Frequently Asked Questions

Women’s healthcare can begin as soon as a young woman has questions or concerns about her reproductive health. Young women are reaching menarche (first menses) at younger ages with each changing decade. Women should definitely initiate gynecologic care by the age of 18 or as soon as the patient becomes sexually active. Yearly exams promote safe sexual practices, preventative health management and opportunity for discussion of issues unable to be addressed by other individuals

Because perimenopausal women often have irregular menstrual cycles, sometimes going three to six months without a period, they may think birth control is not necessary. However, if you have any periods, even irregularly occurring, that means you’re still ovulating and may still get pregnant.

So until it’s official – defined as no periods for a full year or lab work that confirms menopause – you need to exercise safe sexual practices.

Fibroids, benign tumors of the uterus, may be small or large, symptomatic or asymptomatic. If they are not causing you problems, monitoring them carefully should be enough.

If the fibroids are large or are causing bleeding or pain, same-day surgery with D&C or endometrial ablation may offer relief of symptoms. Sometimes fibroids can be removed with a hysteroscopic or laparoscopic procedure. In other cases, a vaginal or abdominal hysterectomy is necessary.

Average weight gain is 25 to 35 pounds. Most women gain approximately 10 pounds by the end of the first 20 weeks and then one pound per week thereafter. If you’re underweight when you learn you are pregnant, you may need to gain more than the average. Overweight women will gain less, sometimes only 10 to 15 pounds. Click here for more information on pregnancy.

Sexual intercourse is generally safe during pregnancy, although you should be aware of several factors.

• As pregnancy advances, different sexual positions may be more or less comfortable than previously.
• Intercourse often causes uterine contractions or cramping due to prostaglandins in the seminal fluid. Using a condom may help.
• You may want to avoid intercourse between weeks 28 and 32 to decrease contractions and fear of preterm labor.
• Intercourse may cause cervical spotting. This is often bright red or pink discharge that changes to brownish over 24 hours.
• Report any persistent, excessive bleeding or contractions to your physician immediately.

Once you have had an incision in your uterus, it is weaker in that area. When labor begins, that weakened area can rupture. Although the chance of a rupture is only about one percent, it can be catastrophic, leading to severe problems, even death of the mother or fetus.

You must speak with your physician about the risks and benefits of avoiding a cesarean section. In some cases, with close observation, you can attempt a vaginal birth. For other women, a repeat cesarean section is the appropriate choice. Click here for more information on cesarean section.

All women recover from pregnancy losses at different rates. You may require more time for mental recovery from a loss than is medically required. After a miscarriage or procedure, we recommend that you allow at least two or three successful menstrual cycles in order to insure your hormones and uterus have normalized.

If you have lost more than one pregnancy, we may recommend testing for clotting or blood disorders before you try again. Lab results could reveal a condition that can be corrected or decreased with medicinal assistance, to promote a healthy pregnancy.

The Human Papillomavirus (HPV) is a sexually transmitted disease with over 100 different strains or types currently identified. It is contracted from skin-to-skin contact. According to the Center for Disease Control, at least 50 percent of sexually active women and men will acquire genital HPV at some point in their life, and by age 50, at least 80 percent of women have been exposed to genital HPV.

Most people exposed have no symptoms and will clear the virus on their own. Several of the strains, labeled as high-risk HPV, are responsible for abnormal Pap smears and cervical cancer. Other types produce genital warts. HPV is most often detected with Pap smear screening, when abnormal pre-cancerous cells are noted. There is no screening test for males. Click here for more information on HPV.

There is no medicine to cure HPV. The focus is on treatment of genital warts or the abnormal Pap smear. While many people clear the infection on their own, HPV can be persistent. Abstaining from sex is the only definitive way to prevent HPV infection. Condoms have not been proven to prevent transmission but are believed to decrease it.

The FDA has approved a new vaccine targeting the four strains of high risk HPV believed responsible for 70 percent of cervical cancer. The vaccine is available to girls and young women aged 9 to 26. If you have tested positive for high-risk HPV, you are still eligible for the vaccine, as it is unlikely that you have all four strains in the vaccine.

The vaccine is given in a series of three injections over six months. Because the vaccine is new, its long term efficacy and side effect profile is not known. Prior to its approval in the US, the effects of the vaccine were studied in over 11,000 women worldwide and is believed safe. The primary side effect noted is soreness at the site of injection.

Honesty is the best answer to this question. A misconception is that herpes can only be spread by direct contact with an active lesion. Unfortunately, the virus can spread without an active lesion, so any sexual contact puts your partner at risk. You and your partner can take daily medications to greatly decrease the chance of spreading the virus, with or without a lesion.

Healthy discussion with your partner and physician about sexually transmitted diseases can reduce the risks of these diseases spreading and creating physical and emotional effects on your relationships. Click here for more information on herpes.