Procedures

What is a pessary fitting? As women age, the ligaments and muscles that support the uterus weaken. In some cases, the support structures can become so weak that the uterus begins to sag and interfere with other pelvic organs. This condition is known as uterine prolapse, or pelvic organ prolapse (“POP”). Treatment for POP often consists of having a support device called a “pessary” inserted to provide the necessary support. Pessaries are made of soft, non-absorbent, medical-grade silicone.

What Is A Pessary Fitting?

Pessary devices come in a variety of shapes and sizes. You need to have a pessary fitting with your doctor to ensure that the pessary device you use is appropriate for your condition. A pessary fitting will be conducted by your doctor during a pelvic examination. Based on the position and condition of your pelvic organs, your doctor will discuss with you the available pessary devices that are designed for your needs. Once you and your doctor have selected the appropriate device, your doctor will insert it into your vagina. After it is properly positioned, your doctor will have you perform some basic movements that will put stress on the pessary to make sure it does not slip out of place.

Once your doctor has determined that the device fits you, your doctor will show you how to insert it, remove it, and maintain it. Within two weeks of the first fitting, you should expect to have to return to the doctor’s office to have the pessary checked and any necessary adjustments made. Your doctor will determine how often you need to return to ensure that your pessary fits properly. If you need a different shape or size device, your doctor will fit you for a new one. After you have been fitted with the right pessary device, you will start to feel more comfortable immediately. The benefits of the pessary include:

Support For Uterine Or Other Pelvic Organ Collapse

As mentioned above, a pessary is designed to provide support for your sagging pelvic organs, including the uterus, bladder and bowel. Over time, these organs can sag and droop so far that it drops down beyond the vaginal opening.

Sagging of the uterus is known as uterine prolapse. Other organs in the pelvic region such as the bladder (a condition called a cystocele) and rectum (a condition called rectocele) can droop as well. Symptoms of POP include pain or pressure in the pelvic region, pain in the abdomen or lower back, pain during sexual intercourse, a bulge at the opening of the vagina, frequent bladder infections, abnormal urination (frequency or urgency), or constipation. A properly fitted pessary can provide immediate relief from these uncomfortable symptoms.

Helps To Relieve Stress Incontinence

Urinary stress incontinence (SI) occurs when an activity such as coughing, sneezing or exercising puts more abdominal pressure on the bladder. That pressure causes a small amount of urine to leak from the tube (the urethra) that carries urine out of your body. SI is a common type of incontinence in aging women and women who have given birth. Other contributing causes include pelvic surgery and a general weakening in the muscles of the bladder and the surrounding area. When the bladder muscles weaken, the bladder can drop down into a position that prevents the urethra from closing completely. As a result, urine can leak out. A pessary can treat some cases of SI. A properly fitted pessary will put pressure on the urethra in order to hold it in its normal position.

Avoids Or Delays The Need For Surgery

A pessary can help some women avoid or delay the need for surgery. Over time, a series of properly fitted pessaries may enable a woman to avoid surgery altogether.

In some cases, however, the patient’s condition may deteriorate and surgery is often appropriate treatment for severe cases. Whether a pessary will be an alternative to surgery for you depends on your specific case. Sometimes the surgery is needed to repair weakened pelvic floor tissues. The surgeon will graft healthy tissue onto your weakened pelvic floor structures to reinforce them. Once reinforced, your body may be able to support your drooping pelvic organs. In some cases, your doctor may recommend the removal of your uterus, called a hysterectomy.

Types Of Pessary Fittings

Types of pessaries and the severity of the prolapse conditions each treat include:

• Ring – The Ring is a circle-shaped device that is the most basic and often the first type of pessary recommended by doctors for their patients. It is easy for the patient to use and maintain.
• Gehrung – The Gehrung is a U-shaped pessary designed for more advanced uterine prolapse.
• Gellhorn – The next level of prolapse severity often uses the Gellhorn pessary, which is a disk-shaped device with a small knob in the middle.
• Cube – Designed for the most advanced-stage prolapse conditions, the Cube is compacted and inserted into the vagina. Once in place, the Cube special design uses suction to support the areas affected by prolapse.

Contact An Experienced Pessary Fitting Gynecologist

For more information about POP, treatments for POP, and pessary devices, contact the specialists at Raleigh Gynecology & Wellness. Their team of experts are available to answer your questions. Get in contact with our office by calling (919) 636-6670 or schedule an appointment for an examination.

An IUD (the abbreviation for “intrauterine device”) is a very popular form of birth control because it is safe, effective, and convenient. To get an IUD, you will need to have an examination by your doctor. During that examination, your doctor will determine which size and type of device are best for your body, insert it properly, and teach you good hygiene practices for maintaining it. The entire process usually takes less than thirty minutes. Here is how you can prepare yourself for it.

Ways To Prepare For An IUD Insertion

You can do a few things that will help you relax and make the entire experience easier on yourself.

Know What To Expect

An IUD is a small, T-shaped device made of plastic that will be inserted into your uterus to prevent pregnancy. Having an IUD inserted is a fairly routine procedure that is much like a pelvic examination. You will lie on an examining table and the doctor will use a speculum to hold upon your vagina until the IUD is in place. As part of the insertion process, the doctor will do an examination to make sure that your pelvic organs are healthy.

The procedure will begin with the doctor measuring the size of your uterus and noting its position. Then, the doctor will use an antiseptic agent to clean your cervix and vagina. Then, the doctor will line up your cervix with your uterus to enable the IUD insertion.

To insert the IUD, the doctor will fold the arms of the IUD and place the IUD into a small tube. The tube will be inserted through your cervix and positioned properly in your uterus. Once in place, the arms of the IUD will open back up, and the applicator tube will be removed. The doctor will trim the string so that approximately 3 cm hangs into your vagina. The string enables the device to be easily removed or replaced.

At the end of the insertion procedure, your doctor will schedule you for a follow-up examination in 4 to 6 weeks. For one week following the insertion procedure, you must refrain from having sex or inserting anything (such as a tampon, douche, or any other object) into your vagina.

Eat A Light Meal And Drink Water

Be sure to eat a light meal or a snack before your appointment so that you are not hungry, but avoid eating so much that you are uncomfortably full or bloated.

Sometimes women get dizzy or faint when they stand up after the procedure. You can reduce the likelihood of getting dizzy or fainting if you have a little food in your system. It also helps to drink plenty of water before the appointment.

Take A Painkiller To Help Alleviate Cramping

Some women experience mild pain and cramping during the insertion process. Take a non-prescription painkiller like ibuprofen before your appointment to help relieve the discomfort.

Give A Urine Sample To Your Doctor

Before your doctor begins the procedure, your doctor will want a urine sample. The urine sample will be tested to ensure that you are not pregnant. If you are pregnant, your doctor will not perform the procedure.

What To Expect After Your IUD Is Inserted

For the first few months after an IUD, many women experience mild cramping and bleeding. You can manage the mild pain with an over-the-counter pain reliever. You may also have irregular bleeding but the bleeding should not be heavy. Many women are unable to feel their IUD strings after the insertion procedure. It is important to notify your doctor if you have heavy bleeding or cramps that are not controlled by over the counter pain medications. If you have concerns about the position of your IUD, it is important to notify your doctor. Do not have sex without using a condom or other backup birth control method until you have contacted your doctor.

Consult With The Experienced Women’s Health Specialists At Raleigh Gynecology And Wellness

Getting an IUD will give you reliable and convenient protection against pregnancy for a long period of time. Make sure you get the best gynecological care by working with the experts at Raleigh Gynecology and Wellness. Contact them for more information about IUDs or to schedule an appointment. They will answer any questions or concerns that you might have.

Many women choose to get an IUD (“intrauterine device”) inserted by their doctor as the preferred way to prevent pregnancy. IUDs are a popular contraceptive device because they provide convenient, safe, and effective birth control for many years.

How Do IUDs Work?

The IUD is a small, plastic T-shaped device that your doctor will place in your uterus. It prevents pregnancy by changing the way sperm cells move so they are unable to reach an egg and fertilize it. Some types of IUDs are made to release small amounts of hormones that prevent ovulation or prevent any fertilized egg from implanting itself in the uterus. Once the IUD is placed in your uterus, you will not be able to feel it. The IUD will only be effective if it is in the proper position in your uterus.

Preparing For The IUD Insertion Process

Before the procedure begins, your doctor will examine you to rule out any infections, STDs, or pregnancy. You will probably have to provide a urine sample which will be tested to ensure you are not pregnant.

Some doctors make it a practice to have their patients take Misoprostol before having an IUD inserted. This drug softens the cervix to help with the insertion in women that have had c-sections or have had difficulty with a prior IUD insertion. Your doctor may also recommend that you heat a light meal or snack and drink plenty of water before the appointment. You may also be advised to take a non-prescription pain reliever such as ibuprofen about 30 minutes before the appointment.

The IUD Insertion Process

Having an IUD inserted usually takes less than 30 minutes in your doctor’s office. The process resembles a pelvic examination. Here is what you can expect.

Your Doctor Will Insert a Speculum

You will lie on an examining table with your legs in stirrups. As part of the insertion process, your doctor will do a manual examination to make sure that your pelvic organs are healthy. Then, your doctor will insert a speculum into your vagina to hold it open for the IUD insertion procedure. You may experience some cramping during this process.

Determine The Size and Location Of Your Uterus

Your doctor will measure the location and size of your uterus to determine what size IUD you need.

Use An Antiseptic Agent To Clean Your Cervix And Vagina

To minimize the risk of infection, your doctor will carefully clean your cervix and vagina with an antiseptic liquid.

Position The Alignment Of Your Cervix And Uterus

To properly place the IUD, your doctor must align your cervix with your uterus.

Insert The IUD Applicator Tube And Properly Position The IUD

The next step is to physically insert the IUD. To do that, your doctor will fold the arms of the IUD and place it into a small tube called the applicator tube. The applicator tube will be inserted through your cervix and positioned in your uterus. Once in place, the applicator tube will release the IUD. Its arms will unfold and it will resume its T-shape. At that point, the applicator tube will be removed, leaving the IUD in the proper position.

Trim The IUD Strings

The last step in the insertion process is to trim the strings of the IUD. The IUD is made with strings that hang into your vagina to enable your doctor or healthcare provider to easily remove the device. Your doctor will trim the strings so that only one or two inches hang into your vagina.

Follow Up Examinations

At the end of the insertion procedure, your doctor will schedule you for a follow-up examination in 4 to 6 weeks to make sure the IUD is still in place and that you have not developed any problems with the device. For one week following the insertion procedure, you should refrain from having sex or inserting anything (such as a tampon, douche, or any other object) into your vagina.

Consult With The IUD Experts And Gynecologists At Raleigh Gynecology And Wellness

IUDs are a convenient way to prevent pregnancy over a long period of time. Many types of IUDs are available, and you need to make sure you get the one that best suits your
needs while providing effective contraception. For more information about IUDs and to schedule an appointment, contact the experts at Raleigh Gynecology and Wellness.

An IUD (the abbreviation for intrauterine device) is a popular pregnancy prevention device for women. It is a safe and effective form of long-term, reversible contraceptive. Some types of IUDs prevent pregnancy for up to ten years.

IUD products are 99% effective in providing long-term birth control for women. One reason they are so effective is they remove the possibility of human error. With an IUD, you do not need to remember to take a pill each day or schedule a trip to the doctor at the right time of the month for a contraceptive injection.

Another reason for their popularity is the convenience; once properly placed in your uterus, you do not have to worry about becoming pregnant. When you are ready to conceive, your doctor can remove your IUD and you are immediately able to become pregnant. Economically, IUDs are inexpensive when compared to other forms of contraception.

What Are IUDs?

An IUD is a T-shaped plastic device about the size of a quarter. Your doctor inserts it into your uterus. Once properly inserted, your cervix will keep it in place. You will not be able to feel it. In fact, you will not know it is there.

The Different Types

In the United States, there are two categories of IUDs available: hormonal IUDs and copper IUDs. Which type of IUD is suitable for you depends on your health and personal preferences, as explained below.

Hormonal IUDs

The hormonal IUD products (brand names are Mirena, Kyleena, Liletta, or Skyla) contain the hormone progestin. By slowly releasing the hormone, these IUDs can prevent pregnancy in several ways: 1) it thickens the mucus of the cervix so that it blocks and traps the sperm, 2) it can stop you from ovulating, meaning your ovaries do not release eggs, thus depriving the sperm of the ability to fertilize an egg, and 3) some IUDs also thin the uterine lining so that if sperm is able to reach an egg and fertilize it, the fertilized egg cannot implant in the uterus.

Once your doctor places a hormonal IUD in your uterus, you need to know that it may take a week to become fully effective. During that period of time, you should abstain from sex or use another form of contraception such as a condom. Hormonal IUDs are effective for three to five years.

For the first three to six months after the hormonal IUD is inserted, you may experience unpredictable menstrual cycles. Later on, many women with hormonal IUDs notice lighter menstrual bleeding and reduced cramps. Some women with hormonal IUDs may have no menstrual periods at all.

Other side effects of hormonal IUDs may include those similar to using birth control pills, including breast soreness or tenderness, headaches, nausea, weight gain, moodiness, and acne, but these are rare due to the low systemic exposure to the hormone with IUDs.

Copper IUDs

The non-hormonal, copper IUD (ParaGard) is another popular form of IUD. The ParaGard IUD can provide birth control for up to ten years. It is a T-shaped plastic frame with a copper wire coiled around it. Once inserted into the woman’s uterus, it works by producing an inflammatory reaction that is toxic to sperm and eggs (ova), thus preventing pregnancy. It provides immediate birth control.

The side effects some women experience during the first few months of using ParaGard include heavier menstrual bleeding and more cramping than usual. After that time, your menstrual periods should lighten up somewhat.

Some other side effects of ParaGard may include backaches, anemia, spotting between menstrual periods, and vaginal discharge. If you experience pain or discomfort during sex, you should consult with your doctor.

Why Use an IUD?

IUDs have advantages over other forms of birth control, as mentioned earlier. You do not have to take a pill or see your doctor for an injection. They can be used while breastfeeding and do not have side effects like blood clots and those related to hormonal birth control methods. Another benefit of an IUD is that it can be used for emergency contraception if inserted within five days after unprotected sex. One of the biggest benefits is that IUDs are extremely inexpensive.

IUDs are not appropriate for all women. They should not be used by women who have uterine abnormalities such as certain types of fibroids, a pelvic infection, or cancer, to name a few. Your doctor can discuss whether an IUD is appropriate for you after a thorough examination and evaluation of your health.

Speak with Raleigh Gynecology and Wellness to Learn More about Your Options for IUDs

IUDs are a safe and effective long-term, reversible form of contraception for many women. Before deciding whether an IUD is right for you, be sure to consult with the women’s health experts at Raleigh Gynecology and Wellness. The professionals at Raleigh make your reproductive health and well-being their top priority. Contact us soon to learn more about the options most suitable for your needs.

A mammogram is an x-ray of the breast. It is performed using a safe, low-dose x-ray machine designed to take images of your breast tissue.

The Reason for A Mammogram

Mammograms are an important, non-invasive tool used to identify changes in your breast tissue and early detection of cancer.

Mammograms Are Used to Find Early Signs of Cancer

According to the Center for Disease Control (CDC), breast cancer is the second most common type of cancer in women in the United States. Early detection is key to treating it and a mammogram is one of the best ways to do that.

Regular Testing is Best

Regular mammograms are critically important to women’s health. An annual mammogram is the best way for doctors to find breast cancer early. It is not unusual for a mammogram to detect cancerous tissue in the breast three years before it is large enough for you to feel during a manual examination.

As beneficial as mammograms are, however, mammograms cannot detect all forms of cancer in the breast. Some cancers detected by physical examination may not show up on the mammogram. Also, a cancerous lesion may be too small or may be in an area that is difficult to view by mammography. That is why regular self-examination or examination by your doctor is important, too.

Screening Mammogram

Beginning at around age 40, women should begin having annual screening mammograms. The reason for this age threshold is that mammograms of younger women can be difficult to interpret. The breast tissue in younger women tends to be dense causing mammograms to be less reliable. Dense breast tissue can obscure signs of cancer; however, as women age, breast tissue becomes fattier and less dense, making mammograms more reliable.

Whether you should begin having screening mammograms done earlier than age 40, or more frequently than annually, depends on your risk factors. Risk factors include a family history of breast cancer or precancerous breast lesions. If you are in the high-risk group, your doctor may recommend earlier mammograms along with magnetic resonance imaging (MRI). This is a subject that you should discuss with your doctor. Also, your health insurance program may not cover a mammogram before you reach a certain age unless your doctor prescribes it.

A screening mammography is used to establish a baseline for your breast health. The baseline will better enable your doctor to detect breast changes and abnormalities by comparing mammograms in later years to the baseline.

Diagnostic Mammogram

Your doctor may order a diagnostic mammography for you. A diagnostic mammography is used to investigate changes in your breast such as a lump, breast pain, an unusual skin appearance, nipple thickening, or nipple discharge. It frequently includes x-ray images of the affected breast in addition to those done during a screening mammogram.

How A Mammogram Is Performed

The mammography x-ray machine is equipped with flat surfaces called compression paddles. The compression paddles compress each breast so that all of your breast tissue can be x-rayed.
Your x-ray technician will position you in front of the machine with one breast positioned against one of the compression paddles. The two paddles will come together and compress your breast so that all of the breast tissue is spread out and visible by the x-ray machine. Once properly positioned, an X-ray will capture black-and-white images of your breast tissue from several different angles. The process will then be repeated on your other breast. The x-ray images will be studied by a radiologist for signs of cancer and other abnormalities.

Mammograms Are Low Risk

As indicated earlier, the radiation dose from a mammogram is very small. As such, it presents little risk to your health, with the benefits of a mammogram outweighing the risk.

Abnormal Mammogram Results Can Lead to Further Testing

Your doctor will compare your latest mammogram to your prior mammograms. If a mammogram shows changes or suspicious areas in the breast tissue, you will likely have to undergo additional testing. Additional testing may include an ultrasound of the breast, or in some cases, your doctor may order a biopsy procedure to remove a sample of breast tissue for laboratory testing. In most cases, abnormalities shown on a mammogram are not cancer.

Call the Women’s Health Specialists at Raleigh Gynecology and Wellness, PA, for More Information about Mammograms

The importance of doing regular mammograms cannot be overstated. Certain types of cancers are aggressive, grow rapidly, and spread early to other parts of your body. A mammogram is one of the best ways to detect breast cancer and have it treated before it becomes life-threatening. If you would like more information about mammograms or need to schedule an examination, contact the women’s health specialists at Raleigh Gynecology and Wellness.