| Women’s Wellness & Cosmetic: Bess Angela MD
19450 Deerfield Ave, Leesburg, VA 20176
DR. ANGELA BESS is one of the area most trusted Gynecologists. After finishing up her studies and practicing in New Jersey, she moved her family to Northern Virginia where she heads The Women’s Wellness & Cosmetic Laser Center of Loudoun.
You are a well-known gynecologist in the Northern Virginia area, you were also a Obstetrician, what made you decide to end that part of your business?
I have been delivering babies in the private practice setting for the past 11 years. It has been both humbling and rewarding to actively participate in this life-changing event with so many dynamic patients and families. I decided to phase out the Obstetric part of my practice this year. Practicing obstetrics is particularly stressful due to the nature of the specialty. The unpredictable schedule makes it rather challenging when it comes to lifestyle, particularly when that lifestyle involves being both a business owner and a parent. I decided to eliminate Obstetrics from my practice in an effort to create balance in my life.
You incorporate laser hair removal in your practice. You are doing something very unique in women’s health by combining beauty with health. What made you decide to do that?
The decision to add cosmetic laser services was largely based on patients requesting the services. Unwanted facial/body hair is closely related to several gynecologic issues including polycystic ovarian syndrome, obesity, menopause, and genetic predisposition. Many of my patients expressed interest in laser hair removal but were reluctant to go to the local spa/salon for their treatments. Patients feel more comfortable getting these services at my office because the procedures are performed by a medical professional and our laser equipment is safe enough to treat all skin types including ethnic skin.
Let’s talk fertility, does the risk of birth defects increase after 35? What are some of the challenges women face after that age?
As women reach their mid-thirties, several issues come up. First, the ability to get pregnant actually starts to decline. This decrease in fertility is due to a decrease in the number of eggs as well as to a decline in the quality of the eggs that remain. Also, as women age they are more likely to have concurrent medical and/or gynecologic problems that can interfere with conception. The risk of miscarriage increases as a woman gets older due to increases in chromosomal abnormalities that result from the decline in the quality of the eggs. The rate of early pregnancy loss is about 20% at ages 35-39 and increases to about 35% by ages 40-44. One-half of all pregnancies in women over the age of 45 will end in miscarriage. Women over the age of 35 who get pregnant are more likely to have pregnancy complications including gestational diabetes, high blood pressure, placental problems, premature deliveries as well as a higher chance of requiring a cesarean section for delivery.
What would you recommend a professional woman in her 20s who does not foresee a pregnancy until well into her 30s? Are there steps that she can take that will make it easier for her to have a baby later in life?
The best advice would be to maintain an ideal body weight through eating a healthy, well-balanced diet and engaging in regular exercise. Women of reproductive age should avoid alcohol, tobacco and drug use. Chronic medical conditions such as diabetes, hypertension, asthma, and epilepsy should be well-controlled prior to attempting pregnancy. All women of reproductive age should maintain up-to-date vaccinations and get the suggested routine annual screenings including gynecologic and dental examinations. Women of reproductive age should take 400 micrograms of folic acid daily for at least three months before conception to decrease the risk of neural tube defects. It is recommended that a pre-conception visit with a gynecologist take place prior to attempting pregnancy. It is at this visit that medications can be reviewed and any risk-factors can be identified and addressed.
What does a routine Pap smear show? What other tests I should ask for? A routine pap smear screens for abnormal changes in the cells of the cervix.
These abnormal changes could represent dysplasia (pre-cancer) or cancer. If precancerous cells are left undetected and/or untreated, the cells have the potential to progress to a more significant lesion that could require further treatment. When appropriate, the routine pap smear can also check for human papilomavirus (HPV) which is a common sexually acquired infection. High-risk stains of HPV are associated with pre-cancer and cancer of the cervix. Identifying those patients who have been exposed to HPV allows for closer surveillance of these higher-risk patients. Current recommendations state that pap smear screening should begin at age 21 regardless of the age of onset of sexual activity. Women ages 30 and above should also get high-risk HPV testing along with their pap smear. When going for your pap smear, request that liquid-based cytology be utilized for better detection rates.
We tend to put on pounds after having babies, and with time it gets even harder to lose weight. Is it related to hormonal changes? What is hormone imbalance? How can someone know that they may have an imbalance?
Hormonal imbalances can have numerous causes. When hormones are either too high or too low, they can adversely affect a woman’s metabolism which then affects her ability to maintain an ideal weight. Pregnancy can further complicate the issue as most women can expect a 20-30 pound weight gain with pregnancy and, often times, the ability to exercise regularly is curtailed both during pregnancy and during the postpartum period. Abnormal thyroid function can be the underlying cause in some cases of hormonal imbalance. Symptoms can include generalized fatigue, constipation, dry skin, hair loss, inability to tolerate cold and heavy/irregular periods. Abnormal estrogen levels can also contribute to changes in metabolism and the inability to lose weight. These fluctuations in estrogen levels can be caused by insulin resistance/diabetes, obesity, stress, and peri-menopause. Symptoms can include acne, excessive hair growth, central obesity, high cholesterol levels, heavy/irregular periods, hot flashes/night sweats, vaginal dryness, sleep disturbance and depression.
You assist women with weight control due to hormonal problems. So many women go through these problems without even knowing it. What are some of the signs of this issue? What can be done?
Once the underlying cause of the hormonal imbalance is determined, treatment can be addressed accordingly. Thyroid abnormalities can be treated with medication or with the removal of lesions that appear suspicious. Imbalances in estrogen are addressed by identifying the underlying cause. Obesity is best treated by combining dietary modification with regular exercise. Consultation with a nutritionist is sometimes indicated. If diabetes or metabolic syndrome is diagnosed, co-management with an endocrinologist may be appropriate. Peri-menopause can be approached through lifestyle changes including exercise, dietary modification and various relaxation techniques. When indicated, medical therapies may include low-dose oral contraceptive pills, anti-depressants and/or herbal remedies.
At what age should we bringing our young daughters to come in and see a gynecologist?
I recommend that girls have their first gynecologic visit between the ages of 14 and 16. That first visit is a time for the younger patient to become comfortable with the healthcare provider and it typically doesn’t involve a pap smear or pelvic exam. It is at this first visit that pertinent issues are addressed including menstrual issues, sexuality, alcohol/drugs/smoking, seatbelt use and emotional issues such as bullying and peer-pressure. Physical examination will be limited to a general assessment and a breast examination. My approach to sexuality is to encourage abstinence unless the conversation dictates that birth control and STD prevention is a more applicable discussion.
How do you manage your practice and home life?
I manage by continually striving to maintain balance between the two. This starts by setting realistic expectations about what it takes to be the best mother I can be while being the best doctor that I can be. When the stresses and strains of delivering babies became too much, I re-evaluated and decided that there was no way I could be as available as I needed to be for my children while being the type of obstetrician that I wanted to be. Therefore, the only option was to change the scope of my practice. Since I made the change to a gynecology-only practice, I have been able to serve my patients without exception while being a more active and a more consistent mom. As a bonus, patient response has been great. Patients and referring doctors appreciate the ability to be seen within one to two weeks of calling to schedule an appointment. Patients appreciate being seen at their appointment time and without interruption. I am able to run my day more efficiently since I am not constantly pulled away for obstetrical emergencies.
- Address 19450 Deerfield Ave, Leesburg, VA 20176
- Phone (703) 726-9680
- Category Health/Practitioners
- Location Leesburg, VA