- ArthritisMenopause usually occurs in women between the ages of 42 and 56. Premature ovarian failure (early menopause) is a condition in which menopause occurs before the age of 40. Women who develop early menopause usually have run out of eggs in their ovaries. The cause of premature ovarian failure is generally unknown. However, there are a few reasons why the ovaries may stop producing eggs at an early age. Exposure to certain chemicals or medical treatments can damage or destroy the ovaries. These may include chemotherapy and radiation therapy. Autoimmune diseases such as rheumatoid arthritis are sometimes associated with an early menopause because the immune system forms antibodies that attack and damage the ovaries. Heredity can also play a role – some genetic disorders lead to early menopause.
- Medical Weight LossDietary changes – a diet (any diet) and exercise can help with weight loss in women with PCOS; weight loss lowers insulin levels, reduces risk of cardiovascular disease and diabetes.
- Primary CareCertain medicines and recreational drugs can decrease male fertility. These include alcohol, marijuana, cocaine, cigarettes, anabolic steroids, sulfasalazine, cimetidine (Tagamet, used for ulcers), nitrofurantoin (used for UTIs), anti-hypertensive drugs (specifically calcium channel blockers), aspirin, Dilantin (for epilepsy), colchicine, and antidepressants. These drugs should never be simply discontinued, but substitutions can be made after consulting with your primary care physician.
- Male InfertilityA thorough evaluation of infertility also includes male fertility testing. Evaluation and treatment options for male infertility are available at all our practice locations including Honolulu, Kailua, Hilo, Kona, and Kahului.
- Constipation
- Irritable Bowel Syndrome
- ImmunizationsPregnancy Screen: (Blood type and Rh Factor, Rubella titer, Varicella titer, complete blood count). Determining Blood type can be helpful if there are problems with a pregnancy. Rubella and Varicella are both infections that can cause serious birth defects if they occur while you are pregnant. However, some people have not been immunized or their immunization is no longer working. These tests determine if immunization is needed. A complete blood count screens for anemia and other blood disorders and can tip us off about certain inherited disorders.
- GynecologyA full array of gynecologic services including well-woman exams, infertility, menopausal care, adolescent gynecology, abnormal Pap smears, ovarian cysts and ultrasounds, and contraceptive management are offered. Both medical and surgical options are available. Learn More
- Female Infertility
- ObstetricsThe American College of Obstetrics and Gynecology recommends that an adolescent first see a gynecologist between the ages of 13 and 15 years. This visit typically does not include a pelvic exam, but instead is a time for the adolescent to get to know and trust a physician. The physician should use this visit to screen for health problems and risk taking behaviors and counsel the teen as appropriate.
- EndometriosisMom J and wife Cheynne, tried to get pregnant for two years. They did multiple Intracervical inseminations (ICI’s), then moved on to IUI’s, both of which were unsuccessful. On top of feeling lost and hopeless, Mom J was later diagnosed with Stage 4 endometriosis and had undergone surgery to help resolve their infertility. The doctor […]
- Pelvic PainWhen pelvic pain persists for longer than 6 months it is called chronic pelvic pain (CPP). This is a poorly-understood condition that likely represents abnormal neurological function, either in the peripheral nervous system or central nervous system. Determining what is causing the discomfort may be one of medicine’s more puzzling and frustrating endeavors. Endometriosis is the most common cause of chronic pelvic pain, but sometimes treatment of the endometriosis does not relieve the pain, and pain level is not indicative to the amount of disease present. Many women who experience chronic pelvic pain never receive a specific diagnosis. If a doctor can determine the source of the chronic pelvic pain, then treatment can focus on eliminating that cause, but there is often no quick and easy fix If no cause can be found, then treatment for chronic pelvic pain focuses on managing the pain. Pelvic physical therapy is often a useful treatment for chronic pelvic pain with little to no side effects.
- Pregnancy
- Testicular CancerDES (diethylstilbestrol) exposure prior to birth: Synthetic estrogen used in the 50’s and 60’s used by women to prevent miscarriage. Can cause low sperm counts, decreased sperm motility, abnormal sperm forms, abnormally small penis size, undescended testicles (risk factor for testicular cancer), and abnormal testicles.
- Cervical CancerAbnormal Pap smear results are sometimes explained by an infection or inflammation. Yeast infections, herpes, trichomonas, recent sexual activity, or use of vaginal preparations are some of the many things which can cause an abnormal Pap smear result. Most commonly the culprit is HPV or human papilloma virus. HPV is a common infection. Up to 60% of sexually- active women may carry this virus on their cervix, genital area, or skin, but most are completely unaware of it. HPV of the cervix or other parts of the genital area is acquired through sexual contact. HPV usually goes away on its own without treatment, but when it causes severe changes to the cells of the cervix, treatment is necessary to prevent progression to cancer. Usually this treatment can be performed painlessly in a physician’s office. There is also a vaccine available to help protect against HPV infection and cervical cancer, reducing the risk by up to 99%.
- Interstitial Cystitis
- Epilepsy
- Depression
- Anxiety
- Diabetes Care
- EndocrinologyOur goal is to provide personalized and compassionate reproductive endocrinology, infertility and gynecologic services to the Hawaii community. Our providers combined have over 60 years of experience evaluating and treating reproductive endocrine, infertility and gynecologic disorders. The office is equipped to provide screening, evaluation, diagnostic testing, and treatment, including surgical procedures for any reproductive medicine and gynecologic disorder encountered. Learn More
- HypothyroidismThe most common thyroid abnormality is a thyroid gland that is not active enough and produces less thyroid hormone, called hypothyroidism. It can make you gain weight, feel fatigued and have difficulty dealing with cold temperatures.
- ThyroidDiseases affecting the endocrine system, especially those that are relatively mild, do not appear to increase the risk of miscarriage. However, certain disorders, including uncontrolled diabetes or thyroid disease are known to increase a woman’s risk of miscarriage. In addition, women with Polycystic Ovary Syndrome are at increased risk for sporadic loss, but the condition has no proven association with recurrent pregnancy loss. Based on an individual’s health history, we may recommend an evaluation for an endocrine disorder. In many cases these conditions can easily be managed with medication and should be corrected prior to further attempts at conception.
- UltrasoundSonohysterography (Saline Sonography) – a procedure performed in our office where a small amount of fluid is placed into the uterine cavity while performing a transvaginal ultrasound. This will provide information regarding the uterus and uterine cavity.
- MRIYour doctor will obtain several blood tests after interviewing you and examining you. These will include a prolactin level and a TSH level. These tests should be done in the morning, prior to any significant meals. You may also be asked to have an MRI of your hypothalamus and pituitary gland done. Other testing will depend upon your history.
- Radiology
- X-Rays
- ChemotherapyPremature ovarian failure is the medical term used to describe early menopause. Menopause usually occurs in women between the ages of 42 and 56. Premature ovarian failure (early menopause) is a condition in which menopause occurs before the age of 40. Women who develop early menopause usually have run out of eggs in their ovaries. The cause of premature ovarian failure is generally unknown. However, there are a few reasons why the ovaries may stop producing eggs at an early age. Exposure to certain chemicals or medical treatments can damage or destroy the ovaries. These may include chemotherapy and radiation therapy. Autoimmune diseases such as rheumatoid arthritis are sometimes associated with an early menopause because the immune system forms antibodies that attack and damage the ovaries. Heredity can also play a role – some genetic disorders lead to early menopause.
- Radiation Therapy
- Minimally Invasive SurgeryThough the causes of infertility are numerous and often complex, both male and female factors can be successfully addressed with many of today’s technologies. Our desire is to help patients achieve pregnancy by providing optimized emotional, financial and physical resources. Treatment options may include the use of ovulation induction agents to enhance the production of healthy eggs, minimally invasive surgery such as laparoscopy or hysteroscopy to correct anatomical abnormalities of the female pelvic organs, intrauterine insemination (IUI) of washed sperm that is precisely timed for when fertilization could occur, or more advanced care such as In Vitro Fertilization (IVF). Below are summaries of some of the more common treatments.
- VasectomyImmune problems: Immune reactions to sperm in the man (autoimmune) can be a problem post-vasectomy, but may also have other causes. Anti-sperm antibodies can “attack†the sperm, thus preventing it from being able to fertilize the egg.
- HysterectomyThe definitive surgery for symptomatic uterine fibroids is hysterectomy (removal of the uterus). However, this is rarely appropriate for women trying to conceive or who want to get pregnant in the future. The best option for treatment of fibroids in women who are trying to conceive is to do a myomectomy. This means to remove the fibroids, but leave the uterus.
- LaparoscopyLaparoscopy – a procedure in which your doctor uses a narrow fiberoptic telescope inserted through an incision near your navel to look for and sometimes remove fibroids.
- Reconstructive SurgeryTubal ligation (having your “tubes tied” to prevent pregnancy) can also leave your fallopian tubes damaged. However, reconstructive surgery to reverse tubal ligation is often successful.
- Laparoscopic Surgery
- Bariatric Surgery
- Acne Treatment
- Cyst
- LesionsHysteroscopy is a surgical procedure that offers a direct view of the inside of the uterus and any abnormalities that may alter the inside of the endometrial cavity. It is accomplished by inserting a long, thin fiber-optic lighted tube through the cervix into the uterine cavity, while fluid expands the cavity to allow for visualization. Hysteroscopy allows for the precise localization of lesions and their surgical treatment with special instruments designed to be used through the hysteroscope.
- Burns
- Physical TherapyVaginal pain unrelated to menopause and dryness is frequently caused by spasms of the muscles surrounding the vagina. Pelvic physical therapy and/ or vaginal dilators can be very effective treatments.