Gynecological Problems

Heavy Periods / Abnormal Bleeding

If your periods last longer than 7 days or if your flow is heavy, making it difficult for you to maintain your regular lifestyle during your period, you should see your doctor. Most problems associated with abnormal bleeding are not serious and can be easily treated so you can return to your normal lifestyle. Others can be serious—like Ectopic pregnancy or certain types of cancer—and should be checked immediately.

About 1 in 5 women experience unusually heavy menstrual bleeding, also known as menorrhagia. Today there are more treatment options than ever before. Your doctor will discuss your symptoms, your diagnosis and the treatment options that are right for you. Here are some of the treatments associated with heavy periods and abnormal bleeding:

Hormone Therapy

Hormones are sometimes used to control some abnormal bleeding. The process may take a few months, and your periods may be heavier at first. However, they usually will lighten over time. Hormones can be given in different ways. Your doctor may prescribe birth control pills to help make your periods more regular. Hormones also can be given as an injection, as a vaginal cream, or through an IUD that releases hormones

Hysteroscopy

Hysteroscopy is a minor, in-office surgical procedure that is used for the diagnosis and treatment of uterine problems. During a hysteroscopy, a thin telescope-like device is inserted through the vagina and cervix to take a look inside the uterus.

Hysteroscopy is often used to
  • Determine and treat the causes of abnormal bleeding
  • Diagnose and treat abnormalities in the uterus that cause infertility
  • Diagnose and biopsy abnormal growths, fibroids and adhesions
Hysteroscopy can be performed with local, regional or general anesthesia. In most cases, your doctor can perform your hysteroscopy in the comfort and convenience of our offices.

Your doctor will discuss your situation and this convenient option during your appointment. Our office staff will be happy to answer any other questions you may have and to schedule your procedure.
Click here to contact us.

Dilation and Curettage (D&C)

A D&C is a minor surgical procedure that involves dilating the cervix and using an instrument to scrape the inside of the uterus.

A D&C can be used to diagnose and treat abnormal uterine bleeding or to treat fibroids or endometriosis. A sample of the tissue removed will be sent to the lab to check for abnormal cells.

Click here to contact us to schedule your appointment to discuss your options with one of our doctors.

Endometrial Ablation

NovaSure®
NovaSure is an endometrial ablation procedure that provides an effective and minimally invasive outpatient alternative to hysterectomy. It is not appropriate for abnormal uterine conditions and your Pap test and biopsy must be normal.

This simple, safe procedure for heavy menstrual bleeding requires no incision and can be performed in the comfort of our office. Unlike other endometrial ablation procedures, there is no need to take pre-treatment drugs to thin the uterus for months before the procedure, so you avoid the cost and potential side effects associated with those drugs.

During the NovaSure procedure,
  1. Your cervix is dilated slightly and a slender wand is inserted. This wand is used to extend a mesh device that gently expands to the dimensions of your uterine cavity.
  2. A safe, electrical energy is delivered through the mesh for approximately 90 seconds.
  3. The mesh is then retracted and the wand removed, so no part of the device remains in your body after the procedure.
For more information, click here to contact our office for an appointment to talk to your doctor. Before your office visit, you may want to visit www.novasure.com to learn more and to make a list of any questions that you may want to address during your appointment.

Hysterectomy

Nearly 1 in 3 women in the U.S. will have a hysterectomy before the age of 60. Fortunately, today’s woman has many more options than those available to her mother or grandmother.

Doctors Short, Strickland and Murphy have extensive experience in all methods of hysterectomy. They are leaders in our area in the use of robot-assisted surgery using the da Vinci Surgical System (to learn more about the da Vinci® surgical system click here). They are also skilled at more traditional approaches.

The chart below provides a brief comparison of the common types of hysterectomy and the techniques and recovery time associated with each

Type of ProcedureTechniqueApproximate Recovery Time
Standard abdominal hysterectomyMajor surgery, a 6 to 12 inch incision through the abdomen.6 weeks
Vaginal hysterectomyAppropriate for women with small fibroids, small uterus. Done entirely though the vagina.2 weeks
Laparoscopic hysterectomyInvolves small “keyhole” incisions, often through the navel.

A laparoscopic approach offers surgeons better visualization of affected structures than either vaginal or abdominal hysterectomy.
2 weeks or less
da Vinci® Surgical SystemAppropriate for a wide range of patients. Involves tiny, 1 to 2 centimeter incisions.

For most women, da Vinci® Hysterectomy offers numerous potential benefits over traditional open surgery, including
  • Minimal blood loss and need for transfusion
  • Fewer complications
  • Shorter hospital stay
  • Quicker recovery and return to normal activities
  • Small incisions for minimal scarring
  • Better outcomes and patient satisfaction, in many cases
2 weeks

Minimally Invasive Laparoscopic Hysterectomy

(Content Note: Does the daVinci tab cover this or do you do other kinds—if so, I need information to narrow the type)

da Vinci® Minimally Invasive Surgery

The da Vinci® Surgical System offers the most advanced, highly effective, minimally invasive treatment option for hysterectomy. Through tiny, 1-2 cm incisions, our doctors 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. For more information see http://www.davincihysterectomy.com/hysterectomy-options/index.aspx

Click here to contact our office to schedule an appointment to discuss your options and determine which type of hysterectomy is right for you.

Abnormal Pap Results

Colposcopy

Colposcopy provides a view of the vagina and cervix that can enlarge the normal view from 2 to 60 times, making it possible to detect problems that cannot be seen by the normal eye alone. Colposcopy is often done to learn more about abnormal cells that are detected by a Pap test.

During the colposcopy, a speculum—like the one used during your Pap test—is used to hold your vaginal walls apart and the colpscope is placed just outside your vagina. A mild solution is applied to your cervix and vagina to make it easier to see abnormal areas.

To make sure your doctor gets the best view during the test, you should not do any of the following for the 24 hours before your coloscopy
  • Douche
  • Use tampons
  • Use vaginal medications
  • Have sex
If your doctor detects an area that appears abnormal, she will remove a small piece of the tissue, a biopsy. This tissue will be sent to a lab for analysis. Click here to contact us to schedule your appointment.

Biopsy

A biopsy is a small sample of tissue that is removed and sent to an outside lab to be analysed for abnormal cells. We use Healthlab for our lab services. You will be responsible for any portion of the lab costs not covered by your insurance plan, so you should check with your insurance plan to see if Healthlab is an approved provider to know what expenses to expect. (Programmer’s note--do we need this as a menu item, or should it just be a background link that the person goes to when they click on the highlighted term in the areas that refer to it? Perhaps combined in a section under labs?)

Cryotherapy

Crytotherapy destroys abnormal cervical cells in the cervix (dysplasia) by freezing them. It is not appropriate for treatment of abnormal cells high in the cervical canal.

Typically, patients experience some discomfort, including a sensation of cold, some cramping, and sometimes a warmth that spread through the upper body and face.

The procedure can be done in our offices without the hassles of preregistration and parking that are associated with hospital procedures.

Click here to schedule your appointment to discuss LEEP and other alternatives to address your condition.

Loop Electrosurgical Excision Procedure (LEEP)

LEEP is an effective method for removing abnormal cervical cells in order to allow new, healthy cells to grow.

During LEEP, your doctor uses a thin wire loop as a “surgical knife.” This loop is inserted through your vagina, while a colposcopy magnifies the cervix to ensure exact placement. An electric current passing through the loop cuts away a thin layer of the surface cervical cells.

Typically, the procedure is done under local anesthesia, takes only a few minutes, and the risk of complications is low.

We perform LEEP in the comfort and convenience of our offices so you can avoid the hassles associated with a hospital procedure.

Click here to schedule your appointment to discuss LEEP and other alternatives to address your condition.

Pelvic Pain

If you suffer from pelvic pain, whether it comes and goes at different times in your menstral cycle or you experience it every day, you should see a doctor. There are many causes of Pelvic pain, so it can be hard to diagnose, but with a careful review of your symptoms and your medical history, we will be in a good position to offer treatment and relief. Here are some of the common causes of Pelvic pain

Uterine Fibroids

Uterine fibroids are non-cancerous growths that occur in 20-25% of all women. Fibroids can occur inside the uterus, on its outer surface, within the uterine wall, or attached to it by a stem-like structure.

Fibroids are most common in women aged 30-49, but they can occur at any age. They are more common in black women and tend to grow more quickly in blacks as well.

Although many uterine fibroids remain undetected because they are small or remain unseen, others cause problems because of their size, number and/or location. Like any growth, fibroids should be checked by a doctor. Symptoms of fibroids include
  • Changes in menstration—more bleeding, longer or more frequent periods, increased cramps
  • Pain—in the abdomen or lower back, often during sex
  • Pressure—with difficult or frequent urination
  • Constipation or rectal pain
  • Miscarriages and infertility


If you think you have symptoms of fibroids, you should see a doctor. If you have been diagnosed and treated for fibroids in the past, make sure you have regular check ups. Your doctor will be able to discuss a range of treatment options—both pharmaceutical and surgical.

Click here to contact our office to schedule an appointment.

Endometriosis

Endometriosis is a condition where the tissue that is normally found in the lining of the uterus, the “endometrium” is found outside the uterus, usually in the abdominal cavity.

Because endometrium tissue outside the uterus responds to the menstral cycle in the same way as the tissue inside the uterus, this tissue can break apart and bleed, causing the area around it to become swollen and inflamed. Over time, these areas can then become scarred, creating “lesions” or “nodules” that can cause increased pain during menstration and discomfort during sex. Endometriosis can make it difficult for you to become pregnant.

Although there is no cure for Endometriosis, there are a number of treatment options. Click here to contact our office to schedule an appointment to discuss your symptoms and treatment options.

Abnormal Vaginal Discharge

It’s normal for a small amount of clear or cloudy white fluid to pass from a woman’s vagina to keep the tissue moist and healthy.

A healthy vagina contains a number of organisms—like bacteria and yeast—in a healthy balance. When these organisms get out of balance, you can experience an abnormal discharge—as well as symptoms like itching, burning, and an unpleasant odor.

While these symptoms can mean something as routine as a yeast infection (candida), they can also be warning signs of other more severe conditions like a bacterial infection, sexually transmitted diseases (STDs), or even HIV, which causes yeast infections to be severe or very resistant to treatment.

Although there are many over-the-counter treatments that promise relief, only your doctor can determine the exact cause of your discharge and ensure that you receive the proper treatment. Click here to contact our office to schedule an appointment to discuss your symptoms, screening test and treatment options.

Genital Warts

Genital Warts are very common, flesh-colored growths that affect hundreds of thousands of individuals each year in the U.S. along. Genital warts are most commonly caused by HPV (human papillomavirus)—a sexually transmitted disease that often goes undetected because there are few visible symptoms. Click here to learn more about the detection of HPV and here to learn about vaccines to prevent HPV.

Although genital warts will sometimes disappear without treatment, you should discuss your situation with your doctor. She can explain treatment options, which range from prescription creams to procedures to freeze, burn, or remove them with laser treatments. In extreme cases, surgery may be needed.

Click here to schedule an appointment to discuss your situation and to discuss treatment options.

Urinary Leakage

Most women leak small amounts of urine from time to time, but if this becomes frequent or severe, it can become an embarrassing problem that keeps you from leading an active, ordinary life. Some data suggests that 1 in 3 women lives with incontinence.

Urinary leakage that occurs when you cough, laugh, sneeze, lift something heavy or simply get up from a chair is known as stress urinary incontinence (SUI) . Other forms of urinary incontinence can include
  • Urgency—a strong desire to urinate whether or not the bladder if full
  • Frequency—the need to urinate more than every 2 hours or more than 7 times a day
  • Nocturia—the need to urinate often during the night, disrupting your normal sleep, or even Enuresis, bed-wetting
  • Dysuria—painful urination
While a physical exam can often confirm the problem of urinary incontinence, our doctors offer sophisticated urodynamic testing to pinpoint the cause and extent of the problem so they can provide the best treatment options.

Urodynamic Testing

UrodynamiUrodynamic testing can asses the bladder pressure at which leaks occur, the amount of muscle pressure available to hold back flow, and other specific aspects of your condition. If we detect a physical problem, you may be a candidate for one of two, new, state-of-the-art treatments to address urinary incontinence

Monach®/Miniarc®ings

Stress urinary incontinence (SUI) occurs when the pelvic floor, the muscles below the bladder, become weak and can no longer support the urethra—the thin tube that carries urine from the bladder outside the body.

The MiniaThe Monarch/Miniarc sling is a new, effective treatment for SUI. The monarch/miniarc, a small mesh sling, is inserted during an office procedure. It does not require any external incision and can be performed under local anesthesia.

Most patients are able to return home in just a few hours and to return to their normal activities in a week or two. However, you should avoid sexual intercourse, heavy lifting, and rigorous exercise for 4 to 6 weeks. /> When it comes to the urethral support slings, our doctors are among the most experienced in the area. You can count on us to help you understand whether this procedure is right for you. Like any surgical procedure, there are some risks and we will be here to help you make an informed decision about your health.

Click here to contact our office to schedule an appointment to discuss your symptoms and treatment options.

Pelvic Organ Prolapse

The muscles that hold your pelvic organs in place can become weakened or stretched from childbirth or surgery. When this happens, your bladder can drop (prolapse) from its normal location in your lower abdomen and push against your vagina.

Click here to Contact our office to schedule an appointment to discuss your symptoms and treatment options.

Infertility

If you are trying to get pregnant and fail to conceive after 6 or more months of unprotected sex, you may want to see your doctor to discuss your fertility. A number of factors can influence your ability to become pregnant, and your doctor will help you decide if there are steps you can take to improve your chances of having a healthy baby.

Infertility Screening

If you suspect you suffer from infertility, your doctor will perform a physical exam and ask you a series of questions about your general health, your menstrual cycle and your sexual habits. In addition, your doctor can perform specific fertility tests, which could include: (Content Note: Need to confirm that these are correct—didn’t have info—referred to Mayo site for general info and inserted it here as a place-holder.)

Ovulation testing A blood test to measure hormone levels to determine whether you are ovulating.

Hysterosalpingography Evaluates the condition of your uterus and fallopian tubes. Fluid is injected into your uterus, and an X-ray is taken to determine if there is any blockage in your fallopian tubes that is preventing the egg from being fertilized. Blockages can often be corrected with surgery.

Laparoscopy can be used to identify endometriosis and scarring.

Your doctor can also detect blockages or irregularities of the fallopian tubes and uterus. Laparoscopy generally is done on an outpatient basis. Hormone testing Checks levels of ovulatory hormones as well as thyroid and pituitary hormones.

Ovarian reserve testing Determines the potential viability of the eggs after ovulation. This approach often begins with hormone testing early in a woman's menstrual cycle.

Genetic testing Can determine whether there's a genetic defect causing infertility.

Pelvic ultrasound Looks for uterine or fallopian tube disease.

Not everyone needs to undergo all, or even many, of these tests before the cause of infertility is found. Which tests are used and their sequence depend on discussion and agreement between you and your doctor.