Gynecology

Well Woman Exam (Annual Exam)

Your well-woman visit is all about you, your body, and your reproductive health. We are dedicated to providing individualized preventative health care for every patient.

The Key to Lifelong Health

Every woman should have a scheduled exam with her gynecologist annually. An annual exam is the best defense we have to prevent future health concerns.

What is included in your well woman exam?

• A physical exam – blood pressure, pulse and weight check
• A breast exam – your Bella Physician will check for breast lumps, skin changes on the breasts, or any irregularities you have noticed in your own breasts.
• A pelvic exam – your Bella Physician will examine your reproductive organs to determine the size and position of your ovaries, uterus and cervix. This can help detect any issues with the vaginal tract, uterus and ovaries.
• A pap smear – The pap smear is used to screen for cervical cancer – this is done during the pelvic exam portion of the exam. We recommend patients have their first pap smear at age 21. Depending on your age, a pap smear is done every 2-3 years just as long as your previous pap smear was normal.
• Fasting labs – it is optional for you to do this at your well woman exam – it is recommended to have fasting labs drawn every 2 years after the age of 26. It is a way for your physician to check on kidney and liver functions, screen for thyroid disease and diabetes, and check on your cholesterol for heart health. If you have already done this with your PCP, then it is not necessary to do this again at your annual exam. We recommend fasting (nothing to eat or drink except water) for at least 6 hours prior to getting your fasting labs drawn.
• STD screening – we are able to screen for sexually transmitted diseases at your annual exam. This is done at the time of your pelvic exam and may also include blood work. Every insurance provider is different on the coverage of these tests so check with your insurance carrier prior to your appointment to see if they are covered with your well woman exam.
• Mammogram screening order form - Based on age and medical guidelines you will receive an order for your annual mammogram screening. There is a MMG center located in our office building – you can call and schedule an appointment with them the same day you have an appointment with us.

What happens if my period comes when it is time for my well women exam appointment?

• No worries! Please keep your appointment. If the cycle flow is light, it usually does not interfere with the exam, any cultures, or pap smear testing. It is obviously up to you…if you don’t feel comfortable being examined while you are on your cycle we are happy to reschedule you. Otherwise, we are very accustomed to examining women for any health care concerns and our goal is to make you comfortable and happy with your experience.

Birth Control/Contraception Management

It is our goal to help you make informed decisions about contraception and what works best for you and your body. Birth control is not a one-size-fits-all scenario.

At Bella Ob/Gyn, we offer all forms of birth control to patients to help make sure you have access to the birth control that is right for you.

Birth control options include:

• Traditional oral contraceptive pills
• Vaginal rings (Nuvaring^®) – just like birth control pills but the hormones get absorbed into your bloodstream through the vaginal tissue. You insert them yourself once a month.
• Birth control patches – just like birth control pills but the hormones get absorbed through your skin into your bloodstream. They are changed once a week.
• IUDs (intrauterine devices) – both hormonal and non-hormonal – these devices are inserted into the uterus by your physician and can prevent pregnancy without the maintenance of taking a pill every day. It is 99% effective. Once you are ready to conceive, they can be removed at any time.
• Birth control implants (Nexplanon^®) – inserted under the skin of the arm by your physician. It lasts up to 3 years and is 99% effective at preventing pregnancy. It can be removed at any time by your physician.
• Injections (Depo-Provera^®) – injection that prevents pregnancy for 3 months. Not reversible.

All these birth control options are available in our office or easily obtainable anywhere in the Houston area with a prescription.

Abnormal pap smear management

The key to preventing cervical cancer is screening with a pap smear. But what happens when that pap smear comes back abnormal? We are here to guide you through the results and recommend treatment plans for monitoring and/or treatment.

Colposcopy

Sometimes a pap smear reveals abnormal cells that need further investigation. A colposcopy is an office exam involving a high-powered magnifying scope that looks at the cervix to determine if abnormal tissue is present. The physician will place a speculum in the vagina and then bathe the cervix in a solution that will help light up any abnormal cells present. We then use the magnifying scope to take a close look at the cervix. We then take biopsies of the cervix in the area that lights up. This is typically only mildly painful (like brief menstrual cramps). The tissue is then sent to the lab for further investigation.

LEEP – Loop Electrocautery Excision Procedure

This is a procedure to help treat abnormal cells on your cervix. A wire loop is used to remove abnormal cells from your cervix – this tissue is then sent to the lab to ensure all the abnormal tissue has been removed.

Cryotherapy

This procedure uses a freezing technique to freeze the top layer of the cervix in order to remove the abnormal tissue.

Problematic Periods

The female menstrual cycle is complex and problematic at times. Heavy, painful and irregular cycles can arise at any point in our lifetime. We strive to get to the cause of these issues and guide you through options that can ease the stress of these problematic periods.

Identifying the cause – abnormal, heavy periods and menstrual bleeding can be caused by many factors including hormonal imbalances, infections, problems with blood clotting, uterine tumors, certain types of cancer, chronic medical problems and even pregnancy. We can evaluate your symptoms and conduct an exam to get to the cause of your problem.

Treatment options

There are many options to help women manage their cycles:

Medical

• Prescription hormones (birth control pills or progesterone only pills)
• IUDs
• Prescriptions to help lessen bleeding (Lysteda^®)

Surgical

• Hysteroscopy – using a camera to look inside the cavity of the uterus to see what is causing the bleeding problems (thickened lining, polyps, fibroids)
• Endometrial ablation – procedure that is used to destroy the lining of the uterus in women who have completed childbearing
• Total laparoscopic hysterectomy
• Minimally invasive robotic assisted hysterectomy
• Total abdominal hysterectomy

Talk to your physician so you can make an informed, careful decision about how to eliminate your heavy cycles. Let the team at Bella Ob/Gyn help you.

Endometriosis

We understand the pain and anxiety that is associated with a diagnosis of endometriosis. We can offer you the endometriosis treatment that is right for you.

It is estimated that 1 in 10 women are affected by endometriosis. Endometriosis is a complicated disease process and can lead to chronic pelvic pain and infertility. With endometriosis, tissue that normally lines the uterus grows elsewhere in the body. The implants respond in the same way that the uterine lining does by thickening, breaking down and shedding. However, since this occurs outside the uterus, the tissue can become inflamed, irritated and scarred. It causes pain and other symptoms:

• Bowel problems – diarrhea, constipation, painful bowel movements
• Painful urination
• Dyspareunia (pain during intercourse)
• Lower back pain
• Heavy or painful menstrual cycle

At Bella, we are dedicated to helping you manage this disease. We offer both medical and surgical options that can help keep endometriosis from affecting your daily life.