Gynecology QuestionsFrequently Asked Questions

We use the ThinPrep liquid-based pap.  You can have a pap smear if you have your period as long as the flow is not very heavy.

Women age 40 and older should have mammograms every 1 to 2 years. Women with an increased risk of breast cancer should talk with their provider about whether to have mammograms before age 40.

More information can be found in the National Cancer Institute's Mammogram Fact Sheet.

Irregular cycles can be caused by many factors including infection, medications, stress and weight loss or gain. Other causes include systemic diseases such as thyroid disease or polycystic ovarian syndrome. It is important to make an appointment so our providers can learn your full medical history, examine you and order appropriate tests to aide in diagnosis. It is helpful for you to track your cycles on a calendar prior to your appointment.

More information can be found at the American Congress of Obstetricians and Gynecologists page for Abnormal Uterine Bleeding.

It is normal to have vaginal discharge and it is normal for it vary throughout the month. Your discharge may be abnormal if it heavier than normal and is associated with persistent itching, burning or a foul odor.

If you have these symptoms, please call for an appointment.

More information can be found on the American Congress of Obstetricians and Gynecologists page for Vaginitis.

When bacteria get into the otherwise sterile parts of the body that form and excrete urine, this is called a Urinary Tract Infection (UTI).

The three most common types of urinary tract infections are:

• Cystitis (infection of the bladder)
• Urethritis (infection of urethra)
• Pyelonephritis (infection of the kidneys)

More information can be found on the American Congress of Obstetricians and Gynecologists page for Urinary Tract Infections.

Cystitis and pyelonephritis usually are caused by bacteria that are normally found in the colon. These bacteria are spread from the rectum or vagina to the urethra and then to the bladder and kidneys. Urethritis, on the other hand, is caused by sexually transmitted infections such as gonorrhea or chlamydia. Females are more likely than males to get UTI's because the urethra is located close to the vagina and rectum. Sexual intercourse may be a common cause of UTI's as bacteria can be forced into the urinary tract during intercourse.

We can often diagnose a UTI just on the basis of your symptoms and a simple test called a urinalysis. If the cause of your infection is not clear, a urine culture may be needed. The culture can tell what type of bacteria is responsible for the infection and which antibiotics will best treat it.

Hot flashes are sudden sensations of flushing and heat that some women feel when they are going through menopause.  They are one of the most common and earliest signs of menopause.

More information can be found on the American Congress of Obstetricians and Gynecologists' page for Midlife Transitions.

The cause of hot flashes is not completely understood, but hot flashes are a result of decrease in the female hormone estrogen. It is believed that estrogen production affects the part of the brain that controls the body’s temperature. Hot flashes usually appear suddenly and without any warning, although they may be triggered by emotional stress, excitement, anxiety, alcohol or some foods. Hot flashes may begin before you have stopped having your menstrual periods.

Try to keep cool, both physically and emotionally. If possible, avoid very hot or spicy foods and beverages, alcohol, and emotional upsets. Keep as cool as you can in hot weather or in warm rooms.

It is a test performed if you have an abnormal pap smear result indicative of possible pre-cancer. Remember, a Pap smear is only a screening test and may be wrong. The colposcopy is the test to determine if you have pre-cancer (known as dysplasia). It is a test performed in the office in which we examine your cervix under magnification and obtain biopsies. The biopsies are tiny and the procedure takes less than 15 minutes. You may have some light bleeding for 1-2 days afterward with some mild cramping only. You should not have sex for 1 week after, otherwise you may resume normal activity. Results take 7 - 10 days to obtain.

More information can be found on the American Congress of Obstetricians and Gynecologists' page for Colonoscopy.

If colposcopy confirms dysplasia (pre-cancer) on your cervix then the LEEP is the procedure used to remove the abnormal cells and its surrounding tissue. It is also done in the office under local anesthetic (lidocaine). You will experience some discharge, bleeding, and cramping for 1 -3 days after the procedure. You should refrain from sex or tampon use for at least 2 weeks after the procedure.

More information can be found on the American Congress of Obstetricians and Gynecologists' page for Loop Electrosurgical Excision Procedure.

This is a very common procedure done in the office to evaluate abnormal bleeding. It obtains tissue from the inside of the uterus (endometrium). It is very quick and you may feel a deep cramp. You may have some mild cramping and spotting for 24 hours after. It is never performed during pregnancy.

A hysteroscopy is a minor surgical procedure used to evaluate the cause of abnormal bleeding or possible abnormalities in your uterus. Your Doctor will insert a very thin sterile telescopic device attached to a camera through your cervix and into the uterus. No cutting is involved. Your Doctor can the look around the inside your uterus to see if there are any growths or abnormalities. It is never done when you are pregnant. This procedure can be done in the hospital or in our office. Most patients are able to have this done in the office thus avoiding hospitalization.

More information can be found on the American Congress of Obstetricians and Gynecologists' page for hysteroscopy.

Women’s Health Today provides several minor surgeries in our office thus avoiding the need for hospitalization. This saves you time, costs, and the need for general anesthetic. You receive your procedure in the comfort of our office that is already familiar and convenient to you. The procedures we do in the office are minor, done under local anesthetic and mild oral sedation. These procedures include Tubal occlusion technique, endometrial ablations and hysteroscopies. Many physicians still do these procedures in the hospital, but for the right patients we can safely do this in the office in a painless fashion thus making the experience much less stressful and convenient for our patients by eliminating the hospital admission.

This is a procedure done in the hospital or in our office to help control or stop abnormal bleeding or heavy periods. Ablation is a short procedure. You can usually go home in 1 - 2 hours after the procedure and resume normal activity the next day. You cannot attempt pregnancy after this procedure is done. We now are able to also perform endometrial ablations in the comfort of our office under local anesthesia thus avoiding the need for hospitalization and general anesthetic. This is a simple option to alleviate abnormal bleeding and/or heavy periods without needing a hysterectomy!

For information about NovaSure® Endometrial Ablation and to download a doctor discussion guide, please visit NovaSure's website.

The past couple of years have seen the improvement of birth control options. There are new, lower dose pills with less side effects than just a few years ago. There is also the birth control shot (Depo-Provera) that you get at the office every 3 months. It has only a 1% failure rate. There is also the birth control patch. It is a patch that goes on the skin once a week. It's side effects are similar to the pill. There is also the NuvaRing which you place in the vagina once a month. Neither you nor your partner can tell it is there. Side effects are similar to the pill. These are great options for patients who frequently forget to take the pill. If you are sure you want no more babies then we can perform a tubal ligation as an outpatient or your husband may have a vasectomy. Both have equal failure rates (<1%). The Intra Uterine Device (IUD) is also an option for certain patients. It has only a 1% failure rate and can last several years. It is placed by the physician in the office. Some IUD's such as Mirena can also help diminish blood flow and alleviate heavy bleeding during periods. Implanon is a new insert we can place under the skin in your arm that offers excellent protection against pregnancy. We also provide the new tubal ligation technique called essure. This is a tubal occlusion with no incision and no abdominal surgery!

Please read our other Frequently Asked Questions for more information about birth control options.

Permanent contraception is “forever” birth control. Permanent contraception, or permanent birth control, is any procedure that prevents pregnancy for the rest of your life.

Traditional procedures for permanent contraception are tubal ligation (or "having your tubes tied") for women, and vasectomy for men. Both of these procedures require surgical incisions.

The next generation of permanent contraception involves a minimally invasive procedure to prevent pregnancy. This means that it does not require any incisions, or cutting of the skin, to perform.

With temporary birth control, you can always change your mind
You can stop using temporary birth control at any time if you decide you want to have children. Diaphragms, condoms, spermicides, birth control pills, and IUDs are all forms of temporary contraception.

Permanent birth control is forever
It is not considered reversible. Therefore, only those women (or couples) who are certain they do not want any children in the future should consider permanent birth control.

Permanent contraception does not provide protection from sexually transmitted diseases
Other than abstinence, latex condoms offer the most effective protection from sexually transmitted diseases (STDs), including HIV (the virus that causes AIDS).

For women, tubal ligation (also known as "having your tubes tied") is a surgical method of permanent contraception. It is performed in a hospital, under general anesthesia. The surgeon cuts through the abdomen to reach the fallopian tubes, which are then sealed off to prevent pregnancy.

The Essure Procedure
Essure is a new tubal occlusion technique we provide in which you receive no incision and no abdominal surgery or laparoscopy is required. It is just as effective and just as permanent as the “standard” tubal ligation through the abdomen. It can be done in the office under a local anesthetic and minimal sedation thus requiring no hospitalization and no general anesthetic. The recovery is very quick and you are back to your normal activities in 1 to 2 days. It is the latest in minimally invasive elective surgery for women!

For more information about Essure and the procedure, please visit their website at www.essure.com.

If you miss one pill, take two the next day. You are still protected from becoming pregnant. If you miss two pills, take two pills on the next two days. You must use a backup method of contraception such as condoms for the remainder of the month. Be aware that irregular usage may cause breakthrough bleeding. Women who persistently miss tablets each cycle should consider other contraceptive choices that do not require daily compliance. If you are late or miss pills you will often have breakthrough bleeding or spotting or irregular bleeding. Check a pregnancy test if your period is late.

More information can be found on the American Congress of Obstetricians and Gynecologists' page for birth control pills.