EDUCATION
- For many women, an OB/GYN serves well as a primary care provider. The compassionate team of women’s health experts at our clinic are women who provide comprehensive gynecological care, and can manage your special health needs, including examinations, screenings, and surgeries when needed. If you’re searching for personalized care with a team of women’s health specialists, call today to schedule an appointment.
Gynecology Q & A
Why do I need a gynecology exam?
You need an annual gynecology exam to stay on top of your health. Your yearly women’s wellness visit allows the physician to monitor your health and identify potential health concerns early for treatment and prevention.
The visit may include:
- Cancer screening, both breast and gynecologic
- Pap smear
- Annual bloodwork
- Mammogram prescription
- Depression screening
- Vaccinations
- Discussion and screening of sexually transmitted diseases (STDs)
- Issues with your menstrual cycle
- Birth control
- Bone density (if indicated)
- Any and all other health concerns you have
What can I expect during a gynecology exam?
The physician will provide a very thorough gynecology exam, which includes a physical exam, pelvic exam, and a discussion of your specific health needs or concerns.
The physical examination is similar to what you might expect from your general practitioner — the women’s health expert checks your height, weight, blood pressure, heart rate, and palpation of your organs.
During the pelvic exam, your female specialist examines the size and shape of your uterus and your ovaries. During this part of the exam, you sit on a special gynecology table with your feet in stirrups so she can examine your vagina and cervix.
Your female doctor may also perform a Pap test during the pelvic exam to test your cervical cells for abnormalities that might indicate cervical cancer.
In addition to the Pap test — if you’re over age 30 — the physician may recommend a human papillomavirus (HPV) test. Certain strains of the HPV virus increase your risk of cervical cancer.
Will I need special tests or procedures?
The gynecology exam helps set a foundation of health and direct care. If you need special tests or procedures, you will be informed during the gynecologic examination. If possible, the test or procedure can be done during your gynecologic visit, otherwise, a separate appointment may be made
- Menopause is a natural part of the aging process, but the fluctuations in hormone levels can wreak havoc on your everyday life. The women’s health experts at the clinic are a team of female health care professionals who provide comprehensive care for women going through menopause.
Menopause Q & A
When will I reach menopause?
While you may begin to experience the common symptoms associated with menopause in your 40s, menopause begins when you’ve gone 12 consecutive months without your period. This marks you reaching menopause and the end of your fertility.
The onset of menopause varies, but you may reach this life change around the same age as your mother. Most women in the United States hit menopause around age 51.
What are the symptoms of menopause?
During the transitional phase to menopause — referred to as perimenopause — you may experience a number of symptoms, such as:
- Difficulty sleeping or fatigue
- Mood changes
- Hot flashes and night sweats
- Vaginal dryness or pain
- Low sex drive
- Slow down in metabolism and weight gain
- Loss of hair
Should I be concerned about my health during menopause?
Menopause not only causes physical symptoms, but also increases your risk of chronic health conditions, including osteoporosis, heart disease, pelvic prolapse, and urinary incontinence.
As experts in women’s wellness, we not only help alleviate the physical symptoms you feel during menopause, but they also help manage your health to reduce your risk of developing a chronic condition.
How is menopause managed?
We use a combination of treatments to help you through menopause. You can’t stop menopause and the goal of treatment is to reduce the symptoms affecting your life and improve your overall health and well-being.
For your physical symptoms, they may recommend:
- Hormone replacement therapy
- Bioidentical hormone replacement therapy, a natural alternative to traditional hormone replacement
- Vaginal estrogen
- Over-the-counter lubricants
- Gabapentin or clonidine to manage hot flashes
For bone health, the team may prescribe medication to help maintain strength, but filling your diet with foods rich in calcium and vitamin D is also recommended.
To reduce your risk of heart disease and help you get to and maintain a healthy weight, they recommend a healthy diet and exercise plan.
If you’re experiencing pelvic prolapse —- which is when the pelvic muscles weaken and can’t support the pelvic organs, causing them to fall — the team may recommend pelvic floor therapy, diet changes, or surgery.
- For every woman, pregnancy is a unique experience. Our team of physicians are women’s health experts who provide specialized, compassionate, and personalized care to help you and your baby have a healthy and happy pregnancy.
Pregnancy Q & A
When should I schedule my first appointment?
You should schedule an appointment as soon as you know you’re pregnant — starting prenatal care early ensures a healthy pregnancy from the get-go.
If you’re not pregnant, but have plans in the near future to become pregnant, it’s also a great time to schedule an appointment with the women’s health experts at our office for preconception health care.
This may include an examination and a discussion of what you can do at home to help ensure a healthy pregnancy, such as avoiding certain foods and taking folic acid.
How often do I need to see the doctor during my pregnancy?
How often you see the Doctor depends on your health and stage of pregnancy.
For the first 28 weeks of pregnancy, you only need to go in once a month. Then, twice a month during weeks 29 through 36. As you get closer to your delivery, the Doctor may want to see you once a week.
As a patient with our clinic, you can expect to deliver your baby at a local hospital in the area.
What special tests do I need during pregnancy?
The tests you need during your pregnancy vary and may be determined partially by your age and health needs.
Common tests include:
- Complete blood count to check for anemia
- Rh factor for blood compatibility with your baby
- HIV test
- Diagnostic tests for genetic disorders such as Down syndrome
- Glucose challenge test for gestational diabetes
As a modern, full-service practice, we offer arranging ultrasounds at the office or referring you to an imaging center.
What is a high-risk pregnancy?
If you’re at risk for complications during your pregnancy, you’re considered high risk.
You may be considered high risk if you:
- Are over the age of 35
- Have a pre-existing medical condition such as diabetes or heart disease
- Developed gestational diabetes
- Gained too much or not enough weight
- Are pregnant with twins or multiples
Endometriosis is a disorder in which the tissue that lines the interior of the uterus begins to grow outside of the uterus. Endometrial tissue is most commonly found in the fallopian tubes, ovaries, and the tissue that lines the pelvis. In some rare cases, endometrial tissue is found in other areas of the body, including the lungs.
The displaced endometrial tissue performs just like the tissues located within your uterus. It thickens as you move through your menstrual cycle, breaking down and bleeding during menstruation. Because the displaced tissue cannot exit the body in the same way as your normal endometrial tissue, it becomes trapped and creates health problems.
What are the symptoms of endometriosis?
The most common symptom of endometriosis is a pelvic pain. Additional symptoms include:
- Excessive bleeding
- Painful periods
- Pain during intercourse
- Pain during urination or bowel movements
- Infertility
- Fatigue
Because these symptoms are also associated with many other health conditions, it’s important to discuss with your physician if you experience any of these issues.
How is endometriosis diagnosed?
Diagnosis begins with a discussion of your symptoms and your monthly cycle. Your doctor then performs a pelvic exam, which allows her to check your pelvic area for abnormalities.
Your doctor may also perform an ultrasound, which uses high-frequency sound waves to develop an image of your internal organs. An ultrasound can be completed using an external device or an internal transducer. The process is quick and painless.
In some cases, a surgical procedure called a laparoscopy is necessary to give a more in-depth view of your reproductive organs. Laparoscopy requires a very small incision, is done using general anesthesia, and is virtually painless.
What are some treatment options for endometriosis?
Your treatment options depend on the severity of your symptoms and your plans to become pregnant in the future. Over-the-counter medication can help reduce pain.
Some women find relief through hormone therapy, and use hormonal birth control options to help regulate hormonal balance or make periods stop altogether. Other drugs work by lowering the amount of estrogen your body creates.
Minimally invasive surgery can remove displaced endometrial tissue, which relieves pressure on nearby organs. These surgeries are done laparoscopically when possible.
In certain cases, endometriosis doesn’t respond to medical management and surgery becomes the best possible option. A hysterectomy, which is the surgical removal of your uterus, cervix, and possible ovaries if indicated, is an effective treatment option. This approach, however, prevents future pregnancy and should only be considered after other options have failed and fertility is no longer desired.
- Uterine fibroids are a common condition that bring many women to seek care , choose between numerous diagnostic and treatment options for uterine fibroids. We can help you find relief from the discomfort that fibroids often present.
Fibroids Q & A
What are uterine fibroids?
Uterine fibroids, or leiomyomas, are growths within your uterus that are non-cancerous most of the time. Fibroids originate from tiny seedlings, but can grow so large that they alter the shape of your uterus.
Some women only develop one fibroid, while others have multiple fibroids. They can present numerous symptoms, or can be completely asymptomatic. In fact, many women have no idea they have uterine fibroids until they are discovered during a pelvic exam or ultrasound.
What are the symptoms of uterine fibroids?
Symptoms of uterine fibroids, when they are present, include:
- Long or heavy menstrual periods
- Constipation
- Sensation of pelvic pressure
- Pelvic pain
- Frequent urination or difficulty emptying your bladder
- Leg pain or a backache
If you notice these symptoms, it’s important to schedule a diagnostic exam. Symptoms of uterine fibroids may indicate serious gynecologic issues and should always be evaluated by a women’s health specialist.
What causes uterine fibroids?
The exact cause of uterine fibroids is unknown, but researchers have identified several risk factors. You may have an elevated risk of developing fibroids if you have a family history of the condition, or if you have an imbalance of estrogen or progesterone.
African-American women are more likely to experience fibroids than other ethnicities, and women who began menstruating early are also at an elevated risk. There are also known connections between fibroids and birth control use, obesity, poor diet, and vitamin D deficiency.
What are the treatment options for uterine fibroids?
If your fibroids aren’t causing any discomfort or symptoms, your doctor may recommend “watchful waiting” as a treatment approach. That’s especially true if you are nearing menopause, when a reduction in estrogen often shrinks fibroids.
If your fibroids are painful, medications can help regulate your menstrual cycle by balancing your hormones. Options include GnRH agonists that block estrogen and progesterone production, tranexamic acid to ease heavy menstrual periods, or a progestin-releasing IUD.
Uterine artery embolization is one option to shrink fibroids, and works by injecting tiny particles into your arteries that carry blood to your uterus. When fibroids experience reduced blood supply, they usually shrink.
Minimally invasive surgical treatments can also destroy fibroids without damaging healthy tissue. One approach uses a laparoscope to access your uterus and remove fibroids. Fibroids can also be removed hysteroscopically depending on the location.
- Few things are more distressing than trying to conceive a child and having no success. Infertility brings many women to our office for expert diagnosis and treatment options. We take pride in helping women reach their goal of motherhood, and can guide you through the process with compassion.
Infertility Q & A
What is infertility?
Infertility is a common condition and affects many couples. Most couples are not diagnosed with infertility until they have tried for six months to a year depending on their age without success.
Many men and women assume that getting pregnant is easy, but there are actually several factors that must be in place for a successful pregnancy, including:
- Healthy eggs
- Healthy sperm
- Clear and open fallopian tubes to transport the egg from ovary to uterus
- Sperm that can fertilize the egg within the uterus
- Successful uterine implantation of the fertilized egg
- A healthy embryo
- Proper maternal hormonal balance
If any of these factors are not ideal, infertility can become a problem.
How do you diagnose infertility?
For women, testing for infertility involves a thorough physical exam and a discussion of your health history and previous pregnancies or attempts to become pregnant. Your gynecologist also evaluates your body temperature and ovulation.
You may also need X-ray imaging or even a laparoscopy to evaluate the condition of your fallopian tubes and other reproductive organs. These tests can help identify conditions that might be preventing you from becoming pregnant.
What are my treatment options for infertility?
Treatment depends on your specific set of needs. If you have ongoing health issues that are not being properly managed, treatment may involve getting you to a healthier state where pregnancy is more likely to occur. You may need to lose weight, change your medications, or make general improvements in your health and wellness.
Timing also plays a critical role in becoming pregnant, which is why your specialist helps you understand the optimal times in your menstrual cycle to try and conceive. There are plenty of tools and techniques that can help you identify when you’re ovulating.
Certain medications can help stimulate ovulation. Some women can become pregnant through a procedure called intrauterine insemination, where healthy sperm are introduced into your uterus during ovulation.
Follicular studies can also help your gynecologist better understand your ovulation cycle. The process involves frequent ultrasound monitoring as your follicles develop, which helps determine the timing and chances of success for in vitro fertilization.
If you have intrauterine scarring, endometrial polyps, a uterine septum, or another physical condition that’s causing infertility, surgical procedures can address the issue and increase your chances of conceiving.
What is a high-risk pregnancy?
A high-risk pregnancy occurs when there’s an elevated risk of complications for either mother or child. There are a number of factors that can cause your pregnancy to be considered high risk, including but not limited to:
- Being over 35 or under 17 years old
- Advanced maternal age
- High blood pressure
- Heart disease
- Gestational diabetes
- Human immunodeficiency disease (HIV)
- Previous miscarriages
- Carrying multiples (twins, triplets, etc.)
It’s important to understand that not every woman who has a high-risk pregnancy will experience complications. It simply means that you need additional monitoring as you near your due date.
Even if you’re not currently pregnant, but you’re thinking about adding to your family and you suspect that your pregnancy may be classified as high risk, contact us in advance to learn how you can prepare for a healthy and enjoyable pregnancy.
How is a high-risk pregnancy managed?
Your obstetrician keeps a close eye on your health as you move through the stages of your pregnancy. You might need to come in for more frequent exams, and additional testing may be required to ensure that both you and your child are healthy.
Part of managing a high-risk pregnancy involves following the advice of your specialist when it comes to lifestyle modifications. You may be advised to make dietary changes, get more or less exercise, and avoid exposure to cigarette smoke or toxic substances.
Many women with high-risk pregnancies require more frequent ultrasounds to check fetal development. These exams are painless, take little time, and provide your doctor with a wealth of information that can help guide your care.
What if my baby requires specialized care?
If your baby shows signs of distress or developmental issues, you may need to work with a perinatologist or other fetal medicine specialist. In those cases, your obstetrician can refer you to a specialist and work with that professional to coordinate your care.
When the time comes to welcome your baby into the world, your obstetrician will be available to deliver your child. Knowing that your delivery will be handled by the doctor you know and trust can provide a deep peace of mind during a high-risk pregnancy.
- Regular Pap smear testing is a critical part of screening for cervical cancer. We offer comprehensive obstetric and gynecologic care to women of all ages.
What is a Pap smear?
A Pap smear, or Pap test, is the most frequently used diagnostic tool to detect cervical cancer. Pap smear testing is part of your routine well-woman examinations, and is a critical part of your overall health.
Most women begin Pap smear testing at the age of 21. After you’ve passed the age of 30 and have three Pap smears in a row with normal results, you may only need a Pap smear once every five years. After the age of 65, your doctor may feel comfortable ceasing Pap smear testing.
Cervical cancer is a serious health issue that affects many women. Most types of cervical cancer are caused by the human papillomavirus, or HPV, a sexually transmitted disease. Your gynecologist may recommend routine HPV screenings in conjunction with Pap testing.
What happens during a Pap smear?
Your doctor performs a Pap smear as part of your pelvic exam, as you’re lying in a reclined position on the exam table with your feet resting in stirrups. A speculum is used to gently expand the walls of your vagina, providing access to your cervix.
Your doctor uses a special spatula or brush to remove a small sample of cervical cells. You may feel a slight cramping sensation, but you shouldn’t experience any significant pain. The collected cells are then sent to a lab, where they’re examined for abnormalities.
After your Pap smear, you may experience mild discomfort or cramping for a few hours. A very small amount of spotting, or vaginal bleeding, is also normal.
What if my Pap smear results are abnormal?
If your test comes back with abnormal results, you may need to come in for more frequent testing. Depending on the type and severity of the cellular abnormalities, additional screening options like a colposcopy or biopsy may be necessary.
If the results of a Pap test are abnormal, the doctor may order a second Pap test to confirm the results of the initial test, or a second type of exam called a colposcopy may be performed. During a colposcopy, a specially lighted magnifier is used to assess the tissue around the cervix, looking for abnormal areas that may need to be sampled (biopsied) for further evaluation.
Can a Pap smear also be used to screen for HPV?
Yes. The human papillomavirus (HPV) can lead to cervical cancer, and testing for for HPV is often conducted at the same time. According to the Centers for Disease Control (CDC), most sexually active men and women will come in contact with HPV, although there are a number of types of HPV, and only some can cause cervical cancer.
What is LEEP and when is it necessary?
LEEP stands for loop electrosurgical excision procedure, and makes use of a low-voltage electrical current directed through a thin wire. The heated wire allows your doctor to shave away abnormal cervical cells without harming nearby healthy tissue.
- Menopause may be a normal stage of your life, but the symptoms brought on by your hormonal fluctuations can be life-altering. As experts in women’s health we offer hormone replacement therapy to help you manage menopausal symptoms.
What is hormone replacement therapy?
Hormone replacement therapy is a treatment for menopausal symptoms.
As you transition into menopause, your hormone levels fluctuate and cause a number of different symptoms. The goal of hormone replacement therapy is to help rebalance your hormones to reduce these symptoms.
Women typically begin their transition into menopause in their 40s. On average, women in the United States reach menopause — which is when you’ve gone 12 consecutive months without your period — around age 51.
There are two types of hormone replacement therapy:
- Estrogen only
- Estrogen and progestogen
If you’ve had a hysterectomy, we may prescribe the estrogen only hormone, while estrogen with progestogen is prescribed to women with a uterus to protect against endometrial cancer.
Hormone replacement comes in a variety of forms as well, including creams, pills, patches, and nasal sprays.
What symptoms can hormone replacement therapy treat?
Hormone replacement therapy can treat a number of your menopausal symptoms, such as:
- Hot flashes and night sweats
- Vaginal dryness or low sex drive
- Bone loss
- Difficulty sleeping
- Moodiness or depression
Is hormone replacement therapy safe?
Hormone replacement therapy is safe for most women when prescribed the lowest dose possible for the shortest period of time, which is why it’s vital to consult with your doctor.
Hormone replacement therapy is recommended after obtaining your health history and completing a thorough examination.
You may not be a good candidate for hormone replacement therapy if you have a history of heart disease, breast cancer, or liver disease.
What are bioidentical hormones?
If you have concerns about traditional hormone replacement therapy, another option is utilizing bioidentical hormones. These hormones are created from yams or soy and act like the hormones in your body to help relieve menopausal symptoms.
Custom-designed options are tailored to specifically match your hormonal needs. The pellets are implanted under your skin to provide a consistent delivery of hormones to help maintain balance, which provides better, more consistent control over your symptoms.
- Surgery of any kind can make you feel uneasy. We understand how you feel and offer minimally invasive procedures, including laparoscopic to reduce your risks and your healing time.
What are common gynecology surgeries?
Common gynecology surgeries include:
- Hysterectomy
- Tubal ligation
- Hysteroscopy
- Endometrial ablation
What is laparoscopic surgery?
Laparoscopic surgery is a minimally invasive procedure that uses a laparoscope — a special surgical camera to assist in looking inside your body so you don’t need highly invasive surgery.
The team may be able to perform a number of procedures laparoscopically, including:
- Hysterectomy
- Tubal ligation
- Treatment for urinary incontinence or pelvic organ prolapse
- Removal of fibroids or polyps
During each procedure, a small incision is made in your abdomen for the laparoscope. Then, one or two additional incisions are made for your doctor to gently perform the relevant procedure.
Recovery following laparoscopic surgery is faster than traditional open surgery, but can vary depending on the procedure.
What are specialized gynecologic surgeries?
Hysteroscopy
A hysteroscopy is a minimally invasive in-office procedure utilized to manage health conditions that affect your uterus.
The procedure uses a hysteroscope, which is a lighted telescope that gets inserted in your vagina to your uterus and allows the physician to view your uterus on a screen.
The team may recommend a hysteroscopy to:
- Remove adhesions
- Locate an intrauterine device (IUD)
- Perform tubal ligation
Endometrial ablation
Endometrial ablation is a procedure that destroys a thin layer of uterine tissue to help improve heavy menstrual bleeding. Due to the nature of the procedure, an endometrial ablation may not be recommended if you plan on having children.
After the hysteroscopy or ablation, you may experience cramping and bleeding. The physicians may recommend or prescribe pain medication after your procedure to manage discomfort.
Not only do women suffer with gender-specific health issues, including pregnancy, menopause, and conditions related to female sexual organs, they often neglect themselves while caring for others. Don’t put off your well-woman exam any longer !
What is a well-woman examination?
Well-women exams are also referred to as annual and gynecological exams. When you visit we screen for health problems that are special to women and help to identify serious health concerns before they become life-threatening.
What happens during a women’s health examination?
You should visit for your first women’s health exam between the ages of 13 and 15 to get to know your doctor and discuss your period, especially if it’s heavy, painful, or irregular.
Regardless of your age, if you’re sexually active, your annual exam is an excellent time to talk about birth control or STD testing.
Around age 21, your doctor will introduce well-woman exams, including:Pelvic exam
Your doctor looks at your vulva and the opening of your vagina for signs of cysts and other issues. The next step is to use a speculum to separate the walls of your vagina and use her gloved and lubricated fingers to check the size, shape, and position of your uterus, as well as to check your ovaries and fallopian tubes.
Pap test
Also referred to as a Pap smear, this exam tests cell changes caused by HPV. During your pelvic exam, your doctor collects a small sample of cells from your cervix and sends them out for testing.
Breast exam
Clinical breast examinations help your doctor detect lumps in your breasts and are an essential early breast cancer screenings. Your doctor looks and feels your breasts, including both nipples, and your armpits.
Mammogram
A mammogram is a kind of X-ray that helps detect breast cancer early by finding lumps too tiny to be felt during a clinical breast exam.
Why are women’s health exams important?
Well-woman exams reduce your risk of health problems going undetected causing your body more damage than if caught early. Additionally, annual physical exams strengthen the relationship between you and your doctor. Your annual exam also helps your doctor remain informed about your health and your personal life.
Women’s health is important. If you need an annual exam, call to make an appointment today
Urinary incontinence is an embarrassing problem affecting nearly 20 million adults in the US. Whether it causes leakage when you sneeze or cough or has you constantly running to the bathroom, if bladder control issues interfere with your life, call to make an appointment
What is urinary incontinence?
The loss of bladder control resulting from urinary incontinence causes issues that range from mild leaking to uncontrollable wetting. Urinary incontinence affects twice as many women as men and becomes more common as you get older. The different types of incontinence include:
Stress
You leak urine when coughing, sneezing, laughing, or heavy lifting exerts pressure on your bladder.
Urge
Urge incontinence results from other medical conditions, including infections, neurologic disorders or diabetes. Urge incontinence causes you to have a sudden, intense urge to urinate followed by an involuntary loss of urine, as well as the need to urinate often, including throughout the night.
Overflow
Your bladder doesn’t empty completely, causing you to experience frequent or constant dribbling of urine.
Functional
Severe arthritis or another physical or mental impairment prevents you from making it to the bathroom in time.
Mixed
Your doctor diagnoses you with more than one type of urinary incontinence.
How is incontinence diagnosed?
The doctors use urodynamic testing to diagnose incontinence.
The different types of urodynamic testing are:
- Uroflowmetry: measures the speed and volume of urine
- Postvoid residual measurement: measures the amount of urine left in your bladder after you go
- Cytometric test: monitors the pressure build-up in your bladder as it fills with urine, the amount of urine your bladder holds, and when you feel the urge to urinate
- Leak point pressure measurement: used during a cytometric test to measure the pressure at your leakage point
- Pressure flow study: measures the pressure your bladder needs to urinate and the flow rate specific pressure generates.
- Electromyography: sensors that measure the electrical activity of the muscles and nerves in and around your bladder and sphincters during cystometric testing
- Video urodynamic tests: combine cystometry, uroflowmetry, and cystography into a single exam using X-rays or ultrasound.
How is incontinence treated?
The doctor treats incontinence in several ways, including:
Pelvic floor rehabilitation and therapy
Pelvic floor rehabilitation and therapy can help improve the strength and function of the muscles that support the bladder, urethra and other organs within the pelvis. Pelvic floor therapy techniques can help relax and lengthen tight muscles and release trigger points to help incontinence patients, who mainly need to strengthen the pelvic floor muscles.
Also known as Kegel exercises, pelvic floor rehabilitation helps to strengthen the muscles that control urination.
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A special laser that delivers controlled energy to your vaginal tissue, revitalizing your cells, enabling them to make more collagen.
