Adolescent Gynecologic Care
Adolescent Gynecologic Care
The American College of Obstetricians and Gynecologists recommends that adolescents have their first gynecologic exam when they reach 12 years of age. At Steward Medical Group Women’s Health Associates, our services for adolescent gynecologic care include:
- First gynecological visit
- Annual wellness exams
- Pap smears (if needed)
- Dysmenorrhea (painful periods)
- Management of irregular cycles
Steward Medical Group Women’s Health Associates offers women – beginning in the teenage years through menopause and beyond – the option of choosing a nurse-midwife for their gynecologic and obstetric care, including annual pelvic and breast exams, preconception counseling, prenatal care, postpartum care, and breastfeeding support. Our certified nurse-midwife specializes in, but is not limited to the following services and procedures:
- Well-woman GYN visits for routine annual exams including pap smears, mammograms, lab tests, birth control and hormone replacement therapy.
- Infection testing for UTIs and STDs.
- Birth control counseling for diaphragms, IUDs, Nexplanon® and referrals for tubal ligation or Essure®.
- Management of abnormal pap smears.
- Screening and treatment of vaginal infections.
- Assessment and treatment of abnormal periods.
- Assessment and treatment of polycystic ovarian syndrome.
- Prenatal care.
- Labor and delivery care with consideration for your preferences for a natural birth or plan one with medication. (Positioning and movement is encouraged, unless your situation necessitates otherwise.)
- Postpartum care.
If you are interested in speaking to a midwife, please call 480-632-2004.
Advanced Gynecologic Care
Health care providers at Steward Medical Group Women’s Health Associates offer advanced care for women with a wide range of mild to severe gynecologic health problems. Many of these health conditions may cause similar symptoms, such as abnormal bleeding, pain during intercourse and/or menstruation, or infertility.
If you are experiencing any symptoms that appear to be caused by a gynecologic-related health condition, let your healthcare provider know immediately. With nearly all health problems, early detection and diagnosis can lead to a more effective treatment plan and better outcome.
Abnormal Uterine Bleeding
Every year more than 10 million women visit their health care provider for problems related to abnormal bleeding. Abnormal bleeding is defined by the American College of Obstetricians and Gynecologists as:
- Bleeding between periods
- Bleeding after sex
- Spotting anytime in the menstrual cycle
- Bleeding heavier or for more days than normal
- Bleeding after menopause
Though abnormal bleeding can be serious, do not assume the worst. In many cases, abnormal uterine bleeding is caused by a hormonal imbalance. Some forms of birth control can cause this imbalance. At Steward Medical Group Women’s Health Associates, your healthcare team is equipped to evaluate, diagnose, and treat abnormal uterine bleeding.
Painful Periods & Cramping
Do you suffer from moderate to severe PMS symptoms, including migraines, fatigue, mood swings or other side effects (both physical and emotional)? At Steward Medical Group Women’s Health Associates, providers are experienced in evaluating, diagnosing and treating these PMS symptoms – and others.
While cervical cancer is a life-threatening condition, the Pap test has reduced cervical cancer deaths by more than 50 percent over the last three decades. (The Pap test should be a part of your Well-Woman exam.) Part of the reason why the Pap test is so effective in detecting and treating cervical cancer is that this type of cancer develops very slowly, allowing your health care provider enough time to administer treatment before the cancerous cells rapidly divide and spread.
The primary cause of cervical cancer is human papillomavirus (HPV) infection. Regular HPV screenings should also be a part of your Well-Woman exam, depending on your age and sexual activity. This test is done at the same time as a Pap test.
Chronic Pelvic Pain
Chronic pelvic pain is clinically defined as pain in the pelvic area that lasts for six months or more. The pain may be constant, sporadic, or follow a regular cycle. Symptoms may also flare up in response to certain behaviors or outside factors.
There are many possible causes of chronic pelvic pain (including many of the health problems discussed on this page). At Steward Medical Group Women’s Health Associates, your gynecologist will usually begin by asking about your medical history and performing a pelvic exam. Other tests may be necessary for evaluating and diagnosing the issue. These tests may include ultrasound, cystoscopy, and laparoscopy.
Treatment depends on the source of the pelvic pain. Diet and lifestyle changes, medication, physical therapy, and surgery are all potential therapies for chronic pelvic pain. Your healthcare team at Steward Medical Group Women’s Health Associates will help you find the treatment that’s right for you.
Dysmenorrhea (Painful Periods)
Dysmenorrhea is the clinical term for pain associated with menstruation. This condition affects at least half of all women who menstruate. There are two types of dysmenorrhea: primary and secondary dysmenorrhea. Primary dysmenorrhea is caused by prostaglandins, naturally occurring chemicals in the endometrium. Pain gradually decreases as the lining of the uterus is shed in menstruation. Secondary dysmenorrhea is caused by a reproductive system disorder; pain tends to last longer than normal menstrual cramps and worsen over time. There are several therapies available for dysmenorrhea. If the pain is caused by endometriosis or fibroids, your gynecologist may discuss in-office procedures, such as endometrial ablation.
Endometriosis occurs in approximately one out of ten women of reproductive age – most frequently in women in their 30s or 40s. This health problem is present in approximately 40 percent of all women who are infertile.
The primary problem in patients with endometriosis is that the endometrium (tissue lining the uterus) grows outside the uterus in other areas of the pelvic cavity (and sometimes beyond). These tissues, known as “implants,” may appear in the ovaries, fallopian tubes, outer surface of the bladder, or elsewhere.
Common symptoms of endometriosis include chronic pelvic pain and heavy menstrual bleeding. However, endometriosis can also be present in women who experience no symptoms at all. Non-steroidal anti-inflammatory drugs, hormone therapy, and endometrial ablation may all be used to treat endometriosis. Your gynecologist at Steward Medical Group Women’s Health Associates can tell you more.
Uterine fibroids are benign tumors that develop from uterine tissue. However, uterine fibroids are not necessarily located within the uterine wall; some uterine fibroids may appear in other areas of the pelvic cavity, attached to the uterus by a stem.
Fibroids are most common in women between the ages of 30 and 40. Research shows that African American women are three times more likely to have uterine fibroids than other women. Also, African American women are more likely to develop fibroids at a younger age. Overweight and obese women are also at a higher risk.
Symptoms of uterine fibroid tumors may include heavy bleeding, pain during sex, a feeling of fullness in the lower stomach, frequent urination, lower back pain, and enlargement of the lower abdomen.
One common treatment for fibroid tumors is myomectomy, the surgical removal of tumors. This procedure leaves the uterus intact, making it preferable to hysterectomy for many women.
Ovarian cysts are small, fluid-filled sacs that develop on the ovaries. In most cases, ovarian cysts are benign (non-cancerous). However, whether cysts are benign or malignant, they can still cause painful symptoms. Many women with ovarian cysts complain of dull or sharp pains in the abdomen. Also, a cyst can pose a serious health threat if it ruptures or bleeds.
In many cases, ovarian cysts may be found during a pelvic exam. (This is just one reason why having an annual Well-Woman exam is so important for adult women.) Cysts may also be detected via ultrasound or laparoscopy. Depending on the size and type of cyst, symptoms, and other factors, your gynecologist may recommend a cystectomy, the surgical removal of the cyst.
Pelvic prolapse is a broad term used to describe a health problem that occurs when a pelvic organ shifts into a position lower than where it should be. Pelvic organs include the uterus, cervix, vagina, bladder, urethra, small intestines, and rectum. All of these organs are held together by the pelvic floor. This condition may be caused by having a cesarean section, menopause and aging, having had a prior pelvic surgery, extra pressure on the abdomen (including being overweight or obese), or intense physical activity.
Symptoms of pelvic prolapse include: feeling a bulge in the vagina, lower back pain, pelvic pressure (especially pressure that worsens throughout the day), feelings of heaviness or fullness in the pelvis, a pulling or aching feeling in the lower abdomen, sexual problems, difficulty inserting tampons or applicators, and organs bulging out of the vagina.
Physical therapy, lifestyle changes, weight loss, and Kegel exercises are all nonsurgical ways to get symptomatic relief. Additionally, your gynecologist may provide you with a pessary, a small medical device inserted into the vagina to support the pelvic organs. In some cases, surgery may be necessary to restore the prolapsed organ to its proper position.
Polycystic Ovary Syndrome (PCOS)
PCOS is a hormonal disorder that affects approximately 4 to 12 percent of women of reproductive age. It is the leading cause of female infertility. PCOS is closely associated with obesity, hirsutism (excess hair growth), and irregular menstruation. The primary cause of PCOS is not entirely understood. However, many physicians and researchers have noted that high insulin levels could be at the root of PCOS. When insulin levels in the body are too high, the ovaries may produce too much androgen, which can interfere with ovulation.
While the name “polycystic ovary syndrome” suggests the presence of multiple cysts on the ovaries, not all women diagnosed with PCOS have cysts. In order to be diagnosed with PCOS, a woman must have at least two of the following three symptoms:
- High androgen hormone levels. These hormones may cause excessive hair growth on the face and body, acne, and male-pattern baldness.
- Abnormal menstruation – defined as fewer than eight menstrual cycles per year, menstrual intervals of 35 days or more, or four months without a period.
- Polycystic ovaries – cysts on the ovaries.
There are many therapies available for the symptoms of PCOS. At Steward Medical Group Women’s Health Associates, your gynecologist will take into consideration your individual symptoms and whether or not you would like to have children in the future in providing you with a therapy.
Sexually Transmitted Infections/Diseases
HPV, genital herpes, chlamydia, gonorrhea, and HIV… both men and women have a lot of reasons to be concerned about sexually transmitted infections and diseases. At Steward Medical Group Women’s Health Associates, patients have access to reliable testing and treatment of sexually transmitted infections and diseases. For at-risk women, testing may be a part of an annual Well-Woman exam.
Urinary Incontinence / Overactive Bladder Syndrome
Urinary incontinence is one of the biggest, but least talked about, women’s health issues. Current estimates suggest that one in four women over the age of 40 have some kind of urinary incontinence. Your board-certified gynecologist at Steward Medical Group Women’s Health Associates can provide a thorough evaluation, diagnosis, and treatment of symptoms. If you are suffering from urinary incontinence, let your provider know at your next appointment. Treatments are available.
Overactive bladder syndrome (OAB) is a type of urinary incontinence that could have causes rooted in renal function, neurological disorders, or the use of certain medications. Your gynecologist can help you sort through your symptoms and get the treatment you need.
Vaginitis is an inflammation of the vagina. This condition is quite common and occurs in one out of three women of reproductive age at least once. If you are experiencing any symptoms, let your gynecologist know. There are many therapies available, including oral medications, gels, creams, and more. Vaginitis can be a relatively easy condition to treat. However, in some cases, the inflammation could be caused by a sexually transmitted infection, which could cause other health complications. For this reason alone, it is critical to see a health care provider about this health issue.
Board-Certified Gynecologists in Gilbert / Mesa / Tempe, AZ
If you are struggling with any of the symptoms listed below, or have been diagnosed with a gynecologic health issue, schedule an appointment with your gynecologist.
- Excessive menstrual bleeding, bleeding between periods, bleeding during/after intercourse
- Short or long menstrual cycles
- Pelvic pain, pressure, or cramping (other than normal menstrual cramps)
- Increased (or different) vaginal discharge, especially discharge of a different odor or color
- Frequent urge to urinate
- Burning sensation during urination
- Burning, redness, lumps, soreness, or itching in the vaginal area
To schedule an appointment with a board-certified OB/GYN in Gilbert, Tempe or Mesa, AZ, call Steward Medical Group Women’s Health Associates at 480-632-2004.
For thousands of women, gynecologic surgery can be an alarming prospect. The pain and potential complications of open surgery, the lost time spent in recovery, and the added risk keeps many women from receiving the treatment they need.
The gynecologists at Steward Medical Group Women’s Health Associates understand the anxiety many patients face about surgically treating gynecologic issues. In an effort to better serve patients, most of the practice’s physicians have undergone training to perform minimally invasive robotically assisted surgery.
Using the da Vinci Surgical System, one of the most sophisticated and advanced surgical devices of our day, physicians are able to treat a wide range of gynecologic issues, including cervical and uterine cancer, uterine fibroids, endometriosis, pelvic organ prolapse, and menorrhagia (excessive bleeding). The revolutionary da Vinci Surgical System features a high-definition 3D monitor and special wristed instruments that offer more mobility and sensitivity than the human hand.
Cervical, Ovarian & Uterine Cancer
There are many types of gynecologic cancer, but cervical, uterine/endometrial, and ovarian cancer are three of the more common kinds. Depending on the stage of cancer and other factors, such as the patient’s health condition, age, and reproductive desires, a hysterectomy may be advised. During a hysterectomy, the uterus is surgically removed. Depending on the factors that necessitate the hysterectomy, the ovaries, fallopian tubes, and certain lymph nodes may be removed, as well.
Women facing early-stage gynecologic cancer may be eligible candidates for da Vinci hysterectomy. This technology has been proven to allow surgeons to remove cancerous tissue more precisely than is possible with open surgery techniques. Also, da Vinci hysterectomy can potentially offer similar or fewer complications, fewer conversions to open surgery, less blood loss, less need for narcotic pain medicine, a shorter hospital stay, and a quicker recovery than traditional laparoscopy.
Uterine fibroids, benign (non-cancerous) tumors in and around the uterus, are very common in women. In fact, as many as one in five women have fibroids during their reproductive years, and half of all women have fibroids by the time they reach age 50. While many women won’t notice any symptoms or require any treatment, some women experience severe pain and excessive menstrual bleeding because of their fibroids. Uterine fibroids may be removed surgically, a procedure known as a myomectomy. In some cases, the entire uterus is removed in a da Vinci hysterectomy procedure.
Approximately 65,000 myomectomies are performed each year in the U.S. alone. Many of these procedures are done as “open” procedures, which entail large incisions and long recovery times. With da Vinci myomectomy, your surgeon may be able to remove uterine fibroids more effectively than if he or she were using an open or laparoscopic approach. The da Vinci Surgical System allows for the removal of heavier, more numerous, and more difficult to access fibroids – with fewer complications. Compared to traditional open surgery, da Vinci myomectomy offers the following potential benefits:
- Less blood loss
- Shorter hospital stay
- Less need for narcotic pain medicine
- Small incisions for minimal scarring
Endometriosis occurs when the endometrium (tissue lining the uterus) begins to grow abnormally outside the uterus. In patients with endometriosis, tissue usually grows on other areas of the pelvic cavity, such as the fallopian tubes, ovaries, bowel, and elsewhere. The result is cramping, menstrual pain, pelvic pain, pain during sexual intercourse, and – in some patients – infertility. The cause of endometriosis is unknown, and there is no cure. Patients of Steward Medical Group Women’s Health Associates, however, have the opportunity to undergo da Vinci endometriosis resection or da Vinci hysterectomy.
During a da Vinci endometriosis resection, the surgeon has amazing visibility with great depth and clarity, which allows him or her to remove deep endometrial tissue implants. Compared to traditional laparoscopy (minimally invasive surgery), da Vinci endometriosis resection offers the following potential benefits:
- Low blood loss
- Low conversion rate to open surgery
- Low rate of complications
- Short hospital stay
- Small incisions for minimal scarring
Organ prolapse occurs when an organ slips out of position. Uterine prolapse is a fairly common women’s health issue. In fact, 40 percent of participants in the Women’s Health Initiative trial in the United States were found to have some degree of uterine prolapse. Risk increases with age. Many women with pelvic prolapse experience little to no discomfort. However, a prolapsed uterus that puts pressure on the bladder or bowel pushes many women to seek medical attention.
da Vinci sacrocolpopexy (pelvic prolapse surgery) is one surgical method for treating uterine prolapse. During this procedure, a mesh is surgically inserted to hold the affected pelvic organs in their natural position. Sacrocolpopexy is sometimes performed in conjunction with hysterectomy, depending on the patient. In addition to less blood loss, a shorter hospital stay, and smaller scars, da Vinci sacrocolpopexy can improve urinary, bowel, and pelvic symptoms and allow for better sexual function. This procedure has a low rate of complications.
Excessive Bleeding (Menorrhagia)
Heavier, longer-lasting periods (menorrhagia) may be caused by a number of factors. However, the two main causes of menorrhagia are hormonal imbalance and uterine growths. Hormonal imbalances may be caused by diabetes, thyroid disease, obesity, stress, anorexia, intense exercise habits, or hormonal changes in your teen or pre-menopause years. Uterine growths, which may be malignant or benign, can be caused by any number of factors, including a few that have been covered on this page (fibroids and endometrial cancer, for example).
Depending on the cause of your excessive bleeding, your gynecologist may try using hormone therapy to treat the health problem. Other surgical options include endometrial ablation, endometrial resection, and hysterectomy. Many women have found relief from their discomfort and pain through da Vinci hysterectomy, which is performed through a few small incisions with some of the most precision-controlled surgical instruments in the world. Learn more about da Vinci Hysterectomy.
For more information about minimally invasive gynecologic surgery, including laparoscopic and da Vinci surgery, call Steward Medical Group Women’s Health Associates at 480-257-2700. Or, book an appointment online.