Patient Services
- Annual Gynecologic Healthcare
- Menopausal Medicine and Hormone Replacement
- Cervical Cancer Vaccine
- Contraception Counseling and Management
- Other Conditions
Our goal is to provide high quality gynecology services in a comfortable office setting.
In addition to the information provided below, The American College of Obstetrics and Gynecology (ACOG) website and the North American Menopause Society (NAMS) website also contain many links to helpful women's health information.
Annual Gynecologic Healthcare
Background
The annual gynecologic exam is one of the most commonly scheduled physician office visits. A woman should schedule her first gynecology exam no later than age 21, or at any age when there is a need for counseling regarding contraception or sexuality. This routine screening exam consists of a complete history taking and physician exam. The exam encompasses women's general health recommendations and cancer screening for the Breast, Cervix, Uterus, and Ovaries.
Our Services
The Pap smear is only one component of the exam and is used to screen for cervical cancer. Cervical Cancer is caused by a sexually transmitted virus called the Human Papilloma Virus (HPV). In 2006 the Food and Drug Administration (FDA) approved the use of the Gardasil vaccine. Gardasil can prevent the transmission of HPV, and is the first vaccine ever produced which can actually prevent cancer. The HPV vaccine is recommended for girls and young women from ages 9 to 26 and boys. In this age group, it is most effective when given prior to first sexual activity. It is considered a routine adolescent vaccination.
Menopausal Medicine and Hormone Replacement
Background
Over the last decade Hormone replacement has been one of the most dynamic, exciting, and controversial areas of medicine. Several large scale randomized studies including the HERS trial and WHI (Womenen's Health Initiative) have greatly expanded our knowledge of the benefits and long term effects of hormone replacement therapy. The initial finding from the WHI indicated that there were some previously unrecognized rare side effects. Unfortunately, the national popular media misrepresented the overall safety of hormone therapy based on these uncommon complications. Consequently many physicians abandoned the use of hormone therapy in their practices, and many women were left to suffer through menopause without any effective treatment.
Symptoms of the menopausal transition may include the following:
- Menstrual irregularity
- Mood changes, mood swings, and irritablity
- Hot flashes
- Night sweats
- Vaginal dryness
- Urinary incontinence
- Bone loss
- Changes in sexual function and loss of sex drive
Dozens of sub-analyses of the WHI data have subsequently been performed, and have demonstrated that in most circumstances, hormone replacement is safe and effective with minimal or no risk of major complications. Also many physicians and their patients are now seeking alternatives to traditional hormone replacement therapy including natural supplements and bio-identical hormone therapy. Although there are limited data regarding the safety and efficacy of these new treatment options, they represent a very promising and active area of research.
Our Services
Dr. Hunter is a strong advocate for women's health education and autonomy. At Hunter Women's Clinic, we provide counseling and education on up-to-date information in menopausal medicine and hormone therapy.
We offer all of the following:
- Hormone testing
- Traditional hormone therapy
- Bio-identical hormone treatment
- Natural alternatives
- Other medical therapies
Additionally we offer initial evaluation and treatment recommendations or referrals for osteoporosis, breast disease, thyroid and adrenal dysfunction. We recommend screening for breast cancer, colon cancer, malignancy of the female reproductive tract, cardiovascular health, and endocrine disorders.
Understanding and anticipating the mental and physical changes that accompany the menopausal transition can make a big difference, and we are confident that our caring approach can make the transition much easier.
Contraception Counseling and Management
Background
There are more contraceptive options available today than ever before. Choosing a method that is right for you can be difficult. Many factors may affect your decision including: duration of contraception desired, cost, expected compliance, ease of use, reliability, and side-effects.
Below is a list of some of the currently available methods:
Hormonal Contraception:
- Oral Contraceptive Pills: Once daily oral medication
- Contraceptive Patch: Once weekly transdermal patch
- Contraceptive Vaginal Ring: Once monthly vaginal ring
- Depo Provera Injection: Every 3 month Intramuscular injection
- Progesterone Intrauterine Device: Placed in the uterine cavity by the physician in the office. Effective up to 8 years
- Implanted Progesterone Rod: Placed subcutaneously in the medial arm by the physician in the office. Effective up to 3 years
- Emergency Contraceptive Pills (Plan B, etc.): Short 1-2 day course of pills available over the counter to prevent pregnancy from condom failure, etc.
Non-hormonal Contraception
- Condoms: Placed prior to each episode of sexual activity. Condoms provide protection against sexually transmitted diseases.
- Other Spermicides and Barrier Methods: Vaginal contraceptive gel, female condom
- Copper Intrauterine Device: Placed in the uterine cavity by the physician in the office. Effective up to 10 years
- Laparoscopic Tubal Ligation; Uterine tubes are permanently blocked by the physician in the operating room.
- Laparoscopic Bilateral Tubal Removal may decrease chances of cancer in the future.
- Natural family planning
- Partner Vasectomy
Our Service
Hunter Women's Clinic offers many contraception therapy options. During the visit, your provider will evaluate your needs and provide individualized counseling and education. We will ensure that the method that you choose is the best method for you.
Cervical Cancer Vaccine
Background
In 2006 the Food and Drug Administration (FDA) approved the use of the Gardasil vaccine in women. Gardasil can prevent the transmission of HPV, and is the first vaccine ever produced which can actually prevent cancer at several sites in the body. The HPV vaccine is recommended for girls and young women from ages 9 to 26 and boys. In this age group, it is most effective when given prior to first sexual activity. It is considered a routine adolescent vaccination.
Our Services
The Gardasil® vaccine is now available via prescription at your preferred pharmacy.
Other Common Gynecologic Conditions
Listed below are a number of common gynecologic symptoms and likely differential diagnoses. Definitions and additional information about these and many other gynecologic conditions can be found at the American College of Obstetrics and Gynecology (ACOG) website.
Genital itching (Pruritis) -- Vaginal and Vulvar yeast infections (Candidiasis), Lichen Sclerosis and other vulvar skin conditions, Vaginal and vulvar infections and Sexually transmitted diseases, Vulvar Cancer
Vaginal discharge (Leukorrhea) -- bacterial vaginosis, sexually transmitted disease, normal discharge, foreign body (retained tampon, pessary, vaginal NuvaRing)
Skipped or Absent periods (Oligomenorrhea or Amenorrhea) -- pregnancy, polycystic ovarian syndrome (PCOS), stress, weight gain/loss, thyroid disease, prolactin disorders
Excessive Hair Growth (Hirsutism)-- polycystic ovarian syndrome, medications, ovarian tumor, menopause, supplement use
Pelvic pain or painful menses (Dysmenorrhea)-- PID, endometriosis, uterine fibroids, ovarian cysts, adenomyosis, irritable bowel syndrome, interstitial cystitis, urinary infection
Heavy menses (Menorrhagia) -- dysfuctional uterine bleeding, polyps, uterine fibroids, hereditary bleeding disorders, medications, pregnancy
Sexual Pain (Dyspareunia) -- vaginal dryness (urogenital atrophy), vulvar vestibulitis, lichen sclerosis, sexually transmitted disease, Bartholina's cyst
Ovarian Cyst -- functional cyst, benign persistent cyst, dermoid cyst, ovarian neoplasm, paratubal cyst
Breast Pain (Mastalgia)-- caffeine use, stress, hormonal changes, fibrocystic disease, fibroadenoma, breast cyst, breast neoplasm, ligament pain
Vaginal Mass -- Bartholina's cyst, prolapsed uterus, prolpased bladder (cystocele), prolapsed rectum (rectocele), hemorrhoid, cervical polyp, vaginal cancer
Menstrual Migraines
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)
Sexually Transmitted Disease Screening
Decreased sexual desire (Decreased Libido)