In-Office

In-Office Procedures

Endometrial Ablation

Minerva and NovaSure are quick, safe, and simple procedures to lighten or stop your periods without the side effects of hormones or the risks of hysterectomy. They work by permanently removing the endometrium, or the lining of the uterus (the part that causes the bleeding), with a quick delivery of radio frequency energy.

Your doctor slightly opens your cervix (the opening to the uterus), inserts a slender wand, and extends a triangular mesh device into the uterus. The mesh expands, fitting to the size and shape of your uterus. Precisely measured radio frequency energy is delivered through the mesh for about 90 seconds. The mesh device is then pulled back into the wand, and both are removed from the uterus.

Immediately after the Minerva or NovaSure procedure, some women may experience cramping, mild pain, nausea, and/or vomiting. Most women feel back to themselves and can resume normal activities within a day or so. Be sure to follow any instructions from your doctor, no matter how well you are feeling.

Plan to give your body about 3 months to fully heal on the inside and resume its normal cycle. At that point, you and your doctor should be able to tell what your cycle and your periods will be like from that point on.

Colposcopy

Colposcopy is a special way of looking at the cervix. It uses a light and a low-powered microscope to make the cervix appear much larger. This helps your health care provider find and then biopsy abnormal areas in your cervix. Colposcopy is done to detect cervical cancer and changes that may lead to cervical cancer. It is most often done when you have had an abnormal Pap smear. It may also be recommended if you have bleeding after sexual intercourse.

How is the test performed?
You will lie on a table and place your feet in stirrups, just like you would do for a pelvic exam. The health care provider will place an instrument (called a speculum) into your vagina . This allows your doctor or nurse to better see the cervix.

The cervix and vagina are gently swabbed with a vinegar or iodine solution. This removes the mucus that covers the surface and highlights abnormal areas.

The health care provider will place the colposcope at the opening of the vagina and examines the area. The colposcope does not touch you.

If any areas look abnormal, a small sample of the tissue will be removed using small biopsy tools. Many samples may be taken. Sometimes a tissue sample from inside the cervix is removed. This is called endocervical curettage (ECC).

How will the test feel?
You may have some discomfort when the speculum is placed inside the vagina. It may be more uncomfortable than a regular Pap smear.
  • Some women feel a slight sting from the cleansing solution.
  • You may feel a pinch or cramp each time a tissue sample is taken.
  • You may have some cramping or slight bleeding after the biopsy.
  • Heavy bleeding is unusual; if you have bleeding that soaks a pad in an hour, call your doctor.
  • Do not use tampons or put anything in the vagina for several days after a biopsy.
Some women may hold their breath during pelvic procedures because they expect pain. Slow, regular breathing will help you relax and relieve pain. Ask your doctor or nurse about bringing a support person with you if that will help.

IUD Insertion & Removal

CWHC offers offer Mirena, Skyla, Kyleena & Lilleta. IUDs release small amounts of hormone to give you continuous birth control for as long as you want, up to 5 years. It is more than 99% effective at preventing pregnancy, contains no estrogen, and can be removed by your healthcare professional at any time so you can try to have another child.

IUDs should be placed within 7 days of the start of your period. If you have just had a baby, IUDs  should not be placed earlier than 6 weeks after you give birth or as directed by your healthcare provider.

Your healthcare provider will place the IUD into your uterus during an office visit. You may feel some discomfort during the placement. Placement typically only takes a few minutes. The provider will apply an antiseptic solution to your vagina and cervix and then pass a thin tube of soft, flexible plastic (the inserter) containing IUD into your vagina and then into your uterus. The provider will check to make sure it is positioned correctly, and then withdraw the plastic inserter, leaving the IUD in your uterus. The provider will ensure that the two threads attached to the stem of the IUD properly extend through your cervix, which helps ensure that it is properly placed. This will also help with removal by your healthcare provider when that time comes. The provider will then trim the threads to the appropriate length.

Some women may experience cramps, pain, feel dizzy and/or have bleeding during and right after the IUD is placed. These side effects are common and usually disappear quickly.

Nexplanon Insertion & Removal

Nexplanon is a hormone-releasing birth control implant for use by women to prevent pregnancy for up to 3 years. The implant is a flexible plastic rod about the size of a matchstick that contains a progestin hormone called etonogestrel. It also contains a small amount of barium sulfate so that the implant can be seen by x-ray. Nexplanon is a soft and flexible implant that is inserted in a discreet location in the inner, upper arm. It is small in size so no one has to know that it is there but you and your health care provider.

Leep - Cervical Loop Electrosurgical Excision Procedure

  • A LEEP procedure is used to burn or remove abnormal cells from your cervix.

Cryo

  • Cryotherapy is used to freeze abnormal cells on your cervix.

MonaLisa Touch®

MonaLisa Touch®: A Novel Laser Therapy for Vaginal Health. Patients are calling it “Life-Changing”.  

The MonaLisa Touch® is designed for postmenopausal women who are suffering from changes in their gynecologic health. Women experiencing side effects as a result of a hysterectomy or breast cancer tretments may benefit from this gynecologic laser therapy. This treatment delivers gentle fractional CO2 laser energy to the vaginal wall tissue that stimulates a healing response by generating new collagen, elastin and vascularization. A typical course of treatment is three procedures over 18 weeks.
  • In-office procedure
  • Requires no anesthesia
  • No downtime
  • Minimal side effect
  • Each treatment is <5 minutes
  • 8 Published Studies
  • 6 Ongoing Studies
  • Thousands of women have been treated worldwide since 2012
In both European and US clinical trials, women reported symptom relief after the very first treatment and even greater improvement after treatments 2 and 3.

Ask us today if the MonaLisa Touch is right for you. 

BMD

  • Bone mineral density testing is recommended for women 65 and over no more than every two years. Post menopausal women younger than age 65 who have more than one or more risk factor should also be tested.
  • BMDs are used to screen for osteoporosis and bone loss. BMDs can help detect problems before a fracture occurs.
  • BMDs can be performed in our office.

IUI - Intrauterine Insemination or Artificial Insemination

After evaluation, if it is determined by your provider that you are a candidate for IUI we can proceed with this procedure in our clinic. Patients need to call on the first day of their cycle to determine if IUI is an option that month. Medications include Clomid, Repronex to stimulate eggs or follicles, and Ovidrel to induce ovulation. Ultrasounds are scheduled on cycle days 10 and 12 and insemination is usually planned for cycle day 14.

Hysteroscopy

Hysteroscopy is a diagnostic and surgical procedure that makes examining the inside of the uterus possible without making an abdominal cut (incision). During hysteroscopy, a lighted viewing instrument called a hysteroscope is inserted through the vagina and cervix and into the uterus. Treatment can also be done through the hysteroscope during the same procedure.

Reclast Infusion

Reclast is an annual osteoporosis treatment. It's a bisphosphonate but it's not a pill that you have to take every week or month. Reclast is an infusion and is the only FDA-approved treatment for postmenopausal osteoporosis that works in just one dose a year.

Unlike pills, Reclast bypasses your digestive system so it's not associated with stomach irritation. Because Reclast bypasses your stomach, you won't have to wait to eat, or remain upright for a half hour or more. And since Reclast is an annual osteoporosis treatment you have just one treatment, once a year. Reclast is given by IV so it goes through your bloodstream to your bones where the majority of the medicine then binds to your bones. We offer Reclast infusions in our office after your provider has determined it is right for you. 

Prolia

Prolia® is a prescription medicine used to treat osteoporosis (thinning and weakening of bone) in women after menopause who:
  • are at high risk for fracture, meaning women who have had a fracture related to osteoporosis, or who have multiple risk factors for fracture
  • cannot use another osteoporosis medicine or other osteoporosis medicines did not work well.
2 shots of Prolia® (denosumab) a year are proven to help women with postmenopausal osteoporosis at high risk for fracture strengthen their bones.

Prolia® isn't right for everyone. Do not take Prolia® if you have been told by your doctor that your blood calcium level is too low. You should take calcium and vitamin D as your doctor tells you to while you receive Prolix®.
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