Services

We offer comprehensive gynecologic care for people of all ages. Our services include, but not limited to, the following:

• Preventive health care including annual exams; Pap smears and HPV screening; as well as contraceptive counseling and provision, and screening for sexually transmitted infections, if/as needed.
  ** Please note: Federal law now requires health insurance to cover, without cost to patients, most women’s health preventive services — including contraceptive methods and counseling (IUDs, pills, injections, implants, and permanent sterilization), STI screening, cervical cancer screening, and annual exams. Please call our office to schedule these important services. For more information, visit http://www.hrsa.gov/womensguidelines/
• Medical and surgical treatment of fibroids, menstrual problems, endometriosis, urinary incontinence, prolapse, ovarian cysts, pelvic pain, and other gynecologic problems (see below)
• Minimally invasive minor and major surgeries, including vaginal, laparoscopic, and robotic-assisted (da Vinci) hysterectomies, for less pain and faster recovery to your optimal health (see below)
• Counseling and treatment options for perimenopausal and menopausal women
• Management of abnormal Pap smears, including colposcopy and LEEP
• Education about and management of all contraception options, including pills, IUDs, removal of fallopian tubes, Nexplanon, diaphragms, etc. – including expertise in contraception for women with medical problems
• Human Papilloma Virus (HPV) vaccination and counseling
• Screening for and treatment of vaginal, vulvar, and urinary tract problems and infections, including sexually transmitted infections
• In-office pelvic imaging with ultrasound (2D and 3D), sonohysterogram, hysteroscopy (standard and Endosee)
• Evaluation and treatment of pre- and postmenopausal bleeding
• Evaluation and management of pelvic organ prolapse, cystocele (bladder prolapse), rectocele (rectal prolapse), and uterine prolapse
• Evaluation and management of urinary incontinence
• Evaluation and treatment of bladder pain/IC (interstitial cystitis)
• Evaluation and treatment of bladder dysfunction, lower urinary tract symptoms (urgency, frequency, voiding problems)
• Evaluation and treatment of recurrent urinary tract infections (UTIs) and blood in the urine (hematuria)
• Evaluation and management of bowel movement problems/fecal incontinence
• Evaluation of treatment of labial hypertrophy
• Counseling and treatment of premenstrual syndrome (PMS) and other gynecologically related emotional concerns
• Evaluation of sexual dysfunction and pain with sex
• Gynecological problems and concerns of adolescents and teens
• Collaboration with other clinicians, including naturopathic doctors, physical therapists, psychotherapists, and others
• Second opinions about gynecological problems
• Surgical services (see below)
• LGBTQ+ friendly
• Transgender care (see below)

When surgery is indicated in your care, we are committed to providing the least invasive approach possible in order to minimize your postoperative pain and recovery time, and to allow you to promptly regain your strength and vitality. We will be by your side every step along the way, from counseling you about your therapeutic options, to scheduling, to navigating the insurance process, to preparing you for surgery, to providing your care at the hospital, to monitoring your post-operative healing, to being on call 24/7 for any concerns. We take seriously our responsibility to prepare you for and help you through this process as safely and with as little stress as possible.

Our minimally invasive surgical procedures include:

• Robotic-Assisted (da Vinci) laparoscopic hysterectomy
• Total Laparoscopic Hysterectomy (TLH)
• Laparoscopic Supracervical Hysterectomy (LSH)
• Vaginal hysterectomy
• Surgical repair of pelvic organ prolapse, vaginal/pelvic reconstructive surgery
• Laparoscopic diagnosis and treatment of endometriosis
• Laparoscopic removal of ovarian cysts and ovarian masses
• Laparoscopic tubal ligation and salpingectomies
• Laparoscopic myomectomy (removal of fibroids)
• Hysteroscopy, D&C
• Hysteroscopic myomectomy
• Hysteroscopic polypectomy
• Hysteroscopic Tubal Occlusion (Essure) – for permanent birth control
• Endometrial ablation
• Treatment of abnormal Pap smears, cervical, vaginal, and vulvar dysplasia
• Vulvar, vaginal, and hymeneal procedures

** Please note: We also offer in-office hysteroscopic evaluation and treatment of abnormal uterine bleeding. Please schedule a consultation with us to see if you are an appropriate candidate. Many women prefer the option to do these procedures in the office to reduce the time and expense of these procedures. **

Providing a safe and comfortable environment as well as expert care for all of our patients is one of our top priorities.

For our transgender patients, we provide:

• Minimally invasive hysterectomies and/or removal of ovaries and fallopian tubes, including Total Laparoscopic Hysterectomies (TLH) with or without Bilateral Salpingo-Oophorectomies (BSO). We generally perform these surgeries through three tiny 5 mm abdominal (laparoscopic) incisions, resulting in less pain, faster recovery, and excellent cosmetic results.
• Gynecological cancer screenings, preventive health, and problem management for transmen
• Hormone therapy for transmen and transwomen
• Post-operative care

Health Insurance
Note that Vermont law requires health insurance plans to provide coverage for medically necessary services for transgender people, including preventive care, hormone prescriptions and management, and gender reassignment surgery, including hysterectomies. As such, it is now rarely necessary to have to pay fully out of pocket for these services. (Self-insured employer plans are not subject to this law, so they may or may not provide coverage for these services. Check your insurance plan.)

For more information, see: State of Vermont Insurance Bulletin 174