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Gynecology is the medical and surgical treatment of disease of the female reproductive tract. This includes the ovaries, fallopian tubes, uterus, cervix, vagina, and external genitals. As part of routine health maintenance, many gynecologists also screen for disease of the breast, bones, cardiovascular, endocrine, and gastrointestinal systems. We also focus on issues with sexual and mental health. Gynecologists divide their outpatient time between annual health maintenance and problem-based office visits as well as serving as a consultant for primary care doctors. Gynecologists are surgeons specializing in the female reproductive tract, performing procedures such as hysterectomy, removal of the ovaries, and treatment of endometriosis.
A women’s gynecologic needs change over time. While it is impossible to list everything, here are some of the more common issues that face women at different points of their lives. Theses are general concepts and many overlap or can show up at any age.
This generally starts when a young woman begins having her period. We focus on education regarding normal menstrual development, the onset of sexual intercourse, safe sex practices, contraception, and STI testing. We also help women with abnormal menstrual cycles, endometriosis, and ovarian cysts. This phase starts to transition as women start thinking about starting a family and optimizing their health and planning the right time for conception.
This is the most common, although not exclusive, phase where the majority of women have most of their children. For those actively trying or unexpectedly pregnant, we focus on supporting patients through the preconception, pregnancy, and postpartum periods as well as the interval between their children. For those not trying for pregnancy, it is a phase of promoting general health and well being through routine health maintenance (annual exams), cervical cancer screening, and treatment of precancerous cervical lesions, contraception and sterilization, and the management of specific gynecologic problems such as heavy periods, fibroids, and endometriosis.
This is the most common time for women to seek out a gynecologist for a specific problem. In addition to the routine health care visits, many women need help with changes in their menstrual cycle in the decade before they reach menopause. This can be due to heavy or painful periods, fibroids, and endometriosis. The 40s are the most common time for women to undergo surgery for a gynecologic problem and much time is often spent determining the best medical and surgical treatment options. Additionally, as women move through menopause, we work with them on multiple physical and emotional issues including hot flashes, night sweats, weight loss, and changes in metabolism, depression, sexual difficulties, and hormonal testing and replacement. Much of this is multi-factorial and we often assist in a multidisciplinary approach.
At this point, most women have become menopausal and their periods have stopped. Many still have some residual symptoms that we continue to manage. We focus on specific needs such as the treatment of pelvic organ prolapse, urinary incontinence, postmenopausal bleeding, and sexual dysfunction. We also spend a great deal of time with health maintenance in screening for breast cancer, diabetes, osteoporosis, uterine and ovarian cancer, high cholesterol, and thyroid disease.
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