May 13, 2022 cosmetic

As we age, the collagen and elastin in our skin break down. This breakdown can cause the skin to lose elasticity, forming wrinkles and aging our appearance.


Wrinkles and deep creases can also form in our skin from sun exposure, smoking, and when our facial muscles are repeatedly tensed when we frown, smile, furrow our brow, or squint.


Luckily, botox injections can help relax the facial muscles and rid wrinkles and fine lines. But how does botox work to get rid of those pesky wrinkles, and how long does it take for wrinkles to disappear? Keep reading to learn the answers.


How Does Botox Get Rid of Wrinkles?

How Does Botox Get Rid of Wrinkles

Botox is one of the most popular anti-aging treatments for both men and women of all ages because it effectively gets rid of wrinkles. But how does it work?


Botox treatment works by temporarily immobilizing and relaxing specific facial muscles that we tend to keep tense. Preventing muscle movement in those areas prevents those muscles from causing fine lines and wrinkles to form in the skin. This causes the skin to look smoother and more youthful, allowing your natural beauty to shine.


Regular botox injections can eliminate or reduce the appearance of dynamic wrinkles such as crow’s feet, forehead wrinkles, frown lines, and more. Botox can also treat static wrinkles caused by natural aging, sun damage, smoking, and more.


How Long Does it Take for Wrinkles to Go Away after Botox?

How Long Does it Take for Wrinkles to Go Away after Botox

Wrinkles will not immediately vanish after your first botox injection. However, you can expect to see positive results from your treatment very quickly. Most patients observe a significant decrease in the appearance of facial wrinkles after just 3–4 days. Patients can expect to see the full effect around 14 days after their botox injection. First-time Botox users might need to wait longer than regular users to see great results.


Fine lines and shallow wrinkles will disappear first, while deeper, harsher lines and wrinkles like forehead lines and frown lines will take longer to fade. Around 14 days, all the treated areas will look smoother, fuller, and more youthful.


Botox treatments use chemical messengers to tell your facial muscles to relax and stop specific muscle contractions. It takes time for the message to get to all of the treated areas, so it can take up to two weeks to see the full results.


Does Botox Remove All Wrinkles?

Does Botox Remove All Wrinkles

Botox injections will rejuvenate your skin and make you look like you’ve gotten a facelift without the need for plastic surgery or other drastic measures. It helps relax your facial muscles and smooth your skin to eliminate or soften wrinkles and fine lines.


While no one wants to have skin covered in deep wrinkles, some wrinkles are natural on the face. They help define our facial expressions and are a key to natural-looking skin. Skin without any wrinkles can appear overly shiny, swollen, and unnatural. Therefore, botox injections should never eliminate all wrinkles from your face.


Our dermatologists will work with you to achieve the aesthetic results you desire while maintaining your skin’s healthy, natural appearance. We can work with you to use botox to remove fine lines altogether while softening the appearance of deep wrinkles and creases.


What Does Botox Tend to Treat?

Botox is excellent for treating and eliminating the appearance of those stubborn wrinkles and fine lines. However, did you know that botox can also be used to treat other medical conditions?


One other FDA-approved use of botox is to treat migraines. Patients who experience frequent and severe migraines can get a series of botox injections around the temples and head. This treatment reduces the severity and frequency of migraines.


Since botox helps relax facial muscles, it can also be injected into the jaw area to reduce painful jaw clenching and tooth grinding.


Finally, botox can be injected into the armpits to treat hyperhidrosis and reduce excessive sweating. It works by blocking the nerves in the sweat glands and preventing them from producing sweat.


Make a Botox Appointment

Are you interested in getting safe, effective botox injections in New York City? Dr. Yelena Tsyba can work with you to achieve and maintain the youthful appearance you’re looking for. Contact us today to add botox to your skincare routine and get the best botox treatment in NYC!


We also provide dermal fillers and other dermatological treatments. Ask our doctors how they can help you keep your skin looking its best with no plastic surgery or other extreme cosmetic procedures.


May 11, 2022 cosmetic

Dermal lip fillers are a great, easy way to enhance your natural lips’ shape and eliminate signs of aging like fine lines and creases around the upper lip and mouth — all without plastic surgery!


Lip fillers are an FDA-approved lip enhancement product that has been used for multiple decades. They work by enhancing lip hydration and locking in moisture in the lips. Lip fillers have also been shown to increase the body’s production of collagen, resulting in more youthful, plump lips.


If it is your first time getting an injectable treatment, you may have many questions about the aftercare and healing process. Lip filler may cause the treatment area to feel swollen, hard, or lumpy at first, but this is all part of the healing process, and the fillers will soften and settle over time. Keep reading to learn more about what to expect in the days after getting lip fillers.


Are Lip Fillers Supposed to Feel Hard?

Are Lip Fillers Supposed to Feel Hard

Your lips may feel stiff or rigid immediately after injection with dermal fillers. Don’t worry — this is entirely normal, and the lip fillers will soften with time. Your lips may also be swollen and tender, which can contribute to the lip filler feeling hard under the skin.


Dermal filler treatments like Juvederm and Restylane are made of hyaluronic acid. This gel-like product naturally occurs in the body in places such as the skin, connective tissue, and the fluids of the eyes. Immediately after injection, the hyaluronic acid will be sitting on top of your cells, and it is designed to break down, bind with your lip tissue, and settle over time.


How Long Does it Take for Lips to Soften After Fillers?

How Long Does it Take for Lips to Soften After Fillers

Luckily, hyaluronic acid fillers should soften and settle pretty quickly. Immediately after lip injections, your pout will be fuller and fine lines around the mouth like smoker’s lines and marionette lines may soften or disappear.


There is little to no downtime after receiving lip fillers. The swelling around the injection sites will go away, and you will begin to see great results after a few days, with the maximum results after 14 days.

Lip fillers are a long-lasting treatment. Once softened and healed, you can expect to enjoy the full results for up to 6–9 months. After that time, you can make a follow-up appointment with your doctor to maintain your results.


Does Massaging Lip Filler Break it Down?

Does Massaging Lip Filler Break it Down

Your doctor will provide you with aftercare instructions after dermal filler injections. Depending on which treatment you receive, your anatomy, and your desired aesthetic results, they may give instructions to massage the lips carefully. Do not massage the lips if you are not instructed to by your doctor, as this may interfere with your final results.


Aftercare should also include drinking plenty of water, staying hydrated, avoiding strenuous exercise, and wearing sunscreen outdoors. You can also use specially designed ice packs to lessen any discomfort immediately after injection.


Is it Normal to Have Lumps after Lip Fillers?

Small lumps can be an average side effect after receiving lip fillers and are not cause for immediate concern. They can be caused by swelling or bruising at the injection site. They can also be caused when you receive a large amount of filler in one area, and the filler will soften over time. Most lumps should go away on their own within a few days.


If the lumps persist, they can be massaged or removed by your doctor at a follow-up appointment. After your first injection has settled and healed, any undesired aesthetic effects can be fixed with a touch-up injection. Your doctor may use hyaluronidase, an injectable enzyme that will break down large lumps of the hyaluronic acid.


If the lumps are extremely painful or appear to be infected, see a medical professional right away as it may signify something more serious.


Make an Appointment for Lip Filler Today

Our professional NYC doctors will work carefully with you throughout the lip augmentation procedure to achieve an enhanced but natural lip shape that works for your unique facial features and makes you look and feel your best.

If you are in NYC, call us and make an appointment for your consultation for lip filler today! Skip the plastic surgeon — our services are the best professional lip augmentation NYC offers.


May 11, 2022 cosmetic

Botox treatments, scientifically called botulinum toxin, are a fast-acting, non-surgical cosmetic procedure that will eliminate wrinkles like crow’s feet, fine lines, unwanted creases, forehead lines, and frown lines. We understand that you want to eliminate these wrinkles fast. But how long does it take to see the effects of botox?


You may see immediate improvements at the injection site, but it can take 10–14 days to see the full results after a botox injection. Keep reading to learn more about what results you can expect after your botox injection and how long it takes for botox to work.


Can You See Botox Results Immediately?

Can You See Botox Results Immediately

Botox injections do not work instantly, but you can expect to see positive results quickly from your treatment. Most patients observe significant improvements in the appearance of their skin after just 3–4 days. Patients can expect to see the full effect around 14 days after their botox injection. First-time Botox users might need to wait longer than regular users to see great results.


The appearance of fine lines and shallow wrinkles will lessen quickly, and deeper, harsher lines and wrinkles will take more than 14 days to fade. Around 14 days, all the treated areas will look smoother, fuller, and more youthful. Wrinkles and fine lines will disappear or appear smaller and softer.


Botox treatments use chemical messengers to tell your facial muscles to relax and stop specific muscle contractions. It takes time for the message to get to all of the treated areas, so it can take up to two weeks to see the full results.


How Long Does Botox last?

How Long Does Botox last

Over time, all of the chemicals from the botox treatment will get used up, so the results usually only last about three to four months. To maintain the maximum results, patients should schedule a follow-up treatment no more than four months after their first treatment.

At Great City Medical, your specialists can discuss your ideal treatment plan to ensure you maintain your desired aesthetic and always look your best.


What Can I Expect Immediately after Botox?

What Can I Expect Immediately after Botox

While you will not see the full results from your botox treatment immediately, you will notice differences in your skin immediately after a botox injection.


Botox is an FDA-approved cosmetic procedure with almost no recovery time and few reported side effects. Immediately after botox, you may experience some swelling and notice small red dots or bumps at the injection site immediately after treatment. Still, these should go away entirely within a couple of hours of treatment.


Try not to touch or rub the injection sites so that the Botox is not disturbed and does not spread to other facial areas. To prevent spread, it is also recommended to avoid exercise for 24 hours after your treatment and to keep your head elevated at night for the first few days for best results.


How Can You Tell if Someone Has Had Botox?

How Can You Tell if Someone Has Had Botox

It might be entertaining to point at celebrities on TV and guess if they’ve had botox and filler — but it is pretty difficult or impossible to tell if someone has had botox when appropriately administered by a medical professional.


Botox treatment will enhance the natural look of your skin with subtle anti-aging effects. It should not interfere with your normal facial expressions or muscle movement. People may compliment you that you look great, but they won’t know you had botox!


Why Does Botox Make Your Forehead Shiny?

Light naturally reflects off of smooth surfaces, so the smoother your skin, the more light will bounce. Botox injections smooth the skin, which can cause it to appear shinier, especially if it is overdone.
Patients tend to struggle with forehead wrinkles the most, as these wrinkles can be profound and apparent. Therefore, it is tempting to request a large dose of botox in this area. At Great City Medical, we recommend dosage levels that will reduce the appearance of forehead wrinkles without causing the forehead to look unnaturally smooth and shiny.


Make a Botox Appointment

Are you interested in getting safe, effective botox injections in New York City? Call us today to set up your botox injection appointment with one of our medical professionals. We also provide dermal fillers and other dermatological treatments. We’ll help you get beautiful results with no plastic surgery. Our doctors help you stay healthy and keep your skin looking its best!


March 18, 2022 primary care

Working as a commercial truck driver can be a very demanding job. Operating a commercial motor vehicle (CMV) is a large responsibility, as you are responsible for both your own safety and the public safety of many others. CMV drivers often have to manage long hours, intense physical demands, and mental stress.

That’s why CMV operators are required to pass a Department of Transportation (DOT) physical exam to ensure that they are fit to perform their job safely under all conditions.

If you have to pass a DOT exam to perform your job as a commercial driver or are just interested in learning more about the exam, keep reading for all the information you need and learn how to make an appointment today.


What is the Exam?

what is the exam

The DOT medical exam is an extensive health check-up that is required by the Federal Motor Carrier Safety Administration (FMCSA) for jobs requiring a commercial driver’s license (CDL). The point of the exam is to certify that commercial drivers are fit to perform their jobs safely and that they do not have any medical conditions that will interfere with their abilities.


The exam consists of two main parts: a medical history review and a physical examination.


When is a DOT Physical Exam required?

when is the dot physical exam required

The DOT physical exam is required for many drivers with a commercial driver’s license (CDL). You’ll need a medical exam if you drive a vehicle that:

  • has a gross vehicle weight of over 10,000 pounds;
  • is paid to transport over 8 passengers, including the driver;
  • is used to transport over 15 passengers, including the driver;
  • or hauls hazardous materials that require a placard.


What is included in a DOT Physical Exam?

What is included in a DOT Physical Exam

The DOT exam includes a comprehensive review of your medical history and a physical examination by a certified medical examiner.

For the medical history portion, you must fill out medical history form that includes questions about:

  • any current medications
  • any history of health conditions
  • if you’ve ever had surgery
  • use of illicit substances and drug testing history
  • any current symptoms
  • other relevant parts of your health history


To help make your visit quick and efficient, you can fill out the medical history form in advance of your visit.

During the DOT physical examination, your certified medical examiner will check things such as:

  • height and weight
  •  blood pressure
  • vision test
  • hearing test
  • vascular system and pulse rate
  • mouth and throat
  • urine test
  • blood sugar levels
  • hernias
  • skin
  • lungs and breathing
  • nervous system and reflexes
  • and more


How often do you need a DOT Physical Exam?

Why is a DOT Physical Exam Required

In most cases, if you pass the exam, you’ll receive a DOT medical card that is valid for up to two years. You’ll need to have an exam every two years as long as you drive a commercial vehicle.

In some cases, if you have an underlying medical condition you’ll be required to have an exam more frequently. Some conditions that require annual or quarterly testing to monitor your health include:

  • diabetes
  • very high blood pressure (hypertension)
  • heart disease

While more frequent testing can be a bit inconvenient, it helps keep you healthy and minimize the risk of impairment or injury while operating a commercial vehicle. If over time your treatable health condition improves (such as high blood pressure), you may be eligible to receive a medical card that is good for one to two years.


Is it possible to fail your DOT Physical Exam?

It is possible to fail your DOT exam if your health does not meet the DOT physical requirements. Reasons for failing the exam might include:

  • failed vision or hearing test
  • narcolepsy
  • epilepsy
  • poorly managed health conditions such as very high blood pressure, diabetes, or heart or lung disease
  • controlled substance abuse or failed drug testing


If you fail your exam and believe you are fit to operate a CMV, you have the right to receive a second opinion from another doctor. Also, you can re-apply if your medical conditions improve. However, you cannot apply again if you fail a second time.


How to prepare for your DOT Physical Exam?

To prepare for your DOT exam and maximize your likelihood of passing, you should do your best to take care of your health and wellness. Focus on eating a healthy diet, exercising regularly, and avoiding excessive smoking or drinking.


What do you need to bring to the DOT Physical Exam?

To help the exam run quickly and smoothly, it is best to bring anything you think might be relevant to your health and ability to perform work. Things to bring might include:

  • A complete list of your doctors and their contact information
  • A complete list of any medication you are taking, including the dosage and prescribing doctor’s name
  • A letter from your doctor if you’re taking any medicines that can cause sleepiness
  • A letter from your doctor if you’re taking the blood thinner called Coumadin
  • Eyeglasses, contact lenses, and/or hearing aids, if you use them
  • If you have diabetes, recent Hemoglobin A1C (HgAIC) test results and blood sugar logs
  • If you have a sleep disturbance such as sleep apnea, a data readout from your machine of at least 90 days
  • If you have a history of heart disease or other heart health issues, a letter from your cardiologist and/or results from any recent stress testing
  • If you have any history of brain injury, a letter from your neurologist
  • A letter from your doctor if you’ve lost permanent use of an arm or leg, including any work restrictions


How Much Does a DOT physical cost?

Many employers who require a DOT exam will cover the cost for you. However, the cost of the exam will be $100. Call our offices today and we can help you determine the cost of getting a DOT physical exam.


Where can you get a DOT Physical Exam?

At Great City Medical in New York City, we provide DOT Physical Exams. Call our offices today to make an appointment!




March 18, 2022 primary care

In order to operate a commercial vehicle professionally, drivers must obtain two very important documents: a commercial driver’s license (CDL) and a valid Department of Transportation (DOT) medical card. These documents help certify that commercial motor vehicle (CMV) drivers are medically fit to safely operate large vehicles and minimize the risk of safety incidents.

To obtain a valid DOT medical card, truck drivers must successfully complete the DOT physical exam every 1–2 years. The DOT exam can be performed by any licensed medical examiner who is listed in the Federal Motor Carrier Safety Administration (FMCSA) National Registry.

So, CMV drivers need to pass the DOT exam in order to maintain employment, but why is it required? Keep reading to learn all about why the DOT physical exam is required and how to obtain a DOT medical card.

What is a DOT Physical Exam?

what is a dot physical exam

The DOT medical exam is a physical examination required by the FMCSA. It certifies that CMV drivers are physically and mentally fit enough to perform their jobs safely and that they do not have any medical conditions that will interfere with their job performance.

The exam consists of two main parts: a medical history review and a physical examination.

Who needs to get a DOT Physical Exam?

Who needs to get a DOT Physical Exam

The DOT physical exam is required for CMV drivers who operate a vehicle that:

  • has a gross vehicle weight of over 10,000 pounds;
  • is paid to transport over 8 passengers, including the driver
  •  is used to transport over 15 passengers, including the driver;
  • or hauls hazardous materials that require a placard.


What is included in a DOT Physical Exam?

What is included in a DOT Physical Exam

The DOT exam includes a comprehensive review of your medical history and a physical examination by a certified medical examiner.

For the medical history portion, you must fill out the medical history form before your visit.

During the DOT physical examination, a certified medical examiner will check things such as:

• height and weight
• blood pressure
• vision test
• hearing loss
• vascular system and pulse rate
• mouth and throat
• urinalysis
• blood sugar levels
• hernias
• skin
• lungs and breathing
• neurological issues and reflexes
• sleep apnea and narcolepsy
• and more


How often do you need a DOT Physical Exam?

In most cases, the DOT medical examiner’s certificate is valid for up to two years.
However, in some cases, an underlying medical condition will require a CMV driver to have an exam more frequently. Some conditions that require annual or quarterly testing to monitor your health include:

  •  unmanaged diabetes
  • very high blood pressure (hypertension)
  • heart disease


If health conditions are well-managed and improve, then a driver can be cleared for a medical card that is good for one to two years.

Why do you need a DOT Physical Exam?

Operating a CMV is no small feat! With the intense schedules, long hours, and mental stress and exhaustion, becoming a CMV operator can put the driver’s life at risk, as well as the lives and safety of the general public. Not just anyone is qualified for this job — drivers must be in good health with high awareness of surroundings, quick reflexes, and sound judgment skills.
Therefore, the DOT physical is a comprehensive health evaluation. The goal is to identify and prevent any medical reasons that could interfere with the safe operation of a commercial vehicle and keep everyone safe.

The exam includes things such as vision and hearing tests to ensure that CMV drivers can see and hear well enough to be aware of their surroundings, safely operate a vehicle, and avoid potential accidents. Screening for health conditions such as diabetes, heart disease, epilepsy, high blood pressure, and hernias is important to minimize the risk of a driver having a medical emergency while driving. Finally, while the DOT exam does not include a drug test, questions about the use of controlled substances is included in the medical history section in order to minimize the occurrence of impaired driving.

How to prepare for your DOT Physical Exam?

To prepare for your exam and minimize the risk of disqualifying for a DOT card, you should do your best to take care of your health and wellness. Focus on eating a healthy diet, exercising regularly, keeping your mind sharp, and avoiding excessive smoking or drinking.

It is also best to regularly see a healthcare professional and keep up to date with things like your vision prescription and any medications or treatment regimens (if prescribed).

What do you need to bring to the DOT Physical Exam?

To help the exam run quickly and smoothly, it is best to bring anything you think might be relevant to your health and ability to perform work. Things to bring might include:

  • A complete list of your doctors and their contact information, including your primary care physician and any specialists
  • A complete list of any medication you are taking, including the dosage and prescribing doctor’s name
  • Eyeglasses, corrective lenses, and/or hearing aids, if you use them to drive
  •  Any letters or medical records from specialist doctors regarding special health conditions and your health history


How Much Does a DOT physical cost?

Since the DOT physical is a requirement of the job, many employers will cover some or all of the cost for you. Otherwise, the cost is $100.  Call our offices today and we can help you determine the cost of getting a DOT physical exam.

Where can you get a DOT Physical Exam in New York City?

At Great City Medical in New York City, our doctors provide DOT Physical Exams. Feel free to give us a call if you have general questions about DOT exams, or if you want to schedule an appointment!


November 19, 2021 gyn

PMS symptoms and period pain can cause exercise to be the last thing on your mind during your time of the month. It probably seems like exercise would only make symptoms such as back pain, bloating, heavy periods, mood swings, and low energy levels worse. You’d much rather stay in bed with a heating pad and lay low.


But did you know that there is no medical reason not to exercise during your menstrual cycle? Physical activity can actually help greatly reduce period symptoms such as pain, menstrual cramps, bloating, depression, fatigue, mood swings, low energy levels, and more. It can also help to release endorphins (“feel good” hormones) and reduce stress to make you feel better and improve your feelings of overall wellbeing. Regular exercise routines may even help reduce the overall intensity and negative symptoms of your period over time. 


Keep reading to learn more about which exercise routines are best for you and your health during your period.


Is it Harder to Work Out on Your Period?

is it harder to work out on your period

While it can be beneficial to workout during your period, it can be harder to workout during this time than the rest of the month. The first day of your period tends to be the hardest day to work out. During your period, hormonal changes cause your progesterone levels to be high and estrogen levels to be low, which can cause low energy levels and low motivation. If you’re already struggling with your fitness routine, finding the motivation to workout on your period can feel impossible. However, some women report feeling stronger during their period, so don’t let your time of the month prevent you from working out if you feel up for it.


If you are worried about workouts being harder on your period, consider sticking to workouts that are easier than your usual workout routine. Also stick to exercises that are familiar to you instead of trying something new and extra challenging. This can help get you moving and feeling your best.


What Exercise is Best During Your Period?

what exercise is best during your period

The best exercises to do during your period are exercises that you will actually stick with and enjoy doing! Pay close attention to your body to figure out what you feel capable of and adjust your exercise routine accordingly. 


If you are suffering from intense cramps and pain, gentle exercise such as walking, yoga, pilates, or gentle stretching can help relax tense muscles in the hips and back and ease pain. Exercises such as walking, yoga, and stretching can also be done at home and at your own pace. This can be very attractive if you feel the need to slow down, take your time, and avoid any extra stress that might come from visiting a busy, public space like the gym or fitness studio. Water activities such as swimming can also feel especially great, as the water can make you feel weightless and ease pain.


Do You Lose More Weight on Your Period?

Everyone’s bodies and menstruation cycles are different, so weight fluctuations throughout the month will vary for each individual. In the time leading up to your period, increased levels of cortisol can stimulate your metabolism. However, researchers have determined that the impact of this on weight loss is probably negligible. 


If you weigh yourself regularly, you may find that you weigh less immediately after your period ends. However, this is likely not due to true weight loss. Many women bloat or retain more water around the time of their period. It is normal to gain as many as 3–5 pounds of water weight before your period. After your period ends, you will stop retaining water and this “extra weight” will shed off. This may make it look like you lose more weight on your period, even though it is just water weight. 


Please Make an Appointment with our Gynecologists’ Today

At Great City Medical, our women’s health specialists are here to answer any questions you may have about staying healthy during your menstrual cycle. If you want to learn more about how to stay healthy and feel your best on your period, give us a call today. Make an appointment to speak with an ob/gyn about managing your period and PMS symptoms.


November 19, 2021 gyn

If you find yourself getting strong food cravings and the urge to eat more around certain times in your menstrual cycle, you’re not alone! About 1–2 weeks before your period begins, fluctuations in your hormones can cause many side effects, including food cravings, increased appetite, bloating, fatigue, sleep disturbances, mood swings, and irritability. These side effects are collectively known as premenstrual dysphoric disorder, or PMS. 


Understanding the symptoms of premenstrual syndrome and why they happen can help you understand your body and prevent food cravings from controlling your life. Keep reading to learn more about why women experience PMS food cravings and what you can do to lessen the impact they have on your diet and wellness. If you’re struggling with severe PMS symptoms, consider making an appointment today with our expert women’s health team at Great City Medical in New York City.


Why does PMS cause increased appetite?

why does pms cause increased appetite

During the 1–2 weeks leading up to the start of your period, dramatic hormonal changes can cause an increase in your appetite. There are three main hormone changes that are responsible for this: estrogen, cortisol, and serotonin.


Estrogen levels increase in the days before your period begins. When estrogen levels increase, so do your cortisol levels. Cortisol, also known as the stress hormone, puts your body in a state of high stress during this time. This can put your body on high alert and stimulate your metabolism, increasing your appetite and causing cravings for foods that are high in fats and carbohydrates. 


Also during this time, serotonin levels can drop. Serotonin is a hormone associated with happiness, feeling good, and overall feelings of well-being. If your serotonin levels are low, your body will signal to you to seek out things that can help you feel better, such as eating your favorite comfort foods. With the effects of the combination of high cortisol and low serotonin levels, it is no wonder that period cravings and increased appetite are such common symptoms of PMS.


How early can PMS cravings start?

how early can pms cravings start

PMS cravings tend to start around 7–10 days before your period begins, but they can start as early as 2 weeks before your period begins. The exact timing and intensity of your PMS cravings will depend on your individual hormone levels and cycle schedule. PMS cravings tend to start at the same time that any other PMS symptoms begin. If you start to notice any other PMS symptoms, this can be a helpful sign that you need to start being aware of your cravings and being more intentional about what you eat. The cravings can last for several days and usually disappear once your period begins.


Is it Good to Indulge Your Food Cravings?

Is it Good to Indulge Your Food Cravings

You may have been taught to feel shameful about your PMS cravings, but there is no need to be ashamed of your body’s natural cycles. It is important to listen to the signals that your body is giving you. An increased metabolism and other changes in your body may mean that you do actually need to eat more calories than usual during this time. Undereating can also raise cortisol levels and worsen your PMS symptoms, so be sure to give your body what it needs.


That being said, it is important to provide your body with the proper nourishment and nutrition. Instead of reaching for comfort foods that are high in sugar and simple carbs that can cause spikes in your blood sugar levels, reach for complex carbohydrates that are high in fiber. Try replacing sugary snacks like ice cream, chocolate, or potato chips with whole grains, dark chocolate, fruit, brown rice, oats, lentils, and other healthier foods. Watch your food intake and try to avoid binge eating or overindulging regularly to avoid excessive weight gain and other negative side effects from letting your cravings take control of your diet.


What foods help with PMS?

Eating big meals with too much refined sugar, simple carbs, and salt can actually worsen PMS symptoms and make you feel awful. These comfort foods might give you a temporary boost in serotonin while you’re eating them, but the effects will be short lived. The resulting drop in blood sugar levels that inevitably come afterwards can leave you feeling more depressed and sluggish than before. 


Eating several small meals throughout the day can help keep hormone and blood sugar levels stable (this can help keep your mood and energy levels stable too!). Focus on eating plenty of lean proteins, complex carbs, fruits, and vegetables. Foods that are rich in vitamin B, magnesium, calcium, thiamine, and riboflavin have been shown to help reduce PMS symptoms. These foods can include whole foods such as whole grains, brown rice, legumes (beans, lentils, peanuts, etc.), nuts, seeds, dark chocolate, and dark leafy greens (spinach, kale, etc.).  If you are concerned about your nutrient levels, you can also talk to your doctor about talking supplements such as a magnesium or calcium supplement. It might sound counterintuitive, but drinking plenty of water can also help reduce cravings and bloating.


Other lifestyle changes such as increased physical activity and better quality sleep can also help curb PMS cravings and other symptoms of PMS. 


Please make an appointment with our gynecologists today

At Great City Medical, our women’s health specialists want to help you stay healthy and feel your best throughout your entire menstrual cycle. We are here to help answer any questions about your sexual and reproductive health and find healthy solutions that work for you. Contact us today to make a NYC gynecologist   appointment and speak with a doctor about managing your PMS cravings and other PMS symptoms.



November 19, 2021 gyn

When you visit your NYC gynecologist or ob/GYN, you may be asked to take a urine test as part of your physical exam. This is a regular test conducted by your health care provider to help take care of your overall health. Urine tests are especially common during prenatal visits and pregnancy visits, but they can be performed during an annual checkup too. While they can be a little uncomfortable or embarrassing, urine tests can tell your doctor a lot about your health and wellness and are nothing to be embarrassed about. 


What can a doctor tell from a urine sample?

what can a doctor tell from a urine sample

Urine tests can provide a lot of helpful information about women’s health. They can be used to screen for health issues such as urinary tract infections (UTIs), bacterial infections in the urethra or vulva, kidney stones, bladder cancer, liver disease, sexually transmitted diseases (STDs) such as gonorrhea, and other abnormalities. Urinalysis can also be used to monitor health indicators such as glucose levels, ketone levels, white blood cell and red blood cell counts, nitrites, and bilirubin levels. Urine tests are also a reliable method for pregnancy tests and can be more accurate when performed by a doctor than at-home tests.


For prenatal visits and pregnant women, frequent urine tests are critical for ensuring the overall health of the mother and the child. They can be used to screen for health issues such a preeclampsia and gestational diabetes.


How is a urine test performed?

how is a urine test performed

Providing a urine sample for a urine test can feel a little strange or embarrassing — but luckily they can be provided quickly, easily, and in privacy. Your gynecologist or a nurse will provide you will a sterile urine cup and sanitary wipe. You will take these items into a private restroom. 


Use the sanitary wipe to clean yourself and then begin peeing over a toilet like you normally would. Hold the urine cup underneath you and collect the urine inside the cup as best as you can. Once you are finished, seal the cup with the provided lid and place the cup in the designated location specified by your nurse or doctor. Remember to wash your hands when you’re finished.


What does the color, clarity, and odor of urine mean?

In addition to testing your urine for diseases and health indicators, simply the appearance of your urine can tell gynecologists a lot about women’s gynecological health. The color, clarity, and odor of urine can provide information about your hydration levels, diet, and overall health. 


Dark-colored urine can indicate dehydration, especially when there is only a small amount at one time. Cloudy urine can indicate a UTI, especially when combined with discomfort, pain, or burning sensations while urinating. Red-tinted urine may indicate that there is blood in the urine, which may require additional testing to diagnose if you are not on your period. Bright yellow urine can be caused by taking vitamin B supplements and is not usually anything to worry about. Clear or pale yellow urine is a good indicator of good health and hydration levels.


Urine odors can change depending on your diet. Certain foods can cause your urine to smell differently, such as asparagus or coffee. Fasting can cause urine to have a sweet or fruity smell to it. Very bad or unusual odors can indicate bacterial infections and may require additional testing to diagnose.


What Can an Abnormal Urine Test Indicate?

Urine testing is typically a very fast process. After taking a urine test at your ob/GYN’s office, you can expect to get your test results back within 3 days Your doctor’s office will likely send your urine sample out to a laboratory to do the testing and call you as soon as the results come back.


In pregnant women, abnormal glucose (sugar) levels in the urine may indicate gestational diabetes. Abnormal protein levels, especially when combined with other symptoms like high blood pressure and headaches, may indicate preeclampsia. Frequent urine tests are important during this time to closely monitor for these and other health risks.


In all women, abnormal ketone levels may be a sign of undereating or dehydration. Abnormal white blood cell counts may be a sign of a bacterial infection, and abnormal red blood cell counts may be a sign of kidney stones or a bladder infection. Abnormal nitrite levels may indicate a urinary tract infection, especially if you are also experiencing burning, pain, or discomfort during urination. Abnormal bilirubin levels may be a sign of liver disease. If you receive abnormal urine test results for any of these factors, your doctor will likely ask you to come back and follow up with additional testing before making a diagnosis or treatment plan.


Make an appointment for a urine test today

It might be a little embarrassing, but urine testing is a routine and important part of gynecological care. These tests can tell you a lot of information about your reproductive health and overall health! 


If you would like to get tested for STDs, UTIs, pregnancy, or other health conditions, or you are experiencing any unusual smells, colors, or pain while urinating, contact us about urine testing today. Call us to make an appointment with our team of women’s health professionals and take control of your gynecological health. If you already have an appointment scheduled, a urine test can also be performed as part of your annual checkup and pelvic exam.



October 25, 2021 primary care

It is essential to be fully informed about your health and wellbeing. The best way to be informed is to ask important questions when you visit your primary care doctor for your annual doctor visit. But it can be hard to know what questions to ask, especially when seeing a new doctor with whom you haven’t built a robust doctor-patient relationship yet. 


Don’t worry! Open communication with your primary care doctor is a critical part of your preventative healthcare journey. Keep reading below for some ideas to help you know what questions to ask when you visit your doctor’s office for your annual checkup and be informed about your healthcare decisions. 


What should I ask my doctor during a checkup?

It is common to feel nervous or embarrassed talking to your doctor, but your doctor’s visits are the perfect time to open a conversation with your primary care doctor and ask them questions about your health. Asking questions is a great way to be involved in your healthcare and make informed decisions with your doctor. Asking questions can also help you feel confident and relaxed at your next doctor’s visit.


So, before your next visit, think about some questions that you might like to ask your doctor. You can even write the questions down on a notebook or piece of paper and bring them in with you if that is helpful.

Some critical questions to ask your primary care doctor at your next annual physical might include:


  • What do my cholesterol levels mean?
  • What does my blood pressure number mean?
  • What can I do to better take care of my health and wellness?
  • Are there any over-the-counter medications I should be taking?
  • Am I at risk for any medical conditions, such as breast cancer, heart disease, heart attack, etc.?
  • Should I be tested for any medical conditions or illnesses?
  • What causes certain medical conditions or diseases?
  • What are the treatment options for this medical condition or disease?
  • How long will treatment take?
  • What is my prognosis?
  • Should I take any precautions to prevent spreading this disease to others?
  • Do I need any vaccines?
  • What symptoms should I look for?
  • What side effects might I experience?
  • If there are side effects, how can I manage them?
  • What does this medical condition mean for me and my lifestyle?
  • What does this medical condition mean for my family members?
  • Do I need further medical tests?
  • When will I know my test results?
  • How do I receive my test results?
  • Can you explain my test results?
  • How safe or accurate is the medical test?
  • How can I get a second opinion?
  • Is surgery a necessary part of my treatment plan?
  • What are the benefits and risks of this surgical procedure?
  • Do I need to schedule any follow-up visits?
  • How much will this test or operation cost?
  • Will my insurance plan cover this test or procedure?
  • Can you explain what you are going to do before you do it?
  • Where can I find more information?


The questions above are a good starting place, but feel free to ask your primary care physician about anything else that is on your mind. They are there to help you and take care of your overall health, so come up with meaningful questions and your specific health concerns.


Should you ask your doctor to explain your test results?

Your primary care physician is there to help take care of your overall health, so yes, you should ask your doctor to explain your test results in a way that you understand. When a doctor reads off medical information, it might be intimidating to speak up, but they will always be happy to explain further. Don’t worry about asking too many questions. It is essential that you fully understand any information that your doctor gives you about your health.


Be sure to ask questions about anything that you don’t understand or would like more information about. This extends beyond just test results. When your doctor discusses your medical records, family history, risk factors for certain health conditions, health insurance, treatment options, side effects, or anything else related to your health and wellness, be sure to ask follow-up questions about anything that you don’t understand. Your doctor will be happy to explain further.


What should you not tell your doctor?

Your doctor needs accurate health information from you to provide you with the best healthcare. Therefore, you should never tell your primary care doctor (or any doctor) anything that is not 100% truthful. You should also not intentionally hide any information that could be relevant to your doctor. Be honest and forthcoming about your medical history, family history, lifestyle habits like diet and supplements, mental health, and more. 


Many things you discuss with your doctor might feel embarrassing or shameful, but your doctor will not judge you for your answers. They need truthful information to make accurate decisions about your healthcare, so don’t be embarrassed!


Make an appointment to see your primary care doctor today!

At Great City Medical, our board-certified doctors are passionate about providing you with the best primary care and preventative care experience. We want to help you take excellent care of your overall health and wellness so that you can live your best life. Call us and make an appointment for your annual checkup today! Your best self is just one doctor’s appointment away.



October 25, 2021 primary care

Primary care doctors, also known as general practitioners or pediatricians for children, offer patients a broad range of general health care services. They help you stay healthy with services such as regular annual checkups and referrals to medical specialists. 


Your primary health care provider can help with many health problems and disease prevention by identifying risk factors for various health issues, performing disease screenings such as cancer screenings and tests for high blood pressure, and keeping you up to date on the proper immunizations. They can also help manage chronic disease and improve your quality of life in the long term.


Primary care physicians are an essential part of the health care system and can take care of a wide range of health needs. They can be one of your most valuable assets when taking care of your health and wellness. Please keep reading to learn more about the benefits of primary care and why it is so crucial for everyone to visit their primary health care provider regularly.



Why is it important to have a primary care doctor?


Primary care physicians are critical for taking good care of your overall health and wellness and for providing good preventative care to keep you healthy in the long term. They can help with good health maintenance practices and help you manage many health conditions.


Often, diseases and other health issues can easily be treated or prevented if your doctor detects early warning signs before the disease progresses. Your annual physical is a great time to build a patient relationship with your doctor and keep your doctor informed about any new symptoms, lifestyle changes, or warning signs in your life.


Primary care doctors and family physicians are familiar with your family and medical history and work to build a strong patient relationship with you so that they can provide you with the best, most comprehensive, overall medical care possible.



What is the Value of Primary Care?


Primary care is more than just your primary care doctor. The primary care team at Great City Medical and other doctor’s offices can also include registered nurses (RN), nurse practitioners (NP), and physician assistants (PA). These medical professionals go to rigorous medical school and can provide high-quality generalized health care on various health topics and prescribe any needed medication. 


Your primary care doctor can refer you to other medical specialists that specialize in your health needs for any health issues that fall outside of the realm of typical primary care. With most insurance plans, referrals from your primary care provider are required to visit other medical specialists. Your doctor should have high-quality recommendations for medical professionals in your area in your health insurance network. This can be a hugely valuable service that helps you get the comprehensive medical attention you need without paying you extra for out-of-network services.



Does primary care save you money?


Most health insurance companies cover annual primary care checkups, and it may not cost you any money to go for your yearly visit. However, depending on your health needs and insurance plan, you may need to pay a small copay at the time of your visit. 


Some tests recommended by your doctors, such as blood tests or extra health screenings, may cost an additional fee. However, these fees are minimal compared to the cost of needing to pay for significant health issues that you may develop down the line if you neglect your primary care today. 


The preventative care that you receive from your health care provider can save you time, money, stress, and even years in your life! That is invaluable. They can provide screenings for health conditions such as cancer, heart disease, high blood pressure, mental health conditions, chronic conditions, and more and catch signs of disease early enough to save you a lot of money down the line.



Make an appointment to see your primary care doctor today!

At Great City Medical, our board-certified doctors are passionate about providing you with the best primary care and preventative care experience. We want to help you take excellent care of your overall health and wellness so that you can live your best life. If you are in the New York City area, call us and make an appointment for your annual checkup today, or ask about seeing one of our nurse practitioners for your health needs! Your best self is just one doctor’s appointment away, so call us today and come in for your annual visit.


Also, check out what is a primary care doctor if you have additional questions!



August 30, 2021 Women

Visiting a gynecologist can be a bit uncomfortable, especially for the first visit. But gynecologists are an essential part of any women’s health care. They can help answer any questions and make sure that you stay healthy down there.


If you aren’t sure what to talk to your gynecologist about, keep reading for some ideas to help you get the most out of your next doctor’s visit and take care of your reproductive health.


What should I talk to my gynecologist about?

A gynecologist specializes in women’s reproductive health needs. They provide regular check-ups, including pelvic exams, pap smears, breast exams, testing for sexually transmitted diseases, treating urinary tract infections, and more. They can help you figure out what birth control options might be suitable for you.


And there is no need to be embarrassed! Your gynecologist is there to answer any questions that you might have about your sexual and reproductive health. 


Typical discussion topics people have for their gynecologist include:


  • Painful periods
  • Irregular periods
  • Other questions about the menstrual cycle
  • Birth control and contraception
  • Vaginal discharge
  • Vaginal dryness
  • Sexual activity
  • Pain during sex
  • Low libido
  • Pimples caused by hormonal acne
  • Sexually transmitted diseases
  • Yeast infections
  • Ingrown hair
  • Endometriosis
  • Ovarian cysts
  • Uterine fibroids
  • Menopause 
  • And much more!


If you’re feeling nervous or confused, you can also ask your gyno to explain everything they are about to do before doing it.


What questions do they ask you at the gynecologist?

If you are getting ready for your first visit to the gynecologist, you might be wondering what kind of questions your doctor might ask you. As far as questions go, a visit to the gynecologist should not differ too much from other doctor’s visits.


A gynecologist will start by asking you questions about your medical history and your family history. These questions will help give the doctor some background on your health and bring awareness to any potential health issues that they should test you for. 



Questions about your medical history and family history might include:

  • Has anyone in your family had breast cancer?
  • Has anyone in your family had cervical cancer or uterine cancer?
  • Have you been vaccinated for HPV?
  • Do you have any concerns about your sexual health?


After they ask about your medical history, questions a gynecologist might ask you include:

  • When was your last period?
  • How long does your menstrual cycle typically last?
  • Do you experience irregular or painful periods?
  • Are you sexually active?
  • How many sexual partners have you had?
  • When you are sexually active, do you use condoms or any other form of birth control?
  • Do you experience any pain or bleeding during or after sexual activity?
  • Are you looking for a new birth control method?


It is vital to find a gynecologist that you feel comfortable talking to. Any questions they might ask you intend to provide the best medical care for you. The questions are designed to evaluate for any medical conditions. The doctor will not pass any judgment on your personal sex life.


What should I wear to a gynecologist appointment?

Wear whatever clothing makes you feel comfortable to your gynecologist appointment. Most gynos will ask you to take off your clothes privately and wear a special robe or gown for the exam, so it should not matter what you wear into the appointment. The only type of clothing to avoid might be difficult for you to remove by yourself.


Many people might feel the need to prepare ahead of time for their appointment out of anxiety or embarrassment. This is a personal choice, but it is best not to shave wax or groom before your gynecologic exam excessively. A simple shower is all that is needed to prepare for your exam. Again, the doctor is there to evaluate you for medical conditions rather than pass any judgment on your physical appearance.


Please make an appointment with our gynecologists today

At Great City Medical, our women’s health specialists are here to talk to you about your sexual and reproductive health. Call and talk to our specialists today to learn more about how to prepare for your first NYC gynecology appointment.


August 23, 2021 Women

NYC Labiaplasty is a plastic surgery procedure, commonly known as a type of vaginal rejuvenation, that is used to reduce the size of the labia minora tissue. This surgical procedure is growing in popularity with women in NYC and across the U.S. 


The labia minora, also known as the inner labia or inner lips of the vulva, come in all shapes, sizes, and colors. Some women have very small vaginal lips that might be hard to see, and other women have very large vaginal lips that overflow to the outside.


The appearance of the labia minora can change naturally as women age, lose a lot of weight, or go through childbirth. Some women might even experience pain, discomfort, reduced sensitivity, or low self-confidence from certain anatomical conditions. 


At Great City Medical, gynecologists are here to help you look and feel your best. We provide personal labiaplasty consultations and perform some of the best labiaplasty procedures in NYC.


When is labiaplasty medically necessary?

Excess tissue can make it difficult for women to feel comfortable wearing form-fitting clothing, such as yoga pants or bathing suits. It can also make women feel self-conscious in the bedroom.


But, the most common reason for women to get labiaplasty is not actually for cosmetic reasons. While it can be a cosmetic surgery, most women who get labiaplasty do so because it can be medically necessary.


Excess tissue can cause severe pain, irritation, chafing, and itching during activities such as exercise, sexual intercourse, and more. Women with enlarged labia minoras may not be able to participate in physical activity such as riding a bike or jogging, which can be reasons that the surgery is medically necessary. Labiaplasty is also considered medically necessary when the labia minora tissue gets tucked or pulled into the vaginal opening during sexual intercourse.


Excess labia tissue can also cause difficulties for maintaining proper hygiene and increases a woman’s risk of urinary tract infections. Many women with this condition may suffer with infections their whole life. Increased risk of infection is another reason that labiaplasty can be medically necessary.


What does a labiaplasty consist of?


The goal of labiaplasty surgery is to reduce the size of the labia minora so that it does not hang down below the labia majora. Labiaplasty is a relatively minor, minimally invasive  outpatient procedure that is performed under general anesthesia (sedation). 


The most common type of labiaplasty is the trim procedure. With a trim labiaplasty, the extra labia tissue is trimmed off linearly around the outside edge of the labia minora. 


Another popular labiaplasty is the wedge procedure. With the wedge procedure, the surgeon will remove a v-shaped section, or a wedge, of the labia minora and then suture the tissue back together. This method helps maintain some of the natural shape and wrinkles of the labia minora.


When getting a labiaplasty, a clitoral hood reduction can be performed at the same time if you also suffer from extra tissue folds around the clitoris.  Either surgical method can help reduce the overall size of the labia minora. Both methods can also help remedy asymmetry.


Since it is a surgical procedure, patients must allow for some recovery time after labiaplasty. After surgery, you should allow 1–2 weeks for recovery time at home and avoid any strenuous physical activity for several days after your procedure. Do not use tampons or have sexual intercourse of any kind for 4–6 weeks following their surgery, or until cleared by a doctor.


Labiaplasty patients may experience some discomfort for a few days after surgery. Some swelling and bruising around the operation site is common. Your doctor may prescribe pain medication to help manage any pain or swelling. Most swelling will disappear within 6 weeks of surgery. Any scars from the surgery will be nearly invisible once fully healed.


How common is labiaplasty surgery?

Labiaplasty is not the most common plastic surgery (when compared to surgeries such as rhinoplasty or breast augmentation), but its popularity is on the rise.


While many women may opt for labiaplasty as a cosmetic procedure, the most common reason women receive this surgery is for medical reasons and to improve sensation. As this surgical procedure grows in popularity, women who have perviously struggled with labial pain, discomfort, and infections are now aware that labiaplasty can be a great solution for them.


Does labiaplasty affect sensation?

Naturally, many women are concerned about reduced sensation after getting labiaplasty, but in general there is nothing to worry about. As with any surgery, there is some risk of decreased sensitivity, numbness, dryness, and permanent scarring, although these risks are relatively very minor.


Many women who opt for labiaplasty do so because they already suffer from discomfort or reduced sensation during sexual activity, so labiaplasty will actually enhance sensation for these women. The excess labia tissue, especially when paired with excess folds in the clitoral hood, can interfere with sensation in the bedroom. 


Getting labiaplasty to remove that excess labial tissue should actually increase sensation and pleasure for women. Many women report that removing the excess tissue is positively life-changing.


Book a labiaplasty consultation

Call us at Great City Medical today and book your labiaplasty consultation our gynecologists will discuss labiaplasty and help you determine if this surgical procedure is right for you! 


We want you to look and feel your best, so we will provide you with the best medical advice and treatment we can offer. 


If you do decide to book a labiaplasty procedure with us, our NYC gynecologists will walk you through it every step of the way. We care about your recovery and provide follow-up appointments after the procedure to make sure everything heals properly and you are completely satisfied.



August 23, 2021 Women

Intrauterine devices (IUDs) and birth control pills are two of the most popular birth control methods for women. Both methods are highly effective contraceptives.


They work similarly. Birth control products deliver hormones to your body that help prevent pregnancy. By preventing ovulation IUDs cause the uterine lining to thin, and cause the cervical mucus to thicken. These effects help prevent sperm from fertilizing an egg and prevent an egg from implanting in the uterus.
There are several women’s health factors to consider when deciding on which forms of birth control might be right for you. No one option is better than the other. It all depends on your lifestyle and your unique medical situation.


It is best to make an appointment to talk to your primary care doctor or gynecologist for medical advice on your reproductive health, but here is some information to help you start thinking about whether an IUD or birth control pills might be the right choice for you.


Which is better IUD or birth control pills?

Both the IUD and birth control pills are highly effective birth control options.


When taken perfectly at the same time every day, birth control pills are about 99% effective at preventing pregnancy. However, with average or “imperfect” use, birth control pills are closer to 91% effective. Both hormonal and copper IUDs are close to 100% effective at preventing unwanted pregnancy.If you are someone who can be responsible to take a pill at the same time every day, birth control pills might work well for you. If you do not want the responsibility or cannot take a pill each day, an IUD might be a better method for you because it can last for years after IUD insertion is performed by a doctor.


Both methods can help regulate your menstrual cycle, lighten period flow, reduce painful cramping, and help manage the symptoms of conditions such as endometriosis.


Negative side effects are rare, but they are possible. Birth control pills can increase your risk of blood clots. This risk is lower with pills with low doses of estrogen. Birth control pills might not be safe for people with high blood pressure.


IUDs do not increase your risk of blood clots or complications from high blood pressure because they do not contain estrogen.
Neither of these contraceptive methods protects against sexually transmitted diseases (STDs), so a secondary barrier method of contraception, such as condoms, should always be used to prevent the spread of disease.


Do IUDs have less hormones than the pill?

There are two main types of IUDs: hormonal IUDs and copper IUDs.


Copper IUDs do not contain any hormones, and therefore are a non-hormonal method of birth control. The most common copper IUD is called Paragard. Once inserted by an Ob/GYN, copper IUDs can be effective for up to 10–12 years.


Hormonal IUDs are a type of hormonal birth control. They are a long-acting form of birth control that slowly releases low levels of the hormone progestin or levonorgestrel. There are several options for hormonal IUDs, including Mirena, Skyla, Kyleena, and Liletta. Once inserted by an Ob/GYN, each IUD option lasts for 3–7 years, depending on which one you choose.


Combination pills usually contain a combination of low levels of estrogen and progesterone. The minipill only contains progesterone. There are many options for birth control pills. Some pills have higher doses of hormones while others have extremely low levels of hormones. Different levels of hormones will work better for different people and their unique medical situations.


The hormones from IUDs are delivered locally to the uterus and cervix, so there may be fewer side effects. The hormones from oral contraceptives are distributed in the bloodstream throughout the body so there is an increased risk of side effects from the hormones.


Is the IUD the safest form of birth control?

IUDs are one of the most effective birth control methods for preventing pregnancy. They are almost 100% effective in most cases. One of the reasons that they are so effective is because they are implanted by a doctor and then you are set for several years. No need to remember to take a pill every day!


Other forms of birth control, such as the pill, vaginal rings, birth control patches, implants or condoms rely more on perfect use to be effective.


So, if you are solely concerned about preventing unwanted pregnancy, IUDs might be considered the most effective birth control option for you. If you are concerned about the potential side effects of starting hormonal birth control, you should discuss your concerns with your doctor. Using a barrier method, such as condoms, diaphragms, or cervical caps with spermicide is recommended in the meantime. These methods are not as effective as IUDs or birth control pills at preventing pregnancy, but they are generally effective when used as directed. Barrier methods can prevent unwanted pregnancy without delivering any hormones to the body. They also protect against STDs.


Talk to your doctor today

At Great City Medical in NYC, we have a team of Ob/GYNs who are ready to discuss your birth control options and figure out which is best for you. Call us to make an appointment today!



August 23, 2021 Uncategorized

Taking birth control is a popular and effective method of pregnancy prevention, also known as contraception. There are many birth control options available for young women, including hormonal methods such as oral contraceptive pills, mini-pill, hormonal intrauterine devices (IUDs), copper IUDs, and vaginal rings, or nonhormonal barrier methods such as the female condom. 


All of these methods of birth control are effective at preventing unintended pregnancy. You can discuss the best option for you with your obstetrics health care provider here at Great City Medical.


But did you know that taking hormonal birth control can have many women’s health benefits other than just contraception?


Keep reading to learn more about the benefits of birth control.


What are the benefits of taking birth control?

In addition to preventing pregnancy, taking hormonal birth control can provide many health benefits for women.

  • Regular periods
    • The hormones in birth control pills can help regulate your period. Birth control contains hormones called estrogen and progesterone, which mimick the hormones that your body naturally makes. Most birth control pill packs contain three weeks of active hormones and one week of inactive pills without hormones. Your period will come during the week you take the inactive pills. That way, your period should always come every three weeks and last for no more than a week. This can be a great benefit for anyone struggling with irregular periods or long menstrual cycles.
  • Lighter, less painful periods
    • In addition to regulating when you get your period, birth control pills can also help control your period symptoms. Taking birth control pills prevents ovulation and thins the uterine lining. This means your menstrual cycle will likely become much lighter and less painful over time, with less bleeding and fewer cramps. This makes birth control pills a great option for anyone struggling with heavy bleeding, painful cramps, and other side effects.
  • Relieve endometriosis symptoms
    • Women with endometriosis — a condition where the uterine lining grows outside of the uterus and causes heavy, painful periods — can benefit from taking birth control. Taking birth control pills will not cure endometriosis, but it can help manage the symptoms of endometriosis. Taking birth control can help reduce the growth of the uterine lining and reduce painful cramps and heavy bleeding. 
  • Prevent ovarian cysts
    • Ovarian cysts, which are painful collections of fluid built up on the ovary, can be caused by hormonal imbalance. Taking birth control can help balance hormones and reduce the risk of developing cysts on the ovary.
  • Relieve PCOS symptoms
    • Polycystic ovarian syndrome (PCOS), is a condition caused by hormone imbalance when the ovaries produce too much testosterone. It is a common condition in girls and young women. Taking birth control can help balance hormones, reduce excess levels of testosterone, regulate your period, and control other potential symptoms such as acne and unwanted hair growth.
  • Reduce acne
    • Acne can be caused by hormonal imbalances and fluctuations. Birth control is commonly taken to balance these hormones and reduce hormonal acne. Acne tends to clear after several months on the pill.
  • Lower risk of ovarian cancer and endometrial cancer
    • Taking hormonal birth control can lower your risk of certain cancers, including ovarian and endometrial cancer. Women who have taken birth control have up to 50% less risk of getting ovarian cancer and up to 30% less risk of getting endometrial cancer. The longer you take the pill, the lower your risks become. The effect is long-acting, as women can benefit from a decreased risk of these cancers for years after they stop taking the pill.
  • Lower risk of anemia
    • Anemia is a common condition in women. It occurs when you do not have enough red blood cells to carry oxygen in your body. Symptoms of anemia include extreme fatigue, weakness, and frequent bruising. Taking birth control can help prevent heavy blood loss during your period and reduce the risk of anemia.


Does your body change on birth control?

Some women do report gaining or losing weight while taking the birth control pill as a contraceptive method. However, in most cases, any weight change tends to be very minimal and temporary.


Taking birth control might also affect body composition. Some women may find it more difficult to put on muscle mass while on the pill.


However, risks of body changes are very low, especially if you are taking birth control with very low doses of hormones. Most birth control pills today contain very low levels of hormones compared to historical treatments.


Can the pill make you infertile?

While birth control pills prevent pregnancy while you actively take them, they do not have any long-term effect on fertility levels. Scientific research has shown that birth control use, even prolonged use, does not directly cause infertility. Most women are able to regain their natural menstrual cycle and get pregnant within just two to three months of stopping taking birth control.


If you started taking birth control to help treat endometriosis, PCOS, hormone imbalances, or other reproductive issues, these issues may return after you stop taking birth control. These conditions may negatively affect fertility and will need to be treated properly before conceiving.


Talk to your doctor about the benefits of birth control today

Birth control can have many women’s health benefits beyond just contraceptive use. However, hormonal contraceptives are not effective at preventing the spread of sexually transmitted diseases (STDs). 


Hormonal birth control might not be right for everyone. Birth control can increase your risk of blood clots and high blood pressure. It might not be a good option for people who smoke. 


At Great City Medical, our specialists are experts on reproductive health. Talk to your doctor today to learn more about the non-contraceptive benefits of birth control and if birth control is right for you.



August 18, 2021 Testing


What is the I-693 medical examination?

An I-693  immigration medical examinationis a required part of the application process to become a permanent resident of the United States. The exam is also called a green card medical exam or an I-693 medical exam. 


These medical exams are completed by a specially authorized doctor, also called a civil surgeon, who is authorized by the U.S. Citizenship and Immigration Services (USCIS).


These exams consist of a physical and mental evaluation, drug and alcohol screening, a review of an applicant for Adjustment of Status medical history and vaccination requirements, and tests for several communicable diseases. The tests may involve a blood test and a chest x-ray. 


The purpose of the exam is to determine if an applicant for Adjustment of Status has any medical conditions or exhibit harmful behaviors that are grounds of inadmissibility for your immigrant visa for entrance to the United States. Please read more details about the I-693 medical exam here.


Successfully completing an Adjustment of Status application towards permanent residence can be a confusing process, but here at Great City Medical, we are here to help! We have a certified civil surgeon on staff to perform these exams and help answer your questions.


If you’ve already received your I-693 medical exam and have questions about what the next steps are in the application process, read more below!


How long is the I-693 medical examination valid for USCIS?

The validity period for the immigration medical exam is two years after the date that you receive a civil surgeon’s signature on your I-693 form. (Remember, please do NOT sign your form yourself until your exam is complete and you are in the presence of your civil surgeon.) If the two-year period lapses before your application is processed, you will be required to complete the medical exam again.


After the exam, your Form I-693, including a report of medical examination and vaccination record will be in a sealed envelope to prevent tampering or modification. If you hang on to the form for a while before submitting it, be sure to keep it safe so that it does not become open or damaged and, therefore, invalid. It is USCIS policy to return any damaged, opened, or modified forms and you will have to receive a new one if you are not careful.


When should I submit Form I-693 to USCIS?

You have two options for when to submit your Form I-693 to USCIS. 


The first option is to submit your Form I-693 at the same time when you submit your Form I-485, Application to Register Permanent Residence or Adjust Status.   Filing Form I-693 and Form I-485 at the same time may eliminate the need for USCIS to issue a Request for Evidence (RFE) to obtain your Form I-693. This may also help avoid adjudication delays if USCIS decides that you do not need to be interviewed.


The second option is to submit your Form I-693 after you file your Form I-485 (as long as the date of the civil surgeon’s signature is no more than 60 days before the application is filed). You may also submit Form I-693 in person at an interview in a USCIS field office, if an interview is required.


If you have further questions about your green card application, green card interview, and the validity period of forms, you may wish to contact an immigration lawyer to help you understand the relevant immigration law and policy guidance and to successfully complete the entire application process. You may also contact USCIS for more help.


While our professionals at Great City Medical are more than happy to help answer any questions on health-related grounds, we are not immigration attorneys and can only help with our piece of the process! It is recommended to have an attorney review your entire application before submission.


What does I-693 deficiency notice mean?

If you received an I-693 deficiency notice (RFE), do not worry because this is not a big deal! The deficiency notice just means that you need to submit your signed and completed Form I -693. 


Contact us about your I-693 medical exam today

At Great City Medical, we are happy to help with your Form I-693. We make it easy to schedule and complete your I-693 medical examination with us, right on-site in NYC. 

Call us today to schedule an appointment with our civil surgeon to complete your I-693 medical examination!




July 13, 2021 Women

Nonsurgical cosmetic procedures like lip fillers are very popular with both men and women. Dermal fillers can help create a fuller, more defined lip with just one 30-minute appointment.
At Great City Medical, we use top-quality products such as Juvéderm Ultra XC. Our lip fillers contain hyaluronic acid, which locks in moisture in the lips and has been shown to increase the body’s production of collagen.

Hyaluronic acid lip fillers are long-lasting, natural-looking, and safe for most people.

There is no downtime needed after receiving a lip filler procedure. But since it is an injectable treatment, the body does undergo a small healing process around the injection site. So, it is important to follow the best lip filler aftercare practices in order to minimize swelling and receive the best aesthetic results.


How Long Does the Swelling Last after Lip Fillers?

how long does the swelling last after lip fillers

While there are very few common side effects associated with lip injections and recovery time is very quick, you may experience some temporary soreness, redness, bruising, or swelling in the area immediately after injection.

If you experience some swelling in the treated area, don’t worry! This is perfectly normal and only temporary. Once the swelling goes down, your lip augmentation will look and feel great.
Patients tend to report that lip swelling is the worst the first day after their injection, particularly in the morning. Swelling should go down within 2–3 days after your lip filler treatment, and should subside completely within 2 weeks post-treatment.

In the meantime, there are some things you should do to help manage swelling and discomfort.


What Helps to Reduce Swelling after Lip Fillers?

After receiving lip filler injections, swelling can be easily managed by applying ice to the lip area. Gently apply an ice pack wrapped in a towel or a cold compress to the lips. Be sure to use soft cloth and do not to use anything that could stick to the lips, as this could worsen the discomfort.

Talk to your doctor if you feel you need to take any medication for the pain. Generally, Tylenol is recommended. Other common medications such as ibuprofen, Motrin, or aspirin are not recommended because they are blood thinners, which can impact the healing process and increase the risk of bruising. Over-the-counter antihistamines may also help reduce swelling, and arnica cream may be appropriate to help reduce the appearance of bruising.

It is recommended that you drink plenty of water and eat lots of healthy fruits and vegetables after your procedure. Avoid very salty or spicy foods, as these can irritate the lips. Staying hydrated and eating well can help the body heal.

At night, you may wish to sleep with your head elevated to reduce blood flow and fluid retention in the area overnight. Avoid sleeping on your face.


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Should You Exercise After Lip Fillers?

should you exercise after lip filler

You should also avoid strenuous exercise, saunas, steam rooms, hot showers, or any high temperatures for 24–48 hours post-treatment.
The increased physical activity and high temperatures can increase your heart rate and blood flow to the area, worsening any swelling, bruising, or discomfort. Heavy sweating can introduce bacteria to the lip area and increase your risk of infection at the injection sites. Sweating can also cause dehydration, so be sure to drink lots of water to replace any fluids.
If you must exercise within the first day or two after getting lip fillers, try to stick to walking or other light activity. Try to exercise early in the morning, late in the evening, or in an air-conditioned climate to avoid the heat.


Can you Kiss after Lip Filler?

It is important to let your body rest and heal after a lip filler treatment. Therefore, it is recommended that you avoid activities such as kissing for 48 hours after receiving lip injections.
Kissing can put a lot of pressure on your lips, causing pain, swelling, and bruising. Kissing can also increase your risk of infection by introducing bacteria to the injector sites.
Other activities, such as drinking from a straw, sleeping on your face, massaging the area, or having dental procedures done can carry the same risks. Avoid any activities that put pressure on your face or cause irritation after getting lip fillers.


Can you Wear Makeup after Lip Filler?

can you wear makeup after lip filler

Be sure to keep the injection area very clean to avoid any risk of infection. Keep your face clean and use a gentle skincare routine. Avoid wearing lipstick and other makeup around your lips until they have healed.

If you must put any sort of lip product on within 48 hours of your lip fillers, be sure to use only new, clean products and apply them very gently. Don’t leave lip products on longer than necessary and clean your lips after wear.

Some patients may not like the look of their swollen lips, but others may enjoy the plump, fuller look. If you find that you enjoy a fuller-looking lip and are disappointed with the results once the swelling goes away, talk to your doctor about getting a top-up injection to increase the fullness of your lip filler.


Make an Appointment for Lip Filler in NYC today!

At Great City Medical, our medical professionals are trained in providing top-quality cosmetic treatments. They are ready to help you look and feel your best.

When you are looking for a lip augmentation procedure, skip the plastic surgeon and use injectable lip fillers instead to get the beautiful, natural-looking, full pout you’ve always dreamed of.

If you are in New York, call us and make an appointment for your consultation for lip fillers today!


July 13, 2021 Women1

Botox injections are a very popular anti-aging treatment for both men and women. Botox is great for reducing the signs of aging and can even prevent fine lines and wrinkles like crow’s feet from forming in the first place. Botox can take years off of your appearance!

Botox injections are a quick cosmetic treatment with virtually no downtime after. Injections can be performed by our medical professionals at Great City Medical in New York City.

While there is no downtime and little risk of side effects of Botox, there are a few key do’s and don’ts after your appointment. The biggest concern post-Botox injection is facial bruising. Luckily, there are some things you can do to minimize the risk of facial bruising.

If you receive Botox injections with us, here is everything you need to know to give yourself the best Botox aftercare.

Can you Wash your Face after Botox?

You can wash your face after getting Botox. It is important to keep your face clean, especially around the Botox injection sites, to avoid any irritation or risk of infection. Just be very careful when washing your face.

Use gentle cleansers only. Avoiding massaging or scrubbing your face, as this can cause irritation. Instead, use a light touch when washing your face. To avoid heat exposure, use warm or cold water instead of hot.

Avoid any additional facial treatments, such as massages, chemical peels or microdermabrasion, within 24 hours of your appointment.

You may also wish to avoid using makeup and other topical creams like Retin A for at least 24 hours after botox injections.

How Soon after Botox can I Exercise?

It is best to avoid any strenuous exercise for at least 24 hours after getting a Botox injection for several reasons.

Physical activity increases your blood flow, which can cause the Botox to break down more quickly. It is better to let the Botox settle first so the skin tightening effects have time to take place.

Strenuous activity also increases your blood pressure. Increased blood pressure can also increase swelling in the face. There is the chance of swelling around the injection sites, so it is best to avoid strenuous activity for 24 hours or until any swelling from the injection subsides.

Finally, exercising can cause you to sweat. Sweat can increase your risk of infection and irritate the injection sites. To avoid sweating, it is best to also avoid using saunas, sunbathing, or other exposure to heat for 24 hours after getting Botox.

In most cases, excising after 24 hours post-Botox injection should be fine. If you can, waiting up to a full week to exercise post-injection is recommended. This will allow plenty of time for your Botox to settle, optimize your results, and significantly decrease your risk of any side effects from exercise.

If you do need to exercise after getting Botox, try to stick to light exercise such as walking. Consider exercising when temperatures are lower or indoors in an air-conditioned space to keep heart rate and sweating low.

Are there any Foods or Drinks I Should Stay away from after Botox?

There are no foods or drinks that you need to avoid when getting Botox and no special diet is required. However, some food, drink, or supplements can increase your risk of bruising so you may wish to avoid them in the days immediately before and after your appointment.

It is recommended to avoid drinking alcohol, especially red wine, for 24 hours before and 24 hours after your procedure. Drinking alcohol has been shown to increase your risk of bruising and can cause you to be dehydrated. Dehydration can negatively affect recovery.

You may also wish to avoid drinking excessive caffeine before or after your appointment, as caffeine can also cause you to be dehydrated and can increase your heart rate. As with strenuous exercise, increased heart rate and blood flow can cause the Botox to break down more quickly before the skin tightening effects have time to take place.

Foods containing garlic and supplements like vitamin e have also been shown to increase the risk of bruising.

Are there any Medications I should Stay Away from After Botox?

Avoid taking blood thinners for 24 hours before or after your Botox appointment, unless recommended by your doctor.

Also avoid taking aspirin or NSAID pain relievers (such as ibuprofen) for 24 hours before or after getting Botox. These painkillers can act as blood thinners.

Blood thinners all increase your risk for bruising or bleeding after your injection.

Instead, Tylenol is recommended for managing any pain and swelling.

You may also wish to use arnica gel around the injection sites several times per day for the first 24 hours to reduce the risk and appearance of bruising.

Key takeaways for Botox aftercare

• DO ice the treated areas
• DO gently wash your face
• DO drink plenty of water
• DO take Tylenol if needed
• DO use arnica gel if needed
• AVOID additional facial treatments, like massage or chemical peel
• AVOID drinking alcohol or excessive caffeine
• AVOID taking blood thinners and NSAID pain relievers
• AVOID strenuous exercise or excessive sweating
• AVOID heat exposure

Book an appointment for Botox injections today!

At Great City Medical, our medical professionals provide appointments for Botox, dermal fillers, and other non-surgical cosmetic procedures.

We can work with you to achieve and maintain the youthful appearance you’re looking for. Skip the plastic surgeon! Add Botox to your skin care routine and get the best NYC Botox treatment now!

Schedule an appointment with our medical professionals today.


July 13, 2021 Women1

Hyaluronic acid lip fillers like Juvéderm Ultra XC are a very popular lip enhancement product that creates a fuller, youthful, more defined pout.

Hyaluronic acid lip fillers are long-lasting, natural-looking, and safe for most people. The procedure is quick, there is no downtime after, very few side effects, and aftercare is very easy!

At Great City Medical, our doctors provide top-quality, non-surgical lip augmentation procedures like lip fillers and other cosmetic treatments in just 30 minutes or less.

While lip injections are a quick and easy cosmetic procedure (especially compared to plastic surgery), there are definitely some do’s and don’ts after getting a filler treatment. Follow these lip filler aftercare instructions and avoid a few key things to get the best results for your new lips.

Can you Eat After Lip Fillers?

can you eat after lip filler

Yes, you can eat after lip fillers with a few considerations.

If you received a numbing treatment, it is best to wait until the numbing has worn off before eating. Eating while numb can be very difficult and dangerous, but luckily the numbing should wear off in a couple hours or less.

Avoid foods that are messy or hard to eat. You want to keep your face clean and avoid rubbing or wiping your face, so stick to foods that are easy to eat. You also may want to avoid stretching or pursing your lips to much.

It is also recommended to avoid very salty or spicy foods. Salty or spicy foods can irritate the lips and cause you to touch or rub your lips.
Keep your lips clean and stick to foods that are easy to bite and chew.

Drink plenty of water. Do not drink from a straw, as puckering your lips can put pressure on your lips and cause pain and swelling. Otherwise, there are no restrictions on what you can eat after lip fillers.

Can you Smoke or Drink After Lip Fillers?

It is best to avoid drinking alcohol or smoking for 24 hours after getting lip fillers.

Alcohol can act as a blood thinner, which increases the likelihood of bruising, inflammation, and swelling. Drinking alcohol can also dehydrate you, and it is recommended to drink lots of water and stay hydrated after getting lip filler.

Smoking has been shown to increase your risk of infection after getting lip fillers, so it should be avoided. Smoking also causes your lips to pucker, which can apply pressure on the lips and be painful after injections. Try to avoid smoking for at least 24–48 hours after getting lip fillers.

Can you Shower After Lip Fillers?

There are no restrictions on showering after getting lip filler injections. Keep your face clean to decrease the risk of infection. But there are a few considerations.

Use gentle, unscented skincare products and cleansers. Be careful when washing around your face. Avoid exfoliation products. Do not touch your lips directly when showering.

Avoid hot temperatures. Use lukewarm water in your shower and avoid using steam rooms, saunas, or hot tubs. Hot temperatures can increase blood flow and blood pressure, which can worsen swelling and bruising. Sweating can also irritate the lips.

Can you Kiss After Lip Filler?

Kissing can apply a lot of pressure to the lips and increase risk of infection (there is a lot of bacteria in the mouth!), so it is best to avoid kissing for 48–72 hours after getting lip filler treatment. Your lips will probably be a bit tender and swollen, so kissing might not be that appealing anyway!

Massaging the lips should also be avoided.

Once your lips have had some time to heal, kissing is fine and there should be no impact on this activity.

Can you Exercise After Lip Filler?

can you exercise after lip filler

Strenuous exercise should be avoided for 24–48 hours after getting lip filler.

Increased physical activity and body temperature can cause blood flow to the lip area, worsening any swelling, bruising, or discomfort. Sweating during exercise can introduce bacteria to the lip area and increase your risk of infection at the injection sites.

Sweating can also cause dehydration, so be sure to drink lots of water to replace any fluids.

If you must exercise within the first day or two after getting lip fillers, try to stick to walking or other light activity. Try to exercise early in the morning, late in the evening, or in an air-conditioned climate to avoid the heat.

Can you Take Painkillers After Lip Filler?

Painkillers like Tylenol are generally fine to manage any pain or swelling after getting lip filler. NSAID pain relievers like ibuprofen or Motrin should be avoided because they also act as blood thinners, which can increase bruising and swelling.

Arnica cream may be used to decrease bruising in the treated area. Vitamin e supplements can worsen bruising, so they should be avoided for a couple of days after injection.

The best treatment to manage any pain and swelling is to ice the lips. Gently apply an ice pack wrapped in a towel or cloth several times per day.

Key Takeaways for Lip Filler Aftercare

key takeaways for lip filler aftercare

• DO ice your lips
• DO keep your lips clean and shower carefully
• DO take Tylenol if needed
• DO eat easy-to-eat foods and drink plenty of water
• DO make a follow-up appointment with your doctor if you have any questions or concerns
• AVOID strenuous exercise
• AVOID high temperatures
• DON’T take NSAIDs or blood thinners
• DON’T smoke or drink alcohol
• DON’T drink with straws
• DON’T touch your lips
• DON’T kiss or massage your lips

Get Lip Filler today!

At Great City Medical, our medical professionals provide lip filler injection appointments and other cosmetic procedures.

We want to help you get the beautiful, natural-looking, full pout you’ve always dreamed of.

If you are in New York, call us and make an appointment for lip fillers today! You’ll love the final result!


April 25, 2021 Women

Getting pregnant and starting a family is an exciting and important decision in a woman’s life, but it can sometimes be difficult. You might have a lot of questions preconception about how to have a healthy pregnancy. Our NYC ob/gyns are ready to help answer your questions and make your pregnancy journey as easy as possible for you and your little one. 

In the meantime, here are some answers to a few of the most frequently asked questions about getting pregnant and what affects fertility.

What lifestyle changes should I make?

Whether you are just considering getting pregnant or have been trying for a while, it is a great idea to talk to your health care provider about lifestyle changes you can make to increase your chances of conceiving and having a healthy pregnancy. 

Even if you don’t intend to get pregnant any time soon, it is important to have family planning conversations with your doctor or gynecologist to be sure you are informed about your reproductive health and how lifestyle choices can affect your chances of conceiving.

Having a healthy diet and eating nutrient-dense food is important for every one, but women considering getting pregnant may especially want to follow a healthy diet. Getting lots of protein and nutrient-dense fruits and veggies can be critical lifestyle changes if you want a healthy menstrual cycle and to get pregnant. 

It is also important to be at a healthy weight, have low blood pressure, and exercise regularly, but strenuous exercise or over exercising should be avoided. Over excising can lead to decreased progesterone production and even amenorrhea (loss of your period).

In addition to a healthy diet, supplements such as prenatal vitamins and folic acid are important to take preconception. These supplements can help prepare your body to support conception and healthy growth and development of the baby. Your gynecologist can help determine what vitamins and levels of supplementation are best for you to take.

If you are thinking of getting pregnant, it is best to also consider reducing or stopping any alcohol, drug, cigarette, and caffeine consumption. It is best to avoid these substances while pregnant or trying to conceive for both your health, your reproductive health, and the health of the baby.

You may also want to consider the health and beauty products that you use, as well as other products you use around the home. Some products may expose you to harsh chemicals, hormones, or other substances that might not be recommended for pregnant women.

Finally, it is a good idea to reduce stress as much as possible and get lots of restful sleep.

Talk to your doctor about these questions and evaluate what lifestyle changes you might need to make if you are considering getting pregnant or having trouble conceiving.

What health conditions affect my chances of getting pregnant?

There are several women’s health conditions that may affect fertility, such as PCOS, endometriosis, STDs, ovulation disorders, irregular periods, thyroid problems, uterine or cervical abnormalities such as fibroids, diabetes, autoimmune disorders, and more.  

Fertility does decrease as you get older. Women over the age of 35 are more likely to have trouble conceiving, although not all women will necessarily have issues getting pregnant. If you have any concerns about your fertility, you can also receive fertility testing to determine if you have a normal ovarian reserve and are healthy enough to conceive.

If you have a medical history or family history of any of these conditions or are over the age of 35, you should speak with your obstetrician or fertility specialist about your options for getting pregnant, and if fertility treatments such as IVF might be required. 

Does my partner’s health affect my chances of getting pregnant?

Yes, your partner’s health can affect your chances of getting pregnant! To increase your chance of getting pregnant, your partner should take care of their reproductive health too and talk to their doctor about any existing medical conditions or family history of health issues. 

There are many similar lifestyle changes that your male partner can make to increase fertility.

Being a healthy weight and eating a nutrient-dense diet is not only good for you, but it can increase the health of the man’s sperm as well. It is a great idea to start eating healthy and working out together as a couple to make sure your reproductive health is great.

It is also a good idea to cut back on alcohol and drug use and smoking. These substances can decrease sperm count and health, decrease testosterone production, and affect fertility. It is also best for you to avoid second-hand smoke and being around these substances.

And just like it is good for you to reduce stress and get lots of sleep, your man can benefit from this as well!

Finally, it is best to avoid sources of high heat, such as saunas, steam rooms, hot showers, and hot tubs. Extreme hot environments can reduce sperm count and increase infertility.

If I’m on birth control, how soon should I stop?

If you are on any type of birth control but want to get pregnant soon, you should talk to your gynecologist about when you should stop taking birth control and how long after stopping until you can safely try to get pregnant. 

If you are taking the pill, you might be able to stop right away. If you have an IUD or implant device, you may be able to stop soon but will need to make an appointment to get it removed.

Luckily, most birth control methods allow you to try to get pregnant shortly after stopping and you should not face any long-term effects. Your regular menstrual cycle should return quickly. 

Schedule a preconception checkup 

Discuss these questions and more with our obstetrics specialists so that you are prepared once your are ready to conceive. We will review your health history and help you determine the best lifestyle changes you can make before starting a family. Schedule your preconception visit with us today!



April 24, 2021 Women

Birth control pills, also known as “the pill,” is a very popular oral contraceptive used to prevent pregnancy. The pill is a very effective form of birth control when taken regularly. It is 99% effective at preventing pregnancy with perfect use, and approximately 91% effective with almost perfect use — which is a more realistic number for most women. 

The better you are at taking the pill every day, the more effective it will be, but no method is 100% perfect so it is important to learn more about the pill and proper birth control. This article answers some FAQs about the birth control pill and how to know if the pill is working for you.

What is the Birth Control Pill?

The birth control pill is type of hormonal birth control that needs to be taken orally at the same time every day. It is a very small, round pill that is easy to swallow. Some pills are even chewable!

Combination birth control pills work by delivering a small dose of estrogen and progestin that signals to the body to reduce or stop ovulation, to thicken the cervical mucus to prevent sperm from entering the uterus, and to thin the lining of the uterus to reduce the likelihood that an egg would be able to attach to the uterine lining if it were fertilized. 

There are also progestin-only pills, known as the mini-pill, that are a better option for some women, including women who are breastfeeding, are at high-risk for blood clots, or who cannot otherwise take estrogen.

In addition to preventing pregnancy, the pill can lighten or stop your menstrual cycle, help reduce hormonal acne, reduce painful cramping, reduce the risk of ovarian and cervical cancer, treat endometriosis, as well as other reproductive health benefits.

Birth control pills often come in a pill pack that includes four weeks of pills. There is usually three weeks (21 days) of active pills and one week (7 days) of inactive pills or placebo pills. Some pill packs can include 24 days, 90 days, or even up to 365 days of active pills. The active pills and inactive pills are often different colors so it is easy to keep track of where you are in the cycle.

Most women will have a menstrual cycle or spotting while taking the inactive pills and may experience some spotting if taking a pill pack with a longer active pill section.

How Do you Know if the Pill is Working?

Based on what type of pill you are taking and when you start, your doctor can help you figure out how long it will take for your pill to start working.

It can take up to seven days for the combination pill to be effective and up to two days for the progestin-only pill to be effective at preventing pregnancy after you take the first dose. If you have intercourse during this time period after starting the pill, be sure to use another form of contraception to be sure you are protected against unintended pregnancy. 

There might not be any obvious external signs that the pill is working, but if you are taking it at the same time every day and not experiencing any adverse side effects then the pill should be effective.

If you are using the pill for other reasons, such as controlling irregular bleeding or hormonal acne, it can take up to four months to see signs that the pill is working. Be patient as your body adjusts to the new treatment and stay consistent with taking it regularly.

Long-term signs that the pill is working might include clearer skin, regular periods, and lighter and less painful periods.

Is it Possible for Birth Control to Not Work?

With perfect use of the birth control pill, it is possible but very unlikely to have an unintended pregnancy. Unintended pregnancies while on the pill can be serious and in case of ectopic pregnancy life-threatening, so call your NYC gynecologist or women’s health professional right away if you have missed a period or think you might be pregnant. Your doctor can discuss emergency contraception and pregnancy test options with you.

Of course, sometimes you forget a pill. If you forget a pill, take it as soon as you remember. If you missed a whole day, take the previous day’s pill plus your regular dose. Be sure to use a backup method of contraception or abstain from intercourse until you’ve gotten back on a regular regimen with your pill pack. It is a good idea to set calendar reminders or an alarm on your phone to help you remember to take your pill each day.

It is recommended to always use a backup birth control method while on the pill, such as condoms, especially if you have any missed pills. It is also important to use a barrier method of birth control, such as condoms, to protect against sexually transmitted infections (STIs). 

How Do you Know if your Birth Control isn’t Working for You?

There are many different types of birth control pills so it is possible you will need to try a couple different kinds before you find the one that is right for your body. If you’re experiencing negative side effects from the pill, you may need to switch to another type of pill with different hormone dosages.

If you are experiencing any side effects, such as headaches, nausea, irritability and mood swings, breast tenderness, or abnormal spotting or breakthrough bleeding, speak with your health care provider about your birth control options. These side effects are common and can usually be resolved by a doctor.

If you don’t think birth control pills are working for you and you are interested in trying another method, ask your health care provider about other birth control options such as a hormonal intrauterine device (hormonal IUD), a non-hormonal copper IUD, or a vaginal ring such as the NuvaRing. These options are great for women who struggle with taking the pill on a regular daily basis because they are inserted into the body rather than taken orally. The vaginal ring can be used for three weeks at a time and IUDs can last for years.

Dr Yelena was amazing, she really made my visit easy and comfortable. Loved her, highly recommend!
Valentina M.
Valentina M.
18:12 24 Jun 22
Amazing customer service! Friendly and efficient! Made it fun going to the GYN!
Clara M.
Clara M.
23:28 16 Jun 22
I received the best medical treatment and follow up services at this clinic.
Dshea Kinta M.
Dshea Kinta M.
13:22 20 May 22
I was in need of a new GYNECOLOGIST. I found Great City Medical in a Google search. I spoke with a staff member after hours via live chat an was scheduled the earliest appointment very quickly. All my basic questions were answered. I was sent to patient portal link to pre-register and fill out the forms. Upon arrival I was greeted with a smile and checked in quickly, wait time was short before the nurse called me in to be triaged. I was placed in a room, which was very clean. Dr. Tsyba greeted me with a smile and was very polite and Thorough with the examination. She explained to me in detail what procedures were going to take place and what testing will be done. The staff was very Knowledgeable and helpful as a first-time patient I enjoyed my visit I highly recommend this practice.
Cheryl B.
Cheryl B.
19:00 16 May 22
The place is very nice, and people are kind and professional. The only downside is that I have waited more than I expected (even though I arrived way earlier than the scheduled time), but maybe it’s been just a coincidence. That being said, nothing else to complain about!
Elena F.
Elena F.
02:02 13 May 22
I waited about 30 min to see the Tech, then spent like 20 min with her as a new patient, then about 10 min. more to see Jaime, the NP who was available, since Dr. Tsyba was in surgery. Jaime then consulted with Dr. Tsyba. I was very satisfied with the gentle, compassionate and thorough care I received by Jaime, and the technician who performed the 2 ultrasounds I needed. I’m happy I found this OB/GYN doctor. I hope to meet Dr. Tysba soon.
Awilda R.
Awilda R.
17:44 12 May 22
They was wonderful, the front desk and even my doctors very gentle with everything they do..I felt very comfortable to open up to them about my needs and I definitely felt like I was in great hands, when it’s comes down to OBGYN’s it’s very hard finding loyalty ,honesty, and security with your doctors THIS WAS WONDERFUL..i found out everything I needed to know and I will definitely enjoy being a new patient here !!!
Londaisha :.
Londaisha :.
12:43 12 May 22
Place was valid … 💯 very respectful and calls patients in a timely manner
Leenia M.
Leenia M.
19:44 02 May 22
Me encantó la atención del personal, y sobre todo la ginecóloga Yelena Tsyba, quien fue la Dra. que fui a consulta, bueno ella es muy profesional, muy amable y gentil ; también la persona que me hizo el sonograma,todos me trataron con mucha gentileza; fue mi primera vez y quedé muy contenta satisfecha…
Sovilek O.
Sovilek O.
02:35 29 Apr 22
The doctor is brilliant!!!
Tyrone H.
Tyrone H.
19:15 21 Apr 22
Very nice always very professional
Madeline C.
Madeline C.
15:38 19 Apr 22
I have known Dr.Tsyba for many years, she sees my friends and my sister gave birth to three children with her, personally in my practice there were moments when I had to urgently go to other doctors, after which I kept returning to her. She, as like a mother, will not advise bad things and will do everything possible to help. The staff is also very responsive and polite professionally fit every patient. You feel at home confidentially. Thank you doctor for your professionalism. I wish you more assistants so that you do not get tired.
Fatima A.
Fatima A.
03:19 06 Apr 22
Great people who made me feel very comfortable for my first appointment at this establishment. Much appreciated.
Nicole De L.
Nicole De L.
16:40 04 Apr 22
Great place to get checked. The staff very professional, they take care of you on your appointment time and the clinic is very clean. My Doctor was great!!
Katty R.
Katty R.
10:43 18 Mar 22
My 1st time going here. All of the staff was friendly and helpful. I loved that I didn’t have to schedule an appointment to go somewhere else for ultrasound. I did 3 things in 1 day and the wait was ok
ivy b
ivy b
20:48 10 Mar 22
good service and everything was very fast no complaints I liked the place
Carmen W.
Carmen W.
18:50 07 Mar 22
It is great office with a best gynecologist Dr Yelena Tsyba
Simon L.
Simon L.
18:40 04 Mar 22
Very good. Attentive staff
Alla T.
Alla T.
22:26 01 Mar 22
Wonderful staff and excellent service
Ramar A.
Ramar A.
22:08 01 Mar 22
Very Professional
Ashlee W.
Ashlee W.
17:35 24 Feb 22
Very amazing service.
Natevia H.
Natevia H.
21:47 23 Feb 22
A++ Service. Great atention to issues and promt call at appointment time👍🏻
Ludo A
Ludo A
16:02 23 Feb 22
My first time visiting this practice. They were very through, from intake, which was done by a Dr. that I assumed was a nurse because he was so young lol. I wound up seeing Jaime who is a GYN NP, she was awesome. They asked a lot of questions about my history, which I really appreciated. Labs and Sonogram are done on-site. I will be returning.
Shay S.
Shay S.
17:25 18 Feb 22
Very nice place with very nice people the place is clean and quiet I love it there
Dj Shabba U.
Dj Shabba U.
01:44 18 Feb 22
Very well cared for. Doctors, nurses, & receptionist are wonderful
Joy H.
Joy H.
21:59 17 Feb 22
Very caring knowledgeable doctor highly recommend!
Alona K.
Alona K.
00:36 05 Feb 22
Great place to come for a Covid test. Everything went pretty quick. Results definitely weren’t ready in 15 min but, the clinic was very, very busy, so it’s understandable. The lady who sits in the middle was very professional, polite and very helpful. Would highly recommend this place!
Lynn In The C.
Lynn In The C.
19:51 03 Feb 22
Actively listened to my concerns and believed me when I said somethings not right. Did not brush me off. And focus on finding the cause to my issues. I definitely recommend. Very clean place.
justina R.
justina R.
16:40 03 Feb 22
Very good Doctor and excellent assistants!
14:15 29 Jan 22
Hello!Today was our first visit, I liked how doctor Tsyba is explaining to us about my daughter’s women health issue. Also I hope doctor will properly treat her/ my daughter. I’ll update later the results.Thank you,Norah & Maftuna.
Nora K.
Nora K.
19:03 28 Jan 22
Good attention, but they should follow the appointments schedule. I saw the doctor almost an hour later
17:17 26 Jan 22
I’ve been going to this doctor’s office for yrs I’m very pleased with my pcp doctor Marly Grana she’s always kind hearted.
Angel's E.
Angel’s E.
20:37 19 Jan 22
Great customer service from the entire team.
Mohammed S.
Mohammed S.
19:27 19 Jan 22
Dr Tsyba is the best doctor I ever knew. Very professional service and so nice stuff!
23:36 18 Jan 22
Great doctor and amazing team.
19:58 14 Jan 22
My experience at your facility was excellent. Your staff members treated me with courtesy and professionalism. Staff members were very friendly and polite. I was contacted within 8hrs of my visit. Thank you for your service.
Alonzo T.
Alonzo T.
23:53 05 Jan 22
Muyyyyyy buena soy una de las primera paciente hace más de 5 años y no voy de hay hasta que dios quiera excelente servicio amabilidad y profecionalismo sigan así
Escarlet C.
Escarlet C.
17:31 05 Jan 22
Great accomodation. Fast and expedient service. Very proffesional.
Jose C.
Jose C.
20:54 03 Jan 22
I had an pleasant experience there . The medical addressed my medical request in an timely manner.
Tyrone M.
Tyrone M.
00:00 28 Dec 21
Great service ! Fast process and no waiting
Fatima S.
Fatima S.
20:47 22 Dec 21
Excellent doctor. Very professional and attentive
Marina Y.
Marina Y.
01:03 22 Dec 21
I’ve been going to Great City Medical for year’s and they are very professional, my Medical and GYN doctors are the best doctors I’ve never had a problem.
Debbie K.
Debbie K.
19:56 15 Dec 21
I thank for finally give my A1C count. I was told I had diabetic in December 2020 at Langone on pine and wall street. I then had a MRI at Corneil Hospital to find out what seizure came back after 15 years while working. I had stress after lost my job. See you January 4 AM hours
Bevelynn T.
Bevelynn T.
15:36 15 Dec 21
La atención de primera recomendado
Martha F.
Martha F.
18:34 09 Nov 21
Came in for immigration medical. Really great staff. They are prompt, proactive and kind!
Aarthi R.
Aarthi R.
23:02 26 Oct 21
They are very welcoming and professional. I can recommend my family and friends.
Bassa N
Bassa N
20:58 14 Oct 21
All the staff members and the doctors are wonderful , competent and kind
Ayne M.
Ayne M.
18:16 14 Oct 21
Front Desk employees are amazing! Very polite, nice and helpful. Dr. Akselrud is the best doctor becausehe LISTENS to all my concert and patiently explains everything to me. Thank you Dr. Akselrud!
Andra T.
Andra T.
21:58 12 Oct 21
Quick, professional and great prices
Jose H.
Jose H.
21:48 12 Oct 21
I was very pleased with this facility. I didn’t have to wait, the nurse and doctor were quite human (vs bureaucratic), and I felt seen and listened to.
Kim P.
Kim P.
17:59 17 Sep 21
Both employees who attended me were very helpful and quick to assist me.
Caro O.
Caro O.
17:26 17 Sep 21
Great City Medical clinic helped me file my green card immigration medical exam form. The team is very knowledgeable and flexible. I scheduled my appointment within one week and got the report quickly. Due to some personal health issues, I had to update my report two days before the interview, and the team helped me correct the form with no extra cost within one day! I really appreciated it and highly recommended having your medical exam report done quickly and professionally with the Great City Medical team.
Hao W.
Hao W.
20:49 16 Sep 21
Very efficient.
Black D.
Black D.
19:12 16 Sep 21
Google Rating
Based on 368 reviews

Doctor in New York City

Looking for a primary care provider in New York City that you can depend on? Make your appointment with the physicians at Great City Medical by calling (212) 281-8600

Working Hours:

Monday 9am – 5pm

Tuesday 9am – 5pm

Wednesday 9am – 5pm

Thursday 9am – 6pm

Friday 9am – 5pm


68 East 131st Street, Suite 100
New York, NY 10037

Call us anytime

Phone: (212) 281-8600
Fax: (212) 281-8601

Patient Portal

Copyright © 2020 Great City Medical. All Rights Reserved.

Copyright © 2020 Great City Medical. All Rights Reserved.