Gynecologic care

A Pap test checks for cancer or precancerous changes of the cervix, the lower end of the uterus. Most changes are caused by the human papillomavirus (HPV). You can get HPV by having sex with someone who has it. 

If an abnormality is found, your doctor may order a colposcopy. This is a procedure to closely examine your cervix. Sometimes a biopsy (a sample of tissue) is needed for diagnosis.

Testing and treatment options:

• Cutting out abnormal tissue using an electrified wire loop 
• Removing a cone-shaped tissue sample for testing
• Freezing abnormal tissue to destroy it 

Endometriosis happens when tissue from the uterine lining is found outside the uterus. It affects women of all ages but is most common in women ages 30 to 40. Tissue may be found on the ovaries, bladder, intestines or other places in the lower belly.

Pain is the most common sign of endometriosis. It may be noticeable during your period and sometimes when having sex. Endometriosis can be treated with medication and/or surgery.

An ovarian cyst is a sac filled with fluid or tissue that grows on or near the ovaries. Ovarian cysts are common and often happen during childbearing years and menopause. Most cysts are not cancerous and may go away without treatment.

Sometimes the cysts can cause pain and discomfort in the lower belly. In rare cases, cysts are cancerous and need to be removed.

Sometimes the organs in the lower belly (the uterus, ovaries, bowel and bladder) can drop. This is called pelvic prolapse. It can happen for a variety of reasons:

• Aging
• Pressure from a previous pregnancy, obesity, frequent constipation or cough
• Past surgery that involved some or all of the organs in the lower belly

Symptoms may include:

• A feeling of pressure or fullness
• Bulge in vagina
• Pain or aches in the lower belly and back
• Inability to urinate or have a bowel movement

Treatment depends on the severity of your condition. Options include:

• Kegel exercises (exercises that strengthen the pelvic muscles)
• Weight loss and exercise
• Dietary changes to reduce constipation
• A device placed inside the vagina to keep organs in place
• Surgery to correct the prolapse

Most women have a period every 21 to 35 days. But problems often happen. This can range from not having periods at all to periods that are too frequent. Other problems include:

• Bleeding or spotting between periods
• Bleeding for seven days or more with each period
• Bleeding during or after sex

We diagnose and treat problem periods at any age, from your first period to bleeding after menopause. We also evaluate and treat premenstrual syndrome, a group of symptoms that can happen a week or two before your period.

Fibroids are noncancerous growths that usually start in the uterus. They often affect women in their 30s and 40s and may contribute to not being able to get pregnant.

Symptoms include:

• Pressure, back pain, or a feeling of fullness or bloating
• Difficulty urinating or having bowel movements
• Period problems, typically longer or heavier periods

If you have any of these symptoms, tell your doctor. She will do an exam and probably an ultrasound.

Treatment for fibroids depends on your age, symptoms and your desire for a future pregnancy. Some treatments include:

• Hormone therapy
• Medication 
• Surgery