Patients with health questions can contact us through any of the following methods:
For the safety of our patients and staff, please call our office to reschedule your appointment if you are experiencing symptoms of illness, such as fever, flu-like symptoms, or other contagious symptoms.
Many common pregnancy questions can be answered by reading What to Expect When You're Expecting or other reputable pregnancy books. The ACOG.org website is also an excellent source of reliable, evidence-based information throughout your pregnancy
Medications During Pregnancy
Many medications are safe to take during pregnancy. However, it is best to limit unnecessary medication use whenever possible, especially during the first trimester.
If you have a chronic medical condition, such as thyroid disease, a seizure disorder, high blood pressure, or another ongoing health condition, it is important to continue taking your medications exactly as prescribed unless your provider instructs you otherwise. Stopping certain medications without medical guidance can be harmful to both you and your baby. Some medications require routine blood work during pregnancy, as dosage adjustments may be needed. Your provider will monitor these medications and make any necessary changes throughout your pregnancy.
For additional information on medications that are considered safe during pregnancy, please refer to the Obstetrical Guide section.
Pap Smear
A Pap smear (also called a Pap test) is a screening test used to detect abnormal cells on the cervix (the opening to the uterus) that could develop into cervical cancer if left untreated. In many cases, the test is performed along with HPV (human papillomavirus) testing, depending on your age and medical history.
A Pap smear does not screen for other gynecologic conditions such as ovarian cancer, endometriosis, uterine cancer, or sexually transmitted infections unless additional testing is performed.
Cervical cancer screening recommendations vary based on your age, medical history, and previous test results. Your provider will discuss the screening schedule that is most appropriate for you.
Colposcopy (Colpo)
A colposcopy is a procedure performed to closely examine the cervix, vagina, and vulva after an abnormal Pap smear, a positive HPV test, or another abnormal finding during your exam.
During the procedure, your provider uses a special microscope called a colposcope to closely evaluate the cervix. If any abnormal areas are identified, a small biopsy may be taken for further evaluation.
You may experience mild cramping during the procedure. Taking an over-the-counter pain reliever, such as ibuprofen (Advil® or Motrin®), about one hour before your appointment may help minimize discomfort unless you have been instructed not to take these medications.
After the procedure, light spotting, mild bleeding, or a dark-colored discharge is common for 1–2 days, especially if a biopsy was performed. The discharge may appear thick or coffee-ground-like due to the solution used to help control bleeding. Please contact our office if you experience: Heavy vaginal bleeding (soaking a pad in an hour or less), Fever of 100.4°F or higher, Severe pelvic pain not relieved with over-the-counter medication, and/or Foul-smelling vaginal discharge.
Endometrial Biopsy (EMB)
An endometrial biopsy is a procedure used to collect a small sample of tissue from the lining of the uterus (the endometrium). It is commonly performed to evaluate abnormal uterine bleeding or assess changes in the uterine lining. A thin, flexible instrument is gently passed through the cervix to obtain a small tissue sample, which is then sent to a laboratory for analysis.
You may experience cramping during the procedure. Taking ibuprofen (Advil® or Motrin®) about one hour before your appointment may help reduce discomfort unless you have been advised not to take these medications. Mild cramping or light spotting may occur for a day or two following the biopsy. Please contact our office if you experience: Heavy vaginal bleeding (soaking a pad in an hour or less), Fever of 100.4°F or higher, Severe pelvic pain not relieved with over-the-counter medication, and/or Foul-smelling vaginal discharge.
Yeast Infection
Symptoms are: thick white vaginal discharge like cottage cheese and vaginal itching. You may treat yourself with an over-the-counter yeast medication like Monistat or Gyne-Lotrimin. If symptoms persist without any improvement, schedule an appointment. If you have abdominal pain or fever, or your discharge has an odor, you need an appointment to obtain treatment. Diflucan, the oral yeast medication advertised in magazines, is not routinely prescribed because of the possible serious side effects associated with its use.
Vaginal Irritation & Possible Vaginal Infection
Vaginal irritation can have many causes, including a yeast infection, bacterial vaginosis (BV), hormonal changes, allergic reactions, skin irritation, or a sexually transmitted infection (STI).
Common symptoms may include: Vaginal itching or burning, Unusual vaginal discharge, Vaginal odor, Redness or swelling, Pain during intercourse, and/or Burning with urination (that seems to come from the vaginal area) Because many vaginal infections cause similar symptoms, it is important to determine the exact cause before starting treatment. Self-treating with over-the-counter medications may not be effective if the infection is caused by something other than a yeast infection.
If you have concerns about a possible sexually transmitted infection (STI), have had a new sexual partner, or believe you may have been exposed to an STI, you will need to be evaluated in the office so the appropriate testing can be performed. To make sure you receive the right treatment for your infection and to help prevent any complications, we will need to see you in the office for an evaluation.
Urinary Tract Infection (UTIs)
A urinary tract infection (UTI) is an infection that can occur anywhere in the urinary system, including the bladder, urethra, kidneys, or ureters. Most UTIs involve the bladder and are caused by bacteria entering the urinary tract. Common symptoms of a UTI include: Burning or pain with urination, Frequent urination, Feeling a strong or urgent need to urinate, Passing only small amounts of urine, Lower abdominal or pelvic pressure, Blood in the urine, and/or Cloudy or foul-smelling urine.
Because urinary symptoms can also be caused by vaginal infections, sexually transmitted infections (STIs), kidney stones, or other medical conditions, an evaluation and urine testing are often needed to determine the correct diagnosis.
To make sure you receive the right treatment for your infection and to help prevent any complications, we will need to see you in the office for an evaluation.
If you develop fever, severe back or side pain, persistent vomiting, or are unable to keep fluids down, please seek immediate medical attention, as these symptoms may indicate a kidney infection requiring urgent treatment.
What is a Hysterosonogram (Saline Infusion Sonogram or SIS)?
A hysterosonogram, also called a Saline Infusion Sonogram (SIS), is a specialized ultrasound used to evaluate the inside of the uterus. It combines a transvaginal ultrasound with the gentle infusion of sterile saline into the uterine cavity, allowing your provider to obtain a clearer view of the uterine lining.
This procedure may be recommended to evaluate: Abnormal uterine bleeding, Uterine polyps, Fibroids, Scar tissue, Congenital uterine abnormalities, and/or Other changes involving the uterine lining.
During the procedure, a small catheter is placed through the cervix, and a small amount of sterile saline is introduced into the uterus while ultrasound images are obtained.
Most patients experience little to no discomfort, although mild cramping during or shortly after the procedure is common. Taking an over-the-counter pain reliever, such as ibuprofen (Advil® or Motrin®), about one hour before your appointment may help minimize cramping unless you have been instructed not to take these medications.
What is a Hysterosalpingogram (HSG)?
A hysterosalpingogram (HSG) is a specialized X-ray procedure commonly performed as part of an infertility evaluation. The test allows your provider to assess the shape of the uterine cavity and determine whether the fallopian tubes are open
During the procedure, a radiologist places a small catheter through the cervix and injects a contrast dye into the uterus while X-ray images are taken. As the dye travels through the uterus and fallopian tubes, images are obtained to identify any blockages or abnormalities.
You may experience mild to moderate cramping during the procedure. Taking ibuprofen (Advil® or Motrin®) about one hour beforehand may help reduce discomfort unless you have been advised not to take these medications.
Your provider will review the results with you and discuss any recommended next steps.
When Should I Have a Mammogram?
Mammograms are an important screening tool used to detect breast cancer early, often before symptoms develop. For women at average risk, routine screening mammograms are generally recommended beginning at age 40 and continuing every 1–2 years, depending on your age, personal preferences, and discussion with your provider
Some women may need to begin screening earlier or undergo additional breast imaging if they have: A strong family history of breast cancer, A known genetic mutation (such as BRCA1 or BRCA2), A personal history of breast cancer or certain high-risk breast conditions, and/or Prior chest radiation at a young age.
Your provider will review your personal and family history to recommend the screening schedule that is most appropriate for you.
Starting Your Birth Control Pills
There are several safe ways to start birth control pills. Your provider will recommend the method that is best for you.
Take one pill at the same time every day to maximize effectiveness. If you are not starting your pills within the first five days of your menstrual cycle, or as instructed by your provider, use a backup method of contraception (such as condoms) for the first 7 days of your pill pack.
If you begin any new prescription medication, over-the-counter medication, or herbal supplement, ask your pharmacist or healthcare provider whether it may affect your birth control. While most antibiotics do not decrease the effectiveness of birth control pills, some medications (such as rifampin, certain seizure medications, and some herbal supplements like St. John's Wort) can reduce their effectiveness. Taking your pill with food or at bedtime may help reduce nausea
Breakthrough Bleeding
Light bleeding or spotting between periods (breakthrough bleeding) is common during the first 2–3 months after starting a new birth control pill. This does not usually mean the pill is not working.
Breakthrough bleeding may also occur if: Pills are taken late or missed, You are taking medications that interfere with birth control, and/or You are ill with vomiting or severe diarrhea.
This spotting typically improves with each pack.
Please contact our office if: Breakthrough bleeding continues after three months, Bleeding becomes as heavy as a regular period or heavier, and/or You have severe pelvic pain or other concerning symptoms.
Missed Pills
If you miss a pill, follow the instructions included with your specific pill pack, as recommendations vary depending on the type of pill and how many pills were missed.
In general:
Missing pills increases the chance of breakthrough bleeding and pregnancy. If you are unsure what to do after missing pills, please contact our office.
Missed Period While Taking Birth Control
Occasionally, you may miss a withdrawal bleed while taking birth control pills.
If you have taken every pill on time and have not missed any pills or taken medications that interfere with your birth control, pregnancy is unlikely. However, if you miss a period, it is recommended that you take a home pregnancy test before starting your next pack.
If the pregnancy test is negative, begin your next pack as scheduled.
Please contact our office if: You miss three consecutive periods, Your pregnancy test is positive, You develop symptoms of pregnancy, and/or You have missed pills and missed your period.
Nausea While Taking Birth Control Pills
Mild nausea is common during the first few weeks after starting birth control pills and usually improves as your body adjusts. To help minimize nausea: Take your pill with food, Consider taking your pill in the evening or at bedtime, and Continue taking your pill at the same time each day. If nausea is severe or persistent, please contact our office