Preventative Women’s Care
Pre-registration is convenient through our Phreesia patient portal, which can be utilized via cell or email. You will receive a notification a few days prior to your visit. When you arrive at our office, you will be greeted by our receptionist, who will request your insurance card in order to facilitate the billing process. Our receptionist may give you some additional health questionnaires to fill out when you arrive. Your doctor’s assistant will escort you to our examination rooms and will probably request a urine specimen. If this is your first visit, we will record your weight and blood pressure. You and your doctor will have time to discuss your medical history prior to the exam, which will probably include a breast exam and pelvic exam, and possibly a pap smear. Please let your doctor know if this is your first pelvic exam so we can make it as easy as possible for you. If you have questions, please consider writing them down in advance, so you don’t forget them.
Pap smears allow us to look for abnormal cells on the cervix so we can catch and treat them before they become cancerous. A speculum, which is a smooth, duck-bill shaped instrument, is gently introduced into the vagina and gradually opened to allow your doctor to see your cervix. Cervical cells are obtained with a special, soft instrument. The pap smear is a useful procedure for identifying the human papillomavirus (HPV), which can be found even in women who have had the HPV vaccine. Some women with HPV have no symptoms and heal naturally, while others might develop abnormal and/or precancerous cells on the cervix. The American College of Obstetrics and Gynecology recommends that women have their first pap smear at age 21. The frequency of future pap smears depends on the results.
A pelvic exam involves looking and palpating or feeling your pelvis to check for abnormal growth inside and out. We look for masses such as uterine fibroids and enlarged ovaries. We also conduct pelvic exams to check for infections or to evaluate pain. Pelvic exams do not always include a pap smear.
During a breast exam, your doctor feels the tissue of the breasts and checks for any lumps or abnormalities that could be breast cancer. There is controversy about whether or not women should do self breast exams. Certainly, many women find their own breast cancer. If you do them at home, examine your breasts during the week after your period when your breasts are the least dense. After age 35 or 40, women should also have an annual mammogram which can detect tumors before they are big enough to be felt. Learn more about breast cancer detection from the American Cancer Society. We are proud to offer state of the art mammography at our Atlanta Women’s Healthcare Specialists Imaging Center which is conveniently located in the same building as our Buckhead office.
A colposcopy is done when we need to further evaluate an abnormal pap smear. Your doctor places a speculum into the vagina and uses a large cotton swab to apply vinegar to your cervix. As we look through a specially-designed microscope equipped with a green light, the vinegar will cause abnormal areas on the cervix to “light up”. We then usually take a few biopsy specimens which can feel like a menstrual cramp. A liquid iron solution is placed over the biopsy area to stop the bleeding, and it will cause a discharge that looks like coffee grounds for up to several days. You should not use tampons or have intercourse for at least one week after your procedure.
You may need a LEEP procedure if you have abnormal or precancerous cells on your cervix (dysplasia). For moderate or severe dysplasia, we will remove the cells using a thin, electric wire loop at the end of a wand. After inserting a speculum into your vagina, your doctor will clean and numb your cervix. Then, the wire loop will be inserted through your vagina to remove the area where the abnormal cells are growing. Your doctor will use a liquid iron solution to stop the bleeding, so you will have a brown discharge that looks like coffee grounds for up to two weeks. After the LEEP, you should not use tampons or have intercourse for two weeks.
An endometrial biopsy is done to obtain tissue from inside the uterus to determine the cause for irregular bleeding, which is sometimes only due to changes in hormones. It only takes a few minutes, and the procedure can also let us know if you have a polyp (extra tissue growth) or even cancer. Your doctor will glide in a speculum and may numb your uterus. A long, thin suction device will then be threaded through your cervix and into your uterus. You may experience a feeling like strong menstrual cramps, which usually resolve within a few minutes. You may resume normal activities after an endometrial biopsy.
A myomectomy is a surgical procedure to remove fibroids. Depending on the size and placement of the fibroids, the myomectomy can often be accomplished through the vagina with no incision. Minimally-invasive myomectomies can also be performed laparoscopically and robotically, which require small incisions through the abdomen. A laparotomy is a more traditional surgical procedure where an incision is made (usually a “bikini cut”) and the fibroid(s) is/are removed.
A hysterectomy is the removal of the uterus, and is recommended to treat a variety of issues including pelvic pressure, pelvic pain, severe endometriosis, uncontrollable bleeding and fibroids. There are many types of hysterectomies ranging from minimally-invasive to traditional surgical procedures, and your doctor will recommend the best procedure for your situation. A hysterectomy is the removal of the uterus only, although sometimes it is necessary to also remove the ovaries. If you are not in menopause at the time of your hysterectomy, and keep your ovaries which control your hormones, you will not be in menopause after the procedure. You should talk with your doctor about whether or not to have your cervix removed along with the uterus.
Many women suffer from endometriosis, a condition of pelvic pain, often worse during your period. Sometimes medications provide sufficient relief, but laparoscopic surgery remains the best way to diagnose and treat the condition.