The Manhattan Center for Gynecology has expert patient care coordinators standing by to answer all of your gynecology questions. If you don’t see your question below, feel free to give us a call.

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Menstrual Pain

Why are some cramps so painful?

The difference between menstrual cramps that are more painful and those that are less painful may be related to a woman’s prostaglandin levels. Women with menstrual cramps have elevated levels of prostaglandins in the endometrium (uterine lining) when compared with women who do not experience cramps. The cramping sensation is intensified when clots or pieces of bloody tissue from the lining of the uterus pass through the cervix, especially if a woman’s cervical canal is narrow.

Do I have to suffer from menstrual pain every month?

No. There many things that can be done including antiprostaglandin agents, hormonal treatment, or analgesics. Speak to us regarding the specific way to control this pain.


How do you check for fibroids?

A thorough history and physical by a physician can be done to diagnose fibroids. They are easily confirmed by an in-office sonogram.

What are the symptoms of uterine fibroids?

Most women with uterine fibroids have no symptoms. However, abnormal bleeding is the most common symptom of a fibroid. If the tumors are near the uterine lining, or interfere with the blood flow to the lining, they can cause heavy periods, painful periods, prolonged periods or spotting between menses. Large fibroids can also cause pressure, pelvic pain and pressure on the bladder with frequent or even obstructed urination.

My mother and sister have fibroids. Does that put me at risk for developing fibroids?

Yes, fibroids have a genetic predisposition and you should be checked for them.

Breast Lumps or Pain

What can cause pain in the breast?

Many possible causes exist for pain or tenderness in one or both of your breasts. Most often the pain can be attributed to harmless causes such as puberty or pregnancy. It can also be a recurrent problem for women with cyclical pain associated with the menstrual cycle. Although cancer is a major concern for women, it rarely causes pain. Some causes of breast pain are: fibrocystic breast disease, premenstrual syndrome, and normal hormonal fluctuations, onset of puberty or menopause, pregnancy, breastfeeding, estrogen therapy, injury to the breast or an infection to the breast.

Are there other causes of breast lumps other than breast cancer?

Yes, there are many causes of breast lumps. Some of these causes are harmless, while others can be painful and/or dangerous. Causes of breast lumps include infections, injuries, non-cancerous growths, and cancer. Our physicians will thoroughly examine you and obtain the proper testing to rule out benign causes such as cysts and benign tumors.

Irregular Menses and/or Pain

What causes painful periods (Dysmenorrea)?

Painful menstruation fall into two groups: Primary Dysmenorrea and Secondary Dysmenorrea. Primary dysmenorrea occurs around the time that menstrual periods first begin in otherwise healthy young women. This pain is not usually related to a specific problem. Secondary dysmenorrea is menstrual pain that develops later, in women who have had normal periods and it is often related to problems in the uterus or other pelvic organs such as, endometriosis, fibroids, PMS, sexually transmitted diseases and/or stress and anxiety.

What causes irregular menses?

The cause of irregular menstrual cycle is mostly related to stresses, tension, ingested medications and caffeine. The other common responsible factors for an irregular menstrual cycle are significant weight gain or loss, over-exercise, breastfeeding, polycystic ovarian syndrome, poor nutrition, chemotherapy, eating disorders, hormonal imbalance or uterine abnormalities.

Birth Control

Can you get pregnant during the week that you take the nonactive (placebo) pills?

Taking the nonactive pills doesn’t put you at a higher risk of unintended pregnancy. If you’re taking your birth control pills exactly as directed, they’re 98 to 99 percent effective at preventing pregnancy.

Are there other options than the birth control pill?

At Manhattan Center for Gynecology we offer many alternatives including Nuva Ring for monthly contraception, Ortho Evra for weekly contraception and IUD’s for longer term. Please ask about Essure for complete contraception when your family is complete.


Are their any risks to having a Colposcopy?

Colposcopy is a safe procedure that carries very few risks. Rarely, complications occur, including: heavy bleeding, infection and pelvic pain.

What is a Colposcopy?

Colposcopy is a telescope which magnifies the cervix. Physicians trained in Colposcopy manage abnormal PAPs, treat precancerous conditions in this minimally invasive way.

Cone Biopsy

How well does it work?

The cone biopsy may remove all of the abnormal tissue, which means no further treatment would be needed.

Will I be asleep?

You will be given some type of anesthesia. Your doctor will discuss which anesthesia will be best for you.

What is a Cone Biopsy?

A cone biopsy is surgery to remove a cone-shaped piece of tissue from the cervix and cervical canal. Cone biopsy may be used to diagnose or treat a cervical condition.

Endometrial Biopsy

How will I feel after the biopsy?

You may feel some soreness in your vagina for a day or two. Some vaginal bleeding or discharge is normal for up to a week after a biopsy. Avoid strenuous exercise or heavy lifting for at least one day after your biopsy. Also, do not have sexual intercourse or use tampons until the bleeding stops.

When are Endometrial Biopsies needed?

Your physician may perform an Endometrial Biopsy to help diagnose endometrial cancer or to find the cause of abnormal uterine bleeding.


How effective is Essure?

Essure is 99.8% effective, the highest of any permanent birth control.

What is Essure?

Essure is a proven, non-surgical, hormone-free permanent birth control procedure that works with your body to prevent pregnancy.

What are the benefits of Essure?

Essure is the most effective permanent birth control available, offering benefits no other birth control ever has. No surgery, no slowing down to recover, no anesthesia necessary, no hormones, and peace of mind.

Endometrial Ablation: Thermachoice

Who can be treated with Thermachoice?

Thermachoice is intended to treat premenopausal women with heavy bleeding (due to benign causes) who do not wish to become pregnant in the future.

How does Thermachoice treat excessive menstrual bleeding?

Thermachoice Uterine Balloon Therapy System uses heat to treat the uterine lining (endometrium) while leaving the rest of the uterus intact and in place. This process removes the primary source of menstrual bleeding.

Hormone Replacement Therapy (HRT)

Will I gain weight if I take HRT?

No, taking HRT is unlikely to cause you to put on weight.

How well does HRT work?

HRT increases estrogen levels which may reduce the frequency and severity of hot flashes, improve moodiness and sleep changes related to hormone changes, maintain the lining of the vagina, increase skin collagen levels, and may help prevent postmenopausal osteoporosis by slowing bone loss.

Hysteroscopy - D&C

What is a Hysteroscopy?

Hysteroscopy is a way for your physician to look inside you uterus. A hysteroscope is a thin, telescope-like instrument that is inserted into the uterus through the vagina and cervix. This tool helps diagnose or treat a uterine problem. Hysteroscopy is a minor surgery which is performed in our office.

What is a D&C?

A D&C is a minor procedure for scraping the uterus and collecting the inside endometrial tissue for examination.

HPV Testing & Vaccine

How do I get tested for HPV?

A pap smear is a screening test for cervical cancer (HPV).

How do I get HPV? Is there a vaccine?

HPV is passed on through genital (skin to skin) contact, most often during sexual intercourse. Gardasil is the only HPV vaccine that helps protect against 4 types of HPV. In girls and women from ages 9 to 26, Gardasil helps protect against 2 types of HPV that cause about 75% of cervical cancer cases, and 2 more types that cause 90% of genital warts cases.


What is LEEP surgery?

A LEEP or Loop electrosurgical procedure treats the cervix when there is at least a moderate precancerous condition. This prevents any possibility of cancer from being missed.

Are there other treatments for abnormal cervical cells?

Yes, other treatments include, laser, cryosurgery, and cone biopsy. Another way to manage abnormal cells is to monitor them and see if treatment is necessary. Your physician may recommend frequent pap tests to see if the cells heal themselves.


Pap Smears

Do all women need pap tests?

It is important for all women to have pap tests yearly, along with pelvic exams as part of their routine health care. You need a pap test if you are 21 years or older.

Should I get my pap test when I have my period?

No. Our physicians suggest you schedule a pap test when you do not have your period.

My pap test was “abnormal,” what happens now?

There are many reasons for an abnormal pap test result. If the results of the pap test are unclear or show a small change in the cells of the cervix, your doctor may repeat the test. If the test finds more serious changes in the cells of the cervix, your doctor may suggest more powerful tests. Please speak with you doctor to decide what treatment is best for you.


Recently I have felt pressure in my vaginal area and even something that seems to bulge out when I walk around or bend down? Are my insides falling out?

As women age, the muscles and ligaments that support the pelvic organs can stretch or weaken. When this happens, the pelvic organs drop down from their original position. This condition is called pelvic prolapse.

Will the Pessary cure the prolapse?

A pessary cannot cure a prolapse. It merely supports the sagging organs and relieves the symptoms. Surgery is the only cure for a prolapsed uterus. Many women, however, are unable or unwilling to have surgery to correct their prolapse. For these women, the pessary is an excellent alternative.

STD Screening

How long does it take before STDs show up in a test?

For bacterial STDs like Chlamydia and Gonorrhea will show up in approximately 3 days from exposure. For type specific STDs like HIV, Herpes, Hepatitis and Syphilis it will take approximately 2 weeks from exposure time.

How fast can I get an STD testing appointment?

We offer same day STD testing and appointments. We are located in the heart of NYC, just a half a block from gran central station. Walk-ins welcome.

Cosmetic Vaginal Surgery

What services do you offer?

Our services include Vaginal Reconstruction: a treatment of both Labiaplasty and Vaginoplasty, Vaginoplasty: a treatment for vaginal laxity that tightens the vagina, surrounding muscles and soft tissue, Labiaplasty: a treatment for enlarged or irregular labia often done for cosmetic enhancement or medical reasons, and Hymenoplasty: reconstruction of the hymen to a pre-sexual state.

Why would I want Vaginoplasty surgery?

Most women who desire a Vaginoplasty complain of feeling “loose”. They note decreased friction during intercourse resulting in lower levels of sexual satisfaction and more difficulty in climaxing. Vaginoplasty will increase friction during intercourse. After surgery, the vaginal tightness is similar to the pre-baby days. You will easily feel the difference and so will your partner.

Who is a good candidate for Labiaplasty?

The typical labiaplasty patient has enlargement of the labia that causes pain during intercourse, discomfort with tight clothing, or irritation. Patients often report being embarrassed about the size and shape of their labia.