We provide comprehensive gynecologic services for women through all stages of life, including:

• Pelvic exam and pap smear
• Abnormal pap smear
• Hormone evaluation
• Irregular, heavy, and painful periods
• Infections of the vagina and female pelvic area
• Birth control and surgery to prevent pregnancy
• Pelvic pain
• Ovarian cysts
• Endometrial ablation
• Menopause management
• Minimally invasive gynecologic surgery
• Urinary incontinence

When You Should Get a Pap Smear, Pelvic, and Clinical Breast Exams

Pelvic and clinical breast exams, and a pap smear, are important for routine women’s healthcare. They help detect abnormalities that can lead to cancer.

Pelvic Exam

We recommend you receive an annual pelvic exam as soon as you become sexually active, regardless of age. This important exam allows us to monitor the female organs for changes in size or shape and signs of disease like inflammation, masses, or fibroids. If any changes are discovered during your exam, we will recommend additional testing, such as a pelvic ultrasound for further examination.

Pap Smear

During your pelvic exam, we can perform a pap smear to test the cells in the cervix for any changes that could lead to cancer. The American College of Obstetricians and Gynecologists (ACOG) recommends:

• Every woman should get her first pap smear test at 21 years old and continue to do so every three years until she turns 30.
• Women aged 30-65 years old: every five years

An abnormal pap smear doesn’t always mean cancer. Many women experience cervical cell changes, and often those changes go back to normal on their own.

Should you receive an abnormal pap smear, we will request additional testing like a colposcopy or cervical biopsy for closer examination of the changes. If results of follow-up tests indicate significant changes, the abnormal cells will be removed. You will need follow-up testing after treatment and regular cervical cancer screening after the follow up is complete.

Clinical Breast Exam

It’s important to conduct monthly self breast exams to know what is normal for your breasts so you can notice small changes and report them right away.

ACOG advises women get a clinical breast exam:

• Every one to three years for women 20-30 years old
• Every year for women aged 40 and older

You should talk with us about your risk factors to make a decision about whether to have a clinical breast exam.

We may recommend endometrial ablation if you’re experiencing heavy or abnormal bleeding and period pain during your menstrual cycle, and don’t plan to have any children.

During this procedure, a thin layer of tissue lining the uterus, known as the endometrium or endometrial lining, is removed through the vagina. This procedure isn’t surgery, and you don’t have to stay in the hospital. We perform endometrial ablations in our office.

Menstrual bleeding should lessen or stop completely. You may not be able to get pregnant after this procedure, because the endometrial lining is where the egg implants after being fertilized, and is removed. Pregnancies that occur after an endometrial ablation aren’t normal, therefore it’s important to use a reliable form of birth control. You will still have your reproductive organs.

Recovery

Typically you’re are able to go home about 2 hours after the procedure. You may want to wear a sanitary pad for bleeding. It’s normal to have bleeding for a few days after the procedure or watery-bloody discharge for several weeks.

While symptoms in women vary after an endometrial ablation, you may experience:

• Strong cramping
• Nausea or vomiting
• Urge to urinate often for the first few days after the procedure

Pain Relief

Take a pain reliever for cramping or soreness as recommended by our office. Aspirin or certain other pain medicines may increase the chance of bleeding and should not be taken. Be sure to only take recommended medicines.

Restrictions

Do not douche, use tampons, or have sex for 2 to 3 days after an endometrial ablation, or as instructed by our office. We will tell you about limits to your activity, such as no tiring activity or heavy lifting.

Diet

You may go back to your normal diet unless we tell you otherwise.

You can also find more information about this procedure by clicking here.

As you begin the exciting journey of pregnancy, our team is here to help you along the way – from planning to birth. Learn more about our pregnancy services.

• Infertility
• Prenatal care
• Prenatal ultrasound
• High-risk pregnancy complicated by diabetes, hypertension (high blood pressure), thyroid disorders, and asthma

We deliver babies at Morristown-Hamblen Healthcare System. For women with high-risk pregnancy complications, we partner with the perinatologists at Fort Sanders Perinatal Center.

As you begin the exciting journey of pregnancy, we will meet with you regularly to monitor the growth of your baby. Below is information explaining what you can expect during your visits with us and the prenatal care you’ll receive before your baby is born.

Prenatal Care Appointments

At your first appointment, we will confirm your pregnancy with lab tests and begin developing a personalized care plan for you and your baby. You can also expect to:

• Hear your baby’s heart beat for the very first time
• Receive a health exam
• Get a prescription for prenatal vitamins and a full list of which medicines not to take during your pregnancy

As your pregnancy continues, you’ll have more prenatal visits, including:

• Monthly checkups during your first two trimesters
• Every two weeks when your 28 weeks pregnant through 36 weeks
• Weekly visits until you deliver your baby

At each prenatal appointment, we’ll monitor your health and your baby’s growth by checking your weight, blood, and urine. You’ll also get to see your baby on ultrasound.

Along the way, other tests may be necessary, but we’ll discuss with you any additional testing.

During your appointment, we’ll answer all your questions. If you have concerns between appointments, your calls are always welcomed. We want you to feel comfortable and confident as you begin this journey!

During your pregnancy, you will have several ultrasounds to monitor your baby’s growth. Below is information regarding when and why you may have an ultrasound.

Prenatal Ultrasound Schedule

First Trimester (Up to the end of week 12)

During the first trimester, we will:

• Determine your baby’s due date
• See if you have one or more babies and check your placenta
• Diagnose an ectopic pregnancy or miscarriage
• Examine the uterus and other pelvic anatomy
• In some cases detect if something is wrong with your baby

Click here to learn more about your first trimester.

Second Trimester (13-27 weeks pregnant)

Next, ultrasound is used in your second trimester to:

• Confirm the due date (a due date set in the first trimester is rarely changed)
• See if you have one or more babies and check your placenta
• Help perform tests, such as an amniocentesis
• Examine your baby for any problems with his or her body
• Check the amount of amniotic fluid (the fluid surrounding your baby)
• Monitor blood flow from you to the baby
• See your baby’s behavior and activity
• Measure the length of your cervix
• Monitor your baby’s growth

Click here to learn more about your second trimester.

Third Trimester (28 weeks pregnant until delivery)

Finally during your third trimester, we’ll:

• Monitor your baby’s growth
• Check the amount of amniotic fluid
• Determine the position of your baby
• Examine your placenta

Additional studies may be scheduled, depending on your unique case.

Click here to learn more about your third trimester.

At times, surgery is required to diagnose and treat gynecological conditions and pregnancy issues.

Reasons for Gynecologic Surgery

Here is a list of common conditions that may require surgery:

• Abnormal cervical tissue
• Abnormal cells in the vulva, vagina, or cervix
• Bladder, rectal, uterine prolapse
• Bladder sling fitting for urinary incontinence
• D&C (dilation and curettage) for miscarriages
• Endometriosis
• Hysterectomy
• Ovarian cysts
• Polyps (abnormal growth) or fibroids in the uterus
• Removal of ovaries and/or fallopian tubes
• Sexually transmitted diseases
• Treatment of ectopic pregnancy
• Tubal sterilization (having your tubes tied)

Laparoscopic Surgery

We perform many surgical procedures laparoscopically. This is a minimally invasive technique that offers patients many advantages, including a smaller incision, less post-operative pain, reduced risk of surgical complications, and a faster recovery.