Frequently Asked Questions
The field of women's healthcare can be confusing. If you have a question, chances are someone else has asked it before. If your question is not addressed here, feel free to Ask Carla.
Where is your office located and what are your hours?
You can find our office at 3122 Blackiston Mill Rd., New Albany, IN. More contact info and office hours can be found on this page.
What is the difference between an Advanced Nurse Practitioner (APN) and a Physician?
The short answer is that Physicians study diseases and how to cure them, while APNs study people and how to heal them. APNs and Physicians are similar in that both diagnose, treat and manage acute and chronic diseases, order and interpret labs and diagnostic tests and prescribe medications. Most insurance companies and suppliers are now referring to both APNs and Physicians as providers. APNs spend more time with patients educating them about how to improve their over all health and assist in healing mind, body, and spirit.
What services are available from an APN, through Finding Her Health?
Numerous women’s health services that embrace a woman’s needs throughout her life span are available including:
Adolescent health care
Well woman exams
Breast cancer screening and problem evaluation
Pap smears, HPV screening
Health and wellness counseling
STD screening, treatment, and follow-up
Preconception health and post partum care
Problems with menstruation – too much, too little, too many, too few
Menopause, perimenopause, post menopause care
Evaluation and treatment of common infections
Urinary tract problems like incontinence or infections
How are these services from Finding Her Health different than services offered by other healthcare providers?
Advanced Nurse Practitioner Carla Copas has a unique and personal approach including:
Collaborating with patients, families, and other health care providers to optimize the health care plan to the individual needs
Promoting health by ordering screenings, prescribing preventive therapies, (immunizations, life-style changes such as weight loss, smoking cessation, etc.) and teaching and counseling
Evaluate an individual’s health by taking a history, performing a physical examination, and ordering and interpreting results from laboratory and diagnostic tests/procedures
Diagnosing health and medical conditions by reviewing all available health information, and applying advanced clinical decision making skills
Managing health problems by developing an individualized plan of care, prescribing medications or treatments, obtaining consultations and referrals and coordinating health care services
Keep reading to see how Carla answers questions specifically related to Hormone Balancing and Hormone Therapy.
How is Bio-Identical Hormone Replacement different from Traditional Hormone Replacement?
That's a great question. Think of a round peg fitting into a square puzzle - it might fit but it is not the right fit and it is not optimal that is traditional hormone replacement. When you have the perfect fit - a round peg fitting in a round puzzle everything works together in a more efficient and natural way. Bio-identical hormones are compounded in a pharmacy, and each prescription is compounded to meet a patient's individual needs and address their specific concerns.
How do you determine what the Bio-Identical Hormone formula should be?
I use symptoms, height and weight, lifestyle, physical and mental health and blood work. While some providers use saliva, I was trained to manage hormones through blood work, and have been very successful with my patients. Most insurance companies will cover blood work and not saliva testing.
What is the hormone panel or blood work that you do and why?
The basic panel that I do on most patients consists of: CBC, TSH with reflex to T4, Pregnenolone, Progesterone, Estradiol, DHEA, Testosterone, Vitamin D3 and Iodine.
Keep in mind, these all work together and are the key to Finding Your Health.
CBC - complete blood count looks at your white cell count, this looks for infection. It also checks for hemoglobin and hematocrit which shows if you are anemic.
TSH with reflex to T4 and Iodine. These are thyroid function tests. If your thyroid is not balanced your hormones won't be either. You may have a normal TSH and T4 and low iodine, so your thyroid is functioning "within normal limits" however with an iodine deficiency your thyroid is not functioning at an optimal level.
Pregnenolone- is one of the first hormones on the hormone chain. I like to call it the Mother Hormone, if the top of the hormone chain is deficient - all the other hormones are not functioning in balance. Not many providers check Pregnenolone, however, studies show it is important for memory, energy, heart disease prevention, anxiety and a general sense of well being.
Progesterone - Pregnenolone converts to progesterone. Progesterone is important for bone health, heart health, sleep, skin, depression and pregnancy. I use progesterone as a marker to prescribe Bio-Identical hormones based on pregnancy. When women are pregnant progesterone levels increase significantly. This is the hormone that helps maintain pregnancy, so women that have low progesterone levels have an increased risk of miscarriage. I ask my patients if they had a happy healthy pregnancy, if they say yes - they are typically progesterone driven, if they say no, I was miserable and hated being pregnant then they are most likely estrogen driven. Progesterone supplements can also be used to help with depression, both post partum depression and generalized depression. After a baby is born, the progesterone levels that were so high, drop down to normal and a lot of women experience post partum depression from this drop in progesterone. Women who are prescribed progesterone sometimes do not need anti-depressants.
Estrogen is important for bone and heart health. As your estrogen depletes in menopause most women put on belly fat. This is the way the body compensates for the lack of estrogen because belly fat produces estrogen. Estrogen deficiency causes symptoms such as hot flashes, night sweats, fatigue, insomnia, weight gain, foggy thinking, vaginal dryness, painful intercourse, just name an important few!
DHEA is the precursor to testosterone. I like to call DHEA the "feel good hormone," it gives us a sense of well being and also helps with our sex drive.
Testosterone is important for libido (sex drive). It also helps with energy and sleep.
D3 is important for bone health, hair loss, sleep, energy and mood.
Since practicing in Indiana for 3 1/2 years, I find that the majority of my patients are deficient in Pregnenolone, iodine and D3. Women don't realize there are other options - not everyone needs a birth control pill, an antidepressant or traditional hormone therapy.
Please keep in mind the above list of topics and questions is not an exhaustive list, these are just the main points. Remember balance is the key. Feel free to contact Carla for more specific information.
"I listen to women. If you listen long enough they will tell you what is wrong with them."
-- Carla Copas, APN