Well woman care encompasses the yearly exam, screening for osteoporosis, breast disease, hormonal imbalances and general health maintenance.  Our office delivers healthcare from adolescent years through the reproductive years and throughout menopause.  This includes contraceptive and hormonal needs. view video

Annual Exam

It is very important that all women have their annual well-woman exams.  Blood pressure, weight, height, hemoglobin (check for anemia) and urinalysis are routinely checked.  In women over age 40, annual mammograms are recommended.  Physical exam includes screening for thyroid enlargement, breast cancer, cervical cancer (pap smear), uterine cancer, ovarian cancer and rectal cancer.  The annual exam also includes time for discussion about any other health issues that are of concern to the woman.  This includes diet, exercise, contraception counseling, menopause management, smoking cessation, sexual problems and sexually transmitted disease screening.  Often times “annual exam” and “pap smear” are terms used synonymously.  It may not be necessary to have a pap smear annually but many other issues are discussed and cancer screenings take place at the annual exam. 

Contraceptive Counseling 

Contraception (pregnancy prevention) is a concern of all women in the reproductive age group.  The most common reversible method of contraception is the oral contraceptive pill (OCP).  OCP’s fill the need for the majority of women and are very effective.  There are also other hormonal agents such as skin patches and vaginal rings that deliver small amounts of contraceptive hormones into the body and are very effective in preventing pregnancy.

Depo Provera is an intramuscular injection of a progesterone compound and is also effective and needs to be repeated every three months.  This usually results in disruption of regular menstrual cycles and may cause irregular vaginal spotting, but the side effect reverse after the medicine is discontinued.

Intrauterine devices (IUD's) are an increasingly popular option for longer term, extremely effective contraception.  They are placed into the uterus through the cervix during an office visit.  Two models are available, Mirena and Paraguard.  Each has advantages.  Mirena contains a very small amount of a progesterone hormone, causing most women to have very light or no periods.  It can be placed for up to five years.  Paraguard can stay in place up to ten years, but the copper that it contains can make periods slightly heavier. 

Implanon is a very new contraceptive method offered at AOG.  This tiny but highly effective progestin containing flexible rod is inserted under the skin of the upper arm as an office procedure, providing three years of contraception. 

Tubal Ligation is available to women if permanent sterilization is desired.  These women can undergo a simple out-patient procedure where the fallopian tubes are cauterized or clipped.  This procedure is not considered reversible and is done only if permanent sterilization is requested. A new option for tubal sterilization offered by AOG is Essure.  This "no incision" method places tiny coils inside the fallopian tubes using a hysteroscope.  A waiting time of three months is necessary to allow scarring of the tubes to occur, and a tubal x-ray (hysterosalpingogram) is necessary to confirm obstruction. 

Testing for Sexually Transmitted Diseases (STD’s)

All sexually transmitted infections can be screened for through our office.  The annual pap smears screen for the human papilloma virus responsible for cervical cancer.  We evaluate some at- risk patients for gonorrhea, chlamydia and trichomonas as well.  For other at- risk individuals, we offer testing for syphilis, HIV and hepatitis.  Many of these infections can be successfully treated with minimal to no long-term sequelae if diagnosed early. 

Mammogram

Associates in OB/GYN provide a full range of mammography  services at the Suburban office..  State of the art and fully accredited mammogram facility and experienced mammogram technologists provide complete breast cancer screening mammograms as well as comprehensive diagnostic imaging procedures when necessary.  All of the mammograms are interpreted by accredited and board-certified radiologists with interest in mammography, thereby providing our patients the quality they deserve in breast cancer screening.  For         information regarding our DIGITAL MAMMOGRAPHY service, click here. 

DEXA (bone density)

It is estimated that one third of all postmenopausal women will have osteoporosis.  Two thirds of all Caucasian women will have osteoporosis by age 70.  Fifty percent of Caucasian women will experience an osteoporosis-related fracture in her lifetime.  For those women who experience hip fracture, there is a 10-20% risk of death within the year.  Although African American women have a lower risk of fracture, their death rate is higher after hip fracture.  A woman’s overall risk of hip fracture equals her combined risk of ovarian, uterine and breast cancer.

There are many risk factors for osteoporosis which include age, gender, race, menopause and genetics. These risk factors cannot be altered.  Other risk factors including calcium intake, cigarette smoking, excessive alcohol use, lack of exercise and medications can be modified by the individual.  Medications which can cause bone loss include steroids, anti-seizure drugs, thyroid supplements, heparin, lithium, depo-provera and immunosuppressants.  Osteoporosis can also be caused by medical conditions such as mal-absorption problems, hyperthyroidism and multiple myeloma.

Currently, the diagnosis of osteoporosis is made by performing a DEXA scan. This test can be performed in the physician’s office, fully clothed and with minimal to no discomfort.  All women 65 and older should be screened if additional risk factors are present.  The National Osteoporosis Foundation recommends treatment if a woman’s bone density is more than two standard deviations from a normal bone density of a young woman (“T” score of –2.0)  If other risk factors for fracture are present, treatment is recommended at a T-score of –1.5.

Prevention and treatment of osteoporosis includes a calcium rich diet, calcium and Vitamin D supplements and weight-bearing and muscle strengthening exercises.  One can also quit smoking, avoid excessive alcohol, and reduce intake of soda and caffeine.

Many medications are also available to prevent and treat osteoporosis.  They include biphosphanate drugs which inhibit bone breakdown, estrogen therapy, selective estrogen receptor modulators, calcitonin and parathyroid hormone.  Treatment is individualized and determined by consultation with your physician.  Osteoporosis and subsequent bone pain, fracture and deformity can be prevented

Menopause & Hormone Replacement Therapy

Menopause, or "the change of life"", usually occurs around age 50 to 52. The ovaries stop producing estrogen and menstruation ceases. Other changes also occur. The most common symptom is hot flashes. Sleep disturbances may occur. Due to the lack of estrogen, the lining of the vagina becomes thin and dry. The risk of bone fractures is greater as the rate of bone loss increases.

Hormone replacement therapy (HRT) can relieve these symptoms of menopause. However, because HRT is not without risk, its use must be individualized.The patient's symptoms, personal history, and family history must be considered in making that decision.

As you make this transition, the doctors at AOG are available to help you enjoy a healthy lifestle for years to come.