Gynecology Education

My First Gynecology Visit

At The Women’s Group of Northwestern, we know that visiting a gynecologist for your women’s health needs can feel intimidating in the beginning. We do everything we can to make you feel comfortable, safe and reassured in our office. We encourage you to refer to the health factsheet from ACOG that explains what to expect from your first gynecological visit. Please feel free to view our Teen Education Page.

Contraception Options

Most women use some form of birth control throughout most of their lives.  Your needs can change from the first time you have intercourse, between children until you no longer get a period.  Since there are a variety of options available, it can be difficult to decide which birth control method is best. The best method is one that you will use consistently, is acceptable to you and your partner, and does not cause bothersome side effects.  The providers at the Women’s Group of Northwestern can provide information on efficacy, side effects, and to help assist you through the decision.

Other factors to consider include:

• How effective is the method?
• Is it convenient? Will I remember to use it?
• Do I have to use/take it every day?
• Is this method reversible? Can I get pregnant immediately after stopping it?
• Will this method cause me to bleed more or less?
• Are there side effects or potential complications?
• Is this method affordable?
• Does this method protect against sexually transmitted diseases?

No method of birth control is perfect. At your contraception consultation, we can discuss which method that you will be able to use consistently and correctly.  It may be helpful to review this fact sheet about contraception choices to get familiar with the most common methods before your office visit.

ACOG Contraception  FAQ : https://www.acog.org/womens-health/faqs/birth-control

Abnormal Uterine Bleeding

Bleeding that occurs in the following situations is abnormal:

• Bleeding after menopause
• Bleeding between periods
• Periods that occur less than 21 days apart
• Periods that occur more than 35 days apart
• Heavy bleeding (such as passing large clots or changing a pad or tampon every hour for more than 2-3 hours in a row)
• Periods that last longer than 7 days
• Bleeding after intercourse

If you are experiencing abnormal uterine bleeding, contact our office for an appointment.  Your appointment may include an ultrasound, physical exam, blood tests and possibly an endometrial biopsy.

Abnormal Pap smears

A Pap smear is used to screen for cervical cancer. In women older than age 30, the Pap smear may be combined with a test for human papillomavirus (HPV), a common sexually transmitted infection that can cause cervical cancer in some women.

If your Pap smear or HPV test come back abnormal, it does not mean that you have cervical cancer. We may perform a procedure called colposcopy using a special magnifying instrument (colposcope) to examine the tissues of the cervix, vagina and vulva. Your doctor also may take a biopsy from any areas that appear abnormal. The tissue sample is then sent to the lab at Northwestern or Quest diagnostics for diagnosis.  Most abnormalities will not require treatment beyond repeat Pap smears, however, some require an additional in office procedure called loop electrosurgical excision procedure (LEEP). A LEEP uses a thin, low-voltage electrified wire loop to cut out abnormal tissue and will cut away abnormal cervical tissue that can be seen during colposcopy.

STDs

Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are generally acquired by sexual contact. The organisms that cause sexually transmitted diseases may pass from person to person in blood, semen, or vaginal and other bodily fluids.  Some infections can also be transmitted nonsexually, such as from mother to infant during pregnancy or childbirth, or through blood transfusions or shared needles.

It’s possible to contract sexually transmitted diseases from people who seem perfectly healthy — people who, in fact, aren’t even aware of being infected. Many STIs cause no symptoms in some people.  STIs have a range of signs and symptoms. That’s why they may go unnoticed until complications occur or a partner is diagnosed. Signs and symptoms that might indicate an STI include:

• Sores or bumps on the genitals or in the oral or rectal area
• Unusual or odd-smelling vaginal discharge
• Unusual vaginal bleeding
• Pain during sex
• Lower abdominal pain

Signs and symptoms may appear a few days to years after exposure, depending on the organism.  If you have signs of an STI or believe you may have been exposed, contact our office for an appointment as soon as possible.

Uterine Fibroids

Uterine fibroids are muscular tumors that grow in the wall of the uterus.  They also are called leiomyomas or myomas. The size, shape, and location of fibroids can vary greatly. They may be present inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. A woman may have only one fibroid or many of varying sizes.  Fibroids can be as small as an apple seed or larger than a grapefruit.

Fibroids are most common in women aged 30–40 years, but they can occur at any age. Fibroids occur more often in African American women than in white women. They also seem to occur at a younger age and grow more quickly in African American women.

Most fibroids do not cause any symptoms, and may be found during a routine pelvic exam.  Some women with fibroids can have:

• Heavy bleeding (which can be heavy enough to cause anemia) or painful periods
• Feeling of fullness in the pelvic area (lower stomach area)
• Enlargement of the lower abdomen
• Frequent urination
• Pain during sex
• Lower back pain

Fibroids that do not cause symptoms, are small, or occur in a woman who is nearing menopause often do not require treatment.

If treatment is necessary, options can include medication to control heavy bleeding and pain or surgery to either shrink the fibroid (uterine artery embolization) or remove the fibroids (myomectomy).

If you think you may have fibroids, schedule an appointment with one of our providers.  The initial appointment may include a pelvic exam.