Gynecological Health

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All women of reproductive age should have regular gynecological exams. An OB/GYN is a doctor specially trained to care for a woman’s reproductive health, including during pregnancy and following childbirth. An obstetrician (OB) cares for a woman during pregnancy, childbirth and postpartum. A gynecologist (GYN) specializes in a woman’s general reproductive health. In addition, many family practice physicians are certified to offer obstetrics and/or gynecology.

A woman’s reproductive health includes physical, mental and social well-being as well as the absence of disease or illness. Topics related gynecological health are listed below. Always consult your physician if you have any questions or concerns.

Infertility
Family planning and avoiding pregnancy
Safe sex
Preconception health
Cervical Health
Common Uterine Conditions
Diseases of the Uterus
Ovarian Conditions
Vaginal Health
Minimally Invasive Techniques/Advances

 

Infertility
Infertility is the inability to get pregnant after one year of trying, or for at least 6 months if you are a woman age 35 or older. Approximately 10 to 15 percent of couples in the United States are infertile. Fortunately, you and your doctor have many safe and effective treatment options to help you and your partner overcome infertility.

Family Planning and Avoiding Pregancy
Family planning means taking control of when you have children through education, preconception health and birth control. Your physician will monitor your health, offer advice and help you decide what options are best for you and your partner.

Click here for an explanation of several birth control options.

 Safe sex
Sex with multiple partners can have some serious consequences including pain, infertility, cancer and even death. Sexually transmitted diseases (STDs) link to STDs under diseases and conditions are spread by sexual contact and often people don’t even know they are infected. Many STDs such as HPV, Herpes and HIV do not have a cure. Some of the ways to practice safe sex are:

  • Abstinence
  • Using a condom
  • Limiting your number of sex partners 

Click here for more information and talk to your physician about any questions you have.

Preconception health
Preconception care refers to health care before a pregnancy occurs.  The goal is to identify health and lifestyle risks that may affect a pregnancy and to initiate interventions to reduce those risks. Ideally, a thorough preconception evaluation is provided by the OB/GYN practice that will provide care during the pregnancy.

Here’s a basic list of things to do before getting pregnant:

  1. Get a complete medical check up.   Proper treatment of chronic illnesses can reduce the risk of problems during pregnancy.  In fact, a proper medical evaluation can help identify problems that do not cause many symptoms, and you may not even be aware.  Common medical conditions that should be addressed prior to pregnancy included: diabetes, hypertension, seizure disorders, thyroid disease, depression, asthma and anemia.
  2. Get to know your “family” medical history.  This history pertains to you, the father-to-be and to both of your families. If there is a history of birth defects, medical problems, or pregnancy complications, you may want to consider special testing to determine if those problems could be a problem for your baby.  Furthermore, based on your ethnic background, you may be a carrier of a medical/genetic problem, and proper testing can help you understand the risks and come up with a plan before you conceive.
  3. Review all medications, including non-prescription drugs and “supplements” with your health provider to determine safety before and during pregnancy.
  4. Update your vaccinations.  “TDap”:  Your tetanus, diphtheria and pertussis vaccine status must be up to date.  There has been a huge increase in pertussis cases in the community, and you can protect your baby if you are vaccinated and immune.  If unsure about prior immunizations for German measles or chicken pox you can undergo blood tests to determine if you are immune.  In addition, special immunizations may be needed if you travel outside of theUS.  We also recommend a periodic test for foreign travelers to be sure you have not been exposed to tuberculosis.
  5. Exposures must be minimized to prevent harm to your unborn child.  Your current prescription medications need to be assessed as to whether they are necessary to continue during pregnancy, and whether they are the safest choice to treat your medical conditions.  Furthermore, it is essential that you eliminate cigarettes, illicit drugs and alcohol.
  6. If you are overweight, get as close to your ideal weight before pregnancy.  Discuss weight-loss goals with your provider.  Seek care with a nutritionist and exercise to reach your goal.  If you are overweight, it may be more difficult to get pregnant, and you have a much higher chance of high blood pressure or diabetes once you are pregnant.
  7. Take a prenatal vitamin or a multivitamin that contains 1 milligram of folic acid daily for at least three months before getting pregnant and continue the vitamin supplementation during your pregnancy. Folic acid promotes healthy development of the baby’s brain and spinal cord.
  8. Eat a healthy diet daily and make sure you are including fruits, vegetables, dairy and healthy protein sources.  Drink adequate fluids and minimize caffeine intake.
  9. Exercise regularly.  This promotes overall good physical and emotional wellbeing!  In addition, the healthier you are, the easier it will be to get pregnant and carry the pregnancy successfully for 9 months.  If you are in great physical condition, you will have an easier time with delivery and you will decrease the chance you will need a c-section.

These recommendations will help you to take good care of your baby before the pregnancy and to help you to take good care of yourself! There are many resources available online and in bookstores regarding preconception care . . . while some recommendations can be confusing, it is always advisable to consult your OB/GYN practice.  The goal is to have healthy babies and moms!

Cervical Health
The most effective way to ensure a healthy cervix is by having regular pap tests. A pap test is done during your routine pelvic exam and is done to detect cell changes in the cervix before they turn into cervical cancer link to cervical cancer under diseases and conditions. Often a pap test is abnormal because of infection with Human Papilloma Virus (HPV). Abnormal Pap smears should be followed up with additional testing and sometimes with surgical procedures, all designed to tell the difference between cancer and changes from low-risk HPV infection.  Reducing HPV infection will reduce the number of necessary follow-up tests and procedures resulting from abnormal Pap smears.

Common Uterine Conditions
Fibroids (leiomyoma): The smooth muscle cells of the uterus are intended to grow in organized sheets, facilitating uterine contraction. In about 30 percent of reproductive-aged women, some of these cells grow in a whorl or a ball, forming a fibroid. Fibroids present in a range of sizes, often they do not cause any symptoms. Occasionally, they can be associated with heavy menstrual bleeding or pelvic pain.

Endometrial Polyp: The “endometrium” is the layer of glands that make up the uterine “lining” that is shed with menstrual periods. Occasionally, these glands grow into finger-like projection from the otherwise flat uterine lining. The blood supply to the polyp is somewhat fragile, and can cause heavy menstrual bleeding or bleeding between periods.

Retroverted Uterus:  The uterus is shaped like a comma. The majority of women have a uterus that curves toward the front, a smaller fraction of women have a uterus that curves toward the spine. The curve of the uterus does not predict pregnancy success and is rarely clinically significant.

Diseases of the Uterus
Endometrial hyperplasia: This is an overgrowth of the glands that make up the endometrium, or uterine lining. This condition often presents as heavy menstruation or bleeding between periods. The diagnosis of endometrial hyperplasia is made by biopsy of the uterine lining, which is a simple office procedure. Treatment options for endometrial hyperplasia are determined by the specifics of gland structure and cell appearance within the biopsy specimen.

Adenomyosis: This describes displaced uterine lining (endometrial) cells within the muscle layers of the uterus. These endometrial cells respond to hormone changes during the menstrual cycle, causing inflammation within the uterine wall. This leads to painful menstrual periods. Symptomatic adenomyosis may be treated medically or surgically.

Ovarian Conditions
Ovarian cysts are fluid-filled sacs. Ovarian cysts are common among women during their reproductive years and are growths that form on either of the two almond-sized ovaries on either side of the uterus. Most ovarian cysts are harmless and go away without any treatment.  Some ovarian cysts are abnormal and require surgery.

Polycystic ovarian syndrome (PCOS) is the most common hormonal disorder among women.  Since the symptoms can vary from woman to woman it is often difficult to accurately diagnose polycystic ovarian syndrome. Because polycystic ovary syndrome can cause significant long-term health consequences, accurate diagnosis and proper treatment are essential.

Ovarian cancer link to ovarian cancer under diseases and conditions is often called the silent killer because many times there are no symptoms until the disease has progressed to an advanced stage.  It is important for women to see their gynecologist regularly for exams.  Women should promptly seek an evaluation from their doctor for pelvic pain or bloating symptoms.

Vaginal Health
Safer sexual practices and routine use of condoms protect women from contracting bacterial and viral infections through the vaginal skin or “mucosa” during sexual encounters. If you have any concern about exposure to sexually transmitted infections, or if you wish to be screened for these infections, you should speak with your doctor.

The human vagina is chronically colonized by both bacteria and yeast. These organisms usually co-exist harmoniously, and it is unnecessary to routinely use douche cleansers, or other “sanitizing” products.

Occasionally, the balance between bacteria and yeast is unsettled, in favor of one or the other organism. Inflammation within the vagina or “vaginitis” may present with a change in odor, discharge, or irritation.  If you experience these symptoms, see your doctor for evaluation and treatment.

Minimally Invasive Techniques/Advances
We are proud to offer current comprehensive care for many gynecologic procedures including fibroids, ovarian cysts, abnormal uterine bleeding, endometriosis, and pelvic organ prolapse — in a minimally invasive manner.  These surgeries, which in the past required large abdominal incisions, can now be done in a safe and effective way using laparoscopy and hysteroscopy.  Laparoscopy involves using a thin, fiberoptic tube with a camera that is inserted through an incision in the navel, to perform removal of cysts and even hysterectomies.  Hysteroscopy uses a thin telescopic tube inserted through the cervix, to see inside the uterus.  No incisions are made during this outpatient procedure used to treat uterine polyps, fibroids and heavy bleeding.  These minimally invasive techniques result in going home the same day, much less pain and discomfort, and a faster recovery with a quick return to regular activities.

Click here for more information about minimally invasive surgery.

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