Home | Services | Gynecology
At Ko'olau Women's Healthcare in Honolulu and Kailua, HI, we pride ourselves in offering a complete line of the most advanced and least invasive treatments for various gynecologic conditions. From contraception to menopause, we thoroughly discuss all the options to help you make the best decisions to meet your needs.
Please, click on each service option to see the detailed information.
Going to the gynecologist isn't something women eagerly anticipate. Women's anxiety and discomfort increase during their first annual exam. There are a few things to remember before your first yearly exam.
Our highly trained OBGYN specialists at Ko'olau Women's Healthcare are devoted to providing the highest quality and compassionate care for women of all ages in the Honolulu & Kailua areas.
The most important thing to do before your first gynecological exam with Ko’olau Women’s Healthcare is research. Women should be prepared to discuss their family medical history and be ready for questions about their menstrual cycle. Some of the most commonly asked questions one of the doctors may ask include:
In addition to checking your height, weight, and blood pressure, your doctor will ask you questions about your general health, menstrual period, and sexual activities. During your exam, your doctor will perform the following exams and tests. If the doctor is male, a female nurse remains in the room during your exam.
Breast Exam
During your breast exam, your doctor will check your breasts for signs of any potential problems, such as a lump. They will examine each breast by moving their fingers around your breast in a pattern. You may also be shown how to perform monthly self-examinations.
Pelvic Exam
During your pelvic exam, your doctor will examine your vagina, cervix, and reproductive organs. Once you place your feet against the footrests at the end of the examining table and slide forward, your doctor will insert an instrument called a speculum into your vagina to spread the walls apart to examine the area gently.
Your doctor then places one or two gloved, lubricated fingers into your vagina, and the other hand presses on your abdomen from the outside to check the size, position, and shape of your internal pelvic organs. The pelvic exam may feel a bit uncomfortable, but it should not hurt.
Pap Smear
A Pap smear checks for abnormal cells in the cervix that could lead to cancer. The doctor will insert a small cotton-tipped swab through the vagina into the cervix. Cells are removed from the cervix and sent to a laboratory to be checked for any abnormalities. The Pap smear is painless.
These assessments should include screening, evaluation, counseling, and immunizations based on age and risk factors.
Our team of highly educated and experienced board-certified OB-GYNs specialize in providing comprehensive care to meet each woman's individual health needs. Women from adolescence through post-menopause can get the personalized, competent, and compassionate care they need in a safe and comfortable environment.
Not only does the annual exam ensure that you maintain good gynecological health, but it is also an opportunity for you to catch health problems in the early stages.
Menopause occurs when women experience changes and symptoms before or after they stop menstruating. They cannot get pregnant because the ovaries no longer release an egg every month. Menopause is a natural process that every woman will experience, but in some cases, these symptoms will require treatment.
Our highly trained OBGYN specialists are devoted to providing the highest quality care for women of all ages in the Honolulu & Kailua areas.
Menopause typically begins when a woman reaches her 40s or 50s. Symptoms may be more pronounced at the beginning of the process and can last a few years.
Perimenopause
Perimenopause is the stage that occurs several years before a woman reaches menopause. The body begins to make less of the hormones estrogen and progesterone. During this time, patients may experience symptoms that will continue through menopause. If more than 60 days elapse between menstruation, this may be a sign that a woman is nearing the end of perimenopause.
Menopause
The severity of symptoms and how long they last during menopause varies for each woman. The most common signs of menopause include:
Postmenopause is the period after menopause when a woman hasn't had her period for 12 months. The symptoms related to menopause gradually improve for most women. However, because of the lower estrogen level, postmenopausal women are at an increased risk of certain health problems, including osteoporosis and heart disease. It's vital to continue to see your OBGYN for routine exams and tests even after menopause.
Stay on top of your health during the transition into menopause, and discuss any symptoms you’re experiencing with our OBGYN specialists at Ko’olua Women’s Healthcare.
Thanks to advances in science and technology, women have various birth control options. These days, you can find choices that guarantee to prevent pregnancy with ratings up to 99.9% if you use them properly.
You can choose from birth control options that best suit your lifestyle, but be sure to discuss your top choices with your doctor at Ko'olau Women's Healthcare.
Hormonal birth control can often help to regulate a woman's menstrual cycle and associated symptoms by stabilizing her hormones. While hormonal contraceptives are particularly common, they are not recommended for every female. This decision will be based on the patient's health and any prior conditions or risk factors she may have.
Birth Control Pills
Birth control pills are a form of oral contraception that generally contain two hormones, estrogen, and progestin, and are taken daily to prevent a woman's ovaries from releasing eggs. They also help to prevent pregnancy by causing the cervical mucus to thicken, which blocks sperm from fertilizing an egg.
Birth control pills are safe, effective, and convenient, though they may be less effective for women who are overweight. Additionally, vomiting and/or diarrhea may keep the pill from working properly to prevent pregnancy. If a woman is concerned about this, a backup method of birth control should be used.
Birth Control Patch
Used correctly, the patch is as effective as birth control pills are in preventing pregnancy. The patch is a form of birth control that a patient wears on the skin and looks like a small bandaid. The hormones it contains (estrogen and progestin) are similar to those used in birth control pills but are absorbed through the skin. The patch works by suppressing the pituitary gland which, in turn, prevents the ovaries from releasing eggs. It also thickens cervical mucus making it more difficult for sperm to reach an egg.
Since the patch contains a dosage 60% higher than that delivered by the pills, there is a risk of side effects such as blood clots. Because of this, it is essential that patients using the patch do not smoke. The patch can also be used to treat irregular periods, menstrual cramps, or endometriosis.
The Birth Control Shot
The Depo-Provera or Depo shot is another very effective method of birth control. This shot must be given once every three months by a trained medical professional, typically during a quick appointment at our office locations in Honolulu. Women who receive this shot will typically experience lighter periods or stop getting their period altogether after several months of consecutive shots. This method is especially beneficial to women looking for a flexible and low-maintenance form of birth control that is still highly effective, with a success rate of over 99%.
Vaginal Ring (NuvaRing)
A vaginal ring is a form of contraception that is soft, flexible, and worn in the vagina. The key benefit of the ring is that a patient does not need to take it daily to get complete monthly protection. In a given one-month period, the ring must be inserted into the vagina, removed after three weeks, and a new ring inserted no more than seven days later.
The hormones it contains (estrogen and progestin) are similar to those used in birth control pills. However, unlike birth control pills, they are absorbed directly into the bloodstream through the vaginal wall, delivering a consistent level of medication, improving effectiveness, and limiting side effects.
Some women can experience adverse side effects from adding more hormones to their bodies via contraceptives. Non-hormonal options are ideal in these situations and are also commonly recommended for women who wish to breastfeed while remaining on an effective form of birth control.
Condoms
Condoms are a barrier form of birth control that physically blocks sperm from entering the vagina. They are the only form of protection that can help to stop the transmission of sexually transmitted diseases (STDs), like HIV, and prevent pregnancy. A condom is a latex or polyurethane sheath closed at one end and fits over a man's penis.
Condoms are also available for females and have a flexible ring at either end. One end is closed and inserted into the vagina, and the other is open, with the ring remaining outside the vagina. To help assure protection, users should read and follow the manufacturer's instructions.
Diaphragm
A diaphragm is a thin, rubber, dome-shaped device with a springy and flexible rim. Inserted into the vagina by the patient, it fits over the cervix and is held in place by muscles in the vagina. The diaphragm is designed to hold spermicide in place over the cervix to kill sperm. To maximize the diaphragm effectiveness, it should be left in place for 6 to 8 hours.
The effectiveness of birth control ranges from 86-94%. If one chooses to use a diaphragm, it must be fitted in a clinic. Additionally, weight changes, vaginal surgery, and pregnancy can affect how a diaphragm fits, requiring a medical provider to check it to ensure it fits properly and to determine if a new size is needed.
Permanent Contraception (Tubal Ligation)
Tubal Ligation is a procedure that seals off a woman's fallopian tubes that carry an egg from the ovaries to the uterus. By blocking these tubes, where fertilization usually occurs, sperm cannot reach the egg to fertilize it. The procedure seals the fallopian tubes with thread, bands, clips, an electric current, or small implants. Patients should be aware that this procedure provides permanent birth control and is NOT reversible.
For those women who wish to have dependable birth control without having to remember to take a pill every day, there are implantable devices.
Intrauterine Device (IUD)
An IUD is a contraceptive device that delivers small amounts of hormones directly to the uterus. It is a form of birth control that remains in the uterus and can last up to 5 years. It is a small, T-shaped, plastic device that is both soft and flexible and is put into place by a gynecologist during a visit to your OBGYN.
An IUD works through several different actions that include thickening the cervical mucus to prevent sperm from entering the uterus, inhibiting the sperm from reaching or fertilizing an egg, and making the lining of the uterus thin. While they are 99% effective concerning birth control, a gynecologist can remove the device if a patient is looking to become pregnant immediately.
Called the “Plan B” pill, this emergency contraception can be used the morning after unprotected sex. It has to be taken within 72 hours to be effective. This method is not made to be used as regular birth control but instead as an emergency method in cases of forgotten birth control, birth control failure, or rape.
The highly trained OBGYN specialists at Ko'olau Women's Health Care will take the time to find the best suited to your needs and those of your partner.
Endometriosis affects one in 10 women in the United States, according to the Endometriosis Foundation of America. Ko'olau Women's Healthcare is Hawaii's expert in alleviating pain and improving the quality of life in women with endometriosis-associated pain.
We are experienced in diagnosing and treating endometriosis and offer effective treatments and testing methods, including pelvic laparoscopies, transvaginal ultrasounds, and pelvic exams. Our surgical approach of radical resection has helped women in Honolulu, Kailua, and surrounding areas achieve a pain-free life.
Typically the inner lining of the uterus is shed with each menstrual cycle. Endometriosis is a condition that occurs in women when the inner uterus lining starts to grow outside of the uterus, behind the uterus, on the bowels, or the bladder. This results in the appearance of endometrial tissue outside of the uterus, which causes pelvic pain. Endometriosis is most commonly diagnosed among women in their 30s and 40s, but the onset typically starts during reproductive years.
Dr. Bhattacharyya and Dr. Awaya can help diagnose your symptoms as endometriosis and determine the best treatment.
There are multiple theories over the root causes of endometriosis.
The older theories of cells spreading from the uterus via the lymph nodes and blood vessels do not seem to be supported by any factual evidence. Furthermore, we know that endometrial cells from the uterus go into the pelvis during menstruation. This process is called retrograde menstruation. Because it happens so often and relatively few women have endometriosis, there must be factors at work other than retrograde menstruation. These other factors include alterations in inflammatory processes, immunologic dysfunction, and various genetic factors.
The most common symptoms women experience with endometriosis include pain, spotting in between periods, heavy periods, infertility, and digestive problems. Not all women experience symptoms, but pain is the most common symptom and can be:
The benign growth of the endometrial lining causes pain from endometriosis. These growths bleed in the same way as your uterus during your period. Other problems can result, such as blocked fallopian tubes, inflammation, and scar tissue around your uterus, intestines, or bladder.
In addition to discussing your symptoms with your gynecologist, they may suggest another exam to diagnose endometriosis. During a pelvic exam, your gynecologist may be able to feel for large cysts or scars behind your uterus. Our team may also do an ultrasound or MRI to check for ovarian cysts.
Surgery is the only way to confirm that you have endometriosis. Your gynecologist may perform a laparoscopic procedure to see or biopsy the endometriosis growths.
Endometriosis treatments depend on the condition's severity. Since there is no cure for endometriosis, talk with your gynecologist about your situation and the best endometriosis management options for you. Because some treatments can end your fertility, one consideration is if you want to have children in the future.
If you're experiencing severe pelvic pain related to your period, problems with infertility, or heavy periods, schedule an appointment to talk to us at Ko'olau Women's Healthcare about endometriosis today.
Forty years ago, cervical cancer was the leading cause of cancer death in American women. Since then, the number of deaths has significantly decreased due to increased awareness of this disease's symptoms and testing methods. Although the numbers have improved, approximately 12,000 women will be diagnosed, and 4,120 will die from it this year.
Our highly trained OBGYN specialists at Ko'olau Women's Healthcare are devoted to providing the highest quality care against cervical cancer for women of all ages in the Honolulu & Kailua areas.
These numbers show the dangers that cervical cancer can pose and the importance of early detection through regular screenings.
Since there is such a dramatic decrease in the survival rate as cancer progresses, women must be proactive and take the necessary steps to catch the problem and seek treatment before the issue develops further.
There are two powerful tools that women should use in the fight against cervical cancer:
HPV Vaccination
The Human Papillomavirus (HPV) is the most sexually transmitted disease in the United States. It is estimated that approximately 90% of men and 80% of sexually active women have at least one type of HPV. Of these types of HPV, two are responsible for approximately 70% of all cases of cervical cancer.
HPV vaccinations have been found to provide nearly 100% protection against the two HPV types that can cause cervical cancer (types 16 and 18). The vaccine can be given at any age, but if a person has been sexually active, there is a chance that they’re already infected. Ideally, the vaccine will be administered before a person becomes sexually active.
Pap Tests
Typically performed on women aged 21 to 65, the pap test allows the doctor to look for changes in cervical tissue that can potentially turn cancerous. The doctor will examine the vagina and cervix and collect samples of any abnormal tissue. The tissue will then be sent to the laboratory for testing.
Although women rarely exhibit symptoms of cervical cancer in its early stages, it is crucial to understand the warning signs. The most common symptoms include:
The symptoms listed above are somewhat common and can be caused by issues other than cervical cancer. But there are some warning signs of advanced-stage cervical cancer:
Early detection is key to cervical cancer treatment. Contact Ko’olau Women’s Healthcare today to schedule a Pap Test for Cervical Cancer.
Ko'olau Women's Healthcare provides the people of Honolulu and Kailua with a range of breast cancer screening services tailored to meet each individual’s needs. We offer mammograms, ultrasounds, and other diagnostic tests to check for breast abnormalities. After testing, Ko'olau Women's Healthcare specialists can provide advice on treatment and answer any questions related to breast health.
The Ko'olau team is dedicated to providing patients with a private and comfortable environment that promotes trust and respect.
Ko'olau Women's Healthcare is proud to offer specialized gynecological and obstetric care, including the removal of any abnormal growths, such as polyps, that may arise.
Our team of wellness practitioners provides expert care tailored to your individual needs, focusing on safety and comfort.
Our facility is equipped with the newest technologies and procedures available today, giving you peace of mind that your procedure will be completed efficiently and thoroughly. Don't hesitate to contact Ko'olau Women's Healthcare for all your gynecology and obstetric needs, including removing any polyps.
Osteoporosis is a condition that reduces bone strength and puts women at greater risk of breaking or fracturing a bone.
In fact, more than one in four women over the age of 65 have the disease. Symptoms are virtually non-existent, and a person may not be affected until they break a bone. If you believe you may have osteoporosis, Ko'olau Women's Healthcare can help with screening and treatment.
The following factors make a person more likely to develop osteoporosis:
Bone density is measured using a process called dual-energy x-ray absorptiometry, commonly known as a DEXA scan. This procedure measures the density of bones in body areas prone to breaks and fractures, such as the spine, hips, and forearms.
DEXA scans do not require any preparation. The patient will lie on an examination table while an x-ray scans different body areas. The process is painless and only takes about ten minutes to complete.
Understanding DEXA Results
In most cases, the patient's bone density will be compared to that of an average healthy young adult. The results of this comparison are called a T-score. This will help the doctor determine if the bones are normal (T-score between +1 and -1,) have lower than average mass (T-score between -1.1 and -2.4,) or have Osteoporosis (T-score of -2.5 or less.)
How Often Should DEXA Scans be Performed?
Because of the radiation exposure, DEXA scans should be completed a maximum of once every two years. Even with high-risk patients receiving treatment, doctors will monitor bone health in other ways.
The main goal of treatment will be to prevent fractures and breaks. In addition to recommending a proper diet rich in calcium, a doctor may prescribe medication. The following is not a list of all medication options, but simply the most commonly used:
Osteoporosis is a condition that shouldn’t be taken lightly. A broken bone can result in hospitalization and even surgery.
If you have concerns about your bone density and would like to schedule an appointment, please call Ko’olua Women’s Healthcare today to schedule an appointment. Our board-certified OBGYNs specialize in the diagnosis and treatment of osteoporosis.
Before a menstrual cycle begins, there are several symptoms that a woman should start to notice. Unfortunately, these symptoms can vary widely from one person to another, so many women are left wondering whether or not their symptoms of PMS are normal.
The highly trained OBGYN specialists at Ko'olau Women's Healthcare are devoted to providing the highest quality care for women of all ages in the Honolulu & Kailua areas.
A majority of all women will experience one or more of the following concerning premenstrual syndrome:
As a result of these uncomfortable symptoms, it is not uncommon for women going through PMS to become particularly irritable or anxious during this time. Such symptoms may worsen with age and the addition of significant stress but should never cause extreme pain or other debilitating symptoms.
Many women often feel embarrassed to talk about their periods or even about their reproductive health in general. This unnecessary silence leads many to assume that their severe pain and discomfort are a regular part of having a menstrual cycle rather than investigating other potential causes.
The truth of the matter is that there are plenty of conditions out there that can cause a woman to experience abnormal occurrences during her period.
Endometriosis
The endometrial lining typically exists around the inside of the uterus and helps to create a hospitable environment for the development of a potential fetus. Those with endometriosis experience growth of this unique tissue outside the uterus or even along other nearby reproductive organs.
This condition causes severe pain during menstruation, in addition to heavy bleeding, pain with intercourse, and more.
Uterine Fibroids
A fibroid is a solid, noncancerous ball of tissue on or within the uterus wall. These tumors occur in most women, though many do not grow large enough to present noticeable symptoms.
When a fibroid is large enough to cause problems, the individual will likely experience an unusually heavy flow, the release of large blood clots during their menstrual cycle, and localized pain in the lower abdomen or, perhaps, even the lower back.
There is a similar condition to fibroids called uterine polyps, which are soft tissue formations that produce many of the same warning signs.
PCOS
Polycystic ovary syndrome is a unique condition that causes an imbalance of hormones. This generally creates an overproduction of the male sex hormone, testosterone, or an underproduction of the female sex hormone, estrogen.
As a result of these hormone fluctuations, women with PCOS are likely to encounter menstrual cycles on a very inconsistent schedule. It is common for ladies with this condition to have fewer than nine periods per year.
All of the conditions above can be very difficult to diagnose without the help of an experienced physician who knows which types of tests to perform to identify the cause of your abnormal menstrual pains accurately. If you would like to schedule a consultation with Dr. Bhattacharyya or Dr. Awaya to discuss some of your concerning PMS symptoms, request an appointment today.
A cyst is a fluid-filled sack that can form in several places throughout the body. Women have two ovaries on each side of the uterus where eggs can develop and mature.
During their lives, most women will develop a cyst of some sort on at least one of their ovaries that may either disappear without treatment or cause severe symptoms. These cysts usually form during ovulation periods but can also happen outside of that window.
Several different types of cysts may have different causes. Most will develop due to your menstrual cycle and are considered functional, while others may develop outside of your menstrual cycle, posing separate issues. The most common types are as follows:
Follicular Cyst
A follicular cyst is a functional cyst and happens around the middle of your current menstrual cycle. The follicle is essentially the sac in which an egg grows and is broken open when the egg is released. However, if the follicle doesn't open, it will eventually become a cyst.
Corpus Luteum Cyst
After the egg is released from a follicle, the follicle becomes a corpus luteum, which is responsible for aiding in conception. If fluid accumulates inside this follicle, it can turn into a cyst.
Endometriomas/ Dermoids/ Cystadenomas
These are non-functional cysts typically created outside of your menstrual cycle. Endometriomas are caused by endometriosis, dermoid cysts are formed from cells present from birth or an embryo, and cystadenomas are developed from watery fluid on the surface of an ovary.
It's important to note that any cyst should be checked by a board-certified OBGYN in Honolulu, HI, to determine the exact cause and type. This will help determine if they are benign or malignant as well.
Most ovarian cysts will not cause symptoms and go away on their own. But, if the cyst is large enough, there is a chance that it may cause issues such as pelvic pain, bloating, dull back pain, unexplained weight gain, or pain during the period.
If you are experiencing anything out of the ordinary, especially during your menstrual cycle, please contact Ko'olau Women's Healthcare today to discuss it.
If you've been diagnosed with ovarian cysts, there's a chance that your doctor will not immediately discuss a plan involving surgery or medication. In fact, many will suggest that you wait and be re-examined to see if the cyst goes away within a month or two. In addition, it is recommended that you receive pelvic ultrasounds during your visits to determine if the cyst has grown. You may be prescribed new hormonal contraceptives to keep them from progressing, but this will not assist in treating existing cysts.
If the cyst is large, your doctor may recommend the removal of the cyst by surgery. However, if the cyst is cancerous, you may be referred to a gynecologic cancer specialist.
If you are concerned that you are affected by ovarian cysts or have further questions regarding treatment options, please schedule your appointment with Ko'olau Women's Healthcare.
Receiving a screening for a sexually transmitted disease, or STD, is an essential step for a sexually active person to take to protect themselves and their partner. In many cases, those infected with a sexually transmitted disease may not even know it because they aren't showing symptoms.
If left untreated, STDs can spread to others and lead to infertility.
Getting tested for each type of STD during your annual visit is expensive and unnecessary in most cases. Patients should speak with their OBGYN at Ko'olau Women's Healthcare about their specific risk factors and lifestyle to determine which tests are proper for them.
It is recommended that you undergo an STD screening if:
It isn't always obvious when you have an STD. Symptoms can be minor or even nonexistent in some cases. Visit the doctor if you are experiencing the following:
If results determine that you have an STD, the type of issue will determine how it is treated. STDs are broken down into three categories:
If you think you may have an STD schedule your appointment right away to prevent any other complications.
Vaginitis is an infection or inflammation of the vagina that can cause itching, burning, a change in vaginal discharge, or pain during sex.
There are four particular forms of vaginitis. Each one will exhibit similar symptoms, but the cause will depend on the exact type of vaginitis. The four types include:
Despite the many forms of vaginitis, their symptoms remain relatively the same. Common symptoms of vaginitis include the following:
The severity surrounding vaginitis depends heavily on your previous experience with different forms of vaginitis. It is not always necessary to consult your doctor about vaginitis, especially if you recognize the signs and symptoms of a yeast infection, have been previously diagnosed with one before, and are not pregnant. In this case, it is best to seek relief with an over-the-counter treatment.
More concerning cases of vaginitis include the following symptoms, for which you should certainly seek advice and care from your gynecologist:
Treatment for vaginitis depends on the particular type of vaginitis diagnosed.
As previously stated, yeast infections are often treated using over-the-counter medications. However, more severe cases require a stronger medication that can only be acquired with a prescription, such as an antifungal cream, suppository, or antifungal tablets.
Both bacterial vaginosis and trichomoniasis are typically treated using antibiotics prescribed by your doctor. In the case of trichomoniasis, it is crucial that both you and your sexual partner receive treatment.
Atrophic vaginitis is often treated using estrogen tablets or creams. There are several different types available, so it is essential that you and your doctor decide together which one will be right for you.
You can reduce your risk of becoming infected with vaginitis in several ways. Best practices for vaginitis prevention include:
If you would like to learn more about vaginitis or to consult with a professional about your vaginitis concerns, call Ko’olau Women’s Healthcare.
Pelvic pain is a widespread symptom, especially in women. Discomfort within the lower abdomen and pelvic region could result from an abnormality or illness relating to various vital bodily systems and functions.
This type of pain is often related to the reproductive, digestive, urinary, or musculoskeletal systems. Our highly trained OBGYN specialists have extensive experience diagnosing and treating the source of pelvic pain.
Generally, pelvic pain is described as either a dull yet constant pain, or a sudden, sharp pain. If the pain is consistently present over a long time, it is classified as chronic pelvic pain. If the opposite is true, then the patient is likely to suffer from acute pelvic pain.
Most individuals will notice that their pelvic pain becomes more intense as they engage in certain activities. For example, if the source of your pelvic pain is your digestive system, then you may experience more pain after consuming certain foods or drinks. It is also common for pelvic pain to worsen during sexual intercourse or while urinating.
Reproductive System
The reproductive system is a common culprit to pelvic pain, particularly for women. Conditions of this system that can trigger pelvic pain include, but are not limited to:
Urinary System
Another likely source of pelvic pain is a person’s urinary system because it can encounter several different conditions or abnormalities, such as:
Musculoskeletal System
It is also possible for pelvic pain to result from a deformity or injury to muscles, tendons, or ligaments located around the pelvis. This can often be a result of situations like:
Although any general discomfort of the pelvis can be described as pelvic pain, it is especially important to seek treatment from Ko’olau Women’s Healthcare if your pain begins to worsen or become severe.
One in five women suffers from heavy menstrual bleeding. Many women experience heavy or irregular bleeding in their 30s and 40s as they get closer to menopause. Heavy periods are more than just a hassle - they also take a physical, social, and emotional toll.
Heavy periods are not something with which you have to live. Today, there are many effective treatment options available. Studies show heavy menstrual bleeding can affect women in the following ways:
If you are experiencing heavy menstrual bleeding, please contact Ko'olau Women's Healthcare in Kailua or Honolulu to request a consultation for Novasure.
The purpose of a Colposcopy is to examine the cervix for indications of cervical cancer. In most cases, this procedure is performed on women whose pap test has returned abnormal results.
The doctor will use an imaging device called a colposcope to look for irregular cervical tissue.
A healthy cervix will appear pink and smooth. If everything looks normal, additional tests may be needed to determine the cause of the irregular pap results.
There is little preparation needed for a Colposcopy. However, before having this test performed, it is highly recommended that you:
Some discomfort may be felt when a mild solution is used to clean and dry the cervix, but the Colposcopy should not hurt since the colposcope does not touch you. If a sample is needed, you may feel a slight pinching feeling as tissue is collected.
For those who did not have a sample taken:
For those who did have a sample taken:
The board-certified gynecologists with Ko’olau Women’s Healthcare specialize in safe and accurate colposcopies.
A hysterectomy is a surgical procedure to remove the womb (uterus). If you have not gone through menopause, you'll no longer have periods, regardless of your age.
During your consultation, our skilled medical professionals will explain the process of a hysterectomy and address any questions or concerns that you may have, so don't hesitate to reach out if this is the right path for you!
A myomectomy is a minimally invasive procedure to remove noncancerous fibroids from the uterus. It can help alleviate symptoms like heavy menstrual bleeding, pain with intercourse, and pelvic pressure or pain.
Our friendly staff is always willing to answer any questions about this procedure. Don't hesitate to reach out if you are interested in learning more about Ko'olau Women's Healthcare's myomectomy!
Sometimes referred to as a D & C, a dilation and curettage is a procedure in which tissue from the uterine lining (endometrium) is removed. In many cases, your gynecologist will use small instruments to dilate the cervix to access the uterus, but medication can also be used.
The OBGYN specialists at Ko’olau Women’s Healthcare are highly trained to perform the Dilation and Curettage procedure. They will take the time to discuss whether the D&C procedure is right for you.
A D&C may be performed to either diagnose or treat a condition.
Sometimes this procedure will be performed under general, spinal, or epidural anesthesia. If you are to receive these types of anesthesia, please do not eat or drink for at least 8 hours before the procedure. If you are receiving a local anesthetic, your doctor will give you instructions on fasting.
If a sedative is given before the procedure, you will need to make arrangements to be driven home.
A dilation and curettage should be relatively painless as you'll receive general, regional, or local anesthesia. Before the procedure begins, you may be asked to empty your bladder. After that, you will lay on your back with your legs in supports. In order to view the cervix, your doctor will insert a speculum into the vagina. Instruments will then be inserted into the cervix to dilate the area. The tissue will be removed with a sharp, spoon-shaped instrument called a curette.
Patients are typically allowed to leave within a few hours and may resume regular activity within a few days.
The board-certified OBGYNs at Ko’olau Women’s Healthcare specialize in safe and effective dilation and curettage.
Loop electrosurgical excision procedure (LEEP) is a common practice used by gynecologists to remove abnormal cells from a patient’s cervix. Women with these abnormal cells may be at risk for serious conditions such as cervical cancer, making LEEP a very important part of the diagnostic and cancer prevention process.
Our OBGYN specialists are highly trained to perform the LEEP procedure. They will take the time to discuss whether this procedure is right for you.
Patients undergoing a loop electrosurgical excision procedure are often a bit nervous beforehand. Although the name of this treatment may seem rather intimidating, the entire process is really quite simple and painless.
The patient will be asked to lie on their back and place the heels of their feet in the stirrups at the end of the examination table, just as they would at a routine gynecologic appointment. Once positioned, the physician will insert a speculum to widen the opening of the vagina enough to get a clear visual of the cervix. A colposcope will also be used to help magnify the treatment area. The area is then numbed using a local anesthetic so that the patient does not feel discomfort during their LEEP.
The device used to extract the cervical cells consists of a thin wire with a loop around the end. The physician will treat abnormal cells by wrapping the loop around them and then using the electricity passed through the wire to remove them.
The entire procedure takes approximately 10-20 minutes, after which patients can return home and continue with regular activities. The physician will have the removed cervical cells analyzed at our lab facility to determine if further diagnostic testing or treatment is needed.
LEEP is a very safe and effective treatment option, though there are several common symptoms that women should be aware of following their procedure, including:
Along with excessive bleeding, patients should contact our office immediately if they experience clotting, fever, or severe pain.
Before the procedure begins, ensure you address any questions or concerns with your physician. It is essential to fully understand the reasoning why a LEEP is being performed and what sort of follow-up care will be needed once it is completed. Patients should also inform their physician of any medications they are currently taking that may impact their treatment, such as blood thinners. No other significant preparation, such as fasting, is required prior to LEEP.
The board-certified gynecologists at Ko’olau Women’s Healthcare have extensive experience performing safe and effective LEEP procedures.
Laparoscopy is the most common procedure to diagnose and remove mild to moderate endometriosis. Instead of using a large incision in the belly, the surgeon inserts a lighted viewing tool called a laparoscope through a small incision.
If better access is needed, the surgeon makes one or two more small incisions for inserting other surgical tools.
Laparoscopy is used to examine the pelvic organs and to remove implants and scar tissue. This procedure is most often used for checking and treating:
Pain Relief
Surgery relieves endometriosis pain for most people but doesn't guarantee long-lasting results. Pain can return a few years after surgery. Hormone therapy may be used after surgery to help prevent pain and new or returning endometriosis.
Infertility
If infertility is your primary concern, your doctor may use laparoscopy to look for and remove signs of endometriosis. Surgery may improve your chances of pregnancy. But in some severe cases, a fertility specialist may recommend skipping surgical removal and using in vitro fertilization.
Endometrioma
There are various ways of surgically treating an endometrioma, such as draining it, cutting out part of it, or removing it completely (cystectomy). These treatments may help relieve pain. But cystectomy is most likely to relieve pain for longer, prevent an endometrioma from growing back, and prevent the need for another surgery.
To schedule an appointment with a gynecologist at Ko’olau Women’s Healthcare, fill out our online form.
A hysteroscopy is a procedure to find and treat problems with your uterus. It may be done to remove growths from the uterus, such as fibroids or polyps. It may also diagnose and treat abnormal bleeding or fertility problems.
During this procedure, the doctor may take out a small piece of tissue for study. Or the doctor may gently scrape tissue from the inner wall of the uterus. This is called a dilation and curettage, or D&C.
It is a minimally invasive technique that uses tiny instruments inserted through the cervix to remove a growth from inside the uterus.
This non-invasive procedure has minimal risks and is a quick, comfortable solution that doesn't require general anesthesia or sutures. So if you need gynecological care, Ko’olau Women's Healthcare is here for you!
Ko'olau Women's Healthcare is the right choice for women considering endometrial ablation. Our experienced team of professionals can help guide you through the treatment process, helping to alleviate any confusion or stress you may have.
Endometrial ablation is an outpatient procedure to reduce or eliminate menstrual cycle bleeding. Ko'olau Women's Healthcare has extensive experience providing modern treatments with minimal side effects, making it one of the best and safest choices when recommending endometrial ablation.
Vaginal natural orifice transluminal endoscopic surgery is an advanced, minimally invasive gynecologic procedure using the vagina as a surgical access route. The vNOTES technique is most commonly used for hysterectomy procedures, as well as salpingectomy, oophorectomy, and cystectomy procedures.
The American College of Obstetricians and Gynecologists (ACOG) and the American Association of Gynecologic Laparoscopists (AAGL) have recommended vaginal hysterectomy as the approach of choice whenever feasible.
You play an essential role in your surgery and your recovery. Research shows that patients who are well-informed about their treatment options enjoy better outcomes and are more satisfied with their results
vNOTES (vaginal natural orifice transluminal endoscopic surgery) is another option for your hysterectomy. It is the next advancement in minimally invasive surgery and does not require abdominal skin incisions.
In the vNOTES procedure, your doctor uses specialized instruments inserted through the vagina instead of creating visible abdominal incisions in the body. This allows your doctor to gain access to the uterus or fallopian tubes and ovaries without any visible scarring.
Before the Procedure
Your OBGYN will advise you on any pre-surgical tests and give you guidelines for eating, drinking, and taking medications.
During the Procedure
vNOTES is performed under general anesthesia, so you will be asleep throughout the procedure.
An incision is made in the vagina, and a specialized vNOTES device is placed to give your doctor access to the uterus, fallopian tubes, and ovaries. The abdomen is then inflated with carbon dioxide gas (similar to traditional laparoscopic surgery) to give your doctor the necessary space to see and operate.
Next, a high-definition camera and specialized instruments are inserted through the vNOTES device, allowing your OBGYN to operate with the utmost precision and visualization. Once the surgery is complete, the vNOTES device is removed, the gas is evacuated, and all internal incisions are closed.
After the Procedure
You may be discharged the same day as your procedure. Your doctor will advise you on your recovery and schedule a follow-up appointment.
Only a trained doctor can determine whether you are eligible for a vNOTES procedure. All minimally invasive surgical procedures, including vNOTES, present risks to the patient, such as the potential for conversion to a traditional vaginal, laparoscopic, or abdominal approach. These specific risks may only be evaluated in consultation with a doctor experienced in vNOTES procedures.
Our board-certified OBGYNs at Ko'olau Women's Healthcare specialize in the Acessa procedure, the latest advancement in fibroid treatment.
Fibroids are noncancerous tumors that grow from the muscle tissue of the uterus. Women are typically between the ages of 30-50 when they develop fibroids, though they can develop fibroids at any stage of their life.
Not all women with fibroids will experience symptoms, but many will go through them. Fibroid symptoms can become extremely debilitating and affect their everyday lives.
Symptoms of fibroids include:
The Acessa procedure is recommended for pre-menopausal women (typically younger than 55 years old). Particularly those who are tired of living with the ongoing pain and discomfort of fibroids and are looking for a minimally invasive option that allows them to keep their uterus and return to daily life quickly after the procedure. Dr. Bhattacharyya can perform this procedure with a minimally invasive single-site incision.
The Acessa® procedure is also known as Laparoscopic Radiofrequency Ablation (LAP-RFA) and essentially delivers heat directly into a fibroid to destroy its tissue and relieve your symptoms. The procedure contains six steps.
Only a trained doctor can determine whether you are eligible for an Acessa procedure. All treatment options for intrauterine pathologies have benefits, warnings, precautions, and risks. These specific risks may only be evaluated in consultation with a doctor experienced in Acessa procedures.