Gynecological FAQs

I am running low on my prescription - how do I obtain more medication?
If it has been less than a year since your last annual exam your prescription can be obtained by calling our office. A nurse will call in the refill to your pharmacy or send you a prescription in the mail at your request. If it has been more than a year since your last annual exam, the nurse will notify you that you need to make your appointment before we can proceed with your refill. We do not refill pain medications or birth control over the weekend.
When should I have my first pap smear?
Within three years of becoming sexually active or by age 21 if you are not sexually active.
How often do I need a gyn exam and pap smear?
If you are taking birth control pills, sexually active with more than one partner or having any gyn problems, you need an exam once a year. Pap smears may be recommended more frequently if they are abnormal. If you are postmenopausal but have a normal pap history, you may have a pap screening every 2 to 3 years. However, you still need annual visits including a screening mammogram with a breast and pelvic examination.
What is a thin prep pap smear and why is it better?
Thin prep is a liquid based pap test. The collection and processing method used in this test provides a better cell sample for analysis. Thin prep has become the preferred test over the conventional pap because it has been more effective in the detection of abnormal cells. Our office uses the thin prep pap test.
What if my pap smear is abnormal?
You will be notified by phone if your pap smear is abnormal by your provider or nurse. Our office automatically screens all paps with atypical squamous cells of undetermined significance (ASCUS) for the high risk human papillomavirus (HPV). This virus is the most common reason why abnormal cells are found with pap smears. You will be scheduled for an office procedure called a Colposcopy to take a closer look at your cervix for abnormal cells. Follow-up may require only monitoring or may involve treatment if cell changes are significant. For more information about HPV go to the American Social Health Association website.
Do I need to be screened for Sexually Transmitted Diseases (STDs)?
We recommend screening for all women who have been sexually active with more than one partner. Tests may include Chlamydia, gonorrhea, HIV, Hepatitis C, Herpes Type 1 & 2 and syphilis. Consider screening on an annual basis if you have had unprotected intercourse with a new partner. Contact our office any time for STD screening if you are worried that you may have been exposed or are showing symptoms of an STD.
What birth control method is best for me?
There are many methods available depending on your interests and lifestyle. Most people are familiar with birth control pills that are taken on a daily basis. Click here for more information on the pill. Newer more convenient methods include the Nuva Ring or the Ortho Evra Patch. The Nuva Ring is inserted like a tampon and stays in the vagina for 3 weeks. It is very comfortable and very discrete. The Ortho Evra patch is worn like a band aid and is changed once a week. Other options include the Depo provera shot, and Mirena IUD. The shot is given every 3 months and eventually makes your periods go away. The Mirena is available for women who have had children and want reversible contraception. This IUD is good for 5 years and helps to reduce heavy periods. Contact our office for an appointment to further discuss the best option for you.
Can I skip periods with my birth control pills?
Yes, many women are taking continuous birth control pills and choosing to have a period every 3 months instead of every month. A new pill called “Seasonale” contains 84 active pills and one week of placebo pills in one pack. You can also do this with regular monophasic pills (skip the 4th week of pills), the Ortho Evra Patch and the Nuva Ring. When you are ready to have a period, discontinue your contraception for 5-7 days, then restart it. Initially you may experience occasional spotting but this improves with time. It is not harmful to skip periods while taking birth control and many women with menstrual problems benefit from this type of schedule.
Is it normal to miss my period?
It is not uncommon for women to have very light to non-existent periods on birth control pills. This is fine because the pill protects the uterus from abnormal cells. Missing periods when you are not on the pill can be a sign of menopause, perimenopause, pregnancy or a hormonal imbalance. If you miss 3 periods and are not pregnant, you should contact our office.
What is abnormal uterine bleeding?
Bleeding that lasts longer than 7 days or comes more often than 21 days needs evaluation. Abnormal bleeding can be due to pregnancy, abnormal cells, mechanical problems (fibroids, polyps) or a hormonal imbalance. Abnormal bleeding after age 35 or any bleeding after menopause needs evaluation by your provider. Intermittent spotting on birth control pills is common in the 1st three months or if a pill is taken late.
What can I do for menstrual cramps?
You can try any over-the-counter product with Ibuprofen (Motrin) or naproxen (Aleve). Start taking this medicine when you first feel the first signs of your period beginning. For most women, 400-600 mg of Motrin or Aleve 1-2 tablets will relieve cramps. A warm heating pad over the abdomen is helpful too. Research shows menstrual cramps improve if you increase your daily calcium to 1500 mg a day. Birth control pills may provide additional relief. If you still have significant cramps after trying the above, please contact our office for an appointment.
What can I do about urinary leakage?
This problem is more common than you think and can be helped. “Accidents” can occur with stress (coughing, exercise, etc.), or the urge to use the bathroom. Overuse of certain foods such as caffeine or citrus can add to the problem. Please contact our office for an evaluation. There are several treatment options available.
When should I begin getting mammograms?
Routine mammograms should begin at age 40 unless specified otherwise by your physician or nurse practitioner. Talk with your provider if you have a family history of breast cancer especially under the age of 45. This would accelerate the start of mammogram screening for you. Many insurance companies will approve a one-time screening mammogram between the ages of 35-40. Check with your insurance carrier to ensure it is a covered expense.
How do I treat hot flashes now that I’ve stopped my hormones or don’t want to start them again?
Hot flashes are mild for some women while other women are just plain miserable. We know estrogen works the best in relieving hot flashes during menopause, but hormone therapy may not be an option for everyone. Recent research on herbal remedies have mixed reviews as to whether they work and if they are safe. Some plant-based products have estrogen-like properties and very little is known about their relationship to the risk of breast cancer. Plants in this category include soy, black cohosh, and wild yam. Non hormonal medications that have shown to reduce hot flashes are in the class of antidepressants. These include low doses of Effexor, Paxil, and Prozac, which can reduce hot flashes by 70%. Lifestyle changes that can reduce hot flashes include regular exercise, reducing your weight, avoiding spicy foods and caffeine, and staying hydrated. Talk to your provider on the best way to manage your symptoms.
Should I have gynecology surgery?
When medication and non-invasive procedures are unable to relieve symptoms, surgery remains the accepted and most effective treatment for a range of gynecologic conditions. These include, but are not limited to, cervical and uterine cancer, uterine fibroids, endometriosis, uterine prolapse and menorrhagia or excessive bleeding.

Traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, has for many years been the standard approach to many gynecologic procedures. Yet with open surgery can come significant pain, trauma, a long recovery process and threat to surrounding organs and nerves. For women facing gynecologic surgery, the period of pain, discomfort and extended time away from normal daily activities that usually follows traditional surgery can understandably cause significant anxiety.

Fortunately, less invasive options are available. Some gynecologic procedures enable surgeons to access the target anatomy using a vaginal approach, which may not require an external incision. But for complex hysterectomies and other gynecologic procedures, robot-assisted surgery with the da Vinci® Surgical System may be the most effective, least invasive treatment option. Through tiny, 1-2 cm incisions, surgeons using the da Vinci System* can operate with greater precision and control, minimizing the pain and risk associated with large incisions while increasing the likelihood of a fast recovery and excellent clinical outcomes.

What is the Da Vinci® Surgery?
Only da Vinci® overcomes the limitations of both traditional open surgery and conventional minimally invasive surgery. The da Vinci® System is a sophisticated robotic platform designed to expand the surgeon’s capabilities – and for the first time – offer a minimally invasive option for major surgery. Click here for more info.
How does the da Vinci® STM Surgical System work?
With da Vinci, small incisions are used to introduce miniaturized wristed instruments and a high-definition 3D camera. Seated comfortably at the da Vinci console, your surgeon views a magnified, high-resolution 3D image of the surgical site.

At the same time, state-of-the-art robotic and computer technologies scale, filter and seamlessly translate your surgeon’s hand movements into precise micro-movements of the da Vinci instruments.

The System cannot be programmed, nor can it make decisions on its own. Rather, the da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon.

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.. Click here for more info


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