Gynecology

Contraception

Contraception, or birth control, describes methods to prevent pregnancy. Women today have myriad choices for birth control. We can help you find the method that will work best for you at any given time. Discussion of birth control options can start at your annual exam or an appointment dedicated to this.

We offer hormonal contraception-birth control pills, patch, or ring by prescription, as well as long-acting reversible contraception (LARC) - IUDs or the Nexplanon implant placed in the office. We also offer permanent surgical sterilization - laparoscopic or hysteroscopic Essure procedures.

We can counsel you about the benefits and risks of all these options, as well as natural family planning, emergency contraception, and vasectomy for your partner. You have lots of options. We’ll help you make the best choice for you.

Endometriosis

Endometriosis is a disease in which tissue from the uterine lining (the endometrium) implants and grows throughout the pelvis. It can be found in women without symptoms, but it can cause cyclic pelvic pain and infertility. A presumptive diagnosis of endometriosis can be made based on history and exam findings, so treatment, usually with hormones, can be started.

A definitive diagnosis of endometriosis requires diagnostic laparoscopy. This is a surgery where a lighted scope is inserted into the abdomen through a tiny incision at the umbilicus. The abdomen is filled with gas so the instruments can manipulate the pelvic organs, looking for the characteristic lesions of endometriosis, and biopsies are taken if needed.

The disease can be treated-excised or cauterized during this surgery. Women with endometriosis who have completed child-bearing often choose definitive surgical treatment with hysterectomy (removal of the uterus) in addition to the removal of one or both ovaries.

Pelvic Pain

Pelvic pain can be a distressing and confusing symptom, as there are many possible causes. General categories of problems that cause pelvic pain include gynecologic, urologic, gastrointestinal, and musculoskeletal problems. Pelvic pain can be acute (sudden in onset) or chronic (of longer duration).

An evaluation for pelvic pain in our office begins with careful questioning about the location and time course of your pain, as well as any associated symptoms and history. Some conditions like endometriosis can run in families, so we ask about family history as well. A physical exam, including a pelvic exam, is done. Additional testing like a urine pregnancy test, bloodwork, and a vaginal ultrasound can all be done in our office.

If a gynecologic cause like endometriosis, pelvic inflammatory disease, pregnancy complication, or ovarian cysts are suspected or found, we can manage this with medication or surgery. Urologic causes like kidney stones or interstitial cystitis, or GI causes like appendicitis, diverticulitis, or inflammatory bowel disease may require referral to other specialists by us or your PCP at our recommendation.

Sexually Transmitted Diseases

Women of all ages and backgrounds may require or request testing for sexually transmitted diseases.

The most prominent sexually transmitted infection is the human papillomavirus or HPV. Persistent infection with HPV is the cause of cervical cancer. In addition to the traditional Pap test, routine testing for this virus is recommended for all women over 30. A vaccine to prevent this infection is offered to all adolescents.

Chlamydia is a common STI (sexually transmitted infection) that can be present with or without symptoms. Chlamydia infection increases the risk of infertility and ectopic pregnancies. Routine testing for Chlamydia, along with gonorrhea, is recommended for all sexually active people under the age of 25.

STIs can cause complications in pregnancy. They are routinely tested for during the first trimester of pregnancy. This also includes testing for HIV, hepatitis B, syphilis, gonorrhea, and chlamydia.

We offer a confidential, comfortable setting to discuss your risks or possible exposures. Testing for any of the mentioned infections, hepatitis C and herpes, can be done upon request.

Prolapse

Prolapse refers to a group of gynecologic problems that develop when pelvic organs herniate through their support tissue. The organs typically involved in prolapse cases are the uterus, bladder, and rectum. Risk factors for prolapse include childbirth, obesity, genetic predisposition, and chronic pelvic straining, as often experienced by those with chronic constipation.

When pelvic organ prolapse occurs, patients become aware of the pressure and vaginal fullness symptoms. Mild degrees of pelvic prolapse are usually well tolerated by patients. As patients become increasingly symptomatic, patients generally seek medical attention.

Patients who are bothered by symptoms caused by pelvic relaxation can often be helped by physical therapy or corrective surgery. Weight loss can decrease symptoms in some patients. A medical device called a pessary can provide either short-term or long-term relief.

We are always happy to evaluate patients with concerns related to pelvic relaxation. After an office visit, we can formulate a plan to assist patients with the options that would be the most helpful to them.

Uterine Fibroids

Uterine fibroids are muscular tumors that usually occur in the uterus. They are almost always benign. Where fibroids occur in the uterus has significance in the type and severity of symptoms they cause.

Fibroids are common. Most patients are not aware that they have them. When fibroids cause symptoms, the most common are abnormal bleeding, pelvic pain, and painful intercourse.

When patients are having gynecologic symptoms, they should be evaluated by a gynecologist. The evaluation can include a physical exam, ultrasound, and possibly a laparoscopy. If you believe you have fibroids, please call our office. Our providers can assist you with diagnosis and management options.