Services
Sexual Health
Sexual health is important to most everyone, and at Nelson Center, we recommend a sexual health check-up. This gives you the opportunity to discuss any sexual health concerns you may have, including concerns about STIs or problems with your sex drive. If you are sexually active, having a regular sexual health check-up is always a good idea. You don't need to have physical symptoms to undergo a sexual health check-up.
If you feel nervous or uncomfortable about having a sexual health check-up, just remember — we are professionals and we discuss this type of information all the time with our patients.
Nelson Center diagnoses and treats:
• Pelvic pain from intercourse or other causes
• Decreased sex drive
• Erectile dysfunction
• Vulvar irregularities
• HPV, STIs and HIV
Some of the treatment and testing methods we use include:
• Zimmer Treatments/Shockwave Therapy
Zimmer or Z Wave is a revolutionary drug-free, surgery free and non-invasive therapy that uses pulsed acoustical waves, providing a breakthrough solution for men seeking better erections and optimal sexual performance. We can easily diagnose, prescribe and treat erectile dysfunction, resulting in restored quality of life for our patients.
• Colposcopy
Colposcopy is a procedure we use to closely examine the cervix, vagina and vulva for signs of disease. During colposcopy, Nelson Center uses a special instrument called a colposcope.
Infertility Workups
Infertility is defined as failure to achieve pregnancy within 12 months of unprotected intercourse or therapeutic donor insemination in women younger than 35 years or within 6 months in women older than 35 years, and it affects up to 15% of couples. Essential components of an initial workup include a review of medical history, physical examination and additional tests as indicated. For the female partner, tests will focus on ovarian reserve, ovulatory function and structural abnormalities. Imaging of the reproductive organs provides valuable information on conditions that affect fertility. Imaging modalities can detect tubal patency and pelvic pathology and assess ovarian reserve.
The male factor is the cause of infertility in 40–50% of couples. Given the high prevalence of male factor in infertile heterosexual couples, a basic medical history and evaluation of the male partner are warranted from the outset.
Before infertility testing, Nelson Clinic will work to understand your sexual habits and may make recommendations to improve your chances of getting pregnant.
Some of the testing methods we use include:
• Hysteroscopy
Hysteroscopy is the exam of the inside of the cervix and uterus using a thin, lighted, flexible tube called a hysteroscope. A hysteroscopy may be recommended if a patient has:
-Abnormal Pap test results
-Abnormal uterine bleeding
-Bleeding after menopause
It can be used to:
-Diagnose the cause of infertility or repeated miscarriages
-Examine and remove uterine scarring, polyps or fibroids
-Find and remove displaced IUDs (intrauterine devices)
-Place small birth control inserts into the fallopian tubes
-Removal of a small tissue sample (biopsy)
-Removal of endometrial lining
• Colposcopy
Colposcopy is a procedure to closely examine the cervix, vagina and vulva for signs of disease. During colposcopy, Nelson Center uses a special instrument called a colposcope.
• ABBI® (Air Bubble Based Infuser)
ABBI is a safe evaluation of fallopian tubal patency using ultrasound versus X-ray. It utilizes ultrasound with a saline and air bubble contrast media to safely evaluate tubal patency in the office. ABBI provides a minimally invasive procedure by reducing the risk of allergic reaction to radiopaque dyes and eliminating exposure to fluoroscopy radiation used in traditional HSG. Dual-function ABBI also enables saline-only SIS exam.
• Blood tests/hormone tests
Depending on the individual couple’s situation, various blood tests on either the female or the male may be needed. Blood tests that might be needed include day 3 follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), AMH, prolactin, testosterone (T), progesterone (P4), 17-hydroxyprogesterone (17-OHP), thyroxin (T4), thyroid stimulating hormone (TSH).
If there is a history of recurrent miscarriages (2 or more) a lupus anticoagulant (LAC) and anti-cardiolipin antibody (ACL) are often done, as well as other tests.
Gynecology Exams & Evaluations
At Nelson Center, we know it can be nerve wracking, but an annual gynecology exam is the best procedure to help maintain overall health. The purpose of a routine annual gynecology exam is to allow us to check your female organs to ensure and maintain good gynecological health. The physical portion of the exam takes about 10 minutes and there is a time before and after the exam to ask and answer any questions you might have.
Our annual gynecological services include:
• Overall wellness exams
• Pap smear screenings and colposcopy if needed
• Breast exams
Nelson Center provides comprehensive gynecological health care services throughout all stages of a woman’s life, from the beginning of their reproductive years and through menopause. Women should start receiving annual gynecology exams between the ages of 18 and 21, or when they become sexually active. However, if someone is experiencing any gynecological symptoms, they should schedule an exam sooner. Such symptoms include irregularities in the menstrual cycle, unusual or severe vaginal or pelvic pain, abnormal vaginal bleeding or discharge, swelling, tenderness, sores, lumps, itching or unusual changes in the breast.
Managing Menopause & Healthy Aging Through Gynecology
A woman’s health care needs change throughout her life and aging well is an important part of health and happiness. We offer gynecological services specific to menopause and healthy aging, including:
• Hormone replacement therapy
• Strategies and options for coping with menopausal symptoms
• Treatments for post-menopausal vaginal bleeding
• Evaluation of and treatment for urinary incontinence
Specialized Gynecology Services
Some women suffer from gynecological conditions that require specialized services. Nelson Center can diagnose and treat most gynecological disorders in the privacy and comfort of our offices, including:
• Diagnosis and management of pelvic pain, including endometriosis
• Management of menstrual disorders, including irregular and heavy menstrual bleeding, and painful periods
• Infertility evaluation and initial treatment
• In-office ultrasound
Hormonal Implants & Birth Control
Choosing a particular method of birth control is a very personal decision, and with so many different contraception options available, it can feel like an overwhelming task. However, women who receive their gynecological care at Neslon Center will find we take time to discuss which birth control options are the best fit for your lifestyle, personal goals and physical health. We also offer consultation regarding and administration of the HPV vaccination with Gardasil®.
Birth control options may include:
• Birth control pills
• NuvaRing®
• Ortho Evra® patch
• Depo-Provera
• Long-acting reversible contraception, including Nexplanon®
• Emergency contraception
• Diaphragm fittings
Hormonal Migraine Treatment
A menstrual migraine (or hormone headache) starts before or during a woman’s period and can happen every month. A migraine is more than a bad headache. It’s a neurologic disease with a series of symptoms that might include debilitating pain on one side of your head that you may describe as pulsing or throbbing. Menstrual migraines, also known as hormone headaches, happen right before or during a woman’s period (up to two days before through three days during) and may get worse with movement, light, smells, or sound. Your symptoms may last for a few hours, but they’ll likely last days.
It’s estimated that 70% of people who experience migraines are women. Of these women, 60% to 70% report a connection between their menstruation (periods) and their migraine attacks. Women experience migraine attacks three times more frequently than men.
Triptans – selective serotonin receptor agonists – are medicines used for acute migraines. They stop your menstrual migraine after it begins.
Other medications that might be prescribed include:
• Small doses of ergotamine (including Bellergal-S®) or a similar compound, methylergonovine maleate (for example, Methergine®).
• Beta blocker drugs such as propranolol
• Anticonvulsants such as topiramate
• Calcium channel blockers such as verapamil
• Estrogen patch, gel or pills
• Contraceptives, which may reduce the number of menstrual migraines.
• Dihydroergotamines (DHE)
• Caffeine
• Analgesics
• Corticosteroids
Menopausal Migraines
Estrogen supplements may be needed after menopause. By maintaining a steady dose of estrogen, the headaches may be prevented. An estrogen patch (such as Estraderm®) may be effective in stabilizing the levels of estrogen.
Pelvic Pain Diagnosis & Treatment
Figuring out what's causing your chronic pelvic pain often involves a process of elimination because many different disorders can cause pelvic pain.
In addition to a detailed interview about your pain, your personal health history and your family history, we may ask you to keep a journal of your pain and other symptoms.
Tests or exams may include:
• Pelvic exam. This can reveal signs of infection, abnormal growths or tense pelvic floor muscles. We check for areas of tenderness. Always let us know if you feel any discomfort during this exam, especially if the pain is similar to the pain you've been experiencing.
• Lab tests. During the pelvic exam, we may order labs to check for infections, such as chlamydia or gonorrhea. We may also order bloodwork to check your blood cell counts and urinalysis to check for a urinary tract infection.
• Ultrasound. This test uses high-frequency sound waves to produce precise images of structures within your body. This procedure is especially useful for detecting masses or cysts in the ovaries, uterus or fallopian tubes.
• Laparoscopy. During this surgical procedure, we make a small incision in your abdomen and insert a thin tube attached to a small camera (laparoscope). The laparoscope allows us to view your pelvic organs and check for abnormal tissues or signs of infection. This procedure is especially useful in detecting endometriosis and chronic pelvic inflammatory disease.
Bladder Function Tests
Bladder function tests, also called urodynamics testing, help to determine the functioning of the urinary bladder. The tests focus on the ability of the bladder to hold urine and release it steadily. Bladder function tests may be suggested if a patient shows symptoms such as urine leakage, painful urination, sudden urges to urinate or problems in completely emptying the bladder.
Bladder function tests range from simple observational to more complex tests depending on the symptoms.
At Nelson Center, we use the Cystometric test for bladder function. This test measures the amount of urine the bladder can hold, the pressure inside the bladder and the state of the bladder at the onset of the urge to urinate. To perform this test, we insert a catheter to drain out the bladder. Then another catheter with a pressure-measuring device, called a manometer, is inserted to record the pressure inside the bladder.
The bladder is filled with warm water, and the patient is asked to inform the health professional when they have an urge to urinate. This test can also indicate whether there are any involuntary bladder contractions.
Endometriosis Treatment
Endometriosis is an often painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Effective treatments, such as hormones, are available at Nelson Center.
At Nelson Center, we use a laparoscopy to determine the level of endometriosis. During this surgical procedure, we make a small incision in your abdomen and insert a thin tube attached to a small camera (laparoscope). The laparoscope allows us to view your pelvic organs and check for abnormal tissues or signs of infection. This procedure is especially useful in detecting endometriosis and chronic pelvic inflammatory disease.
Fallopian Tubal Patency Evaluations
Tubal patency refers to the openness and lack of blockage in the fallopian tubes. If the fallopian tubes are patent (open), an ovulated egg can be fertilized within one of the tubes and travel to the uterus for potential implantation. If the tubes are blocked, the sperm and egg cannot meet, and conception will not be possible.
Blocks or occlusions in the fallopian tubes are a cause of female factor infertility known as tubal infertility.
At Nelson Center, we use ABBI® (Air Bubble Based Infuser) to check tubal patency. ABBI is a safe evaluation of fallopian tubal patency using ultrasound versus X-ray. It utilizes ultrasound with a saline and air bubble contrast media to safely evaluate tubal patency in the office. ABBI provides a minimally invasive procedure by reducing the risk of allergic reaction to radiopaque dyes and eliminating exposure to fluoroscopy radiation used in traditional HSG. Dual-function ABBI also enables saline-only SIS exam.