Gynecology

12540551_760232344110031_7946347390033699452_nPediatric and adolescent gynecologic care

Often your pediatrician will provide care for young women. If there is a gynecologic concern about your daughter, we would be happy to discuss those issues with you both. In general, it is recommended that young women begin routine GYN care by 18. They will be seen earlier for problems or concerns. Visits for younger patients may not involve a pelvic exam unless there is a specific problem requiring an internal exam.

We will respect your daughter’s wishes about whether or not she wants a parent in the room for the consultation and exam. It is an important part of her developing a personal relationship with her gynecologist. The State of Maryland allows girls under the age of 18 access to medical care for pregnancy and sexually transmitted diseases without parental consent. For all other gynecologic care, parental consent is required at the time of the visit. Please see consent form under “Forms”.

Contraception

If a young woman is considering becoming sexually active, we will see her to discuss safe sex and contraception.

Discharge

Is this normal?  Often vaginal discharge in young women is normal, but it may represent a yeast infection or other problem.

HPV Vaccine

We strongly recommend that young women be vaccinated for HPV before they become sexually active.  The HPV vaccine may be given between the ages of 13 and 26.  It provides young women with protection against viruses associated with cervical cancer.  Effectiveness of the HPV vaccine is about 85% for women who receive the full series of 3 shots.

Menses

There are often concerns in a young population about their periods. Why haven’t they started?  Are they too often, too infrequent, too heavy or painful?

Physical Development

We often see young women who are concerned they are not developing normally.  We are happy to address these concerns with our young patients.

Sexuality

There are often concerns about sexuality in this age group that will be honestly discussed.

 

More information

Girls Health is a site for young women looking for information on their health and many of the questions they face.

 

 

Reproductive Years

Annual Exam

All women in their reproductive years should have an annual gynecologic exam.  Testing may often be performed or ordered based on your personal history. This visit will include measure of height, weight, blood pressure and pelvic and breast exam.  You may have a pap smear, cultures and HPV testing, as well as general blood work. We may address general issues of lifestyle; such as diet, exercise and smoking cessation.

Contraceptive Care

We will help you determine what type of contraception is best for you.

Abnormal Pap Smears

An abnormal pap smear always merits an assessment and plan of management.

Abnormal Bleeding

This is a common but important issue for women in their reproductive years.  If you are missing periods, if there is bleeding in between periods, or if bleeding is longer or heavier than normal, we will assess the cause and recommend treatment.

Breast Masses

All breast masses should be evaluated.  Many of them are benign or will go away, but any mass that lasts more than one menstrual cycle should be evaluated thoroughly.

Cancer Screening

We will perform or recommend standard cancer screenings such as pap smears, mammograms and MRIs, colonoscopy and genetic testing for cancer as indicated.

Infertility

Infertility is by definition a couple having unprotected intercourse for a year without achieving pregnancy. We will do basic infertility assessments. In many cases we will then refer you to a fertility specialist.  Review your insurance benefits before making an appointment for fertility concerns, as this is often not a covered benefit.

Fibroids

We will discuss if your fibroids need any treatment and if so which treatment option may be best for you.

Pelvic Pain

Pelvic pain may be caused by a number of different problems. They may be gynecologic, digestive or even musculoskeletal.

Pregnancy

We enjoy working with women during pregnancy and delivery. We take care of both routine and high-risk pregnancies.

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Menopause

This is a time in a woman’s life where a great number of changes occur. We are well versed in helping you through these transitions.

Annual Exam

We will continue to see you on an annual basis. The nature of your issues and concerns will change in this period of life.

Contraception

You will need a reliable method of contraception until you are a full year from your last menses

Hormone replacement therapy

There continues to be new information on hormone replacement therapy.  We will be happy to discuss this option with you.

Osteoporosis

All menopausal women should be screened for osteoporosis. We will start by ordering a bone density test or DEXA. Then we will review the results and discuss options for management based on your history and test results.

Pelvic prolapse

This is an issue that is seen more commonly in postmenopausal women.  It may be managed by physical therapy, surgery or other options such as a pessary.

Post menopausal bleeding

This is a problem that merits immediate attention. It is often benign but can warn us of a significant problem.

Sexuality

There are often many changes in our bodies and how we perceive ourselves. These are important issues that deserve serious attention. We will often recommend a separate visit from your routine care so that we may give this important issue adequate time.

Vaginal dryness

This is a major complaint for women who are approaching or are in menopause. There are very successful ways to manage this issue.

Postmenopausal women of all ages

Women should continue their gynecologic care until they determine in discussion with their gynecologist that they no longer find this care useful.

We will continue to discuss general health, fitness, bone density, sexuality and whatever else you care to bring to our attention.  It is important to remain physically and mentally active.  We will discuss balance issues and how they relate to your bone density and exercise patterns.  We will continue breast cancer screening as well as issues of urinary or rectal incontinence and pelvic prolapse.

 

More information

American College of Obstetrics and Gynecology is the official web site and provides a great amount of current medical information.

Mayo Clinic Health is sponsored by Mayo Clinic and has current and accurate information on a multitude of subjects.

Girls Health is a site for young women looking for information on their health and many of the questions they face.

National Osteoporosis Foundation is a leading website for information on causes, diagnoses, and treatment of osteoporosis

North American Menopause Association is the web site for NAMS which provides the most up-to-date information for women and providers on menopause.