Women are hesitant to acknowledge and discuss their health issues with their gynecologist. In fact, most women find it challenging to visit their gynaecologist and have not yet adopted the practice of regular health check-ups. If you were to ask women what emotions they associate with talking to their Doctor about issues related to sexual and reproductive health, breast health, period problems, they would use words such as anxious, stressful, uncomfortable, etc.
We need to understand that every woman undergoes a number of health issues during her lifetime. When it comes to sexual and reproductive health, it can be hard to know what's normal and what may be a sign of a potential health problem. If a woman is able to talk to her gynaecologist about these issues, she will be able to get the right advice. So, it is important that she is comfortable, not embarrassed and not made to feel any sort of guilt about it.
I have always believed that a Doctor is there to guide you, advice you and treat you, if required, nor judge you. And that is what every woman should understand as they interact with their gynaecologist. Any questions that she is asking is not because she is judging you. All she wants to know is your full health situation which will help her/him diagnose any health problem.
We should be happy to embrace our body and accept the changes that happen at different stages. It is important to know more about them, address any concerns or questions around them rather than brush them under the carpet.
These are some of the issues you should consult your gynaecologist on:
Your sexual history
If you show-up with complaints or queries related vaginal infection, urinary tract infection, sexual orientation, contraception, and your gynaecologist probes you for more information, remember that he/she isn’t judging you on your sexual history or number of partners. If you have contracted an infection such as candidiasis (a fungal infection typically on the skin), gonorrhea (a sexually transmitted bacterial infection), genital warts (a small bump on the genitals caused by a common sexually transmitted infection), syphilitic ulcers (a bacterial infection usually spread by sexual contact that starts as a painless sore) and so on, it would be wise to examine your partner for the same and treat both to stop recurrences. Also, the Doctor can appropriately advice you on any risks and frequency of tests such as Pap smear.
Knowledge on contraception
You need to discuss and educate yourself on the various methods of contraception and their usage, duration, effectiveness, reversibility, side effects and suitability to your health. Shying away from discussing your options can lead to unplanned pregnancy and incorrect selection of contraception (morning after pills are real threat to your future reproductive health).
Consumption of morning after pills can lead to ectopic pregnancy (a life-threatening condition where in the embryo attaches outside the uterus), pelvic infectious diseases such as chronic infections like HPV, gonorrhea, chlamydia, herpes are causative factor behind tubal blockage and cervical cancer.
Your gynae will walk you through every single contraceptive method to choose from after explaining the action, side effects and percentage of failure.
Several gynecological issues are directly influenced by your life style choices. The most common ill effect of having poor dietary habits is menstrual irregularities. Moreover, insufficient hours of sleep, excessive screen time, jet lag and mental stress can affect menstrual cycle and fertility.
If your periods are very painful or have been getting worse over time, it can be a sign of endometriosis (a type of disease that occurs from the lining of the womb) or uterine fibroids (benign tumors that originate in the uterus). Gynaecologists are very adept in dealing with period problems and they are not put off when talking of bodily fluids including blood. So, don’t cancel your appointment just because you are having your menstrual period.
It can be an uncomfortable topic for you but if there is a foul smell or a noticeable change from your normal smell, it may be a sign of bacterial overgrowth or vaginal infection.
As a child, your parents kept track of your vaccines but as a young woman you need to maintain a schedule and visit your gynae for vaccination. Vaccinations are available against cervical cancer, HPV virus, Hepatitis B, Rubella, etc. These are to prevent one from acquiring STDs and for general wellbeing; such as one vaccination for influenza to be taken annually, Hepatitis A, Typhoid and pneumococcal vaccine for asthmatic patients.
A part of the routine health care checkup is the tests for early detection of cervical cancers. If you’re sexually active, pap smear is an important test for early detection of cervical cancer. Liquid base cytology; is a newer pap smear methodology and should be used universally by all the doctors instead of slide method.
It is vital to discuss prenatal tests to prepare for when you plan to conceive. To avoid chromosomal or metabolic or infectious pathology in the offspring, tests for both the partners needs to be done.
Breast self- examination
Breast examination is another very important aspect of a woman’s health. You should learn the basics of self-breast examination and screening frequency.
At the end of the day, your body is your temple. Visit your gynecologist with questions and doubts and never be hesitant when it comes to your personal well-being. Remember, no question is a silly question!
(Author Dr Aruna Kalra is Director, Obstetrics & Gynaecology, CK Birla Hospital for Women)
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