Premenstrual Syndrome (PMS)
Premenstrual syndrome also is a very common problem. It is generally characterized by mood swings/irritability around the time preceding the menstrual cycle. Other symptoms are bloating/breast tenderness/abdominal discomfort in general just not feeling well around the time of the cycle. Most of these symptoms are normal signs that your period is coming but occasionally they can become debilitating which is when evaluation and treatment become necessary.
This is a VERY common problem that has many different causes. We will take a detailed history about your bleeding and based on your age and history will decide what testing you need. Generally you will have an ultrasound, blood count and thyroid check or other testing if necessary. Based on those findings we will discuss a treatment plan with you in detail. Generally we can treat this problem medically with hormones/birth control or with a minimally invasive surgery occasionally it will require major surgery.
This is a condition that we deal with frequently. It is usually marked by pelvic pain that may or may not get worse around the time of the cycle. It is caused by endometrial tissue (the tissue that causes you to bleed when you are on your cycle) that has migrated out of the uterus usually into the abdominal cavity. It is generally a diagnosis that is made just upon your history however if you have had greater than 6 months of pain that is unrelenting with medical treatment it may mean that you need a laparoscopy to confirm the diagnosis or treatment with a laser. There is also a medication called Lupron that had been used with good success to treat this condition.
Polycystic Ovarian Syndrome (PCOS)
Polycystic Ovarian Syndrome is a disorder where the ovaries do not produce an egg each month. Ovulation is what drives the menstrual cycle so when an egg is not produced it throws off the entire cycle making menses irregular. Other symptoms of this can be acne, obesity, abnormal hair growth (usually male pattern such as facial hair) and infertility. Treatment for this disorder generally depends on desire for fertility, if you are attempting pregnancy you will take a fertility medication, if not you will take progesterone or birth control pills. If you have PCOS it is vitally important that you have regular periods unless you are taking medications to suppress your periods.
Menopause Evaluation and Treatment
Menopause can be a very difficult time for women. There are many changes in hormone levels and changes in your body. This is a time of life when it is good to have a provider with whom you are comfortable discussing these changes and coming up with a treatment plan that is right for you and your body. Hormone replacement therapy is not right for everyone, but will definitely benefit some. We treat each patient on a case-by-case basis and make a decision with you based on your symptoms, medical issues and family history. We will also evaluate and treat you for osteoporosis/osteopenia (low bone mass).
We offer full service gynecology, and can take care of most gynecologic issues. We offer the latest office procedures for contraception, as well as abnormal bleeding. Dr. Strebel & Dr. Grolle also perform surgery at the affiliated hospitals ranging from minimally invasive surgery to complete hysterectomy.
- Annual Examinations
- Birth Control
- Oral Contraceptives
- Transdermal Contraceptives
- Intramuscular Contraception
- Intrauterine Contraception
- Permanent Contraception
- Abnormal Bleeding
- Polycystic Ovarian Syndrome
Pregnancy and Obstetrics
We provide care for normal and high-risk pregnancies. We feel strongly that you and your family be an integral part of the decision making process during your pregnancy, labor and the birth of your child. We will always provide you with the necessary information and help guide you through all the important decisions to insure you have a healthy and happy pregnancy. Our main goal is to help you have a healthy baby while also providing a good experience. We have onsite ultrasound services. You will generally get 4 ultrasounds during your pregnancy. Within one week of your first visit we will do a confirmation ultrasound where we make sure that your baby has a heart beat and confirm your due date. The second ultrasound is a screening for Down’s syndrome called the Nuchal Skin Fold/Nuchal Translucency or First Trimester Screen (this time sensitive). The third ultrasound (the one you have been waiting for) is the anatomy scan where we look at all the baby’s organs and measurements to make sure everything appears normal (including the sex). The fourth ultrasound is done around 36 weeks just to check the baby’s growth and position. Occasionally other ultrasounds will be indicated but this would be determined by necessity.
- Prenatal care
- Ultrasound (4D and 3D)
- High risk pregnancies
- Blood Clotting Disorders
Luckily, modern medicine has made surgery less necessary than it was fifty years ago. We can handle many problems that required surgery in the past with medicines or less invasive procedures. When surgery becomes the best option, Dr. Strebel & Dr. Grolle are well trained in the most complicated of surgeries as well as the latest minimally invasive techniques.
Laparoscopy is a technique used to treat many gynecologic problems. It is a non-evasive surgery that is done through tiny abdominal incisions. The largest is about a half-inch long and is inside the navel. Through this incision we place a long tube with a camera and light called a 'laparacope,' to perform the surgery. Using this technique we can do things such as remove ovarian cysts, laser endometriosis, diagnose many causes of pelvic pain, and remove scar tissue.
Hysteroscopy is another modern technique that involves no incisions and can treat many problems that traditionally required a large incision. The hysteroscope is similar to the laparoscope but is inserted into the cervix which is the opening of the uterus that dilates when you're having a baby. Using this technique, we can remove polyps, fibroids, and other abnormalities inside the uterus. These are just a small sample of the surgical procedures we provide our patients. Please feel free to call the office if there is a procedure you have specific questions.
Urinary incontinence is the involuntary leakage of urine that affects over 15 million American, most of whom are women. This embarrassing condition can seriously affect all aspects of life- social, work, and sex life.
Urinary incontinence (UI) can have a huge effect on all aspects of your life – on your social life, your working life, your sex life and your mental wellbeing. Despite its impact, many women don’t raise the issue with their provider. It’s estimated that women leave it for as long as five years before consulting their healthcare provider about the problem. Learn about your options today, you no longer need to live with this condition
Using the latest state-of-art 4D and 3D imaging equipment, we are able to take images and video during your visit. 4D ultrasound takes 3 dimensional imaging and adds the element of time. The advantages of this technology allow our doctors to better view and analyze the development of your fetus. They are able to visualize internal anatomy moving in real-time. The end result is video of your baby.
Da Vinci Surgery
When medication and non-invasive procedures are unable to relieve symptoms, surgery remains the accepted and most effective treatment for a range of gynecologic conditions. These include, but are not limited to, cervical and uterine cancer, uterine fibroids, endometriosis, uterine prolapse and menorrhagia or excessive bleeding.
Traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, has for many years been the standard approach to many gynecologic procedures. Yet with open surgery can come significant pain, trauma, a long recovery process and threat to surrounding organs and nerves. For women facing gynecologic surgery, the period of pain, discomfort and extended time away from normal daily activities that usually follows traditional surgery can understandably cause significant anxiety.
Fortunately, less invasive options are available. Some gynecologic procedures enable surgeons to access the target anatomy using a vaginal approach, which may not require an external incision. But for complex hysterectomies and other gynecologic procedures, robot-assisted surgery with the da Vinci® Surgical System may be the most effective, least invasive treatment option. Through tiny, 1-2 cm incisions, surgeons using the da Vinci System* can operate with greater precision and control, minimizing the pain and risk associated with large incisions while increasing the likelihood of a fast recovery and excellent clinical outcomes.