A woman’s pelvis carries an abundant array of organs, each with its own pathways of nerves. A problem with any of these organs can be translated by its nerves as pain. Pelvic pain receives highly individualized treatment at Academia. Approaches range from holistic to surgical. Our goal is to improve your quality of life by addressing the source of pain medically or laparoscopically and to eliminate the need for narcotic medications.
The lining of a woman’s uterus, the endometrium, is made up of special cells. When these cells grow outside of the uterine cavity they can cause problems, including pelvic pain, pain with intercourse, and infertility, as well as a serious emotional effect on women and their families. Management of a woman with endometriosis requires great attention to her history, symptoms, and current emotional state. After exploring her story and identifying her immediate and long-term goals, we select an approach to treatment that can most effectively address these goals ranging from holistic and medication to minimally invasive laparoscopic/endoscopic techniques.
Other Hormonal Concerns
Normal menstruation occurs in cycles of 28 days, although a variation of up to 21-36 days are still considered normal. Irregular menstruation is diagnosed when a woman’s cycles occur in fewer than 21 days or in more than 36 days. Some common causes include stress, excessive exercise, obesity or significant weight loss, intrauterine devices, and a great variety of hormonal disbalances. If the bleeding occurs between menstruations, intrauterine problems, like polyps, hyperplasia, or myoma, could be the cause . At Academia, we first collect a patient’s history, then, based on this history, perform a physical examination, likely including an ultrasound. We suggest treatment or perform other studies to evaluate a patient for a suspected underlying cause. Once a cause is determined, we provide treatment options that may include lifestyle changes, birth control changes, hormone therapy, or surgery. All of these modalities are available at Academia. Both in-ofice and outpatient surgeries are performed if necessary.
A uterine fibroid is a non-cancerous growth (tumor) of the smooth muscle tissue of the uterus that occurs usually during a woman’s middle and later reproductive years. In some cases, fibroids can cause pain and heavy bleeding during menstruation, painful sexual intercourse, pressure, and urinary and other problems related to their mass effect. At Academia, we can treat patients with the widest variety of options available, including medications, in-office procedures, and minimally invasive laparoscopic and hysteroscopic outpatient surgical techniques.
Academia is well equipped to manage all forms of contraception. Once a patient’s general health, immediate, and long-term goals are assessed, we discuss and prescribe the most appropriate forms of contraception. These may include any of a variety of birth control medications as well as two types of IUD, Mirena and Paraguard. A patient who has completed her childbearing goals may opt for permanent sterilization via hysteroscopy. This procedure, called Essure, involves the placement of small springs and can be performed in-office in the beautiful, music-filled, comfortable setting of Academia.
Müllerian anomalies (malformations)
Müllerian anomalies are malformations in a woman’s reproductive tract, including the uterus, cervix, and vagina . Such malformations can cause menstrual disorders, pain during menstruation and/or sexual intimacy, infertility, and complications during pregnancy. Academia is headquarters of The MRKH and Müllerian Anomalies International Center and is uniquely qualified to treat all forms of gynecologic malformations. For more information go to MRKHMA.com.
Vaginal bleeding & heavy menstruation
At Academia, we explore both the causes of excessive bleeding, and the serious health problem that such bleeding can cause: anemia. Anemia can result in lightheadedness, fatigue, and an increased risk of heart problems. We work with the patient to manage anemia. Vaginal bleeding can be caused by a variety of gynecologic and non-gynecologic conditions: changes in medication, fibroids, hormonal imbalance, and/or changes in the lining of the uterus that, after some time, can lead to the development of uterine cancer. We use a variety of methods to diagnose and treat vaginal bleeding, including ultrasound and various minimally invasive techniques.
MRKH (vaginal agenesis, absence of the vagina and the uterus)
Approximately one in every five thousand women is born without a vagina and the uterus. This is called MRKH Syndrome, named after the physicians who first wrote about the condition (Mayer, Rokitansky, Küster, and Hauser). As the headquarters of The MRKH and Müllerian Anomalies International Center, Academia specializes in the treatment of MRKH Syndrome using techniques that are directly learned from their author and that only a handful of American surgeons have been able to practice. These techniques result in the immediate formation of a “neovagina” making complete sexual intimacy possible. For more information go to MRKHMA.com.
Ovarian and tubal problems
Pelvic floor disorders
Endometrial pathology (hyperplasia and endometrial polyps)
An increased rate in the production of cells in the lining of the uterus (the endometrium) can result in uterine hyperplasia or endometrial polyps. Endometrial polyps are small, protruding growths, while hyperplasia is the actual enlargement of the uterus itself. The most frequent symptom of either is vaginal bleeding (see above). Either condition can be a precursor to cancer if untreated. At Academia, we have a variety of treatment options at our disposal. Endometrial polyps can be comfortably removed in our office. Hyperplasia is treated medically or surgically depending on the patient’s reproductive goals and general medical condition. Should more extensive therapy be needed, minimally invasive outpatient approaches may be applied.
InTone, from InControl Medical, is a combination therapy device designed to treat urinary incontinence in females who have been diagnosed with stress, urge, or mixed incontinence. This device is used in the comfort and privacy of your own home.
“I have studied both the physiological standpoint of InTone and also the results from using this device, and I am very excited to offer it to my patients. Based on my evaluation, I consider this method to potentially be of great benefit to you.”
– Assia Stepanian, M.D.
Services by Condition
The following table outlines the services offered by Academia of Women Health & Endoscopic Surgery. Selection of each of these services in patient’s management is highly individualized and applied as needed.
|CONDITION||Holistic*||Physical Therapy||Hormonal||Pharmacology||In-office surgery||Outpatient hospital surgery||Postoperative Recovery physical and emotional as needed||Intimacy and Sexuality||Addressing psychologic challanges||Addressing marital problems as needed|
|Ovarian and tubal Problems||x||x||x||x||x||x||x||x||x|
|Pelvic Floor Problems||x||x||x||x||x||x||x||x||x||x|
|Other hormonal concerns||x||x||x||x||x|