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.

  • Facebook
  • LinkedIn
  • Pinterest
  • Twitter
Call today! (817) 923-5559
  • Home
  • 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
  • Reviews
  • Specials
  • Blog
  • Patient Desk
  • Contact Us

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

Can Pelvic Floor Therapy Make a Difference?

The pelvic floor is a very important part of the body that does not get as much attention as it should. When this area is weakened or injured, a long list of unpleasant symptoms can result. While surgery may be necessary in severe cases, many people can benefit from pelvic floor therapy instead. By learning how to strengthen and/or retrain your muscles, a variety of problems can be solved. Here at Fort Worth Center for Pelvic Medicine, we encourage you to learn more about how this therapy can benefit you.

What Can Pelvic Floor Therapy Treat?

There are many issues that can be helped through the use of pelvic floor therapy. It can be especially beneficial to women who have recently given birth or anyone who has experienced an injury to the area. Some symptoms that can be alleviated through this therapy include painful sexual intercourse, urinary tract infections, and urinary incontinence.

What to Expect with Pelvic Floor Therapy

Seeing a specialist for pelvic floor therapy can accomplish many things. Strength and flexibility can be assessed. After this, we can begin working on a personalized treatment plan for you. Recommendations for your self-care routine can be made as well. While some people may only need a few sessions to achieve their desired goals, others may need more extensive therapy. At your first appointment, you can expect to discuss in detail any symptoms you may be experiencing as well as your medical history.

Contact Us to Get More Information

You don’t have to suffer pelvic discomfort any longer. To learn more about pelvic floor therapy and how it can make a difference in your life, we warmly encourage you to reach out and make an appointment with Fort Worth Center for Pelvic Medicine! At our convenient location in Fort Worth, TX, our dedicated and knowledgeable staff will be ready and eager to explain your options in full, address any questions or concerns you may have, and help you life a more comfortable and satisfying life. We are also proud to offer 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: Pelvic floor therapy

When to Talk to a Doctor About Endometriosis

Endometriosis occurs when endometrial cells begin to grow outside the uterus. These cells are similar to those forming inside the uterus. The most common location for these cells is on organs of the pelvis, though they can grow elsewhere as well. The majority of women with this condition do not experience any symptoms. When symptoms are experienced they may include various kinds of pelvic pain and infertility.

Pelvic pain during ovulation or menstruation may be a symptom of endometriosis but does not necessarily mean the condition is present. The condition can be diagnosed according to the symptoms of the woman or during a physical examination. A type of surgery called a laparoscopy is usually required for a definite diagnosis.

The Stages of Endometriosis

Endometrial tissue is very similar to the tissues lining the uterus. When a woman menstruates, she sheds this tissue. When an area of endometrial tissue appears in an ectopic location. it is called an endometrial implant. These are most often located on the pelvic lining, the bowels, Fallopian tubes, and the surface of the uterus. The less common locations include the bladder, cervix and uterus. In rare cases, it is possible for an occurrence outside the pelvis.

There have been cases reported in the lungs, liver, and thighs. Although it is possible for endometrial implants to become serious, in most cases they are non-cancerous or benign. If a woman suspects she may have this condition she should consult with her physician as soon as possible for diagnosis and treatment. The majority of endometriosis cases are classified as mild or minimal. This means the scarring is mild and the implants are superficial. Severe and moderate cases often result in severe scarring.

Contact Us to Get More Information

If you believe it is possible you have endometriosis, we encourage you to get in touch with us and book an appointment with Fort Worth Center for Pelvic Medicine! At our convenient location in Fort Worth, TX, our friendly staff of knowledgeable professionals will be more than happy to give you a full examination, address any questions or concerns you may have, and explain your options in full. Contact us today to set up a consultation!

Filed Under: Blog Tagged With: Endometriosis

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

Hormone Replacement Therapy: Am I a Good Candidate?

Hormone levels can fluctuate dramatically. Very high levels or very low levels of a certain hormone can have a dramatic effect on how you feel and how you interact with the rest of the world. PMS, pregnancy, menopause, or other life changes can affect your hormone levels. Fortunately, hormone replacement therapy can raise hormones to normal levels and eliminate many of the negative effects. Not all people are good candidates for hormone replacement therapy. We can help you determine whether or not you are a good candidate for hormone replacement therapy.

Irregular Health Issues for Your Age

If you are experiencing hot flashes or one of the other typical menopausal symptoms at an early age, you may be a good candidate for HRT. This could actually be what is known as perimenopause. It is a condition in which hormone levels fall prematurely.

Weight Gain

Before we delve into weight gain as a possible sign that you could benefit from HRT, we must first establish that weight gain in itself does not indicate a hormonal imbalance. However, it can sometimes be a sign of a condition known as adrenal fatigue. Only medical professionals will be able to evaluate you and determine what the cause of your weight gain may be.

Previous Thyroid Issues

Lowered or heightened thyroid function can be an indicator that HRT will be effective. However, these symptoms will not always be solved with treatment. HRT can only be effective if the low thyroid function is caused by a hormonal imbalance. The only way to discover this is by consulting with a qualified professional.

Depleted Bone Mass

Individuals with depleted bone mass may be a good candidate for HRT, especially if they have not responded to other treatments. If this sounds like you, your bone mass condition may be a result of lowered hormone levels.

Hormone replacement therapy proves to be very effective for patients who display particular symptoms. If you are experiencing abnormal symptoms, make an appointment at Fort Worth Center for Pelvic Medicine to learn more about hormone replacement therapy and your other options, such as MonaLisa Touch®. It may be able to mitigate or eliminate these symptoms. Contact us today to arrange an appointment in Fort Worth.

Filed Under: Blog Tagged With: Hormone Replacement Therapy

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

Signs and Symptoms of Ovarian Cysts

If you’re a female and experience pain on either side of your abdomen, there are a few possibilities to consider. Ovarian cysts are quite common among women of all ages and are sometimes not even noticed until you visit a doctor for a routine physical or until you experience pain associated with the cyst. Fortunately, there are a few signs and symptoms that you can pay attention to if you think that you have a cyst in this area of your body.

What is an Ovarian Cyst?

In order to understand the signs and symptoms, you should know a little about the background of an ovarian cyst. This is a small sac that is often filled with fluid. They are usually benign and nothing to worry about. However, if the cyst doesn’t go away, then surgery could be needed to remove it before it does develop into something more.

Pain

If you have a cyst on one or both ovaries, then you will likely have pain that continues to get worse over time. The pain is often felt on the right or left side and in the lower part of your abdomen. There is a possibility that you can feel the cyst while you’re exercising or if you’re sexually active with someone. The pain will be in a location that is specific to your ovaries instead of traveling to other areas of your body.

Bloated Feeling

After you eat a large meal, you probably feel bloated and like you’ve gained a few pounds. This is the same feeling that you can experience if you have ovarian cysts. Since most cysts are of a small size, not all women experience bloating. However, there are some cysts that can grow to a larger size and can make you gain a few pounds from the excess fluid or tissue that is present in your abdomen.

Urinating

Another common sign of ovarian cysts is the feeling that you have to urinate all the time. This can be misleading sometimes because you would expect to urinate if you drink coffee during the day or if your diet includes a lot of water. However, if you go to the bathroom all the time but can’t seem to urinate when the feeling is there, then you could have a cyst that is pressing on your bladder.

Talk to the Professionals

Don’t diagnose ovarian cysts on your own. Make an appointment at Fort Worth Center for Pelvic Medicine to learn more about your case. Contact our office in Fort Worth today to book a consultation.

Filed Under: Blog Tagged With: Ovarian Cysts

Hormone Therapy for Menopause

Womanhood comes with a lot of struggles from painful menstrual cramps to strenuous menopause symptoms as hot flashes, regular night sweats, vaginal itching, burning, and dryness among many others. Doctors recommend menopausal hormone therapy as a treatment to these bothersome menopausal symptoms while still addressing long-term biological changes such as bone loss that may deter one’s physical abilities.

What is Hormone Therapy for Menopause?

It is a treatment used to augment the woman’s natural hormone levels either as estrogen-progesterone therapy for women who experience menopause naturally during their 50’s or in the form of estrogen-alone treatment for women who have gone through an earlier surgical menopause procedure.

Estrogen therapy

Doctors recommend a low dose of estrogen for women who have undergone the surgical menopause procedure also known as hysterectomy which is the surgical removal of the uterus. Estrogen may be induced in various forms such as a daily pill, gel, spray, vaginal ring and a patch.

Estrogen pill

Pills are the most popular type of medication for menopausal symptoms. Your doctor will give you instructions on how to follow the dosage. Most tablets are taken once a day way long after you have taken your meals.

Estrogen patch

The patch is stamped on the skin of your abdomen. Your doctor will guide you on how long you should have the patch on before replacing with another one.

Topical estrogen

Creams, sprays, and gels take use of entry into the system through the skin. Similarly to the patch, estrogen is absorbed directly into the bloodstream. Depending on the type of topical estrogen the doctor recommends, you will be directed on what part of the body to apply the estrogen treatment.

Vaginal estrogen

Vaginal estrogen is packaged in a vaginal ring, cream or tablets. These treatments are specifically for women struggling with vaginal dryness, pain during intercourse, vaginal itching and burning. Doses should vary depending on the packaging material. For instance, most vaginal rings need replacing after every three months while tablets are used daily for some weeks until changed otherwise.

Progesterone/estrogen/Progestin hormone therapy

It is a combination therapy since it requires both estrogen and progesterone hormones. It is particularly for women who didn’t undergo a hysterectomy. Doctors recommend this treatment for this specific lot of women since progesterone lowers the risk of one contracting cancer of the endometrium. Progesterone is used as a form of birth control but also helps treat menopausal signs such as hot flashes and sweating. Just like the estrogen doses, so does progestin come in various forms.

Oral progestin

These come in pill form. Many doctors prefer treating patients with natural progesterone rather than the synthetic form. Natural progesterone has been scientifically proven to have no adverse effects on lipids and is an excellent option for women with high cholesterol levels.

Contact Fort Worth Center for Pelvic Medicine today to schedule your consultation! We are conveniently located in Fort Worth, TX.

Filed Under: Blog Tagged With: Menopause

Symptoms of Endometriosis

Endometriosis is a condition of the uterus in which the uterine lining, or endometrium, grows outside of the uterus. The disorder is usually quite painful. It can encompass several pelvic organs, including the fallopian tubes, ovaries and the tissues that line the pelvis. About 5 million Americans suffer from this disorder. Below are some of the symptoms of endometriosis as well as how it can be treated at Fort Worth Center for Pelvic Medicine.

About Endometriosis

When the tissue of the endometrial lining is displaced outside of the uterus, it still acts as it normally would. With each menstrual cycle, the material thickens, breaks down and causes bleeding. However, the blood from this displaced tissue becomes trapped because it doesn’t have a way to escape the body. Over time, the tissues of the surrounding areas start to become irritated. They can then develop into scar tissue and adhesions.

These abnormal fibrous tissues become bands that are stuck together. Some have described them as causing a glue-like effect that leads organs and pelvic tissues to stick together. When the ovaries are affected, cysts can develop. These are called endometriomas.

Symptoms of Endometriosis

Pain while menstruating is the main symptom of this disorder. This pain far exceeds that of normal period pain. It also tends to get worse as time goes on. It may creep in before menstruation starts and continue a few days following. You might even experience discomfort in your lower back and abdominal region. Painful urination or bowel movements frequently accompany menstrual issues, as well.

Excessively heavy bleeding during menstruation or bleeding between cycles can occur. Sometimes endometriosis can even lead to infertility. It’s not unusual to notice accompanying issues such as diarrhea, nausea, bloating or constipation during menstruation. Fatigue is also frequent.The extent of your pain may not be a reliable indicator as to how severe your condition is. Even if pain is mild, it’s still possible that the disorder may have progressed to advanced stages.

When to Seek Help

because you never know how severe a potential case of endometriosis has become, it’s important to see one of our medical professionals if you suspect you may be experiencing symptoms. Managing this disorder is frequently difficult. Therefore, early detection is important. Your physician will be better able to advise you if your condition is diagnosed early on. Endometriosis is a progressive disease, meaning it worsens over time. Early treatment can help to lessen issues like the development of fibrous scar tissue and the “gluing” together of organs. Hence, treating the condition will be less difficult.

Endometriosis is a painful medical issue. Many women mistakenly believe their symptoms to simply be a normal part of menstruation. Seek medical advice if you suspect symptoms of endometriosis. It could save you a great deal of pain and frustration.

Contact our office today if you believe you may be suffering from this disorder and we’ll schedule a consultation to meet with you! We are conveniently located in Fort Worth, TX.

Filed Under: Blog Tagged With: Endometriosis

  • « Previous Page
  • 1
  • 2
  • 3
  • 4
  • 5
  • …
  • 7
  • Next Page »

Get Started Now

  • This field is for validation purposes and should be left unchanged.

Tweets by @FWPelvicMed
  • Facebook
  • LinkedIn
  • Pinterest
  • Twitter
Fort Worth
1250 8th Avenue Suite 330,
Fort Worth, TX - 76104
817-923-5559
Willow Park
134 El Chico Trail, Suite 103,
Willow Park, TX - 76087
817-441-1644
Glen Rose
1008 N E Big Bend Trail, Suite 400,
Glen Rose, TX - 76043
817-923-5559
Pecan Plantation
2800 Village Rd., Suite 112,
Granbury, TX - 76049
817-923-5559

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
© 2025 Crystal Clear Digital Marketing | Site Map | TOS/Privacy Policy | Fort Worth Center for Pelvic Medicine