Women’s Health & Wellness
We all have heard the saying… An ounce of prevention is worth a pound of cure.
The most important thing you can do for yourself is to achieve or maintain health and wellbeing. We feel this begins with taking care of yourself on a regular basis and this includes a yearly examination.
These exams are much more than “just a pap smear”. We check health parameters, do cancer screenings and give you knowledge so you can make good healthcare decisions.
Wemen’s Health & Wellness Services We Offer
Going to a gynecologist for the first time can be very scary. Usually you have either no idea of what is going to happen at the appointment or your friends have told you “horror stories” of what happens.
A gynecologist is a physician who specializes in the care of women. When girls are seen for their first gynecology appointment (typically starting between 13-15 years old) our main focus is on wellness counseling. A pelvic exam is usually not performed unless you are having a specific problem in which we would need to examine you for evaluation of that problem.
Most of the time we perform a general physical exam much like what you had done previously by your pediatrician. You can have mom or a friend with you during any part of the visit if you wish.
We may talk to you about…
- Your periods and help explain what is “normal” and “abnormal”
- Your health concerns, cramps, period problems, acne, PMS and moods, sex and sexuality
- Sexually transmitted diseases, what they are and how to prevent them
- Birth Control, there are many options and we can help you choose which one would be best for you
Most of everything we discuss is CONFIDENTAL.You can discuss this with your physician to better understand what this means before you ask any questions or talk about any information.
According to the U.S. Department of Health and Human Services, getting regular mammograms has helped reduce breast cancer mortality in the United States by ⅓ since 1990.
Here are a few facts about mammograms every woman should know:
Both breast exams and mammograms are vital to early detection
85 percent of lesions can be detected with a mammogram. However, in order to make sure you are 100 percent protected, women should get both a breast exam and a mammogram.
Mammograms are important even if you don’t have a family history of breast cancer
A majority of women who develop breast cancer do not have a family history of it. Start getting mammograms every year after the age of 40.
There are two types of mammograms available
Screening mammograms are done for women who have not detected a lump or any symptoms of breast cancer. It involves doing two x-rays of each breast. Diagnostic mammograms are done when a lump has been found with a regular breast exam.
Women with breast implants can get mammograms
Worried your breast implant might be an issue when going to get a mammogram? As long as you notify the radiologist prior to the mammogram, there shouldn’t be an issue. While breast implants hide some tissue, the radiologist or technician will be able to x-ray the breasts at different angles to see as much as possible.
Both false positives and false negatives are possible with a mammogram – False negatives are most common in younger women due to dense breast tissue. but it’s not likely. False positives can happen in women who have had breast biopsies in the past and women who are taking estrogen.
What treatments are available for Cervical Cancer?
Three kinds of treatment are used with cancer of the cervix:
- Surgery – removing the cancer during a surgical procedure
- Radiation therapy -using high dose x-rays or other high energy rays to kill cancer cells
- Chemotherapy -using drugs to kill cancer cells
How is treatment of Cervical Cancer determined?
Treatment for cancer of the cervix depends on the stage of the disease, the size of the tumor, the patient’s age, overall condition and desire to have children.
What is a Pap test?
The Pap test (sometimes called a Pap smear) is a way to examine cells collected from the cervix and vagina. This test can show the presence of infection, inflammation, abnormal cells, or cancer.
How often and at what age should a woman have a Pap test and GYN visit?
According to the Pap Smear Consensus Statement issued by a number of medical organizations, “all women who are, or who have been sexually active, or who have reached 18 years old, should have an annual Pap test and pelvic exam. After a woman has had three or more consecutive, satisfactory, normal annual exams, the Pap test may be performed less frequently at the discretion of your physician”.
Is the human papilloma virus associated with the development of Cervical Cancer?
Human papilloma viruses (HPV) are sexually transmitted viruses that can cause wart-like growths on the genitals. Most infections go away on their own without causing any abnormality. However, there is a clear connection between HPV and cervical cancer. While not all cases of HPV develop into cervical cancer, nearly all cervical cancer cases show evidence of HPV infection.
What should a woman do before having a Pap test to ensure its accuracy?
Although the optimal timing for a Pap smear is midcycle, a Pap smear may be performed as long as heavy menstrual bleeding is not present. To ensure accuracy, a woman should abstain from intercourse for 24 hours prior to the examination and should not have placed any substances in her vagina for at least 48 hours beforehand.
Our physicians are experts in all contraceptive methods. They are experienced in counseling women about contraceptive and pregnancy prevention. Below are some of the methods they counsel on:
Barrier Methods of Contraception
- Cervical Cap
- and Condom
Combined Hormonal Birth Control:
- Patch and Ring
Progestin-Only Hormonal Birth Control: Pill and Injection
- Starting on OCP (Birth Control Pill)
- Hormonal Contraceptive Consent Form
Natural Family Planning
Sterilization by Laparopscopy (BTL)
Sterilization for Women and Men
- Sterilization for women is called tubal sterilization. The fallopian tubes are closed off. Tubal sterilization prevents the egg from moving down the fallopian tube to the uterus and keeps the sperm from reaching the egg
- Sterilization for Men is called Vasectomy. The vas deferens is one of two tubes that carry sperm from the testes. These tubes are tied, cut, clipped, or sealed to prevent the release of sperm. This prevents a woman’s egg from being fertilized with the man’s sperm.
Long-Acting Reversible Contraception: IUD and Implant
- Mirena IUD
- ParaGard IUD
- Skyla IUD
Osteoporosis is a condition seen in both women and men in which the bones become thin, brittle and weak but occurs five times more often in women. These changes can increase the risk of fractures. Osteoporosis may not present with symptoms for many years, if at all. Often there is no pain associated with vertebral fractures. Most commonly seen fractures are hips and vertebrae of the back. It is the vertebral fractures which lead to loss of height and curving of the spine which leads to “humped over” posture.
Some risk factors for Osteoporosis
The following factors cause or contribute to osteoporosis and fractures:
- Certain medications
- Chronic disease, especially autoimmune disease
- Mineral deficiencies; low Calcium, low vitamin D
- Excess vitamin A, aluminum, salt, caffeine intake
- Lifestyle: excessive alcohol intake, inadequate physical activity, smoking
- Falling Being thin
The link between Osteoporosis and menopause
Estrogen, a female hormone, which is produced prior to menopause, protects against bone loss. After menopause, the ovaries produce very little estrogen. With the rapid bone loss in women that starts 1 year before the final menstrual period and lasts for about 3 years.
Bone mineral density test (DEXA)
In a bone mineral density (BMD) test, bone density traditionally measures spine and hip. During the test an scan is obtained much like an Xray.
Who should have a BMD test?
BMD testing are recommended for all women aged 65 years or older. Women who are younger than 65 years should have a BMD test if they have had a bone fracture because of fragile bones or have other risk factors for osteoporosis, as identified by their physician. See the risk factors listed above.
What do DXA scan results mean?
After the test, a T-score is given for each site measured. A negative score means that you have thinner bones than an average 30-year-old woman. A positive score means that you have stronger bones than an average 30-year-old woman. If the T-score at any site is -1 to -2.5, you have a low BMD and are at increased risk of osteoporosis. A score of -2.5 or lower means that you have osteoporosis. Treatment usually is recommended to prevent fractures.
How often should I have a BMD test?
How often you should have your BMD measured depends on your age and results of your previous DXA scan. Women 65 years and older with normal bone mass or mild bone loss can have a test every 15 years. More frequent testing is recommended for women in this age group with T-scores between -1.5 and -2.49.
What is FRAX?
FRAX is a tool used to estimate fracture risk. This computer program helps predict the risk of having a fracture within the next 10 years in women aged 40 years and older who are not taking prescription osteoporosis drugs.
How does FRAX estimate fracture risk?
FRAX takes into account your age, sex, body mass index, smoking, alcohol intake, and other risk factors for osteoporosis. Treatment is recommended if FRAX shows that you have a 3% risk of hip fracture; a 20% risk of a major osteoporotic fracture (fracture of the forearm, shoulder, or spine); or both. FRAX also is used to decide whether women younger than 65 years should have a DXA test. You can calculate your own FRAX by going to http://www.shef.ac.uk/FRAX/.
Treatment is available for osteoporosis
Various medications are used to treat osteoporosis and help reduce the risk of fractures. Some can be used for prevention.
Osteoporosis can be prevented
Lifestyle plays a key role in preventing osteoporosis. Exercise, a healthy diet, and not smoking can help keep your bones strong and healthy throughout your life.
The best time to start taking care of my bones in order to prevent Osteoporosis
It is never too early to start thinking about bone health. Good bone health should start during childhood. This is the time to focus on building and keeping as much bone as you can through exercise, good nutrition, and staying healthy.
Exercise can help prevent Osteoporosis
Exercise increases bone mass before menopause and slows bone loss after menopause. Bone is living tissue and exercise makes it grow stronger. The Centers for Disease Control and Prevention recommend that healthy adults get 150 minutes of exercise a week, which works out to be about 30 minutes on most days of the week.
Types of exercises help prevent Osteoporosis and bone fracture
Weight-bearing exercises can help keep bones strong. Weight-bearing exercises are activities that are performed while standing and that require your muscles and bones to work against gravity. An example is brisk walking. Non-weight-bearing exercises, such as Tai Chi, Yoga and Pilates, can build endurance and improve balance and posture, thereby reducing your risk of falls. Strength training also is good for bones. In this type of exercise, muscles and bones are strengthened by resisting against weight, such as your own body, an exercise band, or handheld weights.
How do calcium and vitamin D help build healthy bones?
Calcium is important to building and maintaining healthy bones. Vitamin D helps the body absorb calcium. Many people do not get enough calcium from food. To increase your daily levels of calcium, eat a variety of calcium-rich foods. Good sources of calcium include dark, leafy greens, like spinach, kale, and collards; dairy foods, such as yogurt, milk, and cheese; and canned fish with soft bones, including salmon and sardines. You can increase your intake of vitamin D by eating foods fortified with vitamin D (orange juice, cereal, and milk). You also can get vitamin D by being in the sun for 15 minutes a few days a week.
Cancer of the ovary is a disease that affects one or both ovaries.
Risk factors for Ovarian Cancer
Factors that have been shown to increase a woman’s risk of getting cancer of the ovary include:
Ovarian Cancer tests
Ovarian cancer is not detected by a pap smear but a pap test is a good way to screen for cervical cancer. A pelvic exam sometimes can detect problems with the ovaries. At this time, there is no good screening test for ovarian cancer.
There are tests which can aid in the evaluation for cancer. These include OVA1 and CA125.
There are tests for women at high risk of ovarian cancer. These are referenced as BRCA1 or BRCA2 mutations. These tests measure a substance made by tumor cells. It sometimes is increased in women with ovarian cancer.
Usually there are few, if any, symptoms of ovarian cancer. There are some “vague” symptoms such as bloating or an increased abdominal size, pelvic or abdominal pain or difficulty eating or feeling full quickly. If you have these symptoms frequently or if they are worsening you should call your physician for further evaluation.
A “pap smear” is a test that a doctor performs by brushing cells off the cervix and sending them to a pathologist for evaluation.
Going to the gynecologist isn’t something women eagerly anticipate. The anxiety and discomfort women feel is increased when it’s their first annual exam. There are a few things to keep in mind before having your first annual exam.
Top Reasons why you should have an Annual Examination:
Birth Control, Cancer Screening, Vaccinations, Health Screening, Depression Screening, Sexually Transmitted Infections Screening, Concerns About Sex, Weight Control, Issues With Your Menstrual Period, Preconception Counseling.
How should I prepare for my exam?
The most important thing to do before your first gynecological exam is research. Women should be prepared to discuss their family medical history and be ready for questions about their menstrual cycle. Some of the most commonly asked questions your provider may ask include:
- When was your last period?
- How long does your period typically last?
- What age did you start your period?
- Are you sexually active?
What should I expect for my Annual Exam?
The pelvic exam only lasts a few minutes and the exam itself doesn’t hurt. Your physician will explain the process before beginning the exam, asking questions throughout the process is encouraged. The pelvic exam consists of the following steps:
- Your physician will typically begin the annual exam with a breast exam to check for lumps that may be a sign of cancer.
- Your physician will then check the external genital area for irritations, cysts or other problems.
- Next, your physician will insert a speculum, which is an instrument that is used to examine the cervix and vaginal walls. During this time, your physician will also conduct a pap smear to check for cancerous and pre-cancerous cells.
- The last step in the physical exam is for your physician to check the uterus, fallopian tubes and ovaries by inserting gloved fingers into the vagina and pressing on the abdomen.
- Not only does the annual exam ensure that you maintain good gynecological health, but it is also an opportunity for you to catch health problems in the early stages.
If it’s time to schedule your annual exam, please contact our office.
Sexually Transmitted Disease (STD)
Sexually Transmitted Infection (STI)
These are infections that are spread through sexual contact or bodily fluids. These infections can be very serious. They can cause infertility problems, hospitalization, affect your unborn baby and even death. Most STD’s can be tested for, treated and cured without causing any further problems.
The most common STD’s include chlamydia, gonorrhea, herpes, trichomonas, HIV, HPV and syphilis.
Risk factors for getting STD’s include multiple sexual partners, unprotected intercourse and partners with history of STD’s.
To reduce your risk for STD’s discuss you and your partner’s sexual history and any previous STD’s with your physician. Using condoms every time you have any sexual contact will help to reduce your risk.
STD’s during pregnancy can lead to blindness, respiratory problems and mental retardation of your baby. You can prevent all of these by obtaining prenatal care. We routinely test for STD’s early in pregnancy and treat when necessary.