get your vaginal health back to normal.
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One in five Americans face poor access to medical care. In some parts of the country, there are serious shortages of doctors and healthcare services. And this is the case for many women living in Georgia.
Georgia has been greatly affected by a nation-wide healthcare shortage. The need for care, specifically women’s healthcare, has increased dramatically over the past decade. Especially in the rural areas outside of major cities, Obstetrical and Gynecological (OB/GYN) services can be hard to find. Fortunately, My Virtual Physician (MVP) has been able to fill the need for some.
Why is there such a need for OB/GYN services in Georgia? And what can be done about the problem? Here's a closer look at the problem.
According to the Georgia Board for Physician Workforce, the state has:
Hence, the lack of doctors is part of the issue. Some women have no choice but to travel to other cities for care. And others even go without.
In many rural areas, there are no OB/GYNs. And in other parts of Georgia, facilities are closing. According to Becker’s Hospital Review, over 100 hospitals have closed during the past decade. Georgia ranked third for most hospitals closed, behind Texas and Tennessee.
To sum it up, a lack of doctors and hospitals is one piece of the puzzle.
Finding a doctor is one problem. But paying for services is another. Many women in Georgia do not have health insurance. Notably, Georgia's insured rate is ranked 48th in the nation.
Another problem is the state's low high school graduation rate. Lack of education is a barrier for access to healthcare. Women struggling with their health may not know where to go for answers.
Speak to one of our board certified OB/GYN virtual doctors today:
Birth control, sexual health, and menopause are sensitive topics. Women need doctors they can trust. OB/GYNs help women through complicated health changes.
OB/GYNs can treat common problems such as:
In addition to new or worrisome symptoms, gynecologists also provide preventative health services.
For example, OB/GYNs encourage women to have breast cancer screenings after age 45 and bone density scans every two years following menopause.
Without regular checkups, women may face major health concerns as time goes on.
Despite the dismal circumstances, care for women in Georgia and other states is changing.
Telemedicine providers offer a new solution. Board-certified OB/GYNs are treating women in Georgia virtually.
According to the American College of Obstetricians and Gynecologists (ACOG), patients can get the same quality care via telemedicine as they would in person. In some cases, patients say their online doctor experience is even better.
Online doctor appointments are affordable and easy to schedule. As well as that, virtual gynecology visits provide a greater sense of safety and security from the comfort of home.
It is getting easier for the women of Georgia to see top-rated doctors for the virtual gynecology care they need. Dr. Howard of MVP treats patients across the U.S., including Georgia. MVP is a multi-state, multi-specialty telemedicine provider that is quickly becoming the preferred choice for many.
Women who want an online gynecology appointment can text the office at 725-228-8277 or visit the patient portal to set up self-scheduled appointments.
My Virtual Physician offers comprehensive virtual gynecology services to address women’s healthcare needs. Our caring doctors can talk with you about your concerns and provide the experience you've been looking for.To talk with one of our expert physicians near you, book an appointment today.
Women looking for a great Obstetrics and Gynecology provider (OB/GYN) in Las Vegas, Nevada, may have trouble. There is an OB/GYN physician shortage in Las Vegas. And the situation is getting worse.
Factors such as physician burnout, population growth, and competition from other parts of the country have created a shortage of OB/GYNs in Las Vegas, Nevada. As a result, some may have difficulty finding the perfect provider to care for their reproductive health.
Women and their partners want an OB/GYN they can trust. Issues like birth control, childbirth, and menopause are delicate matters. Unfortunately, a shortage means there are not enough providers to meet Las Vegas’ needs. Thus, those doctors who are available may be overworked or stretched thin.
Here is why it’s hard to find a good OB/GYN in Las Vegas and what to do about it.
When there are too few doctors to meet a city's demands, it can be hard to find a provider to respond to each patient’s needs. According to NBC News, America is facing an OB/GYN shortage.
Las Vegas, overall, has the most severe OB/GYN workforce shortage.
Other parts of Nevada face an even more serious situation. Some counties lack even one OB/GYN provider. Hence, patients face delays in care. In some cases they are forced to look far away to find a doctor.
Here’s why it is hard to find OB/GYN care in Las Vegas.
And while Las Vegas OB/GYNs may have it rough, the patients suffer too.
OB/GYNs offer services that women need. They provide health counseling, sexually transmitted infection (STI) testing, and more. From puberty to menopause, women need a health expert they can trust. Many patients depend on OB/GYN advice.
Fortunately, Las Vegas residents can now find the best OB/GYNs, right in their neighborhood.
My Virtual Physician has an answer for the physician shortage crisis. Two of the best board-certified OB/GYNs in the nation are on staff and available for appointments near you in Las Vegas.
My Virtual Physician offers OB/GYN visits in Las Vegas with flexible scheduling through telemedicine. While most providers are busy and feel the pressure to treat many patients quickly, My Virtual Physician is different. Online video visits eliminate travel time and the feel of a busy waiting room. Virtual consultations provide a relaxed, personalized, and patient-centered care experience.
During the pandemic, many patients have had questions about staying safe. Some want to know if vaccination is right for them. Women in Las Vegas can now book a visit with My Virtual Physician to discuss their concerns and get real medical advice. Booking an appointment with an OB/GYN in Las Vegas has never been easier.
Are you looking for an OBGYN near you in Las Vegas? My Virtual Physician has two board-certified physicians licensed in Nevada who can address gynecological problems via video visits.
If you would like to talk with a board-certified OB/GYN, you can schedule your appointment online now. My Virtual Physician offers health screening, lab tests, and counseling to meet all of your healthcare needs.
Menopause is manageable. If you or someone you know is going through this stage of life, you may be wondering how to manage menopause.
Menopause is a natural process that many people associate with uncomfortable symptoms. Many women report mood swings, hot flashes, night sweats, and weight gain. Despite the unpredictability, menopause is manageable. With a basic understanding and simple lifestyle choices, women can thrive during this time.
How do you manage some of the common complaints? Well, it helps to start with a grasp on what causes this change.
Menopause is a time in a woman’s life when the menstrual cycle stops. During this period, the ovaries produce less of a hormone called estrogen. Changing hormonal levels affect many body processes.
Three phases make up the process of menopause:
Premenopause (“pre” means "before"): years before periods stop, estrogen levels decrease and periods may become irregular
Perimenopause (“peri” means "around"): the ovaries lower estrogen production, and periods stop; when a woman has not bled in 12 months, she has reached menopause
Postmenopause (“post” means "after"): after menopause, symptoms become milder and less frequent
Menopause generally affects women in their 40’s or 50’s. Studies show that the onset age of menopause is affected by many factors, including genetics (age the mother began menopause), the number of pregnancies a woman has had, body mass index (BMI), physical activity, and other factors. The average age for menopause in the United States is 52.
Symptoms may last during the postmenopausal time for up to four or five years, but they will become lighter.
Menopause varies among women. Yet, many report some common symptoms.
Empowering women with understanding about the natural process, and recommending lifestyle changes known to improve signs and symptoms, helps patients and their doctors manage menopause.
So, below you will find details about what causes these common complaints, and ways to manage them.
Mood swings happen with menopause because of changing hormone levels. Estrogen decreases during menopause. This important hormone relates to production and regulation of other key hormones such as serotonin, dopamine, and norepinephrine.
Serotonin is a mood-stabilizing hormone. Thus, fluctuating estrogen levels can lead to a disruption in serotonin production.
In other words, women in perimenopause may notice that they feel more emotional, sensitive, anxious, or worried.
To reduce or prevent mood swings, women should practice healthy habits, including:
Doctors believe that night sweats and hot flashes occur during menopause because of hormones. Estrogen and progesterone hormones help to regulate body temperature. During the natural process of menopause, when hormone levels change, many women find that they experience periods of feeling very hot to the point of sweating, even though their environment has not changed. Night sweats are episodes that occur while sleeping.
Hot flashes vary from seconds to minutes. They may happen once a day or 20 times in a day. Some women never experience them at all.
To deal with hot flashes, women could:
Weight gain is another common complaint of menopause. And it happens because, you guessed it, hormone changes. Estrogen plays an essential role in regulating fat storage. As estrogen levels go down during menopause, there are changes in the way the body stores fat. Also, for many women in their 40’s and 50’s, activity levels decrease, and metabolism slows. This triple whammy makes weight gain probable.
To prevent menopausal weight gain, women might consider:
Menopause symptoms generally become less intense and less frequent as time goes on. Some women may experience few or none at all. Yet, if you feel like your symptoms are severe or disrupt your life, you should talk to your doctor. There are other medical treatments, such as medications or hormone replacement therapies, available.
To talk with one of our board-certified physicians, click below to schedule an appointment. My Virtual Physician offers comprehensive OB/GYN services to address women’s healthcare needs. Our caring experts can treat menopausal signs and symptoms. If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media.
Researchers at the University of California, San Francisco have been evaluating hundreds of pregnant women who tested positive for coronavirus, and the impact it has had on themselves and their babies during pregnancy. The study aims to better understand the correlation between pregnancy and coronavirus. They also want to evaluate a diverse population for a more thorough grasp of the findings. The study is open for women 14 years or older who have tested positive for coronavirus or are experiencing symptoms. In addition, it will examine the impact of the virus on African American and underprivileged women who are more susceptible due to a lack of health care.
As of May 15th, 2020 The Pregnancy Coronavirus Outcomes Registry, or PRIORITY, has registered 706 women to participate in the study. The year long evaluation includes how the virus impacts maternal health, fetal development, early delivery, newborn health, transmission between mother and child, and the correlation between underprivileged women and the risk of higher mortality. Participants are asked to answer questions about their health and pregnancy, permission to review their medical records related to their coronavirus diagnosis and treatment, and contacted up to 7 times within the next year for routine checkups. The PRIORITY website states that they will continuously update their data so all of the information is available to the public eye. For more information about PRIORITY, click here to navigate to their homepage, and click here if you’re a healthcare provider who wants to refer someone, or if you are personally interested in joining the study.
