Questions to Ask Your Doctor if You are Considering Permanent Birth Control

For some women, permanent birth control is the best option to guarantee that they will not have any more children. However as the name explains, permanent birth control is, well, permanent. In very few cases are these procedures reversible. Before you make the decision to go with a permanent option, you will want to ask your doctor all of the right questions. Be sure you know everything you need to about the procedure before you make a decision.

Below are a few questions that you should ask your doctor before you make your decision.

General Questions

  • What are my options for permanent birth control?
  • Is a permanent option the right one for me?
  • Are there other options that I should consider before I make the decision?
  • What type of birth control, permanent or nonpermanent, would you recommend?

Ask these questions in the beginning. They will give you a good starting place to determining if permanent birth control is the right choice for you.

Tubal Ligation and Implant Birth Control

Tubal ligation is a common procedure in which the fallopian tubes are tied so that the eggs cannot travel to the uterus. Permanent implant birth control includes placing specialty material in the fallopian tubes so that scar tissue will form and completely block the tubes.

  • Should I consider tubal ligation or permanent implant birth control?
  • What are the risks to each of these surgical procedures?
  • Are both of the procedures always successful? If not, what is the failure rate?
  • How do you go about each of the procedures?
  • What type of recovery can I expect from the procedures?
  • What are the benefits to choosing one of these procedures?
  • Would you recommend one of these to me as my own permanent birth control method?


Emotional Factors

The most important thing to remember is that permanent birth control methods should only be chosen if you absolutely know that you never want to have children. There are emotional factors to consider. How will you handle it if you change your mind at a later date and wish to have children? Consider all of the ramifications of the birth control that you are choosing before you go through with any procedure.

Permanent birth control could be the right option for you since it completely cuts out your chances of becoming pregnant at a later date. Make sure to ask all of the questions above when you talk to your doctor to help you make the right choice.




Holiday Hours 2012: Merry Christmas!

Category: Chicago OBGYN

We will be closing early at 5pm on the 26th, 27th, and 28th of December, 2012 and closed on Christmas Day.

Happy Holidays from all of us at Women’s Center for Health!

When Facing Early Stage Gynecologic Cancer, Da Vinci Hysterectomy May Be For You

Category: Hysterectomy

A wide variety of cancers can affect a woman’s reproductive system, which includes the uterus, vagina, ovaries and fallopian tubes. The most common types of gynecologic cancers are cervical, endometrial or uterine, and ovarian cancer. The specific type of cancer a woman has and how advanced it is determines her treatment options.

Women with early stage gynecologic cancer are often treated with hysterectomy – the surgical removal of the uterus. Your doctor may also need to remove your ovaries, fallopian tubes and/or select lymph nodes.

Fortunately, there is a minimally invasive option for treating gynecologic conditions designed to overcome the limitations of traditional open and laparoscopic surgery – da Vinci Surgery.

If your doctor recommends a hysterectomy to treat cancer, you may be a candidate for da Vinci Surgery. Using state-of-the-art technology, a da Vinci® Hysterectomy requires only a few tiny incisions, so you can get back to your life faster.

da vinci s system

da Vinci Surgery enables your doctor to perform a hysterectomy for complex conditions with enhanced vision, precision, dexterity and control. da Vinci offers women many potential benefits over traditional surgery, including:

  • Less pain
  • Fewer complications
  • Shorter hospital stay
  • Quicker recovery and return to normal activities

To learn more, check out our section on [Early Stage Gynecologic Cancer].


10 Minute Procedure for Permanent Birth Control

Once your family is complete, Essure offers a 10 minute procedure for permanent contraception. Essure is a permanent birth control procedure that works with your body to create a natural barrier to prevent pregnancy. The Essure procedure offers women benefits that no other permanent birth control can.

  • Surgery-free—A simple procedure performed in your doctor’s office in less than 10 minutes
  • Hormone-free—A more natural birth control method
  • Anesthesia-free—There’s no slowing down to recover, and most women return to normal activities in less than a day
  • Worry-free—Since 2002 over half a million women and their doctors have trusted Essure as the most effective* permanent birth control

The Procedure

An Essure-certified doctor places soft, flexible inserts into each of your fallopian tubes through the natural pathways of your vagina and cervix. There is no incision necessary. The tip of each insert remains visible, so your doctor can confirm that placement is accurate.


Over the next three months, your body works with the Essure inserts to form a natural barrier within your fallopian tubes that prevents sperm from reaching your eggs. Your ovaries will continue to release eggs, but they will be absorbed naturally into your body. You must continue to use another form of birth control during these three months.


After three months you’ll take the Essure Confirmation Test to confirm you can no longer get pregnant. A special dye is introduced into your uterus, then viewed on an x-ray to confirm that the inserts are in place and your fallopian tubes are fully blocked. Once you receive verification from your doctor, you can start relying on Essure for permanent birth control.



To learn more check out our section on [Essure].

“A Decade after the Women’s Health Initiative scared the h_ll out of women!”

Category: Uncategorized

The Women’s Health Initiative (WHI) was presented to the press in 2002 before it was released to the medical community and way before they had a chance to carefully stratify the data. Meaning, they didn’t account for age primarily.

The bottom line – no new news! Hormone replacement therapy (HRT) is safe and important in young healthy women (less than 55 – 60) and may present problems in older women.

Unfortunately, we are still only recommending it for symptomatic menopausal women. The two-thirds of women who don’t have hot flashes, night sweats, etc. aren’t currently encouraged to go on HRT. Something many of us hope will change. All women that take HRT live longer than women who don’t, a fact for over 50 years.

Estrogen is the hormone that treats the symptoms and progesterone is necessary to prevent uterine cancer. Since the women taking estrogen alone in WHI had no increase in breast cancer, it appears that progesterone is the troubling hormone (needed only in women have their uterus). Research is underway to figure out if specific types of progesterone are better than others (natural, bio-identical, synthetic, compounded etc).

Hormones have other benefits besides eliminating hot flashes. They help maintain strong bones, reduce the risk of heart disease and reduce the risk of increased cholesterol (if you’re young). Hormones help with vaginal dryness, delay the changes of aging in your hair, nails, and skin. The benefits of hormones on the bladder and it’s function are mixed. For some reason, women in WHI also had a reduced risk of colon cancer that was not related to increased surveillance.

Like anything in life – there are always risks. They are rare, especially in younger women. Blood clots are possible with all hormones but HRT use is associated with less risk than that associated with birth control pills and pregnancy! The WHI study showed a slight increased risk of breast cancer when taking both hormones for 5 or more years and the risk decreases to normal after cessation of use.

How long should women stay on HRT (estrogen and progesterone)? Well it’s hard to say, but 5 years is certainly safe. We recommend continuing hormone therapy if symptoms persist. For estrogen alone, 10-15 years is probably appropriate.

Estrogen administered through the skin (patch and creams) have a lower risk of blood clots and stroke than standard oral pills. If you don’t mind something stuck to your skin and you have had a hysterectomy, this might be a safer option. Compounding and bio-identical hormones are gaining popularity but don’t have the safety data available or years of experience that traditional HRT has. (See our bio-identical video in the health library section of our web site.)


Hormones have an important role in managing menopausal symptoms. Endorsed by nearly every medical society, they help treat symptoms and have other health benefits. There are few downsides in younger women (< 60 years old).

Doc O.

PAP smear and High Risk HPV – Why both? How often?

Recently the American Cancer Society revised their recommendations for the frequency of PAP smears (test used to screen for cervical cancer). Ever since liquid-based PAP smears were introduced into the market in 2002, the quality has improved. The addition of computer readers and sexually transmitted disease testing off of the same vial of solution have made modern PAP smears an excellent screening tool. We can now look for abnormal cells as well as test for high-risk human papilloma virus (HPV). Here’s the problem. Many of us were exposed to HPV years ago but have not yet cleared the virus. How do we follow those people who don’t currently have a problem on their cervix?

The good news is that 90% of the time our immune system will clear or suppress the HPV virus and that’s the end of it. A small percentage of women remain positive and it’s those women that may go on to develop cervical cancer 10-20 years down the road. So, when you get a call from our office regarding your PAP smear we will now let you know your HPV status (if your between 30–65). If you are HPV negative that’s very good. A negative PAP and HPV tells us that there is almost no chance of developing cervical cancer within the next 5 YEARS! And guess what? Although, you still need a physical with a pelvic exam, you don’t need a PAP smear for 5 years. (This assumes that you don’t have a history of cervical problems, dysplasia, previous surgery on your cervix, etc.) If your PAP is negative and the HPV is positive that’s a different story. You will need yearly follow up and perhaps a colposcopy (microscope exam of your cervix) if the virus persists. We have no idea when you were exposed to HPV so confronting your current partner doesn’t make a lot of sense. They should be told of your exposure and realize that you have both been exposed. It is unclear if this virus affects men at this time.

Other changes in the PAP smear frequency were issued. No one under the age of 21 needs a PAP smear! Regardless of sexual activity, you can’t get cervical cancer < 21 years old. It takes 10–20 years after you are infected with HPV to develop this cancer. Again, this is rare, the majority of the time you will clear the virus. This is the reason why 21 -29 year olds only need PAP smears with no HPV testing and then only every 3 years. Although many people in there 20’s are exposed to HPV, it won’t develop into cervical cancer for a while, if ever. No need to test for HPV until you are 30 years or age. Previously, if we found you were HPV positive after an inflammatory PAP smear (ASCUS – atypical squamous cells of undetermined significance), we were instructed to ignore it by several medical organizations. That’s tough for patients and doctors, so we won’t do that, but we will follow you without treatment for as long as we can – it sometimes takes up to 3 years for women to “clear” the virus. The most important recommendation is to not over treat young women who will more than likely cure themselves. Some of our treatments can affect you ability to get pregnant and that we don’t want.

And you know what else? – you may not need PAP smears after age 65! You still need a physical exam and a pelvic exam. If you have had normal co-testing (PAP with HPV) for 10 years or normal follow up for 20 years since your cervical dysplasia (pre-cancerous changes) was treated, then you may not need PAP smears anymore. Women who underwent hysterectomy for benign disease, no longer need PAP smears either.

This is hard for gynecologists and patients to accept. We have all grown very comfortable screening for cervical cancer every year and this has provided us with reassurance. “More testing is not necessarily better surveillance” the American Cancer Society tells us. A negative High Risk HPV test is very reassuring – perhaps more reassuring than a PAP smear – so are PAP smears a thing of the past?

Stay tuned!

Doc O

p.s. a word of caution – there are 200 sub-types of HPV – only about 13 are high risk and can cause problems with your cervix. If you Google: “HPV”, be ready to read about venereal warts (HPV 6 and 11). These are two low-risk viruses that cause problems on the outside of the vagina (the vulva) and do not cause cancer. See the health library section on our web site for more information on this sexually transmitted disease.

See What Patients Are Saying About Essure

Category: Essure

Essure is a permanent birth control procedure that works with your body to create a natural barrier to prevent pregnancy. The Essure procedure offers women benefits that no other permanent birth control can.

To learn more check out our section on [Essure].

Da Vinci Surgery Offers Minimally Invasive Option For Pelvic Prolapse

Category: Gynecologists

Surgery may be the best option for many women to repair pelvic prolapse, including vaginal vault prolapse. Da Vinci Sacrocolpopexy is a state of the art minimally invasive operation that only requires a few tiny incisions that allow you to return to your life faster.

da Vinci Sacrocolpopexy offers several potential benefits over traditional open surgery, including:

  • Less blood loss2
  • Minimal need for blood transfusions2
  • Shorter hospital stay2

Potential benefits of da Vinci Surgery compared to traditional laparoscopy include:

  • Less blood loss3
  • Much shorter operation3
  • Small incisions for minimal scarring

To learn more about da Vinci Sacrocolpopexy [Click Here].


90% of Women See Dramatically Reduced Menstral Bleeding With NovaSure®

Category: Heavy Periods

Women suffering from heavy periods now have a 5-minute procedure option with NovaSure®. With no pills or hormonal side effects the 4 step procedure  removes the lining of the uterus with a quick radiofrequency energy.

NovaSure first step

Your doctor slightly opens your cervix (the opening to the uterus), inserts a slender wand, and extends a triangular mesh device into the uterus.

NovaSure first step

The mesh gently expands, fitting to the size and shape of your uterus.

NovaSure first step

Precisely measured radio frequency energy is delivered through the mesh for about 90 seconds, gently removing the lining of the uterus.

NovaSure first step

The mesh device is pulled back into the wand and both are removed from the uterus.

No part of the NovaSure device remains inside your body after the procedure.

For more information [Read More].


Minimally invasive hysterectomy surgery vs. open/laparoscopic surgery

Category: Uncategorized

Treatment Comparison da Vinci Surgery vs Open and Laparoscopic SurgeryThe da Vinci System is a state-of-the-art surgical platform with 3D, high-definition vision and miniaturized, wristed surgical instruments designed to help doctors take surgery beyond the limits of the human hand. By helping doctors to overcome the challenges of traditional open and laparoscopic surgery, da Vinci is changing the experience of surgery for women around the world.

Ultimately, potential benefits including shorter hospital stay, less blood loss and fewer surgical complications allow women to get back to their lives faster. And, unlike conventional laparoscopic surgery, da Vinci Surgery enables doctors to treat women with very complex conditions or symptoms, such as:

  • Enlarged uterus due to fibroids
  • Pelvic adhesive disease caused by endometriosis or prior surgeries

da Vinci Hysterectomy offers women many potential benefits over traditional surgery, including:

  • Less pain
  • Fewer complications
  • Less blood loss
  • Shorter hospital stay
  • Low risk of wound infection
  • Quicker recovery and return to normal activities

For more information [read more]