We strive to create individualized treatment plans for each of our patients as each person has a unique history and unique needs. Some of our services include:
- Urinary Incontinence
- 3D and 4D Ultrasound
- Infertility
- Minimally Invasive Laparoscopic Gynecologic Surgery
- Pap Smear
- Colposcopy
- IUD Placement
- MonaLisa Touch®
- Vaginal Rejuvenation
- Endometriosis
- Cancer Screenings
- Birth Control
- Fibroids
- Women’s Health
- STD Screenings
- Sexual Health
- Menopause
- International Society
- Vaginal Dryness
- Low Sexual Desire
Urinary Incontinence
Many women struggle with urinary incontinence, and it can be an embarrassing and inconvenient issue to live with.
However, there are many ways to manage and treat urinary incontinence, and at Miriam Greene, MD we can help navigate your condition with urodynamic testing, medical treatments, and in some cases, surgery to best address your needs.
Whether you are dealing with stress incontinence or urge incontinence, we can help develop a personalized treatment plan to help you find the relief you deserve.
3D and 4D Ultrasound
Are you expecting a baby and want to get a sneak peek at your little one? Seeing your baby is such a thrilling experience, and with today’s modern technology, you can see your bundle of joy clearer than ever with our 3D/4D ultrasound machine.
Our team here at Miriam Greene, MD is here to provide ultrasound services to you along with the option to learn your baby’s gender at an earlier time than what is typically possible with a 2D ultrasound.
Take home a precious keepsake of your baby in utero and create a lifelong memory of those first moments seeing your baby.
Infertility
Struggling with infertility can be a frustrating, heartbreaking experience for many couples. Nearly 10%-15% of couples are affected by infertility.
Here at Miriam Greene, MD we have compassion for those families, and we are proud to provide evaluations and treatments for common causes of infertility. Whether you are suffering from polycystic ovary syndrome (PCOS) or another cause for infertility, we are here to help find the right solution for you.
Minimally Invasive Laparoscopic Gynecologic Surgery
Minimally invasive surgery offers the best possible results with a shorter period of recovery and a lower risk for complications. For minimally invasive gynecological procedures, trust Miriam Greene, MD and our staff. Our team is highly skilled and trained to offer high-quality treatment using state-of-the-art technology.
Conventional surgeries can result in longer recovery times and larger incisions. However, Miriam Greene, MD offers multiple forms of minimally invasive surgical options such as laparoscopy and robotic surgery as effective forms of treatment for various conditions.
During your consultation, Miriam Greene, MD will conduct a thorough physical examination and review of your medical history to determine which treatment option is best for your condition.
Pap Smear
A Pap Smear is a test that is usually performed yearly after a woman turns 21 or becomes sexually active. The test is a simple, quick collection of cells. While a Pap Smear is not a diagnostic test for cervical cancer, it can detect any abnormalities which can then lead to further testing.
What to expect during a Pap Smear
At the start of the exam, you will be asked to remove your clothing from the waist down. You will be given a medical gown and a half sheet to cover your lap. At the medical center office, there is an examination chair with stirrups at the end for your feet. You will position yourself in the chair, with your feet in the stirrups, so that you can be examined. An instrument, called a speculum, is lubricated and inserted into the vagina. This tool allows the doctor to have a clear path to the cervix. It is important to remember to relax and breath. This will relax the muscles of the vagina and allow for an easier examination by the medical professional.
After the speculum is inserted, a tiny, thin bristle brush is used to collect some tissue from the back of the cervix. Most women do not feel anything besides a light sensation when this is performed while some experience a feeling similar to menstrual cramps. From here, the medical professional places the sample in a small tube to be sent off to a laboratory for testing. The speculum is removed and the Pap Smear is over. A Pap Smear procedure only takes a few minutes to complete. After the Pap Smear is completed you can get dressed and conclude your medical examination.
Colposcopy
At Miriam Greene, MD, we care about preventive healthcare and one of the services we offer is a colposcopy as part of screening for cervical cancer. A typical cervical cancer screening, known as Pap test or Pap smear, can sometimes come back with abnormal results.
It is important to note that abnormal results are common and do not necessarily mean you have cancer or precancerous cells. Sometimes your outside factors such as your menstrual cycle can interfere, so often follow-up tests are required. We may recommend a colposcopy if your recent Pap smear has come back abnormal.
IUD Placement
At Miriam Greene, MD, we understand that your choice of birth control is a personal one. We offer a wide range of contraception options and will help find one that is right for you and your lifestyle. While some people prefer the familiarity of pills, the convenience of an IUD or implant may be more appealing to others.
IUD placement is performed within our office and is a simple procedure that only takes a few minutes of your time. Using a speculum, we can spread your vaginal walls for better access to your cervix, the opening of the uterus. The IUD is then inserted through the cervix and embedded into the uterus.
You may feel a slight pinch during the placement but otherwise should not experience any discomfort or pain. A plastic tail is attached to the IUD and extends into the vagina. We recommend ensuring the tail is in place before having sex for maximum protection. The IUD works by making the uterus inhospitable to host sperm and increasing your body’s production of cervical mucus to make it difficult for sperm to reach the egg.
MonaLisa Touch®
If you find yourself suffering from painful intercourse, sexual dysfunction, vaginal dryness, burning, or urinary incontinence the MonaLisa Touch® may be right for you. MonaLisa Touch® is a form of laser therapy that will help to improve your symptoms and provide you with long-lasting relief.
As women age, estrogen levels begin to decline which can result in vaginal changes and discomfort. It is not uncommon for women to experience these changes during perimenopause, menopause, or even after childhood. Though many women try hormonal therapies, estrogen creams, and other supplements, these treatment options have proven less effective in long-term results.
The MonaLisa Touch® is a form of laser therapy treatment for vaginal rejuvenation that gives effective relief and offers life-changing results. It has been clinically proven to eliminate vaginal dryness, vaginal laxity, itchiness, burning, and urinary incontinence.
This treatment works by delivering laser energy into the cells to stimulate the production of collagen, improving the functionality of the treated area.
During this procedure, a small metal laser wand is inserted into the vagina and rotated during treatment to target the internal and external vaginal tissues.
The treatment is painless, requires no anesthesia, and offers zero downtime following treatment. It is recommended that sexual intercourse and the use of tampons are avoided for several days.
The typical treatment course is three 5-minute sessions over a period of 18 weeks. Many women experience positive results following the first session which will continue to improve throughout treatment.
Vaginal Rejuvenation
Women who are uncomfortable about the appearance, feel, or function of their vagina should seek vaginal revitalization treatments. Vaginal revitalization treatments may be for you if you experience:
- Vaginal dryness
- Itching
- Burning
- Pain during sex
- Urinary incontinence
- Endure excess labial tissue that may interfere with the fit of clothing, sexual sensation, or physical activity
MonaLisa Touch®
MonaLisa Touch® is a form of laser therapy that stimulates blood circulation and the production of collagen to restore your vaginal tissue. After a series of treatments, you will experience an improvement in vaginal strength, resiliency, and sensation.
It is a quick and painless treatment with no scheduled downtime. However, you should avoid sexual intercourse and the use of tampons for several days while you recover.
Labiaplasty
Labiaplasty can be a great option if you have excess labial tissue that may make you feel self-conscious about your body.
There are several techniques that your doctor may use during this procedure to alter the size and shape of your labia. The trim technique involves trimming away the excess tissue and then stitching up the area. The wedge technique means a piece of the labia in the shape of a pie piece or wedge will be removed before the area is stitched together.
Following the procedure, you will need a week of downtime and rest. We recommend elevating your hips and using ice to help keep swelling to a minimum. Minor swelling may linger for up to six months as the body fully heals. Sexual intercourse and the use of tampons should be avoided for six weeks following the procedure.
Endometriosis
1 in every 10 women of child-bearing age has endometriosis, which is the overgrowth of uterine lining beyond the uterus. Our practice offers treatment options for those who struggle with this condition.
What is Endometriosis?
It is a common gynecological condition, in which the tissue that lines your uterus, known as the endometrium, grows outside of your uterine cavity. It can grow on other parts of the reproductive system such as the ovaries or spread to the bowels and tissues lining your pelvis. It is unusual for the tissue to spread beyond the pelvic region, but it is not impossible. Endometrial tissue outside of the uterus is known as an endometrial implant.
Symptoms
Symptoms of endometriosis vary. Some women may experience mild symptoms while others may have more moderate to severe experiences. The severity of your pain does not indicate the degree or stage of your condition. Some women with severe cases only experience minimal symptoms.
The most common symptom of endometriosis is pelvic pain, but you may also experience:
- Painful periods
- Pain in the lower abdomen before and during menstruation
- Cramps one or two weeks around menstruation
- Heavy menstrual bleeding
- Bleeding between periods
- Pain following intercourse
- Infertility
- Discomfort with bowel movements
- Lower back pain at any time during your menstrual cycle
You may also experience no symptoms, which is why it is important to attend routine gynecological exams. This will allow your doctor to note any changes. If suspected, your doctor may recommend laparoscopy as it is the only certain method of identifying endometriosis by viewing it directly. A tissue sample will be sent and analyzed by the lab to confirm the diagnosis.
Treatment
There is no cure, so treatment focuses on the management of symptoms and improving your quality of life. Everyone reacts differently, so we will work with you to design the right treatment plan for your condition.
Pain medication can be used to help manage some symptoms of pain and inflammation. Hormonal therapies can also relieve pain and stop the progression of endometriosis in some cases. By blocking the natural production of estrogen, endometriosis can be slowed but may also bring on early symptoms of menopause.
Laparoscopy, a minimally invasive surgery, may also be used to remove endometrial tissue from various sites. In severe cases and if your condition does not respond to other forms of treatment, your doctor may suggest undergoing a hysterectomy. A hysterectomy removes the uterus, cervix, and ovaries as well as any visible implant lesions. Undergoing this surgery means you will be unable to become pregnant.
Cancer Screenings
Cancer screening is an important part of maintaining your overall good health. Like all cancers, early detection can be the key to treating women’s cancers and increasing the chances of a full recovery. Our practice offers various cancer screening options available in- office so that you can ensure your optimal health.
Breast Cancer Screenings
Clinical breast exams are conducted during each exam to search for any changes in your breasts or unusual lumps. We will ask about your family history and if any members have been diagnosed with breast cancer. Annual mammograms begin at the recommended age of 40.
Cervical Cancer Screenings
Pap smears are important for finding any changes in your cervical cells. These tests begin at the age of 21. The HPV test can also be conducted at this time since the HPV virus can lead to cervical cancer. Even if you have been vaccinated against HPV, it is still important that you follow the screening recommendations for your age group.
Colorectal Cancer Screenings
The screening for colon cancer typically begins at the age of 45, unless otherwise recommended by your doctor. This is accomplished by analyzing a stool sample or by examining the colon and rectum (colonoscopy).
Endometrial Cancer Screenings
During menopause, women should report any unexpected vaginal changes such as bleeding or spotting. There are many causes of postmenopausal bleeding that can be benign such as uterine polyps or fibroids. However, uterine cancer, or endometrial cancer, can also cause abnormal changes during menopause. If you notice any changes, please report them to your doctor so that a biopsy can be conducted to determine whether there is a concern for cancer.
Birth Control
For women who are sexually active but do not wish to become pregnant, there are several birth control options, or contraceptives, available that are safe and effective. We will work with you to find a form of birth control that is right for you and your lifestyle.
As mentioned above there are various kinds of birth control:
- Barrier
These methods of birth control include male and female condoms as well as diaphragms, or cups, that work to prevent sperm from entering the uterus. - Hormonal
Hormonal birth controls may come in the form of pills, patches, shots, or implants. These methods alter your hormone production to either prevent your body from releasing eggs or to thicken cervical mucus so that fertilization does not occur. - Procedural
These birth control methods involve undergoing minor procedures to prevent pregnancy. An IUD, or intrauterine contraception device, is a device placed within the uterus and works to decrease ovulation, thicken cervical mucus, or block sperm from entering the uterus.
Another form of procedural birth control is tubal ligation. This form is permanent as the Fallopian tubes are cut, clamped, or burned off. This prevents eggs from traveling to the uterus or sperm from reaching the eggs.
Effectiveness
Abstinence, or refraining from sexual intercourse, is the only means of birth control that is proven to prevent pregnancy 100%. However, many of the birth control options listed above have excellent rates with less than 1% of women becoming pregnant when using birth control correctly.
Risks and Benefits
Every contraceptive has its own risk and benefits. It is important that you make this decision together with your doctor so that you are aware of all your options and choose the one that is right for you.
Fibroids
Fibroids are noncancerous growths that develop either in or on your uterus. These growths can cause pain, heavy periods, and difficulty becoming pregnant. If you know or suspect you may have fibroids, we will help you achieve relief with the latest treatment options for fibroids.
What are fibroids?
Fibroids are abnormal growths that develop in or on a woman’s uterus. These are typically benign or noncancerous tumors. However, they can become quite large and cause severe pain in addition to other symptoms that may affect your quality of life.
- Intramural
This is the most common type of fibroid and appears within the muscular wall of the uterus. These growths may become large and stretch your womb. - Subserosal
Subserosal fibroids form on the outside of the uterus which is called the serosa. These growths can become large and make your womb appear bigger on one side. - Pedunculated
This type of tumor grows from a subserosal fibroid that develops a slender base or stem to support the tumor. - Submucosal
These fibroids develop in the middle muscle layer of the uterus and are the least common type.
Symptoms
Symptoms will depend on the number of tumors present as well as their size and location. Often smaller fibroids do not cause symptoms, but common signs and symptoms of fibroids include:
- Heavy bleeding between and during your period
- Pain in the pelvis or lower back
- Increased menstrual cramping
- Increased urge to urinate
- Pain during sexual intercourse
- Menstruation that lasts longer than a week
- Pressure or fullness felt in the lower abdomen
- Difficulty becoming pregnant
Your doctor can diagnose fibroids by feeling for any signs of abnormal growths in your uterus during a routine exam. An ultrasound or MRI can help to confirm the diagnosis and show the size and location of the fibroids.
Treatment
If the fibroids are small, do not cause health concerns, or do not affect your quality of life, treatment may not be necessary. Medications, lifestyle changes, and home remedies can help to relieve some discomfort. Other recommendations include:
- Yoga
- Massage
- Dietary Changes
- Regular exercise
- Stress management
Birth control may also help to control any excessive bleeding during your periods. In severe cases, surgery may be recommended to remove fibroids from your uterus.
Women’s Health
At Miriam Greene, MD, we provide comprehensive women’s health services while making you feel at ease and comfortable with your body and any health concerns you may have.
What is women’s health?
Women’s health treats conditions that mainly affect women. These conditions could be related to the female sex hormones, female reproductive organs, and conditions that primarily affect women.
- Endometriosis
- Uterine fibroids
- Ovarian cysts
- Pelvic pain
- Vaginal atrophy
- Polycystic ovary syndrome (PCOS)
- Pelvic organ prolapses (POP)
- Pelvic inflammatory disease (PIDS)
- Menstrual symptom management
- Menopause symptom management
What is a well-woman exam?
A well-woman exam is an annual examination that ensures you are healthy with a particular focus on your sexual and reproductive health. It is also an opportunity to discuss any concerns or questions you have such as contraceptives, testing for STDs and STIs, or symptoms that may indicate a hormonal imbalance or a greater women’s health condition.
During your well-woman exam, we may also do preventive screenings for cervical cancer, endometrial cancer, breast cancer, and colorectal cancer to ensure optimal health and wellbeing. We will check for any underlying causes of your symptoms or concerns and prescribe effective treatment options that fit your lifestyle and needs.
STD Screenings
A sexually transmitted disease, or STD, is an infection passed from one person to another through sexual contact. These diseases can become serious and require immediate medical treatment to prevent further spread of infection. Symptoms will vary depending on the disease contracted but may include bumps or sores, rashes, or pain felt during urination or intercourse.
At Miriam Greene, MD we offer STD screenings, diagnosis, and treatment recommendations as well as education on various prevention methods. Testing may involve urine or blood samples, genital exams, or physical exams. For more information on our STD services or to schedule an appointment, please contact us today at (212) 725-3966.