At Rockville Gynecology we believe emotional, physical, and comprehensive adolescent gynecological care forms the building blocks for a healthy woman. Providing emotional support, education, and individualized care to each adolescent will empower them to make educated and healthy decisions today and in the future. Careful explanation of the provider-patient relationship for adolescents and the safeguarding of their privacy are important to us. Caring for the adolescent is rewarding because we are privileged to witness the formation of a self -aware and healthy adult female.
Are you here for your first gynecological visit? We are very happy to see you and put your mind at ease. Girls should have their first Gyn visit between 13-15 years of age. This visit does not need to include a pelvic exam. A pelvic exam can be performed if there are any current complaints or concerns. Many times it is an opportunity to get to know your provider and for the provider to get to know you!
We will discuss your family medical history, past medical history, and social history. This can be a time for discussion about healthy adolescent practices and prevention of illness. We also discuss the human papilloma virus (HPV), and the vaccine to decrease the risk of cervical cancer and gential warts. If you are having problems with heavy or painful periods, or abnormal bleeding, we will talk about different treatment options. If contraception is necessary, we will discuss all the possible forms, to help you decide which is the right one for you.
At Rockville Gynecology, we focus solely on women who are not currently pregnant. Because of this, we give more time and attention to the gynecological needs of each patient. We perform annual GYN exams, as well as evaluation of abnormal pap smears, fibroids, ovarian cysts, endometriosis, pelvic pain, abnormal bleeding, vaginitis/yeast infections, pain with intercourse, and postmenopausal bleeding. Our goal is to provide each patient with all available treatment options, and partner with them to decide what is best for them.
We want to help each patient decide what's the best method of birth control for them. We can choose from the birth control pill, ring, or patch, a 3 month injection (depoProvera) or one of several Long-Acting Reversible Contraceptives (LARC). Hormonal contraceptives provide additional health benefits including lighter periods, decrease pain with periods, decrease lifetime risk of ovarian cancer, colon cancer, and uterine cancer.
LARC options are >99% effective These include the subdermal implant Nexplanon (1.5 inch rod placed under the skin of the upper inner arm; effective for 3 years); and the intrauterine device (IUD--T-shape device placed in the uterus). The IUD comes in hormonal (Mirena--lasts 5 years & makes periods very light or non-existant, or Skyla--lasts 3 years) and non-hormonal options (Paragard--lasts 10 years).
When you are done having children, we can discuss permanent sterilization, the non-reversible form of contraception. There are several approaches to this procedure, with ESSURE hysteroscopic sterilization (camera in the uterus) being the most popular since it can be done in the office under local or IV sedation (twilight), and no incision is required, with minimal cramping and no time needed for recovery.
Cancer Risk Assessment
The providers at Rockville Gynecology believe that there is “Power in Prevention.” Because of this, we focus on family history of certain cancers, and individual risk factors to determine if there is additional testing that can be performed that would help us determine who is at high risk of developing cancer, especially breast and ovarian cancer. If there is a family history of breast or ovarian cancer, then testing for the BRCA mutation using a test called myRisk™ will be offered. This is done with a simple blood draw in the office. If there is a strong family history of colon, uterine, ovarian, stomach, or kidney cancer, then testing for Lynch syndrome will be offered. Personal recommendations for further screening and treatment are based on the results.
For patients who want to know more about their individualized risk of breast cancer, we offer the BrevagenPlus™ test. This is a cheek swab that assesses a patients genetic material (DNA), and combines it with their family and personal history to give us a better assessment of that person’s individual risk of breast cancer. The test is available to those who are 35 or older, and are Caucasian, African-American, or Hispanic. Insurance often covers testing, but if not, the cost is $275 and the lab offers a payment program. Rockville Gynecology is proud to be one of the only offices in Montgomery County that has this testing available.
Take this quiz to find out your cancer risk
Did you know:
Genetic testing can help you determine if you are at increased risk for developing certain types of cancer. 25 Genes are analyzed by Myriad Genetic Laboratories for hereditary cancer risk. Coverage is excellent! Most insurance companies cover genetic testing at 100%. You will be assessed for the following hereditary cancers:
- breast cancer
- ovarian cancer
- colon cancer
- uterine cancer
- pancreatic cancer
- gastric cancer
- prostate cancer
- hereditary melanoma
Minimally Invasive Surgery
At Rockville Gynecology, we strive to offer a wide-range of treatment options for each patient, including both medical and surgical. If medical options are not appropriate, then both Dr. Young and Dr. Gonzalez have special training in advanced minimally-invasive surgical procedures. These include using the daVinci™ robotic sugcial system in many cases. They also have advanced training in complex laparoscopy and hysteroscopy. When open surgery is required, it can often be performed through a mini-laparotomy (2 inch) incision. The advantages of minimally-invasive surgery include less pain, scarring, and a quicker recovery. Most surgical procedures, including laparoscopic hysterectomy and laparoscopic myomectomy, are done as outpatients, so often there is no need to spend the night in the hospital.
Once a month, we have a board-certified anesthesiologist come to the office to provide IV sedation so we can perform hysteroscopy, often with endometrial ablation (a procedure to make periods much lighter), or Essure™ (permanent sterilization). Providing these services in the office is more convenient for patients, and alleviates additional hospital charges.
Essure™ is the “modern” way of tying tubes (permanent sterilization). It can be done in the office either under local anesthesia (numbing of the cervix), or under IV sedation (twilight) based on patient preference. A small camera is inserted in the uterus and small coils are placed into the opening of the tubes. The procedure takes 5-10 minutes, with mild cramping. If a patient decides to have Essure™ performed under local anesthesia, they can drive themselves home or right back to work. There is minimal cramping for usually one day.
Natural menopause is defined as not having a menstrual period for 12 months. It occurs at an average age of 51 years. The menopausal transition, or perimenopause, occurs after the reproductive years, but before menopause, and is characterized by irregular menstrual cycles, hormone changes, and symptoms such as hot flashes; sleep disturbances, mood symptoms, and vaginal dryness. In addition, changes in cholesterol and bone loss begin to occur, both of which have implications for long-term health.
There are hormonal and non-hormonal options to reduce the symptoms of perimenopause and menopause. Hormone replacement therapy (HRT) has benefits and risks. The goal is to use the lowest dose for the shortest duration. Many women benefit greatly from low dose HRT to improve their quality of life and prevent osteoporosis. Most of the available HRT options are bioidentical and very safe. For those women who have menopausal symptoms but should not use hormones (i.e. breast cancer patients) there are non-hormonal options such as Brisdelle and Effexor (traditionally used as antidepressant), and Neurontin (traditionally used to decrease nerve pain).
We work with each individual patient, and take into account their personal and family history as well as their concerns to decide together which is the best treatment option. We often start with alternative therapies such as soy products (Isoflavones and phytoestrogens), herbs (black cohosh), acupuncture, paced respiration, weight loss, and exercise.
Mona Lisa Touch
The first and only practice in Montgomery County featuring Mona Lisa Touch. The first medical laser for treatment of vaginal atrophy due to menopause.
- Hormone-free, perfect for breast-cancer survivors and those wishing to avoid estrogen exposure
- Three, five minute, painless treatments at 6 week intervals
If you're suffering from Vaginal atrophy, you may experience some or all of these symptoms:
- Burning feeling or irritation
- Pain during intercourse
- Poor vaginal lubrication
- Loosening of the Vagina
- Incontinence and the need to urgently urinate
For more information visit our Mona Lisa Touch Website: Mona Lisa Touch Wesbite
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