Gynecology

Irregular or absent menses and abnormal uterine bleeding (AUB) can indicate underlying problems including fibroid tumors, polyps, hormonal imbalance, cancers, and pre-cancers. If your periods are irregular, absent or heavy, we take your medical history, perform a physical exam, run blood tests, and order any other necessary tests to determine what is causing your menstrual disorder before choosing the appropriate treatment.

For women with heavy periods, NovaSure® treats excessive bleeding so that this condition doesn't interfere with your life.

Our physicians recommend that an adolescent girl have her first gynecological visit when she becomes sexually active, or by the age of 21, whichever comes first. If a young woman has been sexually active, a pelvic exam and screening for sexually transmitted diseases should be performed. A Pap smear should be performed by age 21. Girls having gynecologic issues before this age are encouraged to make an appointment at any time. A pelvic exam does not need to be performed unless symptoms warrant it.

While we encourage open communication between our patient and her parents, many adolescents are hesitant to discuss sensitive topics such as sexual activity. Because of physician-patient confidentiality and HIPAA (Health Insurance Portability and Accountability Act of 1996) regulations, our medical practitioners cannot discuss any health issues with parents of adolescent patients without the patient's permission, unless there is a serious threat to the patient's health. Similarly, if any testing is performed in the office, we are unable to give results to anyone but the patient. Rest assured that we have the best interests of your child in mind, and we are constantly encouraging good health practices and open communication with parents.

Gardisil® is a vaccine that has proven effective for preventing some types of cervical cancer and genital warts caused by the Human Papilloma Virus (HPV). Our providers strongly encourage immunization with this vaccine between the ages of 9 and 26 years old. If you have any concerns about Gardasil, please schedule a consultation with one of our practitioners to discuss this revolutionary vaccine against cervical cancer. We will gladly answer your questions.

Annual exams are recommended for all women who are sexually active or plan on becoming sexually active, or who are 20 years old. During the exam, the gynecologist will examine your breasts and pelvic organs for abnormalities that might indicate cancer or other problems. If you have a Pap smear, he or she will brush some cells from your cervix, and the sample will then be tested for the presence of pre-cancerous cells.  In some situations, guided by national recommendations, a second test for human papilloma virus (HPV) is also performed.  The combination of these 2 tests allow your doctor, in many instances, to perform them less frequently than every year. Your care will be individualized based on your history.  However,  annual wellness exams are still recommended. 

BRACAnalysis® screening assesses a woman's risk of developing breast or ovarian cancer based on the detection of mutations in the BRCA1 and BRCA2 genes. This test has become the standard of care in identifying individuals with hereditary breast and ovarian cancer. The following questionnaire was developed by the physicians at Advocare Burlington County Obstetrics & Gynecology and is based on recommendations of The Society of Gynecological Oncologists and The U.S. Preventive Services Task Force. Feel free to make an appointment to discuss this and determine if testing is right for you.

Some procedures can be performed in our office with minimal discomfort to you in a safe and familiar environment. When completed in the office, these procedures take less time out of your busy schedule than a hospital or surgicenter based procedure. Recovery from these procedures is also faster since no anesthetic drugs are used. Because office based procedures are not for everyone, please discuss this option with our provider at your office visit. Some of the procedures we perform in the office include Colposcopy, Endometrial Biopsy, IUD Procedure, Implanon® Birth Control Implant, and Cystometrics.

Choosing a method of contraception is an important decision that will impact a women's daily life. Talking with your doctor about the right method for you is essential to successful protection for you and your partner. At Advocare Burlington County Obstetrics & Gynecology, our providers will answer your questions and provide you with information about the different types of contraceptives and their respective advantages and disadvantages.

Birth control methods have many variable factors including frequency, convenience, permanence, and effectiveness. Before choosing a method of contraception, it is important to consider your life, age, health, and previous experiences. The decision is ultimately yours, but patients trust our knowledge and experience to help them make the right choice. Our office offers diaphragm fitting; oral contraceptive pills; contraceptive patches and rings; Mirena® or Skyla® IUD and Paraguard® IUD; and the new, implantable device, Nexplanon®. We also offer Essure®, the revolutionary, permanent birth control method delivered without incisions and with minimal recovery. Traditional tubal ligation procedures are also available.

Gardasil® is a relatively new vaccine that prevents the types of genital human Papillomavirus (HPV) that cause most cases of cervical cancer and genital warts. Given in three shots over a six-month period, the vaccine is routinely recommended for girls and women ages 13 through 26 who have not yet been vaccinated or completed the vaccine series, and in some women up to age 45.

Most couples are able to become pregnant after at least one year of trying. Those who cannot, or who suffer from repeated miscarriages, may need medical assistance to achieve a viable pregnancy. More than seven million women in the United States have difficulty getting pregnant. This can be related to both male and female factors.

Infertility problems may be a result of low sperm production or the inability of the sperm to reach and fertilize the egg. In women, the problem is usually caused by ovulation disorders, but may also be the result of blocked fallopian tubes or uterine fibroids. Fertility can also be affected by certain life factors such as age, stress, and alcohol consumption.

Infertility can be a troubling problem for couples trying to start a family. There are several options available to help treat this condition, including various medications to address women's infertility problems, and assisted reproductive technology (ART), in which the sperm and eggs are mixed externally and placed into the women's body. Your doctor can help you decide which treatment option is best for you.

Affecting over eight million women in the U.S., with 22 million more suffering from low bone mass, postmenopausal osteoporosis is a disease that weakens the body's bones, making them more susceptible to fracture. Osteoporosis is more common than heart attacks, stroke, and breast cancer combined. Contrary to popular opinion, osteoporosis is not a natural result of aging and is preventable. All women, especially those at risk for developing the disease (see list below), should work to stay healthy by eating a balanced diet rich in calcium and vitamin D, exercising, not smoking, consuming limited amounts of alcohol, undergoing regular bone density testing, and getting medical treatment when appropriate. These preventive methods are especially important since osteoporosis is not curable.

You have a higher risk of suffering from osteoporosis if you:

• Are going through or have gone through menopause
• Are white or Asian
• Are thin
• Have family members or a family history of osteoporosis
• Have insufficient calcium or vitamin D intake
• Do not exercise
• Smoke
• Drink alcohol frequently
• Take long-term bone-thinning medications.

A simple, painless bone mineral density test (BMT) can determine whether you already have or are at risk of developing osteoporosis.

We recommend that all postmenopausal women take 1000-1500 mg of calcium with vitamin D per day. Pharmaceutical drugs are available to treat osteoporosis but should be started before the onset of severe disease.

A yearly pelvic exam and Pap smears at recommended intervals is one of the greatest gifts you can give to yourself. A Pap smear is performed by collecting cells from your cervix to determine the presence of infection, inflammation, and most importantly, abnormal cells that may indicate cervical cancer. HPV testing is also recommended at different time intervals, based on your age and history.  Together, Pap smears, HPV testing, and pelvic exams can detect benign and pre-cancerous conditions early, increasing the likelihood of successful treatment.

Most abnormal Pap smears require minimal testing. Usually observation over time is all that is required. Colposcopy is often the first test done to evaluate an abnormal Pap smear. Colposcopy is an office procedure visualizing your cervix with a microscope in which very tiny biopsies are taken. There is usually minimal or no discomfort during this procedure.

At a certain time in every woman's life, the ovaries cease producing eggs and the menstrual cycle ends. A woman is born with a limited number of eggs that cause the menstruation and ovulation process. Once the eggs run out, those processes end as well. This event affects women physically and emotionally as their bodies adjust to these biological changes. The average age of the menopause is 52 in the United States. Early menopause can occur as a result of certain disorders, some types of diseases, or damage to the ovaries.

Menopause is diagnosed when a menstrual period has been absent for 12 months. However, the entire process takes several years and begins when the ovaries start producing less estrogen. This stage, known as perimenopause, is when symptoms may begin. Menopause symptoms include:

• Irregular vaginal bleeding
• Hot flashes
• Insomnia
• Night sweats
• Fatigue
• Depression
• Bladder control symptoms

Not all women experience symptoms of menopause, and those who do may find their symptoms to be mild or severe. These symptoms may last from the perimenopause stage through several years after menopause. The loss of estrogen production also increases the risk of osteoporosis, heart disease, and Alzheimer's disease.

We offer effective treatments for most menopause symptoms and for reducing the associated risks. Your doctor can help decide which options are best for you.