Salem Women's Clinic

First of all, don't be afraid, we've all been there, and we will work hard to make your first visit a good one.

Most of the time you won't need a physical exam to start birth control, but we will need to talk about you and your family's health history. We'll talk about what kind of birth control would be good for you, how to take it, and what the side effects are. We also will want to talk about your personal safety, regarding sexual activity and other behaviors.

When we do need to do a physical exam, you can always keep a friend or parent in the room if you'd like, and we'll talk you through the whole process. There's a lot to talk about, and we look forward to meeting you.

There are many reasons why periods may not be regular. Sometimes it's a hormone imbalance, sometimes just a normal part of maturing. Things like weight, diet, activity, and family history all play a part in helping us understand the cause of irregular periods and finding a treatment.

Try writing down when your periods come for a few months, and bring that information with you to your visit. It'll be easier than trying to remember dates from months ago, and it will help us determine possible causes.

First, you should refrain from intercourse or using any vaginal products for at least 24 hours before your visit. Second, bring a list of all the medications and supplements you take, with dosages and frequency‹it will save you time and be more accurate than trying to recall everything from memory. If you are new to Salem Women’s Clinic, plan on arriving a bit early to fill out paperwork. You can also visit the Patient Info section of our site to download and complete some of the necessary paperwork before your visit

Lastly, relax and pat yourself on the back: the annual exam is an important part of your health care, and we do everything we can to make it a positive experience.

We can’t really know what¹s wrong over the phone, so call as early as you can, and ask for a same day visit. We’ll exam you, run some tests, and tell you what you can do to prevent the same thing from happening again.

Sure! Just mention your preference when you call for the appointment.

Your normal results will arrive by mail unless you¹ve signed up for our Portal, which allows you to access lab results over the Internet using a secure pin number and password. For complicated results, or results that require follow-up care, you may get a call asking you to come in for a visit so we can talk in person.

A pap is a test that is specific for cervical cancer (the cervix is the lowest portion of the uterus, found at the top of the vagina). Using a warmed metal speculum to see the cervix, we take a sample of the cells using a soft brush or tiny broom. The sample is sent to a lab which uses human and computerized technology to look for abnormal (pre-cancerous) cells, as well as check for HPV. HPV stands for human papilloma virus, which can live on the cervix and cause cancerous changes over time.

Depending on your age and history, you may need a pap smear every year or every several years. But you’ll always need your annual each year‹there¹s more to your health than just your cervix.

First off, let's establish the definitions of menopause and perimenopause. Menopause is the cessation of periods for 12 months, thus the ovaries are no longer producing eggs. Perimenopause is defined as the transitional period from normal menstrual periods to no periods at all. The transition can, and usually does, take up to ten years. During the perimenopausal transition you may experience a combination of PMS and menopausal symptoms or no symptoms at all. So yes, you may very well be in perimenopause.

The symptoms of perimenopause are often like PMS and include: irregular periods, sleeplessness, mood swings decreased energy, occasional hot flashes, heart palpitations, difficulty concentrating, and poor memory.

Regular exercise can help significantly, as well as a diet low in simple sugar. Reduce caffeine and alcohol intake. Take 2000 IUs of Vitamin D per day, Omega 3 Fatty Acid (fish oil), a good multi-vitamin, 1200 mg of calcium divided throughout the day, and magnesium at bedtime. If you are still struggling, come in and talk with us; we're here to help.

There are many reasons women can’t sleep at night, and many women suffer from lack of rest. Sleeplessness can be caused by diet, lifestyle, menopausal symptoms, medications or simply poor sleep habits. If you are unable to sleep at night, your health can be affected, as lack of sleep can lead to serious medical conditions. Please talk to us; we can help make a plan to get you back to sleep.

Women’s experiences of hot flashes are quite varied. For many women, hot flashes cause mild discomfort, while others have to change their soaked clothes three times a day. For women who experience mild hot flashes, dressing in layers and peeling them down when needed can be a simple solution. Avoidance of hot spicy food also helps. Low carbohydrate diets help many women with their hot flashes. If possible, leave the window open at night (give your partner extra blankets). For women for whom hot flashes are a serious problem, there are a variety of solutions. Of course there is hormone replacement, but know that it may come with hazards. There are other non-hormone medications that might help. If you are experiencing hot flashes that interfere with your quality of life, come see us and explore your options. And take heart: new studies show that women who have hot flashes live longer.

Fatigue has many causes. Sure, people in their fifties don’t have the energy they had in their 20s—that’s just a fact of aging. However, there may be other reasons why you have developed fatigue. Thyroid problems are very common in women and often go undiagnosed. You may have developed an autoimmune thyroid or adrenal problem as well. Low vitamin D (which is extremely common in Oregon because of our lack of sun) will also cause fatigue. Low B12 is another culprit. There are also other organic reasons for fatigue. Before you chalk it up to getting older, come see us for a fatigue study.

The time you spend trying to get pregnant should be fun! Pregnancy is not a pathological condition and trying to get pregnant should not (in the vast majority of cases) become a medical procedure. There are, however, things you can do to help make the course of your pregnancy as easy as possible. For instance, we can help you with current recommendations for vitamins, exercise, diet, and of course, smoking cessation. If you have genetic issues in your family, let us work with you to minimize your risk. Although we do not deliver babies, we can see you from your first trimester to 24 weeks, when it is often hard to find prenatal care. Deciding either to have a family or to increase the size of your current family is a momentous step for you and your partner. At Salem Women's Clinic we’re thrilled to help you get off to a healthy start.

Infertility is a very trying and emotional issue. There are many reasons why some couples cannot conceive. Firstly, it is important to understand exactly what infertility is. Young couples are not considered infertile until they have been trying for over a year. Older couples may need help after just a few months. Infertility can result from problems with either partner; it is important to discover just where the problem is before we can begin to help you. If it is determined that the problem is with the man, we will send you to a urologist. If the problem is with the woman, we will try to help you determine what is causing the problem and what can be done about it. In most cases, it can be resolved simply, although sometimes we will need to refer you to infertility specialists in Portland for more intensive procedures. Our team of providers here at Salem Women’s Clinic looks forward to working with you to help you achieve a pregnancy, when infertility becomes an issue.

Post-partum depression is extremely common. It is impossible to explain to a pregnant woman just how much work it is caring for a newborn. New moms are generally totally spent after caring for that new baby they dreamed about for nine months. Women are up all hours of the night feeding the baby. Sleep cycles are completely upset. Breasts hurt. Laundry needs to be done. Figures don’t look like they did before the baby. Post-partum blues are commonplace and benign, although women must have support to make it past those early days of “what have I done?” Depression that lasts longer than a few weeks, however, may be more serious. It can occur up to a year after the birth. Women who have had depression prior to pregnancy are more likely to suffer serious depression after the baby, but depression can strike any new mother. Depressed moms may indeed not want to get up in the morning, may not want to care for the baby or themselves and will need treatment for post-partum depression. At Salem Women's Clinic we have an experienced psychiatric nurse practitioner who can help you work through this trying time. Very rarely, women can develop post-partum psychosis. If you are experiencing depression lasting more than two weeks, please call for help. It is easily available.

Definitely YES. We can help with diet and exercise and breast-feeding issues. We can guide you in making birth control choices, and we can help with the myriad of questions new mothers and fathers have.

If you are already on birth control pills it is very easy to just skip the “spacer” or period pills for the week of your honeymoon. Then, during the next month you can just go back to having a period or what we sometimes call “monthly withdrawal bleeding” on the birth control pill. If you are on a phasic pill, this may not work as well. You could also change the time for your period a few months ahead of time so your scheduled period will be after, and not during, your honeymoon. By changing the schedule four to six months in advance, then there will be less risk of unexpected bleeding. Check with your provider if you have more question regarding your specific pill and timing.

Sometimes the pill is used to help menstrual migraines. It is important to determine if you have migraine with aura. We do not give combined birth control pills (pills with both estrogen and progestin) to women who have migraines with auras, due to an increased risk for stroke. Check with your provider about your migraines to see what is best for you.

Yes it is, for women who are appropriate candidates for birth control pills. It is also safe to continuously use other hormonal methods, like Depo-Provera injections, the Mirena IUD, or the vaginal ring to suppress menstruation. Up to 44 percent of U.S. women would rather not have period, and often use hormonal contraception to control their cycles for various reasons‹-for travel, athletic or other events, to alleviate medical conditions such as endometriosis, to avoid discomforts like PMS, for convenience, or simply because they don't like menstruating.

Most patients experience a stinging, burning sensation when a laser pulse is delivered. To reduce discomfort, a cooling system automatically removes heat from the surface of your skin before, during and after the laser exposure. You will not need a general anesthesia or pain medication, but a topical anesthetic cream may be applied to sensitive areas.

The number of treatments required to obtain optimal results varies with hair density, hair color, skin types, the treatment area, and your hair growth cycle. The density of your hair and its growth cycle are affected by many factors, such as your age, ethnic background, hormones or medications. Laser treatments impair the growth capacity of hair follicles when they are in a growth cycle at the time of treatment. All hair follicles are not active at the same time. Depending upon the growth cycle of the follicles when the treatment is applied, several treatments with a few weeks in between may be required to obtain the desired effect.

Once the treatment is complete, the area exposed to the laser is cleansed and you are free to return to your normal routine. Some patients may experience a slight reddening around hair follicles following the treatment, which typically disappears within a few minutes. It is always recommended to avoid sun exposure or to diligently use sunscreen following laser treatment. Hair follicles affected by the laser are lifeless and your body will attempt to cast them off over a period of time. It will seem that the hair continues to grow for one to two weeks after the procedure, but in fact these lifeless hairs will easily fall out.

Cosmetic laser treatments reverse the signs of aging and sun-damaged skin by stimulating collagen production and promoting tissue tightening.

If your skin shows signs of aging, then you are a candidate for laser treatment. Your practitioner can help you determine your specific needs.

Laser anti-aging treatment should cause only minimal discomfort. Any redness, swelling or puffiness that occurs is usually gone within a few days, if not a few hours.

Results vary with each case. Patients may require anywhere from two to six treatments to achieve desired results. Each session will last from 15 to 30 minutes.

Just like the aging process itself, this varies from person to person. However, if you take steps to protect and preserve your laser-rejuvenated skin—such as using SPF sunscreen, facial cleansers, and creams—the results will last longer. Our Aesthetics Team will guide you in after-care.

Laser energy is delivered through a hand-held device with a cooling tip, which provides additional safety and comfort during the treatment by lowering the thermal effect on your skin surface. The laser beam passes through the skin and penetrates the targeted vessel. The laser energy heats up and coagulates blood inside the vessel. Unsupported, vessel walls collapse and seal. These vessels later dissolve within the body. The treatment also stimulates the production of collagen, which results in improved skin texture.

You will experience a stinging or burning sensation during the treatment, which resolves after the treatment. In some cases, you may prefer to use topical anesthetic cream, which may completely eliminate any discomfort.

Most patients only require one or two visits. Results are visible within 3 to 4 weeks. This treatment will permanently remove varicose veins, but it will not keep new ones from forming.

The appearance of the treated vessels will dramatically change, turning from blue and purple to light red. Some of the vessels may bulge; however, any inflammation will disappear within a couple of hours. Redness of the treated vessels will gradually disappear during the healing process, which may take anywhere from 2 to 6 months depending on the severity of the veins. Post-operative treatment may include wearing support hose, avoiding medication containing aspirin, and wearing sunscreen.

First of all, don't be afraid, we've all been there, and we will work hard to make your first visit a good one.

If you have areas of fat that will not respond to diet and exercise, then you are a candidate for SmartLipo™ Laser Body Sculpting. Ideal candidates are in good health, of normal body weight, and have realistic expectations for the results.

A very small cannula, or tube, approximately 1.0 mm to 2.0 mm in diameter, is inserted under the skin. This “micro cannula” containing the laser fibers is moved back and forth, delivering laser energy to the fat cells, which causes them to rupture and easily drain away. The laser energy also interacts with the dermis, resulting in collagen shrinkage—which firms the skin.
 Due to the cannula’s small size, laser lipolysis is a minimally invasive procedure and can be performed under local anesthesia. The Laser causes small blood vessels to coagulate immediately on contact, resulting in less bleeding, swelling, and bruising, and a faster recovery time than conventional liposuction. Because general anesthesia is unnecessary, the procedure is very safe with only minimal side effects.

SmartLipo™ is ideal for treating small areas of the face, neck, arms, knees, back, bra strap, mons pubis, and areas of loose and flabby skin. SmartLipo™ can be a great adjunct procedure to traditional liposuction.

For most areas, typically only one treatment is required. The session may last about 4 – 6 hours.

After the treatment, you will have minimal pain or bruising. We recommend 1 – 2 days rest. You will need to wear a compression garment for 1-2 weeks. After that, you may wear a compression garment of your own; we recommend Spanx®.

The procedure will improve the body’s shape and may improve cellulite to a certain degree. It will tighten sagging skin.

Results can be seen immediately, with continued improvement over several months.

Yes. Adults do not easily create new fat cells. When a person gains weight, the fat cells expand. Laser lipolysis permanently removes the fat cells. Should you gain weight, most fat will be deposited in areas where the procedure was not performed.

• Minimal Downtime—We normally advise a day or two of rest, with no vigorous exercise for two weeks.
• Minimal Discomfort—During the procedure, there is no pain. After the anesthesia has worn off, it only feels like the aches and pains that follow a vigorous workout. Any bruising from laser lipolysis is much less than with standard liposuction techniques.
• Less Traumatic—The fiber-optic cannula is inserted through a small puncture in the skin, usually along creases that conceal the scar. As the laser melts the fat, it also coagulates small blood vessels. Compression garments are mandatory. Your natural healing process does the rest of the work by contracting and tightening the treated area as well as the overlying skin.
• Almost “Normal” Skin after 6 Months—It would be very hard to find the insertion points or tell by looking at the skin that any liposuction has ever been done. Skin contracts with the healing tissues that replace the melted fat.
• Safety—Laser lipolysis is less invasive than traditional liposuction, because there is less bleeding and anesthetic drugs used. In fact, in doing the procedure under tumescent technique, we have eliminated many of the risks associated with general anesthesia.

When you enroll in the program through Salem Women’s Clinic, we’ll give you access to a website specifically for purchasing your meals and for tracking your individual progress.

The meals cost approximately $250 – 300 per month. When you add up how much money you spend per month on coffees, snacks, and other unhealthy food, these meals are very reasonably priced. The only groceries you need to purchase is for the one meal of your making.

Our health coaching services are free. We only charge for your initial medical visits, which may be covered by insurance plans. It is recommended that you see us weekly when you first begin the program.

After you become healthy with our program, you may want to become a coach. Ask us about becoming a coach and getting paid to help your family and friends get healthy.  

Nope! No shopping. No cooking. No counting. This program is ideal for busy lifestyles.

Typical coaching is by phone or email. For the first few days of the program you’ll talk with your coach daily, then weekly for the first month, and as needed after the first month. Each coaching session takes less than 5 minutes per day.  

You will need to visit Salem Women’s Clinic at least once every month for weight checks and more frequently if needed.  

The program is backed by controlled studies that show its efficacy. Over one million customers have safely used this program. There are no pills or diet drugs. It is a lifestyle change, designed by physicians, for long-term results.

The peel itself takes about 30 minutes to perform and does not require sedation. Patients say they feel a stinging sensation that usually subsides after a few minutes.

Yes—at least a day, possibly more. You should allow your skin time to lose the blueish tint from the active ingredient in the Peel, which washes off gradually over the course of a few days. In the days following your treatment, your face and neck might look sun burned. It is crucial that you avoid the sun! The peeling and redness last about 7 – 10 days.

The end results are the same, but the ways to get there are different. Affirm Laser Treatments are done several times, every 30 days and there is no down time. With the Blue Peel there is significant redness and peeling that lasts 7 – 10 days. For clients seeking a more gentle treatment every month, Affirm Laser Facial treatments are ideal. For clients wishing for faster, more aggressive treatment over less time, an Obagi® Blue Peel is the perfect solution.

In the weeks immediately following your Blue Peel, the skin on your face and neck will slough off. Do not use harsh exfoliating methods, as your skin will be tender. Please avoid the sun! In four to six weeks you will begin to see the true results of your Blue Peel: firmer, tighter, clearer skin that glows with vitality.

Nope! After your injections, you’ll be ready to return to your normal daily activities.

Any discomfort you might feel will pass quickly after the injection is complete.

Results last 3 to 4 months.

If you decide to stop BOTOX® treatments, your facial lines will return to the way they looked pre-treatment.

The dose of BOTOX® Cosmetic is not the same as, or comparable to, any another botulinum toxin product.

Serious and or immediate allergic reactions have been reported. These reactions include itchy rash, swelling, and shortness of breath. Tell your doctor or get medical help right away if you experience any such symptoms, further injection of BOTOX® Cosmetic should be discontinued.

Do not take BOTOX® Cosmetic if you: are allergic to any of the ingredients in BOTOX® Cosmetic (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® or Dysport ®; have a skin infection at the planned injection site.

Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising. Other possible side effects include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.

Virtually none. The treatment itself only takes about 15 minutes.

The injection itself contains an anesthetic called lidocaine, which improves your comfort during treatment.

A year!

We have many permanent birth control choices available. We offer Adiana and Essure, which are both performed in the office under light sedation. Neither procedure requires an incision. Both require a follow up x-ray to confirm that your tubes are occluded.

We do almost all of our hysterectomies vaginally. There’s no incision at all, and we perform them as outpatient procedures so that you can go home and sleep and recover in your own bed. Vaginal hysterectomies are the gold standard for safety. They offer the least number of complications, shorter operating times, less bleeding, less pain, and fewer infections. Come in and discuss your concerns with us. We will help you decide the best treatment for you.

Don’t despair, there is help. Losing urine can be caused by many different medical problems. It might be something as simple as changing your water intake, adjusting your medications, or doing physical therapy to retrain the bladder. You might need a procedure in the office to help determine why you are leaking. In some cases you might even need surgery. We know this is a sensitive topic, and we want to help. Make an appointment so we can evaluate why you are leaking. Then we create an individual treatment plan so you can throw away those pads.

We offer a range of therapies, depending on the individual and their needs. Some need supportive therapy while others need more cognitive behavioral therapy. And some individuals just need someone to talk with about daily life stressors and get encouragement and support in their decisions.

Most likely your insurance benefits will determine the length of your visits, but we will do our best to tailor the visit length to your needs. Initially, some patients need to be seen more frequently. This may change as their difficulties and stresses resolve or become more manageable. We can maximize your appointment time if your initial paperwork is filled out prior to your first visit. Just ask us for guidance when you set up your appointment.

Absolutely. When we feel a patient can benefit from various reading materials or referrals, we recommend them. Our goal is to provide the very best care for you.

Research shows that depending on the individual’s situation, medication and therapy have the best outcomes for individuals to reach remission. In many cases, talk therapy can work as well or better than medications. For some patients, however, a combination of medication and talk therapy is best. We’ll discuss all the options with you and help you make an informed decision in your care.

Yes. Safeguarding your information is a top priority at Salem Women¹s Clinic. To ensure the security of your personal information, we use industry standard encryption to prevent unauthorized access to data. You will be the only one to access your information.

It's fast! You can access your lab test results as fast as we get them. It's also an easy way to request prescription refills, as well as initiate the referral process, update personal information, and make appointments. Of course, if you prefer, you can always call us or talk to us in person. We offer the Portal for the convenience of our patients.

Call our office at 503.399.2444 to request a PIN. We¹ll send you a PIN number in the mail. Once you receive it, log on to the Portal via our website. You can also visit our office in person to request a PIN.