Holy Cross doctor addresses women's health issues

For many women, menopause is a confusing and confounding time of life.

“A woman is officially in menopause once she has not had menses for one full year, but the symptoms of menopause can begin years earlier.  They can experience hot flashes, night sweats, vaginal dryness and depression,” said Dr. Anele Manfredini, a family physician with the Dorothy Mangurian Comprehensive Women's Center at Holy Cross Hospital in Fort Lauderdale.

While hormone replacement therapy may help address many of these issues, Manfredini says caution should be used because of the risks of therapy.

“HRT is the best treatment for severe symptoms but if taken for a long period of time, research has shown that it can increase the risks of cardio vascular disease and invasive breast cancer,” said Manfredini. 

Manfredini often recommends herbal supplements for a variety of post menopausal concerns.

“I always suggest patients try black cohosh, soy products and vitamin E first,” she said.

One concern among post menopausal women is unexpected bleeding.

“Dysfunctional uterine bleeding, which occurs one full year without menses, is not normal and should be addressed.  We need to rule out any type of cancer, specifically uterine cancer,” Manfredini said.

Manfredini also addressed new pap testing guidelines.

“In 2009, the American College of obstetrics and gynecology released a review of the pap guidelines. It was suggested that we start screening with pap tests at age 21, regardless of a woman’s sexual history or at age 17 if a woman has been sexually active at that point.  Also, between the ages of 21 to 29 women can do a pap every two years rather than every year if they’ve had 3 negative paps in a row and test negative for human papillomavirus, the key factor in cervical cancer.  Women over 30 can be tested every 3 years, again, with 3 negative paps and negative history of HPV,” Manfredini said.

Based on guidelines from the American Cancer Society, women can stop pap screening at age 70 if they’ve had a 10 year history of normal paps or had a hysterectomy for benign causes.

Dr. Manfredini also addressed concerns about the guardisil vaccine for HPV. 

"I personally have never had a problem with the vaccine and recommend it to my patients," she said.