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
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    • Infertility
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    • Pessary Insertion and Management
    • Endometrial Ablation
    • Gynecologic Surgery
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      • Menopausal Hormone Therapy
      • MonaLisa Touch
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    • Vulvodynia
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What Can a Transvaginal Ultrasound in Fort Worth Reveal?

Nowadays, there are more methods than ever to detect potential health problems. A transvaginal ultrasound here in Fort Worth can help you detect and diagnose many potential health problems. It is safe and effective for women who are pregnant as well as those who have other gynecological concerns.

What is a Transvaginal Ultrasound?

Like any ultrasound, a transvaginal one uses sound waves in order to create images. In this type of ultrasound, a probe is inserted a few inches into the vagina. By doing this, your cervix, vagina, fallopian tubes, and uterus can all be examined. The images captured are then examined for any abnormalities.

Who Needs a Transvaginal Ultrasound?

There are many cases in which this type of examination may be recommended for you. For pregnant women, it can be used to monitor the heartbeat of the baby, examine the placenta, or diagnose a potential miscarriage. This type of ultrasound can even be used to diagnose an early pregnancy. If you are not pregnant, you may still need this type of exam. Examples of when this may occur include:

  • Abnormal bleeding
  • Pelvic pain
  • Infertility
  • Cyst check
  • Abnormal pelvic exam
  • Ectopic pregnancy

Many health issues can be revealed using this method. Common ones include:

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

What to Expect with a Transvaginal Ultrasound

All in all, this is considered to be a very comfortable procedure here in Fort Worth. There is very little special preparation required by you prior to the test. The ultrasound probe is inserted and then rotated in order to get accurate images. While you may feel slight pressure, the process is no more uncomfortable than a Pap smear. How long the exam will take can vary. Typically speaking, it takes anywhere from 30 to 60 minutes to complete.

This procedure is considered very safe. Due to the fact that no radiation is used, it is safe for both the baby and the mother when a pregnant woman has one done. Approximately 24 hours after your appointment, results should be in. Assuming that clear pictures were gotten, a diagnosis can be made, if necessary.

Get In Touch with Us for More Information

If you would like to learn more about having a transvaginal ultrasound, feel free to make an appointment with Fort Worth Center for Pelvic Medicine. At our convenient location in Fort Worth, TX, our caring and knowledgeable staff will be pleased to answer any questions about this process and any other treatment such as the MonaLisa Touch. Contact us today to set up your consultation – we look forward to speaking with you!

Filed Under: Blog Tagged With: Fort Worth, Ultrasound

The Power of Hormone Replacement Therapy for Menopause Relief

Menopause and the time leading up to it can bring about a number of uncomfortable and life-affecting symptoms for women. It’s a time that many don’t talk about, but that’s starting to change. Fortunately, there is something you can do to lessen the discomfort you may be experiencing during this time of life. Keep reading the information below to discover the power of hormone replacement therapy for menopause relief. You no longer have to suffer in silence. Knowing about effective treatments can help you to make informed decisions regarding your health and well-being.

About Hormone Replacement Therapy

Hormone replacement therapy, or HRT, is an effective treatment for many of the unpleasant symptoms of menopause and perimenopause, the period of time leading up to it. Menopause is officially defined as having been reached when a woman has gone 12 consecutive months without menstruating. Its symptoms are primarily brought about by falling levels of estrogen that occur with age. It’s not unusual for women to begin noticing these issues between the ages of 40 and 45. Symptoms such as vaginal dryness, hot flashes, and brain fog are common. HRT helps to regulate the hormone balance in order to reduce these problems.

Types of Hormone Replacement Therapy

Estrogen therapy is one form of HRT that is commonly recommended to women who’ve undergone a hysterectomy. It can be delivered in various forms – oral therapy, transdermal, gel, lotion, or pellet. Estrogen, along with progesterone, has added benefits like a lowered risk of certain cancers and more effective treatment of some symptoms like hot flashes. Typically, this therapy is given in pill form. An intrauterine option is available outside the United States.

Candidates for Hormone Replacement Therapy

Your doctor will help you to determine if hormone replacement therapy for menopause relief is right for you based on your particular symptoms, along with your age and medical history. There are some women who shouldn’t undergo HRT. This is particularly true if you have certain conditions. These include cancer, blood clots, heart attack, liver or heart disease, stroke or pregnancy.

Get In Touch with Us for More Information

Hopefully, this information will give you an idea about whether hormone replacement therapy for menopause relief is right for you. To learn more, we warmly invite you to reach out and make an appointment with Fort Worth Center for Pelvic Medicine. At our convenient location in Fort Worth, TX, we are proud to offer options such as this and the MonaLisa Touch to our patients. Contact us today to set up your consultation!

Filed Under: Blog Tagged With: Hormone Replacement Therapy, Hormone Therapy, Menopausal Hormone Therapy, MonaLisa Touch®

Common Questions About Ovarian Cysts

Any kind of abnormal pain that you have in your abdomen should be investigated as there are multiple reasons for the cause. One of those reasons is an ovarian cyst. This is something that is rather common among women of all ages. When you meet with our doctor, there are a few questions that you might have that other women have as well about what causes ovarian cysts to form and the treatment involved.

How Can You Tell if You Have a Cyst?

If you have an ovarian cyst, then you will likely experience pain in your lower abdomen near your pelvic region. You could also experience pain during and after intercourse or before and during your menstrual cycle. Another common sign is bloating in your abdomen that you might experience before your period begins. Menstrual cycles that are irregular or that are abnormally heavy are also signs that you might have an ovarian cyst. Sometimes, a cyst will bleed. If you notice a significant amount of bleeding at one time and it’s not during your menstrual cycle, then it could be from a ruptured cyst. This usually happens as the cyst reaches a size that is simply too large for the area to sustain any longer.

How Long Will I Be in Pain?

A question that you might have for our doctor is how long a cyst can cause pain. For most women, the pain that you experience tends to go away in about two or three months. This is because that’s usually about the length of time that it takes for a cyst to go away on its own without treatment. If you notice that there’s continued pain after about three months or it gets worse, then you should seek treatment from our doctor as it might need to be surgically removed.

Is a Cyst Hereditary?

If there has been a history of ovarian cysts in your family, then you might be predisposed to getting them. Keep in mind that there’s no clear indication that genetics is specifically linked to these cysts, so you usually don’t have to worry for the most part.

Do Cysts Affect Fertility?

When you meet with our doctor about ovarian cysts, you might want to know if they can cause issues with getting pregnant. They can make it difficult to get pregnant, especially if you have several cysts over a period of time. The cysts put pressure on the ovaries and other components of the reproductive system, which can then make it difficult to conceive.

To ask more questions about ovarian cysts, set up a time to visit Fort Worth Center for Pelvic Medicine in Fort Worth, TX. We are experts in vaginal health and offer various services ranging from MonaLisa Touch® to infertility treatments. Contact us today to schedule a consultation.

Filed Under: Blog Tagged With: Ovarian Cysts

The Importance of Visiting Our OB/GYN

As a female, it’s important to take proper care of your body as there are issues that could arise that can be treated if they are seen in the early stages. You also need to take the proper steps by visiting an OB/GYN to ensure that your reproductive health is as good as possible if you want to have children in the future. Breast cancer can also be detected if our doctor feels any lumps during an exam or notices any abnormal areas after a mammogram is performed. Aside from your reproductive health, our doctor can monitor your overall health as well so that you don’t have to seek another office to visit.

One reason as to why you want to visit our OB/GYN is so that you can have clinical breast exams performed. Although you might know how to perform your own exam at home, there are some things that our doctor can look for that you don’t know how to detect. If there are any signs that something could be wrong, then our doctor can order a mammogram or other tests to make sure there are no signs of cancer present. You can also find out the proper way to conduct an exam at home if you’re not sure.

Since an OB/GYN can be your primary provider as well as your reproductive health provider, there are numerous aspects of your personal health that can be monitored. One is your mental health. You can feel free to talk about any emotional issues that you’re experiencing, especially if you’ve had a miscarriage or you’re facing difficulties getting pregnant. Your diet and exercise habits can be discussed so that you can make a plan to stay as healthy as possible. Various health screenings can be provided including a Pap smear and other exams to detect different types of cancers or other issues.

While at the office, you can talk about your menstrual cycle and what should be normal. If you’re of the proper age, you can also talk about what to expect when you go through menopause. If you’re sexually active, then it’s important to visit our OB/GYN to get information about how to prevent pregnancy or what to do if you think that you’re pregnant.

Learn more about why it’s important to visit an OB/GYN by consulting our specialists at Fort Worth Center for Pelvic Medicine in Fort Worth. Contact our office today to book your appointment!

Filed Under: Blog Tagged With: OB/GYN

What Can Microneedling with PRP Accomplish?

Microneedling with PRP is an innovative treatment that helps with a wide range of conditions from lines and wrinkles to stretch marks and everything in between. The method combines two great treatments into one procedure that is minimally-invasive and requires no hospitalization, sedation, or extensive downtime.

What is Microneedling?

Microneedling is a skin rejuvenation technique that is often used in cases of acne scars, wrinkles, hyperpigmentation, skin blemishes, stretch marks, and more. We use a special device to form thousands of microscopic channels in the surface layers of your skin to trigger the formation of new collagen and a reduction in common skin imperfections. Your body will do most of the work itself over the following weeks and months as your skin is rejuvenated and remodeled. Old, damaged skin tissue is replaced with fresh, more youthful-looking skin in a very soft and natural way.

What is the Treatment Like?

We gently glide the device over your skin in a series of sweeps. Each time the device moves over your skin, it forms numerous micro-openings in surface skin layers to trigger the production of new collagen.

In addition to making a fine treatment in its own right, microneedling can be combined with other treatments like topical skin care products. Topicals are able to take advantage of the numerous micro-channels created by the treatment process, allowing them to bypass the outer barrier of the skin and become much more effective through increased skin penetration.

What is PRP?

Platelet-Rich Plasma (PRP) is a blood product derived from the patient’s own blood. We remove a certain amount of blood from the patient and spin it in a centrifuge, separating out blood platelets that are rich in growth factors. The product can then be applied to speed up healing of damaged tissues.

What is Microneedling with PRP?

PRP makes microneedling much more effective by contributing growth factors found in the PRP product. Since microneedling works by creating light skin damage, combining microneedling with PRP helps to greatly speed up the healing and skin remodeling process.

Learn More

If you would like to receive more information about how microneedling with PRP can help you, we encourage you to schedule your initial consultation at Fountain of Youth Medical & Wellness Spa. We would be more than happy to address whatever questions or concerns you may have about the treatment and the results. Our office is conveniently located in Sanford, FL. Contact us today to book your appointment and get started!

Filed Under: Blog Tagged With: Microneedling with PRP

How Can an Infertility Specialist Benefit You?

As you age, many things play into your life. You may have had a complication with your reproductive organ. Your spouse may not have the necessary firepower. Whatever the cause of your fertility concerns, you may need to see an infertility specialist.

Generally, if you are more than 35 years old, it is advisable to see an infertility specialist. If you have tried to get pregnant for over a year without success, a specialist can assist you with that. If you have had a miscarriage lately, seeing an infertility specialist can help you understand the cause. Seeing a specialist has many benefits. Here are just some of them.

Understand Your Risk Factors

Problems with pregnancies range from not getting pregnant to giving birth to unhealthy children. If there is a genetic disorder running in your family, you may consider seeing a specialist about it to understand the risk factors. There is no way of changing the way genetics work, but you can know all the risk factors.

You can also prepare mentally for what to expect when you try to get pregnant. An infertility specialist can shed light on all of the risk factors related to infertility. They can help you understand viable sperm and ovum, the integrity of the cervix, uterine integrity, and many other things.

Prevent Miscarriages and Pre-Term Pregnancies

Losing a pregnancy can be devastating. It can land you in more trouble if you decide to get pregnant immediately without understanding the cause of the miscarriage. Carrying a full-term pregnancy requires an enabling environment. An infertility specialist can guide you on how to prepare the foundation before you get pregnant.

Give Birth to a Healthy Baby

Some children endure a bad environment to term, and they are born with malnutrition or other complications. Imagine a child trying to grow in an environment where he or she competes with a benign tumor. A specialist can work with you to prepare for the child.

Know Your Options in Advance

Getting pregnant the old-fashioned way is not possible for everyone. You may want to consider other options if this method fails. Lucky for you, there are several options available for you and your spouse. You can also get a baby when you are alone through other options.

You can consider all the options when you meet an infertility specialist, and if you are interested, you can also learn about the amazing MonaLisa Touch vaginal rejuvenation treatment. All you have to do is book an appointment at Fort Worth Center for Pelvic Medicine to get started. Contact us today to set up your consultation at our office in Fort Worth!

Filed Under: Blog Tagged With: Infertility Specialist

What is Menopausal Hormone Therapy?

Menopause is a normal part of a woman’s aging process. The word describes the changes that accompany the end of a woman’s reproductive period, which typically happens when she is in her early 50s. If you’re dealing with any issues related to menopause, hormone therapy could help.

During her reproductive years, a woman’s ovaries release an egg every month. They also produce the hormones progesterone and estrogen that regulate menstruation and ovulation. As a woman goes through menopause, her hormone levels drop and she gradually stops ovulating and menstruating.

While menopause is normal, it can cause a variety of unpleasant side effects like the following:

• Hot flashes
• Night sweats
• Vaginal dryness
• Trouble concentrating
• Insomnia
• Muscle weakness
• Urinary incontinence
• Painful intercourse
• Dizziness

Hormone therapy restores the patient’s hormones to their original levels and, thus, reduces the severity of menopause’s side effects or eliminates them altogether. Hormone therapy can also reduce the risk of osteoporosis.

What Does Hormone Therapy Involve?

Since several hormones are involved, and different patients will have different symptoms and hormone levels, we will have to customize the therapy for each patient. We will start by asking the patient about their symptoms and administering blood tests to determine the amount of hormones the patient will need.

There are different ways to administer hormones. The patient may choose from pellet insertion, oral therapy, injections, transdermal (skin patch), lotion, or gel. We will make sure to recommend the methods we think would be most suitable for the patient.

For example, oral therapy is not recommended for patients with liver problems. Such patients will be offered methods that don’t affect their liver. With skin patches, for example, the hormones bypass the liver and head straight into the bloodstream that transports them within the body.

How Does Pellet Therapy Work?

Pellet insertion or pellet therapy is a surprisingly old form of hormone replacement therapy that dates back to the 1930s. It is particularly popular in Australia and parts of Europe.

In pellet insertion, the hormones are contained within a pellet slightly bigger than a grain of rice. Over a period of months, the pellet will dissolve within the patient’s body and release a constant and steady stream of hormones. Pellet insertion avoids the fluctuations that accompany other forms of hormone replacement therapy.

Who is a Good Candidate for Hormone Therapy?

Simply book an appointment at Fort Worth Center for Pelvic Medicine to find out whether or not you qualify for hormone therapy. During this meeting, we can tell you about various treatments you may be interested in, including MonaLisa Touch®. Contact us today to set up your initial consultation at our office in Fort Worth!

Filed Under: Blog Tagged With: Hormone Therapy

All About Infertility

Trying to Have Children?

For many men and women, the topic of infertility can be a difficult one. It may be difficult to admit to yourself, let alone your partner, that you or they may be infertile. However, if you have been trying to have children with your partner without success for a long duration, then you or they may suffer from infertility. While the process of becoming pregnant may seem easy, the actual biological process is a lot more difficult than you might realize.

There are many factors that contribute as to whether or not you are able to conceive. For one, a man needs to have a healthy sperm count in order to increase the chances of conceiving. However, the woman also needs to have a healthy number of eggs, and healthy eggs in general, for the sperm to attach to in the first place. A woman’s Fallopian tubes also need to be unlocked in order for the sperm to reach the egg. It’s also up to the sperm cell itself to be up to the job of fertilizing the egg once it reaches it. Not all sperm cells are healthy enough to do that. Yet the egg itself also needs to be healthy enough to become fertilized in the first place. Essentially, both the man and woman need to have a good number and quality of eggs and sperm cells in order for a child to be conceived. This article will discuss other factors about infertility and some steps you can take to help your fertility.

Getting Tested

If you believe that yourself or your partner may be infertile, then you can have a test performed to determine just that. Embryos will be removed to determine the state of their health and count. Sperm cells will also be examined to determine their health. If either of you is found to be infertile, you can be given a few options to help promote fertility as well as be given options to still have children.

Treatment Options

For women who are infertile due to structural problems in their reproductive system, you may opt for a surgical procedure that can get rid of the problem of your eggs not being able to be fertilized by sperm cells. You may also want to consider in vitro fertilization or Advanced Reproductive Technologies (ART.) In vitro fertilization involves the process of removing a series of embryos from the body and mixing them with sperm cells in a petri dish. Once the egg has been fertilized, it is replaced within the woman’s uterus. This allows the baby to be developed naturally within the body while still bypassing the Fallopian tubes.

Contact Us Today for Further Information

For more information on infertility and what you can do about it, we warmly invite you to reach out and make an appointment with Fort Worth Center for Pelvic Medicine! At our convenient location in Fort Worth, TX, our friendly team of experienced professionals will be happy to explain your options for infertility as well as the benefits of such treatments as the MonaLisa Touch. Contact us today to set up your consultation – we look forward to speaking with you!

Filed Under: Blog Tagged With: advanced reproductive technologies, Fort Worth, in vitro, Infertility, infertility treatment

What to Do If You Have an Ovarian Cyst

An ovarian cyst is a fluid-filled growth within the ovary; this fluid can be watery or viscous. In premenopausal women, cysts are generally normal, for they develop during a woman’s menstrual cycle. Cysts that occur during a woman’s menstrual cycle are called functional cysts and are normal. A woman who has passed through menopause by definition no longer ovulates and thus does not produce functional cysts. If she has an ovarian cyst, something is wrong.

Types of Cysts

There are several different kinds of cysts that are not related to the menstrual cycle. For example, a condition called endometriosis causes when the lining of the uterus grows outside it. This lining can form cysts called endometriomas that attach themselves to the outside of the ovary. Dermoid cysts form from embryonic cells and can thus contain tissues like hair or skin. These are usually not cancerous. Cystadenomas, like endometriomas, form on the ovary’s exterior. They are typically filled with a viscous or watery fluid. While they are generally benign, cystadenomas and dermoid cysts can grow large enough to force the ovary out of position. Cysts can sometimes become cancerous, particularly in older women.

What are the Symptoms?

A small ovarian cyst generally won’t cause symptoms and may even go away on its own. Larger cysts can cause abdominal discomfort, bloating, and pressure. The discomfort can be intermittent, and it can be dull or acute. A woman should notify her doctor if she knows she has a cyst and develops any of the following symptoms, as they may be indicators that the cyst has ruptured:

  • Severe and sudden abdominal pain
  • Weakness, faintness, or dizziness
  • Pain accompanied by vomiting and fever
  • Rapid breathing

How is an Ovarian Cyst Treated?

Treatment will depend on the type and size of the cyst. If the cyst is small and not causing any problems, the doctor may simply prescribe pain medication to keep the patient comfortable, and they may prescribe birth control pills to prevent the formation of new cysts. They will monitor the patient to see if the cyst eventually goes away. If the patient has a large cyst that causes discomfort or pain, looks suspicious on the ultrasound, and/or hasn’t gone away after several menstrual cycles, the doctor will remove it.

Contact Us for Further Information

To learn more about dealing with an ovarian cyst, we welcome you to reach out and make an appointment with Fort Worth Center for Pelvic Medicine. At our convenient location in Fort Worth, TX, our caring and devoted team of professionals will explain what to do if you have a cyst and answer any questions you may have. We will also be happy to explain the myriad benefits of treatments such as the MonaLisa Touch®. Contact us today to set up your consultation – we look forward to speaking with you!

Filed Under: Blog Tagged With: Fort Worth, MonaLisa Touch®, ovarian cyst, Ovarian Cysts

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

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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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