- Oral contraceptives (Birth Control Pills)
- Implantable hormonal contraceptives
- Intrauterine Devices
- Conventional and Bioidentical Hormone Replacement Therapy
Gene Mutations/Hereditary breast and ovarian cancers
Sexually transmitted diseases
Fitness status – Body Composition Analysis
Evaluation and Management of:
Abnormal uterine bleeding
Polycystic Ovarian Syndrome
Hot flushes/night sweats
Minimally Invasive Surgeries
Conventional Gyn Surgeries – Full complement of laparoscopic, vaginal, and open surgeries
Pelvic, breast, thyroid, abdominal ultrasound – by Diagnostic X-Ray
Dual X-Ray Absorptometry (DXA) testing – Bone Density Studies and Body Composition Analysis (lean body weight)
Annual Gynecology Wellness Visit
Gynecologists have a special perspective on preventative medicine. Most women think of a GYN annual visit as “coming in for my pap smear.” That is really just the tip of the iceberg.
There are several reasons to come in for an annual gynecology wellness visit. Many adults do not visit their primary care physician yearly for a check up. It is important to track height, weight and blood pressure regularly, to discuss habits that are at odds with a healthy life such as smoking, drinking, a poor diet, and inactivity. We make sure that a woman’s menstrual cycle is normal and that she does not have sexual concerns. When appropriate, we stress practicing contraception to help her avoid an unintended pregnancy. We offer the full spectrum of contraceptive options. We discuss safer sexual practices to protect against sexually transmitted diseases. We test for STD’s when appropriate and offer vaccines for cervical cancer to women under 26. The physical exam includes a breast exam and full pelvic exam to assess for breast and gyn cancers. The pap smear screens for cervical cancer and can sometimes find other cancers. Every woman is also asked to give a detailed family history of cancer so that we can determine if she should be tested for hereditary breast and ovarian cancer gene mutations. There is another gene mutation, Lynch Syndrome, that redisposes an individual to uterine and ovarian cancer as well as colon cancer. Testing is offered when the family history suggests this mutation. Everyone over 40 is screened for colorectal cancer with a digital exam and testing for hidden blood in the stool. For women over 50, we offer colonoscopy referrals. We also offer bone density screening to identify women at risk for osteoporosis and offer interventions to prevent bone loss.
Hereditary Breast and Ovarian Cancer
Does cancer run in your family?
Medical science is constantly uncovering new answers as to why an individual may get cancer. Often it is a combination of environmental factors (like diet or toxins or chronic stress) and a genetic predisposition. The Artemis Center is proud to offer counseling and testing for individuals who may have a risk for breast cancer and other gynecologic cancers.
All of our patients are screened for family histories that suggest they may carry a specific gene mutation that is known to be a major risk factor for developing cancer. Those who meet national guidelines are offered gene testing (a simple saliva test).
We also have an exciting new option of using computer models to analyze both family history and personal history factors (for example, the age when a woman begins menstruating) to estimate a woman’s lifetime risk of breast cancer. If the analysis shows that a woman has a greater than 20% lifetime risk of breast cancer, she may be eligible for yearly breast MRIs for screening and twice yearly clinical breast exams.
Women found to carry the BrCa gene mutation have sometimes opted for mastectomies and/or removal of their Fallopian tubes and ovaries once they have finished their childbearing. (see Breast Cancer Survivor story in News and Press)
Knowing that you are at increased risk for certain cancers may also help inspire individuals to change their lifestyles to reduce their risk of cancer. Knowledge is power.
Dr. Madejski is happy to be one of the first offices in Western New York to offer office- based ablation of the uterine lining. In the past, a woman would have to go to a hospital and receive anesthesia to have a global endometrial ablation – permanent treatment of heavy menstrual bleeding. We offer two different ablation procedures.
Her Option was designed to be performed in an office setting. Our patients can have the same result as other endometrial ablation techniques without visiting a hospital. Freezing of the uterine lining has a natural anesthetizing effect so that the patient can have the procedure with minimal discomfort and in a fraction of the time required to go to the hospital.
The procedure involves placing a slender tube into the uterus under ultrasound guidance. Once in place, the Her Option cryoprobe drops down to minus 100 degrees centigrade, freezing up to 12 mm into the uterine wall. We can see the cryo zone advance on the ultrasound machine, and can customize the amount of freezing necessary to achieve the best result.
The procedure restores normal bleeding to approximately 90% of women who are good candidates for the procedure and is much less invasive than a hysterectomy.
If you are plagued by heavy periods that interfere with your quality of life, ask about Her Option.
We also offer office based Novasure Endometrial Ablation procedures. Novasure is a cautery based global endometrial ablation procedure that takes about 90 seconds.
The newest generation of laparoscopy (operating through small incisions using a scope) is here. We now have robot assisted technology – wristed instruments that replicate a surgeon’s movements in open surgery. daVinci surgery also offers superior optics. Better control of instruments and better visualization of the operative field means less blood loss, less trauma, and a quicker recovery.
It is now common to go home from the hospital the morning after a daVinci hysterectomy and to be able to return to work in two weeks instead of six.