Welcome to San Dimas Medical Group

100 Old River Road, Bakersfield, CA 93311 | Phone: (661) 663-4800 | Fax: (661) 663–4770

Gynecological Health Management

Menstrual Cycle Irregularities

Menstrual Cycle Irregularities

  • Pregnancy or breast-feeding. A missed period can be an early sign of pregnancy. Breast-feeding typically delays the return of menstruation after pregnancy.
  • Eating disorders, extreme weight loss or excessive exercising. Eating disorders — such as anorexia nervosa — extreme weight loss and increased physical activity can disrupt menstruation.
  • Polycystic ovary syndrome (PCOS). Women with this common endocrine system disorder may have irregular periods as well as enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam.
  • Premature ovarian failure. Premature ovarian failure refers to the loss of normal ovarian function before age 40. Women who have premature ovarian failure — also known as primary ovarian insufficiency — might have irregular or occasional periods for years.
  • Pelvic inflammatory disease (PID). This infection of the reproductive organs can cause irregular menstrual bleeding.
  • Uterine fibroids. Uterine fibroids are noncancerous growths of the uterus. They can cause heavy menstrual periods and prolonged menstrual periods.

Pelvic Pain (Acute & Chronic)

Acute pain occurs suddenly and can be sharp and severe. It’s defined as pain that lasts three months or less. Several issues can cause acute pelvic pain.

  • Ruptured fallopian tube
  • Twisted or ruptured ovarian cysts
  • Ectopic pregnancy
  • Miscarriages
  • Pelvic inflammatory disease, or PID

Chronic pelvic pain involves ongoing pain that lasts 6 months or more

Chronic pain can occur due to certain gynecological and urinary conditions such as:

  • Uterine fibroids
  • Endometrial polyps
  • Pelvic adhesions
  • Endometriosis
  • Vulvodynia
  • Bladder problems
  • Menstrual problems [wildflowerobgyn.com] and
  • Certain types of cancer

When should women seek medical treatment?

Severe pelvic pain could be a sign of a medical emergency and may require immediate medical care. Such as:

  • Pain or problems with urination
  • Pain in the hip or groin area
  • Pain during sex
  • Severe menstrual pain
  • Vaginal discharge, spotting or irregular bleeding
  • Bloated abdomen and/or problems with excess gas (flatus)

Minimally Invasive Surgical Treatment Options

Minimally Invasive Surgery is any procedure that is considered less invasive than open (traditional) surgery and results in minimal scarring, less pain and quicker return to normal activities. Minimally invasive surgery (MIS) is also known as laparoscopic surgery.

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Laparoscopic Surgery

Laparoscopic surgery, is a surgical technique that is performed through small incisions, using the assistance of a video camera illuminating the surgical field within the body.

    Benefits of Laparoscopy
  • Smaller incision
  • Lower costs
  • Faster recovery
  • May not require an overnight stay at the hospital
  • The most advanced type of minimally invasive surgery is robotic surgery. At Hoag, we have a team of dedicated gyn surgeons that specialize in this technique as a treatment option for several gyn conditions such as fibroids, endometriosis, gynecological cancers, pelvic organ prolapse and fertility-preservation.

Contraceptive Services

We offer a large variety of contraceptive (birth control) options including:

  • IUDs, Birth Control Implants (Nexplanon), Birth Control Injections, Birth Control Vaginal Ring, Birth Control Patch, Birth Control Pills, Birth Control Sponge, Diaphragms, Tubal Ligation (Sterilization).
What is an IUD?

An intrauterine device, or IUD, is a long active reversible form of birth control where a small, flexible device which is inserted into the uterus to prevent pregnancy. The most popular IUD releases an extremely low dose of progesterone to the uterus (Mirena/Skyla/Kyleena). This primarily works by thickening cervical mucus. These IUDs usually make your periods much lighter. There is also a non-hormonal IUD for those who do not want any hormone at all (Paragard). This form of birth control is becoming more popular as insertion is a quick procedure and is effective for between 3-10 years depending on the type of IUD selected. These are among the most effective forms of contraception and the non-hormonal option is an effective choice for those who do not react well to hormonal birth control methods.

What is Nexplanon®?

Nexplanon® is a small, flexible birth control implant which measures about 4 centimeters in length inserted discreetly on the inside of the patient’s upper arm under the skin. Nexplanon® provides up to 3 years of pregnancy prevention. This is beneficial for many women because they do not have to remember to take a pill every day. Once inserted, Nexplanon® is over 99% successful at preventing pregnancy. Nexplanon® can be removed at any time during the 3 years of effectiveness and must be removed by the end of the third year. At this time the patient can choose to have a new device inserted.

What is sterilization?

Female sterilization is a permanent way to avoid pregnancy by obstructing the fallopian tubes. Sterilization is performed during either a minimally invasive procedure or during a traditional open surgery, depending on the needs of the patient. Tubal ligation or “getting your tubes tied” is often performed with a laparoscopic procedure because of faster recovery times and less risk of scarring than traditional open surgery. The non-surgical form of sterilization, known as Essure, involves the placement of small coils in the fallopian tubes. This procedure is done manually, with the doctor accessing the tubes through the vagina. Tubal ligation is very effective with the surgical options being effective immediately. Essure takes about three months to be fully effective.

Feel free to make an appointment to discuss any of these options.

Urinary Incontinence

Urinary incontinence — the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time.

Though it occurs more often as people get older, urinary incontinence isn't an inevitable consequence of aging. If urinary incontinence affects your daily activities, don't hesitate to see your doctor. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.

Types of urinary incontinence include:

  • Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
  • Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more-severe condition such as a neurologic disorder or diabetes.
  • Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn't empty completely.
  • Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
  • Mixed incontinence. You experience more than one type of urinary incontinence.

Hormone Replacement Therapy

Hormone replacement therapy (HRT) is a treatment for women who have low hormone levels, like a woman going through menopause. Menopause is the time in a woman's life when her period stops and it is considered a normal part of the aging process. In the years before and during menopause, the levels of female hormones can go up and down. This can cause symptoms such as hot flashes, night sweats, pain during sex, and vaginal dryness. For some women, the symptoms are mild, and they go away on their own. Other women take hormone replacement therapy (HRT), also called menopausal hormone therapy, to help relieve these symptoms. HRT may also protect against osteoporosis. But HRT is not for everyone. You should not use HRT if you:

  • Think that you are pregnant
  • Have problems with vaginal bleeding
  • Have had certain kinds of cancers
  • Have had a stroke or heart attack
  • Have had blood clots
  • Have liver disease
There are different types of HRT. Some have only one hormone, while others have two. Most are pills that you take every day, but there are also skin patches, vaginal creams, gels, and rings.

Taking HRT has some risks. For some women, hormone therapy may increase their chances of getting blood clots, heart attacks, strokes, breast cancer, and gallbladder disease. Certain types of HRT have a higher risk, and each woman's own risks can vary, depending upon her medical history and lifestyle. You and your health care provider need to discuss the risks and benefits for you. If you do decide to take HRT, it should be the lowest dose that helps and for the shortest time needed. You should check if you still need to take HRT every 3-6 months.

Pre & Post Menopausal Care

Pre and post-menopausal questions come up as women have symptoms and their period cycle changes. Pre-menopause (also known as perimenopause) generally occurs for women between 40 and 55 years old, but it can occur earlier. The average age for women in the United States is 52 to enter menopause. During pre-menopause, estrogen levels rise and fall unevenly. This can result in irregular periods, hot flashes, and vaginal dryness, trouble sleeping, which can last for several years until your periods stop. Perimenopause ends when a person goes for 12 months without a period. A person is considered post-menopausal after they have not had a period for more than 12 months.

We are able to assist you during this time, make an appointment and we can discuss your options.