Additional Gynecologic Conditions

Treatment For Additional Gynecologic Conditions at Hoag

Hoag’s team is here to provide you with the quality care to help prevent, diagnose and treat gynecologic conditions, so you can live your healthiest life. Please see your doctor if you are experiencing any of these conditions.


Vaginal & Vulva Conditions

As your estrogen levels decrease, you may begin to experience vaginal dryness. Certain medical conditions or hygiene practices, such as douching, can also lead to vaginal dryness.

Your estrogen levels can fall for a number of reasons, including:

  • Breast-feeding
  • Childbirth
  • Diabetes
  • Smoking
  • Cancer treatment
  • Immune disorders
  • Menopause
  • Perimenopause
  • Oophorectomy (ovary removal surgery)
  • Anti-estrogen medication
  • Sjogren’s syndrome
  • Allergy and cold medications

To diagnose vaginal dryness, your doctor will talk to you about your medical history, including any medications that you may take. You might also be asked to undergo:

  • A pelvic exam to check the health of your vagina and tissue.
  • A blood test to check your hormone levels and check for health conditions that may be causing vaginal dryness.

Treatment will be based on the cause of your condition and could include:

  • Medications
  • Vaginal suppositories
  • Lubricants

Vaginal discharge is a normal, natural clear, white or off-white fluid that comes out of your vagina and is made up of cells and bacteria. It helps clean and lubricate your vagina and helps fight off unwanted bacteria and infection.

Talk to your doctor if you notice a change in your vaginal discharge, such as:

  • An increase in the amount of vaginal discharge.
  • A change in the color of the discharge.
  • A foul-smelling odor.
  • A change in texture or consistency of the discharge.
  • Irritation, itching or pain in or around your vagina.

These changes could indicate that you have an infection or another medical condition that should be addressed. It is important to note that discharge is your body’s natural way of cleaning your vagina. You shouldn’t use sprays, perfumes or douches to improve the smell of your vagina.

There are several possible causes of vaginal itching or burning:

  • Yeast infection, which is caused by fungal overgrowth of yeast.
  • Sexually transmitted infection, such as trichomoniasis, herpes or genital warts.
  • Allergy to a new feminine product, soap or detergent.
  • Tinea cruris, also known as “jock itch,” can develop just like athlete’s foot but in your groin area.
  • Decline in estrogen.
  • Hemorrhoids, which, though it is caused by swollen veins in your rectum, can spread to your vagina as well.
  • Skin conditions.
  • Bacterial vaginosis.
  • Treatment is based on the cause of your condition. Don’t try to self-diagnose or reach for over-the-counter or home remedies before first talking to your doctor.

Vaginitis is an infection or inflammation of the vagina. It can cause pain, odor, discharge and itching. Common types of vaginitis include yeast infections, bacterial vaginosis and trichomoniasis. Talk to your doctor if you notice irritation, itching or pain in or around your vagina, as these changes could indicate that you have an infection or another medical condition that should be addressed.

Vulvar dermatitis is a type of skin condition that can cause itching or vaginal discomfort. It can be caused by or is associated with eczema or an allergic reaction to fragrance, clothing or urinary or fecal incontinence.

Treatment of vulvar dermatitis ranges from medications to avoiding the substances that are causing your itching. Your doctor may talk to you about lifestyle changes, including:

  • Wash with mild, unscented soap and warm water no more than once a day, using your hands instead of a washcloth.
  • Pat your vulva dry with a clean towel instead of rubbing.
  • Wear 100% cotton underwear or no underwear instead of synthetic fabrics.
  • Wear loose-fighting cotton clothing instead of tight-fitting underwear or jeans.
  • Wash your clothes with mild, unscented detergents.
  • Avoid douches and scented feminine hygiene products.

Vaginas naturally produce scents that can change based on your menstrual cycle or after a workout. Scents only become concerning if they are strong, unpleasant and continue for several days. Those kind of smells may be symptoms of health problems, such as:

If you are experiencing symptoms, please reach out to your gynecologist or OB/GYN.

Vaginal dysplasia, or vaginal intraepithelial neoplasia (VAIN), is a “precancerous” condition that starts in the skin of your vagina. If left untreated, VAIN may progress to vaginal cancer.

Vaginal dysplasia can be discovered and diagnosed during a pelvic exam with a Pap test, particularly during cervical cancer screening. Your treatment depends upon the severity of your condition. Low-grade VAIN may go away on its own, while high-grade VAIN is more likely to progress into vaginal cancer. High-grade VAIN can be treated using:

  • Laser ablation
  • Topical therapy
  • Surgical excision
  • Radiation therapy

Please discuss this with your gynecologist or OB/GYN.


Cervix Conditions

Cervical dysplasia is another way of describing precancerous cells found on the cervix’ surface. It does not mean you have cancer. Carcinoma in-situ (CIS) is a high-grade dysplasia. Please discuss this with your gynecologist or OB/GYN to determine a plan that is right for you.

A cervical polyp is a small growth on your cervix that can cause abnormal vaginal bleeding. In most cases, cervical polyps are benign and not a cause for concern.

Your doctor can detect polyps during a pelvic exam. Cervical polyps are usually removed in a relatively quick and painless procedure in your doctor’s office. Removing a polyp can help alleviate abnormal bleeding or other symptoms you may be experiencing. Though most polyps are benign, your doctor will likely want to test it to ensure there are no signs of cancer.

After your polyp is removed, you may experience a few days of mild symptoms, including mild cramping and light bleeding. Your doctor might advise you against wearing a tampon or having sex for two weeks or until the bleeding has subsided.

Cervicitis is an inflammation of the cervix that can be accompanied by vaginal discharge, bleeding or pain during sex. Acute cervicitis is usually caused by infection, while chronic cervicitis is often caused by irritation.

Your doctor will evaluate you for cervicitis, particularly if you have the following symptoms:

  • Abnormal vaginal discharge that may be yellow, white, or gray and have an unpleasant odor
  • Unexpected light vaginal bleeding
  • Painful sexual intercourse
  • Vulvar or vaginal irritation

If your cervicitis is caused by a sexually transmitted infection, your doctor will treat the underlying infection. This should relieve your symptoms. Depending on the type of infection you have, antibiotics may be prescribed.

Uterus Conditions

Adenomyosis is when tissue that is similar to the lining of your uterus starts to grow into the muscle wall of your uterus. This causes your uterus to thicken and enlarge, leading to painful periods, heavy or prolonged menstrual bleeding with clotting and abdominal/pelvic pain. If left untreated it can result in fertility issues.

Your doctor can diagnose adenomyosis based on one or more of these tests:

  • Pelvic exam, to see if your uterus has gotten larger, softer or is painful to the touch.
  • Ultrasound, which would show telltale signs of thickening of your uterine wall.
  • Imaging scans, such as MRI, which could show uterine enlargement and thickening of certain areas of your uterus.

The following treatments can ease pain, help with heavy bleeding and alleviate other symptoms:

  • Over-the-counter pain medications
  • Hormonal therapy, including birth control pills
  • Non hormonal medication, such as tranexamic acid, which can reduce the amount of vaginal bleeding
  • Hysterectomy, a surgery to remove your uterus

Talk with your doctor about a treatment option that is right for you.

Uterine fibroids are noncancerous growths of the uterus that are very common in women during the childbearing years. You may not experience symptoms and, therefore, be unaware that you have fibroids. However, depending on the location of the fibroid and its size, some women do experience uncomfortable symptoms.

The most common symptoms of uterine fibroids include:

  • Abnormal uterine bleeding, such as excessive bleeding and prolonged menstrual periods
  • Pelvic pressure or pain
  • Lower back or leg pain
  • Urinary problems, such as frequent urination, or difficulty emptying the bladder
  • Constipation

Your doctor may diagnose your uterine fibroids during a routine pelvic exam. If you have symptoms of uterine fibroids, your doctor may order additional tests, including:

  • Ultrasound
  • Blood tests
  • Magnetic resonance imaging (MRI)
  • Hysterosonography, or saline infusion sonogram
  • Hysterosalpingography, which uses a dye to highlight the uterine cavity and fallopian tubes on X-ray images
  • Hysteroscopy, which uses a small, lighted telescope called a hysteroscope to examine your cervix into your uterus

Many treatment options exist, ranging from watchful waiting to surgery. Your doctor will work with you on the best approach for you.

Ovary Conditions

Ovarian cysts are fluid-filled sacs in an ovary or on its surface. Most of the time ovarian cysts are harmless, painless and go away on their own. Occasionally, however, ovarian cysts can become twisted or rupture, which can cause pain and serious symptoms.

Get immediate medical help if you experience:

  • Sudden, severe abdominal or pelvic pain.
  • Pain with fever or vomiting.
  • Signs of shock, such as cold, clammy skin; rapid breathing; and lightheadedness or weakness.

A cyst on your ovary can be found during a pelvic exam or on an imaging test, such as a pelvic ultrasound. Ovarian cysts that cause pain or pose a health concern can be treated with medication or surgery. Talk with your doctor to determine the best approach for you.

Ovarian pain is any pain you feel around one or both ovaries. There are two types of ovarian pain: chronic or acute. Chronic pain is experienced frequently and can last several months. Acute pain comes on suddenly.

There are several reasons why your ovaries may be hurting, including ovulation or your period. Most cases are not cause for concern. However, certain types of pain can be a sign of something more serious, such as:

Imaging tests, like pelvic ultrasound, a pelvic exam or a blood or urinalysis can help your doctor diagnose the cause of your ovarian pain. Your doctor will likely ask you questions, such as:

  • When did the pain start?
  • Is it worse during menstruation?
  • How often do you feel pain?
  • Does the pain interfere with your life?

Your treatment will be based on the cause of your pain and could include:

  • Hormonal medications like the birth control pill
  • Over-the-counter pain medications
  • Minimally-invasive laparoscopic surgery
  • Traditional surgery
  • A heating pad for discomfort
  • Antibiotics

Talk with your doctor to determine the best approach for you.

Anovulation happens when an egg doesn’t release from your ovary during your menstrual cycle due to a hormonal imbalance. It is a common cause of infertility.

Irregular periods are an indication that you don’t ovulate. If you’re trying to get pregnant, your doctor may order tests to determine the cause of your anovulation, including an ultrasound or tests to measure:

  • Blood progesterone levels
  • Blood thyroid levels
  • Blood prolactin levels

Treatment for anovulation depends on correcting the hormonal imbalance that’s causing it and your desire to get pregnant. Treatments might include:

  • Stress reduction
  • Weight loss
  • Decreasing exercise intensity
  • Medication to treat underlying causes of anovulation
  • Adjusting current medications
  • Hormone injections

Talk with your doctor to determine the best approach for you.

Ovarian torsion is the twisting of the ovary that occurs when an ovarian cysts becomes so large that causes the ovary to move. If this happens, you might have sudden, severe pelvic pain and nausea and vomiting. Ovarian torsion can also reduce or stop blood flow to the ovary.

If you are in severe pelvic pain and are feeling nauseous, your doctor will perform a pelvic exam and use an ultrasound to look for evidence of ovarian torsion. Ovarian torsion is a medical emergency and requires surgery to untwist your ovary.

An ovarian neoplasm is a tumor or growth in the ovary. The majority of these tumors are not cancerous, but they may require surgery to remove.

Symptoms of both benign and malignant ovarian tumors may include:

  • Stomach bloating
  • Increased belly size
  • Stomach or pelvic pain
  • Constipation
  • Either difficulty urinating or urinating frequently
  • Feeling full more quickly than usual when eating
  • Painful cramps during menstruation
  • Lower back pain
  • Nausea or vomiting
  • Pain during sex

Your doctor may order imaging tests and labs to determine if you have an ovarian neoplasm. These tests include:

  • Pelvic exam
  • Imaging tests
  • Blood tests
  • Genetic testing

Your doctor will recommend a treatment plan that is determined by the cause of your neoplasm.

When your ovaries stop functioning as they should before age 40, you may be experiencing primary ovarian insufficiency, also called premature ovarian failure, which can lead to infertility.

Diagnosis usually involves a physical exam, including a pelvic exam. Your doctor may not be able to help you restore your ovarian function. Instead, treatment for primary ovarian insufficiency usually focuses on issues of estrogen deficiency and could include:

  • Estrogen therapy
  • Calcium and vitamin D supplements

Talk with your doctor to determine the best approach for you.