Comprehensive Gynecologic Services
- Surgical procedures
- Menopause counseling
- Contraceptive management
- Infertility evaluations
- Pelvic pain
- Abnormal PAPs
- Annual exams
- Cancer screening
Dr. Nancy Fisher offers comprehensive gynecologic services. Click here for our Frequently Asked Questions.
Surgical Procedures
Dr. Fisher performs all general gynecologic surgical procedures including Dilitation and Currettage (D&C), hysteroscopy, laparoscopy, tubal ligation, abdominal and vaginal hysterectomy, and cone biopsy. She performs all surgical procedures at Fletcher Allen Health Care in Burlington, Vermont.
Menopause Counseling
Dr. Fisher offers extensive options for the evaluation and treatment of menopause. She thoroughly evaluates all aspects of menopause including physical, pshychological and laboratory components. Treatment options include life stlye changes, alternative treatment options, and hormone replacement therapy both traditional and bioidentical.
Contraceptive Management
Dr. Fisher offers a complete array of contraceptive choices from natural family planning, to hormonal options (pills, injections, patches, vaginal rings), barrier methods (diaphragm fitting) and the insertion of IUDs. Dr. Fisher also performs laparoscopic tubal ligations for those women seeking a permanent contraceptive solution.
Infertility Evaluation
Dr. Fisher provides initial infertility evaluations which include a thorough history, physical and laboratory evaluation. Dr. Fisher performs hystersalpingograms (HSG) to assess the endometrial cavity and evaluate tubal patency. She prescribes medicaton to treat ovulatory disorders. Dr. Fisher refers all patients that require assisted reproductive techniques, such as in vitro ferilization, to infertility specialists.
Pelvic Pain Evaluation and Treatment
Dr. Fisher provides a complete pelvic pain evaluation including symptom history, physical examination, ultrasound,and laboratory tests. This initial and comprehensive evaluation expedites the diagnosis and treatment of pelvic pain. Treatment modalities include counseling, behavior modification, medication, and if necessary diagnostic and therapeutic surgical procedures.
Abnormal PAP tests
Dr. Fisher evaluates and treats abnormal PAP. She provides counseling and treatment for human papilloma virus (HPV) infections including the HPV vaccine. Dr. Fisher offers both colposcopy and LEEP procedures in her office.
Annual Exams
Dr. Fisher provides annual gynecologic exams for women of all ages. She recommends the following guidelines:
Breast Cancer Screening
Early detection of breast cancer has been shown to decrease the chance of dying from breast cancer. A women’s lifetime risk of developing breast cancer (based on a lifespan of 80 years) is 12.5%. Women aged 40-49 should have a mammogram every 1-2 years and women over 50 should have one yearly. Monthly self examination and a breast exam annually by a physician is also an important component of early detection.
Cervical Cancer Screening
Health care providers screen for cervical cancer by performing a Pap test. This test uses a brush to remove cells from the surface of the cervix. Women should begin cervical cancer screening within three years of becoming sexually active. Risk factors for cervical cancer include smoking, exposure to HPV (human papillomavirus), multiple sexual partners, exposure to DES, and HIV. The frequency of cervical cancer screening should be discussed with your health care provider. Annual gynecologic exams (breast exam and pelvic exam) should be performed annually regardless of a woman’s need for a Pap test.
Colon Cancer Screening
All women should have a baseline colonoscopy when they turn fifty to screen for colon cancer and precancerous polyps. The frequency of screening after the baseline exam is determined by the results of the first screening test. Some women with a family history of colon cancer may undergo a colonoscopy before the age of 50 and have more frequent screening tests than women without a family history.
Cholesterol Screening
Heart disease is the number one cause of death in women. All women should have their cholesterol checked starting at the age of 20 and then at least every 5 years. If the results of any of the screening tests are borderline or high risk, more frequent screening should be recommended. Also, women with a family history of heart disease should be screened at closer intervals. In addition, women over 55 should be screened more frequently (every one to two years) even if they do not have a family history of heart disease.