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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    • Alan Johns, MD
    • Christopher Ripperda, MD
    • Crystal Holden, FNP
    • Elizabeth Weaver, WHNP
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      • Menopausal Hormone Therapy
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Is Mona Lisa Touch Permanent?

Vaginal dryness, painful intercourse, and incontinence are common symptoms that a woman experiences as she passes through menopause. Many women are embarrassed by these issues and cope with them in silence, but treatments are available that can improve a patient’s vaginal health and bring relief. MonaLisa Touch, a laser treatment offered at Fort Worth Center for Pelvic Medicine in Fort Worth, TX, is a quick, effective option. Best of all, it offers results that last longer than many other options.

What Is MonaLisa Touch?

This non-surgical, non-hormonal treatment works by triggering the body’s regeneration process. During treatment, you’ll assume the same position you do during a pelvic exam. A topical numbing cream may be applied, and a wand will be used to deliver laser energy pulses both inside and outside the vagina. You’ll be given a pair of safety glasses to wear to protect your eyes from the laser during your session.

The treatment, which only takes about five minutes to complete and involves no anesthesia and no downtime, spurs the development of new blood vessels and bolsters the production of collagen in the vaginal area. The laser pulses don’t create any discomfort. Some patients say they feel a mild vibrating sensation during treatment, but this is the only thing you might feel.

How Many Treatments Will I Need?

For the best results, most patients undergo three treatments administered six weeks apart in our office.

How Quickly Will I See Results?

Most patients say they experience some relief from their symptoms after the very first treatment. By the time the third treatment has taken place, nearly every patient reports a noticeable improvement. This treatment results in stronger, healthier, and more hydrated tissue in the vaginal area.

Is This Treatment Permanent?

Once the initial series of treatments is complete, we usually recommend that patients maintain their results by having one follow-up treatment each year. Even taking into consideration the fact that many patients require annual maintenance treatments, the results of this treatment last much longer than the creams and other options that are available.

What’s the Recovery Like?

The recovery process is fairly straightforward. Most patients take it easy for a couple of days after their appointment, and we also ask that they refrain from sexual activity for several days.

Will I Still Need to Use a Lubricant During Intercourse?

Each patient is different. Although almost all patients experience a noticeable improvement in their symptoms after their series of treatments is complete, some prefer to continue using a lubricant during intercourse.

What Other Benefits Does This Treatment Offer?

This treatment can also be used to address lichen sclerosis, a condition in which thin, white patches of skin develop in the genital area. Postmenopausal women are at higher risk of developing this condition.

What Causes Vaginal Dryness?

A decline in a woman’s estrogen levels, something that often occurs during and after menopause and sometimes after cancer treatments, can cause the vaginal walls to thin. The natural lubrication in the vaginal area may also begin to decline. The decline in estrogen is a completely natural and normal process, but the symptoms it produces can be discouraging, uncomfortable, and disruptive for many women.

The Symptoms of Vaginal Dryness

Because of the personal nature of the symptoms associated with vaginal dryness, women often avoid discussing them with both their partners and their medical providers. Burning, itching, and stinging in the vaginal area are three common symptoms. Women also frequently experience painful intercourse and a loss of interest in sex.

In some cases, patients report frequent or persistent urinary tract infections, increasingly frequent urination, or incontinence. This laser treatment can help resolve these issues, improve your overall vaginal health, and help you regain your confidence.

Am I a Good Candidate?

MonaLisa Touch can be an ideal treatment for perimenopausal and postmenopausal women. Some patients also turn to the MonaLisa touch after forms of treatment have failed to deliver results.

What Other Treatment Options Are Available?

Topical treatments like creams and tablets are often recommended for this type of vaginal condition. Hormone replacement therapy has also occasionally been used as a treatment. The advantage of MonaLisa Touch is that it works to address the underlying issue rather than simply treating the symptoms of vaginal dryness. Many patients also find it to be more convenient than topical options.

How Can I Get Started With This Treatment?

If you’re experiencing burning, itching, pain during intercourse, or any other symptoms, the first step is to talk with us about your concerns. This is a topic you can bring up during your annual gynecological exam. If that exam is months away, you can also schedule a special appointment to talk about this issue. We can discuss your symptoms, review your medical history, and determine if this type of laser treatment is the best direction for you to take.

Your treatment will be performed by Dr. Alan Johns, a gynecologist and surgeon who specializes in MonaLisa Touch treatments. Dr. Johns earned his undergraduate degree from the University of Texas at Austin and attended medical school at University of Texas Medical Branch at Galveston.

Learn More About Treatment

You don’t have to suffer in silence any longer. A series of simple laser treatments can give you the long-lasting relief to vaginal dryness that you’ve been waiting for. Call the Fort Worth Center for Pelvic Medicine in Fort Worth, TX today and ask about the MonaLisa Touch.

Filed Under: Blog

What Is a Transvaginal Ultrasound? Why to Get One, and What to Expect

Ultrasounds have been used safely for over 50 years to create images of internal organs using high-frequency sound waves. These imaging tests play a crucial role in identifying abnormalities, diagnosing medical conditions and effectively treating dangerous conditions. At Fort Worth Center for Pelvic Medicine in Fort Worth, TX, we are proud to be on the cutting edge of the identification and diagnosis of numerous abnormalities and medical conditions using the transvaginal ultrasound.

What Is a Transvaginal Ultrasound?

A transvaginal ultrasound, also known as an endovaginal ultrasound, is a type of pelvic ultrasound used to identify abnormalities within female reproductive organs. These organs include the vagina, cervix, uterus, fallopian tubes and ovaries. This type of ultrasound varies from traditional abdominal or pelvic ultrasounds, which involve using a transducer resting outside the pelvis.

The word “transvaginal” means “through the vagina” because this is an internal exam designed to give doctors a very clear look inside the vaginal canal, at the internal organs, and at all other areas within the pelvic region.

When Is a Transvaginal Ultrasound Recommended?

A transvaginal ultrasound is recommended for many circumstances. The most common include:

  • Infertility
  • Pelvic pain
  • Unexplained vaginal bleeding
  • Abnormal abdominal or pelvic imaging exam
  • Ectopic pregnancy
  • Suspicion of uterine fibroids or cysts
  • Confirmation of properly placed IUD

During pregnancy, a doctor will most often recommend an endovaginal ultrasound to:

  • Confirm an early pregnancy
  • Examine the placenta for abnormalities
  • Monitor the heartbeat of your fetus
  • Identify potentially dangerous changes to the cervix
  • Identify the cause of abnormal bleeding
  • Diagnose a potential miscarriage

 

What Will the Results Show?

The results of a transvaginal ultrasound can diagnose a number of medical conditions. Once the images are analyzed, your doctor will talk to you about which steps need to be taken to improve your health, if any.

For example, if you are diagnosed with ovarian cancer, you may go into early menopause and start to suffer from the symptoms of menopause, such as vaginal dryness, pain during sex and hot flashes. Dr. Alan Johns may recommend MonaLisa Touch to dramatically improve vaginal health, libido, comfort and confidence.

Among the things your doctor may see upon examining your endovaginal ultrasound include:

  • Healthy pregnancy
  • Ectopic pregnancy
  • Miscarriage
  • Pelvic infection
  • Placenta previa
  • Cysts
  • Fibroids
  • Cancer affecting the reproductive organs

 

What Can I Expect During an Endovaginal Ultrasound?

Before an endovaginal ultrasound, you will lie down on the examination table on your back and bend your needs. The transducer is covered with a condom and lubricating gel, then inserted. During your initial consultation, let us know if you are aware of any latex allergies so we can accommodate your needs with a latex-free probe cover.

You may feel a slight pressure when the ultrasound wand is inserted. This sensation is no greater than the pressure felt during a Pap smear when the speculum is inserted. Once the ultrasound wand is in place, it produces sound waves which bounce off of your internal organs to transmit a picture of the inside of your pelvis onto a viewing monitor. During the examination, your provider will rotate the transducer slowly to get a full picture of your internal organs. In some cases, an SIS may be recommended.

What Is an SIS?

An SIS, or saline infusion sonography, is a special type of endovaginal ultrasound. It involves the insertion of sterile saline into the uterus before the ultrasound takes place. This technique is popular because the solution slightly stretches the uterus, allowing for a more detailed picture of the uterus.

This is extremely helpful when trying to identify a potential abnormality within the uterus. However, it cannot be used on pregnant women or women with an active vaginal infection.

What Are the Risks of an Endovaginal Ultrasound?

There are no risks associated with an endovaginal ultrasound.  If you’re worried about how the examination will feel, take a Tylenol a couple of hours before your ultrasound. If you feel anything more significant than a mild pressure, let your doctor know. The angle of the transducer will be adjusted so the rest of the examination is comfortable.

How Should I Prepare for an Endovaginal Ultrasound?

In most cases, an endovaginal ultrasound requires very little preparation on your part. When it is time for your appointment, you will be asked to remove all your clothes from the waist down and put on a gown. Depending on why you are having the internal vaginal ultrasound, the examination may need to be performed with an empty or partially full bladder.

The advantage of a full bladder is it lifts the intestines, which allows for a better picture of your pelvic organs. If your endovaginal ultrasound needs to be performed with a full bladder, you must prepare for your ultrasound by drinking roughly 32 ounces of liquid, such as water, an hour before the examination takes place. If you are menstruating or spotting on the day of your examination, you must remove your tampon or menstrual cup before the examination can take place.

Learn More Today

A transvaginal ultrasound can be used to identify abnormalities affecting your sex organs, diagnose medical conditions, verify the health of your internal organs, and check up on the state of your pregnancy.

To learn more, contact the professional health experts at Fort Worth Center for Pelvic Medicine in Fort Worth, TX today to schedule your initial consultation. We will review your symptoms and medical history to determine what steps we need to take moving forward to improve your quality of life.

Filed Under: Blog

5 Ways an Infertility Specialist Can Help You

Nothing is more exciting or meaningful than taking steps to bring a child into the world. If you are having trouble conceiving, we understand your anxiety and frustration. Fortunately, an infertility specialist can help. There are many treatments available, ranging from antibiotics to high-tech solutions like in vitro fertilization. At Fort Worth Center for Pelvic Medicine in Fort Worth, Texas, we provide services that can help you increase your chances of welcoming a new baby into your life.

What Is an Infertility Specialist?

An infertility specialist is a doctor who specializes in diagnosing and treating the causes behind a person’s inability to have children. To become an infertility specialist, one must complete 4 years of medical school and 4 years of residency training in the areas of obstetrics/gynecology (OB/GYN) or urology (andrology).

When Should You See an Infertility Specialist?

For most people, the time to see a fertility doctor depends on your age and how long you have been trying to conceive. Women under age 30 should try to conceive on their own for up to 18 months before seeing a specialist. Women between age 30 and 35 can wait 12 months. Women over age 35 should seek help after 6 months.

Fertility doctors can be of special benefit to women with polycystic ovarian syndrome (PCOS), as this can lead to reproductive complications. Also, women who have had cancer can improve their chances of conceiving by seeking medical advice. Women who have had miscarriages in the past can benefit by seeing a fertility doctor before attempting to become pregnant again.

5 Ways an Infertility Specialist Can Help You

#1 They Can Determine the Cause of Infertility

Your fertility doctor can perform a series of tests to help determine the cause of your infertility. For men, these tests usually include:

  • A sperm count
  • Bloodwork to determine hormone levels, with a special focus on testosterone
  • A urinalysis to check for infection
  • A physical exam

For women, these tests usually include:

  • A physical exam
  • A transvaginal ultrasound
  • Bloodwork to evaluate your hormone levels
  • X-Ray work to determine if your fallopian tubes are healthy
  • An X-Ray examination of your uterus

As part of your examination, the fertility doctor will talk with you about your medical history. He or she will put special focus on previous pregnancies and past attempts to conceive.

For most women who have trouble conceiving, the cause of the problem is related to ovulation or a blockage in the fallopian tubes. For men, infertility is usually related to the sperm. In 5%-15% of couples who cannot conceive, all tests come back normal. Whatever the cause of your infertility is determined to be, the next step is to get treatment.

#2 They Can Provide Treatment

After receiving the results of your tests, your fertility doctor can recommend a treatment plan. Common treatments for men include:

  • Surgery to correct a blockage in the tubes through which sperm must pass
  • Antibiotics, if the cause of infertility is an infection
  • Medications and counseling to treat erectile disfunction
  • Hormonal therapies

Common treatments for women include:

  • Hormone therapies to promote healthy ovulation
  • Surgery to open blocked fallopian tubes

#3 They Can Recommend Treatment for Your Partner

If you are tested for infertility and all test come back normal, your fertility doctor can treat your partner. If you and/or your partner cannot be treated, your fertility doctor can recommend other options such as third-party parenting.

#4 They Can Determine the Cause of Miscarriages

If you have had miscarriages in the past, your fertility doctor will look into your medical history to try to determine the cause. He or she can take steps with you to help prevent miscarriages in the future.

#5 They Can Refer You to a Reproductive Endocrinologist

If your situation requires a higher level of care, your fertility doctor can refer you to a board-certified reproductive endocrinologist for ART (Advanced Reproductive Technologies). ART includes a wide range of technologically advanced methods of treating infertility.

IUI

During IUI (intrauterine insemination), sperm is collected and inserted into a woman’s uterus during ovulation.

IVF

IVF (in vitro fertilization) is a method that involves combining sperm and an egg in a lab. After being grown in the lab for 3 to 5 days, the resulting embryo is placed inside a woman’s uterus.

IVF

IVF (in vitro fertilization) and ZIFT (zygote intrafallopian transfer) involve collecting sperm and eggs and transferring them to a woman’s fallopian tubes. This can happen either without combining them (in the case of IVF) or after bringing them together in a lab (in the case of ZIFT).

Have You Considered MonaLisa Touch?

MonaLisa Touch is a non-invasive means of laser vaginal rejuvenation. If you are having trouble conceiving because vaginal atrophy is creating a barrier between you and your partner, MonaLisa Touch can help.

The treatment only takes a few minutes, and it has no pain or side effects. MonaLisa Touch works by stimulating the production of collagen in the vaginal mucosa. After the treatment, a healthy trophic balance in the mucus membrane will be restored. This can benefit your relationship with your partner and your attempts to conceive.

Sometimes Having a Baby Just Needs a Little Help

If you are having trouble conceiving, there are many treatment options available to you. An infertility specialist can provide the care you need to determine the cause of your infertility. He or she can then recommend treatment. If your tests come back normal, the same care can be provided to your partner.

Contact Fort Worth Center for Pelvic Medicine in Fort Worth, Texas for more information on our infertility services. We will be happy to speak with you about your efforts to conceive and help make your dream of having a child come true.

Filed Under: Blog

When Should You See a Fertility Specialist?

When you struggle to get pregnant, a fertility specialist can work with you to get you the answers you deserve. Our staff at Fort Worth Center for Pelvic Medicine can evaluate your symptoms and provide you with the treatment that’s right for your situation and your body.

There are several causes of infertility and conditions that may affect your ovulation cycle and your ability to get pregnant. Diabetes, thyroid problems, and polycystic ovary syndrome (PCOS) are a few conditions that can make it difficult for a woman to get pregnant. Most times, your physician or gynecologist can diagnose these conditions, but they may not have the tools necessary to help you get pregnant.

When to See a Fertility Specialist

Your gynecologist should be your first discussion with any fertility concerns. If you’re under the age of 35 and have not been able to get pregnant after one year of trying, it’s time to have a chat with your gynecologist. If you’re 35 or older and have been trying to get pregnant for at least six months, you should also voice your concerns.

What You’ll Discuss

You and your gynecologist will talk about your health history, previous pregnancies, if any, and potential tests to undergo before a referral to a fertility specialist becomes necessary. If you’ve had multiple miscarriages or have health problems that could affect fertility, your gynecologist may suggest that you visit a specialist.

Similarly, if tests your gynecologist orders show no conclusive results, he or she will probably send you to a specialist who can delve further into what might be interfering with your fertility.

Some conditions that may warrant a visit with a specialist to discuss your fertility concerns include:

  • Endometriosis
  • History of sexually transmitted diseases (STDs)
  • Family history of miscarriages and/or fertility issues
  • Absence of a menstrual cycle or having a very inconsistent period
  • Cancer
  • Celiac disease
  • Autoimmune disease

What Will a Fertility Specialist Do?

Your specialist will first set you up with an appointment to discuss your concerns and your medical history. During this appointment, you may have a brief physical, much like you would at your gynecologist’s office, to check your vitals and talk about anything that might be affecting your fertility.

Your partner can also come to the appointment if you choose. Sometimes, fertility problems are caused by an issue with the male partner or by issues both partners suffer from, so it’s a good idea to get the full picture of your history as a couple and have both parties involved in the conversation.

Tests

Our specialist may order tests to further evaluate you, including a pelvic exam and ultrasound to see if any physical abnormalities are preventing you from getting pregnant, and blood tests to check your hormone levels. A pap smear is another standard test that detects an STD or cervical cancer, both of which can affect your chances of getting pregnant. Your specialist may also suggest testing your partner’s semen to determine if it might be contributing to your struggle to conceive.

Potential Treatments

There have been incredible advances in fertility treatments over the past few decades, so most women have several options for getting pregnant regardless of what’s causing their fertility struggles. After taking into consideration your medical history, test results, and everything you, your partner, and your specialist discussed during your appointment, the specialist will create a treatment plan that’s best for you.

Usually, you’ll begin with a fertility drug treatment. This can stimulate the ovulation process by triggering more hormone production. If you have a physical condition preventing you from getting pregnant, however, you may need to have surgery to correct the issue.

When other methods fail or are not a good option for you based on your medical history, the specialist might recommend intrauterine insemination (IUI) or in-vitro fertilization (IVF). The IUI process places sperm directly into your uterus near ovulation while the IVF process transfers a fertilized egg, or embryo, into your uterus.

What to Talk About With Your Fertility Specialist

It’s important to remember that your fertility specialist is an expert at what they do. Their job is to help you decide the best route to take for your body and your family. There’s never a question that’s too silly to ask when it comes to your ability to get pregnant.

Here are some topics you should consider discussing with your specialist:
• How the medical conditions that you have might affect your treatment and vice versa
• If the medications you’re on could be causing your fertility or could intervene with treatment
• What each ordered test will check for and why
• If there’s anything else that you can try before beginning hormonal or another type of treatment
• If the treatment you decided on will have any long-term effects
• Any potential problems with the embryo because of treatment
• How your body may react to treatment

Be sure to bring a notepad with all of your questions jotted down beforehand, so you don’t forget to ask important questions. You should also get contact information for your specialist during your appointment to have a quick way to contact them with questions.

Find Out More

For more information about fertility treatments and the specialists who can help, contact Fort Worth Center for Pelvic Medicine. We can connect you to a fertility specialist who can address your concerns, answer questions you might have, and develop a treatment plan that works for you, your partner, and your family.

Filed Under: Blog

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Recent Posts

  • Providing Urogynecology Services in New Locations
  • Is Mona Lisa Touch Permanent?
  • What Is a Transvaginal Ultrasound? Why to Get One, and What to Expect
  • Take Charge of Your Vaginal Health
  • 5 Ways an Infertility Specialist Can Help You
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