Bio-identical Hormone Therapy
Dena Harris, MD
Bio-identical hormone therapy is a menopause treatment that copies the molecular structure of the hormones our bodies produce. They are made from soy and yam extracts and can be processed and metabolized in the body the same way as other natural hormones. This helps to reduce side effects that are common in conventional hormone replacement therapy. Bio-identical hormone therapy is a safe and natural replacement for the hormones that our bodies lack during and after menopause. This lack of hormones can cause symptoms like hot flashes, night sweats, irritability and weight gain. However, hormone therapy is not the only solution to this condition and should be used only after natural remedies like diet, stress reduction, herbal remedies and exercise are tried.
Colposcopy is a procedure used to magnify the cervix and help diagnose abnormalities. A vulvar colposcopy typically examines lesions on the vulva and is often used to identify cancer, HPV, and vulvar pain causing conditions. The colposcope is a microscope that can help analyze small abnormalities. The exam itself is similar to a pap smear in that a speculum is inserted and the cervix may be cleaned. The colposcope is then placed to view the area at 10 to 40 times its normal size. If any abnormalities are noted, a biopsy of the tissue may be done. A colposcopy is a very safe procedure with few complications. Light bleeding or discharge for up to a week after the exam is normal.
We provide the full range of contraceptive options including oral and vaginal contraceptives, Mirena® and Paragard®, intrauterine devices, barrier method contraception, and permanent sterilization.
Dilation and Curettage (D&C)
Dilation and curettage is a procedure done to scrape and collect endometrium, which is the tissue inside the uterus. Dilation is the widening of the cervix which allows instruments to pass into the uterus, while curettage is the scraping of the uterine walls. This procedure is performed to diagnose uterine cancer or other conditions, remove tissue after a miscarriage, treat heavy bleeding, perform an abortion or investigate infertility. It is performed under general or local anesthesia. A speculum is inserted into the vagina to hold it open, while a metal rod widens the cervix. A curette is then inserted to gently scrape the tissue, which is then analyzed by a pathologist.
An ectopic pregnancy is abnormal pregnancy in which the fetus develops outside of the womb (uterus). Development most commonly begins in one of the fallopian tubes, but can also take place in the ovary or cervix. The fetus cannot survive in an ectopic pregnancy. Most cases are caused by a blockage that keeps the fertilized egg from moving into the uterus. Past infections or surgery of the fallopian tubes can cause this condition. An ectopic pregnancy can also be caused by birth defects, results of a ruptured appendix or endometriosis.
Symptoms of an ectopic pregnancy include abnormal vaginal bleeding, and pelvic pain. Both medical and surgical treatments are available to handle this very serious and dangerous complication of pregnancy.
Endometrial biopsy is a common procedure that exams the endometrium (the inside lining of the uterus) for abnormalities or signs of cancer. The biopsy is done by taking a tissue sample of the endometrium and having a pathologist evaluate it. A speculum is inserted in the vagina, followed by a small plastic tube that suctions a sample of the lining off. Local anesthesia may be used.
Intrauterine insemination, also known as artificial insemination or IUI, is a common solution to infertility. The male partner’s sperm is artificially inseminated into the women’s uterine cavity. Prior to insemination, women are often given medication to stimulate egg development. A semen specimen is produced and then “washed” to separate the sperm from other components before being placed into the uterus.
The actual insemination is virtually painless and only takes a few minutes. The risks of this procedure are low and success rates vary dependent on many conditions. However, intrauterine insemination is found to be more successful than intracervical insemination.
HPV (Human Papillomavirus)
Human Papillomavirus (HPV) is a type of virus that causes genital warts. There are more than 100 different kinds of HPV and some of they may create a higher risk for cancer. While some types can cause genital warts, others will show no symptoms but will eventually lead to cancers of the cervix, vulva, vagina and anus. The virus is contracted through sexual contact. The risk of catching HPV can be reduced by latex condoms.
While there is no cure for HPV, treatment for the symptoms caused by HPV, such as genital warts, cervical changes and cervical cancer is available. A new vaccine, Gardacil®, is now available to prevent the problems caused by HPV. Please ask your doctor if this is appropriate for you.
Hysterectomy is the surgical removal of the uterus. The procedure is done either through the abdomen or vagina. A hysterectomy can remove part or the entire uterus and may also remove the ovaries and fallopian tubes. Hysterectomies are typically performed to treat cervical or ovarian cancer, endometriosis or tumors. The surgery usually requires a 2-3 day hospital stay and full recovery is expected in six to eight weeks.
Loop electrosurgical excision procedure (LEEP) is used to treat abnormal cells on the surface of the cervix. During the procedure, the cells are removed to prevent progression of cervical cancer.
Wire loops attached to an electrosurgical generator remove the affected tissue, causing the cells to heat and burst. The removed tissue is then sent to a lab for further evaluation, including ensuring full removal and assessing the cause of the abnormal area. The procedure takes 20-30 minutes and can be performed in the office. A local anesthetic is administered to minimize pain. Side effects are rare.
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Mirena® is an progestin containing intrauterine contraceptive (IUC) that is effective for up to five years. It is a tiny T-shaped piece of plastic that is implanted in the uterus to block sperm, make the uterine lining thinner and can significantly lighten menstrual flow. Mirena® is 99.9% effective in preventing pregnancy and comes without the hassle and side effects of the Pill. It has become extremely popular with our patients.
Myomectomy is a procedure that surgically removes fibroids, non-cancerous tumors of the uterus, and repairs the uterus for women who plan to bear children or want to keep their uterus. It is helpful for women who plan to bear children at a later age, when fibroid symptoms tend to occur.
This procedure can be done in a few different ways, depending on the type of size of the fibroids. Laparotomy or abdominal myomectomy uses an incision and allows the surgeon to visually inspect the uterus and feel for fibroids. It requires a short hospital stay and a recovery time of 4-6 weeks. Hysteroscopic myomectomy uses a tool called a resectoscope to enter through the vagina, release a liquid to expand the uterus and then shave away the fibroid pieces. Finally, laparoscopic myomectomy inserts a laparoscope, a small tube with a camera, into the pelvis and removes the fibroids through small incisions made in the abdomen. Laparoscopic and hysteroscopic patients are usually released from the hospital the same day.
Paragard® is a hormone-free intrauterine contraceptive (IUC) that is effective for up to 10 years. It is a T-shaped piece of plastic coated in copper that is inserted into the uterus by a doctor. It is 99.4% effective. Side effects of Paragard® are minimal but can include abdominal cramps or longer and heavier periods for the first few months.
Saline Infusion Sonography
Saline infusion sonography, also known as sonohysterography, is a test that checks for intrauterine abnormalities. An ultrasound image is produced to view the uterine cavity and the endometrial lining. This procedure can test for congenital defects, masses, scarring, polyps or fibroids and help determine the next step in treating the problem.
During the procedure, sterile saline is gently injected into the uterus to enlarge the cavity and make any structures more visible. A probe is inserted into the vagina to obtain the sonogram images. The procedure is non-invasive and usually takes about 30 minutes.
Treatment of PMS and PMDD
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are common conditions that up to three out of four women may experience at some point in their life. These conditions are associated with symptoms related to menstrual periods and can include bloating, cramping, fatigue, moodiness, sleep irregularity and depression. PMS is often expected by most women, but chronic symptoms and symptoms of PMDD can and should be treated professionally. If they are affecting your ability to function in your everyday life, they can be considered serious and deserve attention.
Chronic PMS and PMDD can be treated through a variety of solutions. Modifying natural behavior is often the most effective treatment and includes exercising regularly, eating healthy foods, getting enough sleep, dealing with stress and not smoking. Birth control pill can often help reduce the symptoms. For PMDD, anti-depressants or counseling may be prescribed.
Ultrasonography is an imaging technique used to diagnose a variety of gynecologic conditions. It is used commonly during pregnancy, to detect gallbladder disease, cancer and to perform breast exams. The process uses high frequency sound waves and directs them at specified areas of the body to generate images of the internal structure. It is most effective in imaging soft tissues that are solid or filled with fluid. The procedure is done by applying a gel over the surface of the skin and then running a transducer over the area. A probe is inserted into the vagina to obtain the image. The procedure is usually painless and takes less than 30 minutes. The images are projected simultaneously onto a display screen and can be analyzed immediately.
As a board certified obstetrician/gynecologist who is also board certified in integrative holistic medicine, Dr. Eden Fromberg is fully trained, credentialed, and experienced in both traditional and integrative medical theory and practice. Her dedication to caring well for her patients, years of clinical experience, and interest in current research and innovation give her the opportunity to sort out complex issues and develop customized treatment plans. Dr. Fromberg’s medical practice at SOHO OB/GYN in New York City is a sanctuary for truly holistic women’s health care. Patients are given the information, time, resources, and ongoing support that they need to achieve true health and well being in any or all aspects of their lives.
A visit with Dr. Eden Fromberg reaches beyond the typical GYN office visit to truly delve into any issues of concern and keep patients healthy for years to come, including the essential underlying nutritional, metabolic, and hormonal aspects of women’s health. Generous time and focused attention are devoted, with the goal of providing comprehensive, meticulous, personalized, truly holistic care.
Dr. Fromberg’s expertise and ongoing commitment to keeping abreast of current research and clinical updates allows her to treat a range and depth of women’s health conditions. She listens carefully with an open mind and broad perspective, thinks outside the box, and is adept at diagnosing and sorting out complex problems that may be dismissed or not adequately addressed by conventional gynecological care. Her willingness to take the time and thought to seek out and treat the root causes underlying symptoms, and her ability to offer her patients meaningful information, alternative perspectives, and a range of potential options, allow her patients to find the care and relief they need while often avoiding the potential side effects and risks of pharmaceutical medications, synthetic hormones and unnecessary surgery.
Dr. Fromberg is dedicated to caring well for her patients, and she provides detailed, personalized guidance in making informed choices with compassion and respect for each woman’s personal orientation and individual needs. Even problems that may seem straightforward are handled thoroughly, gently, and with kindness and care. Although wellness, prevention, and nutrition are emphasized, conventional care and medications always remain options for women who desire it, or when alternatives do not fully address their needs. Dr. Fromberg makes herself available by email for ongoing contact, and makes every effort to see patients with urgent needs on the same day whenever possible, since she knows that many problems truly cannot wait.
Dr. Fromberg offers:
- Comprehensive, holistic, state of the art gynecological care for women throughout the life cycle
- Complementary & integrative medical approach, including body, mind, and spirit
- Wellness & prevention: beyond gynecology
- Pap smears, GYN & breast exams
- Integrative endocrinology for women, including:
- ovaries, adrenal glands, thyroid, pituitary, hypothalamus, pancreas.
- Testing & treatment of hormonal imbalance.
- Integrative fertility & reproductive endocrinology, including:
- fertility evaluations, testing and treatment;
- fertility awareness & cycle charting;
- sonography (ultrasound);
- natural ovulation enhancement;
- bioidentical hormones;
- intrauterine insemination (IUI);
- prevention & treatment of miscarriage;
- integrative care for women undergoing IVF;
- fertility enhancing diets;
- single women and couples of all orientations welcome.
- Nutrition & metabolism:
- testing and treatment of nutritional deficiencies and underlying metabolic and hormonal imbalances, correlation with current symptoms and health status.
- Experience with all types of diets ranging from vegetarian, vegan, & raw to Weston Price/Nourishing Traditions omnivorous diets, low glycemic, metabolic typing, and various weight loss and popular diets.
- Integrative, personalized nutrition programs.
- Holistic prenatal care & reproductive support. Prenatal nutrition expert.
- Abnormal pap smears, cervical dysplasia, HPV:
- true integrative care,
- immune support,
- important information,
- second opinions,
- nonsurgical treatments
- Abnormal bleeding & irregular periods:
- evaluation and appropriate treatment of underlying causes
- Bioidentical hormones: used judiciously and with care
- Menopause: all aspects, including prevention and treatment of hot flashes, mood swings, cognitive and intellectual changes, lidibo, sexual dysfunction, vaginal dryness and tightness, urinary leakage, pelvic floor weakness or tightness, osteoporosis, weight management, nutrition, exercise, breast changes, energy levels, cancer prevention, and more.
- Contraception & family planning including cervical caps, IUDs, and fertility awareness. How to stay and feel as healthy as possible when taking or discontinuing birth control pills.
- Osteoporosis: beyond calcium
- PCOS (polycystic ovarian syndrome): restore cycles and fertility, improve metabolism
- Hirsutism: testing and treatment of excess hair
- Ovarian cysts
- Sexual dysfunction
- Low libido
- Vulvodynia, pelvic & sexual pain: Dr. Fromberg is an active member of the International Pelvic Pain Society and the International Society for the Study of Vulvovaginal Diseases, and attends yearly courses and meetings to keep up to date in this complex field
- Vulvar dermatology: rashes, bumps, growths, discoloration, peeling, itching, etc.
- Recurrent infections
- Bladder infections/UTI
- Sexually transmitted disease testing, treatment, and prevention, including Herpes
- HIV testing
- Cancer screening
- Organic supplements & botanical remedies
- Osteopathic manual treatment
- Functional medicine
- Anthroposophic medicine: professional coursework and active member of Physicians Association for Anthroposophic Medicine
- Yoga & exercise prescriptions: extensive training and experience
- Minimally invasive & alternatives to surgery
Click here for Dr. Eden Fromberg’s website: http://doctoredenfromberg.com/
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