Dr. Daniel Small of Lawrence OB/GYN

Congratulations to Dr. Daniel Small, who was recently named as one of the American Institute of Minimally Invasive Surgery's (AIMIS) "300 Club." The "300 Club" identifies the best GYN MIS surgeons in the U.S. who support a patient-centric approach to hysterectomy and other procedures.

Dr. Daniel Small is the director of Minimally Invasive Gynecologic Surgery at Capital Health System in Hopewell, New Jersey, an AIMIS Gynecologic Center of Excellence. He has been in private practice with Lawrence OB/GYN Associates for over 25 years. Dr. Small attended Cornell University, where he completed degrees in anthropology and international nutrition, and went on to medical school at the Hospital of the University of Pennsylvania. He completed a residency in obstetrics and gynecology at the Medical College of Pennsylvania.  

During over 25 years as a doctor with Lawrence OB/GYN, Dr. Small has provided basic and advanced services in both obstetrics and gynecology, and has been a leader in central New Jersey in minimally invasive gynecologic surgery. Dr. Small's commitment to minimally invasive surgery grew out of his wish that his patients should have the best possible outcomes. In 1991, he was the first gynecologist in central New Jersey to remove a tubal pregnancy through a laparoscope, and was also the first to perform endometrial ablation. He was the first doctor in his region to perform various kinds of laparoscopic hysterectomy. Dr. Small now chairs the robotic surgery program at Capital Health and serves as a proctor in robotic surgery.  

Dr. Small says, "I take the time to listen to my patients and answer all their questions. I believe that a strong physician-patient relationship is critical to good health care. I see it as my job to translate medical information in a way that each of my patients can understand, because a woman who is well-informed and educated about her options will be in the best position to make a good decision about her health care."

Dr. Small also serves as an expert witness in medical malpractice litigation. Over the past 15 years, he has testified in New Jersey, Pennsylvania, and Delaware about the medical standard of care for gynecologic surgery, office gynecology and many other aspects of obstetrics and gynecology. As an OB/GYN expert, he also serves as a consultant to the New Jersey Board of Medical Examiners.

Unless you're trying for a baby, getting your period regularly is both a blessing and a curse. Suddenly missing your period when babies aren't on the agenda can be a real freak-out moment, but there are a few other factors that may be to blame. Here are some potential reasons your period is late that have nothing to do with a bouncing bundle of joy.

Major Weight Loss or Excessive Exercise.  If your BMI rapidly dips below 18 or 19, you may start to miss periods. This isn't strictly based on BMI, though. Serious conditions like anorexia and bulimia can cause missed periods, but so can training for a marathon or some other major event that requires you to exercise more than usual. Nature has a way of protecting you from getting pregnant if your body is under such extreme stress. Your body prevents ovulation so you don't have a lot of estrogen, don't build a big uterine lining, and then don't get a period.

Stress.  A big scary event in your life can cause hypothalamic amenorrhea. This particular area of the brain, the hypothalamus, is where a lot of the hormones for your period are regulated. The hypothalamus is very affected by stress.  So if you're dealing with a big move, death in the family, huge breakup, or any other life event that's shaking you up, it could be the cause.

A Thyroid Irregularity.  The thyroid gland, located in your neck, regulates your metabolism. It also interacts with many other systems in your body to keep things running smoothly. If you're dealing with any type of thyroid imbalance, whether it's hypo- or hyperthyroidism, that can have implications for your period. If you notice other symptoms of a thyroid disorder, check in with your doctor for an official diagnosis.

Polycystic Ovary Symptom.  PCOS is a hormone imbalance that comes down to a lack of ovulation, so you have altered levels of estrogen, progesterone, and testosterone. It can cause you to completely miss your period or just not menstruate regularly.  Other PCOS symptoms include hair growth in places like the face and chest, difficulty losing weight, and potential fertility issues. Your doctor can help you come up with a treatment plan to manage the condition.  

Your Birth Control.  A missing period can actually be a harmless byproduct of the measures you take to avoid pregnancy. Some low-dose pills will cause a lack of menses that isn't dangerous and is many times a welcome side effect. The same goes for methods like hormonal IUDs, implants, or shots. It can also take some time for your period to come back if you've stopped birth control, but it will usually resume without issue in a few months.

Premature Menopause.  When women under 40 have hormones misfiring in a significant way, they can go through premature menopause, also known as premature ovarian failure. Along with missed periods, signs of it include hot flashes, night sweats, and vaginal dryness. This isn't very common, so you shouldn't immediately worry about it. If your OB/GYN physician rules out the many other potential causes and thinks this may be the culprit, he or she will clue you in.

Source: Women's Health