During her first exam, the patient should be prepared to discuss her medical history and other personal issues, including substance abuse, smoking, domestic abuse, sexual abuse, sexually transmitted diseases and contraception options. Questions from patients at their first exam are not only welcome, but also highly encouraged. The patient should know that her privacy and confidentiality will be protected, and her doctor can be trusted to confide in.

At the conclusion of the exam, the physician will leave the room to go over any results and to allow the patient to get dressed. The results that are immediately available will be discussed with the patient directly afterwards. The patient will then be given an opportunity to ask any questions and voice concerns. It is at this time that contraceptive options can be discussed. If there is a need for a follow-up appointment, this will be addressed.

Upon the completion of a Pap smear and pelvic exam, other testing may be needed. The Pap smear is used to examine cells collected from the cervix. These results can detect cancer or abnormal cells that could lead to cancer. Non-cancerous conditions, infection, and inflammation can also be detected with this test.

Testing for sexually transmitted diseases (STDs) can also be performed at the time of the pelvic exam. STDs may have no symptoms or be accompanied with mild irritation or severe pain.

 Some STDs include:

• Gonorrhea – bacterial infection
• Chlamydia – bacterial infection
• HPV – viral infection
• Syphilis – bacterial infection
• Herpes – viral infection
• HIV – viral infection
• Hepatitis – viral infection

The Human Papilloma Virus (HPV) can be protected against through Gardasil, a vaccination that protects against the four most common strands of HPV. HPV is a very serious condition that can cause cancer of the cervix, vagina, and vulva. HPV may also cause genital warts.

 The HPV vaccine consists of three injections over a six-month period, and women ages 9-26 are encouraged to receive the vaccine             
For more information about Gardasil visit www.gardasil.com

Being informed of your contraceptive options is very important to your health. Choosing the wrong contraceptive option or not using contraceptive can lead to an unintended pregnancy.  Contraceptives are most effective when they are safely, correctly, and consistently used.

Birth Control Pills

Birth control pills contain hormones that prevent pregnancy. The pills don’t prevent or protect against STDs. Risks associated with the pills include:  blood clots, hypertension, stroke, cervical cancer, or breast cancer. Women who smoke cigarettes, have a high number of sexual partners, or don’t have regular Pap smears are at a higher risk for the risks associated with the usage of birth control pills.

Condoms

When used correctly, condoms can be effective in preventing pregnancy and most STDs. This is an inexpensive way to practice safe sex, and you don’t need a prescription. Condoms also protect future fertility by preventing STDs.

Diaphragm & Vaginal Barriers

The vaginal ring and weekly patch is a newer combined hormonal method. The use of these methods reduces the demand of taking pills daily, while still protecting against pregnancy.

NuvaRing

The NuvaRing is inserted into the vagina once every 28 days. The ring is left in place for 21 days and removed for 7 days to allow for a menstrual period.

Ortho Evra Patch

The Ortho Evra patch is replaced every 7 days. This is done each week for three weeks, followed by one week off to allow for a menstrual period.

Depo-Provera, Implanon, & the Mini Pill

These contraceptive methods only use the hormone progesterone. This is important for women who cannot use contraception that contains estrogen. Lactating women can use progesterone only contraception methods.

Depo-Provera

An injection given every 12 weeks

Implanon

This is a small, flexible, plastic rod that is placed under the skin of the arm

Mini Pill- this birth control option is a progesterone only pill that is taken every day.  Women who are breast-feeding use this method.

Contraceptive Sponge

This is a one-size, over-the-counter birth control method. The sponge is moistened with water and inserted deep into the vagina. This provides 24-hour protection; regardless of how many times intercourse occurs. The sponge can be removed and discarded six hours after intercourse.

IUD

Intrauterine devices provide long-term protection against pregnancy, and are reversible.  The device prevents sperm from fertilizing eggs, but provides no protection against STDs.

• ParaGard protects against pregnancy for ten years.
• Mirena protects against pregnancy for five years.

Female or Male Sterilization

This is the safest, most effective, and most effective contraceptive method.

In females, the fallopian tubes are cut or blocked to prevent eggs and sperm from uniting.  Women who don’t want to have any children at all or don’t want to increase the size of their family use this method.

In males, in a procedure called a vasectomy, the vas is blocked in order to prevent the passage of sperm into seminal fluid.

Minimally invasive surgery uses innovative laparoscopic and hysteroscopic technologies, allowing for some surgical procedures to be done through tiny incisions. These procedures decrease hospital stay, post-operative pain, and recovery time. Through the use of this cutting-edge technology, it is our hope to get you back to regular activity and improve your quality of life as quickly as possible.

Carolina Women’s Physicians is dedicated to providing you with the safest treatment option. Dr. Ferguson helped perform the first robotic assisted hysterectomy in North Carolina. She was the first private practice physician to be certified in the use of the da Vinci robot for gynecology.

 In order to ensure safety and optimal outcome of surgery, it is important that you follow certain preoperative procedures.  You’ll have a preoperative appointment scheduled prior to surgery to discuss preoperative/postoperative instructions prior to surgery date with Dr. Ferguson/surgical coordinator.

Two weeks before surgery

• No NSAIDS – aspirin, Aleve, Motrin, and others

Seven days before surgery

• You will see your doctor at a pre-operative appointment
• Take medications as instructed
• Follow any precautions or instructions given by your doctor

 The day before surgery

• Do not eat or drink after midnight
• Take medications as instructed

Some conditions that can be treated through minimally invasive surgery include:

• Blocked fallopian tubes
• Endometriosis
• Uterine fibroids
• Infertility
• Ovarian cysts
• Pelvic adhesions
• Pelvic pain
• Postmenopausal bleeding
• Urinary incontinence
• Uterine scarring

Menopause occurs when menstruation ends. This usually occurs in women after the age of 50. When women stop experiencing monthly periods, their ovaries stop producing the sex hormones estrogen and progesterone. When these hormones stop being produced, there are many effects on the body.

The body can have many responses to menopause, which include:

• Hot flashes
• Interrupted sleep
• Thinner vaginal tissues, which can cause dryness, itching, and pain during sexual intercourse
• Mood swings
• Loss of bone mass density
• Memory Loss
• Depression
• Elevated cholesterol levels

 The symptoms of menopause can be managed in many ways. This may involve hormone replacement therapy, other medications, or no treatment with close follow up by your provider. We recommend a consult with a provider when symptoms begin. This allows to develop a personalized treatment plan that suits the patient’s medical needs, while relieving her menopause complaints.

Other symptoms, including vaginal dryness, itching, and painful intercourse, can have a profound impact on women’s daily lives and intimate relationships. Relief from these symptoms is now possible with minimally invasive MonaLisa Touch™ laser treatments.

Osteoporosis is a term that means “porous bones.” It is a skeletal disease that occurs because bones have lost important minerals and are now more susceptible to fractures. Any bone can be affected, but the most common fractures occur in the back, hips and wrists.

The majority of people affected by osteoporosis are women. However, men can also be affected.

Risk factors that increase the likelihood that someone would develop osteoporosis include:

• Postmenopausal women over the age of 50
• Women over 50 of Caucasian or Asian descent
• Family or personal history of fractures
• Small boned or thin
• Heavy smoker or drinker
• Not enough calcium or vitamin D intake
• Inactive lifestyle

 With the use of medications or lifestyle changes, the loss of bone mass can be stopped or possibly reversed.  It is important to talk to your physician if you believe you could be at risk for osteoporosis.

The first gynecological exam may be done when a girl is in her adolescence if a patient encounters gynecological problems. These include heavy irregular periods, painful periods, or other concerns. At Carolina Women’s Physicians, we recognize the need for a positive first exam in order to better influence her future health decisions.

 Females should undergo a pap smear and pelvic exam by the age of 21, or before, if sexually active.

 Patients that schedule an appointment before the age 21 may not require a pap smear at the first visit. This will depend on the patient’s age, any problems noted, or if she is sexually active. If no pelvic exam is necessary, the first appointment may just consist of a discussion between a patient, the provider, and her parents. The questions asked at the first appointment can be very personal, and it is important to be very honest with your provider and to ask questions.

 We realize that the first gynecological exam may be intimidating, especially for young women. Our nurturing staff strives to make the first appointment as comfortable and relaxing as possible, while supplying the patient with important health information.

 Among the reasons a teenager should see a gynecologist include:

• Problems with menstrual periods
• Hirsutism and acne
• Pelvic pain, which is not responding to standard treatments
• Pelvic masses
• Ovarian tumors