Several common gynecologic conditions can occur throughout a woman's life. Just because they are labelled common does not mean that they should be ignored or that you should suffer with the symptoms. Your physician at Associates in OB/GYN will carely evaluate your condition and individualize your treatment. In most cases, your doctor will be able to offer an appropriate course of therapy to either eliminate or greatly diminish your symptoms.

Menstrual Irregularities

Menstrual irregularities and abnormal uterine bleeding are some of the most common problems for which women seek help.  Frequent, prolonged, heavy, or even absent menstrual bleeding can be caused by a variety of etiologies, including complications of pregnancy, anatomical abnormalities, hormonal imbalances, or even neoplasia, to name a few.  Here at AOG, we utilize historical data, physical exams, and advanced diagnostic techniques to determine the exact nature of the problem, and offer state of the art treatment options tailored to a patient's specific needs.

Urinary Incontinence

Urinary incontinence is a common problem experienced by more than 10 million women in the United States.  There are three main types of urinary incontinence.  Urge incontinence is caused by overactive bladder muscles that may cause you to leak urine.  Stress incontinence is leakage of urine associated with activity such as cough, laugh, sneeze and exercise.  This is usually caused by a weakening of the pelvic floor.  Overflow incontinence often makes you feel that it is difficult to completely empty bladder.  This may be caused by a blockage in the urethra or a neurologic problem.
For more treatment information see TVT .

Endometriosis

Endometriosis occurs when a normal part of the uterus, the endometrium or lining, is in an abnormal location.  This endometrial tissue can attach itself to the pelvic organs such as the tubes or ovaries, the pelvic lining or peritoneum, the intestines or bladder, or anywhere within the abdominal area.  Endometriosis has also been reported as far away as the lungs or arms.  The growth of endometriosis is affected by hormones.

Endometriosis occurs in up to one third of women.  Millions of women experience pain or other problems with endometriosis.  The actual cause of endometriosis is uncertain but there are theories.  The most popular theory is that endometriosis is caused by retrograde menstruation, or the backward flow of menstrual blood through the uterine tubes.  Another theory is that menstrual cells are carried through the blood or lymphatic system and deposited in the pelvic or other organs. Cells in the body may also be capable of undergoing spontaneous change to develop into endometrial tissue.

The hallmark of endometriosis is pain.  This can be cyclic menstrual or premenstrual pain, pain with intercourse, pain with bowel movements, painful bladder symptoms or even constant pain.  The pain can be in the pelvic, lower back, legs, abdomen or buttocks.  The amount of pain does not always  correlate with the amount of endometriosis.  Infertility has also been associated with endometriosis, but is not always present.  Sometimes endometriosis is asymptomatic.

Symptoms give the most clues to the diagnosis, as there may be no findings on physical exam.  Occasionally the physician may feel nodules in the pelvis or a cyst on the ovary.  Endometriosis cysts are known as chocolate cysts.  The diagnosis is often suspected, but not confirmed without surgery.  Surgery is usually minimally invasive, using the laparoscope and tiny abdominal incisions to visualize the pelvis.

Treatment is based on ways to manage the pain and suppress the growth of endometriosis.  Anti-inflammatory medications such as ibuprofen are very helpful in reducing pain.  Exercise can reduce pain in some women.  Hormones that suppress ovulation, such as the birth control pills, Depo-Provera, birth control patches and vaginal rings are also helpful.  There are stronger hormones that suppress both ovulation and estrogen production.  Surgery can also be used to treat endometriosis by destroying or removing the endometriosis tissue.  Some patients may require complete hysterectomy to adequately control pain.  These options are individualized and must be discussed with your physician.

AOG offers expertise in the medical and surgical management of endometriosis.  Medical options include hormonal suppression with oral contraceptives, Lupron, or Depo-Provera.  Surgical alternatives include conservative therapy with laparoscopic resection or ablation, or more definitive therapy with hysterectomy (usually laparoscopic).  The type of treatment is carefully tailored to the needs and situation of our individual patients.
For more treatment information see Endometrial Ablation or LAVH . 

Pelvic Pain

 Pelvic pain, both long-standing and acute, can be completely evaluated.  Gynecologic ultrasound is available on-site.  Patients with a gynecologic source of pain have many treatment options, from non-invasive medical management to minimally-invasive surgical interventions.  For some patients, pelvic pain is due to muscle or skeletal issues.  For these patients, we work very closely with a group of female physical therapists who work exclusively with women.  An overall comprehensive approach is taken to evaluating and treating pelvic pain.

Organ Prolapse

Childbirth and aging can cause damage to the tissues that support the pelvic organs.  This can result in the symptom  of pelvic pressure or actual bulging of the bladder, cervix or rectum through the vagina.  Associated symptoms include loss of urine with coughing, sneezing or straining, or difficulty having a bowel movement.  If conservative management with special exercises, dietary changes, medical treatment, or insertion of a support device called a pessary is not successful, then surgical management may be necessary.
For more treatment information see Organ Prolapse Surgery.