Dr. Nascu
378 Huron Str Unit B, inside Heaton Health N5A 5T5 Stratford, ON, Canada

Good morning! A few former patients have reached out to me on Facebook with questions about their gynecological care. Please make note that unfortunately I have no way to personally help you anymore and I will not answer personal messages. You could reach out to your family physicians who are in possession of all my notes and they may be able to help you. If you experience an emergency you should go to your nearest emergency department. Best wishes to all of you.

Please do the right thing!

JOINT STATEMENT ISSUED BY THE FAMILY PHYSICIANS OF HURON-PERTH To all our patients and the citizens of Huron-Perth, There is no doubt that NOW is the time for all of us to do our part to curb the spread of COVID-19. We now have community spread of the virus within Canada and time is of the essence for implementing changes to flatten the curve before this pandemic overwhelms our healthcare system. As the physicians who have dedicated their careers and their lives to keep...Continue reading

SAN DIEGO Vaginal dryness and dyspareunia (pain with intercourse), along with other symptoms of genitourinary syndrome of menopause, can be safely and effectively treated with laser therapy. This presentation at the North American Menopause Society reinforces the results of a new, non-invasive treatment method for women who can not take vaginal estrogens or do not respond well. The author, dr. Eric Sokol, from the Stanford University School of Medicine in California, is a w...ell-known American gynecologist. His presentation clearly explains the way the lasers work: "During an office visit, clinicians can use either a CO laser or a YAG laser. The procedure does not require anesthesia, is usually painless, and can be performed in about 2 minutes. Women typically receive three treatments 6 weeks apart and are advised to abstain from intercourse for 3 days after each treatment. The laser process increases growth factors that contribute to the restoration of vaginal health. Increased collagen offers better mechanical support, increased glycogen content and delivery leads to an increase in Lactobacillus activity, and more acidic mucopolysaccharides in the ground matrix lead to better mucosal hydration. And the epithelial tissue of the vaginal mucosa thickens considerably, to premenopausal levels. "The increased permeability of the rehydrated extracellular matrix facilitates the diffusion of nutrients, mineral salts, ions, vitamins, antibodies, and hormones from the blood vessels to the tissue of the vaginal wall." Solid evidence for the laser treatment of genitourinary syndrome of menopause has been sparse, but it is increasing. It is still good to know that we have alternatives to shrugging our shoulders.

New study favorable compares vaginal laser (FOTONA) with surgery for urinary incontinence A new study published in the World Journal of Urology shows that the results obtained with Er-YAG vaginal laser treatment are equivalent to the ones obtained with vaginal sling surgery, without the associated complications. The authors compared patients pre-surgery and at one year after, using a standardized questionnaire and the one hour pad test, which measures the number of grams of... urine a person leaks over an hour of normal activity. In 50% of women treated with laser the pad test showed ZERO leakage, compared to 68% of the women in the surgical group. The biggest advantage was actually obtained in women with Mixed Urinary Incontinence (where urgency and stress both contribute to leakage). Some of these women do significantly worse after surgery, as the introduction of a foreign body may irritate the urinary tract. In these women the Er-YAG vaginal laser (FOTONA) was significantly superior to surgery at one year of follow up. These findings are encouraging, as it was previously thought that women with mixed incontinence will not be good candidates for laser treatment. Full article can be found at https://doi.org/10.1007/s00345-018-2445-x via Creative Commons (http://creativecommons.org/licenses/by/4.0/) See more

Oral Contraceptive Pills and the risk of cancer Oral contraceptives (OCP) are some of the most common types of contraceptives used in the world. Certainly, young women at the beginning of their sexual activity are more likely to use OCP and condoms and later on switch to a longer-acting contraceptive, like intrauterine devices/systems (IUD or IUS). A common concern is related to OCP causing cancer, or the worry that one will ingest an 'unnatural' substance or be exposed to a ...'hormone'. OCPs are one of the most used and studied medications in the world. They have been around longer than half a century, and their formulations have been changed a few times in order to provide the lowest efficient dose of medication required. The amount of estrogen in them has decreased by half, or even more. Initial studies looking at high-dose OCPs showed a possible (but not certain) link to a slight increase in breast cancer. Subsequent studies though, involving the OCPs currently in use, have disproved this association. On the contrary, there is a huge amount of data showing that OCP use will decrease the life-time risk of certain cancers, most noticeable ovarian cancer and cancer of the uterine lining (endometrial cancer). Some women will benefit more than others. A new study published in American Journal of Epidemiology looked at over 100,000 women who have used OCPs during their life. The study found exactly that: Use of OCPs was strongly linked to a DECREASE in occurrence of ovarian, endometrial and other cancer, and there was no evidence of increase in the risk of breast cancer. Strongest benefit was for long-time users (every extra 5 years brings an extra drop in life-time cancer rates). OCPs might not be for everyone. But if you are or have been a user at some point, stay assured: they're actually more likely to have protected than harmed you.

Aspirin for prevention of preeclampsia In women at high risk for preeclampsia use of 2 tablets of 'baby-aspirin' at bedtime starting before 16 weeks gestation has been shown to decrease the occurrence of this condition. Starting aftet 16 weeks, or taking one tablet only is of some benefit but may not give the same protective effect. We generally stop the treatment at 36 weeks gestation, but there is no compelling evidence that continuing to delivery will increase the risk of bleeding.

Over a year since we've been using the Erbium-Yag laser! Over 150 treatments done. Many happy women out there. Keep spreading the word, this machine can change lives!

My 12 year old daughter was vaccinated against HPV last week. Because cervical cancer kills. This is a disease of young women. I have seen a happily married woman with 4 children dying of it. I have mourned a friend, my age, who left behind a 12 year old boy. I have seen a young mother diagnosed shortly after giving birth. Cervical cancer is now mostly preventable. 99.7% of it is caused by high-risk HPV strains.... If you think your child will never get HPV because everyone else will be vaccinated, think again: we are only at the beginning of the vaccination campaign. It took 100 years to eradicate smallpox. And many parents do not allow their children to have the HPV vaccine yet, so there will still be lots of carriers and potentially infected partners when your child becomes sexually active. If you think your child will only ever be sexually active with one partner, and that partner would have never had sexual experiences before, think again: what planet do you live on? And if you think Pap smears will be enough to save your child when she develops HPV-related disease please don't forget how horrified YOU were when you had to have your first Pap smear. Take a look at the picture of the normal cervix below, and at the ones involved by cervical cancer.If this makes you feel sick, imagine how I feel when I see this in a thirty-something year-old woman, wife and mother.

I use this chart when patients ask me about probiotic use. Bio-K seems to be the most popular in Canada.

An excellent resource for prolapse and incontinence from Alberta (from one of my patients, thank you for sharing!). Check out http://www.albertahealthservices.ca//calgarypelvicfloorcli (also listed on the website under "Reources")

Probiotics: sorting the evidence from the myths There is a lot of information about probiotics and many women are wondering if they will be helping in their particular situation. Probiotics are yeast or bacteria available in capsules, powder, fermented mils or yoghurt. Probiotics have strain-specific resistance to bile or gastric acid, ability to colonise the gastrointestinal tract, clinical efficacy and benefits to the person taking them. What it means is that EACH probioti...c species has its own properties. Evidence supports use of probiotics in treating acute infectious diarrhea and preventing antibiotic-use related diarrhea. Look for LACTOBACILLUS RHAMNOSUS GG and SACCHAROMYCES BOULARDII There is more evidence in children but there are also studies in adults. Probiotics prevent traveler's diarrhea. S. BOULARDII + high-dose Vancomycin is more effective than antibiotics alone in preventing recurrent Clostridium Dificile diarrhea Probiotics are generally safe and well tolerated, but may be contraindicated in people with severe underlying diseases or who are immmunocompromised See more