Services

Services for Mature Patients

Gynecologic surgery

Dr. Rehder has a special interest in gynecologic surgery. This is partly because she has experienced so much surgery personally. Dr. Rehder needed laparoscopy surgery for painful periods and infertility in her mid- twenties. She went on to have three children. She has been through the experience of hysterectomy, prolapse repair, incontinence surgery and jokingly comments that she has had almost every gynecologic surgery known to women! However difficult these experiences were, they have given her a true compassion for those who have to go through surgery. She also has a real passion for doing surgery the right way and with a gentle approach to the body. Dr. Rehder has taken time to cultivate many relationships in the operating room with anesthesia personnel, nurses and OR techs. All of this makes for a peaceful and organized working atmosphere. Dr. Rehder currently operates at both West Penn Hospital and Shadyside Hospital so that she can meet the needs of all of her patients despite many different types of health insurance. She has trained her nurse practitioner, Ann Hodgin, and her physician assistant, Amber Cvetich to assist her in the operating room; thus our patients can be sure they will meet at least two familiar and friendly faces the day they come for surgery. Dr. Rehder also offers to say a prayer for each of her patients the day of surgery before going into the operating room. Many of our patients say that this really meant a lot to them. We would love to have the opportunity to work with you if you need a surgical procedure.

COMMON SURGERY FOR PATIENTS 50 and Up

Hysterectomy – abdominal or vaginal
Vaginal prolapse repair
Bladder repair
Incontinence surgery – minimally invasive
Dilation and curettage with hysteroscopy

Breast Problems

Almost 1 in 8 women in America will develop breast cancer in their lifetime. An initial baseline screening is generally done at the age of 35 and yearly mammograms are recommended as a routine screen for women over the age of 40. Please call for an appointment if you notice any breast lumps, bleeding from the nipples, or breast pain. In addition, we perform breast exams during your annual exam/pap smear. We can also treat breast problems such as fibrocystic breasts, breast infections, and nipple discharge as needed.

Menopause

As you get older, your body slowly ceases to produce estrogen and progesterone. These two hormones thicken the lining of the uterus each month before your period. These hormones also protect the body from developing uterine cancer and osteoporosis. The decrease in hormones is responsible for many symptoms of menopause such as hot flashes, insomnia, depression, vaginal dryness, and low sex drive. Since these hormones are valuable to our health, many women choose to replace them through a pill, patch, or cream. Estrogen by itself helps to relieve menopause symptoms and prevent osteoporosis. When taken with progesterone, the combination therapy prevents growth of the uterine lining to help prevent cancer of the uterus. Since there are some risks associated with Hormone Replacement Therapy, it is important to take the lowest dosage possible and reevaluate your therapy each year. Your doctor can help you decide which, if any, type of Hormone Replacement Therapy is right for you.

Perimenopause

Menopause is diagnosed when a menstrual period has been absent for 12 months. However the entire process takes several years and begins when the ovaries start producing less estrogen. This stage is known as perimenopause. During perimenopause many women suffer from all the same symptoms as a woman who is fully into her menopause. Dr. Rehder is experienced in treating perimenopause with hormone therapy to ease your transition into menopause. All of this can be done without increasing your risk for cancer in the future. In fact hormone therapy has been shown to decrease the risk of uterine cancer by preventing an unhealthy buildup of uterine lining. Please feel free to make an appointment for treatment of perimenopause even if you are still having some menstrual periods.

Bio-identical Hormone Replacement Therapy

A more natural method of treatment, called bioidentical hormone replacement therapy (BHRT), is becoming increasingly popular among doctors and patients alike. Unlike synthetic hormones, bioidentical hormones are made to have the identical molecular structure of the hormones made by your own body, so your body can metabolize them as it was designed to do, minimizing side effects. Additionally, as opposed to the general, mass-produced synthetic hormones, bioidentical hormones are individually matched to each woman's specific hormonal needs. Although bioidentical hormone replacement therapy is not FDA approved, many of the hormones used have been individually approved. This treatment has been used in clinical trials for over 20 years and is considered a generally safe procedure that offers women more specialized, effective treatment for their troubling menopause symptoms. Dr. Rehder can help you to choose whether bioidentical hormone therapy is right for you and has many years of experience working with compounding pharmacies to prepare individualized prescriptions for hormone therapy.

Bladder Problems

Urinary incontinence (UI) is a common condition that involves the uncontrolled loss of urine. It can occur while laughing, coughing, sneezing or jogging. Urine leakage with movement is known as stress incontinence. It can also come on as a strong urge to urinate without enough time to reach a bathroom, known as urge incontinence. While neither condition is serious, they can be embarrassing and affect your daily life. Incontinence can affect people of all ages, but women are especially susceptible after pregnancy and as they get older. Urinary incontinence should be evaluated by a simple bladder test called urodynamic testing. Dr. Rehder does bladder testing in her office and the test is covered by your insurance. This test will show whether treatment will require medication, surgery, or physical therapy. Treatment of urinary incontinence is simple in most cases even if surgery is required. Dr. Rehder commonly performs corrective surgery through a 1 inch incision which is hidden inside the vagina and most of her patients go home the same day.

Bleeding After Menopause

A woman is considered to be in menopause if she has gone over a year without a period or if her blood tests show that she is menopause. If she has any vaginal bleeding after menopause she should make an appointment for testing. Bleeding after menopause can be an early sign of cancer of the uterus. Fortunately 9 out 10 women who bleed after menopause are found to have a benign problem that can be treated with simple medication or a D&C to remove polyps from the uterus. However we still insist that all women who bleed after the menopause make an appointment to be seen for testing. Your testing may include pelvic exam, pelvic sonogram, biopsy of the uterine lining in the office, or D&C. The testing recommended for you will depend upon your age, general health, and other factors.

Dropped Uterus/Pessary

Pelvic organ prolapse occurs when one or more pelvic organs prolapses or drops from its normal location and pushes against the walls of the vagina. It happens frequently when the muscles in the area are weakened from childbirth or surgery. Symptoms of pelvic organ prolapse include feeling pressure in the vagina from the pelvic organs, feeling very full, feeling a pull or stretch in the groin and having incontinence problems. Some women can even feel a ‘ball of tissue’ pushing out through the opening of the vagina. While this condition may be upsetting, treatment is not an emergency and prolapse can even sometimes get better with time.

For pelvic organ prolapse that does not improve on its own or results in severe symptoms, surgery may be necessary to repair the problem. Pelvic prolapse repair surgery includes many different procedures, depending on which organ is affected. These surgeries can include repair of the bladder or urethra, repair of the vaginal wall, closure of the vagina or a vaginal hysterectomy. Bladder testing prior to treatment will produce the most successful and satisfying result for women with prolapse. Dr. Rehder normally performs a simple bladder test in her office to help determine the correct treatment for her patients with prolapse. This test is not painful, lasts about 20 minutes, and is covered by your insurance. If surgery is required, it is often less painful than other types of surgery and Dr. Rehder has been doing this sort of surgery for over 25 years. Some women who want to avoid surgery can have the prolapse treated in our office by insertion of a rubber supportive ring into the vagina. This supportive ring is called a pessary and this treatment is also covered by all insurances including Medicare.

Osteoporosis

Osteoporosis is a common disease for women over age 50. Osteoporosis leads to broken bones, loss of height, and a hump-backed appearance. Bone loss begins immediately when your periods stop and can happen even faster in women who are thin, have a family history of bone loss, or who smoke cigarettes. One of every two women over age 65 will suffer at least one bone fracture due to osteoporosis. For this reason we begin DEXA bone testing to look for osteoporosis in all of our patients over age 50. The most serious risk for people with osteoporosis is hip fracture following a fall. Everyday activities can result in a fracture. Spinal compression fractures are the most common osteoporosis- related injury and can be triggered simply by bending over. Dr Rehder and her staff having developed a special interest in preventing and treating osteoporosis. They can help you choose from many types of treatment including the following: calcium, prescription vitamin D, weight bearing exercise including physical therapy, oral medications, IV medication in the office, and daily subcutaneous injection. Due to the large number of treatments available we can help you find a treatment plan even if you are currently on other medications, prefer to avoid prescription medications, or have a sensitive stomach.