In addition to providing abortions and pregnancy testing, CHOICES Women’s Medical Center provides comprehensive gynecological services for patients of all ages, from adolescence to post-menopause.
At the GYN clinic, providers understand the intimate and special nature of the relationship between the gynecological provider and patient, and foster that relationship by providing the highest quality of medical care in a truly patient-centered manner.
Gynecological health is central to the overall well-being of a patient, and it is Choices' priority to make sure that each and every patient is empowered to attain the gynecological health care they need and deserve. Through the Gynecology department, patients have access to a full range of birth control options, and counseling to help choose the best contraceptive method for their individual needs. In addition to routine annual and semi-annual exams, patients can receive walk-in pregnancy testing, HIV testing and counseling, STD testing and treatment, and more.
Yearly GYN exams include a Pap test, pelvic exam and breast exam, in addition to addressing any concerns or questions you may have at the time. If your gynecological history indicates, our providers will encourage you to return for an exam more frequently (every 6 months).
We are happy to offer Gardasil, the only FDA-approved vaccine to prevent cervical cancer and genital warts. This vaccine is available to women between the ages of 9 and 26 and can be given regardless of prior infection with Human Papilloma Virus. There is some controversy about this new treatment, but we feel that scientific evidence to date indicates its value. As with any new treatment, research is being continued, and as new scientific evidence becomes available we will provide our patients with that information so that they may make informed choices about their health.
Our staff understands that as women reach midlife, they deal with special physical and emotional issues. Our program for midlife women helps patients deal with perimenopause and menopause through counseling, testing, and treatment.
Under New York State Law, adolescents do not need parental consent to seek reproductive and sexual health information and services. While we encourage adolescents to include their parents or a trusted adult in decisions regarding sexual and reproductive health, your privacy will be strictly protected. You do not need an insurance card to seek care. We offer free pregnancy testing to those with a student ID. Choices provides individualized counseling on birth control, pregnancy, rape and sexual violence.
Patients may pay in cash so that no bills are sent to their homes, and confidentiality is protected.
If you have missed a period, you can come in for a urine pregnancy test and speak with one of our gynecological providers. This service is free for adolescents 18 years old and younger with ID.
If you have missed a period, you can come in for a urine pregnancy test and speak with one of our gynecological providers. This service is free for adolescents 18 years old and younger with ID.
Whether as part of your yearly well-woman GYN exam, or because you may have found an abnormality in your breast, our providers will perform a thorough breast exam. Upon any findings, you will be managed appropriately with (as needed) mammography or sonography exams and follow-up.
At CHOICES, we use the latest Thin Prep technology for your Pap test; our affiliate lab also tests for the Human Papilloma Virus in order for your care to be better managed.
What is a Pap test?
A Pap test is a screening test that checks for changes in the cells of your cervix. It provides information, such as if you have an infection or abnormal, unhealthy cells. Abnormal cervical cells may be an early sign of cervical cancer; routine Pap tests can find these abnormal cells so that, if necessary, you can be treated before cervical cancer develops.
Contraception, or birth control, is a very personal issue. Choosing to use a form of birth control, as well as the type of method utilized, is one of the more important decisions of your life. No one method is right for everyone, so it is important to know about the different methods and understand your own needs and preferences.
A colposcopy is very similar to a microscope. It allows for the examination of the external genital area (vulva), vagina and cervix with magnification in order to check for cellular changes, dysplasia and condyloma (genital warts). Colposcopy can help in the early detection of conditions before they become serious. For example, the colposcope can help with the condyloma (genital wart) virus. If left untreated, cells infected with the condyloma (genital wart) virus can progress to pre-cancerous dysplasia. The colposcope is a useful diagnostic tool.
In order to perform a colposcopy, you will be placed in a similar position as for a routine gynecological office exam. A speculum will be inserted. White vinegar will be applied to the cervix (this may sting slightly). This allows for better visualization of abnormal areas on the cervix. The colposcope will be brought to the level of the vagina. The colposcope itself does not touch you. The entire cervical area will be visible to the person performing the colposcopy. An area of particular interest is where the squamous tissue (covers the vagina and the outside of the cervix) and the columnar tissue (covers the inside of the cervix) joins. It is this area where disease most often occurs.
Often, a biopsy may be needed to obtain a more exact diagnosis. Tiny bits of the cervix will be snipped (slight pinching and some cramping may be left) and sent to a laboratory to be examined.
Intercourse, spermicidal jelly, and vagina medications can all interfere with the accuracy of the colposcopy exam. Thus, they should be avoided 24 hours prior to the colposcopy. In addition, colposcopy cannot be performed if you are having your menstrual cycle.
Post-Colposcopy Instructions
LEEP is a procedure developed to treat diseases of the cervix. Experience has shown that localized removal of early lesions of the cervix prevents their becoming cancerous.
LEEP works through the wonders of modern technology. A very thin wire is formed into a loop. Precise amounts of low voltage, high frequency electrical current are then passed through this wire, allowing it to gently slice through the cervical tissue while at the same time closing off small blood vessels. This allows precise specimens to be obtained with minimal bleeding.
Before the LEEP procedure is started, the physician will examine your cervix with a colposcope to determine the areas that need to be removed. A small pad will be placed on you to act as an electrical ground. The doctor will hold your cervix with a small instrument and than excise the tissue. As the cervix does not have pain fibers, this process is relatively painless.
As the physician removes the tissue, the LEEP instrument will coagulate (stop) bleeding from most small vessels. Occasionally, the physician will need to place a suture (stitch) on certain bleeding areas, or place some tampons or gauze into the vagina. In rare circumstances the bleeding will be difficult to control which may result in blood transfusions and/or overnight stay in the hospital.
Local anesthesia is usually sufficient for the procedure. Although not required, some patients prefer general anesthesia due to the time needed to set-up and perform the procedure (15 minutes) and their general discomfort. If you desire to have anesthesia, you cannot eat of drink anything for 8 hours prior to the procedure.
After the procedure, you must return to the office for a follow-up examination in three weeks.
Post-LEEP Instructions:
Cryotherapy, another method of treatment, uses compressed nitrous oxide to freeze the abnormal tissue.
In order to perform cryotherapy, you will be placed in the position as for a normal gynecological exam. A speculum will be placed inside the vagina, the physician will visualize the cervix with the colposcope and then the physician will freeze the abnormal tissue via compressed nitrous oxide.
The procedure itself takes a few minutes and side effects are minimal. The abnormal tissue will slough off and a follow up visit will be scheduled in four weeks.
Post-Cryotherapy Instructions:
Urinalysis is the process of examining the urine microscopically for the presence of body secretions that can aid Choices medical staff in diagnosing various conditions. For example, when a pregnancy test is done, the urine is checked for the presence or absence of the human chorionic gonaditropin hormone. There may be white blood cells, red blood cells and bacteria in the urine that indicate an infection. Various other diagnoses can be gained as well, by examining the urine.
Blood analysis is one of the cornerstones to diagnose various conditions, illnesses, well-being and the effectiveness of various treatments. Blood may be drawn at Choices for a variety of reasons and, with your permission, to determine a number of conditions. As with any medical procedure, you should always ask your doctor why s/he is taking blood and what s/he hopes to discover.
A sonogram is a safe, non-invasive x-ray taken using soundwaves instead of radiation. It can determine a pregnancy as early as 4.5 weeks and can give fetal age and general health of the fetus. Sonography is also used at CHOICES to diagnose problems of the uterus and ovaries, including ovarian cysts, ectopic pregnancy, fibroids, thickening of the endometrium and masses that may require further evaluation
CHOICES women's health providers encourage all women over age 40 to receive a yearly mammogram. In addition to a Clinical Breast Exam (CBE) and Self-Breast Exams (SBE), annual mammograms have proven to be an integral part of a breast cancer screening services. CHOICES providers will work with you to refer you to a radiological site of your preference and ensure you receive all necessary follow-up care services.
In response to community needs, Choices now offers a confidential HIV Counseling and Testing Program for both women and men. All Choices counselors have been New York State trained.
The program encompasses two visits. In the first visit, there will be pre-test counseling, followed by the lab test. Post-test counseling, along with the test results, will comprise the second visit.
Facts About HIV
HIV is not transmitted from one person to another through any form of casual, non-initimate contact. HIV is transmitted through direct blood-to-blood or semen-to-blood exchange. Direct contact with other body fluids containing blood of an infected person also may increase the risk of HIV infection
Some Questions and Answers about HIV and AIDS:
Who is at risk for HIV infection?
Most cases of AIDS are linked with unprotected sexual activity and intravenous (IV) drug use.
How do women get HIV infection?
Women become infected by engaging in unprotected sexual intercourse or by sharing IV drug needles and works. More than 50% of women with HIV infection and AIDS have used drugs.
Can a person with no symptoms transmit HIV?
Yes. Initially, most HIV infected people have no symptoms and are not even aware they are infected. Any infected person may transmit the virus to another person through sexual contact or sharing drug injection equipment.
Choices accepts HIV positive patients for all services. There are no special procedures or requirements for HIV positive patients.
CHOICES knowledgeable staff has over 30 years training in recognizing and treating sexually transmitted diseases (STDs). If you think you have been exposed to an STD or are experiencing the symptoms of an STD, call (718) 729-2273 to make an appointment for testing, treatment, and counseling on how to make responsible decisions regarding your sexual health.
CHOICES also offers compassionate, informed and up-to-date HIV/AIDS testing and treatment.
If you feel that you may have been exposed to HIV/AIDS or an STD, it is important to remember that you can still transmit HIV/AIDS or STDs to others via sexual intercourse and needle sharing even if you are not currently experiencing any symptoms.
Most methods of birth control DO NOT PROVIDE PROTECTION against HIV/AIDS or sexually transmitted diseases. Only properly used LATEX condoms and barriers provide protection against HIV/AIDS and STDs.
Some common sexually transmitted diseases:
Gonorrhea
Possible signs: about 12-10 days after infection, you may notice discharge from the penis, vagina or rectum; painful or difficult urination; in women, abdominal pain, bleeding between periods.
Possible results: damage to joints, heart, brain; in women, pelvic inflammatory disease (PID) causing problems with pregnancy; infertility.
Treatments: Cured with antibiotics, but damage can be permanent.
Syphilis
Possible signs: About 2-6 weeks after infection, painless sore(s) on or near genitals, anus, or mouth; goes away. About 3-6 weeks after sore appears, you may experience a rash on hands, feet or other body parts; may come and go over 1-2 years.
Possible results: damage to heart, blindness, insanity, death.
Treatments: Cured with antibiotics, but damage may be permanent.
Genital Herpes
Possible signs: About 2-10 days after infection, you may experience itching, burning, pain in legs, buttocks or genital area, vaginal discharge, pressure in abdomen, small red bumps that crust over and heal in days.
Possible results: Signs can reoccur throughout life, possibley set off by sun or stress.
Treatments: NO CURE. Medication can help symptoms; sores should be kept clean and dry and NOT be touched. Wash hands if touched.
Chlamydia
Possible signs: About 1-3- weeks after infection, you may experience discharge from penis or vagina, burning urination.
Possible results: In women, PID and infertility.
Treatments: Cured with antibiotics.
Hepatitis B
Possible signs: About 4 weeks or more after infection, you may experience fatigue, diarrhea, dark, foamy urine, pale feces, abdominal pain, yellowing of skin and whites of eyes, pain in joints.
Possible results: Lifelong infection, possibly fatal liver problems, including cancer; immune system problems.
Treatments: Most people recover, but some become carriers for life. No cure, but medication, diet rest and avoiding alcohol help.
Genital Warts
Possible signs: About 3 months or more after infection, you may notice small, hard, painless bumps inside or around vagina, penis, or anus, or in the mouth. Bumps can develop tops like cauliflower.
Possible results: during pregnancy, can make delivery difficult; some kinds of HPV, the virus that causes genital warts, have been linked to genital cancers.
Treatments: Surface medications, freezing or laser surgery can remove warts. There is no cure for the virus, and the warts may come back.
Trichomoniasis
Possible signs: About 1-2 weeks (or more) after infection, you may experience discharge from the vagina; itching swelling or redness in vagina; pain during sex; burning urination. Men rarely have symptoms but can infect others.
Possible results: problems during pregnancy, including premature breaking of waters and premature delivery; passing of infection to newborn during birth.
Treatments: cured with antibiotics.
D&C is a procedure in which the cervix is dilated (gradually widened), after which a special instrument called a curret is inserted into the uterus and used to gently scrape and remove the contents. This procedure is used at CHOICES for some first-trimester abortions, incomplete spontaneous abortions, and benign thickening of the edometrium.
The Bartholin Gland is the gland at the opening to the vagina that secretes lubricating fluids. This gland sometimes can become blocked by inflammation from infection and develop an abcess. This abcess can then swell and become quite painful. In most cases, however, Choices medical staff can easily treat and cure this condition.
Essure is the new non-incisional (no cutting) method of permanent sterilization approved by the FDA in 2002. This is an irreversible method of birth control. Unlike traditional tubal ligation which requires cutting into the abdomen Essure micro-inserts are placed through the bodies natural openings and does not require general anesthesia.
How does Essure work?
Your doctor will use a camera called a Hysteroscope placed in your uterus to place hormone free micro-inserts into each fallopian tube. Then over a three month period your body will naturally fill in the tissue around the inserts causing your tubes to be permanently blocked. You will need to have a special x-ray called HSG to verify that the tubes are blocked and you can no longer get pregnant.
How does Essure differ from traditional tubal ligation?
Traditional tubal ligation requires general anesthesia and must be performed in an operating room. The woman’s stomach is then expanded using special gas and 3 small incisions are made through which using special instruments the doctor can identify the fallopian tubes and either cut, clip or burn them. Essure is minimally invasive meaning it does not require any cuts be made in the body and can even be done with a local and sedation right in the doctor’s office. Because of the ease of insertion, no incisions and no general anesthesia most women are able to go home within 45 minutes and are able to return to normal activities within 1-2 days. Unlike with the traditional tubal they have had major surgery and may require 1-2 weeks to be able to return to work or school.
How much will Essure cost?
Essure is now being covered by most insurance plans. One of our insurance specialists will be able to assist you in determining what if any costs there will be.
What do I have to do to get Essure?
Well first you will need to come in for a standard PAP and STD screening at which time you can discuss with your provider the desire for permanent sterilization and if Essure is an appropriate and viable option for you. There is a 30 day waiting period even after the decision is made. Most importantly you must be absolutely sure that you do not want to have any more children.
FAMILY PLANNING BENEFIT PROGRAM now available at CHOICES:
For residents of the Five-Boroughs:
All FDA approved birth control methods, devices and supplies; Male and Female sterilization procedures... AND MORE.
ESSURE now available at CHOICES:
non-surgical, permanent birth control
CHOICES Women's Medical Center is a progressive and comprehensive healthcare facility. Our healthcare team assures that every patient receives the highest quality medical treatment in a positive, supportive and educational environment. CHOICES is committed to the concept of knowledgeable choice, and offers complete patient-centered medical care for any of your healthcare needs.
