Writer Julie Zeglen asks basic questions of two gynecologists.
Remember your first visit to the gynecologist’s office? Maybe you’d rather not. Wearing that oh-so-flattering one-sided robe, sticking your feet in those cold, metal “stirrups” – as if you wanted a reason to think of yourself as a horse – and squirming through the vague but personal details of your hookup history for a complete stranger’s edification…
Maybe we can’t all be as witty as Juno when addressing the phrase “sexually active,” but we can prepare ourselves to make the best of a potentially awkward experience. Sexual health is as important to your well-being as that of the rest of your body, and seeing a doctor can help keep you in tip-top shape.
Resident gynecologists Dr. Aiga Charles and Dr. Srijaya Nalla of Crozer Chester Medical Center in Upland, PA answer some basic questions to optimize your sexual health knowledge.
M.L.T.S.: When should women begin seeing a gynecologist, and how often after that should they go?
Dr. Charles: The first visit to the gynecologist should be around age 13-15. Typically this is only an interview, not including an exam, and is purely for information sake. Subsequent visits depend on whether or not she is sexually active, if yes, then she should be seen yearly, if not and she has not complaints regarding abnormal bleeding, then she does not need to be seen until age 21 at which time she would need a pap smear.
Dr. Nalla: The first visit should take place between ages 13-15, for an age appropriate discussion of pubertal development, menses, prevention of sexually transmitted infections and pregnancy, substance abuse and overall healthy habits. Typically they should go every year, but as needed if they have any concerns, and especially [if they are] being tested for STIs or need birth control, etc.
M.L.T.S.: How can women get the most from their visits? By having questions prepared, doing research beforehand, etc.?
Dr. C: To get the most out of your visits have questions prepared and do not feel embarrassed or ashamed about discussing sensitive topics.
Dr. N: Having questions prepared definitely helps and you can do this by going online and performing some background research, but keeping in mind that there is [an] overwhelming [amount of] information on the internet. It always helps to write the questions on a piece of paper or your phone so you do not forget after going to the doctor’s office.
M.L.T.S.: Can you discuss the pros and cons of some popular forms of birth control? (The pill, shots, IUDs, etc.) Is there one that you recommend most often for college-age women?
Dr. C: There are several forms of birth control: oral, transdermal, vaginal, injectable, long acting reversible contraception. Currently, I do not see many college age women, but I do feel that long acting reversible contraception (i.e. Mirena, Paraguard, Implanon) is acceptable for that population. The reason being, I know how busy college age women are and it can be a lot to ask of her to take a pill at the same time every day. Also, I do like to stress that these do not prevent her from acquiring a sexually transmitted disease, therefore a barrier method must be used!
Dr. N: The option of birth control should be individualized, but pills are the most popular method among college-age women, though one should remember to take them every day. Shot is a better option compliance wise as once received, it is good for 3 months. The IUD is the best option in my opinion if someone is looking for a long term birth control. The major advantage of all these methods is significant reduction in menstrual bleeding, as the latter is a common problem among teens.
M.L.T.S.: How can women avoid common gynecological problems, such as UTIs and yeast infections?
Dr. C: Unfortunately some women are just more prone to them. Women frequently get UTIs after intercourse, one recommendation is to try and urinate as soon as possible after intercourse. As for yeast infections, they are a result in an alteration in the normal flora in the vagina, therefore I always tell my patients to wash themselves with regular soap and there is never a need to douche.
Dr. N: [To prevent] UTIs, avoid using diaphragms and spermicides as birth control methods; voiding after intercourse and plenty of hydration are some strategies but few studies have proven them to be effective. [There is] no clear benefit with cranberry juice as most people commonly think. Yeast [infections], there are really no measures to avoid them except taking antifungal as prescribed by the physician.
M.L.T.S.: What advice can you give to young women who are nervous about their first gynecologic exam?
Dr. C: We do understand that it can be an uncomfortable experience. To try and keep your mind at ease; we talk you through everything we are doing and the more you relax, the less uncomfortable the exam.
Dr. N: First of all, there is no need to perform a gynecological (internal/pelvic) exam unless age 21 or symptomatic. The lower age limit for Pap smear is 21, and a gynecological exam is not necessary to prescribe most of the birth control options. Most women can have multiple gynecological visits without having an internal exam. Asking your gynecologist and understanding female anatomy, especially visually by pictures and videos helps to alleviate the apprehension.
M.L.T.S.: Is there a men’s version of a gynecologist, and why don’t men need to see one as often as we do?
Dr. C: I would say that is an internist or even a family medicine doctor. And I’m not sure if it is men do not NEED to see a doctor as often as women do, but that it is simply they do NOT see a doctor as often as women do. As young women it is important to be vigilant regarding your health and address any issues such as menstrual irregularities, pregnancy, sexually transmitted diseases and cervical cancer screening on a regular basis.
As for men and their health, frankly speaking, I feel like women have more at stake than men. If women do not protect themselves and acquire sexually transmitted diseases then that could lead them to infertility which, of course, is devastating. Also, the burden is on the woman regarding pregnancy and choices regarding the matter, therefore it is imperative that women have an established relationship with their gynecologist.
Dr. N: Women are unique in that they have uterus that bleeds every month and women can carry babies, and both can be associated with problems to be taken care by a specialist. Men, they also can have problems like STIs, sexual dysfunction, etc., most of the time treated by a primary care or family doctor. But if you really would like to know the female version of a gynecologist, that would be a urologist.