3 Common Causes of Heavy Menstrual Bleeding

 At some point, all women may experience menorrhagia, or heavy menstrual bleeding during their periods. However, what women often think is abnormally heavy bleeding is not excessive enough to be diagnosed as menorrhagia. The best way to know if you are experiencing menorrhagia is by monitoring how often you change your pad or tampon. If you change more often than every one to two hours, or your period lasts more than 7 days, you may be experiencing menorrhagia and should consult a doctor. (more…)

The role of MRI for breast cancer screening

MRI or magnetic resonance imaging uses radio waves and magnetic fields to provide images of organs and other internal structures that may not be clearly seen with other tools like X-ray or CT. In recent years, doctors have begun to explore its benefit in screening women with a higher risk of breast cancer. Breast cancer is the 2nd most common cause of cancer death in women. In 2013, there were 232,340 new cases of invasive breast cancer, 64,640 new cases of carcinoma insitu and 39,620 breast cancer related deaths.  “Every woman should begin screening mammograms at age 40 and continue them as long as they are in good health. –American Cancer Society” Why is MRI recommended for high risk women? MRI has a 91% better sensitivity for identifying cancerous breast masses when compared to traditional mammography. So why isn’t it used for everyone? In reality, most women with an average risk of the disease will only need a mammogram. This way, the sensitivity of the test will not identify benign lesions or other spots that could raise the risk for additional testing, biopsies and unnecessary fear. MRI diagnostics are reserved for women with the highest risk of the disease and therefore need the most sensitive screening tools available. Screening mammograms, while beneficial for many women, can be less specific or sensitive for women with complicating factors like dense breast tissue when used alone. Some specific types of breast cancer, such as lobular carcinoma may be difficult to visualize with traditional screening mammography as well. Other factors that can classify a woman as high risk for breast cancer include:
  • Women with a known or suspected BRC1 or BRC2 genetic mutation
  • A history of chest radiation therapy between the ages of 10 and 30
  • Women with a greater than 20% risk of developing breast cancer
Remember that for high risk women, MRI isn’t the only tool that’s needed to gather a full picture of breast health. Annual MRI and mammography is currently recommended. My risk is intermediate or in the middle. Should I have an MRI? Right now, the American Cancer Society has not found sufficient evidence to recommend MRI screening for women with an intermediate risk. Women with an intermediate risk include:
  • Women with a personal history of invasive/in situ carcinoma
  • Women with a personal history of lobular neoplasia or atypical hyperplasia
  • Women with a 15-20% lifetime risk of developing breast cancer
The average woman has less than a 15% chance of developing breast cancer. These women do not need screening MRIs. What other methods can assess my risk of developing breast cancer? There are a variety of tools your doctor uses to determine your breast cancer risk. If you are unsure about your risk, make an appointment with your healthcare provider to discuss it. Some providers use what’s called the Tyrer-Cuzick model to determine your risk. This tool evaluates:
  • Age
  • Body mass index (BMI)
  • Hormonal factors
  • Hereditary factors (including cancers in first and second degree relatives)
A note about BRCA1 and 2 Genetic mutations can further raise your risk for breast cancer. Called the BRCA1 OR BRCA2, this genetic mutation is responsible for about 10% of all breast cancer cases. Women who inherit a mutated gene have a 60-80% risk of developing breast cancer. In addition, women with BRCA1 have a 33% higher risk of developing ovarian cancer. Screening and counseling are available for women with a family history of breast or ovarian cancer or known BRCA mutation in the family. BRCA1 associated tumors tend to have smooth margins and appear more benign on mammogram. They are more aggressive, often high grade and tend to be larger at diagnosis.                

Understanding autoimmune diseases

When your body is operating normally, your immune system should defend against foreign invaders like bacteria and viruses to keep you healthy. But for approximately 50 million Americans who develop an autoimmune disease, the immune system turns against the body–believing that normal, healthy cells are foreign and then attacks them.

Autoimmune diseases can affect a variety of different organs and body systems and trigger a variety of symptoms. Some of the most common include:

  • rheumatoid arthritis
  • lupus
  • celiac disease
  • scleroderma
  • irritable bowel disease
  • Hashimoto’s thyroiditis (a form of underactive thyroid)
  • Type 1 diabetes
  • Graves’ disease
  • Addison’s disease and more

What causes an autoimmune disease?

Doctors  aren’t completely sure what triggers an autoimmune disease, but your risk may be higher if you have a first-degree relative (mother, father, brother or sister) with one. Other possible factors are chemical exposure, environmental triggers, drugs, and exposure to some bacteria or viruses.

How are autoimmune diseases diagnosed and treated?

To diagnose an autoimmune disease, your doctor will look at specific blood work to examine the level of inflammation in your body and other messages sent out by the cells if they are being attacked.

There is no medical cure for an autoimmune disease, but there are steps you can take to live a more healthy life and minimize your symptoms.

  • Eat a healthy diet low in inflammatory foods like gluten, dairy, and processed chemicals
  • Avoid triggers (like stress or specific foods or activities)
  • Get plenty of rest
  • Take supplements or vitamins as directed by your doctor
  • Exercise regularly
  • Take any immune suppressing or anti-inflammatory medications as prescribed

Some people also find other therapies like acupuncture, chiropractic care, or hypnosis helpful.

March is autoimmune disease awareness month. It’s important to take good care of your body if you have an autoimmune disease and to monitor your health if those related to you do–just to make sure you catch any problems early. Talk with your doctor about your risk and adopt a healthy lifestyle now to help control symptoms and live your best life.




Cervical Cancer Screening Myths

Cervical cancer used to be the number #1 cause of cancer deaths in women just a few decades ago. Since that time, the Pap smear has become instrumental in lowering these numbers and making cervical cancer detection extremely effective. According to the Centers for Disease Control and Prevention, just over 12,000 women were diagnosed with cervical cancer in 2011.

Cervical cancer is one of the most treatable female cancers. How much do you know about it?

Myth: If I get cancer there is nothing I can do about it.

Fact: A Pap smear (also called a Pap )test checks for changes in the cervix. If changes are found and treated early, cervical cancer can be prevented. If you do have cancer, regular screening can help find it early. The earlier it is found, the more treatment options you have.

Myth: I am too old or young to get cervical cancer.

Fact: Most women with cervical cancer are 50 years of age or younger. But older women can also get cervical cancer. Pap tests should be part of your routine health care starting at age 21.

Myth: I don’t need a Pap test because no one in my family has had cervical cancer.

Fact: You should still get a Pap test. Most women with cervical cancer don’t have a family history of it.

Getting ready for your Pap test

Sometimes just knowing it’s time for a Pap can feel intimidating. If it’s your first exam, you may be even more concerned about what the test will be like. Let me start out by telling you that a Pap smear is painless. During the exam, your doctor will use a tool called a speculum to spread the vagina open so he or she can see the cervix. Then, using what looks a little bit like a small brush or pipe cleaner on the end of a long swab, your doctor will insert the brush into the opening of the cervix just enough to collect some cells. That’s it. Easy.

Sometimes being nervous can make relaxing hard, but the calmer you can make yourself, the more comfortable the exam will be.

Check out these tips to help you feel more at ease with your exam:


  • Try taking deep breaths before and during the exam. Let them out slowly and remember that you are doing something good for your health. Deep breathing can help release tension you may be holding in your pelvis or legs that could make inserting the speculum (a plastic or metal device that opens the vagina) easier.


  • Find a doctor you feel comfortable with. Your Pap smear doesn’t have to be completed by your family doctor, and it doesn’t necessarily have to be done by a gynecologist or vice versa. If you have a skilled doctor that you like who is proficient at the Pap test, by all means see him or her.


  • Talk to your doctor. If this is your first Pap test, ask questions about what the test is like and what you should expect. Find out if your doctor will be doing other screening procedures like a clinical breast exam or pelvic exam at the same time. This can help you be better prepared for your appointment. He or she should be willing to explain every step they are taking during the test.

Never be afraid to take the time to prevent illness. Pap smears are a basic and essential step every woman should be taking to make sure they are as healthy as possible. Contact us today to schedule your Pap test.




Breast Self-Exam Answers

Breast Self-Exam Answers

There is often a lot of confusion about the difference between a clinical breast exam (CBE) and a self- breast exam (BSE).   Breast health and early detection of potential problems have been hot topics for many years thanks to an increased understanding of prevention methods in the fight against breast cancer.  While a self-breast exam is never a substitute for an exam performed by a trained and qualified medical professional , learning the process of self-breast exam may help improve your chances of detecting any early changes in the tissue that would require evaluation by a doctor—and ensure that you receive the best screening in the form of a mammogram if needed. (more…)

What To Expect?

What To Expect?

What to expect when you’re expecting

When you’re pregnant, your baby’s health is your first concern. Dr. Hessel specializes in prenatal care for normal and high-risk pregnancies. She also performs on-site ultrasounds. And when it’s time for your baby to enter the world, Dr Hessel and her team will keep you comfortable by handling your labor, delivery, recovery and postpartum care. Thanks to that more personalized approach, you can rest assured you’ll receive the best possible care from Dr. Hessel and her team.

Every woman experiences pregnancy differently. Some glow with good health and others feel absolutely miserable. Here are some of the changes you might experience during your first trimester:

Bleeding. About one in four pregnant women experience slight bleeding during their first trimester. Light spotting may be a sign that the fertilized embryo has implanted in the uterus. If you have any bleeding, talk to Dr. Hessel.

Breast tenderness. Sore breasts are a common early sign of pregnancy. Triggered by hormonal changes, this condition will likely last through the first trimester.

Constipation. Constipation and gas can make you feel bloated throughout your pregnancy. Increase your fiber intake and drink extra fluids to keep things moving smoothly. Physical activity also helps.

Discharge. A thin, milky white discharge called leucorrhea may occur early in your pregnancy. Do not use tampons because they can introduce germs into the vagina. A foul-smelling, green or yellow discharge should be reported to Dr. Hessel. Wear cotton next to your skin as much as possible.

Exercise. Having a daily regimen is encouraged. However, any activity that may lead to falling (e.g. rollerblading, outdoor cycling, water sports, etc.) should  be avoided during your pregnancy. Also avoid the sauna, steam room and hot tub.

Fatigue. Your body is working hard for a growing fetus, which can wear you out. Take naps or rest as needed throughout the day. Make sure you’re getting enough iron to avoid anemia, which causes fatigue.

Food cravings/aversions. Your food tastes can change while you’re pregnant. Over 60% of pregnant women experience food cravings or food aversions. If you are generally eating healthy, it’s okay to give in to an occasional craving. Cravings for non-foods like clay, dirt and laundry starch – a condition known as pica – can be dangerous. Report this kind of craving to your doctor immediately.

Foods to avoid. You should not eat sushi or any other raw fish. Tuna, shark, mackerel and tile fish contain high levels of mercury (a known cause of birth defects) and should be avoided. If you eat deli meat or unpasteurized cheese like brie or feta, you will need to bring it home and cook it. It can contain harmful bacteria. You should also avoid caffeine.

Frequent urination. Your growing uterus is putting pressure on your bladder. You may feel like you constantly have to urinate. Your body needs fluids, but it’s a good idea to cut down on caffeine, which stimulates the bladder. When the urge hits, go right to the bathroom.

Heartburn. Your body is producing more progesterone, which relaxes the ring of muscle in your lower esophagus. This normally keeps food and acids in your stomach. Muscle relaxation can lead to acid reflux or heartburn. Eat frequent, small meals throughout the day. Avoid greasy, spicy and acidic foods (like oranges or lemons). Try raising your pillows when you sleep.

Mood swings. If you are feeling overwhelmed, talk to Dr. Hessel – she can refer you to a mental healthcare professional.

Morning sickness. Nausea is one of the most common and talked about pregnancy symptoms. It affects up to 85% of pregnant women. It can last through the entire first trimester. Nausea is usually worst in the morning. Try eating crackers, meat or cheese and sipping water, clear fruit juice or ginger ale. Severe nausea can affect the amount of nutrition getting to your baby, so call Dr. Hessel if you can’t keep food down.

No tobacco or alcohol.

Weight gain. This is one of the few times in your life when weight gain is considered a good thing, but don’t overdo it. During the first trimester, you should gain about 3 to 6 pounds. Dr. Hessel may recommend that you adjust your weight gain up or down based on whether you started your pregnancy underweight or overweight. Don’t “eat for two.” You only need about an extra 150 calories a day during your first trimester. Get those calories by adding extra fruits and vegetables, milk and lean meat to your diet.

Understanding Ebola


I know it’s a little scary. If you’ve been watching the news, you know that the outbreak of hemorrhagic fever known as Ebola has been working over time in West Africa and two more American Ebola victims were brought to the U.S. for treatment just a few weeks ago. This  might leave you with more than a few questions about the virus–how is it spread? How deadly is it? Could it spread to the United States? Let’s try to answer some of these questions so you can better understand Ebola and how to protect yourself and your family. (more…)

Lose weight in one of New York’s best weight loss programs

Anyone who has fought the weight loss battle will tell you that it’s no easy task. Somehow, most of us have come to believe that regaining our health means fad diets, deprivation, starvation and misery—but it doesn’t have to be that way. In fact, you can lose weight safely, without deprivation and in a supportive atmosphere when you know where to look.

The research is everywhere: People who attend support groups will lose more weight than those who don’t. And better yet? What if those groups were monitored, organized and developed by healthcare professionals who are committed to you and your health?

Welcome to the unique design of the Weight Loss Program of St. Luke’s-Roosevelt Hospital Center in New York, New York. Where all of this (and more) is possible.

People who attend support groups will lose more weight than those who don’t.

What makes this weight loss program unique?

The New York Obesity Nutrition Research Center has developed one of the most comprehensive weight loss programs in the country: without medications or surgery.

The program focuses on changing the way you eat and the number of calories you consume in a 52-week closed-group format. That means you’ll spend the next year with the same people in the same groups which promotes stability and a sense of support.

Your healthcare team will be guiding you thorough a customized meal plan and help you tackle not just how you eat, but why. The team is composed of registered dieticians, social workers, exercise physiologists, and physicians who are all committed to helping you succeed.

The program is designed for men and women who need to lose more than 50 pounds.

Will I have to exercise? I’m afraid I can’t

You may already know that rigorous exercise alone probably won’t help you lose weight. That’s why the Weight Loss Program focuses first on caloric intake and mental well-being. Exercise will be added slowly over time, as you progress through the program. Don’t worry that you’ll be strapped to a treadmill for hours of sweaty exertion. That’s just not the program’s style.

How can I learn more?

You can find out more by contacting the program through their website or you can also call the program coordinator, Robin Hersch, at nyorc@chpnet.org  or call (212)523-8440. The program fees are $50 per week and a one-time $75 charge when you first enroll. This cost includes weekly meetings plus unlimited support from the program’s experts.

Endometriosis means struggle for many women

Endometriosis means struggle for many women

Nearly 5 million American women suffer from endometriosis.  As the third leading cause of all female-related hospitalizations and infertility, endometriosis can disrupt a woman’s daily life and negatively affect both her physical and mental health.  The most common symptoms associated with endometriosis include abdominal pain, painful menstrual cramps, heavy periods, bleeding or spotting between cycles and infertility.  Study estimates claim that 30%-40% of women diagnosed with endometriosis will struggle with conception and fertility issues. (more…)

Understanding Preeclampsia

Learn about preeclampsia to keep you and your baby safe.

A healthy pregnancy is at the top of every mom’s birth plan.  Sometimes though, your body may have other ideas.  Preeclampsia, which is sometimes called toxemia, is a condition that no mother can plan for or prevent.  Preeclampsia combines high blood pressures along with protein that is released into the urine, and if left untreated can lead to premature birth, a smaller than average baby, and even seizures that could put both mom and baby’s lives in danger. (more…)