Why are regular gynecologic exams important?
Gynecologic exams including a pelvic exam are important for identifying diseases and medical conditions, including sexually-transmitted diseases and cancer, in their earliest stages, when they are
most treatable.
What can I expect during my exam?
During your visit, your doctor will record your blood pressure and weight. You will also have a clinical breast exam which is a critical tool in identifying early-stage breast cancer. In most cases, a pelvic exam will be performed to examine your external genitalia, vagina, uterus and cervix and a pap smear will be obtained to screen for cervical cancer. Your exam will be based in part on your age and other healthrelated factors. Your exam is an ideal time to ask questions and talk about your concerns about sexual health, pregnancy and other issues.
How often should I have a gynecological exam?
The American College of Obstetricians and Gynecologists (ACOG) recommends annual well visits including annual pelvic exams for women over 21, to maintain good health. Postponing visits can allow many diseases and medical conditions to go undetected, allowing them to develop into more serious conditions.

Why do I need prenatal care?
Prenatal care is one of the most important things you can do to ensure your baby is as healthy as possible, both during pregnancy and following birth. By ensuring you do all you can to keep yourself and your developing baby healthy during pregnancy, you set the stage for a healthier infancy and childhood. In fact, some studies have shown getting proper prenatal care can even have an impact on your child's health well into adulthood. Regular prenatal visits also help to identify potentially serious health risks and treat them appropriately so you can reduce your risks of complications during pregnancy and
delivery.
How often will I need to see the doctor while I'm pregnant?
Most doctors like to see mothers-to-be every month up until the 28th week of pregnancy, and then every other week until the 36th week. After that, you will need to go every week until delivery. Some women with high risk pregnancies will need to see the doctor more frequently for additional monitoring, evaluation and testing.
What happens during a prenatal exam?
At the start of your exam, you'll be asked about any unusual symptoms you may be experiencing and your blood pressure will be taken. You will also need to supply a urine sample to be tested for signs of infection or other potential medical issues. Depending on how far along you are in your pregnancy, your belly may be measured and additional testing like blood work or ultrasounds may be ordered to keep an eye on your health and your developing baby. Your visit is time to discuss any concerns you may have and learn what to expect as your pregnancy progresses.

What is a colposcopy?
Colposcopy is a type of examination that uses a magnifying device to gain a close, clear view of your vulva, vagina and cervix so your doctor can look for abnormalities and other signs of disease or medical issues.
Why is colposcopy performed?
Colposcopy may be performed as part of a regular pelvic exam, but it may also be performed to get a closer look at a sore or other abnormality that's visualized during an exam; to follow up on an abnormal Pap test or an earlier abnormal colposcopy; to determine if a treatment for an earlier problem is working; or to evaluate the presence of HPV (human papillomavirus).
What can cause an abnormal Pap test?
Abnormal Pap tests may be caused by viral infections like HPV, yeast infections or other types of infections. Cellular changes that occur in menopause can also trigger abnormal results, as can the presence of cancerous or precancerous cells.
What's involved in the colposcopy exam?
During the exam, a lubricated speculum will be inserted into your vagina to open the interior walls of the vagina for easier viewing. Next, the colposcope will be used to magnify and light the interior of your vagina and your cervix so they can be viewed up close. If an abnormal area is identified, a small sample of tissue called a biopsy will be taken for examination under a microscope. Biopsies can provide important information that can help identify early stages of cancer or other conditions that need treatment.

What is an IUD?
An IUD, or intrauterine device, is a T-shaped contraceptive device that is inserted in your uterus by your doctor. The IUD is connected to a plastic string, sort of like a tampon; this string extends into your vagina, and you can ensure your IUD is still in place by gently feeling for the string.
Are there different types of IUDs?
Yes, there are two types: copper and hormonal. The copper IUD employs a copper wire wound around the base of the device. The hormonal IUD releases hormones that prevent pregnancy.
How does an IUD work?
IUDs prevent fertilization of an ovum by damaging or destroying sperm. The copper IUD works by encouraging the uterus and fallopian tubes to produce a fluid that is toxic to sperm. The hormonal IUD causes the mucus inside the cervix to become thick so sperm can't make it to the uterus. At the same time, it prevents the lining of the uterus from becoming thick, which makes it difficult for an egg to become implanted.

What are minimally invasive procedures?
Minimally invasive procedures use techniques that are designed to avoid the need for major surgery, including smaller incisions and specially designed instruments so patients can enjoy less pain, fewer risks, faster recovery and less scarring.
What types of minimally invasive procedures do we offer?
Several types of procedures are available, some aimed at treating conditions and some that are designed to diagnose or evaluate a condition. These include:
Hysterectomy: Hysterectomy is a very common procedure used to correct a variety of problems, including uterine fibroids, heavy or abnormal bleeding, chronic pelvic pain and pelvic support issues. A hysterectomy can be partial, full or radical (which includes removal of the uterus as well as the surrounding support structures).Laparoscopy: Laparoscopy is used extensively in diagnosing problems as well as some treatments, including sterilization.
Endometrial ablation: This technique destroys the lining of the uterus to eliminate abnormal bleeding.
Hysteroscopy: The hysteroscopy procedure uses a special scope to look inside the uterus to aid in diagnosis of a wide range of problems and it can also be used to assist in sterilization procedures.

What is considered heavy bleeding?
Medically, heavy periods (or menorrhagia) are defined as those that involve passage of more than three ounces of blood; in a normal period, about an ounce of blood is expelled. Practically speaking, since most women don't have a way to measure their blood flow, heavy periods are defined as those that require the use of tampons and pads at the same time; involve passing clots; require frequent changing of protection – for instance, every couple of hours; or last longer than seven days. Other symptoms include the need to wake during the night to change protection, fatigue and anemia in more severe cases.
What are the causes of heavy bleeding?
There are many potential causes of menorrhagia, including:
• hormonal imbalances, most typically occurring in adolescence and during menopause
• benign tumors called fibroids, which occur most commonly during the childbearing years
• miscarriage
• ectopic pregnancy
• problems with IUDs
• use of blood thinners
• pelvic inflammatory disease
• cervical, ovarian or uterine cancer
• diseases of the liver, kidneys or thyroid or platelet disorders, all of which can cause issues with normal
clotting
How is heavy bleeding treated?
The treatment you'll receive will depend on the cause of your bleeding and may include:
• Medication to reduce the loss of blood and manage cramping and discomfort
• Hormone therapy to regulate your cycle or correct hormonal imbalances
• Surgery to remove fibroids, remove or destroy the lining of the uterus or remove the uterus entirely

What is laparoscopy?
Laparoscopy is a minimally invasive technique that can help diagnose and manage a wide range of issues without the need for major surgery. The laparoscopic technique uses a special instrument, called a laparoscope, inserted through a tiny incision in your abdomen. The instrument is equipped with a special camera that enables the surgeon to see the treatment area on a monitor.
Is laparoscopy better than traditional surgery?
Laparoscopy is much less invasive than traditional techniques, which means there are fewer risks and the recovery process is much faster. Plus, pain and discomfort following the procedure are minimized, and so is scarring. Less invasive procedures enable patients to resume their normal activities much more quickly. Laparoscopy is also frequently used to perform sterilization techniques such as tubal ligation or cauterization.
What is recovery like?
Will I be in a lot of discomfort? Because it's minimally invasive, laparoscopy results in much less discomfort than traditional surgical techniques. You may have some mild back ache or cramping caused by the gas used to help visualize the area during the procedure, but these effects should resolve in a day or two.
Will I need to be hospitalized?
Most patients who undergo laparoscopy are able to return home within a few hours of the procedure. You will need to rest for a few days to a week and avoid strenuous activity while you heal.

What is an Ultrasound?
Diagnostic medical sonographic procedures, or “ultrasound exams,” are performed using high-frequency sound waves. The sound waves are reflected by water and tissue, and then reconstructed to form an image. How is the procedure performed? For OB transabdominal ultrasound exams, you will be positioned lying face-up on an examination table. After you are positioned on the table, the sonographer will apply a warm water-based gel to the area of the body being studied. The transducer is placed on the body and moved back and forth over the area of interest until the desired images are captured. Transvaginal ultrasound is performed very much like a gynecologic exam and involves the insertion of the transducer into the vagina. A protective cover is placed over the transducer, lubricated with a small amount of gel, and then inserted into the vagina. The images are obtained from different orientations to get the best views of the uterus and ovaries.
What are some common uses of the procedure?
Obstetrical ultrasound is a useful clinical test to:
• establish the presence of a living embryo/fetus
• estimate the age of the pregnancy
• diagnose congenital abnormalities of the fetus
• evaluate the position of the fetus
• evaluate the position of the placenta
• determine if there are multiple pregnancies
• determine the amount of amniotic fluid around the baby
• check for opening or shortening of the cervix
• assess fetal growth
• assess fetal well-being
Transvaginal GYN examinations can help diagnose symptoms experienced by women such as:
• pelvic pain
• abnormal bleeding
• other menstrual issues
• palpable masses (ovarian cysts and uterine fibroids)
Who will perform my ultrasound?
Our experienced sonographers will perform your ultrasound. They are registered by the American Registry of Diagnostic Medical Sonographers (ARDMS) and our office is certified through the American Institute of Ultrasound in Medicine (AIUM).