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Many of us look forward to the summer: the warmer weather, the vacations, the longer days, the extra sunlight.

But for some, the summer months are not a relief from the seemingly endless winter months. For some, summertime brings on depression. Sometimes, summer depression has a biological cause, like a chemical imbalance, while other times, the particular stresses of summer can pile up and bring on feelings of sadness and depression.

It can be even more frustrating to feel like you are supposed to be happy and enjoying life because it’s the summer and instead, you are bogged down by depression.

Many are familiar with “seasonal affective disorder,” or SAD.  SAD typically causes depression as the days get shorter and colder.  What is less known is that people with SAD can actually get it in the reverse — the onset of summer triggers depression symptoms.

Specific symptoms of summer depression often include: loss of appetite, trouble sleeping, weight loss, and feelings of agitation or anxiety. Summertime depression can also create an increased feeling of isolation.

Here are some things that may cause an increase in summertime depression:

  • Disrupted schedules in summer. Our schedules can get shifted during the summer time months and often times, that disruption can offset depression especially with people who need a reliable routine to keep balanced.
  • Body image issues. Feeling unhappy and self-conscious about one’s looks in summer clothing can also increase depression.
  • Financial worries. Summers can be expensive. With vacation, meeting up with friends for a night out, dinners out, etc. spending can increase and thus, results in increased worry and depression.
  • The heat. It’s not enjoyable for everyone. It can be very oppressive physically and mentally.

So what do you do if you think you are suffering from summertime depression?

  • Get help. If you think you’re getting depressed, no matter what time of year, get help. See a psychologist, talk to your PCP, share with family and friends about how you are feeling.
  • Keep up with your exercise. Regular physical activity can help keep the risk and/or symptoms of depression down. But be careful not to overdo dieting and fitness.
  • Protect yourself. Don’t overextend yourself. Don’t feel obligated to do anything and everything. Take time for yourself.
  • Talk to your doctor about medication and/or adjusting current medications.


For many of us, summer is a wonderful time of year—the days are longer, offering more time to spend with family/friends, our moods improve, there are expanded opportunities for exercise, we go on vacation. At the same time, there are health considerations that we do not face during the rest of the year that can interfere with our enjoyment of these activities, if we’re not being careful.

For starters, there is the threat of sunburn and skin cancer, which most people are now aware of. To recap, you should apply a sunscreen with an SPF of 15 or higher 30 minutes before you will be out in the sun. Reapply completely every 2 hours or any time spent in the water. Try to avoid being out during the hottest hours of the day, between 10am and 2pm. Seek out the shade and stay covered when possible—hats, umbrellas, and clothing with an SPF factor are your friends!

Many people notice that they become more fatigued in the summer. This is due to a combination of factors. First of all, your body is working harder to maintain a safe body temperature in the heat. This is done primarily by sweating, which cools the body as it evaporates, and vasodilation, which dilates blood vessels near the skin and diverts more blood to this area to cool it down. Your heart rate and metabolic rate both increase to accomplish these efforts, utilizing more energy than your body normally does. In addition, if you are exercising in the heat, your body is also trying to divert adequate blood to your skeletal muscle to deliver oxygen to the working muscles. Combined with a lower blood volume (from sweating), this puts even more strain on your cardiovascular system. These changes also make exercise more difficult in the summer months, making you feel more fatigued after a workout. For some people, this fatigue can last for hours.

Finally, Exertional and Nonexertional heat illnesses, including Heat Exhaustion and Heat Stroke, are a real threat in the summer months. Heat exhaustion is characterized by the body’s inability to maintain adequate cardiac output (blood flow/delivery), combined with high body temperatures (101-104 degrees) and sometimes, dehydration. This typically manifests by collapse. Heat stroke is more serious, consisting of high body temperatures (>104 degrees) and central nervous system dysfunction, such as seizures or confusion, and multi organ system damage (heart, kidneys, muscle, etc.). This is an immediate medical emergency. The initial treatment for both of these conditions is rapid cooling of body temperature (most important), fluid/electrolyte replacement, and more aggressive medical intervention if needed.

So how do we avoid unpleasant or dangerous outcomes from the heat? Common sense measures, such as those noted above, combined with staying well hydrated (with water, smoothies, juices, and fruits/veggies that replace minerals lost through sweating) are key. Wear loose clothing that is designed to breathe. Limit outdoor workouts to earlier or later in the day, decrease the intensity of your usual workout, and consider shortening your workouts for a couple of weeks in the early summer to give your body time to acclimate to the hotter temperatures (this allows your body to expand blood volume, improve blood flow to the skin, and decrease the threshold at which sweating starts, among other adaptations that help to manage the heat). Be aware of factors that can decrease your heat tolerance and increase the risk of poor outcomes. Those at risk for heat illness include people who have sweat gland dysfunction, those who have viral/bacterial illness, those who use alcohol before/during time in the heat, and those on certain medications that interfere with cardiac function, heat response, or fluid/electrolyte balance. Such medications include blood pressure medications like ACE inhibitors or ARBs, antihistamines/decongestants, stimulant medications, and beta-blockers.



The summer months are filled with social events. From barbecues to pool parties to beach hangs, the dress code often includes shorts, tank tops, bathing suits, or dresses. It makes sense that this is a time when body image anxiety can arise. For anyone who has experienced eating disordered thoughts or a negative self image, the idea of putting on a bathing suit or other summer outfit can be understandably frightening. It can be easy to slip into negative self talk and restrictive eating.
If you find yourself feeling triggered by this season, try to use one of these tools:
Keep a positivity journal:
  • Each day, write down something positive about yourself.
  • Make a commitment to limiting negative self talk this summer.
Repeat positive affirmations to yourself. Here are some ideas:
  • I am lovable in this body.
  • Every body is a bathing suit body!
  • I accept myself as a beautiful work in progress.
Wear what YOU want. Don’t feel pressure to put on something that makes you feel uncomfortable.
Focus on how the food you are eating is nourishing you. Is it giving you energy? Is it giving you satisfaction?


Cervical cancer is cancer that starts in the cervix, the lower, narrow part of the uterus. Most cervical cancers are caused by the human papillomavirus (HPV). Cervical cancer is the easiest gynecologic cancer to prevent with regular screening tests and vaccinations. It is also very curable when found and treated early.

What causes cervical cancer?

Most cervical cancer is caused by an infection with HPV. HPV is a virus that enters cells and can cause them to change. HPV is spread by skin to skin contact, which means that condoms may not protect you. Some strains of the virus cause genital warts, however most strains cause no symptoms at all. Most of the time, your immune system will clear the virus on its own. If HPV does not go away on its own, it may cause cervical cancer over time.

Other factors which can increase your risk of cervical cancer are:

  • Smoking
  • Long-term oral contraception
  • HIV or reduced immunity
  • Multiple sex partners
  • Multiple Births

What are the symptoms of cervical cancer?

Most of the time you may not notice any signs or symptoms of cervical cancer. Signs of advanced cervical cancer may include; abnormal bleeding or discharge from the vagina. These symptoms may not be caused by cervical cancer, but the only way to be sure is to discuss your symptoms with your provider

How often do I need to be screened for cervical cancer?

How often you should be screened depends on your and your health history. Talk with your provider to find out what is best for you

Most women can follow these guidelines:

  • If you are between the ages 21 and 29, you should get a Pap test every 3 years
  • If you are between the ages 30 and 64, you should get a Pap test and HPV test every 3-5 years
  • If you are 65 or older, ask your provider if you can stop screenings

How can I lower my chances of getting cervical cancer?

Prevention and treatment of cervical cancer continues to move forward; the best way to protect yourself is to make careful choices about sexual activity, consider getting the HPV vaccine and to continue your routine screenings and annual wellness exams.



What comes to mind when somebody says the word “physical activity”? Do you think of the walk you took to get from the garage to work this morning? Or the stairs you climbed on your way out of the subway?  What about the word “exercise”? If this word provokes different thoughts I am not surprised. You might have visions of sweating it out in spin class and loving every second of it, or maybe you have a feeling of dread as you picture dragging yourself to the gym. In celebration of May’s National Physical Fitness and Sports Month, I want to tell you that physical activity is what matters! You might spend an hour in the gym, but what happens during the other 23 hours is crucial. Picture your typical day, you sit as you eat breakfast, you may sit as you commute to work, sit at a desk, sit at lunch, go to the gym for an hour, then sit at the dinner table or in front of the TV. Even athletes can be considered sedentary if their only physical activity is during the hours when they are exercising!

This month, challenge yourself to think about physical activity as a way of life. What errands can you run on foot today? If you have a phone call to make, can you do it while walking or pacing? If you are stuck at your desk for hours in a row, can you make a point to stand up and stretch every hour? Can you stretch while you watch TV at night?

If you need some motivation…

Here are some fun facts on how physical activity can help prevent or reduce health conditions:

High blood pressure: Two brisk 10-minute walks a day can help to prevent high blood pressure. Think of this like your daily dose of movement medicine. As you start your walk, your body sends blood that contains oxygen and energy to your muscles so that they can propel you forward. This rush of blood exerts pressure on your veins causing them to loosen slightly so that more blood can flow through. By asking your veins to loosen twice a day every day, you are preventing stiffness!

High blood sugar: After you eat a meal that is high in carbohydrates your body will digest those carbohydrates and turn them in to sugar which will stay in your blood stream until your cells take it up for energy. If you have diabetes or pre-diabetes this state of high blood sugar can make you feel pretty icky. Luckily, physical activity can help you to bring down your sugar. Going for a walk after a large meal can help your cells to take up the sugar and leave you feeling much better!



You may have seen the slogan on a bumper sticker or a poster stating “Don’t Take Your Organs to Heaven, Heaven Knows We Need Them Here”.  Every day, 22 people die because they are unable to receive a life-saving transplant in time.  Every day, over 2,000 children and 100,000 adults continue to wait for the life-saving transplant they require.  And every 10 minutes, another child or adult is added to that ever-growing list.   April is National Donate Life Month and there is no greater time to be the heroine that someone needs and to commit to registering as an organ donor at RegisterMe.Org.

One donor can save up to 8 lives, restore vision to 2 people and heal more than 75 through organ and tissue donation.  However, you are allowed to dictate which organs and tissue that you wish to donate.  You are still able to have an open casket funeral and your family does not incur the costs associated with organ donation.  Every major religion approves of organ donation.

As a former Emergency Department nurse, I am unfortunately all too familiar with the pain and suffering that families and patients go through while waiting on a transplant match.  I am also familiar with some of the myths surrounding organ donation – the most common being that if a patient was an organ donor, we would not work as hard to save them.  I can personally attest to the fact that we have no idea whether or not our patients are organ donors unless one of their family members tells us of their donor status to ensure that their loved one’s wishes were met.  It is so important to tell your friends and family that you are a donor so that this selfless gift can be honored in times of crisis.

Here in Philadelphia, we are fortunate enough to benefit from the professionalism and experience of the Gift of Life Donor Program. Time is of the essence in those fraught moments where difficult decisions need to be made but I have personally witnessed the compassion with which Gift of Life transplant coordinators have guided and empowered family members respecting the final wishes of their loved ones.

Organ Donation is a way to leave a lasting and meaningful legacy.  It is a beautiful thing to know that your gift will provide another person the gift of health.  It is a comfort to those left behind to know that a part of their loved one is still living through another.  And it is an excellent time to register today so that you can be the heroine someone in the future will need.  In honor of National Donate Life Month, visit RegisterMe.Org to register as an Organ Donor or visit donors1.org for more information from the Gift of Life Donor Program.



Polycystic Ovary Syndrome, or PCOS, is a health problem that affects approximately 1 in 10 women of childbearing age. Women with PCOS have a hormone imbalance and metabolism problems that may affect their overall health. The syndrome is characterized clinically by oligomenorrhea (fewer than nine menstrual cycles in a year), hyperandrogenism (acne, hirsutism, male-pattern hair loss and/or elevated serum androgen levels, or “male hormones”), as well as the frequent presence of other associated risk factors for cardiovascular disease (obesity, fatty liver, glucose intolerance, etc).

The Polycystic Ovary Syndrome diagnosis is a condition that our whole RWWC team can help stabilize…
  • Our providers are able to prescribe medications commonly used to treat PCOS and its symptoms. A great example is hormonal birth control to regulate the menstrual cycle, improve acne and reduce the risk of endometrial cancer.
  • Our Registered Dietitian can assist with diet management.
  • In more complex cases, our GYN specialist Dr. Shanis will craft an individualized treatments plan according to symptoms, other health issues, and if the patient is considering pregnancy.
  • Our Medical Spa can address acne and unwanted facial hair.
  • Our psychologists are available for emotional support.
  • We have a variety of fitness partners that offer our members discounts. They can assist with weight reduction to treat high blood pressure, high cholesterol, and irregular cycles.

The diagnosis of PCOS is suspected when a women presents with irregular menstrual cycles and symptoms of hyperandrogenism, like acne, hirsutism, or male-pattern hair loss. The presence of overweight or obesity should further raise suspicion. There is no single test to diagnose PCOS but your Health Care Provider will talk to you about your medical history and do a physical exam, and order different tests. The physical exam may show signs of hyperandrogenism, like acne, extra hair on your face, chest or back or skin discoloration, called acanthosis nigricans. A pelvic exam may also be completed at this time. Blood tests can check your androgen hormone levels, as well as checking for irregular thyroid levels, a common issue that also affect menstrual cycles. Since PCOS is thought to be related to insulin resistance, glucose levels will also be ordered. A pelvic ultrasound is ordered to assess for cysts and to check the lining of the uterus. Women with polycystic ovaries seen on ultrasound and no other clinical features of PCOS do not have the syndrome and do not need further evaluation.

Studies have found that PCOS may be associated with other health problems, like diabetes. More than half of women diagnosed with PCOS will have diabetes or prediabetes. These women are also at a greater risk for high blood pressure, higher cholesterol levels and sleep apnea. Medications commonly used to treat PCOS and its symptoms, include hormonal birth control to regulate the menstrual cycle, improve acne and reduce the risk of endometrial cancer. Anti-androgen medications block the effects of the male hormones and can help reduce body hair, acne, and hair loss. Metformin is often used to treat Type 2 Diabetes and may help some women with PCOS. Diet and exercise helps with weight reduction to treat the high blood pressure, high cholesterol, irregular cycles and to improve insulin resistance. Treatment is individualized to each women according to symptoms, other health issues, and whether she wants to become pregnant.

 


26/Mar/2019

Botox is the most commonly performed cosmetic procedure worldwide and has an incredible safety record for prevention and treatment of wrinkles! I’m sure Botox is one of those things you assumed you would start to doing only once you absolutely needed it. However, it should be something on your radar during your 20’s and 30’s. Doctors say the number of young people who are doing preventive Botox (or as I like to call it, Baby Botox) is growing.

I am a big supporter of Baby Botox. Treating women in their mid to late 20’s and 30’s to stop wrinkles before they ever start makes the aging process slow down dramatically. I believe the best time to start Baby Botox is when you start to develop the earliest sign of resting wrinkles.

Initially, wrinkles will start to show up when you’re making facial expressions, but go away at rest. Unfortunately, over time these wrinkles will start to make permanent marks even when you’re not making a particular facial expression. Slowing down the use of these muscles with Botox early in adult life will prevent the lines from developing. Personally, I’ve been treating myself with Botox for the past 5 years (I’m 31 now) and I get told all the time, “I don’t know why you do Botox! You don’t have any wrinkles.” My response always is, “Exactly. I don’t have any wrinkles, because I’ve never allowed myself to have wrinkles!”

Botox will only get you so far with slowing the aging process down; therefore I recommend a good skin care regimen that includes a Retinol and an SPF that you reapply throughout the day. Last but not least, you can take advantage of the skin care treatments that our DermaCenter offers that stimulate collagen regrowth! After all, we start to lose about 1-2.5% of volume in our face every year starting at a young age.



What is the ThermiVa®?

ThermiVa® is a non-surgical, safe and effective procedure that uses radiofrequency heat to tighten loose, sagging skin and increase blood flow and nerve sensitivity in the vaginal area.

What are the benefits of the ThermiVa®?

  • Vaginal and labial laxity
  • Vaginal dryness
  • Urinary incontinence and overactive bladder
  • Painful sex

How is it performed?
During the procedure, a small wand is slowly moved over the areas of concern, gradually heating the tissue.  The procedure takes less than an hour, during which most women report feeling only a warm sensation and no pain.  There is no down time once completed, women can return to exercise and sexual activity immediately.

What is the O-Shot®?
The O-Shot® is a non-surgical, minimally invasive procedure that can help improve a woman’s sexual desire and orgasm, decrease urinary incontinence and treat a chronic skin condition called lichen sclerosus.   Up to half of women experience low sexual desire and many others experience issues with arousal, lubrication and orgasm.  The O-Shot® uses platelet-rich plasma (PRP) that contains growth factors from the woman’s own blood, and is injected into the clitoris and vaginal wall.  This increases the blood flow, nerve sensitivity and collagen formation in the area, leading to improved sexual function.

What are the benefits of the O-Shot®?
This injection can increase a woman’s sexual desire and arousal, as well as improve the number or quality of her orgasms.  In addition, this procedure can help with

  • Leaking urine
  • Painful sex
  • Vaginal dryness
  • Decrease symptoms and long-term consequences of lichen sclerosus

How is it performed?

Blood is drawn from the patient and then using a special double-spin process the red blood cells are removed, leaving the plasma which is full of growth factors.  Numbing cream is then placed onto the areas that will be injected, and a lidocaine injection is performed to ensure there is minimal to no discomfort during the procedure.  The PRP is then injected into the clitoris and vaginal wall.  The procedure takes less than an hour.

If you would like to learn more about these procedures, schedule a consultation with one of our Women’s Health providers.



In celebration of National Condom Week (4/14-4/21), a reminder about the importance of safe sex is due.   Last year, the CDC reported that rates of Syphilis, Chlamydia, and Gonorrhea in the U.S. had all increased for the fourth straight year.  Forty-five per cent of the new Chlamydia cases were found in young women—a particularly alarming statistic, as this infection can lead to infertility if unrecognized/untreated.  Genital herpes is estimated to have a prevalence of 1 in 6 Americans, with women far outnumbering men in new cases.  And the HPV virus, as we all know, can lead to cervical dysphasia and even cancer in infected women.   All of this points to the importance of awareness and preventive measures in limiting the spread of various sexually-transmitted infections.   First of all—know your/your partner’s risks. Higher-risk populations for contracting STIs include men who have sex with men (MSM), those with new or multiple sexual partners, those who live in an area of high STI prevalence, and those who exchange sex for drugs or money.   Second—consider preventive measures you/your partner can take before you become sexually active.  The HPV vaccine series has proven very effective in reducing infections with the viral strains that the vaccine is designed to prevent.   Hepatitis B infection can also be prevented though vaccination.  Individuals with genital herpes can reduce the likelihood of transmitting the virus to their partners by taking a daily suppressive medication.  And certain high-risk individuals can take pre-exposure antiretroviral prophylactic (PREP) medication regularly to ward off acquiring HIV from an infected partner.  If you do decide to become sexually active, using condoms consistently and getting tested regularly are paramount.  Condoms are not 100% effective at preventing STIs, so the importance of regular screening cannot be underestimated—be safe!


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1632 Pine Street
Philadelphia, PA 19103
Phone: 215-735-7992
Fax: 215-735-7991
Email: info@rwwc.com

Hours

Monday – Thursday:  8am – 8pm

Friday: 8am – 4pm for the summer

Saturday: Closed for summer

Sunday: Closed

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