It’s important to have a well-woman exam, also called an annual exam, with your caregiver once a year. This exam helps you learn more about your body and what steps you need to take to become healthier.

A well-woman exam is recommended once a year. It often includes breast and pelvic exams and a pap smear but can also address any individual needs. You’re able to bring up any concerns or questions you might have regarding sexuality, stress, parenting, family planning, and/or hormones. Your caregiver will take your vitals, height, and weight and give you a physical exam. We will also ask about updates on your current life and work situation, family health history, and basic questions about your diet and health.

A pelvic exam is very important for a woman’s overall health and checks the health of your reproductive organs—including your vulva, vagina, cervix, and uterus. Your physician will also check for ovarian cysts, sexually transmitted infections, or certain cancers. This is usually done by taking a pap smear/test. A pap test consists of gathering cells from your cervix with an extended swab and are typically recommended every three to five years. These procedures are quick, often painless, and vital for your health.

Cache Valley Women’s Center also offers vaccines, including Gardasil, which is a vaccine for HPV, a virus known to cause certain cervical and uterine cancers.

A sexual health visit, or basic gynecological exam, helps you get to know your doctor before you get married or become sexually active. It usually includes a discussion of birth control options, what to do if you get a UTI, and other related topics.

A sexual health visit can include a discussion of anything you’d like. Below are a few ideas of topics to discuss during your appointment:

• Contraceptive counseling (birth control) and a prescription or placement.
• Your anatomy and physiology
• How to make sexual activity an enjoyable experience
• Testing and counseling for sexually transmitted infections
• The HPV vaccine: What it is and when we recommend it
• Cervical cancer screening: What it is and when we recommend it
• Any specific questions or concerns you may have
• Any questions about becoming pregnant

Your physician will check for signs of illness or abnormalities in the uterus, cervix, fallopian tubes, ovaries, and bladder during a pelvic exam. Unlike a Pap test, this is suggested to be performed once a year. A pelvic exam is not a pap test.

A pap smear/test is a type of screening that checks for cancer of the cervix or any cervical abnormalities that might lead to cancer. Your gynecologist examines the vulva and the cervix with a speculum and will take a small sample of cells to examine.

According to the American Cancer Society, guidelines say that as long as you have never had an abnormal pap test, you only need a pap test every 5 years, beginning at the age of 25. HPV (human papillomavirus) testing will always be included with the pap test due to HPV most frequently being the cause of cervical cancer. Being seen for a well-woman exam prior to age 25 is recommended, but a pap/HPV test will
not be obtained.

If your daughter has painful, heavy, or irregular periods, if she plans to become sexually active, or if she has any questions regarding her health, she should be seen by a provider.

One of the most popular forms of birth control is most commonly known as “the pill.” Oral contraceptives come in an estrogen/progestin combo pill or a progestin-only form. You must take the pill at the same time every day for maximum effectiveness. It can also help reduce heavy periods, cramping, and offer some protection against certain health conditions.

IUDs are small, flexible devices inserted into the uterus to prevent pregnancy. IUDs have the advantage of being long-term, low-maintenance forms of birth control. Fertility usually returns quickly after having an IUD removed. Women who choose an IUD have the option between a hormonal or non-hormonal IUD. Hormonal IUDs (brand names such as Mirena, Kyleena, and Skyla) emit small amounts of progesterone into the uterus to prevent pregnancy.

Some hormonal IUDs are now considered effective for 8 years, but you should talk to your doctor about which IUD you have and the duration of its effectiveness at the time of insertion. Non-hormonal IUDs emit trace amounts of copper that prevent pregnancy and are effective for up to 10 years.

For women who know they are done having children, sterilization is a permanent birth control option. Options include tubal ligation, hysterectomy, and in some cases, minilaparotomy (removal of a section of the fallopian tube on each side and done one to two days after a woman gives birth).

For men who wish to undergo sterilization, we ask that you visit with your urology physician.

Depo-Provera is a progestin shot you receive from your OB/GYN every 12 weeks. This low-maintenance shot can offer fewer cramps and lighter periods for some. However, it can take up to a year to get pregnant after you stop.

The patch is an adhesive square worn on the body. It releases hormones similar to the pill to prevent pregnancy. You must change the patch weekly.

The vaginal ring is a flexible, small ring that you insert into the vagina every three weeks. It releases estrogen and progestin to prevent pregnancy.

There are various barrier methods including condoms, diaphragms, and spermicide.

Some women become pregnant quickly and for others, it takes longer. It’s normal for it to take some time.

• The average woman under 30 years old has about a 20% chance of getting pregnant within each month, provided there aren’t any undiagnosed fertility issues.
• Within a year of trying, the average woman’s chances of conceiving are 90% (again assuming no underlying complications).

Several factors can affect a couple’s chances of conceiving, such as:

• Age
• Weight
• Nutrition and lifestyle
• How often you have sex
• Stress levels

The recommendation from both the American Congress of Obestetricians and Gynecologists and the American Society for Reproductive Medicine is that women under age 30 try to conceive for 12 months before seeking treatment. For women over age 30, try for six months before seeking help from a fertility specialist. Both partners should undergo a comprehensive physical and medical assessment.

For women, tests are very comprehensive and can include exams for:

• A hormone imbalance
• A tumor or cyst
• Eating disorders
• Alcohol or drug use
• Thyroid gland problems
• Excess weight
• Stress
• Brief menstrual cycle
• Pelvic inflammatory disease
• Polyps in the uterus
• Endometriosis or fibroids
• Scar tissue or adhesions
• Chronic medical illness
• A previous ectopic (tubal) pregnancy
• A birth defect
• DES syndrome (certain medication given to women to prevent miscarriage or premature birth can result in fertility problems for their children)
• Abnormal cervical mucus

For men, a semen sample is tested.

Normally, a complete medical history and physical exam are the first steps in diagnosing a fertility problem. After that, some of the diagnostic tests may include:

• Blood and urine tests to check hormone levels
• A pap smear to check the health of the cervix
• Urine test to evaluate LH surges
• Basal body temperature test. This checks whether the woman’s ovaries are releasing eggs
• An endometrial biopsy. The physician removes a piece of tissue in the uterine lining
  • Examining this tissue helps tell the physician whether eggs have been released and whether the corpus luteum produces enough progesterone.
• An ultrasound to look for fibroids or cysts in the uterus or ovaries
• A post-coital test. The physician takes a sample of mucus from the woman’s vagina. She must have the test during her fertile days and within 12 hours after she and her partner have sex. This test helps determine whether the man’s sperm can survive in the woman’s cervical mucus.
• A laparoscopy checks for scar tissue or endometriosis in the woman’s fallopian tubes or ovaries.
  • This procedure usually requires general anesthesia
• Hysterosalpingogram, the cervix is clamped and a needle filled with dye is injected into the uterus. An x-ray is taken to determine whether the dye passes through the open ends of the fallopian tubes. This procedure is performed at Logan Regional Hospital.

Women and men are each responsible for 50% of all infertility cases. According to the Center of Disease Control, around 10% of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant.

Intrauterine Insemination (IUI) is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization.

IUI provides the sperm an advantage by giving it a head start but still requires a sperm to reach and fertilize the egg on its own. It is a less invasive and less expensive option compared to In Vitro Fertilization.

Routine breast exams are very important to detect breast cancer as early as possible. In addition to your annual breast exam, we encourage you to give yourself a monthly breast exam. A woman should begin with yearly mammograms at age 40, or sooner if you have a family history of breast cancer.

Become familiar with how your breasts look and feel. This helps you notice any symptoms such as lumps, pain, or changes in size that may be of concern. You should report any changes that you notice to your doctor or healthcare provider. Learn more tips for knowing when and why to get a mammogram on our blog.

A breast self examination (BSE) is important for early detection of breast cancer. Try to get in the habit of doing a breast self–examination once a month to familiarize yourself with how your breasts normally look and feel. Look for any changes in breast tissue, such as changes in size, feeling a palpable lump, dimpling or puckering of the breast, inversion of the nipple, redness or scaliness of the breast skin, redness or scaliness of the nipple/areola area, or discharge of secretions from the nipple.

Tests are not typically needed to diagnose menopause because women tend to experience irregular periods and hot flashes as her hormone levels fluctuate. Under certain circumstances, your doctor may recommend blood tests to check your levels of:

• Follicle-stimulating hormone (FSH) and estrogen (estradiol). Your FSH levels increase and estradiol levels decrease as menopause occurs.
• Thyroid-stimulating hormone (TSH). An underactive thyroid (hypothyroidism) can cause symptoms similar to those of menopause.

Menopause does not require medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Talk with your physician about which treatments are right for you. Treatments may include:

• Hormone therapy
• Vaginal estrogen
• Low-dose antidepressants
• Gabapentin (Neurontin, Gralise, others) has been shown to help reduce hot flashes.
• Clonidine (Catapres, Kapvay, others) might provide some relief from hot flashes
• Medications to prevent or treat osteoporosis.

If you have had unprotected sex, have a new partner (or more than one partner), or worried for any reason that you may have been exposed to an STI, talk to your healthcare provider.

Common STIs we test for include: chlamydia, gonorrhea, HIV, herpes, HPV, syphilis, and trichomoniasis. You and your healthcare provider work together to determine if you need to be tested for all of these, some, or other types of STIs.

A colposcopy is done when the results of a cervical cancer screen show abnormal changes in the cells of the cervix. It is the process of looking at the cervix through a special magnifying device called a colposcope. This exam allows your physician to find problems that cannot be seen by the eye alone.

Cryotherapy is a treatment that prevents cervical cancer. Your doctor uses chemicals to essentially freeze abnormal cells from your cervix so normal ones can grow back.

LEEP stands for Loop Electrosurgical Excision Procedure and also helps prevent cervical cancer. In this case, a small electrical wire loop is used to remove abnormal cells from your cervix. This procedure may be performed after abnormal cells are found during a pap test, colposcopy, or biopsy.

Also commonly known as a laparoscopic hysterectomy. Your physician uses specialized tools that are inserted through fingernail-size incisions in the abdomen. This approach often results in a much faster recovery and less pain than with a traditional hysterectomy.

A laparoscopy is the most common type of surgery for both the diagnosis and treatment of endometriosis. It allows observation of the reproductive organs without the need to create a large abdominal incision. During the procedure, the surgeon makes a small incision in the abdomen to insert the surgical instruments and a small camera (laparoscope) to increase visibility. Your surgeon will either remove the lesions or cysts or destroy them with intense heat and cauterization.

Sometimes a woman’s muscles or tissues that support the urethra, bladder, uterus, or rectum are damaged. There are a few different types of surgery for treatment:

• Injections
  • Synthetic materials are injected into the tissue around the urethra to provide support and tighten the opening of the bladder neck. The procedure is usually performed in your health care professional’s office with local anesthesia. A lighted scope is inserted into the urethra and the material is injected through a thin needle. The procedure takes less than 20 minutes and may take two or three injections to get the desired result. The injections may improve symptoms but do not usually result in a complete cure of incontinence.
• Urethral Sling — There are two types
  • Midurethral sling—The mid-urethral sling is the most common type of surgery used to correct SUI. It is a narrow strap made of synthetic mesh and placed under the urethra. It acts as a hammock to lift or support the urethra and the neck of the bladder.
  • Traditional sling—In this type of surgery, the sling is a strip of your tissue taken from the lower abdomen or thigh. The ends of the sling are stitched in place through an incision in the abdomen.
• Colposuspension
  • The part of the urethra nearest to the bladder is restored to its normal position.