Women's Health

Have you been to your gynecologist for your annual exam? While receiving an annual exam may not always be pleasant, they are key to ensuring your good health as you age.

The Importance of Annual Exams

Annual gynecological exams serve a number of purposes. The most important is to diagnose any abnormalities as quickly as possible. The sooner you begin treatment, the better your chances of managing or recovering from a condition will be. By going in for annual exams, you may catch a potentially dangerous disease before it’s too late.

At What Age Should Women Begin Getting Annual Exams

The American Congress of Obstetricians and Gynecologists recommends that girls begin seeing for annual exams as early as thirteen years old, though these check­ups won't be as comprehensive as later exams. Pelvic exams and Pap tests generally begin around age 21. Of course, women are always encouraged to see their doctors sooner if there is any cause for concern.

What Happens at an Annual Exam?

At your annual exam, the nurse and doctor will check you over to ensure you are in good health. They will start by taking your health history if they don't have it on file already. Then the nurse will take your measurements and vital signs, including your height, weight, blood pressure, heart rate, respiratory rate and temperature.

The doctor will examine your body to see that everything is in order. Depending on the type of exam, your doctor may also check your breasts and pelvis, either manually or by performing a Pap test.

Because annual tests can be a little invasive, and because you should plan to have one every year, it is important to find a knowledgeable OB/GYN that you trust. If you have any nervousness about the exam, talk to your doctor. They can address any of your questions or concerns.

A Pap smear, sometimes called Pap test or cervical smear, is a routine screening done at a gynecologist's office to detect irregularities in and on the cervix. Its name is an abbreviation of its inventor's, Greek doctor Georgios Papanikolaou, who developed the test in 1923. It is the most common form of cervical screening in the United States.

Pap smears are in-­office procedures performed by a doctor on an exam table. The vaginal opening and canal are expanded with a speculum; cells are then collected from the outside of the cervix using a tool called a spatula. The procedure itself only takes a few minutes. Some patients report mild cramping or spotting during or immediately following the test, both of which should be brief.

The cervical cells are then transferred to a glass slide and examined under a microscope. The test's main objective is to identify any pre-­cancerous conditions, most of which are caused by sexually transmitted viruses known as HPV. The results, which can take a week or two to come back, can also be used to diagnose other cervical problems.

A Pap smear is recommended. Regular Pap screenings can reduce deaths from cervical cancer by as much as significantly, provided that patients with abnormal results follow their doctors' recommendations for treatment.

Contraception

Also known as birth control, prevents pregnancy by using one or more methods, medications or devices. Medical contraception has been available since the 1960s, and, in that time, a wide variety of options have been introduced, ranging from permanent sterilization to products for one­-time usage .

-Intrauterine devices (IUD)

Intrauterine devices (IUD) are the most efficient removable birth control implements available, with the failure rates less than 1 percent. IUDs are small T­-shaped appliances that are placed in the uterus by an obstetrician during an outpatient appointment. They are long­-acting contraceptives, meaning that they administer the active ingredient - either copper (a natural spermicide) or a hormone - without any maintenance on the user's part. Depending on the type of IUD, they can maintain effectiveness for as long as ten years before removal and reinsertion is needed.

-Hormonal Birth Control

There are a number of other hormonal birth control methods on the market, including patches, implants, injections and pills, all of which prevent fertilization by stopping ovulation. The effectiveness of hormonal methods is generally dependent upon the user; those who take pill have a daily schedule they must follow, while the patch must be used in a cycle, changed every week for three weeks with a fourth week off. Implants, like IUDs, are long­-acting, but must be replaced every three years.

-Barrier Methods

Barrier methods of contraception, including condoms, diaphragms and sponges, work by preventing sperm from entering the uterus, sometimes with the inclusion of a spermicidal agent. These methods are popular because they are typically easy to use, readily available and inexpensive, but they tend to have higher failure rates due to the possibility of user error.

-Sterilization

Both male and female sterilization are minimally invasive surgical procedures that sever the channels through which reproductive cells travel. The recovery time is generally short and there are no long-­term side effects. In fact, female sterilization (tubal ligation) may possibly reduce the risk of ovarian cancer.

Sterilization is designed to be permanent, although there can be a measure of success in reversing the procedure, which varies depending on the gender of the person sterilized and the sterilization method that was used.

All contraceptive methods have benefits and risks. Disclosing your medical history and your goals for contraception with your doctor will help to determine which method is best for you.

Sexually transmitted diseases

Also called sexually transmitted infections, are spread through sexual contact. Because most of these infections do not immediately cause symptoms, it is important for sexually active people to have screening done regularly, to treat any STIs before complications occur or they are spread to others. Untreated STIs can have adverse effects on the entire body, and put you at a higher risk for contracting HIV.

It is important to remember that STI screening is not usually a fundamental part of regular medical checkups. The patient must inquire about testing; most doctors do not automatically suggest it unless symptoms are present. Various STIs have different screening schedules, so talk to your doctor about your sexual history and current sexual activity to decide which diseases you should be screened for.

Many STIs can be detected with a urinalysis or a cotton swab. Some infections, including HIV, hepatitis, and syphilis, are diagnosed with a blood test. Pap tests, also called Pap smears, are performed at a gynecologist's office during a woman's yearly exam. This test can check for HPV, but doing so isn’t routine, so you should ask your doctor if you would like to have an HPV test at this time.

If a test is positive, appropriate treatment measures should be taken. Current and former sex partners should be notified so that they can receive testing as well.

Concerned that you may have symptoms of an STI? Contact your OB/GYN immediately to schedule testing, and catch the infection now.

Menopause

Menopause is a natural and expected hormonal shift that marks the end the childbearing age with the cessation of the menstrual cycle. Nearly all women go through this change at some point in their lives, with the vast majority of women experiencing it between the ages of 40 and 60. Menopause can happen earlier, however, as the result of medical interventions. Menopause is considered official when a woman misses 12 menstrual cycles in a row.

What are Common Menopause Symptoms?

Irregular periods and hot flashes are the menopause symptoms that are the most well known, but the symptoms don't end there. Women going through menopause often also experience vaginal dryness, night sweats, mood changes and loss of breast fullness. Sleep problems, a slowed metabolism, weight gain and thinning hair are all common menopause symptoms as well.

Any bleeding or spotting after menopause is complete is not normal. Consult with your doctor right away if you notice any of these symptoms, especially if you thought you were done having menstrual cycles.

What Causes Menopause?

When menopause occurs naturally, it happens as a result of the natural decline in reproductive hormones that occurs as women age. Menopause can also occur as the result of a hysterectomy, radiation or chemotherapy.

What Menopause Treatments are Available?

Common treatments for menopause are not designed to reverse the condition, but rather to alleviate any annoying, painful or inconvenient symptoms that accompany it and to make the transition easier for the women going through it. For example, the first measures doctors will generally recommend include eating a better diet, exercising, getting enough sleep, quitting smoking and wearing layers to help prevent overheating during a hot flash.

For women whose symptoms are more serious, doctors may also recommend treatments including hormone therapy, antidepressants, medications and supplements. If you think you may be going through menopause, talk to your doctor about your symptoms and ask which treatment method might be right for you.

Hormone replacement therapy is a medical intervention designed to boost a woman's hormone levels. As women get closer to menopause (the average age at onset is 51), their naturally occurring hormone levels ­- particularly estrogen and progesterone ­ decrease considerably. This deficiency can bring on uncomfortable symptoms such as hot flashes, night sweats, painful intercourse due to vaginal dryness, mood swings and problems sleeping. The prospect of osteoporosis ­- a loss of bone density ­- also increases. Menopausal hormone therapy (MHT) works to reestablish those hormone levels, which can curtail the negative side effects and help to prevent osteoporosis.

Estrogen/progesterone therapy is appropriate for women who have reached menopause naturally. These therapies work best for women who are having severe menopausal symptoms or those who are genetically predisposed to osteoporosis. Women who have a history of breast cancer, heart or liver disease, and blood clots are not good candidates for MHT. Both treatments are available in a variety of forms: pills, patches, and gels. For those with predominantly vaginal symptoms, topical creams and intravaginal rings can be prescribed.

Health professionals recommend that all women use the lowest dosage possible, for the shortest amount of time possible. Long­-term, high-­volume doses have been associated with an increased risk of breast cancer and heart disease. Talk to your doctor about whether hormone replacement might be right for you.

Ovarian Cysts

What are Ovarian Cysts?

Ovarian cysts are pockets of fluid that form on the surface of a woman's ovary. Ovarian cysts are very common, and most women have one away on their own without treatment.

Symptoms

Ovarian cysts do not always cause symptoms. When they do, the symptoms can include loss of appetite, nausea, weight gain, frequent urination, breast tenderness or a feeling of heaviness in the abdomen. They may also cause pain, particularly pelvic pain shortly before or after a period, during intercourse or during bowel movements.

Call the doctor right away if your pain is accompanied by fever or vomiting, if your abdominal pain is sudden and severe, or if you have cold, clammy skin, lightheadedness or rapid breathing, as these are all signs of a medical emergency.

Types of Ovarian Cysts

Ovarian cysts are typically classified into various types based on their sources and causes. Functional cysts, for example, form during ovulation when an egg is not properly released from the follicle. Dermoid cysts form from cells that produce human eggs and may contain human tissue, teeth or hair. Endometriomas develop when uterine endometrial cells attach to an ovary and form a growth. Cystadenomas develop from ovarian tissue.

Ovarian Cyst Treatment Options

The most common treatment option for ovarian cysts is simply to wait and see. Since most cysts are not harmful and they tend to go away on their own within a few cycles, more invasive measures are generally not needed. Alternately, some doctors will prescribe birth control pill, which can inhibit the growth and formation of new ovarian cysts.

If these less invasive treatment methods do not prove effective, more invasive measures will be needed. Other, more invasive, treatment options for ovarian cysts do include surgery. These generally are not used unless the cysts are causing problems or refuse to go away on their own, however.

Do you ever have trouble with bladder leakage or making it to the bathroom in time? If so, you may be suffering from urinary incontinence, a common medical condition which involves a loss of bladder control. It may happen when you laugh at a friend’s joke, or when you cough during a bad cold. You may also have an occasional urge to urinate that seems to come out of nowhere, but find yourself unable to reach the bathroom in time.

Urinary Incontinence

What Causes Urinary Incontinence?

Urinary incontinence can be caused by a number of different factors. Its root cause lies in the muscles that control the flow of your urine. If your bladder contracts without warning, or your sphincter muscles can no longer hold back the flow of urine, you may urinate without intending to.

Common causes of urinary incontinence include pregnancy, childbirth, and menopause. It can also be caused by a urinary tract infection, constipation or certain neurological disorders. Risk factors, such as gender, weight and other conditions, do not generally cause urinary incontinence, but they can make it worse.

Temporary urinary incontinence is often caused by consuming too much alcohol or caffeine. It can also be caused by certain medications and sedatives.

What Treatments are Available for Urinary Incontinence?

For mild cases of urinary incontinence, you may be able to manage simply by wearing pads and using the bathroom frequently. If not, your doctor will likely have several recommendations.

Kegel exercises help strengthen your pelvic floor muscles. This is one of the most popular treatment options for urinary incontinence, as Kegel exercises can be performed almost anywhere, from your desk at work to watching TV at home. It is recommended that you discuss how to perform them with your doctor, however. Ensuring you are performing Kegel exercises correctly will make them much more effective.

Other methods to improve your bladder control include losing weight, and lifestyle changes such as quitting smoking. There are medications available which may help. You may also want to try biofeedback, nerve stimulation, or pessary devices. If nothing else is helping, surgery is a treatment option, depending on the type of urinary incontinence you have.

Urinary incontinence may be embarrassing, but if you are suffering, you aren't alone. Speak to your doctor about your treatment options today.

Hysterectomy

A hysterectomy is a medical procedure in which all or part of a woman's uterus is removed. A woman's ovaries and Fallopian tubes may also be removed at the same time, depending on the reason for the hysterectomy.

When is a Hysterectomy Needed?

A hysterectomy can be used to treat a number of problems or conditions. For example, a hysterectomy can be used to treat uterine fibroids, endometriosis, chronic pelvic pain and adenomyosis. It can remedy uterine prolapse, cancer of the uterus and unusually heavy bleeding. Because of its invasive and non­-reversible nature, however, a hysterectomy is typically only done when absolutely necessary. You will need to speak to your doctor about your options to find out if a hysterectomy is the best option or you.

How is a Hysterectomy Performed?

A hysterectomy can be performed several ways. In an abdominal hysterectomy, the doctor will remove the uterus by making an incision in the abdomen. In a laparoscopic hysterectomy, the entire surgery is done using only small incisions for a faster healing time.

What Risk Factors are Associated with a Hysterectomy?

Most women who have a hysterectomy suffer no serious complications as a result. Women who do suffer complications are more likely to have vaginal prolapse, chronic pain, blood clots, fistula formation, urinary incontinence or hemorrhage.

One unavoidable side effect of a hysterectomy in young women and women of childbearing age is that it eliminates the possibility of becoming pregnant, and sends them into menopause instead. For this reason, many doctors hesitate to perform a hysterectomy on a young woman unless it is medically necessary, even if she thinks she is probably done having children. A hysterectomy is not reversible later if she should change her mind.

If you are currently suffering from a condition for which a hysterectomy is a known cure, talk to your doctor about your treatment options today.

Polycystic Ovarian Syndrome

What is Polycystic Ovarian Syndrome?

Polycystic Ovarian Syndrome, or PCOS, is a common endocrine disorder affecting as many as 1 in 10 women of childbearing age, according to womenshealth.gov. PCOS is characterized by enlarged ovaries that contain follicles, or small collections of fluid, and it has been known to affect girls as young as 11 years old.

What Causes Polycystic Ovarian Syndrome?

While no one knows the exact cause of PCOS, doctors do know that the condition is caused by a hormonal imbalance. Factors such as heredity, excess weight, excess insulin, and inflammation can all play a role in causing the condition as well.

What are the Symptoms of Polycystic Ovarian Syndrome?

PCOS is typically characterized by infrequent menstrual periods, infertility and an increase in male hormone production, which can cause excess facial hair growth, weight gain, adult acne and even male pattern baldness. PCOS is also sometimes accompanied by oily skin, dandruff, skin tags, pelvic pain, depression and sleep apnea as well.

What Treatments are Are Available for Polycystic Ovarian Syndrome?

If you are diagnosed with PCOS, your doctor will likely recommend that you eat a healthier diet (including fewer processed foods), that you exercise more and that you lose weight if you are overweight. These simple at-­home treatments can be effective in managing mild cases of PCOS. If your condition is more severe, your doctor may recommend certain medications, such as birth control pills, or surgery.

Health Risks Related to Polycystic Ovarian Syndrome

While missing periods and producing excess male hormones can be unpredictable, annoying and embarrassing, the health risks don't stop there. Women who have PCOS are also at a greater risk for diabetes, high cholesterol, high blood pressure, heart attack and depression. Pregnant women who have PCOS are also at an increased risk for gestational diabetes, premature delivery and miscarriage.

If you are experiencing irregular periods, infertility, weight gain or excessive hair growth, PCOS may be to blame. Speak to your doctor for more information, a diagnosis and a treatment plan today.

Uterine Fibroids

What are Uterine Fibroids?

Uterine fibroids, also known as leiomyomas, are noncancerous tumors that form on the uterus, most typically during the childbearing years. Uterine fibroids are typically not dangerous and they often come with no symptoms. According to Womenshealth.gov, 20-­80% percent of women will have uterine fibroids before age 50, some without even knowing it.

What Causes Uterine Fibroids?

While doctors do not know for sure what exactly causes uterine fibroids, both your genes and hormones are thought to play a role in their development.

What Symptoms are Associated with Uterine Fibroids?

The majority of women who develop uterine fibroids experience no symptoms at all. In fact, they often don't even know they have the growths until their doctor discovers them during a routine exam.

Among women who do experience symptoms, however, lower back pain, pain during intercourse, heavy menstrual bleeding, an overactive bladder, pressure and fullness in the abdomen, and complications during pregnancy are among the most common. Infertility can be caused by uterine fibroids, but this is very rare.

What Treatments are Available for Uterine Fibroids?

Because most uterine fibroids are not serious and tend to go away on their own, most doctors will initially opt for a "wait and see" approach. If you are experiencing significant symptoms, or if the fibroids don't go away on their own, your doctor may recommend additional treatment options, including medication and surgery. Talk to your doctor to find out which treatment option may be best for you.

While the amount of blood a woman loses during a menstrual cycle can vary widely depending on the woman and the cycle, some unlucky women experience blood loss and cramping so severe that it interferes with their day to day activities. The condition is called menorrhagia, and it affects more women than you might expect!

Menorrhagia

Symptoms of Menorrhagia

Women who have heavy menstrual periods often soak through a pad or tampon in an hour for multiple hours in a row, and they often bleed longer than a week. They may pass large blood clots past the first day of their menstrual cycle, and they may suffer additional complications such as tiredness or shortness of breath. Women who suffer from heavy menstrual periods often must double up on sanitary protection, wake up in the middle of the night to change pads or tampons, and miss out on fun activities where they will not have frequent access to a bathroom.

What Causes Menorrhagia?

Heavy menstrual periods can be caused by a number of different factors, including a hormone imbalance, uterine fibroids, polyps, uterine dysfunction and cancer. They can also be caused by certain inherited bleeding disorders or medical conditions, pregnancy complications, an intrauterine device and certain medications. Identifying the cause of the excessive bleeding is typically an important step in finding the right treatment method.

What Treatments are Available for Heavy Menstrual Periods?

In many cases, heavy menstrual periods are treatable and reversible. Doctors generally recommend treatments such as oral contraceptives, medications and hormones. For especially serious cases, doctors may also recommend dilation and curettage, focused ultrasound ablation or hysterectomy. Doctors also commonly prescribe iron supplements to replenish the iron that is lost through the heavy bleeding. Speak to your doctor about your symptoms to find out which treatment option may be best for you.

Vaginal Prolapse

What is Vaginal Prolapse?

Vaginal prolapse, a type of pelvic organ prolapse, is a medical condition in which a woman's uterus weakens and falls out of its normal position, causing complications. The condition is not life-­threatening, but it can be quite painful and inconvenient if not treated.

What are the Symptoms of Vaginal Prolapse?

Common symptoms of vaginal prolapse include a pull in your pelvis, pain, pressure, a bulge of tissue protruding from your vagina, and the sensation that something may be falling out through your vagina. Women may also experience painful intercourse, urinary tract infections or difficulty emptying their bladder or bowels. Some women, on the other hand, experience no symptoms at all.

What Causes Vaginal Prolapse?

Vaginal prolapse happens when a woman's ligaments and pelvic floor muscles weaken and sag. This typically happens as the result of childbirth, particularly multiple childbirths, and aging. Factors such as obesity, heredity, physical strain and pelvic surgery can increase a woman's risk of developing this condition as well.

What Treatments are Available for Vaginal Prolapse?

Women suffering from vaginal prolapse often have several treatment options. Women whose symptoms aren't severe will likely benefit from non-­invasive treatment options, such as Kegel exercises.

For women who have severe symptoms, pessary devices or surgery are often the most effective and reliable options. There are various procedures available to treat uterine prolapse, including tissue grafts onto the pelvic floor support structures. A hysterectomy may also be deemed a good choice depending on the severity of the woman’s case, and whether she is done having children or has no intention of having children.

Vaginal prolapse may be inconvenient and painful, but the good news is that it is treatable. If you suspect that you have some degree of vaginal prolapse, consult with your doctor about your treatment options today.

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