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 at 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)- IUD’s 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 is a disease in which tissue from the uterine lining (the endometrium) implants and grows throughout the pelvis. It can be found in woman without symptoms, but it can cause cyclic pelvic pain and infertility.
A presumptive diagnosis of endometriosis can be made on the basis of history and exam findings, so that treatment, usually with hormones, can be started. A definitive diagnosis of endometriosis requires a diagnostic laparoscopy. This is a surgery in which a lighted scope is inserted into the abdomen through a tiny incision at the umbilicus. The abdomen is filled with gas so that the instruments can manipulate the pelvic organs, looking for the characteristic lesions of endometriosis, and biopsies taken if needed. The disease can be treated-excised or cauterized- at this surgery.
Woman with endometriosis who have completed child-bearing often choose definitive surgical treatment with hysterectomy (removal of the uterus) in addition to removal of one or both ovaries.
Pelvic pain can be a distressing symptom, and sometimes a confusing one, as there are so many possible causes. General categories of problems that cause pelvic pain include gynecologic as well as urologic, gastrointestinal, and musculoskeletal. 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 past history. Some conditions such as endometriosis can run in families, so we ask about family history as well. A physical exam including a pelvic exam is done. Additional testing such as urine pregnancy test, bloodwork and vaginal ultrasound can all be done in our office.
If a gynecologic cause like endometriosis, pelvic inflammatory disease, pregnancy complication or ovarian cyst is suspected or found, we can manage this with medications and/or surgery. Urologic causes such as kidney stones or interstitial cystitis, or GI causes such as appendicitis, diverticulitis, or inflammatory bowel disease may require referral to other specialists, by us or through 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 human papilloma virus, or HPV. Persistent infection with HPV is the cause of cervical cancer. Routine testing for this virus, in addition to the traditional Pap test, is recommended for all women over the age of 30. A vaccine to prevent this infection is offered to all adolescent girls.
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 when under the age of 25.
STI’s can cause complications in pregnancy, and are routinely tested for during the first trimester of pregnancy and also includes testing for HIV, hepatitis B, syphilis, gonorrhea and chlamydia.
We offer a confidential and comfortable setting to discuss your risks or possible exposures. Testing for any of the mentioned infections, as well as hepatitis C and herpes, can be done upon request.
Prolapse refers to a group of gynecologic problems that develop when pelvic organs herniate through their support tissue. The organs that are typically involved in prolapse cases are the uterus, bladder and rectum.
When pelvic organ prolapse occurs, patients start to become aware of 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. Risk factors for prolapse include childbirth, obesity, genetic predisposition and chronic pelvic straining, as often experienced by those with chronic constipation.
Patients who are bothered by symptoms caused by pelvic relaxation can often be helped by physical therapy and/or corrective surgery. Weight loss can decrease symptoms in some patients and a medical device called a pessary 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 patient with the options that would be the most helpful to them.
Uterine fibroids are muscular tumors that usually occur in the uterus, and almost always benign. Where the fibroids occur in the uterus has significance in the type and severity of symptoms they cause.
Fibroids are very common and 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 that are of concern to you, please call our office. Our providers are capable of assisting you with a diagnosis and management options.