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  1. Learn About CVMC
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  5. Women's Health | Central Vermont Medical Center - Berlin, VT

Our providers are eager to care for all of your concerns including your high-risk needs. Our office offers the latest in diagnostic ultrasound, fetal monitoring and laboratory testing.

Gynecology: Our physicians work hard to offer the latest information, diagnosis, and treatment to promote healthy living. In caring for our gynecological patients, our goal is to partner with each woman in every season of life.

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We encourage women to take an active role in their health care. Beginning in adolescence through the senior years, we provide specific care, support, and education to meet these ever changing needs. For many women, lack of bladder control negatively impacts their daily routine. Loss of bladder control, or urinary incontinence, can restrict activity, as women are afraid to lift, bend, or exercise for fear of an accident.

Many women are forced to wear urinary liners, pads, or even diapers due to bladder leakage and this daily expense can quickly become a financial burden as well. For years women have been forced to tolerate this embarrassing problem, but there are easy solutions for women to improve their bladder control. Specialists in Women's Health at Primary Care are trained in modern diagnosis and treatment for urinary incontinence, providing medical and surgical solutions to women with difficulty controlling their bladder.

In office testing can be performed to diagnose the reason for leaking and to determine if the problem would be better treated with medications or a simple outpatient procedure. Urinary incontinence remains an undetected and undertreated problem for women. If you answered yes to any of these questions, you may benefit from a personal bladder control solutions. See one of our providers to find out more.

This measurement calculates your bone health compared to a young healthy population and gives a score based on these results. The BMD is given as a T-score. Osteopenia is diagnosed when the T-score is These conditions increase your risk of developing a bone fracture that can occur without trauma. Screening for these conditions allows physicians to identify patients at risk and help them decrease their chances of developing a fracture. Recommendations for screening by expert opinion include DEXA screening in all postmenopausal women age 65 and older.

The National Osteoporosis Foundation recommends screening in women age 50 and older with known risk factors such as the following: advanced age, previous fracture, long term glucocorticoid treatment, low body weight, family history of fracture, cigarette smoking, excess alcohol intake. Endometrial ablation is an alternative to hysterectomy for the treatment of abnormal uterine bleeding. This procedure can be performed in the office or as an outpatient surgery. Candidates for this procedure should meet the following criteria: abnormal uterine bleeding due to benign disease, non-pregnant and no future plans for childbearing, a desire to retain their uterus, and no evidence of infection.

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The most common postoperative side effects are cramping, vaginal discharge and nausea. A pinkish to dark discharge may be present for two to three days following the procedure and usually resolves by the tenth day. Essure is an alternative to traditional permanent sterilization.

Women's Health

Hysteroscopic sterilization can be performed in the office or as an outpatient procedure by placing a tiny coil through the cervix and into the fallopian tubes. Once the coils are placed, scar tissue develops, causing the tubes to seal shut. The advantages over traditional sterilization procedures are no incisions, possibly no anesthesia, and less postoperative pain. After the procedure has been performed, women may leave the office. Most women experience mild cramping which can be treated with over the counter medications such as Tylenol or ibuprofen.

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The most common reasons women choose to have this procedure performed are the following: Uterine fibroids, prolapse, pelvic pain or infection, Abnormal heavy or often uterine bleeding, and malignant or premalignant disease. The vast majority of patients can have their hysterectomy performed laparoscopically which speeds recovery due to 2 to 3 minimal small incisions on the abdomen. Most patients will have their hysterectomy and be allowed to return home on the same day as their procedure. Modern approaches to hysterectomy allow fewer complications, less pain, and quicker recovery.

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Hysteroscopy is an in office procure in which a telescope hysteroscope is inserted into the vagina and through the cervix to evaluate the inside of the uterine cavity. Hysteroscopy can be performed to evaluate women experiencing abnormal uterine bleeding, infertility, or those found to have abnormal endometrial linings per imaging.

Hysteroscopy can also be used to treat such conditions, sterilization procedures, endometrial ablations, and removal of foreign bodies such as intrauterine devices. Prior to arrival for the procedure, patients are given pain medication and an anxiolytic. In the office a cervical block is used for pain control. Patients are awake during the procedure and may leave immediately after completion. Some women experience cramping afterward that is well controlled with OTC medications such as Tylenol and ibuprofen.

Infertility is defined as a couple unable to become pregnant within 1 year of unprotected intercourse. Fecundity is the chance of becoming pregnant with each cycle. The proper evaluation of infertility is taken in a step wise manner. Physiology of the menstrual cycle: The growing dominant follicle produces increased levels of estradiol. Ovulation happens hrs following the LH surge usually around day The cyst corpus luteum remains and produces progesterone until implantation occurs.

If no implantation takes place, the lack of progesterone induces menses and the cycle begins again day 1.

Women's Health | Central Vermont Medical Center - Berlin, VT

Initial Treatment: Clomid- a mild fertility drug. Take on days , then start having intercourse every other day ie day 11, 13, Signs and symptoms of menopause can include hot flashes, night sweats, vaginal dryness, and urinary symptoms. Estrogen is an important hormone that affects many organs of the body including the brain, skin, blood vessels, heart, bone, and breasts.

Recently, there has been much debate concerning the risks and benefits of hormone replacement therapy HRT. Here, I will cover these risks, benefits, who is a candidate for HRT, and who should absolutely avoid this therapy. First, what is HRT? HRT can come in the form of estrogen alone or with another hormone called progesterone. Postmenopausal women who still have their uterus need the addition of progesterone to protect against uterine cancer, as estrogen alone can stimulate the growth of the uterine lining, which can lead to cancer.

Women who have had a hysterectomy do not need this additional hormone. Estrogen can be given in the form of a pill, patch, or vaginal preparation. It should be used in the lowest effective dose, for a short period of time, usually for duration of five years or less. Second, what are the benefits? HRT can help with the unwanted side effects of menopause including a decrease in hot flashes, night sweats, vaginal dryness, and urinary problems.

It also has a positive effect on bone health, decreasing the risk of fractures due to osteoporosis. It has also been shown to decrease the risk of colon cancer. One of the most important benefits is improvement in quality of life due to the positive effects on mood and decreased symptoms brought on by menopause. Third, what are the risks?

As I stated earlier, estrogen has an influence on many parts of the body. That is why it is important to discuss these risks with your physician to see if you are a candidate or if other non-hormonal therapies should be considered. Lastly, who should receive HRT? Any woman experiencing problems irregular bleeding, hot flashes, night sweats, depression, vaginal dryness, or urinary problems should schedule an appointment with their physician to discuss their particular risks.

Women with a history of heart disease, blood clots, stroke, or breast cancer should avoid hormonal replacement. Schedule an appointment with us today to discuss your symptoms and an individualized plan to help you. We take great pride in allowing our patients to choose the provider of their choice for pregnancy care and delivery.