SeeBaby Gynecology Services

Taking care of women at every stage of life…Adolescence, Pre-Pregnancy & Menopause

SeeBaby Gynecology is dedicated to providing options and support to women in the community! Support is encouraged to help provide the following Women’s Health options.

SeeBaby Gynecology Services

  • Review your personal medical and family health history
  • Recommend appropriate screening tests (Pap, HPV, STI, hormone testing)
  • Perform a physical examination (depending on age and other factors), including breast and pelvic exam
  • Provide counseling / health education
  • Discuss healthy lifestyle choices
  • Breast Health
  • Contraception (birth control)
  • Exercise and Nutrition (general information)
  • Vaginal Health
  • Sexual Health and Sexuality
  • Sexually Transmitted Infection (STI) Prevention and Testing
  • Cervical cancer prevention (vaccines), screening, and management
    of HPV (human papilloma virus) infection.
The menopausal transition can be a very challenging time for many women. You are officially “in menopause” when you have not had a period for a year. However, the time before this when your hormones start to decline and/or wildly fluctuate- “perimenopause”- is often more difficult.

Symptoms:

  • Hot flashes, night sweats
  • Vaginal dryness and painful intercourse.
  • Sleep problems
  • Depression and anxiety
  • Weight gain
  • Cognitive (memory) problems
  • Loss of sex drive
  • Fatigue

Not all of these symptoms are directly attributable to the loss of estrogen, but often may result from changes that accompany this stage of life and the loss of balance of the hormones.

Treatment options:

  • Alternative/herbal therapies: a variety of herbal remedies are available both over the counter and through health-care practitioners. We carry a full line of products in our office and we are happy to recommend ones that may be right for you. Keep in mind that these therapies have no data proving either efficacy or safety.
  • Serotonin reuptake inhibitors have been used in breast cancer patients and seem to decrease hot flashes and night sweats in some patients.
  • Hormone replacement therapy.
Current recommendations are to take the lowest amount of hormone therapy for the shortest amount of time. Using hormones and trying to achieve a physiologic balance in the hormone levels to resolve symptoms and restore a normal sense of energy and well being. We also favor transdermal estrogens, found in patches, gels, troches or pellets, as they may be safer than oral estrogens. The advantages of transdermal estrogen compared to oral estrogen:

  • Does not affect the coagulation factors associated with increased risk of blood clots; Lower plasma triglycerides
  • No effect on cardiac CRP levels (an inflammatory marker associated with heart disease)
  • Lower rate of glucose intolerance
  • Associated with increased lean body mass (compared to oral estrogens)

Long Acting Reversible Contraception

For women who are interested in convenient long-term contraception
(5 or 10 years), intrauterine contraception is an option. This is commonly referred to as an IUD (intrauterine device). There are two types of IUDs available in the US, both are over 99% effective at preventing pregnancy. However if pregnancy does occur, there is an increased risk of ectopic pregnancy, or a pregnancy outside of the womb.

Scientists believe that IUDs work in many ways, not all of which are fully understood. They work mainly by interfering with fertilization of the egg. There are other differences between the two IUDs available that enhance their effectiveness.

For both types of IUDs, insertion is similar. It is done in the office and can cause cramping, bleeding and dizziness. Usually over the counter medicines such as Advil or Aleve can reduce any discomfort. Risks of inserting an IUD are bleeding, infection, uterine perforation, where the IUD goes through the uterus, and finally expulsion. Except for bleeding, these risks are rare. It is not uncommon for women to experience irregular bleeding for up to 12 weeks after insertion.

It is recommended that people who have an IUD inserted return after
one month to confirm the IUD is still in place. IUDs can be inserted in both women who have and have not had children. Talk with our providers to determine if an IUD is right for you.

***For women with certain types of cancer, uterine anomalies, or undiagnosed abnormal uterine bleeding, the IUD is not appropriate.
***The IUD does not protect against STDs.

Progestin IUD
(Mirena, Lyletta, & Skyla)

These IUD’s are FDA approved for long-term contraception as well as control of heavy menstrual bleeding. It is a small, flexible device that is inserted in the office and provides contraception for up to 3-5 years. A very small amount of progestin is released and acts at the level of the uterine lining to keep it thin resulting in lighter periods. Twenty to thirty percent of women after one year of the IUD insertion report amenorrhea, or no periods. This is safe and is an expected outcome.

Progestin IUD (Mirena, Lyletta, and Skyla)

Progestin IUD
(Mirena, Lyletta, & Skyla)

Paraguard IUD

This IUD provides up to 10 years of contraception and has been FDA approved for over 20 years. It is non hormonal which is appealing to many women. It is has a flexible T shape that is coated with copper that is believed to kill sperm cells. Heavier periods have been recognized as a possible side effect. There are a few contraindications for its use specific to Paraguard that you should discuss with your healthcare provider.

Paraguard IUD

Paraguard IUD

Nexplanon

is a long-acting prescription contraceptive that lasts for up to three years. Nexplanon contains a progestin only hormone. Because it doesn’t contain estrogen, your healthcare provider may recommend Nexplanon even if you cannot – or don’t want to – use estrogen.

Nexplanon is more than 99% effective at preventing pregnancy, which means that there is less than one pregnancy per 100 women who use Nexplanon for one year. It is not known if Nexplanon is as effective in very overweight women because clinical studies did not include many overweight women. Nexplanon must be removed by the end of the third year and may be replaced with a new Nexplanon at the time of removal, if continued contraceptive protection is desired. Your healthcare provider can remove Nexplanon at any time. If you decide you want to become pregnant, the ability to become pregnant usually returns quickly after your healthcare provider successfully removes Nexplanon. Some women have even become pregnant within days of having the contraceptive removed.

After removal, if you don’t want to become pregnant, you should start another birth control method right away. Tell your healthcare provider about any medications you are taking, or intend to take, including over-the-counter medicines, herbal medicines and prescription medicines. Certain medicines may make Nexplanon less effective, and you may also need to use a barrier method of contraception as backup.

SeeBaby Gynecology Procedures

Colposcopy/Cervical biopsy

The colposcopy examination looks for dysplasia, which is precancerous lesion of the cervix. Dysplasia usually does not cause symptoms. Sometimes it causes bleeding during or after sexual intercourse.

You may have a greater risk for dysplasia if:

  • You have a high risk HPV infection (human papillomavirus).
  • You have had more than 1 sex partner.
  • Your sex partner has been sexually active with other partners.
  • You had sexual intercourse before the age of 18.
  • You smoke.
  • You have a weakened immune system; for example, because you are taking immunosuppressive drugs, or you have AIDS.
What is Colposcope?

The colposcope is an instrument that looks like a pair of binoculars mounted on a tripod, and is used to magnify the tissues of the cervix, vagina, or vulva. This enables the examiner to see minor changes in the color of these tissues and surface blood vessel patterns, which are not visible to the naked eye. It is these subtle differences, which help to distinguish healthy tissue from abnormal tissue. The colposcope is usually used to evaluate women with an abnormal Pap smear. The Pap smear is a screening test and looks at the characteristics of individual cells. The colposcope allows us to identify any microscopically abnormal areas to biopsy for more thorough tissue evaluation by a pathologist.

What Happens During The Colposcopic Examination?

The colposcopy is performed during a regular office visit. It is preferable to schedule this while you are not on your menses. We recommend that you take two ibuprofen or Aleve tablets prior to coming to the office, as the procedure can cause some cramping. Prior to the examination, we will want to verify that you are not pregnant. The colposcopy can be performed during pregnancy, but there certain types of biopsies we would avoid. The provider will first do a regular pelvic examination. Then a speculum will be placed in the vagina to visualize the cervix. The cervix and vagina will then be washed with a vinegar solution to help remove any mucous or discharge from the cervix and vagina. Another benefit of the vinegar solution is that it brings out the color changes and blood vessel patterns of abnormal tissue. The provider will then look through the colposcope to carefully examine all the tissues. The colposcope itself remains outside the body and is not inserted into the vagina. If any abnormal areas are identified during the examination, it may be necessary to take a small biopsy. In cases of colposcopy of the cervix, often a biopsy will be taken on the outside of the cervix, and then a second biopsy taken from higher up inside the endocervical canal. The biopsies only take a short time to obtain and the provider will let you know before she is about to take a biopsy. The biopsy may cause some cramping similar to menstrual cramps and last only a few minutes. The entire procedure lasts about 15 -20 minutes. After the procedure, you may resume all normal activities as you feel up to it. You are able to drive yourself home and/or return to work. You may experience some spotting for 2-3 days from the biopsy sites. The provider will often apply some silver nitrate to your biopsy sites, which acts as a chemical cautery. This may cause a charcoal, grayish discharge, which is to be expected. We recommend that you avoid intercourse for about a week after the biopsy to allow the biopsy sites to heal.

It usually takes 7 days for the test results from the biopsies to return to our office. We will call you with the results or notify you through our Electronic Health Record Patient Portal if preferred. If additional evaluation or treatment is indicated, appointments will be scheduled at that time.

Please remember to bring your insurance card to your appointment so we may file your insurance for the procedure. There will also be a separate bill from the pathologist if any biopsies are taken.

How Is It Treated?

It is very important to have dysplasia treated to help stop it from becoming cervical cancer. The specific treatment may depend on whether the dysplasia (squamous intraepithelial lesion) is low grade (LSIL) or high grade (HSIL).

LSIL (Mild Dysplasia):

also called CIN 1, often goes away without treatment. Most dysplasia is associated with HPV infections and 80 % of women with an HPV infection will clear the infection within 2 years. When the infection clears, the abnormal cervical cells go back to normal. These patients are usually followed with repeat Pap smears every 6 months.

HSIL (Moderate-Severe Dysplasia):

also called CIN2-CIN 3. The abnormal tissue can be removed with a thin wire loop attached to an electrical unit. This is called the loop electrosurgical excision procedure (LEEP). Severe cervical dysplasia may also be treated
with a cone biopsy, which is the removal of a cone-shaped piece of
the cervix. This procedure is also called conization of the cervix. It
removes the tissue containing abnormal cells. Your provider can cut
the tissue out with a surgical knife, cautery (burning tool), laser, or
wire loop. If the procedure is done with a knife or laser, it is usually
done in an operating room. The tissue removed is examined in the lab to check for cancer.

Very few women have trouble getting pregnant or have miscarriages as a result of any of these treatments, including cone biopsies. If you become pregnant and have had a cone biopsy, tell your prenatal care provider about it. Most women who have had a cone biopsy are able to become pregnant and carry the baby to term without problems.

How Can I Take Care Of Myself?

Follow your health care provider’s advice for treatment and checkups. Your provider may recommend that you have a Pap test at least twice a year for the next 2 to 3 years. This will allow your provider to detect any progression or recurrence of dysplasia and treat it promptly. Then, if your Pap tests have been consistently normal, you may need the test every 1-3 years.

Endometrial Biopsy

An endometrial biopsy is a procedure performed to assess the lining of the uterus. It is a helpful diagnostic test for women over 35 yo who are experiencing abnormal, similar to the instrument used for pap testing irregular or heavy menstrual bleeding. The procedure involves inserting a speculum (similar to the instrument used for pap testing), into the vagina, clean the cervix, and insert a thin suction catheter into the uterus withdrawing the tissue sample. We recommend taking ibuprofen 30 minutes prior to your appointment. You can expect mild cramping during the procedure, which will typically resolve in a few hours. Some women also experience light bleeding or spotting after the procedure. The tissue sample is sent to the lab to look for abnormal cells or hormonal effects on the endometrial lining.

Vulvar/ Vaginal Biopsy

A vulvar or vaginal biopsy is a procedure performed to assess any lesions, redness, discoloration, or persistent itching of the tissue from the labia, clitoris, or vaginal opening/inside vagina. The procedure involves cleaning and numbing the area of concern and removing a small sample of tissue to send to the lab. If the area of concern is in the vagina, a speculum will be inserted (similar to the instrument used for pap testing), to examine the vagina. Most women feel some pressure or slight discomfort. A medication to control bleeding is applied to the area, as stitches are rarely needed. The external areas can be covered with a light bandage or Vaseline. You will need to keep the area clean and dry for a few days. If your biopsy is inside the vagina, we recommend you avoid putting anything in your vagina for 3-5 days.

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