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Center for Specialized Women's Health

Holly Thacker

Holly L. Thacker, MD, founded the interdisciplinary Center for Specialized Women’s Health at Cleveland Clinic. She has appeared on national television and is regarded as a national thought leader in women’s health. She has published The Cleveland Clinic Guide to Menopause, lectured extensively on the topic of menopause and is a NAMS-credentialed menopause clinician. Dr. Thacker is the executive director of Speaking of Women’s Health, a nonprofit foundation dedicated to educating women on health, safety, and well-being. The Center for Specialized Women’s Health is located on the first floor (A10) of the Crile Building on Cleveland Clinic’s main campus. To schedule an appointment with Dr. Thacker call Cleveland Clinic 4HER® Women's Health Line at 216.444.4HER.

Cleveland Clinic Women’s Health Fellowship Program

The first of its kind nationally, the Women's Health Fellowship program is a unique blend of clinical skills, focused research and interdisciplinary education. The goal is to create women’s health leadership for the future.

Download more information on the program.

The Center for Specialized Women's Health can make it easier to see the right combination of specialists. If a woman has a serious breast or gynecologic problem, she may need to see numerous doctors from Imaging to Surgery to Internal Medicine. The center brings specialists and their services to one female-friendly place.

Women can access specialized health care at the Center for Specialized Women's Health.

The center provides convenient "one-stop shopping" for all of a woman’s health care needs. In addition to routine wellness exams and health care screenings, we offer evaluation and treatment of numerous medical problems of special concern to women.

Center professionals are happy to accommodate patients who are seeking second opinions, as well as patients who prefer female providers.

The center includes services of the Clinic’s Breast Center, as well as the departments of Internal Medicine and Obstetrics & Gynecology.

A Special Blend of Care for Women

A Special Blend of Care for Women

Over 15 years ago, Holly Thacker, MD, came to Cleveland Clinic to specialize in cardiology – until she learned that treating hearts had more to do with gender-based biology than she thought. She became fascinated with the field of menopause while rotating with now-retired Clinic gynecologist Delbert Booher, MD.

"While studying heart disease, I observed how women and men displayed different symptoms and responded differently to medications. Gender, life-cycle stage, and risk factor assessment are at the core of disease prevention," says Dr. Thacker, now director of the Center for Specialized Women's Health at the Clinic. "I found that heart disease in women was not well studied from a hormonal perspective, and that’s when I realized the value of interdisciplinary medicine, particularly for women."

That interest, coupled with her respect for Joseph P. Crowe, MD, who founded the Clinic’s multidisciplinary Breast Center, is what sparked Dr. Thacker’s vision for the Center for Specialized Women's Health, designed to provide comprehensive specialty care for women at one location. The center is located at the Flo and Stanley Gault Women’s Health and Breast Pavilion in the Crile building on the Clinic’s main campus, and last year alone served more than 20,000 women.

The center has drawn international attention, too, with physicians from Israel, Canada and Saudi Arabia visiting to find out how they could set up similar women’s health facilities in their countries.

An Interdisciplinary Approach

What sets the Center for Specialized Women's Health apart from many women’s clinics is its interdisciplinary approach, in which physicians with different medical specialties, nurses and other allied health professionals collaborate on patient care. Women can come to the center for menstrual, breast and hormonal concerns, and other conditions specific to women and receive a complete menu of services, from consultation to imaging, to outpatient surgical procedures – all custom-designed for the individual.

"I practiced in a women’s health center in New York City before coming to Cleveland last year and I find the center here more comprehensive," says Elizabeth Ricanati, MD, a woman’s health specialist. "I recently diagnosed an abnormality during one of my patient’s exams, and she was immediately taken to a procedure room down the hall for a diagnostic test. There was no need for scheduling and waiting. When resources are in one place, it’s much easier for physicians and patients."

The center is pleased to have a new state-of-the-art breast imaging machine.

Physicians from the Clinic’s Breast Center, Internal Medicine, Gynecology and Psychiatry converge at the Center for Specialized Women's Health, some working only at the center, while others rotate in from other offices one to two days a week.

In addition to standard health screenings and consultations, the center handles cross-disciplinary issues and special concerns. Often these physical concerns can lead to psychological issues and the center is there to help with that, too.

"For those women who struggle with mood disorders related to their hormonal cycle, this is the place to get the best treatment," says psychiatrist Lilian Gonsalves, MD. "Common problems we see here include anxiety and mood disorders, and we use a combination of medications, psychotherapy and stress management to treat patients."

The center handles cross-disciplinary issues and special concerns such as:

  • finding a breast lump while breastfeeding
  • hormonal and menstrual disorders
  • chronic pelvic pain
  • urinary incontinence
  • severe PMS
  • depression
  • heart disease prevention
  • breast cancer risk assessment
  • osteoporosis prevention and treatment
Clinic Care Plus

In addition to interdisciplinary treatment, the Center for Specialized Women's Health is one of the first areas to offer Clinic Care Plus – shared medical appointments for 10 to 15 women with their physician and a women’s health social worker or health psychologist. Rather than the standard 10- to 15-minute one-on-one appointment scheduled weeks to months in advance, women can spend up to 90 minutes with their physician for follow-up care along with other women who have similar health issues.

Center for Specialized Women's Health physicians host their Clinic Care Plus appointments at set times each week. Women may also opt to have a private exam first and attend a shared visit that same day. Analysis of patient satisfaction scores shows that many prefer shared medical appointments to individual appointments; in fact, women who shared appointments showed an 85 percent reschedule rate. We are the premier interdisciplinary women’s health center in the region," says Dr. Thacker. "Our goal is to be the premier model, nationally and internationally, for interdisciplinary women's health care and education." So far, so good. The center serves tens of thousands of women and hosts numerous international tours and educational summits for physicians.

Questions?

Confused about hormone replacement therapy? Wondering if you really need a yearly mammogram? Wanting to check which foods affect PMS?

Many women have questions about their health care. Now there's a resource for answers. Simply call Cleveland Clinic 4HER® Women's Health Line at 216.444.4HER and speak with a nurse who has special training in women's health issues. This free service of the Center for Specialized Women's Health is available Monday through Friday, 8:30 a.m. to 4:30 p.m.

The Flo & Stanley Gault Women’s Health & Breast Pavilion is made possible through the generous support of an Avon Foundation grant.

Be Strong...Be Healthy...Be In Charge with Speaking of Women's Health!

Speaking of Women's Health (SWH) is a national health education program from Cleveland Clinic's Center for Specialized Women's Health. The programs mission is "to educate women to make informed decisions about health, well-being and personal safety for themselves and their families". Under the leadership of Holly L. Thacker, MD, SWH consists of exciting women's conferences, an interesting and interactive website, www.speakingofwomenshealth.com, and a free monthly e-mail newsletter.

Log on today and sign up for the Speaking of Women's Health monthly e-newsletter to receive health and lifestyle tips, delicious recipes, conference updates and more.

Women are notorious for putting their healthcare needs behind those of everyone else. Cleveland Clinic experts in the Center for Specialized Women’s Health encourage every woman to follow this guideline for their screenings and immunizations.

Download our guidelines

In addition to wellness exams, professionals within the Center for Specialized Women's Health offer a variety of services, including evaluation and/or treatment of:

  • Breast cancer risk assessment and breast concerns
  • Cervical disease including HPV, colposcopy and LEEP
  • Female Sexual dysfunction
  • Hormonal concerns and menopausal hormone therapy including “bio-identical” hormones
  • Menopause
  • Obesity Management for Women
  • Osteoporosis including bone density and treatments which include yearly infusion therapy
  • Peri- and post- menopausal concerns
  • Sexually transmitted infections and vaginitis
  • Uterine Fibroids and hysterectomy alternatives including UFE and endometrial ablations
  • Urinary incontinence/urine leakage
  • Urinary tract infections/bladder symptoms

Women can access routine cancer screenings and information on cardiovascular disease prevention. In addition, expert counseling is available with respect to:

  • Contraception
  • Preconception/pre-pregnancy concerns

For women wanting primary care for routine and repeated observation with doctors who can also perform regular pap smears, visit with one of our women’s health primary care providers.

Download the directory.

A comprehensive, convenient and catered approach to your health.

CustomFit Physicals for Women provide a uniquely personalized health care service that offers you the convenience of receiving a comprehensive set of evaluations and an individual plan of action based on your results—in just one day. 

Whether you’re a busy executive who puts in 60-hour work weeks or a mom who is busy putting the needs of her family before her own, you can’t afford to neglect your health.

With our CustomFit Physical, you’ll have the comfort of knowing that you’re getting all the care you need, along with the confidence of knowing you’ll be able to get it all done without impacting your busy life.

Your CustomFit Concierge

Your CustomFit experience starts with a call to women’s health expert Mary McDonnell, RN. After discussing your medical history, health concerns and lifestyle, Nurse Mary will consult with Center for Specialized Women’s Health physicians to recommend a set of evaluations tailored to your needs. She will then schedule your exams in succession to optimize your visit.

CustomFit Comforts

Take advantage of complimentary valet parking when you arrive. Then, enjoy your own private waiting room during any downtime between exams. Your room will feature Wi-Fi, an assortment of healthy snacks and refreshments—along with a robe and slippers to help you relax.

Beyond Your CustomFit Physical

Before you leave, you’ll have a complete picture of your health and a personalized take-home plan to improve your wellness and reduce risks. Should you require additional screenings, consultations or follow-up visits based on your CustomFit Physical, Nurse Mary will arrange access to top-ranked Cleveland Clinic specialists on your behalf.

Your CustomFit Experience

All this personalized service and convenience is offered for a $1,000 out-of-pocket fee.

Call 216.445.7600 to begin your CustomFit Physical experience.

Baseline Physicals* include:

  • Detailed physical exam
  • Basic laboratory tests
  • Pelvic exam
  • Breast exam
  • Breast cancer risk assessment
  • Hormone assessment

Additional exam options* that may also be recommended for you include:

  • Mammogram and breast cancer risk assessment
  • Thyroid (TSH) test and hormonal assessment
  • Cervical pap smear with HPV test, if indicated
  • Cholesterol screening and complete lipid profile
  • Bone density test, if indicated
  • Personalized genetic assessment
  • Body fat, nutritional analysis and counseling
  • Body scan, if indicated
  • Physical therapy and/or exercise consultation
  • Echo cardiac stress test
  • Aesthetic skin care services (not covered by insurance)
  • Female sexual dysfunction evaluation and discussion of treatment options
  • Urine leakage evaluation and nonsurgical treatment options

* All medical treatments and services listed above will be billed to your insurance. Patients may be responsible for co-pays and deductibles, or out-of-pocket expenses based on the terms and conditions of their insurance plans.

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Mary Clarkin, CNP
 

Mary Clarkin, CNP

Clarkin, Mary, CNP
216.444.6601

Location(s): Cleveland Clinic Main Campus

Department: Center for Specialized Women's Health

Specialties: Menopause, Menstrual Disorders, Osteoporosis, Premenstrual Syndrome (PMS), Vaginitis, Complete Physical Examinations, Contraception more

Treats: Adults Only

Surgeon: No

Education: Virginia Commonwealth University

 
Karen Cooper, DO
 

Karen Cooper, DO

Cooper, Karen, DO
216.636.5027

Location(s): Cleveland Clinic Main Campus

Department: Obstetrics and Gynecology

Specialties: Bariatric Medicine, Women’s Health Weight Management

Treats: Adults Only

Surgeon: Yes

Education: New York College of Osteopathic Medicine

 
Margery Gass, MD
 

Margery Gass, MD

Gass, Margery, MD
216.444.3024

Location(s): Cleveland Clinic Main Campus

Department: Obstetrics and Gynecology

Specialties: Menopause, Sexual Dysfunction, Specialty Women's Health

Treats: Adults Only

Surgeon: No

Education: University of Cincinnati College of Medicine

 
Lilian Gonsalves, MD
 

Lilian Gonsalves, MD

Gonsalves, Lilian, MD
216.636.5860

Location(s): Cleveland Clinic Main Campus

Department: Psychiatry and Psychology

Specialties: Coping With Chronic Medical Conditions, Depression, Interstitial Cystitis | Pelvic Pain, Premenstrual Dysphoric Disorder (PMDD), Psychiatric Disorders, Liaison Psychiatry Consultation, Medication Management more

Treats: Adults Only

Surgeon: No

Education: Cleveland Clinic

 
M. Cecilia Lansang, MD, MPH
 

M. Cecilia Lansang, MD, MPH

Lansang, M. Cecilia, MD, MPH
216.444.6568

Location(s): Cleveland Clinic Main Campus

Department: Endocrinology, Diabetes and Metabolism

Specialties: Adrenal disorders, Adrenal insufficiency, Adrenal Tumors, Beta-cell disorders, Calcium Disorders, Carcinoid Syndrome, Conn's Syndrome more

Treats: Adults Only

Surgeon: No

Education: University of Santo Tomas Faculty of Medicine & Surgery

 
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Need an Appointment?

For questions, or if you'd like to schedule an appointment at the Center for Specialized Women's Health, call Cleveland Clinic 4HER® Women's Health Line at 216.444.4HER.

Location

The Center for Specialized Women's Health is located on the main floor of the Crile Building (on East 100th Street between Euclid and Carnegie avenues) on the Clinic’s main campus.

Shared Medical Appointments

Interested in a Shared Medical Appointment (SMA)? This is an opportunity to share and discuss medical concerns with women who have similar health problems and concerns. They often provide patients with new insight and valuable information about their own health. Patients also enjoy the additional time they spend with their physician and appreciate the support of other healthcare professionals.

To learn more about shared medical appointments, call Teresa Westbrook at 216.475.2720.

Or, download our flyer.

Publications

The Cleveland Clinic Guide to Menopause
The Cleveland Clinic Guide to Menopause

If you're careening through midlife in crisis mode, this book will help you feel more confident about the changes that are occurring. The Cleveland Clinic Guide to Menopause is a compassionate, practical guide that gently reminds women that midlife is not only a time of change but also a time of great freedom.

Full of insightful information, The Cleveland Clinic Guide to Menopause provides peace of mind and helps women regain control of their personal health during midlife. Here's the truth about hormone therapy as well as other safe and effective methods for finding wellness. You'll learn about:

  • How to stop hot flashes and get a good night's sleep
  • The facts about vitamins, supplements, and antidepressants
  • Using diet and exercise to boost energy
  • The basics of good bone health
  • Preventing cancer and heart disease
  • How to recharge your sex life

Dr. Thacker's new book is a compassionate, practical guide that gently reminds women that midlife is not only a time of change but also a time of great freedom.

The Cleveland Clinic Guide to Sexual Health in Menopause
The Cleveland Clinic Guide to Sexual Health in Menopause

When it comes to intimacy, there are no standards of how often you should have the desire. If you are bothered by how increasing age is affecting you in the bedroom, download this free guide to help you understand what’s going on and restore your enjoyment.

This guide contains information on:

  • Common complaints during menopause
  • Treatment options for hormonal and non-hormonal issues Suggestions on how to enjoy intimacy during menopause and beyond

Health Information for Women

Birth Control

Today there are many methods of birth control, or contraception, that offer a high degree of safety and effectiveness. Birth control allows you to choose if and when you wish to have children and to plan your family just as you plan other aspects of your life. Without using any type of birth control, up to 85 percent of sexually active women would be expected to become pregnant within a year. Some types of birth control, such as condoms and spermicides, offer added protection against sexually transmitted diseases and cancer of the cervix.

Bleeding Abnormalities

Abnormal bleeding may be caused by any number of problems, including fibroids, endometrial polyps, changes in hormone levels, infection or cancer. If you experience abnormal bleeding, call your physician immediately.

Breast Cancer

Breast cancer is a condition in which breast cells grow abnormally and divide without control or order. Breast cancer is the most common form of cancer in women. Early detection and prompt treatment help many women live long, full lives.

Breast Center

Patients who suspect or have been diagnosed with breast cancer should consider meeting with our breast care specialists. High-risk patients also can participate in the world’s largest breast cancer prevention trial, called STAR. In conjunction with the Clinic’s Cancer Care centers, patients have access to leading-edge medical therapies, as well as clinical trials. Our plastic surgery and breast center staff work together to offer breast reconstruction following cancer surgery.

Breast Disease

Breast disease includes breast pain, nipple discharge, breast lumps and swelling, fibrocystic disease and breast cancer. Breast specialists thoroughly evaluate patients by performing breast exams and, if necessary, diagnostic tests such as mammograms, ultrasounds or biopsies. Risk assessment and prevention may also be performed.

Breast Health

Early detection of breast abnormalities through regular breast screenings is the key to maintaining breast health and reducing your chance of breast cancer. Regular breast screening includes performing monthly breast self-exams, getting annual breast physical exams from your physician and following the American Cancer Society’s guidelines for mammography.

Cervical Cancer

The incidence of cervical cancer, in its invasive form, has decreased over the past several decades. However, recent evidence shows that the risk of cervical cancer is linked to repeated human papillomavirus (HPV) infections. HPV is one of the most common sexually transmitted diseases. Because HPV usually doesn’t cause symptoms, infected persons often don’t know they have it. Cervical cancer is highly curable when identified and treated early. When performed regularly, PAP smears can detect cervix changes early so any abnormalities can be treated right away.

Colorectal Cancer

According to American Cancer Society estimates, colorectal cancer is the third leading cause of cancer and cancer deaths among American men and women. Every year, more than 130,000 new patients are diagnosed with colorectal cancer, and more than 46,000 colon cancer-related deaths occur. Unfortunately, many colorectal cancers are "silent" until they become advanced, at which time they begin to produce symptoms. However, through regular screenings, colorectal cancer is preventable and, if detected early enough, curable. Screening recommendations depend upon an individual’s personal risk of colorectal cancer.

Depression

Women are twice as likely than men to develop depression. In fact, 10 to 25 percent of women will experience an episode of major depression at some time in their lives, and there are several reasons for this. Hormonal changes associated with the reproductive cycle may cause depression, especially during the premenstrual, postpartum and perimenopausal periods. Stressful lifestyles, such as trying to balance a home and career may contribute to depression. Women in midlife are faced with certain challenges, such as aging, marital changes, "empty nest" syndrome, competition with adolescent daughters and bodily changes (e.g. menopause), that also may contribute to depression. The increased incidence of depression in women may also be because women report symptoms of depression more readily than men and are more likely to seek help. Whatever the cause, treatment for depression is available.

Diabetes

Diabetes, or "high sugar," is a chronic disease that results when the body does not make enough insulin (Type 1 Diabetes) or the insulin does not do its job properly (Type 2 Diabetes). Diabetes is the sixth leading cause of death in the United States; there is no cure.

If left untreated, diabetes can lead to many other problems, including blindness, cataracts, kidney failure, nerve damage, heart disease and vascular disease that often requires amputations. The good news is that diabetes can be controlled with proper nutrition, regular exercise and, for many, medications. Controlling one’s glucose levels can dramatically reduce the chances of developing diabetes-related complications.

Eating Disorders

Common among girls and women, eating disorders are mind and body illnesses in which eating habits and attitude about one’s body become harmful. A person may move from a healthy desire to lose some weight to the use of extreme methods of dieting, including intermittently fasting, purging (through vomiting, exercise and use of diet pills and diuretics) and other unhealthy eating or lifestyle-related habits. Eating disorders can be seen in children as young as three and in women in their nineties; five to 10 percent of eating disorders are found in males.

There are three main types of eating disorders. One is anorexia nervosa (characterized by intentionally starving oneself). Another is bulimia nervosa (characterized by binge eating followed by some means of compensatory behavior, such as vomiting or exercise). The third type is referred to as "eating disorder not otherwise specified," a catch-all category that includes individuals with abnormal eating attitudes and behaviors. For example, a person may have a binge-eating disorder in which they binge but don’t purge. Others may have behaviors consistent with anorexia or bulimia, but they haven’t lost weight, or they haven’t lost their periods yet.

If left untreated, eating disorders often will get worse and result in life-threatening medical complications including harm to internal organs and risk of sudden cardiac death. Early detection and treatment of eating disorders are crucial.

Prevention and treatment of eating disorders usually include a multidisciplinary approach from a number of trained specialists such as a registered dietitian versed in eating disorders to help ensure adequate food choices; a psychologist and/or psychiatrist to help build stress management skills; and a medical doctor to monitor physical health.

Endometriosis

Endometriosis is a condition whereby fragments of the inner lining of the uterus develop in places outside the uterus, such as within the uterine wall, in the ovaries, or sometimes in the fallopian tubes, the vagina or the intestine. Not all women with endometriosis experience symptoms. Typical symptoms include abdominal cramps or back pain during menstruation; painful bowel movements; painful urination, especially during menstruation; abnormal or heavy bleeding during periods; painful sex; and difficulty becoming pregnant. Severe cases of endometriosis can lead to infertility. Although there is no cure for endometriosis at this time, there are medical and surgical treatments to reduce the size of tissue growth and to relieve painful symptoms.

Female Sexual Dysfunction

Female Sexual Dysfunction is defined as a disturbance in, or pain during, the sexual response. It is estimated that 25 to 63 percent of American women suffer from FSD. Sexual problems can occur in the areas of arousal, desire and orgasm. In addition, some women experience pelvic and genital pain with or without intercourse.

Fitness

Fitness is defined as the ability to perform moderate to vigorous physical activity without undue fatigue. Fitness can be maintained throughout one’s lifetime, regardless of age or sex, and often despite many pre-existing medical conditions. It is believed that many cases of heart disease, diabetes, high blood pressure, cancer and arthritis could be prevented by regular exercise. Exercise helps decrease the risk of chronic disease, as well as provide stress relief. Besides all of the above, it’s fun!

Heart Disease

The leading killer of women is not cancer, but heart disease. Although women know what they need to do to prevent this disease-maintain a healthy weight, don’t smoke, eat a healthy diet and seek treatment of hypertension, high blood lipids and cholesterol-most are not taking these steps. The facts are:

  • 50% of adult women are overweight
  • 75% eat fewer than five daily servings of fruits and vegetables
  • 33% don’t get any exercise
  • 20% smoke

Symptoms of a heart attack are different in women than men. Women may experience nausea, dizziness, breathing problems, back, jaw or neck pain, in addition to chest pain.

Hormone Replacement Therapy

For many women the benefits of hormone replacement therapy appear to outweigh the risk. Hormone replacement therapy is the best therapy for treating menopausal symptoms and preventing menopausal-associated bone loss. However, hormone replacement therapy may increase the risk of blood clots and gallbladder problems in some women. Short-term hormone therapy does not increase the risk of breast cancer; the risk of breast cancer associated with long-term hormone replacement therapy is still actively being studied.

Hysterectomy

Hysterectomy is the surgical removal of the uterus and possibly other organs and tissue. Most often, a hysterectomy is performed in order to treat abnormal vaginal bleeding; severe endometriosis; severe uterine fibroids; increased pelvic pain related to the uterus but not controlled by other treatment; uterine prolapse; and cervical or uterine cancer. Today, there is a minimally invasive surgical procedure available for hysterectomy and, in some cases, alternatives to hysterectomy.

Incontinence (urinary and fecal)

Incontinence is the inability to control the passage of urine or stool. Often, embarrassment and the stigma associated with incontinence prevent the person from seeking treatment, even when incontinence threatens her quality of life. It is important to know that urinary and fecal incontinence can be cured or significantly improved once the underlying cause has been detected.

Infertility

Given the intricate nature of the human reproductive system, it is not surprising that approximately one of every six couples will not be able to conceive a child after trying for one year. For couples who want to have a child of their own, infertility is like a roller coaster ride of emotional highs and lows. One important step in reducing the feelings of frustration and helplessness associated with infertility is to access the latest in advanced reproductive technology. Fortunately, advances in the treatment of infertility are helping more and more couples achieve their dreams of conceiving their own child.

Mammography

Mammography is a way to detect abnormal growths or changes in breast tissue. To perform mammography, a health care provider takes an X-ray of the breast tissue. This X-ray is called a mammogram. Screening guidelines suggest women have yearly mammograms beginning at age 40.

Menopause

Menopause is an important time in a woman’s life. The ovaries stop making eggs and the female hormones precipitously decline. This may or may not lead to symptoms and health consequences. Menopause is an excellent time for a woman to reevaluate her overall health status and visit a physician for a menopausal risk assessment.

Menstrual Disorders

The term menstrual disorders encompasses many syndromes affecting women of childbearing age. The disorders can include premenstrual difficulties, painful periods and ovulation, and headaches related to menstruation. Although all of these problems are different, they have one thing in common: These disorders significantly affect the lives of otherwise healthy women on a monthly basis.

Mental Health

Mental disorders are more common than cancer, diabetes or heart disease. During a given year, roughly 23 percent of American adults suffer from a diagnosable mental disorder, such as depression, anxiety, insomnia, chemical dependency or eating disorders according to the U.S. Surgeon General.

Mental illness is a general term that refers to a group of brain disorders that affect the way a person thinks, feels, behaves and/or relates to others and to his or her surroundings. While the symptoms of mental illness can vary from mild to severe, a person with mental illness often is unable to cope with life’s daily routines and demands.

Many "physical" factors, such as heredity and brain chemistry, play a role in the development of a mental illness. As such, many mental disorders can be treated effectively with medication, psychotherapy (a type of counseling) or a combination of both.

Migraines

The National Headache Foundation estimates that 28 million Americans suffer from migraine headaches. They occur about three times more frequently in women than in men. Migraines can last anywhere from four to 72 hours and can be debilitating. Researchers believe that migraines are caused by inherited abnormalities in certain areas of the brain. People with migraines may inherit the tendency to be affected by certain migraine triggers, such as fatigue, bright lights and weather changes. Avoiding triggers is the best preventive measure, but many medications are available to help prevent and treat migraine headaches.

Nutrition

Research over the last few years has shown that the way people eat has a lot to do with how healthy they are-and how healthy they stay. This research also has shown that eating a healthy diet that is low in fat, high in fiber and includes plenty of fruits and vegetables, may help to lower cancer risk. In addition, some foods contain properties that may prevent and even help treat disease, from cancer to heart disease and osteoporosis.

For the child, adolescent and young adult in particular, care must be taken so that a low-fat diet does not mean a no-fat diet; their bodies require a minimum of 30 to 50 grams of fat per day to maintain brain and body health. They also require two to three 3-oz. servings of protein each day.

Obesity

Obesity is a common problem in the United States, affecting nearly 40 million adults. Defined as an excess of total body fat, obesity can be assessed by calculating body mass index using a person’s height and weight. A variety of factors contribute to obesity, including genetic, environmental and psychological. Because obesity can be hazardous to our health, it is absolutely essential that it be treated properly.

Be Well MomsSM

Cleveland Clinic’s Be Well MomsSM program will give you the information you need to optimize your weight and health before and during pregnancy, and after delivery. To welcome the healthiest possible baby into the world, you’ll want to do everything you can to enjoy a healthy pregnancy and a safe delivery.

Osteoporosis

Osteoporosis, also known as the "silent thief," is a major health problem affecting up to half of all women. Women are more likely than men to get osteoporosis because women have less bone density. At menopause, half of all women lose bone mineral density at a rate of five percent per year. In addition to maintaining a healthy lifestyle, postmenopausal women should make sure to get enough calcium, vitamin D and exercise to help prevent osteoporosis.

Ovarian Cancer

Although rare, ovarian cancer is one of the deadliest cancers in women. It is difficult to detect, but when the cancer is caught early, the five-year survival rate is about 95 percent. Symptoms of ovarian cancer, which often include abdominal or back pain, bloating, feeling full early after eating, nausea and constipation, are frequently associated with other illnesses. At this time, there are no routine screening tests for ovarian cancer. A pelvic exam, performed during a woman’s "annual" examination, may identify an ovarian mass. Ovarian cancer is more common in women with breast cancer or a family history of breast and/or ovarian cancer.

Pelvic Floor Disorders

Specialists in urogynecology, a subspecialty area of gynecology, concern themselves with pelvic floor disorders that include fecal and urinary incontinence; rectal, vaginal or bladder prolapse; constipation and diarrhea; and pelvic floor pain. A wide variety of surgical and medical treatments are available for pelvic floor disorders, including minimally invasive techniques to treat urinary incontinence and vaginal prolapse.

Pelvic Pain (chronic)

Chronic pelvic pain is defined as pain-unrelated to menstrual cramps-in the lower abdomen and pelvic area that lasts at least six months. There are many different causes of chronic pelvic pain, including uterine fibroids, pelvic inflammatory disease, endometriosis, intra-abdominal scar tissue, stress, urinary tract or bowel diseases, and overly tense pelvic floor muscles, to name just a few. Your physician can help identify the source of the pain with exams and tests. If necessary, he or she may recommend laparoscopic exploration. Even if the source of the pain cannot be identified, treatments and techniques are available to help you manage the pain.

Reproductive Health

Maintaining reproductive health should be a priority for every woman, regardless of whether or not having children is a goal. Scheduling regular screening exams and seeking treatment for disease are important to maintaining good health. Regular screening exams include Pap smears to screen for cervical cancer and mammograms to screen for breast cancer. Eating right and exercising regularly also are critical. Certainly, if a woman plans to become pregnant, extra consideration should be given to developing and maintaining healthy habits that have a direct effect on the fetus, such as avoiding smoking.

Sexually Transmitted Diseases (STDs)

Diseases that are sexually transmitted can affect both women and men. Often there are no symptoms; when symptoms do occur, immediate treatment should be obtained. Both sexual partners must be treated to avoid spreading the disease. To protect against STDs, women and men should limit their sexual partners. Mutually monogamous relationships and regular use of a condom are the best protection. Spermicides can provide additional protection from STDs.

Sports Health

This program serves to help female athletes achieve optimal health and sports performance by preventing injuries, providing expert guidance for exercise and nutrition, and returning injured athletes back to an active lifestyle. Led by Susan Joy, M.D., a primary care sports medicine physician, this program serves both orthopaedic and medical needs of female athletes at any level.

Thyroid Disorders

The thyroid is a butterfly-shaped gland found at the base of the throat. Its purpose is to control the body’s metabolism by producing hormones, T4 and T3, which tell the body’s cells how much energy to use. When the thyroid produces too much hormone, the body uses energy more quickly than it should. This condition is called hyperthyroidism. When the thyroid doesn’t produce enough hormone, the body uses energy more slowly than it should. This condition is called hypothyroidism. Hypothyroidism can cause fatigue, weight gain and depression. Thyroid nodules and goiter are other conditions that may affect the thyroid gland. Currently, about 20 million Americans have some form of thyroid disease, and women are more likely than men to have thyroid problems.

Thyroid dysfunction can be diagnosed with a simple blood test. Nodules of the thyroid may require aspiration (sampling fluid for diagnosis). Treatment of hypothyroidism (under function) involves normalizing the thyroid hormone level with synthetic thyroid hormone (pills). Treatment of hyperthyroidism may involve medication, radioactive iodine or, occasionally, surgery. Depending on results of aspiration, treatment of nodules may involve surgery.

Uterine Fibroids

Uterine fibroids are non-cancerous nodules that most commonly develop within the wall of the uterus. They may grow as a single nodule or in clusters and may range in size from 1 mm to more than 20 cm (8 inches) in diameter. Most fibroids do not cause any symptoms and do not require treatment other than regular monitoring.

If symptoms are present, they may include excessive or painful bleeding during menstruation; bleeding between periods; a feeling of fullness in the lower abdomen; frequent urination from a fibroid pressing on the bladder; pain during intercourse; and low back pain. Treatment, including minimally invasive surgery, is available for patients with severe symptoms.

Women’s Health Center staff can determine if a woman with fibroids is a candidate for a new, non-surgical procedure called uterine artery embolization.

Urinary Tract Infections

Bacteria are normally present in some parts of the body, such as the vagina and rectum. However, when bacteria invade a part of the urinary system, infections can occur. Women are more likely than men to have urinary tract infections, because a woman’s urethra, vagina and rectum are close together. Also, because the urethra is fairly short, it is relatively easy for bacteria from the vagina or rectum to travel up the urethra into the bladder and then to the kidneys. The typical symptoms of a bladder infection are frequency, urgency and pain with urination.


Chat Transcripts

Read transcripts of previous chats with Dr. Thacker and other experts on a variety of topics of interest to women.

Video: Women, smoking and contraceptives

If you're over the age of 35, are a smoker and use contraceptives, then this informative video warns of potential dangers to your heart. Be heart-healthy, and find out why this combination can be damaging to your heart.

 

 

Be Strong...Be Healthy...Be In Charge with Speaking of Women's Health!

Speaking of Women's Health (SWH) is a national health education program from Cleveland Clinic's Center for Specialized Women's Health. The program’s mission is "to educate women to make informed decisions about health, well-being and personal safety for themselves and their families."

Under the leadership of Holly L. Thacker, MD, SWH consists of exciting women's conferences, and an interactive website with health information from women’s health experts, recipes, tips and more. Visit us at www.speakingofwomenshealth.com. Log on and sign up for the free Speaking of Women's Health monthly e-newsletter to receive health and lifestyle tips, delicious recipes, conference updates and more delivered twice a month, right to your inbox.

Join the Cleveland membership program for updates on events: clevelandclinic.org/swhmembership.

Special events in Ohio and at cities around the United States provide women with the opportunity to speak with Cleveland Clinic experts about prominent women’s health issues during a physician question and answer session. The popular events are hosted by local medical professions in such areas as women’s health, obstetrics, cardiovascular health, dermatology, nutrition, and more.

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Female Cancers: What You Need to Know

Robert DeBernardo, MD and Thomas Morrissey, MD
Friday, September 12, 2014 | Noon (ET)

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Pap Smears and Cervical Cancer Survival
Pap Smears and Cervical Cancer Survival

Dr. Holly Thacker says smear tests can boost chances of surviving cervical cancer.

Holly L. Thacker, MD, Executive Director of Speaking of Women’s Health, Awarded Research Grant

Holly L. Thacker, MD, was awarded a $10,000 research grant as one of 10 winners of the Healthnetwork Foundation Service Excellence Awards. The Service Excellence Awards are given annually to 10 top physicians who have consistently gone above and beyond for members. Dr. Thacker also is being recognized for demonstrating a long-term commitment to premium-level patient care and medical research.

Healthnetwork Foundation is a Cleveland-based non-profit that networks presidents and CEOs into the top hospitals in the U.S. when their members have medical needs. Its mission is to improve medicine for all society through philanthropy.

Dr. Thacker is the director of the Cleveland Clinic Center for Specialized Women’s Health and the Executive Director of Speaking of Women’s Health. She is an associate professor at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. Dr. Thacker published her second women’s health book “Cleveland Clinic Guide to Menopause.”

Dr. Thacker was honored by the American Medical Women’s Association (AMWA) and the Journal of Women’s Health with the "Lila Wallis Women’s Health Award" in recognition of her lifetime achievements, accomplishments, motivation, mentorship, energy and enthusiasm for women’s health.

Certified Menopause Practitioner Program

Several Cleveland Clinic staff members have participated in the North American Menopause Society (NAMS) Certified Menopause Practitioner Program (NCMP), a competency examination program to set the standards for menopause practices, and to assist women in locating clinicians who could provide optimal menopause-related health care.

Pictured: Front Row: Mary Clarkin, CNP NCMP, Jessica Strasburg, MD NCMP, Holly L. Thacker, MD FACP CCD NCMP Second row: Margery Gass, MD NCMP, Hannah Lisbona MD NCMP, Wulf Utian, MD PhD NCMP, Julian Peskin MD NCMP, Andrea L. Sikon, MD FACP CCD NCMP

Not Pictured: Pelin Batur, MD NCMP, Yvonne Braver, MD FACP NCMP, Laura Lipold, MD NCMP, LynnM. Pattimakiel, MD NCMP, Jennifer Poptic, MD NCMP, Sudhaker Rao, MD NCMP, Sheila Rice Dane MD NCMP, Shaila Sundaresh, MD NCMP, Kristi A. Tough, MD NCMP, Judith Volkar, MD NCMP, Devorah R. Wieder, MD NCMP.