Gynecological Care | Board Certified OBGYN | Rockville Silver Spring Montgomery County
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Gynecological Care

Menopause Evaluation and Symptom Management

The average age of menopause is 51, but some women may begin perimenopause in their early 40’s. Symptoms may include hot flushes, sleep disturbance, mood changes, menstrual irregularities, vaginal dryness, painful intercourse, memory loss and decreased sexual desire. These changes can result from decreased levels of hormones such as estrogen and testosterone. Although many of these symptoms are considered “normal,” if they affect your quality of life, there are options that may help.

For mild symptoms, lifestyle changes such as personal lubricants, sleeping with a fan, layered clothing, healthy sleep habits and exercise may provide some relief. Some women benefit from certain herbal remedies such as black cohosh, soy products and chamomile tea. Women whose symptoms are severe or don’t improve may require prescription medications.
Hormone replacement can be prescribed in formulations such as pills, creams, patches, sprays and rings. Sometimes nonhormonal medications can also be used to treat hot flushes. If you decide upon a hormone therapy regimen, we recommend the lowest effective dose for the shortest duration possible. This is different for every woman and will be reassessed at each of your visits.

Contraceptive Counseling for Permanent and Nonpermanent Birth Control

As many as 50% of pregnancies are unplanned. Those women who prefer birth control may consider options such as pills, patches, rings, and injections. Everyone can respond differently to each type and depending on different factors, certain options may be preferable for some women. Women interested in long term birth control may prefer an intrauterine device or IUD. This small hormonal or nonhormonal “T” shaped device is placed inside the uterus. An arm insert known as Implanon can also be used as a long term option. Some women have completed childbearing and are interested in permanent birth control. These may include a tubal ligation or “tube tying” where small incisions are used to locate the fallopian tubes so that they may be burned, cut, or blocked. Another option is Essure, which is done through the vagina and using a small camera your tubes are visualized and then blocked.

There are many non-contraceptive benefits to birth control such as treatment of abnormal or heavy bleeding, menstrual pain, and other conditions such as endometriosis. Certain options can also decrease your risk of ovarian and uterine cancer. To find out which birth control option may be right for you and to see how you may benefit from being on birth control, please call to schedule a consultation today.

Screening for Sexually Transmitted Diseases

Sexually transmitted diseases or STD’s are transmitted through intimate contact or exposure to certain bodily fluids such as blood. Barrier methods of birth control (condoms) help prevent transmission of STD’s, but cannot guarantee protection. You may not always have symptoms of an infection. Undiagnosed and untreated infections can cause serious illness, infertility and even death. While not all infections are curable, most can be treated. Testing includes blood work and vaginal cultures. If you would like to discuss testing and treatment or if you have any questions regarding STD’s please schedule a consultation today.

Abnormal Pap Smears

Pap smears are a part of routine screening that evaluates your risk of cervical cancer. If your result is abnormal, you may be scheduled for a colposcopy where your cervix is evaluated using a microscope after ascetic acid (vinegar) is used to highlight abnormal tissue.

Depending upon your age, risk factors and the appearance of your cervix, a biopsy may be taken. This is analyzed and depending on the findings, you may be scheduled for pap smears on a more frequent basis or you may need treatment. If a biopsy was performed, a medication called Monsel’s is applied to your cervix to help prevent bleeding. You may notice a brown/black or even mustard appearing discharge for a few days and you should avoid intercourse during this time as well.

If you require treatment a Loop Electrosurgical Excision Procedure (LEEP) may be recommended. This is where the abnormal tissue is removed using local anesthesia or sedation. Afterwards, you may need pap smears more frequently to make sure the abnormality has been cleared. Depending upon certain factors, we may also recommend the HPV Vaccine to help protect you against certain strains of HPV or Human Papilloma Virus which increases you risk of cervical and rectal cancer. Even if you have had an abnormal pap smear you can still benefit from getting the vaccine. Be sure to ask about the HPV Vaccine at your next visit.

If you have any further questions regarding these and any other Gynecology Services, please call us today to schedule a consultation.

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