Dr. Ramirez Zamudio, English-Speaking Gynecologist in Paris

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Dr. Ramirez Zamudio, English-Speaking Gynecologist in Paris American 🇺🇸 Colombian 🇨🇴 Gynecologic Surgeon in Paris
💡 Evidence-based GYN education
🏳️‍⚧️ Gynecologist for all 🌈

06/10/2026

🌸 Did you know some gynecologic surgeries can be performed without any abdominal incisions?

That’s the beauty of vaginal surgery.
Although it’s sometimes called a « lost art, » vaginal surgery remains one of the most elegant minimally invasive techniques in gynecology.

It may be used for:
✔️ hysterectomy
✔️ pelvic organ prolapse
✔️ urinary incontinence
✔️ reconstructive surgery

Because surgery is performed through the vagina—a natural opening—patients often experience:
✨ no visible scars
✨ less pain
✨ quicker recovery

France continues to have many surgeons who are highly trained in vaginal surgery, and several hospitals maintain strong expertise in these techniques.
Not every patient is a candidate, but if you’re planning gynecologic surgery, it’s worth asking your surgeon whether a vaginal approach could be an option.
Sometimes, the oldest surgical techniques are still some of the best.

15/09/2026

🤖 Does the robot perform the surgery?
No!
Despite the commonly used name, robotic surgery is actually robot-assisted laparoscopy—the surgeon controls every movement throughout the procedure.

The robotic system offers:
🎯 highly precise instrument movement
👀 magnified 3D vision
🪡 excellent dexterity for delicate dissection and suturing

This can be especially helpful for:
✔️ endometriosis
✔️ large fibroids
✔️ prior abdominal surgery
✔️ pelvic adhesions
✔️ complex gynecologic surgery

Possible considerations include:
• slightly longer operating times
• more small incisions
• limited availability depending on the hospital

Whether your surgeon recommends traditional laparoscopy or robotic-assisted surgery, both are minimally invasive approaches designed to reduce pain, shorten recovery, and help you return to your normal activities sooner.

The “best” approach is the one that’s best suited to your condition and your surgeon’s expertise.

07/09/2026

🇫🇷 Has your doctor recommended a “coelioscopie” and you’re wondering what that means?

Good news—it simply means laparoscopy, one of the most common minimally invasive gynecologic surgeries performed in France.

Laparoscopy uses:
📹 a high-definition camera
🔧 long surgical instruments
✨ tiny incisions (usually hidden in the belly button and lower abdomen)

The abdomen is gently inflated with gas, giving your surgeon space to operate safely and precisely.
It’s commonly used to treat:
✔️ endometriosis
✔️ adenomyosis
✔️ ovarian cysts
✔️ fibroids
✔️ ectopic pregnancy
✔️ many hysterectomies

Compared with traditional open surgery, laparoscopy usually means:
✅ less pain
✅ smaller scars
✅ less blood loss
✅ lower infection risk
✅ shorter hospital stays
✅ faster recovery

One unique feature? During traditional laparoscopy, the surgeon holds the instruments directly, providing tactile feedback that many surgeons value.
If you’re navigating gynecologic surgery in France, understanding what a coelioscopy is can help you feel more confident before your operation.

01/09/2026

🏥 Have you been told you need a hysteroscopy in France but aren’t sure what to expect?

Many patients don’t realize there are two very different types of hysteroscopy.

🔍 Diagnostic (office) hysteroscopy
• Performed with a tiny camera
• Usually no cervical dilation
• Often done under local anesthesia
• Takes less than an hour
• Minimal downtime
It’s commonly used to investigate:
✔️ abnormal uterine bleeding
✔️ uterine polyps
✔️ fibroids
✔️ uterine septums
✔️ intrauterine adhesions

🩺 Operative hysteroscopy
If something needs to be treated, a larger camera allows your surgeon to remove polyps, fibroids, adhesions, or a uterine septum—all without making any incisions on your abdomen.
Because the cervix needs to be dilated, this procedure is usually performed under general anesthesia as ambulatory surgery.

✨ The best part?
Both procedures are minimally invasive, meaning no external scars and typically a smooth recovery.

If you’re an expat living in Paris and navigating gynecologic surgery in France, understanding the difference between diagnostic and operative hysteroscopy can make the process much less intimidating.

27/07/2026

🏳️‍⚧️ Are you a transgender woman living in Paris and wondering if you still need gynecological care?

The answer is often: yes.

After vaginoplasty, many people are followed closely by their surgeon during the first months after surgery — but long-term vaginal and gynecologic health still matters.
The type of tissue used during vaginoplasty can influence what conditions may occur.

Depending on the surgical technique, care may include monitoring for:
✨ vaginal irritation or skin conditions
✨ infections or changes in discharge
✨ s*xually transmitted infections (when relevant)
✨ dermatologic conditions
✨ other concerns specific to the type of tissue used

A provider experienced in transgender gynecologic care can help determine what exams or screenings are appropriate for you.

A wellness visit can also be a chance to discuss:
🩺 hormone therapy
🩺 dilation practices
🩺 s*xual health
🩺 breast cancer screening (depending on age and hormone exposure)
🩺 bone health and density testing when indicated

Gender-affirming care does not stop after surgery.
Your health deserves ongoing, respectful, and knowledgeable follow-up.

20/07/2026

🏳️‍⚧️ Do you avoid cervical cancer screening because Pap smears feel uncomfortable or dysphoric?

You’re not alone.

For many trans masculine, non-binary, and gender-diverse people, a speculum exam can be physically uncomfortable or emotionally difficult. It can also be challenging for trauma survivors.
The good news? There are now more options.

🩺 If you have a cervix, cervical cancer screening is still important—regardless of your gender identity.
In France, primary HPV testing is recommended from age 25 and, for many people, can be repeated every 5 years if the result is negative.

✨ Even better, HPV screening can be performed using a self-collected vaginal swab in many situations, allowing you to collect the sample yourself instead of having it taken during a speculum exam.
A self-swab may be a great option if your main goal is cervical cancer screening.

That said, a pelvic examination may still be recommended if you’re experiencing symptoms such as pain, bleeding, unusual discharge, or if your healthcare provider needs to evaluate your uterus, ovaries, or vaginal canal.

💙 The most important message?
If you have a cervix, it deserves appropriate screening—no matter your gender identity. And today, there are more comfortable, gender-affirming ways to do it than ever before.

If you’re looking for information about cervical cancer screening in France, HPV self-swabs, transgender healthcare, or finding an affirming gynecologist in Paris, follow for evidence-based gynecologic and LGBTQ+ health education.

06/07/2026

🏳️‍⚧️ Considering a gender-affirming hysterectomy in France and unsure what to do about your ovaries?

This is one of the most important conversations to have with your surgeon.
A hysterectomy removes the uterus — which can stop menstrual bleeding, eliminate uterine cramping, and may help relieve gender dysphoria related to this organ.

But an important distinction:
The uterus does not produce your s*x hormones.

Your ovaries produce hormones like:
✨ estradiol
✨ progesterone
So the decision to remove or keep your ovaries is a separate and personalized choice.
Things to consider:
1️⃣ If the ovaries are removed
Your body will become dependent on external hormones (such as testosterone or estradiol) for important functions including:
🦴 bone health
❤️ cardiovascular health
🧠 mental wellbeing
This is why lifelong hormone access and follow-up are important parts of the discussion.

2️⃣ If the ovaries are kept
They are usually suppressed while taking testosterone, but they may become active again if testosterone is stopped.
This may be an important consideration for people with:
• ovarian cysts
• endometriosis
• certain family histories or risk factors
• future hormone goals

3️⃣ Fertility considerations
The ovaries contain your “eggs”, so fertility preservation should also be discussed before surgery if this is something you may want in the future.
There is no single “correct” choice.
The right decision depends on your health, your goals, your relationship with your body, your access to hormones, and your future plans.

22/06/2026

🏳️‍⚧️ Recently moved to France and wondering how to start gender-affirming hormone therapy?

The good news is that France offers multiple options for gender-affirming hormonal treatment, and most are covered by the French healthcare system.

✨ Here’s what you should know:

To start treatment, the initial prescription is typically written by:
• an endocrinologist
• a gynecologist
• or a urologist

These specialists can initiate treatment, monitor bloodwork, and help adjust doses during the first months of therapy.

🩺 Once you’re stable on treatment, follow-up care and prescription renewals can often be managed by your primary care physician.

For testosterone, options available in France include:
💉 Long-acting injections
💉 Shorter-acting injections
🧴 Daily testosterone gel

For estradiol, options include:
✨ Daily transdermal gel
🩹 Weekly or twice-weekly patches
💊 Oral tablets

Injectable estradiol is not currently available on the French market. If you obtain injections abroad, make sure your healthcare provider is aware so they can help monitor treatment safely.

Progesterone is also available, and additional medications such as androgen blockers may be used depending on your individual goals and treatment plan.

💶 Another reassuring point: many hormone therapies are covered through the French Social Security system, and even without coverage, generic formulations are often very affordable.

The most important thing to remember is that there is no single “right” hormone regimen.

Your treatment should be individualized based on your goals, medical history, and preferences.

If you’re looking for information about transgender healthcare in France, gender-affirming care in Paris, HRT, testosterone, estradiol, or navigating the French healthcare system as an expat, follow for evidence-based gynecologic and transgender health education.

04/06/2026

🤔 Are you in perimenopause and confused about your treatment options in France?

You’re not alone.

As an American gynecologist practicing in Paris, one of the biggest differences I’ve noticed between France and countries like the US is how perimenopause has traditionally been managed.

📅 Menopause is officially defined as 12 consecutive months without a menstrual period.

But perimenopause can begin 10–15 years before that final period.

During this transition, hormone levels don’t gradually decline, they fluctuate dramatically, which can cause symptoms such as:

✨ Brain fog
😴 Sleep disturbances
😟 Anxiety
💔 Palpitations
🦴 Joint and muscle pain
🎢 Mood swings
🔥 Hot flashes and night sweats (sometimes—but not always)

Many women assume that because they’re still having periods, their hormones must be stable.
They aren’t.

For years, some French guidelines recommended waiting until menopause was officially reached before prescribing hormone replacement therapy (HRT). In contrast, North American, British, and Australian guidelines have recognized that hormonal treatment can be safe and effective during perimenopause in appropriately selected patients.

This obviously leads to changes in clinical practice.
💡 The most important takeaway:
You do NOT need to wait until your periods stop completely to start a conversation about treatment options.

Every patient is different, and decisions about HRT should be individualized based on symptoms, medical history, and personal preferences.

If you’re an expat living in Paris and trying to navigate perimenopause, menopause, or HRT in France, follow for evidence-based health information explained clearly.

26/05/2026

✉️ Did you receive a letter from the Assurance Maladie about menopause and wondered what this is all about?

France has introduced a dedicated menopause consultation to improve care during perimenopause and menopause, and to encourage conversations around symptoms that can go unexplained.

Menopause is not just hot flashes !
Symptoms can include:
 • sleep problems
 • anxiety or low mood
 • brain fog
 • attention difficulties
 • vaginal dryness
 • recurrent UTIs
 • irregular periods
 • joint pain
 • fatigue

Many women don’t realize these symptoms can begin YEARS before periods stop completely.

This consultation is also important for prevention, since hormonal changes can increase risks of: high cholesterol, weight gain, diabetes, heart disease and osteoporosis. 

Who can you see in France?

Midwives can help guide menopausal care, but hormonal treatment may require a gynecologist or GP trained in menopause medicine.

If you’re an expat living in Paris and trying to understand menopause, HRT, or the French healthcare system, follow for evidence-based gynecologic information explained clearly.

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Neuilly-sur-Seine
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