I can’t say I vividly remember my first gynecologist appointment. I know my mom explained the basics of how the appointment would go and I remember my time in the stirrups was less painful than I anticipated. But to be honest, once that first pap smear came back all clear, I figured I didn’t need to worry too much about visits to the gynecologist, yet.
From all that I’d learned from health class and other resources (like women’s magazines my mother probably didn’t want me reading), a visit to an OB-GYN seemed to be focused on pregnancy, fertility issues, and sexual health issues (like STD testing, birth control, etc). In my twenties, I was not sexually active, and, therefore, not worried about any of the aforementioned issues. Furthermore, my period came more or less regularly, with more or less the same flow, PMS symptoms, and so on.
So, I did what the American College of Obstetrics and Gynecology (ACOG) recommends and got a pap every three years. If I wasn’t due for a pap smear, I didn’t schedule an appointment with my gynecologist. Because I moved a few times in my twenties, this also meant I didn’t establish a consistent relationship with an OB-GYN.
Somehow, I missed the memo that annual well-women exams at the gynecologists are still valuable. It wasn’t until my thirties that I discovered what I was missing by not attending my regular well-woman exam.
You can learn a lot from a regular well-woman exam
To understand the value of a regular well-woman exam, it’s necessary to understand what happens in a typical OB-GYN appointment and what that information is telling you and your doctor.
Early in an OB-GYN appointment, a nurse and also your doctor will ask you questions about your period and sexual activity. They’ll likely want to know the date your last period started, how long your cycle typically lasts, and also details about how heavy or light your flow is. These details will inform them of your overall health and may tip them off to health issues you may not be aware of yet.
Recent research has led many doctors to consider a woman’s period to be a vital sign of her health—just like temperature and heart rate. The reason for this assertion is that many health conditions women might be experiencing may show up in a woman’s bleeding pattern. Additionally, a healthy monthly cycle has been shown to protect bone density, heart health, and general immune system responses.
The appointment will also include a breast exam. Regular monitoring for unusual lumps in your breasts is recommended in order to catch breast cancer early. Annual mammograms are recommended starting at age forty, but if you have risk factors for breast cancer or it runs in your family you and your doctor may decide to start those mammograms sooner.
The pap smear tests for HPV (which causes cervical cancer) and cervical cancer. Research has determined that cervical cancer is slow growing, and a pap can discover pre-cancerous cells, so three years between them is enough time to be preventative.
While you’re in the stirrups, your doctor will also perform a pelvic exam, during which one or two lubricated, gloved fingers are inserted into the vagina while their other hand is on your abdomen to feel the size and shape of your reproductive organs (fallopian tubes, uterus, etc). According to the Mayo Clinic, “During this part of the exam, your doctor will check the size and shape of your uterus and ovaries, noting any tender areas or unusual growths.” The pelvic exam can sometimes detect cysts on the ovaries, uterine fibroids, and sexually transmitted diseases.
Pelvic exams, like pap smears, used to be recommended annually. Presently, ACOG recommends pelvic exams be performed in accordance with symptoms, pre-existing conditions, and whatever you and your doctor determine is best for you and your health.
The right doctor for you matters
Many women understandably feel uneasy about visiting the OB-GYN. A close to complete stranger is examining your private parts and asking you about the time of the month that is often the most awkward for most (all?) of us.
This is why having the right doctor for you matters.
Asking friends in the area for recommendations is a great place to start your search, and it’s worth asking your friends why they like their doctor.
Speaking with Verily Magazine in 2014, Dr. Kecia Gaither explained what to look for in credentials: “Board Certification lets the consumer know that the physician has put in the time for study and is up to date with the latest medical information.” It’s important also to consider if you need a doctor who has specialized in a particular sub- field—such as fertility awareness, endometriosis, PCOS, or high-risk pregnancies.
There are also more subjective factors to consider in selecting the right doctor for you:
Do you have a preference if the doctor is female or male?
Do you want your doctor to be located close to your home or office? Or are you willing to drive a distance for the right doctor?
What sort of bedside manner will make you feel comfortable?
Bedside manner is a term used to describe how the doctor interacts with their patients. Because it’s important that you feel comfortable with your doctor, it’s worth considering what will put you at ease. Do you want a doctor who lingers in appointments, so that you have plenty of time to ask questions? Do you want your doctor to take charge and have a plan, or do you hope it’s a more collaborative process?
Your relationship with your doctor is like a working relationship. Different personalities will mesh better than others, so don’t hesitate to meet with different doctors until you find the right fit. You’ll be talking about some of the most intimate parts of your life, so feeling comfortable can’t be overstated here.
There is nothing to be ashamed of
Our monthly period is messy, uncomfortable, and generally, we’re just glad when it’s over each month. But our monthly period tells us a lot about our health.
When it comes to talking with your doctor about your period, a general rule of thumb is if something feels off or unbearable ask your doctor about it—even if it’s a consistent symptom (or maybe especially because it’s consistent).
The range of normal cycles is wide, which can make it difficult to know if what is happening in your cycle is a sign of health or not. If your flow is very heavy, your cramps are very painful, or your fatigue interferes with your daily life, it could be a sign that hormones in your body are unbalanced.
Because our period is a monthly ritual, it can be easy to tolerate its unpleasant nature and, consequently, write off certain troublesome symptoms as just “that time of the month.” And of course, shifts in your exercise, prolonged periods of stress, and changes in weight can all impact your monthly period.
This is where visiting the doctor yearly can be a help, too. When you can see patterns year over year, you and your doctor can better understand what is normal for you, what is cause for concern, and what to investigate more deeply.
It should go without saying, but if your gut tells you something is off, but your doctor isn’t taking it as seriously, it never hurts to get a second opinion.
Finding doctors who I can trust with my health, who have helped me understand what my cycle is telling me about my health, has been so helpful and empowering for me. But our experiences of feminine health will be as unique as we are. While you might gain some insight from my experiences, you’ll gain the best insight from talking with a trust doctor about your experiences with your cycle and feminine health.