July 2019 Sale $50 OFF TLC™ Integrative Wellness Programs

Take advantage of our summer sale: $50 OFF all TLC™ Integrative Wellness Programs!  Sale ends July 31, 2019.

What is Total Lifestyle By Couri, TLC™

Science-based, TLC™ incorporates in-depth labs, nutrition, and exercise. TLC™ is based on traditional and integrative medicine principles.

Tailored just for you, TLC™ incorporates food sensitivity, hormone, metabolic and expanded lab profiles. Whether you need a boost to lose weight & improve eating habits or a comprehensive wellness program, we can help guide you.

In 2012, Dr. Couri, MD graduated from a 2-year Fellowship in Integrative Medicine at the University of Arizona under the direction of the all-inspiring Dr. Andrew Weil. Inspired to share the integrative principles gleaned from her Integrative Fellowship, with her patients, Total Lifestyle By Couri was born.  The TLC™ program combines the power of Integrative Medicine with the foundation of traditional Western Medicine for an unsurpassed experience that you will benefit from for years to come.

Is TLC™ a one-size-fits-all program?

No.  TLC™ is completely personalized!  Choose from a 60-minute integrative consultation, TLC™ Core, a 12-week program or TLC™ Plus, a robust 15-week program.  Each is customized just for you.  Schedule your complimentary consultation for details and to review pricing options.

How do I get pricing and learn more?

The Origin of the Gynecological Speculum By Dana Humes Goff

For some women, the most dreaded aspect of the annual gynecological exam involves the speculum. A speculum, which can be either metal or plastic, is a device, which is placed into the vagina in order to visualize the vaginal walls and the cervix. While this procedure may be uncomfortable for some, it should not be painful, and it is a useful tool for assessing female anatomy.

Variations of the speculum can be dated back to 130 A.D., and early examples of the device have been discovered in archeological digs as far back as 79 A.D. amidst the ruins of Pompeii. The design of today’s speculum is primarily credited to a physician by the name of James Marion Sims, a gynecologist in the 19th century who performed numerous experiments on slave women, those of whom he purchased and kept as property in the back of his private hospital in Montgomery, Alabama.

One of the most common problems he encountered during his career was a condition known as a rectal or vaginal fistula, which can be caused by childbirth. A fistula is an opening that is formed between the bladder or rectum and the vagina. This tear can result in urine or stool collecting in the vagina, which can cause infections, pain, and incontinence. Repairing this type of tear required him to be able to look into and inspect the vaginal canal.

Dr. Sims was an imaginative man and utilized what he had at hand to draft a prototype of the first modern speculum: a gravy spoon. This allowed him better access to the vaginal tissues and he was able to perform the surgery necessary to repair the fistulas.

The introduction of the speculum by Dr. Sims, in the late 1800s, was very controversial and set off a vigorous debate within the medical community. The fear was that the use of a speculum might corrupt those women who were being examined and subsequently turn them into prostitutes or sex-crazed maniacs.

Thankfully, over the last 150 years, medicine has advanced, and the speculum design has improved and moved past the gravy spoon prototype, and gynecological exams have become routine. While there have been many attempts to improve upon the current speculum design, the basic design has remained unchanged.

So, for those women who avoid or fear gynecological exams due to perceived discomfort, I encourage you to discuss this with your provider. Often, the use of a smaller speculum, relaxation techniques, and gentle explanations with tips for making the exam easier can make your annual exam much more comfortable.

Update: Teen Girl’s First Gynecological Visit By Dana Humes Goff, APRN, CNM, DNP


One question I often get asked as a women’s health care provider is, “when should I bring my teenaged daughter in for her first gynecological visit?”

In the past, my answer was usually dependent upon many variables: if she’s having any problems; if her periods are regular; if she’s sexually active, and so on.

ACOG Updates Age for Teens First Gynecological Visit

But recently, The American College of Gynecology and Obstetricians (ACOG) published a Committee Opinion recommending a first gynecological visit should occur between the ages of 13 and 15 years of age to discuss healthy relationships in addition to general reproductive health.

This initial visit would provide opportunities for women’s health providers to educate teenage girls and their guardians about age-appropriate health issues, such as sexual relationships, dating violence, and sexual coercion. Between the ages of 13 years and 15 years is an ideal window because middle school is a time that some adolescents develop their first romantic and sexual relationships.

Why is this initial visit so crucial?

Establishing a non-judgmental, open relationship with a trusted clinician at this point in a young woman’s life can be instrumental in the development of their self-respect and self-confidence.  Knowledge is powerful, and encouraging teen girls to become better educated about their anatomy and reproductive health can empower them to have better control over their bodies, and avoid sexually transmitted diseases and pregnancies.

The first gynecological visit doesn’t have to be feared. Often, the visit can be conversational and informational only: obtaining a full medical history and providing education about normal periods and puberty, intimacy, relationships, and what components make up a physical gynecological exam for future visits.

The importance of patient confidentiality is an essential factor to be stressed with young patients so they can feel confident that their clinician will protect their privacy regarding questions and personal issues, and that questions will be answered honestly and openly.

Building Relationships with Your Teen

The relationship that develops between women and their women’s health provider becomes more valuable over time.  Studies have found that a strong role model early in puberty can help to decrease a young patient’s participation in risky behaviors in the future.

I am especially fond of seeing young women for their first visit: allaying their fears and answering their questions.  Setting a positive tone at the initial visit establishes the foundation of trust that evolves as our professional relationship develops.

Personalized Teen Visits, only at the Couri Center

In 2019, The Couri Center will be introducing an exciting new program, TLC Teen, which will focus on the various issues that young women may face during their adolescence. We look forward to continuing to provide outstanding women’s health care to this next generation.

 

Happy 2019!

Dana Humes Goff

 

 

 

 

 

Contraception: Past, Present and Future By Dana Humes Goff

According to the CDC, 83% of all women of reproductive age (15-44) in the United States will use a contraceptive method at some point during their lives. Reliable contraception has allowed women to have considerable freedom; however, this has not always been the case. The following information will make you thankful for the abundance of options currently available in today’s market.

As far back as 1550 B.C., ancient writings noted that Egyptian women were directed to mix crocodile dung, honey, acacia leaves and wool to form a pessary, which was then placed against the cervix to prevent pregnancies. Ancient Greeks reportedly utilized a plant called Silphium, which was so successful in preventing pregnancy, it was harvested to extinction.   In Casanova’s memoirs, as documented in the 1700s, he resourcefully detailed the use of a lemon half as a makeshift cervical cap to attempt to prevent pregnancies.

Fish bladders, animal intestines, sea sponges, chastity belts and other substances were creatively used over the years as primitive contraceptive devices: Albeit, without much effectiveness, and certainly did little to stop the spread of sexually transmitted diseases.

In the 19th century, Charles Goodyear invented vulcanized rubber which led to the manufacturing of rubber condoms.  The industrialized nation now had a new scientific method of pregnancy prevention.  Unfortunately, Congress, in 1873, passed an anti-obscenity law, which deemed birth control as obscene, and outlawed its use and distribution. This bill was known as The Comstock Law, and was the law of the land until 1938.  The Comstock Law was overturned in 1938; however, the Supreme Court didn’t legalize contraception use for married couples until 1965. Remarkably, the use of birth control by unmarried women remained illegal until 1972.

From the 1920s-1960s, Lysol disinfectant was commonly touted to housewives as  “feminine hygiene” and was used as contraception. Unfortunately, this was false advertising and not based on scientific fact, and as a result, women died, or suffered severe inflammation and burns.

The FDA approved the first oral contraceptive in 1965 and “the Pill” soon dominated the market with its convenience and effectiveness. The Depo Provera shot was introduced in the 1990s, and soon the Nuva Ring, Patch, IUD and implants followed a decade later.

The future promises to bring even more exciting options for both men and women within the realm of contraception.  The Bill and Melinda Gates Foundation has announced that it is backing a Massachusetts biotech company that is developing an implantable contraceptive that can be activated and deactivated by the user by remote control, according to MIT Technology. A male method for a reversible vasectomy, as well as, a male oral contraceptive pill is also in development and available in the early 2020s.

Historically, both men and women have struggled to find available, imaginative means to prevent pregnancies over the years. Fortunately, science and biotechnology have creatively developed effective contraception for both sexes, and continues to do so.

Thankfully, and I think it goes without saying; we’ve come a long way from crocodile dung and fish bladders.

 

Dana Humes Goff

 

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To customize your skin care regime, call 692-6838 to schedule your Free consultation with our Licensed Esthetician today!

 

MedPax: Custom Monthly Supplements

Dr. Michele Couri, FACOG, ABIHM has personally created several customized MedPax™ (individualized daily supplement dosing packs) based on the most common symptoms and conditions patients discuss with Couri Center providers.

Couri girl MedPax™ are available for:

  • Bone Health (Osteopenia and Osteoporosis)
  • Heart Health (elevated cholesterol)
  • Menopause Relief
  • PMS Management
  • Gut Health
  • Mood and Anxiety
  • Stress and Sleep Issues
  • Hair, Skin and Nails
  • Inflammation and Joint Pain
  • Diabetes
  • Athletic Performance

MedPax™ are able to be further customized to each patient’s individual supplement needs to maximize effectiveness and affordability. So, if you have a certain medical issue or constellation of symptoms (other than the ones listed above) that you want resolved, we can customize MedPax™ just for you.

How it works:

After reviewing your medical history and any pertinent lab work, we will make recommendations for appropriate supplements for you. After we meet with you, we will input our recommendations for your personalized MedPax™ securely online to Xymogen®. You will then receive your supplements shipped directly to your house.

MedPax™ Benefits:

  • MedPax™ is convenient. You can easily take your nutritional supplements on the go.
  • It takes the guesswork out of organizing and remembering if you took your supplements.
  • MedPax™ clearly tells you when to take your next dose.
  • You don’t have to ever worry about running out. Your MedPax™ can be automatically sent to you every 30 days.

If you would like to find out if Couri girl MedPax™ are right for you, email info@couricenter.com or call 692-6838 to set up an appointment to learn more. Or if you are tired of buying several different bottles and brands of supplements to achieve optimal results, switch to MedPax™ and let us make it easier and more effective for you to achieve your goal. And our Earth will thank you — less bottles in our beautiful oceans!

 

Bare Down There? By Dana Humes Goff, APN, CNM, DNP

As a women’s health care provider, one thing I have observed over the years is the ongoing disappearance of pubic hair. What once was a constant among women is now a rare occurrence, regardless of age. Over the last two decades, our society has gone from trimming the bikini line, to believing that the entire labia and pubic region must be bare to be clean. In fact, 95% of women admit to altering their pubic hair by trimming, shaving, or removing it completely. This, now, mainstream-grooming routine has made me question why we have pubic hair and what is its purpose?

There are many theories as to the purpose of pubic hair. One theory is that it helps in spreading pheromones. Research shows that our sweat glands secrete a smelly substance, which mixes with the bacteria and oil from the sebaceous gland. This results in a unique substance and scent known as pheromones. Pheromones can be trapped in the armpit hair and pubic hair of both women and men. The pheromone enhances sexual awareness and increased desire for sex.

Pubic hair can reduce friction when parts of the body rub together and offer a natural barrier to help keep things clean. Female pubic hair helps to decrease contact with viruses and bacteria to keep the tender skin around the genital area from being abraded. Offering protection is, therefore, one of the main purposes of pubic hair in the female reproductive system. Pubic hair also protects the reproductive system from bacterial pathogens such as streptococcus and viruses. Pubic hair controls moisture by wicking it up and away from the skin, and therefore, reduces the chances of skin breakdown. Pubic hair keeps the skin around the genital area moist and balanced.

In addition, at the end of each hair follicle is a nerve ending. These nerve endings are different from the other nerve endings whose purpose is maintaining pressure and temperature. When pubic hair is touched, a sensation is sent down the shaft of hair to the nerve ending. These feelings are registered in the brain as pleasurable.

So, if pubic hair has a purpose and is beneficial, why have so many jumped on the hair removal bandwagon? The January 2015 issue of The Journal of Sex noted that women reported stronger associations with feelings of cleanliness, comfort, sex appeal, and the social appeal of their peer group as reasons for removing pubic hair. The same article found that 60% of men reported preferring “hair free” partners and, in turn, were, therefore, more likely to trim and groom their own private areas.

Unfortunately, shaving and waxing can cause an infection in some of the small hair follicles around the vulva, which may create bumps and lumps called folliculitis. Folliculitis may present as a rash, better known as razor burn, or pus filled boils that are difficult to treat and very painful. Vulvar irritation is common after shaving or waxing. When skin irritation is combined with the warm environment of the genitals, it becomes a perfect breeding ground for some bacterial pathogens such as methicillin resistant staph aureus (MRSA) and other staph infections. Studies have also shown that shaving and waxing can increase the risk of contacting infections such as Herpes, HPV, and Syphilis.

If you do decide to shave, here are some tips to help reduce the risk of skin irritation:

  1. Soak hair follicles in a warm bath or shower to soften;
  2. Exfoliate the area with a salt or sugar scrub;
  3. Use a shaving foam or inexpensive hair conditioner;
  4. Use a new, sharp razor and shave in the direction of the hair growth;
  5. Moisturize the area after shaving and apply a thin film of Neosporin to reduce the skin bacteria.
  6. Apply a gentle deodorant to the shaved area to reduce perspiration and promote dryness.

If you’re interested in an alternative to shaving or waxing, consider laser hair removal at The Couri Center and free yourself from the constant need to shave and wax unwanted body hair.

During laser hair removal, energy is used to target and destroy hair follicles responsible for hair growth. The follicle absorbs the energy and is destroyed, unable to produce hair again. According to the American Society for Aesthetic Plastic Surgery, laser hair removal is the 3rd most performed non-surgical cosmetic treatments in the US. For more information, please schedule your free 15-minute consultation:  or call 692-6838.

So, my friends, while there are no known health benefits to removing hair from your lady region, removing pubic hair is the current popular trend. If you do decide to bare all, be sure it is your decision and please do it in a safe manner. If you have a chronic health condition, such as diabetes, ask your health care provider if there are special reasons you should not shave or remove your pubic hair. And, finally, please contact your health care provider if you develop folliculitis or any other symptoms of infection.

Dana Humes Goff

Welcoming NEW Gynecology Patients

 

Welcome to the Couri Center for Gynecology & Integrative Women’s Health.  We are accepting NEW patients and look forward to meeting you!

At the Couri Center we specialize in women’s health.  With years of advanced medical training and decades of experience, our success is easily measured in volumes of patient praise.  From traditional gynecology & surgical procedures to integrative health programs and aesthetics, take comfort in knowing you can trust the Couri Center.

LEARN MORE ABOUT THE COURI CENTER HERE

If you would like to schedule your new gynecology visit with one of our providers, please call 309-692-6838.  To expedite your appointment process, please complete the below forms and return them to us. 

What do I need to bring to my appointment?

To allow us to better serve you, and expedite your check-in process, we have included the below forms for you to fill out at your convenience at home:  Patient Information Form, Gynecologic Questionnaire and Medical Release. Also, please include a copy of the front and back of your insurance card. Please complete and return all forms to:  Couri Center, 6708 North Knoxville Avenue, Suite 1, Peoria, Illinois, 61614 or email to info@couricenter.com.  Unfortunately, if we do not receive these forms two weeks prior to your appointment, we will ask you to reschedule. We take pride in providing the utmost in compassionate and comprehensive gynecologic care and your paperwork helps us do just that right from the start.

Thank you so much, we look forward to meeting you!

Regards,

The Couri Center for Gynecology

If you are a NEW PATIENT: Please plan on arriving 15 minutes early.

Please complete the below (3) forms as follows:

A.  Print all (3) forms and fill in by hand. Then either:

  1. Mail to our office.  Or
  2. Scan completed documents and email to info@couricenter.com.

OR

B. Complete forms online as .pdf:

  1. Please open each form and save it on your computer, preferably add your last name to the file name while saving
  2. Open the saved documents and complete each fill in form
  3. Save completed documents.
  4. Email completed documents as attachments to:  info@couricenter.com

 

The Menstrual Cup By Dana Humes-Goff, APN, CNM, DNP

How would you like to have a healthy, inexpensive and ecological alternative to pads and tampons during your period? Many women have discovered menstrual cups; a feminine hygiene product made of flexible medical grade silicone that is shaped like a bell with a stem. The bell-shaped cup seals around the cervix, and every 4–24 hours (depending on the amount of flow), the cup is removed, emptied and rinsed, and reinserted.

Menstrual cups have been around since the 1930s, but have recently increased in popularity. The first menstrual cup for U.S. use was manufactured in 1987, and they are marketed under various names: MeLuna Shorty, FemmyCycle, DivaCup, Lunette, Ruby Cup, or the LilyCup Compact. The cups can be reused for 5 years and come in 2 sizes: a smaller size for women under 30 who have not given birth vaginally, and a larger cup for those women over 30, who have had a vaginal birth or have heavy flow.

The cups are flexible which allows them to be folded for vaginal insertion. Some women may find the insertion somewhat difficult at first, but after some practice the cup should set against the cervix and create a tight seal. The stem of the cup is pinched to allow for removal and the cup can then be rinsed or wiped and reinserted. Specific cleaning instructions for between periods vary by brand.

Menstrual cups are safe according to several studies and do not appear to be associated with Toxic Shock Syndrome since they collect the menstrual blood instead of absorbing the blood like tampons.

Menstrual cups are kind to the environment considering that each year an estimated 20 billion pads and tampons are discarded in North America. Since menstrual cups are reusable, they help to reduce solid waste. Some disposable sanitary napkins and plastic tampon applicators can take 25 years to break down in the ocean or a landfill and can cause a significant environmental impact.

It’s true that some women may experience difficulty in inserting or removing the menstrual cup, depending on previous experience and certain physical factors. Remedies for this include: coaching from experienced users; selecting a different size, shape, or material; using a water-based lubricant to ease insertion; changing the folding method for insertion; and practice. For some women, these difficulties disappear with continued use, while for others they may remain. In addition, some women find menstrual cups to be uncomfortable. This may also lessen with practice and continued use. Selecting a smaller or softer cup, and/or trimming the stem of the cup, if there is one, may also help.

Women with pelvic organ prolapse may not be able to use menstrual cups comfortably or safely.

Many companies recommend that women using IUDs for contraception consult their gynecologists before using menstrual cups since there have been rare cases in which women have dislodged their IUDs when removing their menstrual cups.

Unfortunately, the removal of a menstrual cup can be messy. Sometimes menstrual blood can spill during removal, although many women remove the device while hovering over a toilet to catch such spillage.

Cleaning a menstrual cup in a public restroom can pose problems since sinks are usually, though not always, in a public space rather than in the toilet cubicle. Some manufacturers suggest wiping out the cup with a clean tissue and cleaning the cup at the next private opportunity. Some users carry a small bottle of water in their handbag to rinse the cup privately over the toilet. Since menstrual cups may only need to be emptied every 4–24 hours, many users do not have to empty them in public restrooms but can wait to do so in the comfort of their own home.

A menstrual cup costs around $25–30, depending on the brand. Since menstrual cups can stay in longer than tampons, which have to be changed every 4-8 hours, cups are a less expensive alternative.

As with all things, there are some drawbacks to using menstrual cups. Some women reported irritation of the vaginal tissues initially; however, the more they used the cup, the fewer problems they had. It can also be difficult for some women to find the right fit, due to their anatomy and medical history. And, as previously stated, removal and reinsertion can be messy.

However, if you’re looking for a change in your menstrual routine, menstrual cups are a safe, economical and eco-friendly option for you to consider.

 

Dana Humes-Goff

 

Abnormal Bleeding and Steroid Use By Dana Humes Goff, APN, CNM, DNP

 

If you’ve ever suffered from an inflammation in a joint or tendon, your healthcare provider may have prescribed a cortisone injection or a prescription of oral prednisone. These steroid preparations are commonly prescribed and can greatly relieve the symptoms of a painful joint, tendonitis, arthritis, or other bodily discomforts.

Unfortunately, for some women the use of steroids may result in abnormal uterine bleeding. Abnormal uterine bleeding (AUB) is defined as a change in menstrual frequency, duration, and/or volume, as well as bleeding between periods. In postmenopausal women, AUB is defined as bleeding 12 months or more after the cessation of periods.

The use of steroids interferes with the normal regulation of hormones by the hypothalamus, pituitary gland and the ovaries. When this relationship is disrupted, an imbalance of estrogen and progesterone occurs and too much estrogen remains in circulation. This can cause a thickening of the uterine lining, which results in AUB. An episode of AUB can be alarming for women and it warrants an evaluation by your gynecologist to determine the cause.

A comprehensive history is important when evaluating someone with AUB because the presentation can be complicated due to many causal factors. Since the incidence of AUB after steroid use is only 2.5%, and, since bleeding post steroid use many not present right away, it is often not considered a probable cause of abnormal bleeding.

Your gynecologist will perform the testing necessary to exclude a more serious diagnosis of AUB. Lab tests, an ultrasound, and a procedure to test the uterine lining are often recommended. While these procedures may seem unnecessary if your bleeding to due to steroid use, the diagnosis of post-steroid induced AUB is often made retrospectively after all other possible causes have been ruled out.

It is important that you are aware of the potential side effects of all medications you are on, including steroids. Women should be advised of AUB as a potential adverse effect after steroid administration and healthcare providers should be aware of this association when evaluating abnormal uterine bleeding.

Stronger together,

Dana

 

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