Dr. Ramirez Zamudio, English-Speaking Gynecologist in Paris

27/04/2026

Did you know you don’t always have to pay upfront with international insurance in France? 🤯🇫🇷

If you have international health insurance (through your employer or privately), you might be used to:� 💸 Paying first� 📄 Then submitting for reimbursement

That’s manageable for a consultation… but what about surgery or hospitalization? 🏥
� Costs can reach thousands of euros — and reimbursement delays can make this a real barrier to care.

✅ Here’s what many expats don’t know:� Some hospitals in France have direct agreements with international insurers. These hospitals have teams dedicated to working with many global insurance providers and can:� ✔️ Request a guarantee of payment (guarantee of benefits)� ✔️ Coordinate directly with your insurance� ✔️ Help you avoid paying upfront

💡 This can also apply to:� • Pre-operative visits� • Post-operative care� • Planned procedures

✨ A small trick that can make a HUGE difference when navigating healthcare abroad

💾 Save this for later — you never know when you might need it� 👯‍♀️ Share with another expat in France!

23/04/2026

The best thing about being a clinician-researcher is the variety of activities I can have in a single week: patient consults, surgery, field work, research meetings... I never get bored, I balance my work, and I enjoy every minute of it 😍

20/04/2026

In France:

✅ Any adult woman can request sterilization (though you may encounter surgeons refusing to do it for young patients or those without children).

✍️ A written request is required.

📅 There is a mandatory 4-month reflection period between the initial consultation and the procedure.
This reflection period is established by law and is designed to ensure that the decision is fully considered, as sterilization is intended to be permanent.

🇺🇸 🇫🇷 This differs from countries like the United States, where access depends more on physician practices, hospital policies, insurance coverage, and state regulations. For example, Medicaid requires a specific consent process and waiting period, while private insurance policies may differ.

In both countries, thorough counseling is essential because these procedures are permanent.

If you are living abroad, understanding the legal and medical framework of the country where you receive care can make these decisions feel clearer and less overwhelming.

Save this post if you are navigating reproductive healthcare in France, or share it with someone who may have questions about the process.

13/04/2026

🇫🇷 Just moved to France and need a doctor but don’t know where to start?

👇 Here’s your step-by-step guide:

🩺 Step 1: Start your Carte Vitale process.
You’ll need to be registered in the French healthcare system and get a social security number first.
Your eligibility depends on your job, residency status, and country of origin, so apply ASAP to access coverage as soon as possible!

💳 Step 2: Get a mutuelle (complementary insurance)
The Carte Vitale typically covers ~65% of costs. A mutuelle helps cover the rest, and many employers provide one. If they don’t, you can buy your own online.

🌍 Have international insurance?
I’ll be making another video explaining exactly how that works in France 👀

💸 No insurance yet?
You can still pay out of pocket, and you’ll likely find costs are much lower than in countries like the US 🇺🇸

🔎 Step 3: Find a doctor
Use websites like Doctolib to search by location, specialty, and language 🗣️

⚠️ Not all hospitals and providers pay for this service, you may need to call
Also check expat groups, embassy lists & word of mouth!

📄 Step 4: Go to your appointment
Bring your records and keep all documents (prescriptions and results are often still paper-based in France!)

✨ Save this post & share it with another expat who needs this!

07/04/2026

🇫🇷 In France:

• Any adult woman can request sterilization (though you may encounter surgeons refusing to do it for young patients or those without children).
• A written request is required.
• There is a mandatory 4-month reflection period between the initial consultation and the procedure.

This reflection period is established by law and is designed to ensure that the decision is fully considered, as sterilization is intended to be permanent.

🇺🇸 This differs from countries like the United States, where access depends more on physician practices, hospital policies, insurance coverage, and state regulations. For example, Medicaid requires a specific consent process and waiting period, while private insurance policies may differ.

In both countries, thorough counseling is essential because these procedures are permanent.
If you are living abroad, understanding the legal and medical framework of the country where you receive care can make these decisions feel clearer and less overwhelming.

Save this post if you are navigating reproductive healthcare in France, or share it with someone who may have questions about the process.

03/04/2026

Getting an IUD soon? A little preparation can make the experience much more comfortable.

Here are a few simple things to consider before your appointment:

🍽️ Eat normally beforehand, you do not need to fast.

💊 If appropriate for you, taking an NSAID such as ibuprofen about one hour before the procedure may help reduce cramping.

💉 Ask in advance about pain-control options, including local anesthetic spray or a lidocaine injection around the cervix. Not all practitioners use the same approach, and it’s reasonable to ask.

🎧 Bring your headphones if you want to listen to music during the insertion.

💆🏽‍♀️Try to keep your schedule light afterward. Mild cramping or fatigue can happen, and giving yourself time to rest can help.

IUD insertion is typically a very quick procedure (often just a few minutes) but understanding what to expect can make it feel much less stressful.

For expats navigating contraception in France, especially in a second language, clear information makes a difference.

Save this post if you have an upcoming IUD appointment, or share it with someone who may find it helpful.

01/04/2026

Hormonal intrauterine devices are not just for contraception.

As a gynecological surgeon based in Paris, I often explain that the intra-uterine device (IUD) can also be an effective treatment for several gynecological conditions, not only birth control.

In this video, I explain how these devices work and how they can help with:
• endometriosis
• heavy menstrual bleeding
• painful periods
• perimenopause and menopause symptoms

The mechanism of action of levonorgestrel goes far beyond preventing implantation.

It also reduces inflammation and limits the amount of uterine lining that grows and sheds every month, which is why many patients experience less pain and lighter bleeding.

If you live in France and are looking for expert gynecological care or a specialist in endometriosis treatment, this information may be helpful for you.

30/03/2026

For young women without children, getting an IUD in France can sometimes feel discouraging.

Although IUDs are safe and appropriate for women who have never had children, some patients are told to “wait” or are advised to choose another method first.

If you feel strongly that an IUD is the right contraceptive choice for you, it is reasonable to continue seeking a practitioner who is comfortable placing one.

You deserve to be part of the decision about your own contraception.

Another common concern is pain during insertion.
Pain varies from person to person, but there are ways to make the procedure more comfortable:
• Taking an NSAID (such as ibuprofen) beforehand can help reduce cramping.
• A local anesthetic spray or lidocaine applied to the cervix may reduce discomfort.
• In some cases, a small lidocaine injection around the cervix can significantly improve comfort during insertion.

Not every practitioner uses the same pain-control approach, so it is appropriate to ask in advance what options are available.

Clear communication makes a difference.

For women navigating the French healthcare system, especially in a second language, understanding your options can make the experience feel much less intimidating.

Save this post if you’re considering an IUD, or share it with someone who may need reassurance.

27/03/2026

🥐 Living in Paris means beautiful springs and summers, but also limited sun exposure for much of the year ☀️

🌸 Even with spring arriving, vitamin D deficiency remains extremely common in northern latitudes like France.

This is because Vitamin D is synthesized in the skin and depends on sun exposure. Compounding this is the fact that unlike in other countries like the U.S., food products here are not fortified with vitamin D, which increases the risk of low levels.

As a gynecologic surgeon, I frequently see:
• Osteopenia
• Osteoporosis
• Hormonal and reproductive health concerns linked to vitamin D deficiency

Emerging research also connects low vitamin D to:
• Fibroids
• Endometriosis
• Poor ovarian health

✔️ Daily supplementation is often more effective than high-dose monthly or quarterly regimens
✔️ Strength training is key for protecting long-term bone health

If you’re an expat in France, this is something worth paying attention to.

24/03/2026

“Conisation” in France… What’s in a name? 🇫🇷🩺

If you’re an expat receiving gynecologic care in France, you may hear the word “conisation” when discussing treatment for cervical dysplasia.

In English, however, we usually distinguish between two different (main) techniques:
🔹 LEEP (Loop Electrosurgical Excision Procedure)�🔹 Cold Knife Cone (cone biopsy)
Both procedures remove abnormal cervical tissue and are very effective at treating cervical dysplasia caused by HPV.
But they are not exactly the same.

A LEEP typically removes less cervical tissue, which means that if you’ve had only one LEEP, the risk of complications in future pregnancies—such as preterm birth—is generally very low.

A cold knife cone removes more tissue and is usually reserved for specific medical situations where a deeper or more precise excision is needed.

The important takeaway:�All of these procedures are designed to prevent cervical cancer by removing precancerous cells.

If you are told you need a “conisation” in France, it’s reasonable to ask your gynecologic surgeon:
➡️ Am I a candidate for a LEEP instead of a cone biopsy?

Understanding the terminology can help you feel more informed and confident in your care, especially when navigating a healthcare system in another language.
💬 Have you ever been told you need a conisation or LEEP and didn’t know the difference?�Ask your questions in the comments and I’ll address them in future videos.

👉 Follow for clear gynecologic health information in English from a gynecologic surgeon in Paris.

Read more at: https://www.drramirezzamudio.com/conisation/

20/03/2026