Patient Resources

WELL WOMAN CARE

A yearly examination will include but is not limited to a breast exam, pap smear, and possible bloodwork.  If you have Medicare, check with them regarding how often they will cover a pap smear, usually every two years, although your doctor may still want to see you yearly for a breast and pelvic exam.

CONTRACEPTION

Adams Patterson Gynecology & Obstetrics offers a full spectrum of contraception (birth control).  We offer the following birth control options: 

• Oral Contraceptives
• Ortho Evra Patch
• Nuvaring
• Paragard IUD/Mirena IUD
• Implanon Implant
• Depo-Provera Injection
• Tubal Ligation
• Essure Permanent Birth Control Procedure

ORAL CONTRACEPTIVES 

 More than 60 million women take the pill worldwide and it is the most popular form of contraception in the United States. Most pills contain estrogen and progestin and work by preventing ovulation. Used correctly (taking it at about the same time every day), it is 99% effective. Pills available today are a much lower dose than the original birth control pill of the 1960's and have fewer side effects.

Side Effects

There are some minor side effects associated with the birth control pill. These include: breakthrough bleeding (bleeding between periods), nausea, headaches, and breast tenderness. Many of these side effects decrease during the first three months of usage.

 Not all women are good candidates for the birth control pill. You should not take the pill if you are over 35 and smoke. You should not take the pill if you begin getting SEVERE migraine headaches after starting the birth control pill. Women who have a history of blood clots or stroke, have heart disease, or high blood pressure, have had breast cancer, have liver problems, have kidney problems or have active gallbladder disease should not take the pill. 

NUVARING 
 

Nuvaring is a flexible vaginal ring containing estrogen and progestin that is inserted into the vagina and stays in place for three weeks at a time. It is then removed for a week which is when your period will occur.

INTRAUTERINE DEVICE (MIRENA/PARAGARD)

An IUD is a small, T-shaped piece of plastic that is inserted into the uterus by your doctor. The effectiveness is about 99%. Once the IUD is inserted, it offers protection for 5 to 10 years depending on the IUD used. A Mirena IUD is a hormone containing IUD which has the added benefit of less menstrual flow and cramping. Paragard is a hormone free IUD. The most common side effects of Paragard are heavier menstrual cycles and cramping.

There are rare but serious complications that can arise from using the IUD’s such as infection, tubal pregnancy (pregnancy located in the fallopian tube), and perforation of the uterine wall.

IMPLANON IMPLANT

Implanon is a flexible plastic rod the size of a matchstick that is put under the skin of your arm in an in-office procedure. It is more than 99% effective. It is a progestin only form of birth control that can be left in your body for up to three years.

DEPO-PROVERA

Depo-Provera is an injectable form of contraception that protects you against pregnancy for a full three months.  It is a a good alternative for birth control for patients who cannot remember to take a pill. It is over 99% effective.

TUBAL LIGATION

Tubal ligation is a permanent form of female sterilization in which the fallopian tubes are blocked or cut in order to prevent fertilization. This is an outpatient surgical procedure done in the hospital. 

ESSURE PERMANENT BIRTH CONTROL PROCEDURE

The Essure procedure is a method of permanent birth control for women in which micro-inserts are placed within the fallopian tubes by catheter and hysteroscopy. The micro-inserts produce eventual occlusion of the fallopian tubes (usually in three months) by causing the in-growth of tissue. It does not involve any incisions into the body. It is performed in the office and is 99.80% effective.

GYNECOLOGICAL HEALTH CONDITIONS

Adams Patterson Gynecology & Obstetrics helps our gynecology patients identify and treat a wide range of health conditions and concerns. Certain health concerns might be identified during a routine annual wellness exam or the patient may notice or experience an abnormality.

Our gynecology care services include (but are not limited to) the following:

ABNORMAL PAP SMEARS/HPV

A pap smear is a screening test to detect cancerous cells in the cervix. Positive findings result in the pap smear being referred as abnormal. Women are recommended to get annual pap smears to aid in the early detection of cervical cancer.

HPV (Human Papilloma Virus) is a very common infection that is passed person to person. Some types of HPV cause cells on or around the cervix to become abnormal. In some cases, these cells may progress to precancer. A pap test is the best way to detect these cell changes. 

MENOPAUSE MANAGEMENT/HORMONE REPLACEMENT THERAPY

 Beginning in the early 30's, the levels of estrogen and progesterone produced by a woman’s ovaries start to decline. When the supply of eggs is finally exhausted, ovulation stops. The levels of estrogen and progesterone eventually drop so low that menstruation stops. A woman knows she has passed menopause when she has no periods for 12 months.

The lack of estrogen can bring on symptoms such as hot flashes and vaginal dryness. It can also increase the risk of osteoporosis (bone loss). Because of this, women may choose to take hormone replacement therapy to restore estrogen after menopause.

Before making a decision about HRT, talk to your doctor about what may work best for you, considering your personal needs and family and medical history. 

OVARIAN CYSTS

Ovarian cysts are very common in women during reproductive years. Although most cysts at this time are harmless, your doctor will want to keep track of the growth of any cyst to be sure that it does not persist or cause symptoms. Your doctor will work with you to monitor its progress and determine the best course of treatment. 

INFERTILITY

Infertility is generally defined as not being able to get pregnant after at least one year of actively trying.

Most healthy women shouldn't worry about infertility unless they've been trying to get pregnant for at least a year. At this point, women should talk to their doctors about a fertility workup.

Some health issues also increase the risk of fertility problems. So women with the following issues should speak to their doctors as soon as possible:

• irregular periods or no menstrual periods
• very painful periods
• endometriosis
• pelvic inflammatory disease
• more than one miscarriage

No matter how old you are, it's always a good idea to talk to a doctor before you start trying to get pregnant. Doctors can help you prepare your body for a healthy baby. They can also answer questions on fertility and give tips on conceiving. 

ENDOMETRIOSIS

Endometriosis is a common cause of pelvic pain. Normally, during the menstrual cycle tissue builds up and breaks down within the uterus. In endometriosis, endometrial tissue (tissue from the lining of the uterus) is found outside the uterus. During the menstrual cycle this tissue builds up and breaks down in the same way but there is no way for it to leave the body. These areas bleed internally, causing irritation, inflammation, and scarring.

Women with endometriosis have symptoms ranging from mild to severe, although some women have no symptoms at all. Symptoms can include menstrual cramps, pain during intercourse, low back pain, constipation, pain with bowel movements, and infertility. 

FIBROIDS

Fibroids are benign growths that develop from the cells that make up the muscle of the uterus. The size and location of fibroids can vary greatly. They may appear inside the uterus, on its outer surface, or within its wall.

The two most common symptoms are abnormal uterine bleeding and pelvic pressure. Menstrual periods with fibroids may be very long and very heavy. There may be pressure in the pelvic region from the enlarged uterine size caused by the fibroids. However, many women with fibroids never have any symptoms at all.

If you have uterine fibroids you should be checked by your doctor on a regular basis. Getting regular checkups and being alert to warning signs will help you be aware of changes that may require treatment. 

ABNORMAL BLEEDING

Irregular menstrual periods can result in abnormal uterine bleeding. This bleeding lasts longer than the normal cycle or occurs outside the cycle. Contributing factors may include weight changes, heavy exercise, stress, illness, or side effects of certain medications.

Irregular bleeding is not uncommon the first three months on new hormone therapy (birth control pills, HRT). If you are postmenopausal (no bleeding in one year) and have any menstrual bleeding, please call your physician.

Some medical tests that your physician may also use are endometrial biopsy, ultrasound, hysteroscopy, and/or laparoscopy. 

STD TESTING AND TREATMENT

Sexually transmitted diseases (STD’s) are among the most common infectious diseases. Unfortunately many STD’s have no symptoms, especially in women. Some STDs, especially Chlamydia and Gonorrhea, can spread from the vagina to the uterus and fallopian tubes causing PID- pelvic inflammatory disease. The scarring left by PID can lead to infertility or ectopic pregnancies (a pregnancy outside the uterus which if not terminated early can lead to death.) HPV can cause cervical cancer and other cancers of the genitals. Undiagnosed STDs can be passed from mother to baby before and during delivery. We offer discrete confidential screening for all types of STD’s including HIV, Herpes, Hepatitis B, Hepatitis C, Gonorrhea, and Chlamydia. 

VAGINAL INFECTIONS

Vaginal infections are the most common gynecologic disorder and are usually caused when the normal vaginal flora that are found in the vagina become imbalanced. The key to successful treatment is accurate diagnosis of what is causing the infection. Therefore, before you use any over the counter medication such as a treatment for vaginal yeast infection you should be sure it is the right drug to treat the problem. Using the wrong sort of medication may make the situation worse. If you have any doubt, you should consult your doctor.

PREMENSTRUAL SYNDROME

Premenstrual syndrome (PMS) is a term used to describe the abnormal symptoms many women experience one to two weeks before the beginning of their period. Physical symptoms such as breast tenderness, headaches, bloating, food cravings, accompanied by mood swings and depression, are the classic signs. All PMS symptoms should disappear when menstruation begins.

PELVIC PAIN

Pelvic pain can have many different causes. It can be caused by a gynecological condition such as endometriosis, uterine fibroids, ovarian cysts, and pelvic adhesions. It can also be the result of an intestinal, urinary, or muscular problem. It is important to consult your physician if you are experiencing undiagnosed pelvic pain to determine the cause and any following treatment necessary. 
 
 

GYNECOLOGY PROCEDURES

Our in-office procedures include:

• COLPOSCOPY
• CRYOTHERAPY
• LEEP
• ENDOMETRIAL BIOPSY
• ULTRASOUND
• SONHYSTEROGRAM
• HYSTEROSALPINGOGRAM
• NOVASURE ENDOMETRIAL ABLATION
• ESSURE

COLPOSCOPY

Colposcopy is an office procedure used in the evaluation of an abnormal pap smear or cervical lesion. A speculum is placed in the vagina, and the physician uses a magnifying scope to examine the cervix and upper vagina. Tissue biopsy samples may be obtained at this time to guide further management. It is normal to experience light vaginal bleeding and brown discharge for several days following the procedure. 

CRYOTHERAPY

Cryotherapy is an in-office procedure used to treat certain types of cervix cell abnormalities. A special probe is used to freeze the abnormal area of the cervix, destroying the abnormal cells. It may be used to treat genital warts or other lesions as well. It is normal to experience mild cramping during the procedure, and afterwards, a watery vaginal discharge will be present for 2-3 weeks. 

LEEP (LOOP ELECTROSURGICAL EXCISION PROCEDURE)

If you’ve had a Pap test and cervical biopsies come back showing dysplasia, a LEEP may be recommended as treatment for these cells. Dysplasia is not cancer, but can lead to cervical cancer if not treated. In this in-office surgical procedure your cervix will be numbed with a local anesthetic. Then an electric current is directed through a thin wire loop which is used to remove the thin layer of cervix containing the area of abnormality. You may feel mild cramping for a few days after the procedure and you will have a vaginal discharge sometimes for up to 2-3 weeks. 

ENDOMETRIAL BIOPSY

This test takes a tissue sample from the lining of your uterus (the endometrium) to evaluate it for problems that might explain unusual bleeding. A thin tube is inserted through the cervix into the uterus during a pelvic exam. A small amount of tissue is removed and sent to the lab for analysis. It is normal to experience cramping during the procedure and some light bleeding for several days.

ULTRASOUND

Ultrasound can be very helpful in diagnosis a whole host of gynecologic disorders. It is a relatively non-invasive method of viewing the reproductive organs in the pelvis to determine the nature and extent of structural abnormalities present. Many gynecologic disorders do not show early symptoms and ultrasound can often diagnose problems well before a patient may know a problem exists.

The Uterus

Uterine size and shape can be determined. Common problems such as uterine fibroid tumors can be localized, measured and followed over time to help determine their significance. Endometrial lining thickness can be measured in patients who experience abnormal uterine bleeding.  

The Ovaries

Ovarian size can be determined. Cysts inside and outside of the ovary can be measured and their characteristics determined.

The Pelvis

Fluid in the pelvic can be a cause of pelvic pain. It can occur for several reasons such as ruptured ovarian cysts, ovulation and bleeding from the ovary or fallopian tubes. The presence of fluid in the pelvis can be determined by ultrasound.  

SONOHYSTEROGRAM

A sonohysterogram (SHG) is an ultrasound procedure used to better visualize the inside of the uterus and endometrium.  Most often it is used to view fibroids and polyps. A sonohystogram takes around 30 minutes. A catheter is inserted through the cervix, and a small inflated balloon holds it in place.  Saline is injected into the uterus and ultrasound pictures are then obtained.  

HYSTEROSALPINGOGRAM

A hysterosalpingogram (HSG) is an x-ray examination of one’s uterus and fallopian tubes that helps to evaluate the structure and the shape of the uterus, as well as to determine the openness of the fallopian tubes. A contrast dye is inserted through a catheter into the cervix, and then begins to fill the uterus while images are being taken. This test is scheduled by our office nurses, and is done in the outpatient radiology department of the hospital. This test is extremely time sensitive, and can only be done on day 7, 8, or 9 of your menstrual cycle.  If your doctor orders this test, please call our office on the day that your cycle BEGINS, so that we may have adequate time to schedule it for you. 

NOVASURE ENDOMETRIAL ABLATION

Novasure is a minimally invasive in-office procedure performed along with a hysteroscopy that is an alternative to hysterectomy for excessive menstrual bleeding. Most women will have reduced menstrual flow following endometrial ablation, and up to half will stop having periods. This procedure is performed either in-office or outpatient at the hospital depending on your insurance.

ESSURE

The Essure procedure is an in-office method of permanent birth control for women in which micro-inserts are placed within the fallopian tubes by catheter and hysteroscopy. The micro-inserts produce eventual occlusion of the fallopian tubes (usually in three months) by causing the in-growth of tissue. It does not involve any incisions into the body. 

 Our hospital procedures include (but are not limited to):

• HYSTERECTOMY
• MYOMECTOMY
• OVARIAN CYSTECTOMY
• HYSTEROSCOPY
• D & C
• LAPAROSCOPIC SURGERY
• DA VINCI ROBOTIC ASSISTED SURGERY AND HYSTERECTOMY
• TUBAL LIGATION