Gynecological Health

The SHWC can perform your annual wellness exam or pap smear.  Annual wellness exams are preventative visits not associated with a specific problem, but rather to keep you as healthy by checking your current health and risk factors. Pap smears are recommended for patients over the age of 21 and are used to screen for cervical cancer. Paps are usually accompanied by a pelvic exam.

Colposcopy (colpo) is a basic procedure to look closely at the cervix and vagina and may be recommended if you have an abnormal pap smear.  The machine is similar to a large microscope and is used to see these areas at a greater magnification and look for any possible abnormalities.  The colposcopy itself does not hurt at all - it is just like a longer version of a pap smear.  90% of the colposcopy is spent with the gynecologist looking at areas that may be causing the abnormal cells on the pap smear.   If any of these areas are identified, a small biopsy may be taken and sent to pathology to determine further management.  This may cause some minor cramping, similar to menstrual cramps, but can be eased by taking an over the counter pain reliever 30 minutes prior to the procedure.

A colposcopy can be done at the SHWC with our staff gynecologist.  If you have had a recent abnormal pap smear and were advised to have a colpo for further evaluation, please call 940-565-2333 for a consultation.  During that visit, the entire process will be explained in detail and you will be given a chance to ask any questions before the appointment is made for the actual procedure.

Birth Control Pills 

Birth control pills are one of the top forms of contraception that has been available in the United States since 1960. The pills taken today are much different from those first pills. Today, all birth control pills are considered to be low dose - referring to the amount of estrogen each pill contains. The effective doses of estrogen range from 10mcg to 35mcg in each pill available today. Older pills contained as much as 50-75mcg of estrogen, which was responsible for an increased chance of side effects during that time.

In the majority of cases, birth control pills are a combination of estrogen and progesterone. It is important that you take birth control pills every day, at approximately the same time every day. There are alarms you can set on your phone or even apps to help you remember. When taken correctly, birth control pills have an effective rate of 99%, but it is hard to take them perfectly all the time. The typical effectiveness rate is about 92-96%. Birth control pills do not protect against STIs or HIV and consistent condom use is recommended. In addition to preventing pregnancy, birth control pills can help make periods shorter with lighter menstrual bleeding and can also significantly improve painful cramps. Birth control pills are not for everyone due to their associated risk of side effects.

If you have questions about birth control pills or contraception in general, please contact the SHWC for an appointment to speak with one of the providers about your concerns. You can call (940) 565-2333 or go online to schedule an appointment.

Intrauterine Device (IUDs) 

An IUD is a long-acting form of birth control that has become much more popular over the last several years.  There are currently 3 types of IUDs available in the US - 2 that contain the hormone progesterone and 1 that does not contain any hormones and is made of copper.  The progesterone-containing IUDs are the most common: Mirena lasts for 5 years and the newer, smaller version, Skyla, for 3 years.  Mirena is available at the SHWC.

IUDs are very effective against preventing pregnancy - greater than 99%.  In addition to their contraceptive uses, IUDs can typically help with heavy periods and painful cramping.  After the first few months, periods are typically several days shorter, with much lighter bleeding and decreased cramping.  Some people don't have periods at all!  People who have an IUD will tell you they love not having to worry about taking a pill every day or remember to get a shot every 3 months.  It is one less thing a busy college student has to worry about.

As with any birth control, there are some risks associated with an IUD and they are not recommended for everyone.  One common misconception is that you have to have had a child before you can get an IUD.  This used to be a recommendation but is no longer valid.  In fact, younger individuals who have not had children are the specific group the manufacturers of the newer IUD, Skyla, had in mind when coming up with this product.  As with any method of birth control, IUDs do not protect against STIs and consistent condom use is always recommended.

If you are interested in learning more about IUDs and if they would be a reasonable option for you, please call (940) 565-2333 to schedule a consultation with the gynecologist.

Nexplanon 

Nexplanon is a long-acting contraceptive implant that provides birth control for 3 years.  The device is a small, flexible plastic rod that contains the hormone progesterone and is inserted under the skin of the upper arm. It is easily inserted at an office visit and numbing medicine is used beforehand so it is quick and painless.  The implant can be felt under the skin but not seen so it is very discreet.

It is one of the most effective types of birth control available and has a pregnancy prevention rate greater than 99%.  Many people prefer Nexplanon over other forms of birth control, like the pill, because they do not have to remember to take it at the same time every day and they don't have to think about birth control for the next 3 years.  Like other forms of birth control, Nexplanon does not prevent against any STIs and consistent condom use is recommended.  Also, as with any form of birth control, there can be risks associated with Nexplanon as well as possible side effects.

If you have questions about Nexplanon or contraception in general, please contact the SHWC for an appointment to speak with the staff gynecologist. You can call (940) 565-2333 or go online to schedule an appointment.

Menstrual cramps are one of the most common complaints when it comes to periods. Painful menstrual cramping, also known as dysmenorrhea, affects a majority of reproductive-age individuals at some point in their lives, with as many as 90% of teenagers affected. Symptoms can gradually worsen over the years until the pain becomes so severe they miss work or school one or more days each month.

Menstrual cramps typically begin prior to the onset of bleeding and can last for 1-2 days of the cycle. Patients often experience pain in their lower back and thighs. Other symptoms that can be associated with the onset of bleeding are headaches, fatigue, nausea and vomiting, and occasionally diarrhea. In a majority of cases, dysmenorrhea is due to natural chemicals, called prostaglandins, produced in the body that are released in menstrual blood. These substances cause increased uterine contractions and pain. In a majority of cases, cramps can be controlled by taking NSAIDs (Advil, ibuprofen, Aleve, etc.) during the first few days of the period. Another great option that helps control the pain caused by periods as some of the other symptoms listed above are birth control pills. Not only does the pill prevent pregnancy, but it can also make periods much more tolerable.

If you suffer from painful periods, please contact the SHWC for an appointment to speak with one of our medical providers about your concerns. You can call (940) 565-2333 or go online to schedule an appointment.

Genital Herpes (HSV) 

One of the most common STIs is genital herpes, with more than 750,000 new infections each year. It is caused by an infection with the herpes virus (HSV), of which there are 2 types: HSV-1 and HSV-2. Oral lesions associated with HSV-1 are also known as “cold sores” or “fever blisters” but can be present in the genital region as well. Typically, HSV-2 only infects the genitals. Once you have been exposed to the virus, it stays with you for the rest of your life, but that does not mean you will have symptoms forever, as the disease usually becomes milder over a period of years.

HSV is passed between partners through vaginal, oral, and anal intercourse as well as direct skin to skin contact. HSV infections are characterized by multiple blisters on the penis or vulva that eventually break open to form shallow, painful ulcers. These ulcers eventually heal completely in a few weeks, leaving no evidence of any disease. This is an example of an “outbreak.” If you have sores, cuts, or areas of irritation that tend to reappear, this may be recurring outbreaks and it is important to come in and be evaluated. Even though the virus is always present in the body, there are medications available to help prevent outbreaks and/or make them shorter, milder and reduce the risk of transmission of the disease to others.

Many people with herpes infections may not experience an outbreak and never know they have the disease, thereby unknowingly transmitting it to others. The virus may also be passed between partners when no active sores are present in a phenomenon known as asymptomatic viral shedding. It is impossible to know how you will react to an HSV infection - some will never even know they have the disease, others may have only a few outbreaks in their lifetime, and some will have issues with recurrent outbreaks several times per year. It is important to avoid any sexual activity if any suspicious lesions are present and condoms are a crucial way to help prevent the spread of the disease.

If you have questions about herpes or are worried about a possible infection, please contact the SHWC for an appointment to speak with one of the providers about your concerns. You can call (940) 565-2333 or go online to schedule an appointment.

Genital Warts 

Another very common STI is genital warts.  Genital warts are caused by an infection with human papillomavirus (HPV).  Over 100 different types of HPV have been identified with more than 40 infecting the genital tract alone.  In many cases, these infections often go undetected unless a person has an abnormal pap smear or a person develops genital warts that can be seen.

In the majority of genital HPV infections, the warts are asymptomatic (do not cause any problems) but can be very bothersome to patients emotionally as well as cosmetically.  The lesions are usually flesh-colored growths of varying sizes that can be flat or elevated.  It is common to have several groups or clusters of warts on the penis or labia or at the opening of the vagina.  If the warts grow large enough, they can be itchy or painful depending on their location.  Warts can be treated in several different ways, many of which are provided at the SHWC.  Your provider can help you decide which method may be the best option for you.  There is also a vaccine (Gardasil) available which is effective against 2 types of HPV which cause 90% of genital warts.  This is a series of 3 injections, which is also available at the SHWC, but does not cure HPV and is most effective when received prior to active sexual activity.

If you have questions about genital warts, HPV infections, or the Gardasil vaccine, please contact the SHWC for an appointment to speak with one of the providers about your concerns.  You can call (940) 565-2333 or go online to schedule an appointment.

Urinary tract complaints are a very common reason to seek care with their medical provider. It is much more common for individuals with vaginas to get a urinary tract infection (UTI or bladder infection) based simply on their anatomy. The urethra (the tube that connects the bladder to the outside of our body) is much shorter and therefore more susceptible to becoming infected with bacteria that are normally found in the genital region.

Symptoms of a UTI include frequency of urination, pain or burning during or at the end of urination, pelvic pain, back or side pain, and blood in the urine. Symptoms can range from mild to severe. A patient can develop fever and chills as well as nausea and/or vomiting in a severe infection. If left untreated, UTIs can turn into severe kidney or bladder infections which may require hospitalization and intravenous antibiotics. It is important to seek medical care if you think you might have a UTI. When you make an appointment at the SHWC, a urine sample is collected and tested while you wait to see if an infection is present. If so, a short course of antibiotics will be prescribed. The symptoms typically resolve in a few days with medical treatment.

The likelihood of getting a UTI increases with sexual activity, therefore it is important to remember to empty your bladder immediately after intercourse. Also, always practice good hygiene. Drinking plenty of fluids can help flush the bladder as well. 

Bacterial Vaginosis 

Most people of reproductive age will have symptoms of increased vaginal discharge, odor, and itching/irritation at some point. These symptoms are consistent with a vaginal infection. Typically, patients will assume they have a yeast infection and treat with over-the-counter medication. This may be the case, but a more common vaginal infection is bacterial vaginosis (BV). These infections can be very similar to one another and difficult to tell apart, especially if you have never had something similar before.

BV is characterized by a thin, clear, or whitish vaginal discharge, and, usually, an odor is present. Irritation and itching can occur, although in most cases it is milder than what patients experience with yeast infections. BV is not considered a sexually transmitted infection. A simple test called a wet prep can be done at the SHWC to tell what type of infection is present. The results are ready in about 15 minutes. If the test confirms bacterial vaginosis, a prescription will be written for antibiotics. It will usually resolve with medication in about a week.

If you think you might have a vaginal infection, please contact the SHWC for an appointment to speak with one of the providers about your concerns. You can call (940) 565-2333 or go online to schedule an appointment.

Yeast Infections 

Yeast infections are common and most people will get a yeast infection at least once in their lifetime. Some individuals will have infections more frequently - up to several times per year. Typical symptoms of a yeast infection are fairly well recognized and include thick, white vaginal discharge and itching. The skin in the genital region may be red and swollen or irritated. Sometimes symptoms may be more subtle and harder for a patient to recognize. For example, there may be itching or irritation only and no discharge. Many vaginal infections can present in the same way, making self-diagnosis more difficult.

With a pelvic examination and testing done at the time of an appointment at the SHWC, a yeast infection can be easily diagnosed. Patients have a variety of treatment options, including a one-time dose of oral medication or traditional vaginal preparations that can be purchased over the counter. Symptoms usually resolve quickly with either type of medication.

If you think you might have a vaginal infection, please contact the SHWC for an appointment to speak with one of the providers about your concerns. You can call (940) 565-2333 or go online to schedule an appointment.