Women’s Specialized Health & Reproductive Care

Women’s Behavioral Health/Reproductive Medicine Services provide specialized treatment that is unique to women’s health care needs.  Informed by evidence-based practices, HLCC customizes and tailors her treatment interventions to exclusively address the sensitive medical issues that are unique to women.  HLCC is passionate and dedicated to delivering the highest quality of services to help women live healthier lives.  Some of the medical conditions and emotional difficulties that HLCC can help women with:

  •  Body image, eating, weight/obesity issues
  •  Breast cancer diagnosis (early and advanced stages)
  •  Chemo Brian: teaching cognitive remediation skills to increase focus, attention, & memory during and after chemotherapy treatment
  •  Gynecologic oncology
  •  Infertility issues
  •  Menopause/menopausal transition (insomnia, depression, anxiety, hot flashes/flushes)
    • Research has demonstrated that women who have entered perimenopause are twice as likely to experience depression in comparison to postmenopausal women (Cohen, Soares, & Otto, 2006).
    • Insomnia occurs more frequently as we age, but especially for women during menopausal transition with approximately 40-50% of women suffering from significant sleep disturbance. Additionally, 61% of postmenopausal women report insomnia per the National Sleep Foundation and Sleep Poll in 1998.
    • Hot flushes are experienced by 60-70% of menopausal women and are very problematic for 20-25% of these women. However, cognitive-behavioral therapy that involves relaxation training has been empirically supported to be an effective method of intervention for reducing the intensity and frequency of hot flashes in naturally occurring menopausal women and for women experiencing premature menopause secondary to their breast cancer treatment (Ayers, Mann, & Hunter, 2010).
  •  Emotional disorders during pregnancy (e.g., perinatal depression and anxiety)
    • Approximately 10-15% of women suffer from both depression and anxiety during their pregnancy (Matthey, 2004).
    • Recent studies estimate that depression occurs during pregnancy in about 30% of all patients in the United States. Thus, screening for depression during this time is important because untreated antenatal depression increases risk for delivery complications and postpartum depression, and for the child there can be increased risk for preterm birth and low birth-weight (Bennett, Einarson, & Taddio, 2004).
  •  Postpartum depression, anxiety, OCD
    • Postpartum depression is the most frequent complication of childbirth occurring in one of eight women (APA, 2010).
    • Anxiety co-occurs in 50% of women with postpartum depression (O’Hara & Swain, 1996).
    • Postpartum OCD occurs in about 4% of new mothers (Uguz, Akman, & Kava, 2007).
  •  Pregnancy loss
  •  Reproductive health issues
  • Reproductive trauma (psychotherapy with infertility, pregnancy loss, neonatal loss-loss of baby less than 28 days old)
  • Chronic Pelvic Pain (CPP)
    • CPP is estimated to occur in 10% of outpatient gynecological visits and costs the healthcare system more than $2 billion dollars annually (Reiter, 1990)
    • Childhood and adult sexual abuse is noted in 20% to 30% of women with CPP and grows higher to 64% in women whose pain is of unknown etiology (McDonald & Elliott, 2001). Many of these women meet criteria for posttraumatic stress disorder (PTSD).
    • Posttraumatic stress disorder secondary to abuse or assault can put women at increased risk for reproductive health issues, chronic pelvic pain, complications during pregnancy or childbirth and therefore highlights the importance of assessment and management of PTSD in this population.
    • In addition to the high rates of PTSD in the CPP sufferer, depression and anxiety are also highly present.
    • Sexual dysfunction is a common secondary problem for women with CPP. Fortunately, sexual problems can be treated successfully with the utilization of sex therapy techniques for the CPP patient and her partner (Elliott, 1996).
    • Women with CPP who receive psychological treatment report significant reduction in frequency and/or intensity of pain. Strategies that have demonstrated empirical support include stress management, cognitive-behavioral therapy, sex therapy, relaxation training, & trauma therapy.
  • Women’s Sexual Health concerns
    • Vaginismus: is the involuntary tightening of pelvic floor muscles surrounding the vagina which can make penetration very painful, if not impossible.  Vaginismus may prevent women from using tampons, menstrual cups, having a pelvic exam or sexual intercourse. Some women will describe the experience as if the vagina turns into a brick wall upon any initiation of possible penetration.
    • Vaginismus treatments include the widespread use of vaginal dilators, physical therapy with or without biofeedback, biofeedback, sex and relationship counseling, psychotherapy, cognitive behavioral therapy, therapist-aided exposure, hypnotherapy, and lubricants.

How Psychological Support Can Help in Women’s Health, Reproductive & OB/GYN Care:

  • Cognitive Behavioral Therapy for Insomnia
  • Biofeedback for pain, anxiety and sleep using HeartMath, Alpha-Stim and other methods
  • Relaxation training and respiratory therapy (breathing retraining)
  • We can teach evidenced-based skills such as biofeedback, relaxation training, identification of triggers, training on cognitive appraisal and excessive worry, restructuring core beliefs, and problem-solving to women who are suffering from chronic pain to decrease their pain intensity (Elliott, 1996).


For further information regarding services call Dr. Kukla at 847.701.4452.  We look forward to your call!



APA (2010). Integrated care is nothing new for these psychologists. Monitor on Psychology, 41, 40-41.

APA (2001). New rule will change the psychologist physician relationship. Monitor on Psychology, 32, 66-68.

Ayers, B., Mann, E., & Hunter, M. (2010). A randomized controlled trial of cognitive-behavioral therapy for women with problematic menopausal hot flushes. BMJ Open, doi:10.1136/bmjopen-2010-000047.

Bennett, H. A., Einarson, A., & Taddio, A. (2004). Prevalence of depression during pregnancy: systematic review. Obstetrics & Gynecology, 103, 698–709.

Cohen, L. S., Soares, C. N., & Otto, M.W. (2006). Risk for new onset of depression during the menopausal transition: the: The Harvard study of moods and cycles. Archives of General Psychiatry, 63, 389-390.

Elliott, M.L (1996). Chronic pelvic pain: What are the psychological considerations? American Pain Society Bulletin, 6, 1-4.

Frank, R., McDaniel, S.H., Bray, J.H., & Heldring, M. (2004). Primary care psychology. Washington, DC: American Psychological Association.

Kersting, K. (2007). Health-care change is coming: What do we do? Monitor on Psychology, 42, 56-59.

Leader, A., Taylor, P., & Danilak, J. (1984). Infertility: Clinical and psychological aspects. Psychiatry Annals, 14, 461.

Matthey, S. (2004). Detection and treatment of postnatal depression (perinatal depression or anxiety). Current Opinion in Psychiatry. 17, 21-29.

McDonald, J.S., & Elliott, M.L. (2001). Gynecological pain syndromes. In J.D. Loeser & D.C. Turk (Eds.), Bonica’s management of pain (3rd ed., pp. 1415-1447). Baltimore: Williams & Wilkins.

O’Hara, M., & Swain, A. (1996). Rates and risks of postpartum depression-a meta-analysis. International Review in Psychiatry, 8, 37-54.

Reiter, R. (1990). Chronic pelvic pain. Clinical Obstetrics and Gynecology, 33, 117-118.

Scroggins, K. M., Smucker, W. D., & Krishen, A. E. (2000). Spontaneous pregnancy loss: evaluation, management, and follow-up counseling. Primary Care, 27, 153–167.