You will be escorted to an exam room in which to remove your clothing and put on an examination gown. A sheet is provided for added privacy. Before the exam begins, you will be asked to place your feet in the stirrups at the end of the table. The clinician will use a latex glove to manually examine your genital area then will gently insert a speculum device to hold open the vaginal canal. You will feel some pressure when the speculum is inserted, especially against the bladder, but the exam should not be painful.

Once the speculum is opened, the wall of the vagina and the cervix will be visually examined and the clinician will perform a pap test. For best results, avoid the use of douches, vaginal creams or vaginal medications for at least 48 hours prior to your exam because these products can distort the appearance of the cells. Use a condom if you have vaginal intercourse less than 24 hours before your exam. Pap smears generally should be done when you are not menstruating.

After removing the speculum, the clinician will do a digital examination. Two gloved fingers are inserted into the vagina and the other hand placed on the abdomen, applying slight pressure. The doctor may also insert a gloved finger into the rectum while applying slight pressure on the abdomen. This detects any growths, abnormalities, swellings, or areas of tenderness in the pelvic area. The entire exam takes only a few minutes.

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Why do I need a pap smear?

The pap smear is a way of detecting abnormal cell changes in the cervix. These changes can indicate infections, the presence of sexually transmitted diseases, and, most importantly, cervical cancer. The test should be conducted annually upon age 18 or within six months after becoming sexually active.

A pap smear is a simple procedure performed during your annual exam. Cells are taken from several areas of the cervix and is an excellent screening test for certain Gyn conditions. These cells are then smeared on a slide and sent to a lab to be studied under a microscope.

Since the development of the pap smear, fewer women die from cervical cancer because yearly pap smears may detect abnormal cell changes long before they turn into cancer. Luckily, if a problem is caught before it spreads beyond the cervix, treatment is safe and usually effective.

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Who should have a mammogram?

A mammogram is a simple, safe low-dose radiation x-ray of the breast which is very helpful in early detection of breast tumors. The American Cancer Society recommends that women between the ages of 35 and 40 should have an initial baseline mammogram and women over 40 should have a mammogram every year. Women whose mother or sister had breast cancer should let their doctor know and discuss when to begin mammograms. REMEMBER...self exam monthly clinician exam yearly and mammogram are all necessary components of a good breast care plan. All 3 exams need to be reassuring to provide adequate clinical significance on the absence of breast cancer. A "negative" mammogram does not mean "no cancer present"

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When is the best time to do a breast self-exam?

The best time to examine your breasts is at the end of your period, when your breasts usually aren't tender or swollen. Every woman over age 20 should conduct a self-exam every month to check for lumps, thickening, dimpling of the skin, or any unusual discharge from the nipple. If you find anything unusual, contact us right away, so we can examine you and plan appropriate care.

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What can I do to relieve the pain of menstrual cramps?

You can begin with an over the counter pain reliever such as acetaminophin, ibuprofen or Alleve.Call the office for further evaluation if symptoms progress or persist despite "simple" measures.Worsening cramps can mean Gyn problems, such as infection, growths or endometriosis. Using a heating pad or taking a hot bath can also help. Many women find relief in exercise, meditation, yoga and acupuncture. Additional benefit can be gained with nutritional therapies such as calcium, magnesium and potassium supplements.

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What are the symptoms of premenstrual syndrome (PMS) and how is it treated?

PMS can be defined as the monthly physical, behavioral, and emotional changes that typically take place two weeks before your period starts and ends dramatically within two days after it begins. PMS is related to hormonal changes during the menstrual cycle. Though the cause of PMS is unknown, it is attributed to an imbalance of female hormones.

Physical symptoms include breast tenderness, bloating, weight gain, headaches and fatigue. Emotional symptoms include irritability, mood swings, crying, depression, sensitivity and hostility. Behavioral symptoms include insomnia, withdrawal and overeating. Various treatments include dietary changes, vitamin & mineral supplements, such as PMS Compose and exercise.

Dietary changes suggested are eating frequent, but smaller meals and not skipping meals as hunger will exacerbate symptoms. Avoid refined sugars, caffeine, nicotine, alcohol and artificial sweeteners. Limit dairy products to two servings per day, limit red meats & saturated fats and lower your sodium intake. Eat foods consisting of mostly complex, unrefined carbohydrates such as green leafy vegetables, whole grains, cereals, legumes and fresh fruits.

Vitamin and mineral supplements include magnesium (250 mg daily), zinc, vitamin E and vitamin B6. Natural supplements include evening primrose oil. Take 500 mg three times a day during the second half of your cycle (days 14 to 28.) One particular supplement, PMS Compose is a nutritional formulation designed to regulate and normalize the female reproductive system and cycle, thus preventing and managing symptoms associated with menstrual and reproductive dysfunction. PMS Compose contains chaste berry extract, dong quai extract, and alfalfa extract. Go to the Products page for more information or call the office to place an order.

Regular exercise is very important and helps reduce symptoms in many ways. It increases our endorphins, the body’s natural painkiller, which in turn raises our serotonin levels. It is a stress reducer and therefore helps you sleep better. A daily exercise program such as brisk walking, biking, rollerblading, aerobics or yoga are all excellent ways to get the endorphins pumping.

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What are the causes of vaginal infections?

The vagina contains various organisms which are necessary to keep it healthy. When the normal balance of these organisms is upset, one or more can multiply out of the usual proportions and cause an abnormal vaginal discharge. Three major organisms, bacteria, trichomonas, and monilia (yeast) cause vaginal infections. If you notice a change in the color, quantity, or odor of your usual discharge and/or develop itching, contact your doctor.

Chemicals in commercial douches, vaginal sprays, and spermicidal foams, gels, or condoms can sometimes cause "noninfectious" vaginitis. Certain factors such as poor diet, lack of sleep, increased stress, oral antibiotics, or presence of another disease or infection may also make the vagina more susceptible to infection. Intercourse without enough lubrication and tight fitting clothing may also irritate the vagina and lead to infection.

You can minimize the chances of getting a recurrence of your infection by completing all of your medication. More importantly, stop infections before they begin by following the rules of good hygiene: wear clean underwear, change sanitary pads often when menstruating and wipe from front to back after a bowel movement. Don’t use commercial douches, deodorant tampons or other perfumed products that can irritate the vagina.

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How can I prevent a urinary tract infection?

Urinary tract infection (UTI) is an inflammation in the urinary tract. If left untreated, UTIs can cause permanent damage. A UTI is the result of bacteria that multiplies and spreads from the rectum to the urethra and to the bladder or kidneys. Your doctor will diagnose a UTI by reviewing your symptoms, examining you and ordering lab tests including urine analysis and cultures. Generally, your doctor will treat a UTI with antibiotics.

Symptoms include: chills, fever, nausea and vomiting, perspiration, frequent need to urinate, strong-smelling urine, pain during sexual intercourse, blood in the urine, pain in the lower pelvis, abdomen, lower back or side, and pain or discomfort when urinating.

Ways to prevent UTI’s include the rules of good hygiene (see) above in addition to the following: try not to postpone urination for long when you feel the urge, empty your bladder completely when you urinate, urinate after sexual intercourse, wear all-cotton or cotton-crotch underwear and pantyhose, drink plenty of fluids and avoid strong soaps, douches, antiseptic creams, and feminine hygiene products (sprays, powders.)

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