Women’s Health Glossary
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Amniocentesis: Amniocentesis involves the withdrawal of a small amount of amniotic fluid surrounding the fetus using a very thin needle. The procedure is performed on an outpatient basis and requires only a few minutes. Ultrasound is used throughout the entire procedure to monitor the progress and to optimize safety. Patients can return to normal activity the day after the procedure.
Amniocentesis is typically performed for the purpose of diagnosing chromosomal disorders. Read more about genetic screening and diagnosis >
Birthing Plan: Many women, especially first-time mothers, think that delivery is what it is and that they don't have much say in the matter. The reality is that you have many, many choices regarding the delivery of your baby. Do you want to use drugs or not? How do you want to handle pain? Do you want music? What do you want to wear? What are your preferences if inducing labor becomes necessary? Who do you want present? What position do you want to use? We will work with you in advance to develop the birthing plan you want and to ensure that your medical team is aware of your preferences. Read more about birth plans in the Wellness Journal >
Breast Disease Screening: See mammogram.
Breast Health Exam/Breast Self Exam: Breast health exams, ideally completed annually by your healthcare provider, and breast self exams, ideally completed by you every month, are physical examinations of the breasts to help detect changes that could be signs of a problem. Most women experience changes in their breasts each month as part of their cycle. Completing a breast self exam at the same time each month helps you learn what normal feels like for you. If you’re still menstruating, breast self exams should be completed around the time your period ends. They consist of a visual inspection to look for changes, as well as a manual inspection to feel the breast tissue for changes. Visit the American College of Obstetricians and Gynecologists to learn more.
Cervical Cancer Screening (Pap Test): Screening for cervical cancer, also known as the pap test, pap smear or cervical cytology screening, is the collection and microscopic examination of cells from the cervix to look for abnormal cells that could lead to cancer. The American College of Obstetricians and Gynecologists recently revised its guidelines for how often women should be screened for cervical cancer:
- Begin pap tests at 21 years of age regardless of sexual activity (only 0.1% of cervical cancer occurs before the age of 21)
If previous pap tests are normal for the last three years future tests should be performed:
- Every two years for women age 21-29
- Every three years for women over age 30
Women’s Healthcare Associates strongly recommends annual exams for all women. A pap test is only one component of your health that is discussed at an annual exam. Talk to your provider to determine how frequently you should be screened for cervical cancer.
Certain types of Human Papilloma Virus (HPV) can cause cervical cancer. Read more about preventing HPV and cervical cancer >
Cesarean Delivery (c-section): At least 22 percent of American women give birth by cesarean delivery (c-section). Although it is sometimes clear that a woman will need a c-section before she goes into labor,most commonly, it's because of something the medical team couldn't anticipate before labor started. Women's Healthcare Associates physicians are committed to preventing unnecessary c-sections, but will counsel and guide you and your partner if surgery becomes necessary.
Chorionic Villus Sampling (CVS): Chorionic villus sampling is a medical procedure used to diagnose fetal chromosomal abnormalities. In CVS, an experienced physician obtains a sample of the chorionic tissue from the developing placenta. The sample can be obtained through the cervix using a thin tube or through the abdomen using a thin needle. Which approach is used depends on the position of the placenta and the fetus determined by ultrasound immediately before the procedure. Ultrasound is used to visually guide the physician throughout the procedure to optimize safety.
CVS can be performed as early as the 11th week of pregnancy. The risks of CVS are very similar to those associated with amniocentesis. Your Women’s Healthcare Associates provider can help you decide if prenatal diagnosis is appropriate for you and can refer you to one of our experienced maternal-fetal medicine specialists at Northwest Perinatal Center for the procedure.
Read more about genetic screening and diagnosis >
Endometrial Ablation: If heavy vaginal bleeding is a problem, a hysterectomy may not be your only option. The providers at Women's Healthcare Associates and Northwest Gynecology Center can help you find the best medical or surgical treatment, such as hormonal adjustments or insertion of an intrauterine device (IUD).
Another solution could be endometrial ablation. In this procedure, a special instrument is used to treat the lining of the uterus in order to alleviate heavy bleeding. This treatment can be a safe and effective alternative to a hysterectomy; we can help you determine if it is right for you. The procedure can be performed in-office, with most patients back to routine activities within one or two days.
Read more about abnormal menstrual bleeding >
Endometriosis: Endometriosis is a condition where endometrial tissue, which makes up the lining of the uterus, is found outside the uterus. A healthy woman’s endometrium changes in response to hormones during her menstrual cycle to prepare for a potential pregnancy. If a pregnancy does not occur, the endometrium is shed during menstruation and the process begins again.
In the case of endometriosis, endometrial tissue found outside of the uterus, sometimes on the ovaries, fallopian tubes or the surface of the uterus, responds the same way to hormones as does the endometrium inside the uterus – breaking down and bleeding during the menstrual cycle. This process may cause pain and can lead to scar tissue over time.
Fibroids: Fibroids are benign (non-cancerous) growths. Uterine fibroids are benign growths found as part of the uterus. Some fibroids remain small and do not cause symptoms. Some women experience symptoms, such as changes in menstruation, pain, pressure, miscarriage or infertility, as a result of the size, number or location of uterine fibroids.
If you have symptoms associated with uterine fibroids, your Women’s Healthcare Associates provider may recommend additional tests for more information, such as ultrasound or hysteroscopy, or treatments that could include medication or surgery.
Genetic Counseling: Genetic counseling translates scientific knowledge into practical information. Our providers specialize in counseling for chromosomal disorders and genetic screening test options. We work with patients and families to provide counseling for inherited diseases, birth defects, effects of medications on pregnancy, and hereditary cancer screening (such as breast cancer). Our counselors are experienced in helping families understand birth defects and how inheritance works. They provide information that helps families make personal decisions about pregnancy and child care. People who might be especially interested in genetic counseling include:*
- Those who have or are concerned that they might have an inherited disorder or birth defect.
- Women who are pregnant or planning to be after age 34.
- Couples who already have a child with mental retardation, an inherited disorder or a birth defect.
- Couples whose infant has a genetic disease diagnosed by routine newborn screening.
- Women who have had two or more miscarriages or babies who died in infancy.
- People concerned that their jobs, lifestyles or medical history may pose a risk to pregnancy, including exposure to radiation, medications, chemicals, infection or drugs.
- Couples who would like testing or more information about genetic defects that occur frequently in their ethnic group.
- Couples who are first cousins or other close blood relatives.
- Pregnant women who, based on ultrasound tests or blood screening tests, have been told their pregnancy may be at increased risk for complications or birth defects.
* Information provided by the March of Dimes
Human Papilloma Virus (HPV): HPV is a very common infection in women and men. Genital HPV infections can be passed from person to person through sexual contact. Some types of HPV infections are insignificant, but some types can cause genital warts and some types can lead to cervical cancer. Changes to cervical cells that lead to cancer occur over a long period of time and can be detected through a Pap test, also known as a cervical cytology screening.
Your Women’s Healthcare Associates provider will help you determine the best schedule for you for getting pap tests. He or she can also discuss treatments for genital warts and whether the HPV vaccine is right for you.
HPV Vaccine: Like all vaccines, the HPV vaccine boosts the ability of woman’s own immune system to fight off certain types of HPV when she is exposed to them. The vaccine is design to protect against four types of HPV – two that can lead to cervical cancer and two that can cause genital warts.
Because HPV is so common among the sexually active, Women’s Healthcare Associates follows the ACOG guidelines in recommending the vaccine for girls beginning at age 11. It has recently been approved for use in boys, as well. While it is ideal to administer the vaccine before a young woman becomes sexually active, because the vaccine protects against several types of the virus, we still recommend it for teens and young women age 13 to 26 that may be sexually active and may have already contracted HPV. The vaccine is given in three doses over a six-month period.
Read more about the HPV vaccine and preventing cervical cancer >
Hysterectomy: is the surgical removal of a woman’s uterus. Removal may be partial or total. Common reasons for a hysterectomy include:
- Fibroids (non-cancerous uterine growths that may cause bleeding)
- Abnormal uterine bleeding with heavy periods, spotting, or bleeding in-between periods
- Pelvic pain with bleeding
- Painful intercourse
- Endometriosis (patches of uterine tissue found outside the uterus, which can cause pain and/or bleeding)
Fortunately, surgery to perform a hysterectomy often no longer requires a large incision or long hospital stay. Minimally invasive surgery is often an option. The skilled surgeons of Women's Healthcare Associates and Northwest Gynecology Center can help you choose the best alternative for your situation.
Incontinence and Pelvic Support Problems: Many women have pelvic support problems. We can help with pelvic pressure, aching abdomen and leakage of urine, among other conditions. For instance, if you lose urine when you cough, sneeze or laugh; walk, exercise, run or lift something; or get up from a seated or lying position, you may have Stress Urinary Incontinence (SUI).
SUI shouldn’t be embarrassing — urinary incontinence can be treated at any age. Your provider may suggest:
Mammogram: Mammography uses low-dose x-rays to examine the breast for early-stage cancers that are undetectable by any other method. Further, it is the only proven method for detecting carcinoma in the milk ducts. Mammography is also used to diagnose breast disease in women who are experiencing symptoms, such as a lump or pain in the breast. In recent years, mammography has led to approximately 30% fewer breast cancer deaths.
Digital mammography can replace traditional film mammography and, in many cases, makes early-stage cancers even easier to find. For younger women, women with dense breasts or perimenopausal women, it yields enhanced results. Digital mammography results are stored electronically rather than on film. The technology's reduced “noise” and better contrast, along with other technological advantages, enables it to reveal small cancers more efficiently and earlier.
Read more about when you should have a mammogram according to national guidelines.
Menopause: Menopause, when a woman stops having menstrual periods, signifies the end of a woman’s reproductive years. The average woman goes through menopause at age 51. Perimenopause is the term used to refer to the period of time leading up to menopause.
Menopause occurs because the ovaries produce less and less estrogen over time. Estrogen is the hormone that causes a thickening of the uterine lining, the endometrium, each month in preparation for pregnancy. When pregnancy does not occur, the lining is ‘shed’ during a woman’s period. Eventually, the amount of estrogen produced by the ovaries is not great enough to cause the uterine lining to thicken, and periods cease. Before this point, many women notice changes in their menstrual cycle, such as shorter, longer, lighter or heavier periods or changes to the length of the cycle.
Other symptoms of menopause can include hot flashes, sleep problems, changes in the vagina and urinary tract and emotional changes. This period of life also brings with it specific preventative health recommendations, including screening for osteoporosis and breast cancer.
Your Women’s Healthcare Associates provider will help you understand the symptoms you may experience as menopause approaches and what you can do to alleviate or treat them. He or she will also recommend the proper health screenings for you, several of which can be completed in our office in conjunction with your annual exam.
Menstrual Irregularities: Menstrual irregularities can range from heavy menstrual bleeding (called menorrhagia in extreme cases) to the complete absence of your period for three months or longer (unrelated to pregnancy), referred to as amenorrhea. It can also include painful periods, called dysmenorrhea, including severe menstrual cramps.
Menstrual irregularities can be caused by a wide variety of underlying conditions, ranging from something as simple as stress to more serious conditions like polycystic ovary syndrome, uterine fibroids or endometriosis. Talk with your Women’s Healthcare Associates provider if you’re experience irregularities. He or she may suggest birth control, endometrial ablation or minimally invasive surgery to treat your condition and/or alleviate your symptoms.
Minimally Invasive Surgery: Gynecological surgery doesn’t always require large incisions and a long hospital stay. Often, such surgeries can be performed using much smaller incisions that are less painful and heal more easily. Recovery times are typically shorter, too, enabling you to return to work and activities sooner. Many procedures may be performed in our offices.
Today, minimally invasive surgery may be used for:
- Removal of polyps and fibroids
- Treatment of endometriosis
- Endometrial ablation (sometimes used to alleviate heavy bleeding)
When the situation dictates, Women's Healthcare Associates and Northwest Gynecology Center also have experts trained in the most recent advance in minimally invasive surgery, robotic-assisted surgery.
Multiple Births: If you're expecting more than one baby, your pregnancy is higher risk and you may or may not develop complications. An early confirmation that you are carrying twins (or more) will assure that your Women's Healthcare Associates provider can take the proper steps to ensure healthy babies. We will balance your risk of developing complications with your risk of delivering premature babies and decide with you how to maximize the outcome for your babies.
Women's Healthcare Associates and Northwest Perinatal Center specialize in complete medical services for high risk pregnancies. If necessary, one of the Maternal-Fetal Medicine Specialists (Perinatologists) on staff at Northwest Perinatal Center will be part of your Women's Healthcare Associates medical team.
Myomectomy: Myomectomy is the surgical removal of uterine fibroids while leaving the uterus in place. It can be performed through an incision in the abdomen (called a laparotomy), through laparoscopy, where a camera to guide the surgeon is inserted through one small incision and the fibroids are removed through other small incisions, or hysteroscopy where the fibroids are destroyed inside the uterus requiring no abdominal incisions.
Osteoporosis: Osteoporosis, or "porous bone," is a condition in which bones become weak and can break from something as simple as a minor fall. The condition affects four times as many women as men. In fact, one in every two women over age 50 is likely to have some evidence of low bone density. What's more, osteoporosis can progress completely painlessly until a fracture occurs, most often in the hip, spine, or wrist. Hip fractures are especially worrying since they usually require major surgery and can result in permanent loss of mobility.
The good news is that osteoporosis can be detected and treated. Painless, non-invasive bone density screening is available using state-of-the-art technology, described below.
Read more about your risk for osteoporosis.
Osteoporosis (Bone Density) Screening: A scan performed using low-level x-rays to measure bone density or assess spine fractures. The radiation level used is about ten times lower than that of a standard chest x-ray.
- DXA (Dual-energy X-ray Absorptiometry) uses two x-rays of differing energy levels to measure your bone mineral density. The result is your "T-score." Generally, the lower your T-score, the more risk there is for osteoporosis.
- VFA (Vertebral Fracture Assessment) is used to identify possible spine fractures by examining the bones in your back. If any of the bones is shaped abnormally, there could be a vertebral fracture, which would indicate osteoporosis or a spine injury.
Read more about what to expect during your bone density scan.
Ovarian Cysts: Ovarian cysts are fluid or tissue filled growths that form on the ovaries. They are common among women during childbearing years. Most are non-cancerous (benign), but can be cancerous (malignant) in rare cases.
Most cysts are small, do not cause symptoms and will disappear on their own. In some cases cysts may cause pain or other complications and you and your healthcare provider may discuss treatment options.
Pap Test/Pap Smear: See Cervical Cancer Screening.
Pelvic Exam: A pelvic exam consists of examining the vulva, the external genital area, looking at the vagina and cervix and checking the internal organs. A pelvic exam is typically part of a woman’s annual exam, which may also include a pap test.
Pelvic Pain: Many women experience pain in the pelvic area to some degree. More severe pain can be caused by conditions such as ectopic pregnancy, pelvic inflammatory disease or ovarian cysts. Chronic pain can be caused by endometriosis, ovulation, uterine fibroids or other issues unrelated to the pelvic organs.
Discuss any pelvic pain you’re experiencing with your healthcare provider. He or she may recommend additional tests to diagnosis the source of the pain. Treatments could range from medication to surgery.
Permanent Birth Control: When your family is complete, you may wish to consider permanent birth control, also known as sterilization. Today’s sterilization is a gentle procedure that can performed in minutes in the privacy of our office. It is as safe and effective as tubal ligation. Instead of clamping (‘tying’) the fallopian tubes, small devices are inserted. Scar tissue forms around the devices, blocking the tubes and preventing pregnancy.
Today’s permanent birth control offers:
- No incisions
- No general anesthesia
- No artificial hormones
- Rapid recovery (1-2 days)
Postpartum Care: Most physicians and midwives will want to see you approximately six weeks after giving birth to ensure that you are recovering well. If you had a c-section, your physician may want to check your incision earlier. Your provider will check your weight, blood pressure, and do an examination to ensure that you are healing properly. You will probably have questions about your body and childbirth-related aches and pains. Additionally, you may have concerns about your emotional state. This can also be a good time to address birth control needs. Please know that your Women's Healthcare Associates provider is there for you following delivery to help you adjust both physically and emotionally.
Polyps: Polyps are benign (non-cancerous) growths that develop from membrane tissue and can be found in a number of places, such as the lining of the uterus or colon.
Premenstrual Syndrome (PMS): Premenstrual syndrome (PMS) is the name given to the collection of physical or emotional symptoms a woman may experience before the start of menstruation. Emotional symptoms can include irritability, anxiety, depression or changes in sexual desire, among others. Physical symptoms can include breast tenderness, bloating, weight gain or fatigue, among others.
Talk to your Women’s Healthcare Associates provider about your symptoms. He or she may recommend lifestyle changes, such as exercise, diet or supplements. If your symptoms are more severe, medication may be recommended.
The term Premenstrual Dysphoric Disorder (PMDD) is a term that is sometimes used to refer to PMS.
Pre-pregnancy Counseling: If you are thinking of becoming pregnant, we can help you with many considerations. If you believe you may fall into a high-risk category based on your age, family history, ethnicity or medical history, let us meet with you to review your high-risk issues, address your concerns, and prepare you for your upcoming pregnancy.
Prenatal/Maternity Care: Prenatal care means taking good care of yourself and your baby before your baby is born. If you know you are pregnant, or think you might be, call Women's Healthcare Associates right away and schedule a visit. Regular appointments with your Women's Healthcare Associates provider throughout your pregnancy will help to detect problems early and assist you in being as healthy as possible.
Prenatal Diagnosis: Prenatal diagnosis is the process of determining early in pregnancy whether a fetus might be affected by certain disorders. Currently, more than 300 different fetal disorders can be detected during pregnancy. Among these are chromosomal abnormalities (such as Down's syndrome) and single gene disorders (such as cystic fibrosis, sickle cell anemia, Duchenne muscular dystrophy and Tay-Sachs disease). Because a simple screening test for all prenatally detectable diseases is not currently available, laboratory tests are specifically chosen to rule out disorders for which your fetus might be at risk. In such cases, prenatal diagnosis may likely be determined from the amniocentesis. Additional diagnoses can be made from ultrasound studies.
Who should consider Prenatal Diagnosis? Women who:
- have had a previous child or fetus with a chromosome abnormality, such as Down's syndrome.
- are carriers of a known chromosomal disorder. This also applies if the father is a carrier.
- have had a positive maternal serum screening result.
- have a birth defect, such as a heart defect repaired as a child.
High-risk parents receive genetic counseling, targeted ultrasound, and amniocentesis, if appropriate, as part of our comprehensive service.
Prenatal Screening for Chromosomal Abnormalities: Prenatal screening is the process of testing for possible chromosomal abnormalities. Women’s Healthcare Associates uses the most recent innovation in prenatal screening call the Sequential Screen. The Sequential Screen tests for Down’s syndrome, trisomy 18 and open neural tube defects. It uses the First Screen, which includes a blood sample and an ultrasound measurement of an area on the fetal neck (nuchal translucency) taken between the 11th and 14th week of pregnancy, along with a second trimester blood sample taken between the 15th and 22nd week.
Sequential screening provides two risk assessments: an early risk assessment in the first trimester and a final one in the second trimester. The first assessment detects 70% of fetuses with Down’s syndrome with a 1.2% false positive rate, as well as 80% of the fetuses with trisomy 18. After the second trimester results are available, the Sequential Screen has a 90% detection rate for Down’s syndrome with a 3.7% false positive rate, a 90% detection rate for trisomy 18 and an 80% detection rate for neural tube defects.
Robotic-Assisted Surgery: One of the most recent innovations in minimally invasive surgery is the advent of robotics—more properly termed “robotic-assisted laparoscopic surgery.” Using uniquely ‘wristed’ instruments and three-dimensional vision, the surgeon remotely operates from a bedside console while a robot manipulates the laparoscopic instruments.
Robotics offers more precise surgical control and an ability to address conditions which previously would have required open abdominal surgery through a traditional large incision. In 2009, Women’s Healthcare Associates physicians began performing robotic assisted hysterectomy, myomectomy and pelvic support procedures with the goal of improving outcomes by reducing the length of hospitalization and significantly shortening a woman’s surgical recovery.
Read more about robot-assisted laparoscopic surgery >
Ultrasound: Ultrasonography uses sophisticated equipment to produce and analyze sound waves. During your ultrasound examination, a smooth probe which emits sound waves into the body is placed on the abdomen or in some cases into the vagina. The sound waves are reflected back and an image of the fetus is displayed on a monitor screen. Light pressure is the only sensation felt during the examination. Fetal measurements made by the ultrasonographer help determine the size and age of the pregnancy. Some major birth defects may be detected by this technique. Follow-up studies have not shown any harmful effects of appropriately used ultrasound.
Types of ultrasound and their uses:
Two-dimensional (2D), real-time ultrasound. Used throughout the pregnancy to image and examine your baby. This 2D imaging enables the ultrasound technician to examine not only surface structures, such as the baby's face, but internal organs as well. Motionâ€”the baby's heartbeat and limb movement for exampleâ€”can also be easily detected with this type of ultrasound. It is the most common type of fetal ultrasound and the one most people are used to seeing.
Three-dimensional (3D) ultrasound. Used when the physician who interprets your ultrasound image decides 3D ultrasound would be helpful to further examine a fetal anomaly. This is one way we might check into the possibility of a birth defect.
Four-dimensional (4D) ultrasound. Adds motion to a 3D image of the baby.
In addition to using ultrasound during pregnancy, new developments in ultrasound have also made it extremely useful for imaging the reproductive system in order to diagnose problems, such as pelvic pain, unusual vaginal bleeding or infertility issues.
Read more about the ultrasound services at Women’s Healthcare Associates.
Urogynecology: Urogynecology is a subspecialty field within obstetrics and gynecology. Urogynecologists treat women with pelvic floor disorders, such as urinary or fecal incontinence and prolapse of pelvic organs, such as the vagina, bladder and/or uterus.