gynecologyAnnual Well Woman Exam

 

 

 

 

 

 

 

  • Pelvic and breast exam
  • Thin Prep Pap smears for those > 21 years old
  • Human Papillomavirus (HPV) screening, if > 21 yrs old
  • Blood pressure check
  • Height/Weight measurement
  • Urine screening CBC (complete blood count) and TSH (thyroid screen) may be requested with your annual well-woman exam
  • Cholesterol screening every 3-5 years

These are other tests or guidelines we recommend for your age group:

  • Monthly self breast exam
  • Gonorrhea/Chlamydia Cultures, if more than one sexual partner in the last year.
  • 1,200 mg of Calcium and 1000 IU of Vitamin D daily
  • Annual dental exam

Recommended Immunizations:

  • Tdap (tetanus, diphtheria, pertussis) once during adulthood, ages 18-64;
  • tetanus booster q 10 yrs
  • Hepatitis B series, if sexually active or high-risk
  • Hepatitis A, if high risk
  • Seasonal Influenza vaccination, if desired or at risk
  • Cervical cancer vaccine, up to 26 years of age

  • Pelvic and breast exam
  • Thin Prep Pap smear with HPV screening
  • Blood pressure check
  • Height/Weight measurement
  • Urine screening
  • Cholesterol screening every 3-5 years
  • CBC (complete blood count) and TSH (thyroid screen) may be requested with your annual well-woman exam
  • Screening for blood in stool, if positive family history of colon cancer

These are other tests or guidelines we recommend for your age group:

  • Monthly self breast exams
  • Screening mammogram between ages 35-40, then yearly mammograms from age 40 and on
  • Gonorrhea/Chlamydia Cultures if > 1 partner in last year
  • Sexually Transmitted Disease (STD) tests, including HIV; both partners, before initiating sexual activity
  • Calcium 1200mg and Vitamin D 1000 IU daily
  • Bone Density screening every 2 years if at risk
  • Fasting blood sugar, if obese or positive family history
  • Monthly mole self-exam; by an MD every 3 years
  • Annual dental exam

Recommended Immunizations:

  • Tdap (tetanus, diphtheria, pertussis) once during adulthood, ages 18-64;
  • tetanus booster q 10 years
  • Hepatitis B series, if sexually active or high-risk
  • Hepatitis A, if high risk
  • Seasonal Influenza vaccine, if desired or high risk
  • Pelvic and breast exam
  • Thin Prep Pap smear with HPV screening
  • Blood pressure check
  • Height/Weight Measurement
  • Urine Screening CBC, Thyroid screen, and cholesterol may be requested with your annual well-woman exam
  • Screening for blood in stool

These are other test or guidelines we recommend for your age group:

  • Monthly self breast exams
  • Annual mammograms
  • Consider hormone replacement therapy (HRT), if symptomatic
  • Gonorrhea/Chlamydia Cultures, if > 1 partner in last year
  • Sexually Transmitted Disease (STD) tests, including HIV; both partners, before initiating sexual activity
  • 1500 mg of Calcium and 1000 IU of Vitamin D daily Fish Oil / Omega 3 Fatty Acids ( DHA);
  • One capsule daily Antioxidant vitamins and low dose (81mg) enteric coated aspirin for cardiovascular health
  • Bone Density screening every 2 years, if at risk
  • Colonoscopy
  • Fasting blood sugar screening
  • Monthly mole self-exam; by an MD every 3 years
  • Glaucoma and vision checks every 2-4 years with ophthalmologist
  • Annual dental exam

Recommended Immunizations:

  • Tdap (tetanus, pertussis, diphtheria) once during adulthood, ages 18-64;
  • tetanus booster q 10 years
  • Pneumovax at age 65, or sooner if at risk
  • Seasonal Influenza vaccination
  • Hepatitis B series, if sexually active or high-risk
  • Hepatitis A, if high risk
  • Herpes Zoster, if greater than 60 or desired
  • Pelvic and breast exams
  • Thin Prep Pap smear
  • Blood pressure check
  • Height/Weight measurement
  • Urine Screen CBC, thyroid screen, and cholesterol may be requested for your annual well-woman exam
  • Screening for blood in stool

These are other test or guidelines we recommend for your age group:

  1. Monthly self breast exams
  2. Annual mammograms
  3. HIV, if multiple sexual partners in recent years
  4. Calcium 1500 mg and Vitamin D 800 IU daily (through diet and vitamin supplements)
  5. Antioxidant vitamins and low dose (81mg) enteric coated aspirin for cardiovascular health
  6. Fish Oil / Omega 3 Fatty Acids (DHA); one capsule daily
  7. Bone Density Screening every 2-3 years
  8. Colonoscopy
  9. Fasting blood sugar screening
  10. Monthly mole self-exam; by an MD every 3 years
  11. Vision and hearing checks every 1-2 years with ophthalmologist and audiologist
  12. Annual dental exam

Recommended Immunizations:

  • Tetanus booster q 10 years
  • Seasonal Influenza vaccine
  • Herpes Zoster
  • Pneumovax at age 65, or sooner if at risk

 

Other Areas of Concern:

Metrorrhagia is a menstrual disorder that involves abnormal bleeding in between or unrelated to the menstrual period. This is often caused by a hormonal imbalance and results in light to heavy bleeding that may or may not be accompanied by menstrual cramps. Treatment for metrorrhagia depends on the cause of the condition, but may include hormone supplements, antibiotic medication, removal of an intrauterine device or surgery for cancer, polyps and other medical conditions.
An abnormal Pap smear doesn’t necessarily indicate a condition like HPV or cervical cancer. Pap smears are constructed to detect any changes within the cervical cells, and abnormal results may indicate other conditions such as inflammation, hyperkeratosis, or atypical squamous or glandular cells. False positives are also common from Pap smears, but we take every precaution we can to ensure your health.

Your doctor may perform a colposcopy after abnormal cells are found in order to examine the cervix more closely and take a biopsy of any abnormal tissues. Any necessary treatment will be performed after further examination.

Gynecological exams are valuable to adolescents in many ways. It is important for young women to be assessed early, especially if they are sexually active, and to begin a relationship with a doctor that may guide them through many important times in their lives. Our doctors promise special care and confidentiality to their younger patients.
Amenorrhea is a condition that involves the absence of menstrual periods. Some women may never start having a period, while others may stop suddenly. While amenorrhea is a symptom and not a disease, it can be worrisome for many women. But this condition can usually be treated by identifying and treating the underlying cause.
Perhaps the most effective form of breast cancer prevention is early detection and treatment. A breast self-exam should be performed every month to identify any changes or abnormalities. You should look and feel around your entire breast for any signs of a lump, swelling, irritation or pain. Any of these symptoms or other abnormalities should be discussed with your doctor immediately. It is recommended to perform monthly breast exams when you reach age 20. You should also schedule a breast exam with your doctor every 3 years. Women over 40 should have a clinical exam and mammogram every year. Those at a very high risk for breast cancer can also consider a mastectomy, the surgical removal of the breast, to prevent or greatly reduce the risk of breast cancer in the future. Talk to your doctor about other ways to reduce your potential risk for breast cancer.
Cervical dysplasia refers to abnormal cell growth on the outside of the cervix. While cervical dysplasia itself is not necessarily cancerous, it is considered precancerous. Cervical dysplasia usually appears with no noticeable symptoms, remaining unnoticed until a gynecological examination is done. Severe cases of cervical dysplasia may require cryosurgery, electrocauterization, or the LEEP procedure to remove the abnormal growth. Your gynecologist will develop a customized treatment plan based on your individual condition.

Choosing a method of contraception is an important decision that will impact a woman’s daily life. Talking with your doctor about which method is right for you is essential to successful protection for you and your partner. At Carlos & Parnell, M.D.  we will provide you with information about the different types of contraceptives and their respective advantages and disadvantages.

Birth control methods have many different variable factors including frequency, convenience, permanence and effectiveness. It is important to take into consideration your life, age, health and previous experiences. The decision is ultimately yours, but using our knowledge and experience can help you make the right choice.

Contraception is the strongest protection available for women who wish to have protected sex and are not looking to get pregnant. There are many contraception options available for women depending on their age, overall health and life . These options can be permanent or temporary and may be needed every time you have sex, every day, or just once. Some of these options are more effective than others, but it is up to you to decide which one is best for you.
Dysfunctional uterine bleeding (DUB) is abnormal bleeding that typically occurs at the beginning and end of the reproductive years because of hormone changes. DUB often occurs as a result of high estrogen levels that are not balanced by an appropriate level of progesterone. This stops an egg from being released and thickens the uterine lining, causing it to shed irregularly.

Dysfunctional uterine bleeding occurs most often in women over the age of 45, as well as in many adolescent girls. It is classified as periods that occur more often than every 21 days or fewer than every 35 days, last more than 7 days and are heavier than normal.

Your doctor will rule out any other causes of abnormal bleeding in order to diagnose dysfunctional uterine bleeding. Treatment for DUB depends on your age, severity of bleeding and whether or not you wish to become pregnant. The treatment options may include oral contraceptives, medication to stimulate ovulation, dilation and curettage or even a hysterectomy.

Dysmenorrhea is a menstrual disorder that involves painful cramps with or without an underlying gynecological disorder. Over 50 percent of women with a menstrual period suffer from primary dysmenorrhea, which has no underlying cause and is part of the regular menstrual cycle for many. Secondary dysmenorrhea only affects about 25 percent of women with dysmenorrhea symptoms, and is a result of conditions such as endometriosis or uterine fibroids. Primary dysmenorrhea can usually be treated with anti-inflammatory drugs such as aspirin or ibuprofen to help lessen the contractions of the uterus and reduce symptoms.
Endometriosis is a medical condition in women in which the uterine lining (endometrium) moves out of the uterus and into other parts of the pelvic area such as the ovaries, bowels or behind the uterus. This condition affects about five million women in the US and is one of the most common health problems. It is generally not a serious or harmful condition, but can be painful and may interfere with your daily life. Endometriosis can be diagnosed through an ultrasound or MRI. There is no cure for the disease, but symptoms can be treated depending on their type and severity. Talk to your doctor today if you think you may be experiencing endometriosis.
Human Papillomavirus (HPV) is a type of virus that causes genital warts. There are more than 100 different kinds of HPV and some of they may create a higher risk for cancer. While some types can cause genital warts, others will show no symptoms but will eventually lead to cancers of the cervix, vulva, vagina and anus. The virus is contracted through sexual contact. The risk of catching HPV can be reduced by latex condoms.   Carlos & Parnell offers the HPV vaccine, Gardasil, to our patients.

While there is no cure for HPV, treatment for the symptoms caused by HPV, such as genital warts, cervical changes and cervical cancer is available.

Many women going through menopause suffer from a wide range of symptoms including irregular bleeding, hot flashes, insomnia, night sweats, fatigue, depression and more. There are several treatment options available to help relieve these symptoms, and our doctors can work with you to help you decide which option is best for you.

Prescription medication with estrogen and progesterone, known as hormone replacement therapy, is a popular treatment for women to treat symptoms of menopause and reduce the risk of osteoporosis. Patients can also seek treatment for their individual symptoms, and should maintain an active and healthy life to help feel their best.

Heavy menstrual bleeding is a common problem that most women experience at some point in their life. Excessive menstrual bleeding on a regular basis is classified as a condition called menorrhagia, which can cause troubling symptoms. If conservative methods are unsuccessful, surgery may be required to treat menorrhagia, including dilation and curettage, endometrial ablation and hysterectomy. With the proper support, most women can control the symptoms of menorrhagia without the need for surgery.
Genital herpes is a sexually transmitted disease that affects up to one out of every five adolescents and adults in the US. Patients may acquire herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2), most often as a result of sexual contact with a partner who is infected.

Most patients affected with genital herpes experience little to no symptoms from this condition. When symptoms do occur, they often involve one or more blisters on or around the genital area. These outbreaks usually come and go over the course of many months or years, but the infection remains present in the body. Sores can also appear on the mouth or lips in patients with HSV-1, usually as a result of mouth-to-genital contact.

While there is no treatment currently available to cure genital herpes, antiviral medications can often help shorten and prevent outbreaks from occurring. Patients with regular symptoms from herpes may benefit from daily suppressive therapy to reduce their risk of spreading the infection to their sexual partner.

As you get older, your body slowly ceases to produce estrogen and progesterone, two hormones that thicken the uterus to prepare for implantation of a fertilized egg. However, these hormones also protect the body from developing uterine cancer and osteoporosis. The decrease is also responsible for many symptoms of menopause.

Since these hormones are valuable to our health, many women choose to replace them through a pill, patch or cream and retain the benefits that they produce through hormone replacement therapy (HRT). Estrogen by itself helps to relieve menopause symptoms and prevent osteoporosis. When taken with progesterone, the combination therapy allows the uterine lining to shed each month without the regular bleeding. Since there are risks associated with HRT, it is important to take the lowest dosage possible and reevaluate your therapy each year. Your doctor can help you decide which, if any, type of HRT is right for you.

Menstrual disorders can turn your monthly period from a minor hassle to a major, debilitating inconvenience. These disorders can cause physical and emotional symptoms and can severely disrupt your daily life for days or weeks at a time. Menstrual cycle disorders can cause symptoms like:
  • Heaving bleeding
  • Abdominal pain
  • Nausea and vomiting
  • Missed periods
  • Mood swings

These symptoms are characteristic of several different menstrual disorders including abnormal uterine bleeding, amenorrhea, fibroids, dysmenorrhea, PMS and PMDD. While these disorders are not usually serious, they are often very painful. Fortunately, treatment methods, from over-the-counter medications to a hysterectomy, are usually successful in relieving these symptoms to make that time of the month a little less dreadful.

An ovarian cyst is a fluid-filled sac found on the ovaries. These sacs can cause pressure, swelling and pain in the abdomen in some women, while others may experience no symptoms at all. Many cysts disappear on their own, but some require surgery. Surgery for ovarian cysts may be recommended if:

  • Cysts are present in both ovaries
  • A cyst is larger than three inches
  • You have already been through menopause
  • A cyst is not a simple functional cyst

Surgery can be used to both diagnose and treat ovarian cysts in the same procedure. Smaller cysts can often be examined and removed through laparoscopy, a minimally invasive procedure that uses a lighted tube and tiny instruments to remove the cyst. The cyst may be removed, or a biopsy sample can be taken. Larger cysts may require tradition “open” surgery, called a laparotomy. This procedure requires a bigger incision and may remove the cyst or the entire affected ovary and fallopian tube.

Painful intercourse, also known as dyspareunia, is a common condition experienced by many women, which may be caused by an underlying condition. Pain during sex may be a result of injury, inflammation, skin disorders, recent trauma, certain conditions, or from stress or psychological factors. In order to determine the cause of pain during intercourse, your doctor will evaluate your medical history and perform a pelvic exam to detect any skin irritation, infections or structural abnormalities that may indicate problems.

Pelvic inflammatory disease (PID) is an infection of the reproductive organs in women usually caused by the same sexually transmitted bacteria that causes gonorrhea and chlamydia. PID spreads from the vagina to the uterus, ovaries and fallopian tubes and can lead to infertility or complications during pregnancy.

PID is almost always accompanied by a sexually transmitted disease and can develop after having unprotected sex, especially with more than one partner. Bacteria can sometimes enter the vagina from inserting an IUD, childbirth, miscarriage or abortion. Women under the age of 25 are most often affected. Most cases of PID can be treated with antibiotics. More severe cases may require hospitalization or even surgery. PID can often be prevented by practicing safe sex.

Chronic female pelvic pain is classified as pain below the belly button lasting longer than 6 months. The pain can range from mild to severe, dull to sharp and may come and go or be constant. It is usually a symptom of another condition. Pelvic pain can be a result of several different causes, many of which can be successfully treated.
Polycystic ovary syndrome (PCOS) is a common condition that involves enlarged ovaries that may contain many cysts and produce high levels of male hormones. This condition affects one in every ten women in the US and is the leading cause of infertility in women. The specific cause of PCOS is not known, but it involves an interruption in the reproductive cycle.
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are common conditions that up to three out of four women may experience at some point in their life. These conditions are associated with symptoms related to menstrual periods and can include bloating, cramping, fatigue, moodiness, sleep irregularity and depression. PMS is often expected by most women, but chronic symptoms and symptoms of PMDD can and should be treated professionally. There is no official diagnosis of these conditions, but if they are affecting your ability to function in your everyday life, they can be considered serious.
Most sexually transmitted diseases (STDs) have no symptoms, especially in women, so it is hard to know if you have been infected. Periodic testing is recommended for anyone with multiple sexual partners, even if they are having protected sex. Condoms are the only form of contraception that protects against STDs. It is important to communicate with your partner and ask them if they have or have ever had an STD. At Carlos & Parnell, M.D. we offer safe and confidential STD testing and treatment.

Fibroids, also known as myoma, are tumors that grow in the uterine walls. They are usually benign but can range in size and quantity. Uterine fibroids are most common in women in their 40s and early 50s. The cause of fibroids is unknown, but they may be affected by hormones and genetics. Most fibroids do not turn into cancer, but can lead to pregnancy complications.

Treatment for these cases may include medication to relieve symptoms, or surgery for more severe cases. Surgeries can include a myomectomy to remove the fibroids or a hysterectomy to remove the uterus. Other treatment options are also available to keep symptoms at a minimum and preserve your overall health.

Vaginal discharge is a common substance excreted from the vagina during different stages of the menstrual cycle. The consistency of discharge can vary as your cycle progresses and is usually most abundant before ovulation, as well as while breastfeeding or when sexually aroused. Vaginal discharge is considered normal for most women, especially those of childbearing age. Normal discharge is usually clear or white and odorless.

It is important to note any changes to vaginal discharge, as this may indicate an infection or other type of problem. Changes such as an increase in amount of discharge; different color or smell; or irritation, itchiness or burning around the vagina could be signs of a problem. If you are experiencing any of these signs, talk to your doctor as soon as possible.

Bacterial vaginosis (BV) is an infection of the vagina in which the balance of bacteria is disrupted and there is more harmful bacteria present than beneficial bacteria. BV is the most common vaginal infection in women of childbearing age, and is also common in pregnant women.
Vulvodynia is classified as chronic vulvar pain or discomfort, including burning, stinging, irritation or rawness of the female genitalia. The word “vulvodynia” actually means “painful vulva.” This condition can severely impact the quality of life for affected women and may prohibit participation in sexual activity, physical exercise and even social activities. Treatment for vulvodynia does not cure the condition, but instead helps to relieve symptoms.
A vaginal yeast infection is a common condition that affects over 75 percent of women at least once in their life, caused by a fungus called Candida albicans. While this type of fungus exists naturally in the vagina, too much of it can cause a vaginal infection. A yeast infection causes itching, burning, redness and irritation in the vaginal area, as well as a white discharge that looks similar to cottage cheese and pain during sexual intercourse.