General Women's Health FAQs

• What do you think of the HPV vaccine (Gardasil)? Should my daughter get it? Do you all administer it?

  We believe the Gardasil vaccine is an important weapon in the effort to prevent cervical cancer. We encourage all patients who meet the age criteria to consider it. If you have a daughter who meets the age criteria you should encourage her to get vaccinated.

  We are happy to administer the Gardasil vaccine to you or your daughter. Prior to receiving the injection you must be evaluated and counseled by one our providers. If you're interested in learning more about Gardasil, schedule an appointment with one of our providers.

  Gardasil vaccine is approved by the Food and Drug Administration for girls and young women ages 9-26. The vaccine protects against 4 strains of human papillomavirus (HPV), two that are known to cause 70% of cervical cancers and two that cause genital warts. To be successfully vaccinated, a patient must receive a total of three injections over the span of 6 months (0, 2 and 6 months).

   

• What age should my daughter have her first gynecological exam?

  A young woman should have her first complete GYN exam about six months after becoming sexually active, or at the age of 21.

• When should I have my first mammogram? How’s that work? Where do I go, what do I do?

  There are several recommendations about mammograms from different organizations. If you have a family history of breast cancer, a baseline mammogram is usually ordered at age 35. If you do not have a family history of breast cancer, the baseline mammogram might be delayed to 37 or 38. This decision is also based on your office breast exam.

  The American Cancer Society and Society of Radiologists recommend mammograms yearly beginning at age 40. The College of Gynecologists and College of Surgeons recommends mammograms every year or two after age 50, depending on family history and breast exam.
  
  Many of our patients get their mammograms at Northside Hospital's Radiology Department. We also refer patients to Breast Care Specialists. Both facilities require a written order from one our physicians. We are happy to provide this for you. If you are here for an annual exam, be sure to ask your physician for a written order. You should save this and bring it with you when go for your mammogram. If you are already an established patient of ours and you prefer to get the mammogram done prior to your visit with us, send a web message to one of our nurses or call us at (404) 252-5196. We'll make sure the order is received in time for your test.

  The radiology department will send you written notification of your mammogram results. Usually this information arrives within 4 weeks. If you would like to hear your results sooner, we would be happy to provide that information. Simply call the office or send us a message via your My Health Record and we will forward that information to you.

   

• A nurse told me I need to come in for an appointment before my birth control pill prescription will be renewed. Why?

  We think it is important for each of our patients to receive an annual well woman exam. This exam, which typically includes a pelvic exam, a pap smear test, and a manual breast examination, also provides us an opportunity to discuss healthy lifestyles and contraception.

  Although it is uncommon to have medical complications from birth control pills, it is important that we assess your health status in an ongoing manner to be sure birth control pills continue to be a good choice for you.

  If you already have an appointment scheduled, but know you will run out of pills before your visit, call or send a web message to one of our nurses. They may able to extend your prescription.

   

• What do I do if I forgot to take my birth control pill yesterday?

  If you miss one active pill, take it as soon as you remember. Take the next pill at your regular time. This means you may take two pills in one day.

  If you miss two or more active pills in a row, take two pills on the day you remember and two pills the next day. Continue this pattern until you catch up again (you will know you have caught up when the pill you take is labeled correctly as far as the current day of the week). Then, take one pill a day until you finish the pack.

  You may become pregnant if you have sex after you miss pills. You must use another form of birth control such as condoms or foam as backup for the rest of the pack. This may be different from the information printed inside the pill pack. We have chosen to be very conservative in this regard, hopefully reducing the risk of unplanned pregnancy.

  Important Message:
  If you are not sure what to do about pills you have missed, use a back-up method of birth control any time you have sex and keep taking one pill a day until you can speak to someone in our office.

  For more information on taking birth control pills, read "How to Take the Birth Control Pill," available in our Articles and Information Section. If you prefer to talk to someone, do not hesitate to call one of our nurses, or schedule an appointment with one of our providers.

   

• My pap test came back abnormal. What does that mean?

  The PAP test is a screening test for abnormalities of the cervix that may be precursors to cervical cancer. The purpose of the test is to find abnormalities early so they can be treated. Treatment of these abnormalities is very successful in preventing cancer. Because early detection profoundly increases the chances of cancer prevention, we recommend yearly Pap test for virtually all of our patients.

  If your Pap test result is abnormal it could mean one of four things.

  1. It may indicate the presence of abnormal cells (ASCUS). Unless a virus known as HPV (human papilloma virus) is also present-which is determine via a reanalysis of the same cells-this result is not concerning and is considered a normal test result. If the HPV is present, you may be asked to come in for further testing or treatment.
  2. It may indicate precancerous cells, also termed squamous intraepithelial lesion. If so, you will need a diagnostic exam of the cervix called a colposcopy. This test will help determine whether the precancerous cells are low grade or high grade. Low grade changes rarely progress to cancer and will usually resolve with time. A small percent of High grade changes can progress to cancer if left untreated over time.
  3. It may indicate atypical glandular cells. The presence of these cells also means you will need a colposcopy of the cervix.
  4. It may indicate squamous cancer or adenocarcinoma cells. This results means the cells are so abnormal that the pathologist is certain cancer is present. Cancer cells in the flat surface cells of the vagina or cervix are termed squamous cancer. Adenocarcinoma cells indicate cancer arising the glandular cells. If these cells are found, you will be referred immediately to an oncologist (cancer specialist) for further evaluation.

   

   

• What are fibroids? How are they treated?

  Fibroids are benign tumors that grow in the muscle of the uterus. They are common in women aged 30-40. Little is known about what causes fibroids. Most fibroids produce no symptoms and do not need to be treated. If symptoms occur they may include: heavy periods, long periods, painful periods, abnormal bleeding, infertility, painful intercourse, pelvic pressure and frequent urination. Since these symptoms are also caused by other problems, you should see your doctor for evaluation. A pelvic exam may reveal signs of a fibroid. Other methods used to diagnose fibroids include ultrasound and hysteroscopy.

  We now have several choices for managing fibroids or their symptoms. Treatment choices depend on your fertility desires, the size of your fibroids and your symptoms.

  If you have fibroids or have had them in the past, you should get regular checkups. Also be aware of changes that may indicate your fibroids need to be treated. The warning signs include: heavy or painful periods, bleeding between periods, rapid increase in size of fibroid, infertility and pelvic pain.

   

• I noticed a vaginal discharge and odor today. What causes this and how is it treated?

  A vaginal discharge and odor are most commonly caused by a bacterial infection called bacterial vaginosis (BV). To confirm this, you will need to come into the office for testing. There are several choices for treating BV. We treat BV with an oral or topical antibiotic. Most vaginal infections have no apparent cause. They sometimes occur in times of stress or other illness. They also often occur (especially yeast infections) following a course of antibiotics taken for other reasons.

• I get vaginal infections occasionally. When it happens, can you just call in a prescription for me? Do I need to be evaluated each time?

  In most cases, you will need to come into the office for testing. If your infection is caused by bacteria or yeast, we can treat it with an oral or topical antibiotic. The common symptoms of a vaginal infection include increase or change in the vaginal discharge, vaginal redness, swelling, itching, or pain, vaginal odor, burning with urination, pain or bleeding with sex. If you experience any of these symptoms, call or send a web message to one of our phone nurses. Based on the symptoms you describe, they can determine if a visit to the office is necessary. For more information on yeast infections read this article.

• How is Chlamydia/Gonorrhea treated?

  Chlamydia and Gonorrhea infections are among the most common sexually transmitted diseases. If you tested positive for Chlamydia, you will be treated with single dose oral antibiotic, such as azithromycin, or 7-day antibiotic regimen known as doxycycline. If you tested positive for Gonorrhea, you will be treated with an intramuscular antibiotic injection or a single dose oral medication. These treatments cure more than 95% of all Chlamydia/Gonorrhea infections.

  Since these infections are sexually transmitted, your partner will also need to be treated. To remove the risk of re-infection, we'll ask you and your partner to abstain from sexually activity until your treatment is completed. You must return to our office for a "test of cure" after your treatment was completed.

   

• What causes irregular periods? How can it be treated?

  Irregular periods can be caused by a number of things including: hormones, nutrition, significant weight gain or loss, stress, diabetes, fatigue, too much exercise, too little exercise, caffeine, smoking, breast feeding and many others. Sometimes we can identify a cause and address it; sometimes we can't explain it. Determining the cause of your irregular periods is impossible without further evaluation. If you are experiencing irregular periods, make an appointment with one of our providers.

• Do you recommend getting the breast cancer gene test?

  A lot of thought needs to go into the decision to be tested for the breast cancer gene. Northside Hospital has set up a program with a genetic counselor and the Gynecology Oncology department to help women understand if they are a candidate for this testing. We would be happy to help you schedule an appointment with the counselors to talk about this testing in detail.