Gynecology

Preventive Women’s Health

Prevention is more than just common sense—it’s the best way to protect and maintain your physical, emotional, and financial health. While it’s impossible to prevent everything, early diagnosis and treatment means better chances to beat the odds and make a full recovery. The benefits of regular checkups include the assurance or confirmation of your current health status, and the early detection of infections, tumors, and other physical issues.

Essential preventive care includes:

  • Annual pelvic exams to check the health of the pelvic organs, such as screening for STIs, vaginal infections, ovarian cysts, and uterine fibroids
  • Pap tests to check for abnormalities in your cervical cells
  • Mammograms to detect early signs of breast cancer
  • Birth control and family planning
  • Hormone testing and lab work for older, at-risk patients

Contraceptive Management


Family planning and birth control is an integral part of managing and protecting your reproductive health. Choosing the right contraceptive will depend on many factors, including your medical history and your plans regarding pregnancy and childbirth. Modern contraceptives are highly effective, though each method has advantages and disadvantages to consider before making your choice.

Hormonal contraception is the most common method used by women today, due to its proven safety and effectiveness. This type of birth control prevents pregnancy by releasing hormones that stop ovulation or prevents the fertilized egg from implanting in the uterus.

Hormonal methods include:

In contrast, barrier method contraceptives work by physically preventing the sperm from fertilizing the egg. Barrier contraception includes:

  • Male and female condoms
  • Intrauterine devices (IUDs)
  • Diaphragms
  • Cervical Caps

Other options include natural family planning (also known as the “rhythm method) and sterilization, which is permanent and is usually non-reversible.

Sexual Health


There are many factors that can affect your sexual health, which can impact your quality of life as well as your personal relationships. Intimacy should always be a pleasurable activity for both partners. If you experience persistent pain during intercourse (dyspareunia), it is important to understand that this is not “normal”, but a sign that something is wrong. Pain during intercourse can be caused by many things, which include STIs, pelvic muscle disorders, hormonal imbalance, and much more. Pain is never a necessary part of intimacy—if you experience pain during intercourse, make sure to see your doctor right away.

One of the most common concern regarding sexual health is the threat of sexually transmitted infections (STIs), especially among non-monogamous patients. You can completely eliminate your risk by abstaining from sex, but this may not be an ideal choice for most patients. Fortunately, you can greatly reduce your risk of contracting an STI by practicing safe sex and properly using condoms during sexual activity.

Depending on your diagnosis, perineoplasty (also called perineorrhaphy) may be recommended for treatment, which is a surgical procedure that repairs damage to the perineum (the tissue between the vagina and rectum). This procedure is generally effective for treating women who:

  • Sustained perineal damage during childbirth
  • Suffer from obesity-induced stress to the perineal muscles
  • Have dyspareunia and/or vaginismus (involuntary contraction of vaginal muscles)
  • Have sustained perineal injury through circumstance or accident

Menopausal Management

Hormone Replacement

While menopause has always been a normal part of a woman’s aging process, it can bring about plenty of changes that can negatively affect your overall health. From hot flashes and early onset osteoporosis, to mood swings and vaginal dryness, menopause can be a trying time as you adjust to the next stage of your life.

Hormone replacement therapy can effectively treat menopausal symptoms and protect against the increased risk of osteoporosis, heart disease, anxiety or depression, and early death. However, hormone therapy may not be ideal for everyone. Patients who will benefit the most from hormone therapy are healthy and:

  • Have moderate to severe menopausal symptoms (such as hot flashes and mood changes)
  • Have experienced loss of bone density
  • Or underwent premature menopause (stopped having periods before 40)

We offer bio-identical hormones and work closely with a compounding pharmacist to get the right formula for each patient’s needs.

General Gynecology

Chronic Pelvic Pain

Chronic pelvic pain is a general condition or symptom that is characterized as pain in your lower abdomen (below the belly button and between the hips) that lasts 6 months or longer. This disorder can have many causes, and may actually be a symptom of another underlying medical condition.

The most common sources of chronic pelvic pain are:

  • Endometriosis—Tissue that is supposed to be found only inside the uterus grows outside the uterus. Every month, this tissue responds to the monthly menstrual cycle by thickening and breaking down each month, but because it is outside the uterus it cannot leave the body through the vagina (like what normally happens during menstruation). Instead, it remains in the abdomen, which may develop into painful cysts or scar tissue.
  • Chronic pelvic inflammatory disease—This can develop when a long-term infection of the pelvic organs (usually sexually transmitted) goes untreated.
  • Fibroids—These smooth muscle tumors in the uterus are noncancerous, but may cause pain and pressure if they become too large.
  • Crohn’s Disease or Irritable bowel syndrome (IBS)—Symptoms such as bloating, constipation, or diarrhea can cause pelvic pain and pressure.
  • Painful bladder syndrome (interstitial cystitis)
  • Undiagnosed cysts or tumors in the pelvic organs

Though it can be difficult to pinpoint the cause of pelvic pain in certain cases, the disorder can be effectively managed with the right treatment.

Dysfunctional Bleeding

Dysfunctional uterine bleeding is abnormal bleeding from the vagina due to fluctuating hormonal cycles. This condition is generally more prevalent among teenagers and women approaching menopause, though it can potentially afflict a woman at any time during her reproductive years.

Signs that you may be suffering from dysfunctional bleeding include:

  • Bleeding or spotting between periods
  • Irregular periods
  • Menstrual cycles are shorter than 21 days or longer than 35 days
  • Unusually heavy bleeding (such as having to change tampons or sanitary napkins once an hour for several hours in a row)
  • Bleeding that lasts longer than 7 days

Fortunately, this condition can be easily treated with birth control pills, hormone therapy, or anti-inflammatory drugs like ibuprofen.

Chronic UTIs (Urinary Tract Infections)

Urinary tract infections (UTIs) can occur when bacteria enters and proliferates in the bladder or kidneys. Though both men and women can get UTIs, it is generally much more common in women. The unmistakable signs of a UTI include:

  • Pain or discomfort during urination
  • Bloody or cloudy urine
  • The urge to urinate even when your bladder is empty
  • Pain in your lower back (kidneys) or pain in the pelvic region (bladder)

Your risk for developing a UTI can be aggravated by a variety of factors and activities. The most common risk factor for women is sexual intercourse, which can push bacteria up the urethra. Barrier birth control methods such as diaphragms and cervical caps can also promote bladder infections, since it can push against the urethra and prevent proper voiding. Improper bowel hygiene may also increase the chances of contracting a UTI.

Treatment usually involves a short course of antibiotics, though this can be problematic with recurrent or chronic UTIs. Frequent antibiotic use can breed antibiotic resistance and may cause recurrent yeast infections or altered gut flora in many patients.

  • Urinating when you feel the urge, especially after intercourse
  • Refrain from using a diaphragm, cervical cap, or spermicide for birth control
  • Wear cotton underwear
  • Take supplements that support urinary tract health such as hibiscus, cranberry, or uva ursi
  • Practice proper hygiene by wiping front to back or washing with soap and water afterwards
  • Drink plenty of water

Pelvic Floor Mesh Repairs

Pelvic floor mesh implants is one of several ways to treat pelvic organ prolapse and stress urinary incontinence in women, providing support to the pelvic organs (bladder, uterus, ovaries, vagina, and rectum). In addition to a mesh implant, pelvic organ prolapse can be successfully treated using only your native tissue. Mesh implants are generally safe and effective, however a small population of women do experience complications, most of which can be treated in the office, but some may require surgical repair or even removal.

Mesh erosion is the most common complication. Again, many times this can be treated in the office setting, but there are times erosion does require a delicate surgery to correct. This condition occurs when the mesh implant gradually erodes or moves through the vagina into the surrounding pelvic organs. Symptoms of mesh erosion may manifest with the following symptoms:

  • Pain, bleeding, and/or infection
  • Scar tissue
  • Reoccurrence of prolapse or incontinence
  • Nerve damage
  • Damage to the bowel, bladder, and other pelvic organs
  • Recto-vaginal fistula (a small tunnel connecting the rectum to the vagina)
  • Abscess
  • Exposure (when the edges of the mesh pierce through the vaginal tissue and are visible)

Fortunately, improvement and restored quality of life is possible when mesh removal or revision surgery is performed by an experienced urogynecologist. If you are experiencing pain and other serious adverse reactions from your mesh implant, don’t suffer in silence—consult your urogynecologist right away to consider your options for treatment.