Heymam Joe

Information may not be reliable

There are many different ways to treat the annoyances of menopause. I keep an open mind and respect your preferences. We can discuss your concerns about hormone replacement therapy and whether it is right for you.

I generally offer two types of annual physical examinations. You can have a complete annual examination if you don't obtain an annual examination from another clinician. When you routinely have someone else for your primary care needs, I tend to do a careful breast examination along with a thorough examination of your pelvic organs with a Pap smear. I try to satisfy your preference for my communication with your primary care physician.

There have been lots of changes in the treatment of infertility during the last decade. I no longer need to do some of the many procedures I used to do. The advent of in vitro fertilization and other highly technical ways of acheiving pregnancy have lessened the need for some very complicated and frequently unsuccessful procedures that used to be quite common. Since I am a general gynecologist, I can help you do the simple things rapidly to acheive conception, and then, if necessary, refer you to a more highly technical environment.

It is important to prevent a loss of bone density throughout your life. As you approach menopause we can check your skeletal system and make sure you are not developing brittle bones. There are many different ways to improve bone density. You should always get adequate amounts of calcium, vitamin D and exercise.

There are three common vaginal infections: yeast, trichomonas and vaginosis. I can examine the vaginal contents microscopically and reliably identify which organism is troubling you. Then I give you appropriate treatment to get rid of the particular problem. If you need symptomatic relief as well, that is no problem.

Pelvic pain may come from ovulation, ovarian cysts, infection, endometriosis, ectopic pregnancy, benign fibroid tumors of the uterus, kidney stones, bladder inflamnmation and many other more rare conditions. Pain is never "normal". It can manifest itself cyclically during your period or ovulation, or during sexual activity, with exercise, or just always be there. Once we identify the problem, there is almost always a satisfactory solution. Identifying the problem is much easier than it used to be, thanks to increasingly sophisticated imaging and (when necessary) surgical techniques.

Abnormal Pap smears
A Pap smear is a simple test performed by obtaining a sample of the cells from your cervix with a tiny rough brush. Cancer of the cervix was very common a generation ago, but now is very rare. Most abnormal Pap smears are caused by some early changes which appear to be the body's reaction to a particular virus. That reaction is a change in the cervical tisuue called "dysplasia". Dysplasia may either go away on its own, remain unchanged throughout life, or very slowly progress to cancer.
When you have an abnormal Pap smear, there is no reason to panic about cancer. Almost always it is just dysplasia. I can easily treat it in my office or as an outpatient at the Anna Jaques Hospital. I am a very experienced colposcopist (someone who examines the cervix microscopically).

Losing urine is a very common problem. It's a real nuisance for active people. Fortunately there are treatments available that frequently solve the problem or greatly improve it. Incontinence can arise from neurologic, anatomic and inflammatory causes. The first goal is to identify the cause. I offer different solutions for different problems. Sometimes a simple pill will solve your problem. Specific exercises called Kegels may help. Occasionally surgery is the best alternative. I often say that nobody ever died from incontinence -- so you can take your time deciding what is best for you.

Very heavy periods or bleeding at the wrong time may come from many different causes. Anatomical changes and hormonal abnormalities are the two most common reasons for abnormal bleeding. Pregnancy should always be excluded as a reason for the problem. Once the cause is identified, many different medical and surgical techniques are available to you. Sometimes a simple birth control pill can solve the entire problem. There are techniques of examining and treating the inside of your uterus that make it so far fewer women need hysterectomies than only a decade ago.

There are a large variety of problems associated with sex. I hope I can establish an environment where you are comfortable talking about any problems you might have. I understand that each of us approaches sexual activity with different wants, needs and sexual experiences and activities. A satisfactory sex life depends on comfort, privacy, respect and caring.
The problem can be simply a lack of communication or knowledge. It can be related to the skills and experience of either partner. A poor relationship doesn't help. Sometimes there is a medical problem. There are medical methods of increasing your sexual desire when your hormones are waning. If you can be comfortable talking about the problem, then the solution is well under way.

I try to offer all of the latest methods of preventing conception. I believe strongly that you should have many choices when it comes to control of your reproductive system. From mechanical methods to the morning-after pill, you should be able to choose what best fits your life style. And when you are finished with child bearing, and prefer something more permanent, a simple outpatient procedure is available for sterilization.

Gynecology deals with all of the health needs of women. It tends to focus on the reproductive organs and characteristics of women of all ages. It includes all of the special care I have listed on my home page.

I am here to serve you with respect, privacy and genuine regard for your concerns and needs. I believe you should always be in control of your own body and health care.