Procedures

An IUD, which is the abbreviation for “intrauterine device”, is a very popular method of contraception. IUDs provide long-term, reversible birth control and are a safe and effective way to prevent pregnancy for many years without the need to take pills or make frequent trips to the doctor to get injections.

How Do IUDs Work?

The IUD is a small, plastic T-shaped device that your gynecologist 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. Once properly placed in your uterus, you will not be able to feel it.

The Procedure For Getting An IUD

Before you have an IUD placed, your doctor will test you to ensure you are not pregnant. You will also have to be tested to rule out any pelvic infection. The IUD insertion procedure requires a visit to your doctor. Usually, you can have an IUD inserted any time during your cycle. However, your cervix is most open while you are menstruating, and that may be the most comfortable time for you to have one placed.

Most women tolerate IUD placement quite well. You will lay on an examining table while the doctor uses a speculum in your vagina to hold it open. The doctor will insert a small tube holding the IUD into your vagina and move it up through your cervix and into your uterus. Once the IUD is placed in the proper position, the doctor will remove the tube, leaving the IUD in place.

The IUD has small strings attached to it which will hang 1-2 inches into the vagina. These strings are what you will use to periodically check to be sure your IUD is still in place. On rare occasions, the IUD may come out of the uterus on its own, and you will need to visit your doctor for an examination and replacement. During the procedure, you may feel crampy and experience some bleeding. These symptoms will gradually improve over the next few days to weeks.

Two Types Of IUD

In the United States, two categories of IUDs are available. One is a copper IUD, the other is a hormonal IUD.

Copper IUD

One type of IUD is wrapped in copper. If you have a copper IUD inserted within five days of unprotected sex, it will prevent you from becoming pregnant. Also, a copper IUD will provide effective birth control for up to ten years.

Hormonal IUD

Another type of IUD contains a hormone called Levonogestrel, which is a progestin. Like the copper IUD, the hormonal IUD impedes the sperm from reaching the egg. The hormones on the hormonal IUD also thicken the cervical mucus so that it blocks and traps sperm before it reaches the egg. Some hormonal IUDs also prevent eggs from leaving your ovaries, depriving the sperm of any egg to fertilize.

If you have an IUD placed while you are menstruating, it will become effective immediately. If you have one placed at another time during your cycle, it can take up to 7 days to be effective. The hormonal IUD is effective for three to five years. The length of time of effectiveness depends on the specific type of hormonal IUD you use.

Advantages Of IUDs Over Other Forms Of Contraception

Here are some of the top advantages IUDs have over other forms of contraception.

Immediate Fertility Possible

When you are ready to get pregnant, your doctor can quickly and easily remove it. Immediately after the IUD is removed, you can become pregnant.

Provides Effective Birth Control Option When Other Options Are Not Suitable

IUDs are 99% effective in preventing pregnancy. Unlike oral contraceptives, IUDs are suitable for women who are breastfeeding. Copper IUDs should not be used by women with allergies to copper or who have Wilson’s disease (a condition where your body holds too much copper).

IUDs are considered safe for women who have contraindications to other forms of birth control, like birth control pills. These may include a history of hypertension, blood clots or certain types of Migraine headaches.

Convenient

Once you have an IUD, you never have to remember to take a pill or schedule a trip to your doctor for an injection. When you are ready for sexual intercourse with your partner, neither of you will even realize that it is there.

Inexpensive

The only expense is the initial placement and a follow-up exam. After that, you incur no additional expenses until you are ready to have it removed.

Speak With The Raleigh Gynecologists For More Information

When you are considering the best type of contraception for yourself, IUDs offer many advantages over other forms of birth control. Be sure to consult with the experts at Raleigh Gynecology and Wellness.

At Raleigh Gynecology, your health is our first priority. We will work with you to evaluate your lifestyle and overall health to determine the best form of contraception for you. Give Raleigh Gynecology a call at 919.636.6670 or schedule an appointment online.

Long acting reversible contraceptives (known as LARCs) are very convenient and effective methods of birth control. They are not only more reliable than condoms and birth control pills, LARCs are also much less expensive to use over time. When a woman using LARCs decides she wants to get pregnant, she can have the contraception undone, or reversed, and be ready to conceive safely immediately.

Types Of Long Acting Reversible Contraceptives

Contraceptive Implants

Products such as the well-known NEXPLANON, are hormone-releasing birth control implants for women that prevent pregnancy for up to 3 years. The implant 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, and may also contain magnesium stearate.

The implant is a flexible plastic rod that resembles a matchstick. It is implanted just under the skin of the inner side of your upper arm. Once implanted, it may take up to a week to become effective. Your doctor can discuss with you the need to abstain from sex during that period of time or use a backup method of birth control, such as a condom.

NEXPLANON is very effective in preventing pregnancy but certain medications can affect its efficacy. Your doctor can discuss with you whether any medications you are taking would interfere with the NEXPLANON product.

Intrauterine Devices (IUDS)

IUD products are more than 99% effective in providing long-term birth control for women. An IUD is a T-shaped device that is placed inside the uterus by your doctor. The cervix keeps it in place. Once it is properly in place, you cannot feel it.

There are two forms of IUDs: non-hormonal and hormonal.

Non-Hormonal

The first form is the popular, non-hormonal ParaGard IUD. It 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.

Hormonal

The second form of IUD is the hormonal IUD. The hormonal IUD products (Mirena, Kyleena, Liletta, or Skyla) use progestin to prevent pregnancy in two ways: 1) they thicken the mucus of the cervix so that it blocks and traps the sperm, and 2) they can stop you from ovulating, meaning your ovary does not release eggs, thus depriving the sperm of the ability to fertilize an egg. These IUDs are effective for three to five years. Once in place, however, 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.

IUDs may be removed at any time by your doctor. Once the IUD is removed, you can become pregnant immediately. IUDs have advantages over other forms of birth control. They can be used while breast-feeding and do not have side effects like blood clots and those related to some other 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.

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

Injectables

Some injectable contraceptives are considered LARCs. They are not as long lasting as the methods described above, but injectables may be appropriate for women who choose not to use the implant or IUDs described above. Depo Provera is a progestogen-only hormonal injection which contains no estrogen. The injection must be given once every twelve weeks.

The other type of injection is a monthly injection containing combined formulations of estrogen and a progestin to prevent pregnancy. Using the injections requires regular visits to your doctor. If you use the injectables for a longer period of time, it may take time for you to be able to become pregnant once you stop the injections. You should discuss with your doctor other possible side effects resulting from continuous use of the injections for more than two years.

Talk To The Experts On Long Acting Reversible Contraceptives

Women have many options when it comes to effective long-term, reversible contraception methods. When choosing the best method for your own lifestyle, you should discuss it with the experts at Raleigh Gynecology and Wellness. Their highly-rated specialists will take the time needed to understand your entire health profile and determine the safest LARC for your health.

At Raleigh Gynecology and Wellness, the specialists truly care about their patients’ wellbeing and go the extra mile to ensure their patients use the contraception method that is the safest one for them. Contact Raleigh Gynecology for more information by calling 919.636.6670 or schedule an appointment online.

The process of seeking advice for any health condition can be confusing. With specialists available focusing on a variety of disciplines, you may be overwhelmed trying to decide which treatment may be right for you in any given circumstance.

When it comes to reproductive health, things can get even more difficult. The intimate nature of reproductive health compounds the challenge of finding a doctor you trust and feel comfortable with. A gynecologist can give you the expert reproductive health information and treatment you need in a setting that is personalized and comfortable.

Specialize in women’s reproductive health

A gynecologist is a medical health professional who specializes in women’s reproductive health. After completing a bachelor’s degree, a gynecologist must obtain a medical degree and complete a four-year residency specializing in gynecology to become board-certified.

Gynecologists commonly advise on and treat conditions such as:

• Issues relating to pregnancy, fertility, menstruation, and menopause
• Family planning, including contraception, sterilization, and pregnancy termination
• Problems with tissues that support the pelvic organs, including ligaments and muscles
• Sexually Transmitted Infections (STIs)
• Polycystic ovary syndrome
• Urinary and fecal incontinence
• Benign conditions of the reproductive tract, for example, ovarian cysts, fibroids, breast disorders, vulvar and vaginal ulcers, and other non-cancerous changes
• Premalignant conditions, such as endometrial hyperplasia and cervical dysplasia
• Cancers of the reproductive tract and the breasts, and pregnancy-related tumors
• Congenital abnormalities of the female reproductive tract
• Emergency care relating to gynecology
• Endometriosis, a chronic condition that affects the reproductive system
• Pelvic inflammatory diseases, including abscesses
• Sexuality, including health issues relating to same-sex and bisexual relationships
• Sexual dysfunction

Fertility Issues

If you are experiencing or suspect you may have fertility issues, a gynecologist can help. Fertility concerns can be addressed actively or be avoided proactively with the guidance of a gynecologist.

Common factors in fertility include:

• Tubal Factor, which occurs when sperm cannot travel through the fallopian tube to the ovary
• Male Factor, which occurs when the male partner has a low sperm count
• Age Factor, which decreases chance of conception in both males and females
• Uterine Factor, which occurs when a condition in the uterus prevents conception or carrying a pregnancy to full term
• Peritoneal Factor, which occurs with scar tissues inside the peritoneum or endometriosis

While these are common examples, diet, hormones, genetics, and mental health all have the potential to impact fertility. Monitoring these can help for those trying to conceive, but a gynecologist can use technical equipment and years of professional experience to help you plan for your family on your own terms.

Hormone Disorders

When your body’s endocrine system is not functioning at full health, you can experience hormone imbalances which can lead to disorders. Some hormone disorders can cause temporary changes in physical appearance while others have potential to lead to permanent harm like diabetes. Many hormone disorders are tied to reproductive health and gynecologists can provide insight. Gynecologists can treat hormone disorders such as excessive hair growth, menstrual irregularities, and polycystic ovary syndrome.

Sexually Transmitted Illness

For sexually active women, a gynecologist can lend peace of mind as a resource for best practices. In addition to having expertise in preventing transmission, gynecologists can diagnose sexually transmitted illnesses. Routine procedures and annual screenings can reveal STIs and start treatment.

Many practices also offer support counselling to women recovering from or living with sexually transmitted illness. This provides a safe environment for patients to discuss concerns with a medical professional.

Schedule an Appointment with RGW today

At Raleigh Gynecology & Wellness, we understand and respect the intimate nature of your health. We provide a safe and comfortable environment for you to find answers. If you are experiencing pelvic or vaginal pain or concerns, scheduling a gynecology appointment is the first step in getting treatment.

In addition to scheduling appointments for treatment of pain or discomfort, a yearly gynecologist visit provides critical screening for disease and illness. Health is more successfully managed when we take a proactive approach. Annual screenings allow medical professionals to identify and get ahead of harmful disease or health trends.

Want to learn more about what a gynecologist does? Reach out to Raleigh Gynecology & Wellness today to schedule a wellness screening and become more involved in the management of your health.

If your pelvic exam or pap test result is abnormal, your doctor may recommend that you undergo a colposcopy procedure. During a colposcopy, a special instrument will be used that is designed to enable your doctor to closely examine your cervix, vagina, and vulva for signs of disease.

Who Should Have a Colposcopy?

Many women who have had an abnormal pap smear are good candidates for a colposcopy. A colposcopy procedure may also be recommended when a doctor notices an abnormality on your cervix during a pelvic exam. It is also useful when testing shows a woman has the human papillomavirus (“HPV”) or if a woman has unexplained bleeding or other problems such as an inflamed cervix, noncancerous growths, or genital warts.

How is a Colposcopy Performed?

The procedure is similar to a pelvic exam. Most patients experience little more discomfort than a pelvic exam.

In the doctor’s office, the patient will lie on an examination table with the patient’s feet in the stirrups. The doctor will insert a speculum into the patient’s vagina to keep the vagina walls open during the procedure. The doctor will then dab a cotton swab in a vinegar solution and apply it to the cervix and vagina. It may sting a little bit, but it will enable the doctor to better see abnormal cells and tissues.

Next, the doctor will use the colposcope to examine the patient’s cervix and vulva. The colposcope is a special magnifying instrument that will be placed near the opening of the patient’s vagina. The doctor will shine a bright light into it, and look through the instrument’s lenses.

If the doctor observes abnormal tissue, the doctor may use biopsy tools to take small pieces of tissue from the vagina and/or the cervix. If the doctor wants to take a larger sample of cells from the patient’s cervical canal, the doctor may use a small, scoop-shaped instrument (called a “curette”). The patient may feel an uncomfortable pinch when tissues are taken. The doctor may apply a solution to the biopsied area to prevent bleeding.

The doctor will send tissue samples out to a laboratory for analysis and contact you with the results.

How to Prepare for the Colposcopy Procedure

The doctor will try to schedule the procedure when you are not menstruating. Inform your doctor if you are pregnant. You may also be asked to give a urine sample for a pregnancy test prior to your procedure. You should follow your doctor’s instructions for preparing.

For at least 24 hours before the examination, the doctor will instruct you not to use a douche, tampons, or any other feminine hygiene products that are inserted into the vagina. You will need to abstain from vaginal sex or use of intervaginal medications.

About 30 minutes prior to the procedure, the doctor may suggest that you take an over the counter pain reliever such as ibuprofen or acetaminophen, but no aspirin or other blood-thinning medications.

What is the Recovery Process Like?

After a colposcopy, you can resume your regular daily activities immediately. You may experience mild abdominal discomfort, cramping, and pain for one or two days after the procedure. Some women may also notice slight vaginal bleeding and a dark-colored vaginal discharge that could last for up to one week.

If you had a biopsy during your colposcopy, you may need to limit your activity for a short time while your body heals. Your doctor will instruct you not insert anything into your vagina for at least several days — do not have vaginal sex, douche, or use tampons or other feminine hygiene products. Depending on how much tissue was taken, the doctor may apply a liquid bandage to your cervix to stop bleeding. If so, you will likely notice some brown or black vaginal discharge for a couple of days.

You should contact your doctor immediately if you experience any heavy vaginal bleeding, severe pain or cramping in the lower abdomen, or a fever or chills, or notice yellowish or malodorous discharge.

What do my Results Mean?

Tissue samples taken during the colposcopy will be analyzed in a laboratory. After reviewing the lab results, your doctor will have determined what steps, if needed, should be taken next. The presence of abnormal cells may indicate another procedure to remove more tissue or could indicate something to watch for on the next pap smear.

If your tests show precancerous changes, be assured that it is usually very treatable — especially if your doctor caught it early. Depending on what your test results show, your doctor may recommend one of a number of procedures commonly used to treat precancerous or cancerous conditions in the cervix.

If more aggressive treatments are needed, your doctor will discuss those with you.

Speak to Raleigh Gynecology Today

For more information about a colposcopy procedure or the results of one you have already had, contact the experts at Raleigh Gynecology. They can provide the highest quality care or provide you with a second opinion if you are wondering about advice you have already been given.

Your doctor has suggested you undergo an endometrial biopsy and you’re not really sure what it involves. Knowing how an endometrial biopsy is performed can help ease some of the stress of the unknown. An endometrial biopsy is a procedure that is often recommended to determine what may be causing irregular periods, abnormal vaginal bleeding or occasionally when the results of a pap smear are abnormal. The procedure itself only takes five minutes or so, yet it can give your doctor a lot of information about what may be happening in your reproductive organs.

What Is an Endometrial Biopsy?

An endometrial biopsy is a procedure performed by your doctor as part of an evaluation of the health of your reproductive system, primarily the inner lining of your uterus. The uterus is the organ in your lower belly that carries your baby during your pregnancy. Your uterus lining is called the endometrium.

During an endometrial biopsy, your doctor will use special tools to remove a small sample of tissue from the endometrium. The tissue samples will be studied under a microscope to look for abnormal cells such as polyps (small or large growths in your uterus), uterine infections such as endometritis, or for the presence of precancerous or cancer cells. Endometrial cancer is one of the most common cancers of the female reproductive organs.

How to Prepare for the Procedure

An endometrial biopsy generally is not a procedure that requires anesthesia. As such, you should not have to fast or change your diet in the days prior to the procedure. However, there are some preparatory steps your doctor may want you to take before your procedure. These include:

1. Pregnancy Test. If there is any chance you could be pregnant, your doctor will want you to take a pregnancy test before the biopsy for the safety of your unborn baby. If there is any chance you might be pregnant, your doctor will postpone an endometrial biopsy. Endometrial biopsy during pregnancy can lead to miscarriage.
2. Record Your Menstrual Cycles. If you are an age when you are still menstruating, your doctor may want you to keep a record of your menstrual cycles for a certain amount of time before the biopsy. Sometimes a record of your cycles is requested to help establish the best date for a test that needs to be done at a particular time during your cycle.
3. Inform Your Doctor about Any Medications You Are Taking. Your doctor needs to know about any prescription or over-the-counter medications you are taking. You might have to stop taking blood thinners before an endometrial biopsy. Certain medications can interfere with the blood’s ability to clot properly.
4. Inform Your Doctor about Any Bleeding Disorders and Allergies. Your doctor needs to know whether you have any bleeding disorders or if you have allergies to latex, iodine, or other substances that could be used during the procedure.
5. Take a Pain Reliever 30 Minutes before Your Procedure. Depending on your specific case, you may want to take an over-the-counter pain reliever 30 minutes before your visit. On occasion, your doctor may also give you a mild sedative to make you more comfortable during the procedure. (In those cases, you will need to have someone available to drive you home afterward).

How an Endometrial Biopsy Is Performed

Procedures may vary based on your condition and your healthcare provider’s practices. Generally speaking, the biopsy procedure will be conducted similar to a pelvic exam. Your doctor will have you lie on the exam table and place your feet in stirrups.

The doctor will then insert an instrument called a speculum into your vagina and will cleanse your cervix with a soap solution. To take the tissue samples, the doctor will use a special catheter. It is a tube with a smaller tube inside it. The doctor will withdraw the inner tube creating suction at the end of the catheter, then gently rotate and move the tip of the catheter in and out to collect small pieces of endometrial tissue.

Once all samples have been taken, the doctor will remove the catheter and speculum. The samples will be sent to a lab for analysis.

Understanding Your Results

If your results are abnormal, your doctor will review them with you. Abnormal results could mean you have benign, noncancerous growths (like polyps or fibroids), or an infection like endometritis. It could also indicate a more serious condition such as endometrial cancer, or a variety of other conditions. Your doctor will give you advice as to what your next steps should be based on the results.

Reach Out to Raleigh Gynecology Today!

An endometrial biopsy is a simple procedure but it can be intimidating for many patients. Contact Raleigh Gynecology to get your questions answered about your reproductive health and to schedule an appointment.