Gynecology Services

Your Urogynecologist Specialist

Location: Bellingham, WA

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Conditions Treated

Express UTI Care

Urinary Incontinence

Orgasmic Dysfunction

Cosmetic Gynecology

Pelvic Health Conditions

Express UTI Care for Women

Same-day appointments are offered, subject to availability.

Our Express UTI Care for Women provides fast, convenient evaluation and treatment for urinary tract infections. Patients can choose an in-person visit or telehealth appointment, depending on availability and clinical need.

In-person visits include an evaluation by a physician, urine testing when indicated, and the first dose of antibiotics to help expedite treatment, with a prescription provided if appropriate.

Telehealth visits include a physician phone consultation, lab orders, and a prescription when indicated.

This service is designed for prompt care with transparent, all-inclusive pricing.

Appointment Options

Available during weekdays 5pm – 7pm
Weekends and holidays 9am – 5pm by appointment only
Patient needs to call or text to check availability (360-599-5545)
 
In-person appointment…. $329  Includes:
+ a visit with physician
+ urine test if indicated
+ 1st dose of antibiotics to expedite treatment and Rx if indicated
 
Telehealth visit…..$175 Includes:
+ Phone call from physician
+ Lab order and prescription if indicated 
*Payment is required at the time of booking

Pelvic Health Conditions

Pelvic health conditions refer to a range of disorders affecting the muscles, ligaments, nerves, and organs in the pelvic region, which includes the bladder, reproductive organs, and bowel. These conditions can impact both men and women, though they are more common in women due to pregnancy, childbirth, and menopause.

 

Common Pelvic Health Conditions

  1. Pelvic Floor Dysfunction (PFD) – Involves weakness, tightness, or coordination issues in the pelvic floor muscles, leading to pain, incontinence, or difficulty with bowel movements.
  2. Urinary Incontinence – Loss of bladder control, causing leakage or urgency. Types include stress incontinence (leakage during coughing, sneezing) and urge incontinence (sudden, intense need to urinate).
  3. Pelvic Organ Prolapse (POP) – When pelvic organs (e.g., bladder, uterus, or rectum) drop from their normal position due to weakened support structures, often occurring after childbirth or menopause.
  4. Chronic Pelvic Pain (CPP) – Persistent pain in the lower abdomen or pelvis lasting over six months, potentially linked to conditions like endometriosis, interstitial cystitis, or pelvic floor tension.
  5. Interstitial Cystitis (Painful Bladder Syndrome) – Chronic bladder pain and pressure, often accompanied by frequent and urgent urination.
  6. Dyspareunia (Painful Intercourse) – Pain during or after sex, which can be caused by pelvic floor muscle tightness, hormonal changes, or medical conditions.
  7. Fecal Incontinence – Loss of bowel control, leading to accidental leakage, often due to nerve damage, weak muscles, or rectal prolapse.

Treatment Options

  • Pelvic Floor Physical Therapy – Strengthening, relaxing, or retraining pelvic muscles.
  • Medications – Pain relievers, hormone therapy, or muscle relaxants.
  • Lifestyle Changes – Diet modifications, bladder training, and weight management.
  • Minimally Invasive Procedures – Injections, nerve stimulation, or surgery (if necessary).

Pelvic health conditions are often manageable with early intervention and proper care. If you have concerns, consulting a healthcare provider or pelvic health specialist is recommended.

Urinary Incontinence

​Urinary incontinence is the loss of bladder control, leading to involuntary leakage of urine. It can range from occasional minor leaks when sneezing or coughing to a complete inability to control urination.

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Types of Urinary Incontinence:

  1. Stress Incontinence – Leakage occurs due to pressure on the bladder, such as during coughing, laughing, sneezing, or exercising.
  2. Urge Incontinence – A sudden, intense urge to urinate followed by an involuntary loss of urine, often associated with overactive bladder.
  3. Overflow Incontinence – Inability to fully empty the bladder, leading to frequent or continuous dribbling.
  4. Functional Incontinence – Urine leakage due to physical or cognitive impairments that prevent timely access to a restroom.
  5. Mixed Incontinence – A combination of different types, often stress and urge incontinence.

Treatment Options

  • Lifestyle Changes: Reducing caffeine, managing fluid intake, weight loss
  • Pelvic Floor Exercises: Kegel exercises to strengthen muscles
  • Bladder Training: Scheduled voiding and urge suppression techniques
  • Medications: Prescription drugs to relax the bladder or strengthen the sphincter
  • Medical Devices: Axonics System, Pessaries (for women), catheters
  • Laser Procedures: Non-invasive used to treat mild to moderate stress urinary incontinence
  • Botox: FDA-approved treatment for overactive bladder (OAB) and neurogenic detrusor overactivity
  • Injections:  a water-based gel used as a bulking agent (Bulkamid)

Urinary Incontinence Procedure Options by Dr Anna Pilzek, MD

Bulkamid Injection: Bulkamid is a water-based gel used as a bulking agent to treat stress urinary incontinence (SUI) in women. It is injected into the urethral wall to help it close more effectively and prevent urine leakage. The gel is made of 97.5% water and 2.5% polyacrylamide, making it a long-lasting and biocompatible option for SUI treatment. Unlike some other treatments, Bulkamid does not require surgery and is typically performed as a minimally invasive outpatient procedure.

Sacral Neuromodulation: (SNM) with Axonics. The Axonics System is a rechargeable, long-lasting SNM device that helps regulate bladder and bowel function by stimulating the sacral nerves with mild electrical impulses. It is implanted under the skin and can be controlled externally. Axonics offers a small, MRI-compatible device that is designed to last over 15 years, making it an attractive alternative to traditional SNM systems.

eCoin: is a minimally invasive, neurostimulation-based treatment for urge urinary incontinence (UUI) caused by overactive bladder (OAB). Unlike traditional sacral neuromodulation (SNM) devices, eCoin is implanted in the lower leg near the tibial nerve, making it simpler and quicker to implant than sacral-based solutions like Axonics or Medtronic’s InterStim. A small, coin-sized neurostimulator is implanted under the skin near the ankle in an outpatient procedure that takes about 20 minutes. The device delivers automatic, programmed stimulation to the tibial nerve, which plays a role in bladder control. The battery lasts about 3 years before replacement.

The MonaLisa Touch is a non-surgical laser treatment designed primarily for vaginal rejuvenation, mild stress incontinence (SUI) and lichen sclerosis in women. It uses fractional CO₂ laser technology, similar to what’s used in dermatology for skin resurfacing, but it’s specially adapted for vaginal tissue. It’s often chosen by women dealing with vaginal dryness, itching, burning, or laxity, especially due to menopause, childbirth, or hormonal changes.

Botox (onabotulinumtoxinA): is an FDA-approved treatment for overactive bladder (OAB) and neurogenic detrusor overactivity (NDO) when other treatments, like medications or behavioral therapies, are ineffective. It works by relaxing the bladder muscles, reducing involuntary contractions that cause frequent urges to urinate, urgency, and leakage.

Orgasmic Dysfunction

Orgasmic Dysfunction (also known as anorgasmia) is a condition where a person has difficulty reaching orgasm, experiences delayed orgasms, or is unable to orgasm at all, despite adequate sexual stimulation. It can affect both men and women and may be lifelong (present from the start) or acquired (developed later in life).

 

Types of Orgasmic Dysfunction:

  1. Primary Anorgasmia – Never having experienced an orgasm.
  2. Secondary Anorgasmia – Previously able to orgasm but now experiencing difficulty or inability.
  3. Situational Anorgasmia – Orgasms occur only under specific conditions (e.g., only through masturbation or a certain type of stimulation).
  4. Generalized Anorgasmia – Inability to orgasm in any situation, regardless of partner, setting, or type of stimulation.

Physical Factors:  Hormonal imbalances (low estrogen or testosterone), Nerve damage or medical conditions (e.g., diabetes, multiple sclerosis), Side effects of medications (e.g., antidepressants, blood pressure meds), Chronic pain or pelvic floor disorders

Psychological Factors:  Stress, anxiety, or depression, Body image issues or low self-esteem, Past trauma or sexual abuse, Relationship problems or emotional disconnect

Lifestyle Factors:  Fatigue or lack of sleep, Excessive alcohol or drug use, Poor communication with a partner about sexual preferences

Treatment Options

  • Medical Treatments: Adjusting medications, hormone therapy if needed
  • Therapy & Counseling: Sex therapy, cognitive behavioral therapy (CBT)
  • Lifestyle Changes: Stress management, exercise, and improving intimacy with a partner
  • Pelvic Floor Exercises: Strengthening pelvic muscles for better sexual response
  • Sexual Education & Exploration: Learning about personal preferences and stimulation techniques

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Cosmetic Gynecology

Cosmetic Gynecology is a branch of medicine that focuses on enhancing the appearance, function, or sensation of female genitalia. It includes both surgical and non-surgical procedures that aim to improve aesthetic appeal, sexual function, or address concerns related to aging, childbirth, or genetics.

 

Reasons for Cosmetic Gynecology

  • Aesthetic Concerns – Some women seek procedures for a more symmetrical or youthful appearance.
  • Post-Childbirth Changes – Vaginal laxity or perineal damage after childbirth can be addressed through tightening procedures.
  • Aging-Related Changes – Loss of collagen and elasticity can affect the look and function of genital tissues.
  • Sexual Function Enhancement – Some procedures claim to improve sensitivity and orgasmic response.
  • Physical Discomfort – Enlarged labia can cause chafing, irritation, or discomfort during exercise or intercourse.
  • Cultural or Personal Reasons – Some individuals opt for procedures based on personal or societal expectations.

Treatment Options

Common Cosmetic Gynecology Procedures:

  1. Labiaplasty – Reshaping or reducing the size of the labia minora or labia majora for aesthetic or comfort reasons.
  2. Vaginoplasty – Tightening of the vaginal canal, often sought after childbirth or aging to improve muscle tone and sexual satisfaction.
  3. Hymenoplasty – Reconstruction of the hymen for cultural or personal reasons.
  4. Monsplasty – Reduction of excess fat or skin in the mons pubis (the area above the pubic bone) for a smoother contour.
  5. Clitoral Hood Reduction – Removal of excess skin around the clitoris to enhance stimulation and sensitivity.

Non-Surgical Procedures

  1. Laser Vaginal Rejuvenation – Uses laser or radiofrequency energy to tighten vaginal tissues and improve lubrication.
  2. PRP (Platelet-Rich Plasma) Injections – Injecting PRP into the vaginal area to enhance sensitivity and sexual pleasure.
  3. G-Spot Amplification – Injection of fillers into the G-spot area to potentially enhance sexual pleasure.

Pelvic Floor Disorders

Pelvic Floor Disorders (PFDs) occur when the muscles, ligaments, and connective tissues of the pelvic floor become weak, tight, or damaged, leading to issues with bladder, bowel, or sexual function. The pelvic floor supports vital organs, including the bladder, uterus (in women), and rectum, and helps control urination, bowel movements, and sexual response.

 

Common Types of Pelvic Floor Disorders

  1. Pelvic Organ Prolapse (POP) – Occurs when the pelvic organs (bladder, uterus, or rectum) drop from their normal position and push against the vaginal walls due to weakened pelvic muscles.
  2. Urinary Incontinence – Loss of bladder control, leading to leakage during activities like coughing, sneezing, or exercising.
  3. Fecal Incontinence – Inability to control bowel movements, leading to accidental leakage of stool.
  4. Pelvic Floor Muscle Dysfunction – Tight or weak pelvic muscles that cause pain, discomfort, or difficulty with urination, bowel movements, or intercourse.
  5. Chronic Pelvic Pain – Ongoing pain in the pelvic region due to muscle tension, nerve damage, or other underlying conditions.

 

Symptoms of Pelvic Floor Disorders

  • Feeling heaviness or pressure in the pelvic area
  • Urinary leakage or frequent urge to urinate
  • Difficulty emptying the bladder or bowels
  • Pain or discomfort during intercourse
  • Bulging or protrusion in the vaginal area (in cases of prolapse)

Treatment Options

  1. Pelvic Floor Physical Therapy – Exercises (like Kegels) to strengthen or relax muscles.
  2. Medications – For bladder control, constipation, or pain management.
  3. Lifestyle Changes – Maintaining a healthy weight, avoiding heavy lifting, and managing bowel health.
  4. Pessary Devices – Support devices placed in the vagina to help with prolapse.
  5. Surgical Treatments – Procedures to repair prolapse or reinforce pelvic floor support.

Fairhaven

The Pause Clinic

1440 10th Street – 102-H
Bellingham, WA 98225

Call:  360.599.5545
Email: thepauseinstitute@gmail.com

Conditions treated at this location: Facials · Express UTI Care · Esthetic Procedures · Menopause · Sexual Health · Cosmetic Gynecology

 

Book a Facial – use this form

The Pause Clinic Contact Form

You contact us by phone, text or by filling out the online form and we will get back to you to schedule a consultation.

For prolapse or incontinence inquiries, please call our Mt. Vernon office at 360-428-2575 and mention Dr. Anna Pilzek, MD as your preferred provider.