There you are in the exam room at your doctor’s office, sitting in that ill-fitting paper dress and waiting for your doctor. You’re wondering how much to disclose during this OB-GYN visit — and wondering how soon you can get the heck out of there.
Whether this is your regular check-up with your doctor or something more unusual, the visit can be daunting. But routine check-ups can help protect you or your daughter from a lot of heartache and health concerns down the road.
HPV (human papillomavirus), a common infection spread through sexual activity, is a major cause of cervical cancer. The vaccine aims to prevent both. For women who are older, or who have never had the shots, cervical cancer can often be prevented with regular screening tests and follow-up care.
But these are just two of many issues to watch for. This trip to the doc is important, ladies. There are important issues you should ask about and probably done.
“Women don’t ask about these because they think it is normal, and that’s urinary incontinence and decreased libido. Both issues are generally correctable and not something you have to live with. But we can’t help you if you don’t ask,” said Dr. Shawn Tassone, a Texas-based board-certified OB-GYN.
Dr. Jessica Shepherd, an OB-GYN at the University of Chicago, added others, including: “When I exercise, why might I have heart palpitations?”
Silence can actually hurt patients.
“If we wait for patients to ask the questions, the timing is typically too late, and if there is an issue, some sort of intervention may be needed,” said Dr. Ursula Balthazar, a reproductive endocrinologist at RMA of Texas.
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“The care provider should also ask more questions, such as: ‘Do you plan on having children in the future?’ or ‘How many children do you want to have?’ Someone in their prime may not be thinking about these future life events. But by the time the patient ‘plans’ to have a family, their fertility may already be on the decline.”
A number of physicians said the appointment is not the time to be shy. Among their advice:
Speak up! “Nothing concerning your health should ever be a private struggle,” Balthazar said. “Any and all questions can set you on the right path.”
Dr. Mylaine Riobe, a Florida-based board certified OB-GYN with expertise in traditional Chinese medicine and functional medicine, said women need to do a better job of taking charge of their health, and avoid waiting when it seems there may be a problem.
“I wish my patients knew to come in sooner for certain problems so those problems don’t linger too long,” Riobe said. “Patients tend to wait a long time before coming in for certain things, like pain or abnormal bleeding.”
Whatever it is, your gynecologist may have likely seen it before and know an easy fix. “To me the silliest question is the one you didn’t ask,” Tassone said.
We’re not judging you. “So many lovely normal women are going through difficulties such as divorce, body-image issues, family crisis — you never can judge a book by its cover,” said Tassone. “Sometimes the most put-together person on the outside can be a mess once the exam door closes.” Tassone said that questions your doctor will ask are geared toward finding the best care for you, including the number of romantic partners you’ve had.
“This is not so we can judge you, but so we can make a recommendation for the best quality of health care we can provide,” said Balthazar. She added that the number of partners patients have is confidential “and will most likely be forgotten once the next patient arrives.”
You’re not alone. Despite your concern that you’re an anomaly patient — you most likely are a common case. Got a tipped uterus? It’s normal. In a phase where you’re not interested in sex? You’re also not alone.
“Most women in their 30s and 40s will have an extended time period when they are not interested in sex,” Tassone said. “This is completely normal.”
When the time is right, however, doctors say the same goes for everyone. Take care of yourself and talk with your doctor about the best protection for you. “Safe sex is always important no matter your age,” said Dr. Draion M. Burch, a Pittsburgh, Pennsylvania, OB-GYN who practices concierge medicine.
And because HPV, syphilis or HSV (herpes) remain fairly common diagnoses, even among an older population, discussing safe sex practices is nothing to omit.
“Many women feel if they have these infections, they have somehow failed in protecting their health,” Riobe said.
She said HPV is extremely common and difficult to prevent, especially since condoms do not protect women from the infection. “Women deserve to have more information about these conditions for both prevention and effective treatment,” she said.
Infertility is also a common topic of discussion. “Some women feel if they cannot become pregnant, then they are less of a woman,” said Balthazar. “In the past 35 years, physicians have successfully used assistive reproductive technology to deliver an estimated 5 million babies.”
Ultimately, the goal is to be comfortable with your body and understand how it works.
“Men are not afraid, yet I see so many girls and women who are simply embarrassed of their body,” Tassone said.
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