Obstetric & Gynecologic Services

Common causes of heavy or irregular bleeding include fibroids, endometriosis, adenomyosis, polyps and gynecologic cancers. Treatment for this problem will depend on the cause, as well as a woman's age and her plans for future pregnancies. Medication such as birth control pills or IUDs may help some women. Others may find relief from radiologic or radiofrequency procedures, or from removal of fibroids, endometrial lesions, polyps or the uterine lining. Our specialists will identify the cause of the abnormal bleeding, discuss all the treatment options and find the best option for each individual patient.

Q&A: Getting your period: What is a "normal" menstrual cycle for teens and preteens?

Endometriosis occurs when tissue normally found in a woman’s uterus grows outside of the uterus. It is a condition that affects approximately 10 percent of reproductive-age women and can cause many symptoms. Most commonly, women have pain in the lower belly and pelvic area that can occur before or during monthly periods, when urinating or having a bowel movement, and during or after sex.

Endometriosis and the development of cysts on the ovaries, called endometriomas, can make it difficult for a woman to conceive a pregnancy. Symptoms tend to worsen with time and can significantly affect physical and emotional well-being during menstruation. Initially, medical therapy is used to relieve pain and symptoms. Often, if medication does not work, laparoscopic and robotic procedures can alleviate symptoms by removing cysts or even pelvic organs.

At UChicago Medicine, we offer highly specialized, effective care for women with uterine fibroids. Our multidisciplinary physician team has expertise in innovative surgical and non-surgical fibroid treatment techniques, including some that are not widely available. Most importantly, our goals are to help you understand that you have options for uterine fibroid treatment, and to assist you in making the choice that best meets your unique physical and personal needs.

UChicago Medicine gynecologic oncologists are skilled in minimally invasive techniques for the treatment of gynecologic cancers, including:

• Cervical cancer
• Gestational trophoblastic disease (GTD)
• Ovarian cancer
  
• Uterine (endometrial) cancer
  
• Vaginal cancer
• Vulvar cancer

Minimally invasive cancer surgery allows patients to recover and begin their path to wellness more quickly. Some cancers may be treated with robotic gynecologic surgery. Additionally, laparascopic gynecologic surgery can be used to remove tumors, and when necessary, lymph nodes.

At UChicago Medicine, women with gynecologic cancers may also have access to other advanced treatment options, including:

• HIPEC for ovarian cancer
• Radical vaginal trachelectomy for early cervical cancer
• Clinical trials offering access to new medications

Our surgeons use the latest laparoscopic gynecologic techniques and hysteroscopic procedures to diagnose and treat conditions associated with infertility and reduced fertility (subfertility), including endometriosis, blocked fallopian tubes and malformations of the uterus. Our surgeons partner with fertility specialists, offering services to give women the best possible chance for a healthy pregnancy. Our areas of expertise include:

• Oncofertility (fertility for cancer survivors)
• Polycystic ovarian syndrome (PCOS)
• Ovarian insufficiency
• Transabdominal cerclage, a surgical treatment for incompetent cervix (cervical insufficiency)

Menopause is the end of a woman’s menstrual cycle, and it’s a natural part of life. During perimenopause — the months or years leading into menopause — most women experience symptoms, such as irregular periods, hot flashes, night sweats, insomnia, vaginal dryness or changes in sexual desire. At UChicago Medicine, our gynecology team specializes in helping women navigate these natural changes. Our experts offer hormonal, non-hormonal and alternative treatment options to help women maintain their quality of life as they transition to menopause.

Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. If a cyst is detected, our gynecologists will examine you and perform an ultrasound to determine whether surgery or observation is the best approach.

Ovarian cysts can almost always be treated using laparoscopic gynecologic surgery — without removing the ovary. Using minimally invasive surgical techniques, our surgeons remove ovarian cysts with minimal recovery time and without a large incision.

There are many different reasons why people go to the bathroom frequently. When frequent urination becomes bothersome or you wake up at night more often than you like, you’ll want to discuss treatment options with your doctor for overactive bladder. UChicago Medicine physicians in the Center for Pelvic Health can diagnosis your condition and recommend a treatment plan that works for you.

Weakness in pelvic muscles and tissues can sometimes cause organs to shift out of place. This condition, called pelvic organ prolapse, may involve the bladder, uterus, small bowel, vagina or rectum. Symptoms vary based on which organs, muscles and tissues are affected. The most common cause of prolapse is pressure from pregnancy, labor and childbirth. Additional causes may include obesity, constipation, cancer, hysterectomy and chronic coughing conditions. Whenever possible, our urogynecologists perform laparoscopic gynecologic surgery or vaginal surgery to reposition prolapsed organs and repair weak pelvic floor muscles.

Pelvic pain is discomfort that occurs in the lower abdomen below the navel. More common in women than in men, pelvic pain can be a sign of other health problems, some of which may be serious.

Our experts perform a comprehensive assessment to diagnose and treat the various causes of pelvic pain. If necessary, our surgeons use minimally invasive treatment approaches such as:

• Laparoscopy to remove pelvic adhesions (scar tissue) and other abnormal tissue, such as endometriosis, fibroids and cysts
• Laparoscopic uterosacral nerve ablation (LUNA), which involves cutting some of the nerves for the uterus that may be responsible for pelvic pain or cancer pain

Polycystic ovary syndrome (PCOS) is a condition that may result in irregular menstrual cycles, elevated testosterone levels, and enlarged ovaries that may have a “polycystic” appearance. The term “polycystic” may sound concerning, but in reality, most people with PCOS have more follicles in their ovaries. Follicles contain eggs which are used to reproduce. The brain and ovary communicate via hormones to coordinate ovulation — the release of an egg. People with PCOS may have differences in hormonal signaling that leads to infrequent ovulation and abnormal menstrual cycles.

Symptoms of PCOS:

• Infrequent or unpredictable menstrual cycles
• Skin problems, such as acne or excessive hair growth
• Infertility
• Predisposition to diabetes
• Issues with weight gain/loss

Up to 10% of women may have PCOS and it can run in families. It is treatable with lifestyle management and sometimes medications to help induce ovulation or periods. Doctors such as reproductive endocrinologists or other endocrinologists can help determine if you have PCOS and work with you to create a treatment plan that fits your needs. 

At the Family Birth Center, our team of obstetricians, midwives, maternal-fetal medicine physicians, nurses, lactation consultants and other specialists provide exceptional care for pregnant women, new moms and newborns. From planning your pregnancy through postpartum care and bonding with your newborn, we offer a range of services and resources to support expectant families, including several free prenatal and family classes.

High-Risk Pregnancy Care (Maternal-Fetal Medicine)

Our maternal-fetal medicine physicians provide specialized diagnostic, ultrasound and risk management services for women with complex medical issues affecting pregnancy, including:

• Abnormal placentation (placenta previa, accreta, increta and percreta)
• Incompetent cervix (cervical insufficiency)
• Fetal anomalies
• Gestational diabetes
• Hypertension (high blood pressure) in pregnancy and preeclampsia
• Multiple births (twin, triplets and more)
• Preterm labor
  

More than two dozen types of bacteria, viruses and parasites can be transmitted from an infected person to another through sexual contact — including Human Papillomavirus (HPV), herpes, trichomoniasis (trich), genital warts, Hepatitis B, vaginitis and HIV/AIDS.

Sexually transmitted infections are serious, and not all infections have obvious symptoms. If left untreated, some STDs can eventually cause infertility or even cancer. That’s why UChicago Medicine encourages all women to have regular well woman check-ups, regardless of whether you’re sexually active or not. Our team of supportive gynecologists and midwives understand the anxiety some may feel about sexually transmitted diseases, and are committed to excellence in confidential, compassionate personalized care. All STDs can be treated, and several can also be cured, including chlamydia, gonorrhea and syphilis.

About 30 to 40 percent of American women admit to having problems with bladder control, or urinary leakage (incontinence). Many of these women delay getting help for urinary incontinence for years due to feeling embarrassment. Surgery can significantly improve incontinence that does not respond to initial therapies such as medication, biofeedback or Botox injections. Using laparoscopic surgical approaches, our urogynecologists can reposition or secure the bladder to prevent leaking of urine from coughing, exercise or laughing.

Our areas of expertise include:

• Robotic sacrocolpopexy, to repair vaginal prolapse
  
• Pessaries, to treat prolapse without surgery
  
• Electric stimulation
• Fistulas (connections between the bladder and the vagina)
  
• Complications from vaginal mesh (placed for the treatment of incontinence)
  
• Recurrent incontinence and reoperation

Uterine adhesions are a condition in which scar tissue develops within the uterine cavity, often from infection or a previous surgery. They may cause no symptoms, or they may be linked to problems such as infertility, menstrual cycle problems, monthly pelvic pain or recurrent miscarriage. Uterine adhesions may be removed through hysteroscopy.

Uterine polyps are growths attached to the inner wall of the uterus that extend into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous although some can be cancerous or precancerous. Polyps may occur in premenopausal or postmenopausal women. Symptoms may include infertility, heavy or painful periods, infection and irregular vaginal bleeding before or after menopause. Uterine polyps can be removed on an outpatient basis, using hysteroscopy.

Our women’s health experts provide specialized care for vaginal infections.

Common Types of Vaginitis

Bacterial Vaginosis

Bacterial vaginosis is characterized by thin, white, gray or green discharge, vaginal itching, a fish-like odor and burning sensation when urinating. It’s one of the most common vaginal infections and occurs when there’s an imbalance in naturally present bacteria in the vagina. The cause of vaginosis is still not clear, but it is commonly treatable with antibiotics.  

Yeast Infections (Candida)

Signs of a yeast infection include a cottage cheese-like discharge and vaginal itching and burning. This fungal infection occurs when a naturally present yeast called candida grows out of control. This can be caused by hormonal changes (caused by pregnancy or birth control pills, for instance), a weakened immune system, diabetes or even antibiotics. If you’re unsure whether you have a yeast infection or your symptoms remain after using a over-the-counter antifungal treatment, visit your UChicago Medicine gynecologist or midwife for evaluation.

Learn more about common types of vaginal infections, including viral vaginitis, trichomoniasis vaginitis (trich) and noninfectious vaginitis.