Gynecology Services

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Our physicians provide women with compassionate and sensitive healthcare. We provide services to women of all ages.  There are many areas of women's healthcare needs that affect one's quality of life. As a result, our women's wellness and medical services are individualized to help our patients manage their healthcare needs for all periods of their life.

We provide the following medical services to support women's health

  • Physicals
  • Abnormal Uterine Bleeding
  • Contraception
  • Infertility
  • Diaphragm Fittings
  • Endometriosis
  • Mammography Referrals
  • Menopause
  • Premenstrual Dysphoric Disorder (PMDD)
  • Sexually Transmitted Diseases
  • Teenage/Adolescence Care
  • Women’s Wellness

Abnormal Pap Smears

A pap smear is a screening test to detect cancerous cells in the cervix. Positive findings result in the pap smear being referred to as abnormal.


Women are recommended to get annual pap smears to aid in the early detection of cancer. Please consult with your physician to learn more. 

Abnormal Uterine Bleeding

Irregular menstrual periods can result in abnormal uterine bleeding. This bleeding lasts longer than the normal cycle or occurs outside the cycle. Contributing factors may include weight loss/gain, heavy exercise, stress, sickness, or medication side effects. 


To diagnose the condition, your physician will review your medical history and may ask you to keep a diary of your menstrual cycle. Some medical tests that your physician may also use are endometrial biopsy, ultrasound, hysteroscopy, and/or laparoscopy. 


Treatment for this condition includes medications, hormone therapy, or surgery. 

Contraception

Contraception is the prevention of conception or impregnation. There are several forms of contraception. Available methods include:

  • Natural family planning
  • Barrier methods
  • Hormonal methods
  • Intrauterine Device (IUD)
  • Nexplannon Insertion
  • Tubal Ligation

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Infertility

Infertility Evaluation

During an infertility valuation, exams and tests are done to try to find the cause of infertility. If a cause is found, treatment may be possible. Infertility often can be successfully treated even if no cause is found.

Infertility Testing

Testing for infertility include laboratory test, imaging test, and certain procedures.

Infertility Treatment

Counseling

Treatment of hormone problems

Surgical treatment Tuboplasty


You should consider having an infertility evaluation if any of the following apply to you: 

  • You have not become pregnant after 1 year of having regular sexual intercourse without the use of birth control.
  • You are older than 35 years of age and have not become pregnant after 6 months of having regular sexual intercourse without the use of birth control. 
  • Your menstrual cycle is not regular.
  • You or your partner have a known infertility problem.

Intrauterine Device (IUD)

An intrauterine Device (IUD) is a female form of contraceptive placed in the uterus. The advantages of using an IUD are long protection and ease of use. Depending on the product, cycles may be heavier, or in come cases, lighter or even absent. IUDs have a slight risk of causing a serious pelvic infection, and are ideally suited for women between children, or after their families are completed. The failure rate is approximately 1%, with an increased risk of an ectopic (tubal) pregnancy if pregnancy occurs.


Overall, IUDs are very effective methods of birth control which are very popular worldwide, but less so in the United States. Years ago, older IUDs were associated with complications that are now infrequent with the newer products available. 


The Liletta IUD is a product that can provide contraception for  years. They are inserted at an office appointment after appropriate medical counseling and examination. Please note, IUDs are not right for everyone. 5

Contraception

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Birth control is the use of various devices, drugs, agents, sexual practices, or surgical procedures to prevent conception or pregnancy.  Ask us about the options that fit your needs.

Mammography Referrals

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Mammograms are x-rays used to detect masses and lumps in breast tissue.  Starting at age 40, women are recommended to have an annual mammogram.

Endometriosis

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Endometriosis is a highly unpredictable, common gynecologic disorder that affects women. Symptoms include increased menstrual cramps, infertility, and pain during intercourse. Medication and surgery are usually the treatments. 

Pregnancy Testing

We conduct pregnancy testing to ensure accurate readings.

Pregnancy tests work by checking your urine for a hormone called human chorionic gonadotropin (HCG). Your body only makes this hormone if you’re pregnant. HCG is released when a fertilized egg attaches to the lining of your uterus — when pregnancy begins.

Annual Exams

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Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment are better. 

Teenage/Adolescence Care

The physicians at Premier Associates for the Healthcare of Women consider it a special privilege when we are asked to see your daughters, or any young woman, as they begin the transition through adolescence into womanhood. We take seriously the skill and trust that is needed to help these patients understand how the life-long habits of good preventive care and thoughtful reproductive health choices will enhance their quality of life.


Our doctors follow current adolescent healthcare guidelines recommended by the American College of Obstetricians and Gynecologists, as well as those from other accepted authoritative sources. We will, of course, provide the screening and care specific to the patient’s individual needs; however, these guidelines recommend the following: 


Women’s Health Initial Visit for Teenagers

The first visit is recommended between ages 13-15, and should be followed by annual visits.

  1. The initial visit does include a thorough medical history and examination. Generally, it does not involve pelvic examination, although certain circumstances may indicate that it is appropriate.  
  2. The visit allows establishment of a relationship, and open discussion and education regarding the patients role as a part of the healthcare team. Other topics discussed include, but are not limited to: 
    1. Menstruation
    2. Normal Development
    3. Sexual activity and safe sexual practices
    4. Contraception
    5. Smoking, drugs, and alcohol
    6. Screening for emotional and behavioral issues, hypertension, substance abuse/issues, sexual activity, depression, and school performance. 
  3. Generally, a Pap smear is performed by age 21, or 3 years after the onset of sexual activity.
  4. HIV screening is recommended annually for all patients from age 13 to 64 (per CDC, 9/2006)
  5. Once sexually active, annual screening for chlamydia and gonorrhea is performed. 

Please feel free to ask any of us about initial or subsequent services available for your daughter. Keep in mind that doctor-patient confidentiality as to the content of the visit must be observed in keeping with federal and state privacy laws. 

What about HPV vaccination and testing? 

In the summer of 2006, the FDA approved the use of Gardasil©, a vaccine for 4 types of HPV (human papilloma virus). This virus is responsible for virtually all cases of cervical dysplasia, cervical cancer, and genital warts. The vaccine is highly effective against the 4 types of HPV that account for 70% of cervical cancers and 90% of genital warts. HPV is commonly acquired when women become sexually active, and it is estimated that up to 80% of the women are exposed at some point in their lives. While most infections are silent and transient, many lead to future disease that can be largely prevented by vaccination. 


  1. HPV vaccination is best given between ages 11-13, as it is most effective before sexual activity. It can be given between ages 9 to 26.
  2. Vaccination is still appropriate after sexual activity, up until age 26.
  3. Vaccination does not prevent the need for annual pap smears once sexually active. 
  4. Vaccination is NOT treatment.
  5. Vaccination gives immunity for 5 years, and perhaps more; it is not known if a booster is needed at this time. 
  6. HPV testing is not appropriate in adolescents, whether sexually active or not. 

Vaccination details


  1. The vaccination is an injection given at 0.2 and 6 months.
  2. A woman must establish care here in order to receive the vaccine.
  3. We will request insurance information for the patient IN ADVANCE of the appointment so that we can verify coverage beforehand. The information is best obtained by a photocopy of the insurance card sent via mail, fax, or brought in to the office.
  4. The patient is responsible for payment if the insurance company ultimately does not pay for the vaccination. 

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