Dr. Kochenburger is Alameda's Only Minimally Invasive Gynecologic Surgeon!

Since 1993, Harvard-educated, Board Certified Obstetrician/Gynecologist, Dr Richard Kochenburger, has enthusiastically served the women's health needs of East Bay women.

With daily office hours and a cheerful, holistic/prevention-oriented approach, Dr. Kochenburger and Nurse Practitioner Ms. Azam Moore provide attentive, compassionate care. Every attempt is made to provide personalized, "old fashioned" service in a "partnership model". Dr. Kochenburger is only one of a handful of solo private practice obstetrician gynecologist that remain in the greater East Bay area. He offers concierge type service, and is present at around 90% of his patient's births and deliveries.

Whether expecting the birth of a child, requiring an annual PAP smear, discussing family planning or a related women's health concern, Dr. Kochenburger, Ms. Moore and our friendly staff would love to meet you!

Tuesday, October 4, 2011

Managing excessive nausea in early pregnancy

Virtually all expectant women experience marked fatigue in the first trimester of pregnancy--I believe that it's nature's way of trying to make our Moms "slow down a bit and give themselves some TLC".  IN CONTRAST, only approximately 33% of women experience consider appreciable nausea; a fraction of these experience considerable vomiting. When vomiting is consistent and extreme, it's known as "Hyperemesis Gravidarum".
               What are ways to ameliorate nausea/vomiting in early pregnancy? Various dietary adjustments can be tried such as bland foods (toast, crackers, 7 UP, white rice, mashed potatoes) or ginger/ginger ale/ginger tea. I knew 1 pregnant Obstetrician who benefitted awhile from butter,salty mashed potatoes and another friend who did well with hot,spicy chili! Vitamin B6 taken several times per day (capsules, B-Natal, Preggie Pops) can help some women. Lemon water and/or Raspberry Leaf can help others. Treatment from a licensed accupuncturist is definately well proven. There is also a "nausea accupressure point" on the inner wrist--located 2 fingerbreaths down from the wrist crease.  There's a bunch of prescription medications we could try such as metoclopromide (Reglan), Compazine, Phenergan, Zofran etc.  The worst nausea and vomiting usually resolves by 11-13 weeks of pregnancy. Taking nitetime antacids (i.e. TUMs, Rolaids etc) can also neutralize nitetime stomach acid and lower morning nausea.
           Although a nuisance, pregnancy-associated nausea is usually a comforting sign that "all is well with the pregnancy"!

Thursday, January 6, 2011

The various faces of menopause

The average age of achieving full menopause is 50 1/2 years.  Usually menopause (absence of periods, hot flashes, nite sweats, dysphoria,vaginal dryness, changes in libido etc.) is a gradual process evolving over 1-2 years rather than an abrupt event.  There is a subset of women who actually begin having very frequent (2-3 times per month) annoying periods, spotting etc.  Most women begin skipping months and their periods basically "fade out".  Contrary to common views, the majority of women do not experience hot flashes nor excessive perspiration/nite sweats (vasomotor symptoms).
               The once widespread use of hormone replacement therapy is controversial and rarely used.  There are numerous herbal supplements and phytoestrogens/soy extracts useful for treatment of vasomotor symptoms, mood changes, and libido issues.  Over-the-counter vaginal moisturizers/prescription estrogen cream can treat vaginal dryness. Vitamin D supplements, extra dietary calcium and various prescription meds can enhance bone strength.  Check out the American College of Obstetrics and Gynecology Website
for information on various Women's Health topics.