Gynecology
Young Women
The health care professionals at Barrington Health Care for Women work closely with young women educating them about safe-sex, sexually transmitted disease and birth control. For young women who are having their first gynecological exam, our physicians will answer any questions or concerns they may have prior to the exam.
The physicians at BHCW treat a wide range of gynecological disorders.
- Premenstrual Syndrome (PMS)
- Amenorrhea (absence of menstruating)
- Dysmenorrhea (painful menstruation)
- Endometriosis
- Ovarian Cysts
- Gynecologic Inflammations and Infections
- Menopausal Disorders
Cancer Screening and Prevention
Cancer is obviously a terrifying and often deadly disease. But it can be prevented or treated if identified early. There are many cancers that just affect women: cervical, breast, uterine, ovarian, vaginal and vulvar – to name a few. With regular screening and follow up many of these cancers can be prevented. For instance, according to the Center for Disease Control (CDC), “6 out of 10 cervical cancers occur in women who have never received a Pap test or have not been tested in the past five years.”
Cervical Cancer can be identified early through the use of two test:
- The Pap test (Pap Smear) which looks for precancers and cell changes in the cervix.
- The Human Papillomavirus (HPV) test looks for a virus that is known for causing changes in the cells which lead to cancer.
The Thin Prep pap test, along with a pelvic exam is an important part of a woman’s yearly preventative health care program. The exams may detect abnormalities that can lead to invasive cancer. Most invasive cancers of the cervix can be detected early if a woman has a Thin Prep pap test and pelvic examination regularly. As with many types of cancer, cancer of the cervix is more likely to be successfully treated if it is detected early. The Thin Prep pap test can also detect other changes in the cervix and vagina such as inflammation. Women who are or have been sexually active, or have reached age 21, should have pap tests and pelvic examinations regularly. Generally, there is no upper age at which pap tests cease to be effective. Older women should continue to have regular physical examinations including pelvic exams and pap tests.
Talk to your doctor about the Gardisil Vaccination which is a vaccine which protects against cervical cancer. Girls and women ages 9 to 26 should consider Gardisil to help prevent the following diseases:
- Cervical Cancer
- Genital Warts
- Abnormal and precancerous cervical, vaginal, vulvar lesions
Uterine Cancer typically occurs in women who are going through or have gone through menopause, although all women are at risk. Signs and symptoms of uterine cancer include:
- Bleeding that is not normal because of when it happens and how heavy it is; this includes bleeding after menopause
- Periods that are longer than seven days
- Bleeding between periods
- Pain or pressure in the pelvis
If you have any of these symptoms, talk to your doctor.
Ovarian Cancer is the leading cause of female cancer deaths, but it can be treated effectively if caught early. All women are at risk for ovarian cancer but it typically occurs in women 55 years of age and older; most cases (about 90%) occur in women 40 years of age and older. Signs and symptoms of ovarian cancer include the following:
- Pain in the pelvic or abdominal area
- Back pain
- Being tired all of the time
- Bloating
- Change in bathroom habits such as passing urine badly or more often
- Upset stomach or heartburn
- Vaginal discharge that is not normal for you
Talk to your doctor if any of these signs and symptoms persist every day for two weeks or more):
Vaginal Cancer and Vulvar Cancer are both rare. When these cancers are found, in particular Vulvar Cancer, treatment is often effective.
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Abnormal Menses
Abnormal bleeding is also known as abnormal menses. This is a flow of blood from the vagina that occurs either at the wrong time during the month or in inappropriate amounts. We at Barrington Health Care for Women will assess the bleeding through basically three questions:
- Are you pregnant?
- What is the pattern of the bleeding?
- Are you ovulating?
Often women do not realize that their bleeding is abnormal and that there is a non-surgical treatment. Traditionally hysterectomies have been the answer but innovative advances in treatment have been made and a potential alternative may be available; abnormal menstrual periods can be treated through an outpatient surgical procedure known as endometrial ablation. Consult your doctor to determine what is right for you.
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Hysterectomy
Hysterectomy (the removal of a woman’s uterus) is used to treat the following:
- Fibroids. More hysterectomies are done because of fibroids than any other problem of the uterus. Fibroids can cause heavy bleeding or pain in some women.
- Endometriosis. This happens when the tissue lining the inside of your uterus grows outside the uterus on your ovaries, fallopian tubes, or other pelvic or abdominal organs.
- Uterine prolapse. This is when the uterus moves from its usual place down into the vagina. This can lead to urinary problems, pelvic pressure, or difficulty with bowel movements.
- Cancer. If you have cancer of the uterus, cervix, or ovary a hysterectomy may be part of the treatment your doctor recommends.
- Persistent vaginal bleeding. If your periods are heavy, not regular, or last for many days each cycle and nonsurgical methods have not helped to control bleeding, a hysterectomy will bring relief.
- Chronic pelvic pain. Surgery is a last resort for women who have chronic pelvic pain that clearly comes from the uterus. However, many forms of pelvic pain aren't cured by a hysterectomy, and so this approach can be a permanent mistake.
If you have fibroids, endometriosis or uterine prolapsed there may be other treatments to try prior to having a hysterectomy. Talk to your doctor. Other treatments include:
- Drug therapy. Certain medications may lighten heavy uterine bleeding or correct uterine bleeding that is not regular. Certain medications can help with endometriosis.
- Endometrial ablation. If you have heavy or irregular uterine bleeding, this procedure might ease your symptoms. With a special device, a doctor uses electricity, heat, or cold to destroy the lining of your uterus and stop uterine bleeding.
- Uterine artery embolization. For treating fibroids, this procedure involves blocking the blood supply to the tumors. Without blood, the fibroids shrink over time, which can reduce pain and heavy bleeding.
- Myomectomy. If you have fibroid tumors, this surgical procedure removes the tumors while leaving your uterus intact. There's a risk that the tumors could come back.
- Vaginal pessary. This is an object inserted into the vagina to hold the uterus in place. It may be used as a temporary or permanent form of treatment. Vaginal pessaries come in many shapes and sizes, and they must be fitted for each woman individually.
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Endometriosis
Understanding Endometriosis
Many women suffer from endometriosis, a disorder in which tissue resembling the inner lining of the uterus (the endometrium) appears at unusual locations outside the uterus. Endometrial tissues outside the uterus respond to hormones like the endometrium does. During the menstrual cycle, hormones signal the lining of the uterus to grow and thicken to prepare for pregnancy. If there is no pregnancy, hormone levels decrease and cause the endometrium to break down. These hormones may cause the tissue growing outside the uterus to break down and bleed causing mild to severe pain. Scar tissue may grow around the area contributing to infertility. There are several treatments for endometriosis that include, hormone therapy, medication for relief of pain and surgery to remove the scar tissue. When endometriosis is so severe or recurs, the patient may need to consider a hysterectomy and oophoredomy (removal of the ovaries, fallopian tubes and uterus.) Remember, if one therapy does not work, another can be tried. Symptoms of endometriosis almost always disappear completely with menopause or if the ovaries are removed. If surgery is needed, talk with your doctor before the operation. Be sure that you understand what is involved.
Chronic Pelvic Pain (CPP)
Chronic Pelvic Pain (CPP) is very common in women. However, the reason for the pain is often hard to identify. The source of this pain may be a condition known as Interstitial Cystitis (IC). IC is a chronic bladder condition that is difficult to diagnose. It is usually associated with pain in the lower abdomen, pelvic area, or thighs and is easy to confuse with other medical conditions, such as urinary tract infections and endometriosis. Do you experience:
- Sudden urges to use the bathroom?
- Frequent trips to the bathroom during the day or night?
- Chronic pain in bladder, pelvis, and/or vaginal area, or lower stomach region?
- Frequent urinary tract infections?
If you experience any of the symptoms above, you may have IC.
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Menopause
Menopause affects all women. It marks the end of a woman’s reproductive period and is a term that describes the changes a woman experiences just before or after she stops menstruating. Menopause is caused by the ovaries halting production of an egg every month and menstruation stopping. This typically occurs naturally after the age of 40 years old.
Symptoms may include:
- Irregular periods
- Hot flashes
- Night sweats
- Sleep difficulties
- Irritability
Natural menopause occurs in three stages:
- Perimenopause – Ovaries gradually produce less estrogen and lasts up until Menopause (the point when eggs are no longer released.)
- Menopause – the last menstrual period.
- Postmenopause – the years following menopause where symptoms begin to ease. Health risks need to be monitored due to the loss of estrogen.
Barrington Health Care for Women has been helping women manage menopause for over 35 years. Contact us today so that we can help with this stage of your life.
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Premenstrual Syndrome (PMS) / PMDD
PMS is a group of symptoms associated with the menstrual cycle. It typically occurs a week prior to menstruation (monthly shedding of the uterine lining commonly known as bleeding.) PMS affects menstruating women of all ages and is thought to be linked to hormonal changes.
If you feel your premenstrual syndrome is atypical and requires attention, please make an appointment with one of our physicians. Otherwise, here are a few lifestyle changes you can make to possibly ease some of the symptoms of PMS:
- Take a multivitamin with folic acid and vitamin D
- Exercise regularly
- Eat healthy (fruits, vegetables and whole grains)
- Avoid smoking, alcohol, salt, caffeine and sugary foods
- Get enough sleep
Premenstrual Dysphoric Disorder (PMDD)
PMDD is a condition associated with severe emotional and physical problems closely linked to the menstrual cycle. Many consider PMDD to be a severe form of PMS (although they are not the same.) PMDD is very disruptive to a woman’s life and typically occur after ovulation and gets worse before menses. Talk to your doctor about the symptoms of PMDD as a combination of severe symptoms is descriptive of this disorder.
There are prescription medications to help treat PMDD as well as non-prescriptive means.
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Urinary Continence / Bladder
Incontinence is defined as the involuntary loss of urine, severe enough to constitute a social or hygienic problem. While it is not life threatening, it can significantly effect quality of life when patients start avoiding activities such as exercise or social events. If you answer yes to any of the following questions you may be suffering from a form of urinary incontinence:
- “Do you have trouble leaking urine when you cough, sneeze or exercise?”
- “Do you have a severe urge to void?”
- “Do you leak before you can actually make it to the bathroom?”
- “When you go shopping, do you know where all the bathrooms are in the shopping mall?”
Urinary incontinence is very common, affecting nearly 13 million Americans. Approximately 10-35% of adults are incontinent. Women are more 2-3 times more likely to be incontinent than men. Childbirth, menopause, obesity, and smoking are risk factors. Caucasians are affected most, followed by Asians and Latin Americans, with African Americans with the least risk. People with certain conditions are also at increased risk including those with spinal cord injuries, history of stroke, multiple sclerosis or diabetes. Other factors that may worsen the condition, include certain medications and dietary habits, especially the intake of caffeine.
Two types of incontinence exist. Stress urinary incontinence occurs when involuntary leakage occurs with effort or exertion such as sneezing or coughing. Urinary urge incontinence is involuntary leakage accompanied or immediately preceded by urgency. However, both of these types can co-exist in mixed urinary incontinence.
Symptoms Include:
- Frequent urination
- Uncontrollable urge
- Leakage when coughing or sneezing
- Leakage when lifting
- Getting up often at night to empty bladder
If you do suffer from any of the above symptoms, a visit to your physician can help improve your quality of life. First, a thorough review of one’s medical history, medications, previous surgeries, and diet will be performed. Then, an overall physical exam will help uncover any underlying medical diseases. Studies can be performed which can also rule out a urinary tract infection or stone. A voiding dairy is also useful to determine timing and frequency of bathroom activity and urinary leakage, in addition to quantity and types of intake. Urodynamic studies may then be recommended for studying the performance of the bladder.
When diagnosis of urinary incontinence is made, there are many non-surgical modalities for its treatment. First, includes adjusting one’s diet that would include a moderate intake of fluids and a decrease of caffeine intake. Kegel exercises are useful in strengthening pelvic floor muscles. Biofeedback and physical therapy are more directed methods at identifying and strengthening pelvic floor muscles. Pessaries, which mechanically correct bladder leakage, are also available. Also, depending on the type of incontinence, various types of medications are available that can alleviate the symptoms of urinary incontinence. Stress urinary incontinence may also be surgically corrected with an outpatient procedure such as a urethral sling.
So with the various non-surgical modalities for treatment of urinary incontinence available, anyone should feel comfortable discussing symptoms with their physicians so that proper treatment can be initiated and life can be enjoyed to its fullest.
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Osteoporosis Diagnosis and Management
Osteoporosis is the loss of both calcium for strength and matrix for support in the bones. The bones become too fragile to withstand ordinary stresses, and a fracture typically results. Medical research shows that bone loss begins as early as twenty years of age and is three times greater in women than in men. It is estimated that over 25 million people in our country are afflicted – most of whom are women. In fact, osteoporosis affects half of all women over the age of forty-five, and 90 percent of women over age seventy-five. BHCW provides state-of-the-art technology for early diagnosis with the assistance of the Dexa-Scanner that monitors bone density. Early diagnosis means early intervention.
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Contraceptive Counseling
Barrington Health Care for Women can provide a variety of contraception options depending on your personal need and health. After an initial consultation, we can discuss options including abstinence, long-term reversible contraception, or permanent solutions such as essure or tubal ligation.
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da Vinci
Robotic-Assisted Surgery for Benign Gynecologic Conditions
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, 8-12 mm 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.
Learn more about da Vinci
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