HCA Midwest Health - February 23, 2018

If you’re like most women, you think of your ObGyn as the go-to person for pregnancies and Pap smears. But there is a whole array of gynecological issues your ObGyn can help you with throughout your life.

A gynecologist specializes in the health of women’s reproductive system, including the uterus, cervix, ovaries and vulva. Obstetricians/gynecologists (ObGyns) also care for women during their pregnancy and just after the baby is born. But some GYNs focus only on gynecology or specialize in certain areas, such as gynecologic oncology (cancer) or urogynecology (bladder and pelvic floor health)

Following are just a few of the conditions a gynecologist may be involved in treating throughout a woman’s life.

Pelvic Pain

Pelvic pain is basically any pain that is mostly or only in the area below your belly button. It can be constant or come and go. Pelvic pain is considered chronic if it lasts for more than 6 months, and affects a woman’s quality of life. About 15 percent of women in the United States are believed to have chronic pelvic pain.

Sometimes the cause of pelvic pain is obvious, such as when you are recovering from a hysterectomy or other surgery. But many times the cause can be more challenging to pin down and can even have multiple causes. Gynecological conditions that can cause pelvic pain include:

  • Adhesions — scar tissue that can develop after a surgery or infection such as pelvic inflammatory disease (PID).
  • Uterine fibroids — noncancerous tumors that form within the walls of the uterus.
  • Ovarian cysts or masses — fluid-filled pockets that form in or on an ovary. Small cysts are normal and often go unnoticed. But if they become too large and fail to drain on their own, can cause severe pelvic pain.
  • Endometriosis — when tissue that is supposed to only grow inside the uterus grows in other body areas and the body reacts to it.
  • Interstitial cystitis (an inflammation of the bladder) — a condition marked by the need to urinate often and urgently as well as general pelvic pain.
  • Pelvic floor disorders — when the muscle and connective tissue that holds the pelvic organs in place become weakened, injured or overly sensitive.
  • Severe menstrual cramps — called dysmenorrhea, painful menstrual cramps can occur on their own or combined with another issues (e.g., endometriosis).

Urinary Incontinence (Leakage)

Urinary incontinence is the loss of bladder control that can result in leakage. It is NOT, as many people think, a normal part of aging. Your gynecologist can help you determine the type of urinary incontinence you have, its cause and potential treatment options ranging from lifestyle changes to medication, to surgery.

There are two main types of urinary incontinence:

  • Stress incontinence — Leaks occur when there is pressure on your bladder, such as coughing, sneezing, laughing or exercising.
  • Urge incontinence — There’s a sudden, intense urge to urinate followed by an unintentional loss of urine. This often comes with the need to urinate frequently.

It’s also common to have mixed incontinence, which is a combination of incontinence types.

Cervical Cancer

Your ObGyn plays a huge role in the prevention and early detection of cervical cancer. Your ObGyn educates you on the factors that can increase your risk, such as exposure to human papillomavirus (HPV). Your ObGyn also performs regular screenings, including a Pap smear to detect cancer cells (or pre-cancerous cells) early.

Gynecologists are involved in the treatment of cervical cancer. At the Sarah Cannon Cancer Institute, at HCA Midwest Health a multidisciplinary team of experts in gynecological cancers oversees patients throughout their treatment and recovery. They work with the patient’s other physicians to provide exceptional, coordinated care.

Treatment may involve a combination of chemotherapy, radiation therapy and/or surgery—ranging from LEEP (loop electrosurgical excision procedure to remove abnormal cells from the cervix) to hysterectomy (complete removal of the uterus and cervix).


Endometriosis affects more than 5 million women in the United States. Any teen or woman who has a menstrual period can get endometriosis. The endometrium is the inside of the uterus. Endometriosis is when endometrial tissue grows in other body areas (mostly in the pelvis). Even though the endometrial tissue isn’t inside the uterus, it behaves like it is and, once a month or so, breaks down and bleeds with the menstrual cycle. With nowhere to go, endometrial cysts may form and surrounding tissue may be irritated. The pain women feel when menstruation may occur, can be felt everywhere endometrial tissue is present.

The cause of endometriosis is unknown and it requires a minor surgical procedure to definitively diagnose. But your ObGyn can recommend a variety of treatment options and work to help you find the best one for you. Your treatment options will be different depending on whether you wish to become pregnant now or in the future.

Abnormal Periods (Painful or Heavy Periods)

Menstruation is, of course, a normal body process that involves bleeding and possibly some cramping or pain. But, for some women, abdominal cramps and pain are so severe, it interrupts their ability to function (dysmenorrhea). Sometimes pain isn’t the issue at all, but blood loss from heavy periods causes anemia and fatigue. And some people can have all (or none) of these issues.

“Abnormal periods” is a general term that can refer to any number of problems with a woman’s cycle. Here are some examples:

  • Menstrual flow that is either much heavier or much lighter than usual
  • Periods lasting longer than seven days
  • Bleeding between periods or after menopause
  • Bleeding after sex
  • Missing three or more periods in a row (amenorrhea) without a normal cause like pregnancy, breastfeeding and menopause
  • Infrequent periods (oligomenorrhea)
  • A combination of heavy, long lasting periods and spotting (abnormal uterine bleeding)

Ovarian Cysts

During ovulation, an egg is released from a group of cells in the ovary called a follicle. An ovarian cyst occurs when the follicle doesn’t break open to release the egg. Instead, the fluid remains and forms a cyst. Ovarian cysts are relatively common, especially during a woman’s childbearing years. They are rare after menopause.

Functional cysts are related to the normal function of your menstrual cycle and are fluid-filled. Functional cysts often resolve on their own in a few months. If they don’t, they can be removed through minimally-invasive surgery. Sometimes the cyst can become so heavy it causes the ovary to twist (torsion), which is extremely painful and can severely damage the ovary. An ovarian torsion needs to be surgically corrected to preserve ovary function.

Non-functional cysts can be caused by endometriosis or other conditions and may require treatment to preserve normal function and fertility.

Pelvic Floor Rehabilitation & Repair

The pelvic floor is made of muscle and connective tissue that supports and holds the pelvic organs in place—the vagina, cervix, uterus, urethra, bladder, rectum and small intestines. The muscles and connective tissue can become weakened, torn or stretched as women age or after pregnancy.

Pelvic organ prolapse is when the muscles and connective tissue can’t support the organs, causing them to drop downward. This can lead to a variety of symptoms from back pain to urine leakage, and can affect one organ or several organs.

Symptoms can range from minor to debilitating. Kegel exercises and weight loss can help. As can treatments specific to your symptoms (e.g., bladder training, increasing fiber). Surgery is also an option.

HCA Midwest Health hospitals offer the most advanced and specialized pelvic floor programs in the Kansas City region—at Overland Park Regional Medical Center and Lee's Summit Medical Center, including minimally invasive procedures. In fact, Overland Park is a Center of Excellence in Minimally Invasive Gynecology (COEMIG). Our team of physicians, nurses and highly-trained support staff is here to help.

Robotic Surgery Options

Robotic surgery (also called robotic-assisted surgery) allows the surgeon to see and access areas of the body with much more precision. The surgeon controls robotic arms and procedures can be done with smaller incisions, less pain, less blood loss and faster recovery. This often leads to a much shorter hospital stay and a faster return to your life and activities.

HCA Midwest Health hospitals offer robotic-assisted surgery for the following gynecological conditions and procedures:

  • Hysterectomies
  • Fibroid removal
  • Ovarian cyst removal
  • Endometriosis removal
  • Severe menstrual cramps

If you are looking for a new gynecologist or a second opinion on a gynecological issue, we can help.

Find a Gynecologist in Kansas City  

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