What is LEEP?

LEEP is a procedure used to address abnormal cells on the cervix. LEEP, or loop electrosurgical excision procedure, removes irregular tissue by cutting it away using a thin wire loop which is attached to a mild electrical current. It can be performed once abnormal cells are discovered during a pap exam, colposcopy, or biopsy.

How effective Is LEEP?

LEEP treats the issue roughly 90% of the time. If LEEP doesn’t cure the issue, the procedure can be repeated or the doctor can recommend another type of treatment.

How does LEEP work?

During the procedure, the doctor typically looks through a colposcope to see the cervix more clearly, then:

Patients lie down on an exam table like during a pap exam.

A speculum is inserted into the vagina to open the area further.

A numbing medication is placed on the cervix.

A vinegar-like solution is applied to make the irregulars cells easier to view.

The doctor uses an electrical wire loop to excise the abnormal tissue. The tissue is then sent to a lab to be tested.

Any bleeding is stop with the electric cauterization and the doctor can also apply a special paste, Monsel’s Solution, to avert bleeding.

The procedure takes roughly 10 minutes.

What can I expect after the procedure?

Following the procedure, patients may feel  mild cramping for about a day. If patients are uncomfortable, they can use oral pain relievers such as acetaminophen or ibuprofen. Patients will likely have a watery discharge for several weeks and it can be heavy and may be mixed with a small amount of blood. There also can be some odor to the discharge. Patients should not douche or use tampons for several weeks following the procedure. The doctor can also help patients decide how long they should wait to engage in intercourse. Generally, women should wait three to four weeks before having vaginal intercourse. Continuing to take their medications as usual, including the birth control pill, is also important. Patients can also continue to use any other method of birth control.

What is hormone replacement therapy?

Menopause is a phase of a woman’s life where periods stop and estrogen levels decrease. It is a normal part of getting older. In the years prior to and during menopause, the levels of female hormones often fluctuate. This frequently causes symptoms including hot flashes and vaginal dryness. For some women, undergoing hormone replacement therapy (HRT) can relieve these symptoms. HRT can also protect against osteoporosis.

What are they benefits of hormone replacement therapy?

HRT is the most effective treatment for minimizing vasomotor symptoms (hot flashes, flushing, nights sweats). Vasomotor symptoms are typically improved within four weeks and the maximum benefit is seen in three months. A significant reduction in the frequency of hot flashes, by around 18 week, and the severity of hot flashes by roughly 87%.

Improvement in quality of life- HRT can also improve sleep, muscle aches, and quality of life.

Improvement in mood changes- HRT can improve mood and depressive symptoms. HRT should be considered to eliminate mood swings which are the result of menopause.

Improvement of urogenital symptoms- Several studies have shown that HRT dramatically improves vaginal dryness and sexual function. HRT is successful in improving these symptoms related to vaginal atrophy. HRT can also alleviate symptoms of urinary frequency. Topical estrogen can be very effective in improving urinary symptoms. With this treatment, vaginal symptoms are improved, vaginal atrophy and pH decrease.

Reduction in osteoporosis risk

Reductions of cardiovascular health risks

When is it a good option to use HRT?

Today’s guidelines recommend using HRT for troublesome vasomotor symptoms in premenopausal and early postmenopausal women who do not have high risk factors associated with the medication including heart disease. HRT can be used:

For the treatment of menopausal symptoms when the risk to benefit ratio is in favor of the woman, who understands those risks.

For women with early menopausal symptoms until the age of natural menopause, around 51 years, even if they are asymptomatic.

For women under 60 years who are at risk of an osteoporotic fracture when non-estrogen treatments shouldn’t be used.

What is HPV?

HPV, or the human papillomavirus, is actually a term which describes more than 100 related viruses. Each HPV virus is classified with a type or number and can cause varying symptoms. HPV exists in the body’s epithelial cells. Epithelial cells are the flat, thin cells located on the surface of the skin. The cells also exist on the surface of the mouth, throat, vagina, vulva, cervix, penis head, and anus. Several strands of the virus are transmitted through sexual contact.

Is there a cure for HPV?

Infection with HPV is unfortunately quite common with roughly 80 million people in America being affected. HPV transmission can cause genital warts and irregular cell changes at the cervix and on other genital areas. These changes can cause cancer. While there is presently no cure for HPV, the infection frequently clears on its own and if this is not the case, treatment is required. There are several HPV treatment options available at the practice and there are three vaccines offers including Cervarix, Gardasil, and Gardasil-9. These can protect against contracting the virus.

How is HPV treated?

If the virus has caused irregular cell changes which could lead to cervical cancer, there are a few treatments which are used. Cryotherapy, which is used to freeze the cells with liquid nitrogen, is a commonly used treatment. Also known as a cone biopsy, conization, is employed to excise the irregular areas. Laser therapy and loop electrosurgical excision procedure (LEEP) can also be employed to address irregular cells. The goal is to extract all the abnormal cells, effectively removing most or all of the cells affected by HPV. HPV which leads to genital warts will also need to be treated. The warts are frequently raised, flat, and can range from very small to large. Genital warts can develop on the groin, thigh, cervix, scrotum, anus, or penis. When treatment is required, patients can obtain a prescription for a topical cream from the physician.

The physician can show patients how to apply these ointments at home. Podofilox is used for approximately four weeks and destroys the wart tissue. Imiquimod boosts the immune system to combat the virus. The physician may use other wart removal products if these are not effective.


Should I get tested for an STD?

Patients should be tested for an STD if they have symptoms or they have been exposed to STD. Some frequent symptoms of STDs can include:

Sores on the genitals

Discharge from the penis or vagina

Itching of genitals and anal areas

Burning during urination

It’s important to remember that many infections frequently don’t cause any symptoms. Several individuals contract STIs without ever knowing and many people spread infections without ever displaying symptoms. If you have had sex with another person and did not use a type of barrier, it is recommended that you talk to the doctor about STD testing. Getting tested ensures that you, and your partner, can determine if treatment is needed. If treatment is needed, patients can receive the care needed before the condition becomes more serious.

How do I get tested?

Patients will need to ask the doctor to conduct an STD test. Some individuals may think they will be tested for STDs when they undergo an exam for a different reason, such as a pap test or when a man has a physical. This is not the case; patients need to ask to be tested for STDs. If you are visiting the health care provider for a different reason, and are not sure if you should have an STD test, just ask. The doctor can assist you to decide if you need any tests and which ones are required.

Which STD tests do I need?

There is no single test for used for every type of sexually transmitted disease. Tests are specific to each type of infection and some infections can be found using certain kinds of tests. In most cases, the doctor will first ask questions about:

your sexual practices — including how many partners you have had, if you have used condoms or other barrier methods, and what body parts are involved during sex play

whether you have symptoms —describe the symptoms occurring and how long they have been occurring

whether symptoms occurred in the past

whether you have ever been diagnosed with an STD

whether you have used over-the-counter drugs to address symptoms

whether your partner(s) have any STDs or symptoms

any drug allergies

your last period to determine if you could be pregnant

It is important to be honest with the doctor. The doctor will help you make important decisions about what tests are needed.

What is PCOS?

Polycystic ovary syndrome, or PCOS, is a disease which changes a woman’s fertility, heart, menstrual cycle, hormones, and can even cause her appearance to change. Women with polycystic ovary syndrome generally have higher levels of androgens, occasionally referred to as male hormones even though both genders make them, irregular or missed periods, and many small cysts found the ovaries. Currently, the exact cause of polycystic ovary syndrome is not known, though it is believed to stem from hormonal imbalances. Insulin is also believed to affect the condition and increased levels have been shown to an increase in a woman’s quantity of androgens. High levels of androgens can cause a woman to have abnormal hair growth, acne, trouble with ovulating, and weight gain.

What are the symptoms of PCOS?

Symptoms usually differ from woman to woman, however they typically include:

Absent or irregular menstruation

Ovarian cysts

Pelvic pain

Increased hair growth on chest, stomach, back, face, thumbs, and toes

Acne, oily skin, and dandruff

Weight gain, particularly around the waist

Skin tags, excess skin flaps, on the neck or armpits

Dark brown or black patches of skin on neck, breasts, arms, or thighs

Infertility because of lack of ovulation

Anxiety or depression

Sleep apnea

How is PCOS treated?

While currently there isn’t a cure for polycystic ovary syndrome, there are many ways to treat the condition. Changes to the person’s lifestyle can help to address issues of weight gain and oral contraceptives can help to regulate female hormones. Fertility medications can assist a woman with polycystic ovary syndrome to ovulate if she wants to conceive and medications are available to treat the excess hair growth and extra androgens occurring with the condition. If you are concerned that you may have polycystic ovary syndrome, contact the office to schedule an appointment with the gynecologist. Treatment is available and can help patients to conceive and have regular menstruation.


What is a Pelvic Ultrasound?

A pelvic ultrasound is a diagnostic test that produces images of the inside of the pelvis. Pelvic ultrasounds can provide images of the uterus, cervix, vagina, fallopian tubes, and ovaries.

What is a Pelvic Ultrasound Used For?

A pelvic ultrasound can be used to determine the size, shape, and position of the pelvic structures. It can show changes in the shape of the bladder and the blood flow through the pelvic organs. A form of this technique called the fetal ultrasound is used during pregnancy to monitor fetal development. A pelvic ultrasound doesn’t provide an actual diagnosis, but can show abnormalities like tumors or infections.

What’s the Procedure Like?

A pelvic ultrasound may be performed by placing the transducer on the abdomen (trans-abdominal) or through the vagina (trans-vaginal). In some cases, both may be used to obtain the best information. It is not painful, although some women report slight discomfort with a trans-vaginal ultrasound. It’s important that your bladder be full for the trans-abdominal procedure, so drink plenty of water. For a trans-vaginal ultrasound, however, you should empty your bladder just before the procedure.

Will I Need Other Tests?

A pelvic ultrasound is only one of several diagnostic tests you may need. For example, you may need a pelvic examination and pap smear to look for cervical cancer. If your doctor thinks you have a vaginal infection, you may need to have a specimen collected for analysis. If you are having abnormal bleeding, your doctor might want blood tests to check your hormonal levels or the number of red blood cells (which will show if you are anemic).

What is a Pap Smear?

A pap smear is a test for cervical cancer. The test is a laboratory examination conducted on cells that are gently scraped from the cervix during a pelvic examination. The cells are spread on a glass slide and examined under a microscope. The test will identify atypical cells, which might indicate a condition like cancer cells or HPV infection, the human papillomavirus, which causes genital warts and cervical cancer.

How Often Do I Need a Pap Smear?

The current recommendation is that women should begin having pap smears at age 21. After the first test, you have two different options. You can have a Pap test every three years to check for cervical cancer. Most cervical cancers grow very slowly, and this interval offers sufficient time to catch a type of cancer. If you are over age 30 and have both a Pap test and HPV testing, you can then be tested every five years if both are normal.

Do I Prepare for a Pap Smear?

If your period starts, reschedule your pap smear, as blood can make the results inaccurate. If the bleeding is unexpected, however, go in for the appointment and tell the doctor so he can discern if there is a problem or not. Tell your doctor about any and all medications you’re taking, if you’ve ever had an abnormal pap test, or if you might be pregnant. Don’t douche, have intercourse, or use tampons in the 24 hours prior to the pap test. Empty your bladder just before the pap test.

Can I Stop Having Pap Smears?

If you have had three negative pap tests within the previous 10 years and have reached the age of 65, you no longer need to continue having pap tests. Women who have had a total hysterectomy where the uterus and cervix are removed and have not had abnormal pap smears or pelvic cancers do not need to have pap smears. It is best to discuss with your doctor when and how often to scheduled pap smears to make sure problems aren’t likely to arise.

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