Gynecologic Conditions

At The Center for Women’s Health we are equipped to diagnose, counsel, and treat a vast number of gynecologic problems. We consider ourselves diagnosticians who desire to get to the root of the problem. Whether we treat or refer to a specialist in the necessary field, we will be with our patients every step of the way. Here are some of the disorders with which we are prepared to assist our patients:

By clicking the links below, information may be found on each condition provided by the American Congress of Obstetrics and Gynecology:

Pelvic Pain

A condition experienced by many women, pelvic pain may come from a wide variety of sources. Explaining the duration and type of pain will give your physician clues as to the cause.

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Pelvic Inflammatory Infection

This is the infection of the uterus, fallopian tubes and ovaries. This infection is caused by several different bacteria including gonorrhea and chlamydia, and the primary treatment is antibiotics.

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Abnormal Uterine Bleeding • Heavy Menstrual Bleeding or Menorrhagia

Several abnormalities can occur in the menstrual cycle. Menses can be heavy, long, or occur too frequently. Menstrual cycles that are longer than 35 days or shorter than 21 days are abnormal. The lack of periods for 3–6 months is also abnormal. There are many reasons that menstrual changes occur. They may be related to problems with the uterus itself, for example, fibroids or adenomyosis, or the irregularities may be seen in patients with hormonal imbalance, for instance, polycystic ovarian syndrome.  Treatment of these conditions is based on the cause of the condition.

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Vaginal Discharge  • Yeast Infection • Vaginitis

Vaginitis is an inflammation of the vagina. A change in the balance of bacteria that normally live in the vagina can result in vaginitis and vaginal discharge.  Many times vaginal discharge is abnormal and can be accompanied by other symptoms like vaginal itching. By obtaining a sample of the discharge, the physician can determine the source. Treatment is often via the appropriately prescribed medication in cream, gel, or pill form.

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Sexually Transmitted Diseases

Sexually Transmitted Diseases

STDs if left untreated can have many health ramifications and may result in pelvic inflammatory disorder. Often times, there are no symptoms of the infection. Screening for STDs is recommended and encouraged in many patient populations. Cure can often be obtained through antibiotics.

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Vulvodynia

Vulvodynia is a condition involving chronic pain and discomfort of the vulva. Burning, soreness, and stinging are just some of the symptoms of vulvodynia. Vulvodynia can affect every area of a woman’s life from everyday comfort to sexual intercourse. Many simple life style modifications can help to improve symptoms.

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Urinary Incontinence

Although not often discussed, a large number of women will experience symptoms of urinary incontinence. This can range from leaking a small amount of urine with laughter to the urgency of finding a restroom.  Risk factors for urinary incontinence include vaginal childbirth and chronic constipation.  Treatment of this condition may vary based upon a patient’s symptoms, and these treatments include medication and surgery.

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Endometriosis

Endometriosis is a condition in which the type of tissue that lines the uterus (the endometrium) is found outside of the uterus. Patients may experience chronic pain and difficulty becoming pregnant.  Pain is often associated with the menstrual cycle. As estrogen stimulates these implants of tissue, pain will increase. Diagnosis of endometriosis is confirmed via laprascopic surgery and biopsy of these area of endometriotic tissue.  Treatment includes suppressing the menstrual cycle with hormonal therapy.  When pain is not controlled through medication, patients may require surgery.

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Dysmenorrhea

Dysmenorrhea is pain that is experienced during menses.  Causes of dysmenorrhea include fibroids, adenomyosis, and endometriosis, but it may also occur from the time a woman first starts menstruating.  Treating dysmenorrhea may include pain medication and treating the root causes of the pain.

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Ovarian Cysts

Ovarian cysts are more likely to form during the child bearing years. Cysts are fluid filled sacs which most times are benign but rarely are malignant.  The decision on whether treatment is required rests on the appearance and size of the cyst.

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Polycystic Ovarian Syndrome

Patients with PCOS will present with a variety of symptoms including menstrual irregularities, increased growth of facial hair, obesity, acne, and infertility. Treatments for PCOS include combination birth control pills, weight loss and medications used to treat diabetes.

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Human Papillomavirus (HPV) and the HPV vaccine

HPV is a common virus which when transmitted through sexual contact may cause genital warts or changes in the cervix leading to cervical cancer. There is no definitive cure for HPV, but it can be prevented from being contracted by the HPV vaccine.  This vaccine may be a administered to girls age 9-26.

HPV Infection

HPV Vaccine

Uterine Fibroids

Fibroids are benign masses that grow in the muscle of the uterus. Fibroids may  lead to pelvic pain and abnormal uterine bleeding, as well as infertility and a higher rate of miscarriage.  Fibroids can be diagnosed on ultrasound and MRI.  Treatments for fibroid uteri can include symptom relief via pain medications and oral contraceptions or surgical procedures including excision (myomectomy) or hysterectomy.

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Genital Herpes

Genital herpes is a sexually transmitted disease which is characterized by sores. Many people infected with herpes have no symptoms. When symptoms do occur, they can be mild (only a few sores) or severe (many sores). Symptoms usually appear about 2–10 days after the herpes virus enters your body.

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Pelvic Support Problems & Pelvic Organ Prolapse

As women age, loss of the strength of the support of pelvic organs is common. A feeling of pelvic heaviness and bulging are frequently reported symptoms, and these symptoms may be accompanied by many others including incontinence.  The primary treatment for pelvic organ prolapse is surgery, but less invasive treatments are available, for instance, pessaries.

Pelvic Support Problems

Pelvic Organ Prolapse

Cancer of the Cervix

Cervical cancer is caused by the human papilloma virus. The screening test for cervical cancer is the pap smear.  If the screening test is positive, the physician may proceed to further testing including colposcopy, where he or she may  look more closely at the cervix and perform biopsies.  Many times a patient diagnosed with cervical cancer will be treated by a gynecologic oncologist.

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Cancer of the Ovary

Ovarian cancer may begin in one or both ovaries and spread to the uterus and surrounding organs.  Woman with family histories of breast, ovarian, or colon cancer are at increased risk of ovarian cancer. Unfortunately at this time, there is no routine screening for ovarian cancer, but it is important to be aware of symptoms including abdominal pain, bloating, and increased abdominal girth.  Treatment often includes a team of physicians.

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Cancer of the Uterus

Uterine cancer most commonly arises from the lining of the uterus called the endometrium. Women who are at increased risk for this type of cancer include women with a family history of endometrial cancer, obesity, infertility, irregular periods, and use of tamoxifen for the treatment of breast cancer.  These are just a few of the risk factors for uterine cancer. For many patients, the first sign of endometrial cancer is abnormal bleeding or vaginal bleeding after menopause.  Diagnosis of this condition may be accomplished in the physician’s office by a biopsy of the uterine lining. The first line of treatment is often hysterectomy, but each treatment plan is tailored to an individual patient’s diagnosis and needs.

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Premenstrual Syndrome (PMS)

Mood changes, fatigue, and abdominal pain are just a few symptoms of PMS. PMS typically begins up to 5 days prior to the start of the period and ends 4 days after the period starts. Exercise and diet changes have been shown to relieve some symptoms of PMS, but other treatments, for instance, anti-depressive medications have been shown to be effective.

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Pap Tests & Abnormal Pap Smear Results

Pap smears are the screening tool for cervical cancer. Changes in the cells of the cervix can be seen by the pathologist reading the Pap smear. These changes may be mild to severe, and based upon the severity of the changes, the physician will further investigate or treat the pathological findings. Many times, the next step after an abnormality is seen on a pap smear will be a colposcopy. This procedure allows a closer and more accurate view of the cervix and the ability to perform cervical biopsies. Some Pap smear results require no treatment but will increase the amount of cervical surveillance.

Cervical Cancer Screening

Abnormal Pap Results

When Sex is Painful

Pain during intercourse is experienced by many women at some point during their lives. Painful sex may be the sign of many gynecologic conditions for example, endometriosis, ovarian masses, and vaginal or cervical infections. Treatments are targeted toward the physical cause of painful intercourse or the emotional component that many women experience. A physician may suggest counseling or therapy based upon a woman’s history or symptoms. It is important to speak to the physician about these concerns because this issue affects many women’s quality of life.

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IUD Insertion and Removal

An intrauterine device (IUD) is a form of birth control that is placed into the uterus in the physician’s office. Depending upon the device inserted, this form of birth control may last 5-10 years, and once the device is removed the woman may return to her natural rate of fertility. It is not unusual for a patient with an IUD to experience irregular bleeding for the first 3-6 months after IUD insertion. Some women may no longer have a period within the first 2 years after insertion.

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Infertility evaluation and treatment

Infertility is defined as having regular unprotected intercourse for 1 year without conception. A workup for infertility might include blood work with evaluation of hormone levels and imaging studies which may include ultrasound and hysterosalpingogram (HSG). A physician will also consider a woman’s partner for evaluation. These tests might include a sperm count and possible referral to a urologist. It is not uncommon that treatment for infertility will result in referral to a reproductive endocrinologist, an OBGYN who has had specialized training in reproductive medicine.

Infertility Evaluation

Treating Infertility

Contraception/ Birth Control

There are several different forms of birth control. A woman should decide which form will be right for her. Birth control methods may be permanent, long term, short term, or even emergent. Each form of birth control has a different level of efficacy. This is a decision that a patient and her physician should make based upon her lifestyle, personal health history, and preference. Examples of forms of birth control include oral contraceptives, hormonal injections, condoms, intrauterine devices, tubal ligations, and Essure tubal occlusion.

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Menopause and Hormone Therapy

The average age of menopause is 51. During the perimonpausal and postmenopausal period, symptoms can occur that alter a woman’s daily life. Hot flashes, night sweats, and mood changes are just a few examples of what many women experience. Treatment for these symptoms is often done by hormone replacement. There are risks to hormone replacement, but the patient and her physician must decide if the risks are outweighed by the benefits. Hormone replacement is an effective way to relieve symptoms and return a woman to her normal way of life.

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