Gynecology Services
We are here to help guide you through the changing care your body requires over the course of your life (from puberty to menopause and beyond). We offer various types of gynecological exams, as well as many other services. Please learn more below about these services below.
Having an annual pelvic exam or women’s wellness exam is a fundamental part of medical care and is valuable in promoting prevention practices, recognizing risk factors for disease, identifying medical problems, and establishing the clinician–patient relationship.
Components of the annual pelvic exam, include checks of the vulva, vagina, cervix, uterus, rectum and pelvis, and may identify masses, growths or other abnormalities. A Pap test, which screens for cervical cancer, is also performed during a pelvic exam.
The components of your annual examination may vary depending on your age, risk factors and physician preference.
The American College of Obstetricians and Gynecologists states annual pelvic examination of patients 21 years of age or older is recommended. For patients under 21 years it is currently recommended that it take place during the first visit to the obstetrician–gynecologist for screening and the provision of preventive services and guidance take place between the ages of 13 years and 15 years. This visit generally does not include pelvic examination.
Frequency and depth of breast examinations will be determined through shared communication with your physician. At this time, no data exist regarding the ideal age at which to begin clinical breast examinations in the asymptomatic, low-risk patient.
Expert opinion suggests that the value of clinical breast examination and the ideal time to start such examinations is influenced by the patient’s age and known risk factors for breast cancer. The occurrence of breast cancer is rare before age 20 years and uncommon before age 30 years. Based on available evidence, the College, the American Cancer Society (ACS), and the National Comprehensive Cancer Network recommend that clinical breast examination be performed annually in women aged 40 years and older. Although the value of a screening clinical breast examination for women with a low prevalence of breast cancer (eg, women aged 20–39 years) is not clear, the College, ACS, and the National Comprehensive Cancer Network continue to recommend clinical breast examination for these women every 1–3 years.
All three organizations also recommend the teaching of breast self-awareness and inquiry into medical history and family history of risk factors for breast disease. Breast self-awareness educates patients about the normal feel and appearance of their breasts. For many patients, breast self-awareness also may include performing breast self-examinations. Both methods have the potential to alert the patient to changes in her breast that should be reported immediately to her physician and may lead to earlier detection of breast cancer.
Accredited by the American College of Radiology
Mammography is the primary tool for breast cancer screening, and the roles of the clinical breast examinations and breast self-examinations have been questioned by some experts. The 2009 U.S. Preventive Services Task Force report on breast cancer screening states that “current evidence is insufficient to assess the additional benefits and harms of clinical breast examinations beyond screening mammography in women 40 years and older”. The data evaluated by the U.S. Preventive Services Task Force in its 2009 recommendation suggest that teaching breast self-examination does not reduce the mortality rate of breast cancer and it recommends against clinicians teaching women how to perform breast self-examination. However, 8–17% of cases of breast cancer are missed by mammography.
The clinical breast examination and breast self-awareness, which may include breast self-examination, have the potential to detect a palpable cancer. Some studies show that clinical breast examination and mammography together have a better sensitivity than mammographic screening alone for detecting breast cancer). Thus, a breast examination and mammography performed by your physician still is recommended as part of the periodic health examination of women, especially those with known risk factors for breast cancer. See us for your mammogram once per year if you have a previous family history or are above age 45. Breast care guidelines change frequently, so speak with your physician about when you need to get your mammogram.
An annual visit with your obstetrician/gynecologist, provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks. The annual health assessment should include screening, evaluation and counseling, and immunizations based on age and risk factors. The interval for specific individual services and the scope of services provided may vary in different ambulatory care settings. The performance of a physical examination is a key part of an annual visit, and the components of that examination may vary depending on the patient’s age, risk factors, and physician preference. Speak with your physician about what elements of the annual exam make sense for your health.
BONE DENSITY STUDIES
A bone density test is the only test that can diagnose osteoporosis before a broken bone occurs. This test helps to estimate the density of your bones and your chance of breaking a bone. NOF recommends a bone density test of the hip and spine by a central DXA machine to diagnose osteoporosis. DXA stands for dual energy x-ray absorptiometry.
You can find out whether you have osteoporosis or if you should be concerned about your bones by getting a bone density test. Some people also call it a bone mass measurement test. This test uses a machine to measure your bone density. It estimates the amount of bone in your hip, spine and sometimes other bones. Your test result will help your healthcare provider make recommendations to help you protect your bones.
Are you a postmenopausal woman or man age 50 and older? Have you recently broken a bone? If you answered “yes” to both questions, you should talk to your doctor or other healthcare provider about getting a bone density test if you’ve never had one.
A bone density test tells you if you have normal bone density, low bone density (osteopenia) or osteoporosis. It is the only test that can diagnose osteoporosis. The lower your bone density, the greater your risk of breaking a bone. A bone density test can help you and your healthcare provider:
- learn if you have weak bones or osteoporosis before you break a bone
- predict your chance of breaking a bone in the future
- see if your bone density is improving, getting worse or staying the same
- find out how well an osteoporosis medicine is working
- let you know if you have osteoporosis after you break a bone
IN-OFFICE SONOGRAMS AND ULTRASOUNDS
An ultrasound exam is a procedure that uses high-frequency sound waves to scan a woman’s abdomen and pelvic cavity, creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam.
TRANSVAGINAL SCANS
– Specially designed probes are used inside the vagina to generate sonogram images. Most often used during the early stages of pregnancy.
ADVANCED ULTRASOUND
– This exam is similar to the standard ultrasound, but the exam targets a suspected problem and uses more sophisticated equipment.
DOPPLER ULTRASOUND
– This imaging procedure measures slight changes in the frequency of the ultrasound waves as they bounce off moving objects, such as blood cells.
FETAL ECHOCARDIOGRAPHY
– Uses ultrasound waves to assess the baby’s heart anatomy and function. This is used to help assess suspected congenital heart defects.
STANDARD ULTRASOUND
– Traditional ultrasound exam which uses a transducer over the abdomen to generate 2-D images of the developing fetus .
4-D OR DYNAMIC 3-D ULTRASOUND
– Uses specially designed scanners to look at the face and movements of the baby prior to delivery.
3-D ULTRASOUND
– Uses specially designed probes and software to generate 3-D images of the developing fetus.
HOW IS AN ULTRASOUND PERFORMED?
The traditional ultrasound procedure involves placing gel on your abdomen to work as a conductor for the sound waves. Your healthcare provider uses a transducer to produce sound waves into the uterus. The sound waves bounce off bones and tissue returning back to the transducer to generate black and white images of the fetus.
WHEN ARE ULTRASOUNDS PERFORMED?
Ultrasounds may be performed at any point during pregnancy, and the results are seen immediately on a monitor during the procedure. Transvaginal scans may be used early in pregnancy to diagnose potential ectopic or molar pregnancies.
There is not a recommended number of ultrasounds that should be performed during routine prenatal care. Because ultrasound should only be used when medically indicated, many healthy pregnancies will not require ultrasound. The average number of ultrasounds varies with each healthcare provider.
Additional ultrasounds might be ordered separately if your healthcare provider suspects a complication or problem related to your pregnancy.