The Latest On Women’s Health

Dr. David Kim
OB/GYN

Interviewed by Melissa Moniz

How long have you been practicing?

I have been in practice for seven years.

Where did you receive your schooling and training?

I did my undergraduate work at the University of California in San Diego. It was a little tough to go from the beautiful scenery of La Jolla, where UCSD is located, to New York for medical school, but it was a wonderful experience. I attended medical school at the State University of New York Health Science Center at Brooklyn. After graduating from medical school, I moved to Washington, D.C., where I did my residency training in OBGYN at George Washington University. We would often see Vice President Cheney each time he had chest pain, because the Labor and Delivery Suite was on the same floor as the Cardiac Units at The George Washington University Hospital.

Since being in Hawaii, I have also completed a graduate program in clinical research at the University of Hawaii, where I received a master’s in science degree, and I am currently pursuing a Ph.D. in the field of clinical research. I am also concurrently pursuing my MBA at the Shidler School of Business, at the University of Hawaii.

Where are you currently practicing/working?

I have two offices, one located on Kapahulu Ave. in Honolulu and the other office at the Physician Offices at the Kapiolani Medical Center at Pali Momi in Aiea. I do my surgeries and deliveries at Kapiolani Center for Women and Children and at Queen’s hospital.

What are the most exciting changes affecting women’s health?

One of the most exciting new developments in women’s health has been the introduction of the Human Papilloma Virus (HPV) vaccine. The vaccine, made by Merck, is a quadriava-lent vaccine, which helps protect against the HPV genotypes 6, 11, 16 and 18. Seventy percent of the cervical cancers result from infections with genotypes 16 and 18, and 90 percent of genital warts results from genotypes of 6 and 11. This vaccine has been found to be 100 percent effective in preventing cancerous and precancerous cervical lesions caused by genotypes 16 and 18. That is amazing. When was the last time a vaccine came on the market that prevented so many women on a large scale from getting precancerous or cancerous lesions? The vaccine is most effective when it’s given before a female becomes sexually active.

And new innovations in contraception are providing women with even greater choices to help them with family planning. For instance, while birth control pills and injectable contraception have been available for a long time, there are many newer methods of contraception. There are diverse forms of contraception similar to the birth control pill but delivered through a patch (Orthorevra Patch) or through a vaginal ring (Nuvaring). There are also devices that are excellent forms of contraception, such as the Mirena Intrauterine Device, which is inserted into the uterus and lasts five years, or the Implanon, which is a small, single rod inserted just under the skin in the arm and lasts three years. If a woman wants permanent sterilization, there is even a new procedure, which can effectively sterilize a woman’s tubes without having to cut an incision or leave a scar. The Essure is a procedure done through the vagina with a hysteroscope (a surgical camera lens), where a nickel micro-insert spring is placed in the tubes and permanently sterilizes the fallopian tubes.

There are also many newer minimally invasive surgical procedures available for helping women with fibroids, endometriosis, urinary incontinence or heavy menstrual flow.

What are the most common STDs women are diagnosed with?

Though many women may not think of Human Papilloma Virus (HPV) infection as an STD, it is actually the most common STD infection. By the time sexually active women reach 50 years old, 80 percent have been infected with genital HPV at some point in their life. Most women may not think about it because most of the time there are not symptoms associated with HPV infections. But, in some cases, those infections can result in genital warts or cervical dysplasia with the potential of advancing to cervical cancer. The next most-common STD is genital herpes. Many more women are infected than they realize. This is because many women have minimal symptoms from a sub-clinical presentation. But in some studies, the prevalence of genital herpes is around 26 percent. The other common STDs are chlamydia and gonorrhea infections. These are often actually “seen” more, only because there is regular screening for these infections with every annual gynecologic exam for young women.

Are there any new products or procedures that can treat or cure these STDs?

There aren’t any new products, but there are newer studies and insights. In general, the bacterial STDs, such as chlamydia and gonorrhea, are treated with antibiotics. The HPV vaccine, as stated before, can help prevent HPV infections. For genital herpes (HSV), it has been found that a person with herpes can pass it to his or her partner about 2 percent of the time, even when there are no visible lesions, and this is due to asymptomatic shedding of the virus. By taking Valacyclovir daily, the HSV transmission to their partner can be decreased down to less than 0.5 percent.

What are some of the most common questions that you are asked by patients?

Pregnant women often want to know if it’s safe to eat fish for concern about mercury in fish. Some of the larger fish such as shark, king mackerel and tile-fish should be avoided because of high mercury content. For fish lower in mercury, 12 ounces per week can be eaten. Some fish with lower mercury levels include salmon and canned light tuna (not albacore tuna). Ahi (tuna) steaks have larger amounts of mercury and should be limited to 6 ounces per week.

I also take care of many patients with pelvic pain. I am commonly asked the cause of someone’s pelvic pain. The management for acute pelvic pain is highly successful and will depend on the particular cause of the pain. Also pain with intercourse is quite common, and sometimes the cause can be due to some of the same ones listed above or from vulvovestibulitis, which is hyper-sensitivity of the vulva.

Women commonly also have sexual dysfunction during various phases in their lives, and there some medications available that can help improve libido and sexual function.

What key advice do you offer patients for keeping their body healthy?

First, if the woman smokes, she should stop now! A woman usually has her heart protected from a heart attack by up to 10 years when compared to a man. But when a woman smokes, she drops down to the same risk of having a heart attack as a man does. Smoking will reduce a woman’s life span by at least 10 years. Smoking causes chronic obstructive pulmonary disease, heart attacks, stroke, lung cancer, bladder cancer and cervical cancer.

The other well-known habit that can help improve a woman’s health is exercise. Doing moderate exercise, such as brisk walking, 30 minutes a day for five days a week, can improve the quality of a woman’s life and also help prevent disease and prolong survival. Oftentimes, some women forget to add weight-bearing exercise to their workout. Weight-bearing exercise helps to increase bone density and also increases a woman’s resting metabolism by increasing her muscle mass.

For a healthier lifestyle, I would also recommend reducing caloric intake. More and more studies are demonstrating that a reduction in food caloric intake turns on survival genes and turns off the bad genes that accelerate aging. While many of these studies are done with a 1,500 calorie diet, which for most people would be very difficult, any reduction in the caloric intake will help improve a woman’s health. But it is important that a woman’s nutritional intake is well-balanced.

 

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