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Problems & Procedures

Many women are concerned with their vaginal health and being that this is such a private issue, women tend to be reserved when inquiring about the real-life problems that can occur. We hope to offer some guidance in the form of the solutions and procedures that will help or treat some of the common problems or concerns that come up.


PROBLEM: “I am not satisfied with the appearance or feel of my vagina. After childbirth, I feel stretched out and honestly, I’m not enjoying sex as much as I used to because I just don’t feel tight enough. I think it might be affecting my husband’s pleasure as well. What can I do?”

PROCEDURE: Vaginal Rejuvenation. This is a combined surgery of both labiaplasty and vaginoplasty. A vaginal rejuvenation is performed surgically to restore or improve the vagina’s cosmetic appearance or function. These two distinct surgeries can be performed at the same time at our office yielding cosmetically enhanced labia and a tightened vagina during one surgical visit.


PROBLEM: “I can’t stand these horrible menstrual cramps anymore. Is there anything I can do about it?”

PROCEDURE: There many things that can be done including antiprostaglandin agents, hormonal treatment, or analgesics. Lack of exercise and emotional stress also contribute to the increasing discomfort of menstrual cramps.


PROBLEM: “I tend to have breast lumps and an occasion, they cause me pain. A breast lump scares me. Should it?”

PROCEDURE: Causes of breast lumps include infections, injuries, non-cancerous growths, and cancer. Our physicians will thoroughly examine you and obtain the proper testing to rule out benign causes such as cysts and benign tumors.


PROBLEM: “I’m looking for another method of birth control other than the pill. What are my options?”

PROCEDURE: At Manhattan Center for Gynecology we offer many alternatives including Nuva Ring for monthly contraception, Ortho Evra for weekly contraception and IUD’s for longer term. Please ask about Essure for complete contraception when your family is complete.


PROBLEM: “I need to be tested for precancerous conditions. What’s going to happen during that procedure?”

PROCEDURE: You will get a Colposcopy. This is a telescope which magnifies the cervix. Physicians trained in Colposcopy manage abnormal PAPs, treat precancerous conditions in this minimally invasive way.


PROBLEM: “My doctor wants to schedule me for a Cone Biopsy. What is that?”

PROCEDURE: A cone biopsy is surgery to remove a cone-shaped piece of tissue from the cervix and cervical canal. Cone biopsy may be used to diagnose or treat a cervical condition. You will be given some type of anesthesia. The cone biopsy may remove all of the abnormal tissue, which means no further treatment would be needed.


PROBLEM: “I was told I have cervical dysplasia and that I have to have the abnormal cells removed. How will they do this?”

PROCEDURE: Cryosurgery. This is used as a treatment for cervical dysplasia, or abnormal cells on the cervix. It may also be performed in the very early stages of cervical cancer. Cryosurgery kills pre-cancerous cells and cancerous cells by freezing them.


PROBLEM: “My period is way too heavy. I think I might have endometriosis. What next?”

PROCEDURE: Endometrial Biopsy. Your physician may perform an Endometrial Biopsy to help diagnose endometrial cancer or to find the cause of abnormal uterine bleeding.


PROBLEM: “I’m at the stage of my life where I’m absolutely sure I don’t want to get pregnant — ever again. I’m looking for permanent birth control. Anything like that on the market?”

PROCEDURE: Essure. Essure is a proven, non-surgical, hormone-free permanent birth control procedure that works with your body to prevent pregnancy. Essure is 99.8% effective, the highest of any permanent birth control. Essure is the most effective permanent birth control available, offering benefits no other birth control ever has. No surgery, no slowing down to recover, no anesthesia necessary, no hormones, and peace of mind.


PROBLEM: “I have excessive bleeding and I want it gone! I have no plans whatsoever to have children so I’m not concerned with how the procedure will effect future pregnancies. I just want the bleeding to stop!”

PROCEDURE: Endometrial Ablation: Thermachoice. Thermachoice is intended to treat premenopausal women with heavy bleeding (due to benign causes) who do not wish to become pregnant in the future. This process removes the primary source of menstrual bleeding.


PROBLEM: “I’m menopausal and the hot flashes are driving me crazy! Plus, I’m moody, can’t sleep and I’m just feeling old. Anything I can do about this?”

PROCEDURE: Hormone Replacement Therapy. HRT increases estrogen levels which may reduce the frequency and severity of hot flashes, improve moodiness and sleep changes related to hormone changes, maintain the lining of the vagina, increase skin collagen levels, and may help prevent postmenopausal osteoporosis by slowing bone loss. And it is unlikely to cause weight gain.


PROBLEM: “My doctor wants to look inside my uterus and scrape the tissue in order to conduct some tests. What is that called?”

PROCEDURE: This is called a Hysteroscopy and D&C. Hysteroscopy is a way for your physician to look inside you uterus. A hysteroscope is a thin, telescope-like instrument that is inserted into the uterus through the vagina and cervix. This tool helps diagnose or treat a uterine problem. Hysteroscopy is a minor surgery which is performed in our office. A D&C is a minor procedure for scraping the uterus and collecting the inside endometrial tissue for examination.


PROBLEM: “I keep seeing those commercials for Gardasil and HPV. Should I be concerned?”

PROCEDURE: HPV is passed on through genital (skin to skin) contact, most often during sexual intercourse. Gardasil is the only HPV vaccine that helps protect against 4 types of HPV. In girls and women from ages 9 to 26, Gardasil helps protect against 2 types of HPV that cause about 75% of cervical cancer cases, and 2 more types that cause 90% of genital warts cases. A pap smear is a screening test for cervical cancer (HPV).


PROBLEM: “My cervical cells were diagnosed as abnormal. What kind of treatment is available to me?”

PROCEDURE: LEEP Surgery is one form of treatment. A LEEP or Loop electrosurgical procedure treats the cervix when there is at least a moderate precancerous condition. This prevents any possibility of cancer from being missed. Other treatments include, laser, cryosurgery, and cone biopsy. Another way to manage abnormal cells is to monitor them and see if treatment is necessary. Your physician may recommend frequent pap tests to see if the cells heal themselves.


PROBLEM: “What can I do just to maintain my general gynecological health?”

PROCEDURE: It is important for all women to have pap tests yearly, along with pelvic exams as part of their routine health care. You need a pap test if you are 21 years or older. If the results of the pap test are unclear or show a small change in the cells of the cervix, your doctor may repeat the test. If the test finds more serious changes in the cells of the cervix, your doctor may suggest more powerful tests.


PROBLEM: “I just found out I have a pelvic prolapse, which means that because of the stretched or weakened muscles in that area, I feel pressure in my vagina and it feels like something is bulging out when I walk or bend.”

PROCEDURE: Surgery is the only cure for a prolapsed uterus. Many women, however, are unable or unwilling to have surgery to correct their prolapse. For these women, the pessary is an excellent alternative.


PROBLEM: “I think I might have an STD, but I have no idea which one. What’s my next move?”

PROCEDURE: You need an STD Screening. For bacterial STDs like Chlamydia and Gonorrhea will show up in approximately 3 days from exposure. For type specific STDs like HIV, Herpes, Hepatitis and Syphilis it will take approximately 2 weeks from exposure time. Manhattan Center For Gynecology offers same day appointments.


PROBLEM: “This whole Cosmetic Vaginal Surgery idea intrigues me, mostly because I’m seriously considering having some work done. I’ve heard of Vaginoplasy and Labiaplasty, but I don’t know if I’m even a candidate.”

PROCEDURE: Our services include Vaginal Reconstruction: a treatment of both Labiaplasty and Vaginoplasty, Vaginoplasty: a treatment for vaginal laxity that tightens the vagina, surrounding muscles and soft tissue, Labiaplasty: a treatment for enlarged or irregular labia often done for cosmetic enhancement or medical reasons, and Hymenoplasty: reconstruction of the hymen to a pre-sexual state.

Most women who desire a Vaginoplasty complain of feeling “loose”. They note decreased friction during intercourse resulting in lower levels of sexual satisfaction and more difficulty in climaxing. Vaginoplasty will increase friction during intercourse. After surgery, the vaginal tightness is similar to the pre-baby days. You will easily feel the difference and so will your partner.

The typical patient has enlargement of the labia that causes pain during intercourse, discomfort with tight clothing, or irritation. Patients often report being embarrassed about the size and shape of their labia.


PROBLEM: “I’d actually love to come in for the Vaginal Rejuvenation, but in all honesty — I don’t think I can afford it. Is there any kind of financing plan available for people like me?”

PROCEDURE: Our Solution. We have arrangements with two financial institutions for no interest and low interest financing of your surgery.