It is very important for a woman to have annual gynecological exams with a Pap Smear after she becomes sexually active. An initial or annual gynecological examination will include the following:

�¡ A short discussion about the nature of the appointment as well as past medical and family history.

�¡Breast exam as well as instructions on how to do it once a month.

�¡ External examination of the patient�fs lower abdomen, during which the clinician checks for any pain the patient might be experiencing and/or enlargements of certain parts of the female reproductive system.

�¡Pelvic examination includes a general overview of the external and internal genitalia making sure everything looks normal and that the patient is free of any lesions and/or bumps.

�¡ Pap Smear - The pap smear is a screening test for cancer of the cervix as well as vaginal and viral infections. A pap smear should be done once a year after a woman becomes sexually active.

�¡The bimanual exam is the last portion of the gynecological exam.

Birth Control Options: We offer a variety of birth control options, including Birth Control Pills, Depo-Provera (The Shot), Nuva Ring (The Vaginal Ring), Diaphragm, Cervical Cap, and IUD (Copper and Mirena).

Birth Control Pills

Most birth control pills contain two female hormones - estrogen and progesterone. These hormones prevent pregnancy mainly by turning off the message to the ovary to release an egg. The pill also causes the cervical mucus to thicken making it difficult for sperm to pass through the cervix to fertilize the egg. When taken correctly the pill is 99% effective.

Depo Provera is an injection of progestin given by a healthcare professional every 12-13 weeks. The progestin stops release of the egg from the ovary. Depo Provera is effective 24 hours after the initial injection.

NuvaRing is a flexible, contraceptive vaginal ring used to prevent pregnancy by releasing two hormones - estrogen and progestin, which signal the ovaries not to release an egg. You insert the ring into your vaginal canal and leave it there for 3 weeks. You remove the ring during week 4 (that is when your period is expected).

The diaphragm is a shallow, rubber cup, and is placed over the cervix. The diaphragm protects against pregnancy for up to 6 hours after insertion and should remain in place for at least 6 hours after intercourse. It should not be worn longer than 24 hours.

The cervical cap is a thimble-shaped, latex cup. It is placed directly covering the cervix and should remain in place for at least 8 hours after intercourse and can remain in place for up to 48 hours.

The IUD is a small device inserted into the uterus by a healthcare professional. It works by preventing the sperm from fertilizing the egg. IUDs are effective for 1 to 10 years, depending on the type. The IUD is an ideal method of birth control for women who need semi-permanent, reversible, yet effective contraception.

REMEMBER, THE IUD DOES NOT PROTECT YOU AGAINST HIV OR STDs!

IMPLANON

Implanon is a new method of birth control that does not require having shots or taking pills daily.  Implanon is a flexible plastic rod, about the size of a matchstick that is placed underneath the skin in an in-office procedure with local anesthetic.  The insertion procedure only takes a few minutes.  Implanon can be used for up to 3 years but can be removed at anytime.  A new Implanon can be inserted after the third year if continued contraception is needed.

You should always protect yourself from exposure to Sexually Transmitted Diseases by practicing abstinence or using latex condoms during intercourse. You should limit the number of partners you have and know their sexual histories. If you feel you have been exposed to STDs, you should seek testing and treatment to prevent yourself from long-term complications and spreading.

American Health Center offers testing and treatment for the following: Gonorrhea, Chlamydia, Syphilis, Trichomonas, Genital Herpes, Genital Warts, Hepatitis B, Hepatitis C, HIV/AIDS, and PID.

Chlamydia is also a common STD and is treated with antibiotics. If left untreated, it could cause serious health problems in women like PID (Pelvic Inflammatory Disease), which could lead to infertility (inability to get pregnant). If left untreated in men, it could lead to a painful infection that can require hospitalization, permanent damage to the reproductive organs, and the inability to have children.

Symptoms for Chlamydia include:

Females:

* Any vaginal itching or yellowish discharge
* Pain and/or spotting with intercourse
* External tenderness in the vaginal area
* Sever pelvic pain with fever
* Pain with urination
* Often, there are no symptoms

Males:

Syphilis is a well-known bacterial STD that is treated with antibiotics. There are three stages to syphilis:

Stage one:

* Painless red sores called chancres in and around the genitals
* Swollen lymph nodes

Stage two:

* Skin rash, which often appears on the palms of the hands and the soles of the feet

Stage three:

* Heart, nervous system, and other internal organs may be affected

Trichomonas is a highly contagious STD for both men and women. It is treated with antibiotics and is curable. Although it can be asymptomatic (meaning no symptoms are present), it is often associated with the following symptoms:

Genital Herpes has become one of the most common STDs in the country. It is spread by skin to skin contact during sexual intercourse. Symptoms of genital herpes usually occur within 2 to 10 days of sexual contact and can last for up to 2 to 3 weeks. However, some people who are exposed to this virus may never experience an outbreak. Symptoms may include:

* Tingling, burning, or itching in the genital area
* Small painful blisters on the genitals and/or buttocks
* Headache, fever, malaise
* Burning or stinging during urination

Genital Warts are caused by HPV (Human Papillomavirus) and are spread from person to person through direct vaginal, anal, or oral contact. Symptoms of Genital Warts include:

* Painless, fleshy, cauliflower-like growths that grow singly or in groups
* Genital warts may be found on the external genitals, but may also appear in the vagina or anal canal where they are less visible and less easily detected.

Hepatitis B is a viral and potentially deadly STD. It can be transmitted through sexual contact or contact with blood, semen, and vaginal fluids. Hepatitis B is more common and more transmissible than HIV. Symptoms include:

* Jaundice (yellowing of the skin or the whites of the eyes)
* Fatigue (feeling tired)
* Pain in the abdomen
* Nausea
* Vomiting

Unfortunately, there is no cure for Hepatitis B. This infection is very serious and it can cause chronic hepatitis, severe liver damage, liver cancer, and even death. However, it can be prevented through a series of vaccinations. These vaccinations are recommended for people with multiple sex partners, people who have been previously diagnosed with a STD, users of illegal drugs, people traveling to certain foreign countries, and health care workers.

Hepatitis C is a disease of the liver caused by the Hepatitis C virus (HCV). You may be at risk for Hepatitis C if you:

PID is an infection of the uterus, fallopian tubes, and ovaries. Gonorrhea and Chlamydia, either alone or together, are common causes of PID. This disease is one of the major causes of infertility, ectopic pregnancy (where pregnancy occurs outside of the uterus), and chronic pelvic pain.

Symptoms of PID:

* Lower abdominal pain and discomfort
* Fever
* Vaginal discharge
* Abnormal vaginal bleeding
* Nausea
* Vomiting

Dysmenorrhea is pain associated with menstruation (menstrual cramps). It is very common and occurs in almost all women. Pain occurs typically in the lower abdomen and lower back. It begins just before or at the onset of menstrual flow and usually lasts from a few hours to one day or more. Pain is frequently associated with nausea, vomiting, and frequent bowel movements with intestinal cramping. A woman may also experience dizziness and fainting.

Amenorrhea is the absence of menstruation. It is a normal condition before sexual maturity, during pregnancy, after menopause, and during the intermenstrual phase of the monthly hormonal cycle. When it is abnormal, it can be caused by dysfunction of the hypothalamus, pituitary gland, ovary, or the uterus.

PMDD is the intense mood and physical symptoms that happen the week or two before your period and reoccur month after month. These symptoms include:

* Irritability
* Sadness
* Sudden mood changes
* Tension
* Bloating
* Breast Tenderness

PMDD can interfere with your daily activities and relationships. It can be frustrating, tiring, or even isolating. Many doctors believe that PMDD may be caused by an imbalance of a chemical in the body called Serotonin. Fortunately, there are medications that can help with the symptoms of PMDD.

American Health Center offers surgical consultations for: Colposcopy with Biopsy, Laser Surgery for Genital Warts, Tubal Ligation, Hysteroscopy, Hernia Repair, Hemorrhoid Diagnosis & Treatment, Mole Removal, Incision & Drainage, Vasectomy and much more!

Osteoporosis is abnormal loss of bone density. Risk factors for osteoporosis include:

* Female
* Existing bone fracture
* Small thin body frame
* Family history
* Removal of the ovaries
* Alcohol and tobacco use
* Early menopause
* Low calcium diet
* Lack of exercise
* Eating disorders
* Certain medicines (such as steroids or anticonvulsants)
* Depo Provera use