FW Center for Pelvic Medicine

Dr. Alan Johns has been in the practice of Gynecology since 1978. He has performed over 8,000 laparoscopic surgical procedures.

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  • About Us
    • Alan Johns, MD
    • Christopher Ripperda, MD
    • Crystal Holden, FNP
    • Elizabeth Weaver, WHNP
    • Meet the Staff
  • Services
    • Infertility
    • Endometriosis
    • Gynecologic Ultrasound
    • Ultrasound
    • Pelvic Floor Therapy
    • Pessary Insertion and Management
    • Endometrial Ablation
    • Gynecologic Surgery
    • Laparoscopic Surgery
    • Clinical Research
    • Pelvic Pain
    • Menopausal Medicine
      • Menopausal Hormone Therapy
      • MonaLisa Touch
    • Women’s Health Awareness and Prevention
  • Conditions
    • Adhesions
    • Bladder Disorders
    • Breast Cancer
    • Congenital Anomalies
    • Endometriosis
    • Fibroids
    • Hysterectomy
    • Infertility
    • Incontinence & Prolapse
    • Interstitial Cystitis
    • Leaky Bladder
    • Menopause
    • Osteoporosis
    • Ovarian Cysts
    • Pelvic Pain
    • Urinary and Fecal Incontinence
    • Vulvodynia
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Why Not All Women’s Clinics in Fort Worth are Created Equal

When looking for women’s clinics in Fort Worth, it is important to remember that some medical facilities offer higher quality services. Females have special health care requirements that are different from what males need. A woman needs specialized medical care throughout her lifetime for a variety of issues. In some cases, females may need medical attention for sensitive issues that include treatment for sexually transmitted diseases or for life-threatening cancerous conditions. A good women’s clinic will have medical experts who have extensive training in female medical problems. When a woman visits our women’s clinic, it is possible to receive these types of services:

  • Breast cancer physical examinations and mammograms 
  • Pap tests to find cervical cancer cells
  • Prenatal care during pregnancy
  • Urine and blood tests for STDs 
  • Menstrual problems 
  • Pelvic examinations to find tumors or other abnormalities 
  • Birth control information and prescriptions for supplies
  • Fertility issues that make it difficult to get pregnant
  • Pregnancy urine tests
  • Treatment for kidney and bladder infections
  • Medical and psychological counseling after a rape occurs

What Types of Services are Offered? 

When you schedule an appointment with our medical clinic for women, make sure to inform our receptionist about your reason for a visit. You should bring along your insurance card from an employer or your private insurance company so that we can collect the medical fees. You may need to make a co-payment before or after your appointment, so make sure to bring along your debit card, checkbook or credit card. Depending on the type of medical service that you need, you might talk to a registered nurse, general physician or a gynecologist. If you are pregnant, then you should arrange an appointment with an obstetrician to plan your child’s delivery. During your visit, you may need a physical examination that requires disrobing before you put on a hospital gown and recline on a special examination table. For some examinations, you are directed to place your feet in metal stirrups so that a physician can collect samples for the Pap smear. You may also need to provide a urine sample for testing for a variety of health issues that include pregnancy, infections from bacteria or STDs. For a breast examination, the physician will check your breasts manually to find lumps or other issues. When you need a mammogram, each breast is placed between special devices to collect an image of the body part to find abnormalities. 

Help with a Variety of Health Issues

Our women’s clinics in Fort Worth are also concerned about medical issues that occur in both genders, including:

  • Diabetes mellitus 
  • Obesity 
  • Drug addiction
  • High blood pressure
  • Vision abnormalities 
  • Arthritis 
  • Dementia conditions
  • Hearing abnormalities 
  • Nutritional deficiencies 
  • Cancer
  • Heart disease
  • Thyroid disorders
  • Anemia 
  • Mood disorders

Contact Us Today to Find Out More

The medical experts at women’s clinics can help you with a variety of health problems to improve the quality of your life. To learn more, we warmly invite you to reach out and make an appointment with our team at Fort Worth Center for Pelvic Medicine. At our convenient locations in Fort Worth, our caring and knowledgeable staff will be happy to answer any questions you may have. Contact us today to set up your consultation!

Filed Under: Blog Tagged With: Fort Worth, Women's Clinics

Treat Your Menopausal Symptoms with Bioidentical Hormone Therapy

You’ve always been in good health. You’ve been able to maintain an attractive figure, you feel good, and you look good. You know you can’t defy time, but you feel like you have held your own as the years fly by. Everything changed after you reached the magical age of 40. Ever since then, you have been noticing unsettling changes. Your weight is on the rise even though you have not changed any of your habits. Night sweats and hot flashes are driving you crazy. You have no energy. You are so tired that you could sleep all day. Worse yet, you never feel rested even when you do sleep well. You’re also experiencing vaginal changes that are causing discomfort. They have affected your relationship with your partner. It’s hard to find any interest in the bedroom when it can be painful. You’ve got to do something, and bioidentical hormone therapy could be the answer.

Dealing with Menopausal Symptoms Effectively

Whether you realize it or not, your body is preparing for menopause. Eventually, your reproductive system is going to shut down completely. As it prepares for this natural phase of life, your reproductive hormones are going to drop. For some women, these changes are so gradual that they don’t even notice anything different about their bodies. For others, the symptoms of menopause are extreme. As your hormone levels drop, your body is no longer in balance. The end result is troubling symptoms that can make you feel like your body is out of control. You can take the wheel and get in the driver’s seat by choosing bioidentical hormone therapy.

How Does Bioidentical Hormone Therapy Work?

Bioidentical hormone therapy involves using replacement hormones that have the same chemical makeup as your own hormones. Once low hormone levels have been identified, your physician can prescribe bioidentical hormone therapy. Once you have been receiving consistent dose of bioidentical hormones, your symptoms will improve. You may not be able to stop menopause from coming, but you can find a way to improve your quality of life.

Ask Our Doctor about Bioidentical Hormone Therapy Today

Your doctor has the answers when it comes to bioidentical hormone therapy. The first step is to come in for an evaluation. Your doctor will examine you, discuss your concerns, and look at your health history. A blood test will be taken to identify any hormone levels. Your doctor will want to rule out any other conditions that could be causing your issues. If hormones are at the root of the problem, you can have bioidentical hormone therapy prescribed for you. Visit Fort Worth Center for Pelvic Medicine in Fort Worth, TX, or contact us today to schedule your consultation! 

Filed Under: Blog Tagged With: Bioidentical Hormone Therapy, Menopause

Consider Pessary Insertion in Dallas Instead of Pelvic Reconstruction

A pelvic organ prolapse is a medical condition that occurs when one or more of the pelvic organs breaks away from its normal position and starts to push on the vagina. This will only occur after the pelvic muscles and tissues have become extremely weakened. This prevents the muscles and tissues from holding the organs in the right place. The most common symptoms of pelvic organ prolapse are urinary incontinence, stool incontinence, fullness in the vagina and intense pressure in the pelvis. Some may think that pelvic reconstruction is the only way to fix this issue.

While there are several different types of pelvic organ prolapses, they are all generally treated in the same manner. The goal of every woman with pelvic organ prolapse is to get their body back to normal without causing too much disruption to their life, and that is exactly what will happen when you opt for pessary insertion in Dallas. 

What is Pessary Insertion?

A pessary is a small prosthetic device placed inside the vagina in the exact position of the pelvic organ prolapse. The pessary will help strengthen the surrounding pelvic muscles and tissues to keep the problematic organ in its proper position. The great thing about pessaries is that they come in many different sizes and shapes. The doctor will know the perfect one for your needs after a full examination of your vagina. 

What Will Occur During the Procedure?

The first step of the pessary insertion process is an examination of the vagina. The doctor will take several measurements inside the vagina. This will help them find the perfect prosthetic device for your needs. It will also tell them exactly how big it needs to be in order to work properly. The pessary will not eliminate your issues while also potentially causing additional painful symptoms if it is not the correct size. 

Once the perfect prosthetic device is found, the doctor will gently insert it into the vagina. You will be asked to stand up and move around the exam room a little bit to ensure you do not feel any pressure or pain. The doctor will then give you directions on how to remove and insert the pessary device on your own. This is extremely important information because you will need to regularly remove and clean the device at home. You will be allowed to go home after you comfortably grasped the maintenance instructions. 

What Will Occur After the Procedure?

You will be able to immediately return to your normal activities after leaving the treatment center in Dallas. You will have to return for a followup appointment in exactly one week. The doctor will examine the vagina to ensure the pessary is properly fitted. They will also remove the device to check for any signs of discomfort. If everything looks alright, then the doctor will reinsert the prosthetic device after it is cleaned. 

You will be tasked with removing and cleaning the device every week after this followup appointment. An additional followup appointment will be scheduled six months later. The doctor will need to make sure the prosthetic device is not showing any signs of wear and tear. You should be able to wear the same pessary for roughly two years without any complications. While you will generally never know you have a device inserted in the vagina, it should be removed before having sexual intercourse. 

Why Choose Pessary Insertion Over Pelvic Reconstruction?

This treatment option is generally preferred over pelvic reconstruction because it does not require you to undergo a complicated surgical procedure. A pessary can easily be fitted in one short visit to the doctor. Pelvic reconstruction is a lengthy surgery with a long recovery process. Instead of returning home after the initial appointment, you will have to stay in the hospital for several days after undergoing the pelvic floor repair surgery. 

There is also a huge difference in the recovery processes of these two common procedures. Pessary insertion requires absolutely no downtime or unwanted side effects. You will be in considerable pain after getting pelvic surgery in Dallas. Pelvic floor reconstruction requires you to take at least six weeks off of work. You will not be able to perform many normal duties during this recovery time including driving and sexual intercourse. After returning to work, it will take six more weeks to fully recover. 

Get In Touch with Us for More Information

Dealing with pelvic organ prolapse can be extremely embarrassing, but you should not be afraid to get the help you need. You will be amazed at how much your life improves after seeking treatment. To learn more, we welcome you to reach out and make an appointment with Fort Worth Center for Pelvic Medicine. At our convenient location in Fort Worth by Dallas, our caring and devoted team of professionals will be pleased to explain pelvic reconstruction to you in full and answer any questions you may have. Contact us today to set up your consultation!

Filed Under: Blog Tagged With: Dallas, Pelvic Reconstruction

Understanding Vulvodynia

Vulvodynia is classified as chronic vulvar pain with no known cause. There are variations in the location, severity and constancy of the pain for those affected. Some women have pain in numerous areas of the vulva, while others experience pain in just one. The most common symptom reported is burning with different descriptions of the pain. One woman stated the pain felt like a knife, another said it felt like her skin was being burned by acid. The two main types of vulvodynia are generalized and localized and they can co-exist.

Localized vulvodynia is when the pain is concentrated on one vulvar site. When the pain is located in the vestibule or the tissue around the opening of the vagina, it is diagnosed as vestibulodynia. The majority of women with this condition have PVD or Provoked Vestibulodynia. This is when pressure on the vestibule causes pain. This includes:

  • Inserting a tampon
  • Sitting for a prolonged period of time
  • Wearing tight or fitted pants
  • Sexual intercourse

Clitorodynia is a more uncommon form and causes severe pain in the clitoris. The classifications of PVD are primary and secondary. Women diagnosed with primary PVD have had vestibular pain since the first time they experienced vaginal penetration. Women diagnosed with secondary PVD can have sexual intercourse without pain before they develop vulvar pain.

GV or generalized vulvodynia causes spontaneous pain that is usually constant but periods of relief may be experienced. The symptoms usually become worse if pressure is applied to the vulva such as having sexual intercourse or sitting for long periods.

The Treatments for Vulvodynia

The treatments include surgery, therapy and medication. The most effective treatment for all women is combining more than one treatment. The best results occur when this combination is specifically tailored for the symptoms of each woman. Our physician will recommend the right treatment or treatments. Many women attend support groups or go to therapy due to the impact of chronic pain on their emotions.

The medication can be given by injection, topically or orally. This includes:

  • Topical estrogen creams
  • Nerve blocks
  • Local anesthetics including lidocaine
  • Serotonin-norepinephrine reuptake inhibitors
  • Tricyclic antidepressants
  • Anti-inflammatory medications including mast cell inhibitors or steroids
  • Anticonvulsants
  • Spinal infusion pump and neurostimulation

Alternative or complementary medicine may also be recommended by the physician.

It is important to see one of our specialists at the Fort Worth Center for Pelvic Health in Fort Worth for this condition. Our physician can provide a recommendation regarding treatment. If you are suffering from any of the different types of vulvodynia and are interested in finding out more about the available treatments, please contact us today to schedule your consultation!

Filed Under: Blog Tagged With: Vulvodynia

TVUS for Vaginal Health

You have most likely heard of a transdermal ultrasound exam. This is when images of your internal structures are produced by passing an ultrasound transducer over the surface of your skin. In order to see specific issues regarding your vaginal health, a TVUS or transvaginal ultrasound may be necessary. This procedure involves the placement of a transducer into the vagina. This enables a better assessment of certain conditions by providing clearer images.

The TVUS exam is beneficial and often necessary for controlling your overall health. If you are feeling apprehensive about the vaginal health exam, make certain you ask any questions you may have. Once you understand the procedure, you will most likely be much more relaxed. There are a lot of reasons your physician may have recommended this procedure. This may be to determine the cause of infertility, abnormal bleeding, unexplained pain, to identify tumors, fibroids, polyps or cysts, or to check the placement of an IUD.

The vaginal health exam is important during pregnancy to detect the fetal heartbeat earlier and identify and possible complications. Although there are alternatives for this exam, they do not have the same benefits.

The TVUS Procedure

The TVUS exam has similarities to a standard gynecological exam. Unlike a transabdominal ultrasound, the TVUS exam does not require that your bladder be full. The exam generally requires 10 to 15 minutes.

For some TVUS exams referred to as infusion sonograms or sonohysterograms, a small catheter is used to introduce a saline solution into the uterine cavity. This enables a better image of the uterine lining. Ultrasound images are taken prior to and after the introduction of saline solution. This procedure is not used if the woman is pregnant, but to determine the cause of abnormal bleeding, infertility or multiple miscarriages.

It is important to both understand and follow the directions provided by the physician. If the scheduled exam is a sonohysterography, it must take place during a specific point in your menstrual cycle. The standard exam can be given at any time. It is important to remain comfortable and fairly relaxed during the exam. If you become uncomfortable for any reason, make certain you tell your technologist.

You may have already been told by your doctor you should have a TVUS exam, you may have reasons of your own for believing you should have this exam or you may want more information. The learn more about this exam for vaginal health and the benefits it can offer, speak with the professionals at the Fort Worth Center for Pelvic Medicine in Fort Worth, TX. Contact us today to schedule your appointment!

Filed Under: Blog Tagged With: Vaginal Health

What is Laparoscopic Surgery and How Can It Help?

The Definition of Laparoscopic Surgery

Laparoscopic surgery involves a specialized technique used to perform minimally invasive surgery. This technique has been used in the past for gynecologic surgeries. Laparoscopic surgery has been successfully used for intestinal surgery, open surgery, and traditional surgery for a number of years. The surgery begins when a single opening is made by the surgeon to enter the patient’s abdomen.

A tubular instrument is then inserted into the opening. A specialized camera or a laparoscope along with special instruments are used and pass directly inside. This allows the surgeon to see and work inside the patient’s abdomen. Images are transmitted by the laparoscope of the abdominal cavity to video monitors. These high-resolution images are sent directly to the monitors located in the operating room. During laparoscopic surgery, the surgeon is able to watch the monitors displaying highly detailed images of the patient’s abdomen. This type of surgery gives the surgeon the ability to use much smaller openings to perform the same operations used for traditional surgery.

It is important to note there have been several studies conducted recently regarding laparoscopic surgery. These studies revealed this type of surgery is safe for gynecologic cancer. The studies also showed when a comparison was made between laparoscopic and traditional open surgery, laparoscopic surgery offered a shorter recovery period, greater comfort, and less scarring.

Is This Procedure Safe?

Laparoscopic surgery is considered to be just as safe as traditional surgery. In some cases it may be necessary for the surgeon to increase the size of the opening to ensure a clear view and a successful operation. To determine if the individual is a good candidate for this type of surgery, the laparoscope is inserted close to the belly button via a very small opening. This enables the surgeon to determine if the surgery will be safe and effective for the patient.

Get In Touch with Us to Find Our More about Laparoscopic Surgery

If you are interested in laparoscopic surgery, we warmly invite you to get in touch and make an appointment with the Fort Worth Center for Pelvic Medicine! At our convenient location in Ft Worth, TX, our caring and knowledgeable professionals will be ready and eager to explain the particulars of this process, address any questions or concerns you may have, and help you decide if this procedure is right for you. Contact us today to set up your consultation – we look forward to speaking with you!

Filed Under: Blog Tagged With: Laparoscopic Surgery

Treat Vaginal Dryness with Hormone Therapy

You feel like a plane coming in for a bumpy landing. Your final destination is menopause, but it is taking a long time to get there. You’re experiencing all of the typical problems that your friends have warned you about. You can’t stay awake at night anymore because you are so tired. You don’t have enough energy to get yourself moving. However, there is one additional problem and you didn’t see it coming. You are going through serious vaginal dryness.

It’s so bad that you can’t enjoy intimacy. You feel irritation all day long. There are times when pressure builds in your abdomen and it burns when you try to go to the bathroom. You thought it was a urinary infection but testing proved it wasn’t. It all boils down to a shortage in estrogen. Hormone therapy can help you to do something about it.

It may feel like your body is going against you, but you are simply going through a part of life for most women. As you get older, your reproductive system is headed toward a shutdown. Your reproductive hormones will be produced in lower and lower numbers until your menstrual cycles stop. If you don’t have any extreme changes in hormone levels, you might not really notice any troubling symptoms. If you have more extreme changes in your hormone levels, your symptoms are going to be worse. Vaginal dryness is caused when the tissues in your vagina begin to thin and lubrication drops because of your low estrogen levels. Hormone therapy can help you to address this problem when lubricants and estrogen cream aren’t enough.

Let Hormone Therapy Help You to Combat Vaginal Dryness

If your hormones are the problem, our doctor can lead the way toward hormone replacement. A physical exam and a blood test can pinpoint changes in hormone levels as the source of your symptoms. You can choose to wear a patch, have hormone pellets that are placed beneath the skin, get injections, receive oral therapy, a gel application, or a lotion application. Our doctor will prescribe the right dosage for you and help you to choose the easiest method for replacement.

Ask Our Doctor About Hormone Therapy to Treat Vaginal Dryness

You don’t have to live with the discomfort that comes with vaginal dryness. Our doctor at Fort Worth Center for Pelvic Medicine can offer you help in this difficult time. With hormone therapy, your estrogen levels will build back up again, and we also offer MonaLisa Touch® treatments. We are conveniently located in Fort Worth, TX. Contact us today to schedule your consultation!

Filed Under: Blog Tagged With: MonaLisa Touch®, Vaginal Dryness

How to Check for Signs of Breast Cancer

Whether there is a history of breast cancer in your family or you want to monitor your health so that you stay on top of issues that could arise in the future, one of the things that you can do each month is to perform a few simple examinations at home to check for breast cancer. This is a type of cancer that can begin with a small lump that might not be felt right away but that can quickly spread to the lymph nodes and other areas of the body. Treatment options can include chemotherapy, radiation, and surgery depending on the stage of your cancer and whether the cancer is genetic or not.

Keep in mind that not every type of breast cancer can be detected by a self-examination. However, with routine exams, you can notice if there are any changes in your breasts from month to month. Try to perform a breast exam at home on a regular schedule. Choose a day each month that is easy to remember, such as the first or the last day or a few days after your menstrual cycle ends as your breasts won’t be as swollen or tender.

Understand the various neighborhoods associated with your breasts. These include the upper areas as well as the areas near your armpit. This neighborhood of your breasts tends to be where more lumps can develop instead of in the lower neighborhoods or near your nipple. Areas in the lower part of your breasts might feel like small pebbles or sand if there are any signs of cancer present.

Make a journal so that you can record how your breasts feel when you perform your examination and when you examine your breasts. Try to take pictures that you can include as well to notice any physical changes that might be present from one month to another. Write a few details about what’s normal for your body so that you know of what to look for and what should alert you as to when to call a doctor. There could be small lumps that form during the month, but these lumps should go away on their own. If you notice any lump that is hard, that doesn’t seem to move, or that gets larger, then you should consider getting a mammogram to determine if breast cancer is present.

Schedule a consultation today to talk about your options and to talk about the tests available to detect breast cancer if you are concerned. We also offer MonaLisa Touch® treatments for women who have gone through menopause. Fort Worth Center for Pelvic Medicine is conveniently located in Fort Worth, TX.

Filed Under: Blog Tagged With: Breast Cancer

Leaky Bladder: What Are My Treatment Options?

You’re so frustrated by a leaky bladder. You suffer from urinary incontinence at the most aggravating times. Every time you laugh, cough, or sneeze, you have a small leak. You have also found that you cannot control your bladder as well as you used to. You can’t wait to go to the bathroom. When a sudden urge comes on, you have to go right away or you are going to experience a leak. Sometimes those leaks are more pronounced than others. You must want to take back control again. Know what your treatment options are in order to find relief for your leaky bladder.

Understanding What Kind of Incontinence You Have

As you consider your treatment alternatives, you need to have an understanding of what kind of bladder leak you have. If you have stress incontinence, you are dealing with leaks when anything applies pressure against your abdomen. This would explain those leaks when you sneeze, cough, or laugh. You might find that you experience leaks during physical activity as well. If you have urge incontinence, you may feel like you have to go all the time. You may also have times when your bladder empties itself without your control. It is possible to experience both kinds of incontinence. If you are a woman and you have had children, you are at greater risk of stress incontinence due to the strain placed on your muscles. If you smoke or you are overweight, you are at greater risk of stress incontinence.

What Can You Do About Your Leaky Bladder?

You have several options that can help you to take control of your bladder once again. You can begin with Kegel exercises that target the muscles of your pelvic floor. Mainly, you tighten the muscles that you use when you are trying to hold back your urine. Kegels are recommended for pregnant women to help them prepare for delivery. You can perform Kegels at any time to strengthen your muscles for better control. Bladder control is another option. Try scheduling visits to the bathroom.

What Can You Do if Your Own Efforts at Bladder Control Don’t Work?

If you are not successful on your own in controlling your bladder, your doctor can offer you solutions. At Fort Worth Center for Pelvic Medicine, our board-certified urogynecologist, Dr. Michael England, will evaluate your situation to find out which treatment option would be best for you. We offer medical therapy or surgical procedures to treat leaky bladder. Contact our office today to schedule your consultation! We are conveniently located in Fort Worth, TX.

Filed Under: Blog Tagged With: Leaky Bladder

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1250 8th Avenue Suite 330,
Fort Worth, TX - 76104
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Granbury, TX - 76049
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