Pap Smear

Pap smear is a screening test, which means that it is not intended to diagnose a condition. Instead, it is used to identify women who require further testing (eg, colposcopy and biopsy) to identify the potential abnormality and determine the best course of treatment.

Women who have an abnormal Pap smear should be sure to follow their healthcare provider's recommendations about the need for treatment and subsequent follow up. While not all women with an abnormal result will require treatment, all women should have cervical cytology screening on a regular basis.
 

Abnormal Uterine Bleeding/Menorrhagia
There are several medical treatments for heavy uterine bleeding (heavy periods). Most involve the use of hormones. This is often used by women who wish to retain their fertility and can be effective in decreasing bleeding without the need for surgery. The most common is to use the oral contraceptive pill. The oral contraceptive pill will decrease the amount of flow in a woman's period.

Surgical Treatment of Dysfunctional Uterine Bleeding
The least invasive surgery to treat this problem is called endometrial ablation. This procedure may be performed under general or regional anesthesia. It requires an instrument to view the uterus (hysteroscope) and an energy source. The procedure typically is finished in less than an hour and the patient may return home the same day. This method will reduce heavy bleeding approximately 85% of the time. This procedure is not an option if you still want to have children because the uterine lining is destroyed during therapy.
 
Adolescent/Pediatric Gynecology
Pediatric gynecologic patients are a small group of young patients who experience uncommon gynecologic problems during their childhood. These problems can range from external genital irritations and abnormalities, to early manifestation of puberty that is inappropriate for the particular age of the child

HPV Vaccines
HPV vaccines are offered to our young patients (9 to 26) for protection from genital warts and cervical cancer caused by HPV viruses.

 Oral Contraception
 In order to determine which contraceptive is right for you, your doctor may want to know something about your sexual history, such as:
The nature of your sexual relationship - is it stable, or do you have multiple partners?
What kind of protection you plan to use against sexually transmitted disease (STDs) and HIV
Whether you are looking for a long or short term birth control method.

From hormonal contraceptives to barrier methods and natural methods, the types of birth control available today can be divided into several categories.

• 
  Hormonal Contraception - Oral contraceptives (the pill)injections, implants, and patches that work to prevent pregnancy.
• 
  
• Barrier Methods - Diaphragms, cervical caps, sponges, and male and female condoms that work by physically preventing sperm from entering the female reproductive system.
• 
  Intrauterine Devices (IUD) - A small, T-shaped plastic object inserted into the uterus by a medical professional to prevent pregnancy.
  
  Sterilization (Vasectomy or Tubal Ligation)
  
• Natural Methods - Withdrawal, abstinence, and fertility observation (or the calendar or rhythm method).
  

Gynecological Cancer Screen
Early detection of cancer is an important emphasis at our clinic.  Risk assessment and screening programs for selected cancers are available through a variety of services. It is important to note that only selected cancers can be detected early, and each screening test is unique to each type of cancer.

The American Cancer Society guidelines for early detection of specific cancers in women are as the following:

Sigmoidoscopy female age 50 and over: Every 3 to 5 years
Fecal Occult Blood test female age 50 and over: Every year
Digital Rectal Exam (DRE) female age 40 and over: Every year
Pap test : Female Women who are, or who have been sexually active, or have reached age 21, should have an annual Pap test and pelvic examination. After age 30 with three or more consecutive normal annual examinations, the Pap test may be performed less frequently at the discretion of the physician.
Breast Self-Examination Female age 20 and over: Monthly
Breast Clinical Examination Female 20 to 40: Every three years
over age 40: Every year
Mammography Female age 40 to 49: Every 1 to 2 years age 50 and over: Every year
 
Pre menopausal care
Menopause is a transition that can start in your 30s or 40s and last into your 50s or even 60s.You may begin to experience signs and symptoms of menopause well before your periods stop permanently. Once you haven't had a period for 12 consecutive months, you've reached menopause. Symptoms of menopause may include one or more of the following: hot flashes, night sweats, mood swings, vaginal dryness and decreased libido. We provide you with personalized menopausal care counseling and in depth discussion of treatment options. We help you to choose the safe and effective way in relieving your menopausal symptoms.

 Pelvic Prolapse and Pelvic Reconstruction

Pelvic organ prolapse refers to descent (or prolapse) of the vaginal walls and/ or uterus below their normal positions. In severe cases, the vaginal walls or cervix protrude beyond the vaginal opening and are visible or palpable outside the body.

Many women with pelvic organ prolapse report problems with bladder and bowel functions. Symptoms that are often associated with pelvic organ prolapse include urinary incontinence, difficult urination, discomfort with sexual intercourse, stool incontinence, difficult defecation, low back pain and low abdominal pain.

Some women with pelvic organ prolapse have minimal symptoms and do not require treatment. For a woman who is bothered by the symptoms from her prolapse, there are two treatment options.

Pessary: This is an internal vaginal device, usually made of silicone, that supports the vaginal walls. A woman who chooses this option is fitted with an appropriate pessary during a gynecologic examination. Once inserted into the vagina, the pessary should be comfortable and should stay in place with a variety of activities. Most pessaries should be removed and reinserted periodically, at least once a week. Most women are able to remove and reinsert the pessary themselves. Some pessaries can be worn comfortably during intercourse, while others must be removed for intercourse.

The second option for the treatment of pelvic organ prolapse is surgery. The physician will recommend a specific type of surgery, based on the specific weakness(es) of the ligaments and the specific areas of prolapse. A combination of several surgical procedures may be performed at one time to correct multiple areas of prolapse within the pelvis.
 
 What is premenstrual syndrome (PMS)?
Premenstrual syndrome (PMS) is a group of symptoms related to the menstrual cycle. PMS symptoms occur in the week or two weeks before your period (menstruation or monthly bleeding). Common PMS symptoms are:
. breast swelling and tenderness
. fatigue and trouble sleeping
. upset stomach, bloating, constipation or diarrhea
. headache
. appetite changes or food cravings
. joint or muscle pain
. tension, irritability, mood swings, or crying spells
. anxiety or depression
. trouble concentrating or remembering.

What is Premenstrual Dysphoric Disorder (PMDD)?
PMDD is a severe, disabling form of PMS. In PMDD, the main symptoms are mood disorders such as depression, anxiety, tension, and persistent anger or irritability. These severe symptoms lead to problems with relationships and carrying out normal activities.
Women with PMDD usually also have physical symptoms, such as headache, joint and muscle pain, lack of energy, bloating and breast tenderness. According to the American Psychiatric Association, a woman must have at least five of the typical symptoms to be diagnosed with PMDD. The symptoms must occur during the two weeks before her period and go away when bleeding begins.
 
 Urinary Incontinence
The main types of urinary incontinence are:
Stress incontinence: This is loss of urine when you exert pressure - stress - on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.

Urge incontinence: This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Your body may give you a warning of only a few seconds to a minute to reach a toilet. With urge incontinence, you may also need to urinate often

Overflow incontinence. If you frequently or constantly dribble urine, you may have overflow incontinence. This is an inability to empty your bladder, so it overflows uncontrollably and you leak urine.

Mixed incontinence. This means having more than one type of incontinence, typically stress incontinence and urge incontinence. Usually one type is more bothersome than the other is. The cause of the two forms may or may not be related.

Treatment
Treatment for urinary incontinence depends on the type of incontinence, the severity of your problem and the underlying cause. Your doctor will recommend the approaches that are best suited to your condition.

Osteoporosis Bloodwork
There are several ways to measure bone density. Your doctor may recommend one of the following tests.  

Bone mineral density tests (BMD) shows how dense bones are and whether you have osteoporosis. This information helps determine which prevention or treatment steps are needed.

The most common osteoporosis test is dual X-ray absorptiometry -- also called DXA or DEXA. It measures people’s spine, hip, or total body bone density to help gauge fracture risk.

Various methods can check bone density, including ultrasound and quantitative computed tomography (QCT).  Whether you're being screened or treated for osteoporosis, your doctor may order a blood or urine test to see the metabolism of bone. This provides clues to the progression of your disease.

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