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Gynecology FAQs

When should I have my first pap smear?

We follow the ACOG (The American Congress of Obstetricians and Gynecologists) recommendations when deciding at what age to perform a pap smear. Currently the recommendations are to have your first pap smear at the age of 21.

How often do I need a gyn exam and pap smear?

The majority of women will need a yearly gyn exam and pap smear, especially if you are sexually active with more than one partner, or having any gyn problems. Pap smears may be recommended more frequently if they are abnormal. If you are postmenopausal and have a normal pap history, spacing out your pap smears to every two years may be recommended. However, you will still need a yearly gyn visit with a breast and pelvic exam.

What if my pap smear is abnormal?

If your pap smear comes back abnormal, you will be contacted by phone to be informed of the results and discuss the recommendations for follow-up. Follow-up may be as simple as a repeat pap smear in 4-6 months, or may involve an in office procedure called a colposcopy.

What is a colposcopy?

Colposcopy is done when a pap smear shows abnormal changes in the cells of the cervix. It’s a way of looking at the cervix through a special magnifying device called a colposcope, which allows problems that can not be seen by the eye alone to be identified. If any abnormal areas are seen during the procedure, a biopsy of the area may be taken and sent to the lab for further evaluation.

Do I need to be screened for Sexually Transmitted Diseases (STD's)?

Screening is recommended for all women who have been sexually active with more than one partner. However, screening is not a routine part of your yearly exam. If you are unsure if you need screening, please discuss your concerns at your appointment. Contact the office at any time if you are worried you may have been exposed or are showing symptoms of an STD.

What is HPV?

HPV is a very common virus that affects approximately 75% of all sexually active people at some time in their lives. HPV is primarily spread through sexual contact, but can also be spread by skin-to-skin contact. There are two types of HPV, high risk and low risk.

High risk HPV causes abnormal cells on the cervix, which can lead to cervical cancer.Low risk HPV can cause genital warts, and has not been linked to cancer.There is no medical cure for HPV, however, women can minimize their risks of becoming infected by limiting their number of sexual partners.

What is abnormal uterine bleeding?

Abnormal uterine bleeding is one of the most common reasons women see their doctors. It can occur at any age and can have many different causes. It can be defined as bleeding after intercourse, bleeding between periods, bleeding that lasts longer than 10 days, bleeding that is heavy enough to saturate a super pad or tampon sooner than every hour, or bleeding after menopause. Menstrual cycles that are longer than 35 days or shorter than 21 days are also abnormal.

What causes abnormal bleeding?

Abnormal bleeding can have many causes. It is important to first check for problems that are most common in your age group. Many causes are not serious and are easy to treat, while others can be more challenging. Some common causes of abnormal bleeding include pregnancy, miscarriage, ectopic pregnancy, problems with birth control, hormonal imbalances, infections, uterine fibroids or polyps, clotting disorders, thyroid disorders, diabetes, and certain types of cancers, such as uterine, cervical or vaginal cancer.

What can I do for menstrual cramps?

The first recommendation may be over the counter products that contain Ibuprofen (Motrin) or Naproxen (Aleve) for the relief of menstrual cramping. For best relief, start taking Motrin or Aleve at regular intervals the day before your period starts. Soaking in a warm bath or applying a heating pack to your abdomen can also be very effective. Some research has shown that increasing your daily calcium intake to 1500mg can improve menstrual cramping as well. If you continue to have severe cramping after trying the above recommendations, call the office for an appointment to discuss other treatment options.

What can I do about urinary leakage?

Please contact the office for an appointment.

Urinary leakage is also know as urinary incontinence and is a common problem for many women. Incontinence can present itself in several different forms, such as stress incontinence, which occurs when a woman coughs, sneezes, laughs, or during exercise. Urge incontinence, otherwise know as overactive bladder, is when a woman suddenly has an urge to urinate and leaks urine before she can get to the bathroom. Mixed incontinence is when a woman has symptoms of both stress and urge incontinence.
Often times women are too embarrassed to discuss their symptoms, however, with a proper diagnosis, urinary incontinence can most often be treated. Most of the treatments you can do at home revolve around lifestyle changes, such as avoiding caffeine, which acts as a diuretic, losing weight, avoiding constipation, limiting the amount of water you drink in the evening, and smoking cessation. Please contact our office for an appointment if you are having any problems with your bladder. Sometimes urinary leakage can be caused by something as simple as a bladder infection, which can be easily diagnosed and treated.

When should I start getting mammograms?

Most women should begin having yearly screening mammograms at age 40. However, if you have any risk factors, such as a family history of breast cancer, having a baseline mammogram done earlier than age 40 may be recommended.

Most insurance companies will cover a one time screening mammogram between the ages of 35-40 if risk factors are present. You probably should contact your insurance company regarding coverage before your appointment, especially if you are over the age of 35.

What is Osteopenia?

Osteopenia refers to bone mineral density (BMD) that is lower than normal, but not low enough to be classified as Osteoporosis. Bone mineral density is a measurement of the minerals in the bones, which indicate how dense and strong they are. Having Osteopenia puts you at a greater risk for developing Osteoporosis.

What is Osteoporosis?

Osteoporosis occurs when more of your bone is lost than formed, which causes your bones to become thin and brittle. There are two types of bone, compact bone and spongy bone. Compact bone looks solid and hard and is found on the outer part of the bones, while spongy bone is filled with holes (just like a sponge) and is found on the inside of the bones. With osteoporosis, the bones remain the same size, but the outside walls of the compact bone become thinner and the holes in the spongy bone become larger. The combination of these two changes drastically weakens the bone and puts you at a greater risk for fractures.

What is a bone density scan?

A bone density scan is a safe, painless test that determines whether or not you have osteopenia or osteoporosis. It also measures your rate of bone loss and your risk of a future fracture. The most accurate test available is called a DEXA scan. During this scan, you will be asked to lie down for 3-10 minutes while an arm like device (an imager) scans your body.

Who needs bone density testing?

Most women should begin having DEXA scans at age 50. However, there are some instances when women would need tested earlier than age 50, such as long term use of certain medications like prednisone or depo provera, history of a spinal fracture, or a history of certain thyroid disorders. If you are unsure if you should begin having routing DEXA scans, please discuss your concerns at your next visit. Since DEXA scans are considered a screening tool for osteoporosis, some insurances may not cover it or may only cover it if done at a specific facility. You should check with your insurance regarding your coverage before your appointment.

How often should I have a DEXA Scan?

DEXA scans should be done every 2 years unless otherwise recommended.

What can I do to prevent osteoporosis?

Try to pinpoint what triggers your hot flashes and avoid them if you can. For example, some women find that hot drinks like coffee and tea, alcoholic beverages, or spicy foods precipitate hot flashes. Try dressing in layers so you can remove a pieces of clothing when you feel a hot flash coming on. Keep your office and home thermostat low and keep a fan handy. Studies have shown that women who exercise regularly experience fewer and less intense hot flashes. If you have tried the recommendations listed above without improvement, call the office to schedule an appointment to discuss hormones or other therapies which can be prescribed.

What is perimenopause?

Perimenopause refers to the years leading up to menopause, and can last for a period of up to 10 years. On average, perimenopause begins in the mid-40’s and it’s during this time that the ovaries begin to produce less estrogen and you may start to experience hot flashes – the most common symptom of perimenopause. You may also begin noticing other changes, such as trouble sleeping, night sweats, irregular bleeding or spotting may occur, periods may be heavier or longer than normal some months, and may be shorter and lighter in other months, the number of days between periods may increase or decrease, and you may even start to skip periods. Some women may also experience a decreased libido, begin having mood swings or become more irritable than normal, experience memory lapses, or have trouble concentrating.

How do I know if I'm in menopause?

Menopause refers to the period in a woman’s life when the ovaries completely stop functioning and menstruation stops. If you have not had a period for 12 consecutive months, you are most likely in menopause.

What do hot flashes feel like?

Approximately 75-85% of perimenopausal women experience hot flashes. A hot flash is a sudden feeling of heat that spreads through the upper body and face. Your face may redden like a blush and you may break out in a sweat. They can last for a few seconds to several minutes, and at times, even longer. Some women experience a few hot flashes a month, while others will experience several per day.

What can I do to prevent hot flashes?

Try to pinpoint what triggers your hot flashes and avoid them if you can. For example, some women find that hot drinks like coffee and tea, alcoholic beverages, or spicy foods precipitate hot flashes. Try dressing in layers so you can remove a pieces of clothing when you feel a hot flash coming on. Keep your office and home thermostat low and keep a fan handy. Studies have shown that women who exercise regularly experience fewer and less intense hot flashes. If you have tried the recommendations listed above without improvement, call our office to schedule an appointment with to discuss hormones or other therapies we can prescribe.

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