6 Things You Can Do at the Gynecologist’s Office That Aren't Pap Smears
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6 Things You Can Do at the Gynecologist’s Office That Aren't Pap Smears

Beyond just sexual and reproductive health issues, your OB can work with you on the health of your bones, heart and more.

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By Olivia DeLong

You probably associate your annual trip to the gynecologist’s office with Pap smears, human papillomavirus (HPV) testing and sex questions, among other womanly topics.

But did you know that you can also have other key health conversations with your OBGYN? Heart health, weight control and osteoporosis are all fair game to raise with your OB.

If you’ve got an appointment coming up, get your cheat sheet ready. Here are six surprising topics that might come up.

Typical OBGYN topics

2 / 9 Typical OBGYN topics

Before we get into the “extra” items your OBGYN can help with, let’s discuss what a typical appointment will probably be like. Mariko Shelton, MD, an OBGYN at Saint Joseph Mercy Health System in Bloomfield Hills, Michigan, says the following topics are most discussed at standard visits, in addition to routine cancer and HPV screenings. (In most cases Pap smears are needed every three years for most women age 21 to 29, and every 3 to 5 years for those age 30 to 65.)

  • Painful periods and pelvic pain
  • Sexual history and concerns like pain with intercourse, vaginal dryness or low libido
  • Sexually transmitted infections
  • Plans for getting pregnant or not getting pregnant
  • Menopause
  • Urinary concerns such as leaking
  • Unusual vaginal discharge or odors

Most OBGYNs will perform a typical physical exam, which includes measuring your height, weight and blood pressure. A gynecologist may also perform a pelvic exam, which usually involves checking organs like the vulva, vagina, cervix, ovaries, uterus, rectum and pelvis for anything out of the ordinary.

Because different physicians may have different opinions on how often you need a pelvic exam and the frequency may be individualized, ask your OBGYN about an ideal timetable.

Cancer screenings

3 / 9 Cancer screenings

You know that a typical Pap smear can detect cervical cancer. But your OBGYN can also discuss other types of cancer—like breast, ovarian or endometrial cancer—especially if you have a family history of these diseases.

If you’re having any bloating, pelvic or abdominal pain, trouble eating or urinary trouble such as incontinence, especially for more than 12 days each month, discuss these symptoms with your OBGYN. Although having them doesn’t necessarily mean you have ovarian cancer, they could be signs of ovarian cancer, and its best to find out what’s causing them. Your OBGYN may recommend an ultrasound to check for ovarian growths and order blood work to test your CA 125 level, since high levels of CA 125 may mean you have cancer.

Symptoms of endometrial cancer, meanwhile, include unusual vaginal discharge, spotting between periods (or after you’ve gone through menopause), pelvic pain or unexplained weight loss. If you feel a mass in your pelvic region, that may indicate a problem, too. All of these symptoms could of course indicate something else, but it’s important to let your OBGYN know if you notice any of them.

If symptoms warrant a closer look, an ultrasound (either pelvic or transvaginal) may be recommended to get a closer look at whether or not the uterus has a mass. Further testing like a hysteroscopy, biopsy or a dilation and curettage (D&C) may be needed to remove endometrial tissue for examination and testing for cancer.

When it comes to breast cancer, the American College of Obstetricians and Gynecologists states that OBGYNs should discuss screening options with their patients starting at age 40 for patients with an average risk and continue monitoring their mammogram frequency at well-woman visits. Your OBGYN can go over your breast cancer risks and the screening options available to you, as well as any benefits or harms associated with screening.

Weight management

4 / 9 Weight management

A weight check is routine at each and every OBGYN appointment, and Dr. Shelton says if you’re overweight or obese, your OBGYN is likely to start a conversation with you about how to improve your eating habits and get more physical activity.

If you’ve noticed a sudden drop or increase in weight, let your doctor know that, too.

Most physicians will discuss your body mass index so that you know roughly where you stand—underweight, normal weight, overweight or obese. From there, your OBGYN will discuss a proper eating and exercise plan based on your needs.

High blood pressure concerns

5 / 9 High blood pressure concerns

It’s normal to be a little nervous at the doctor’s office and for your blood pressure reading to be higher than normal. But if you do register high blood pressure at your OBGYN’s office, she may suggest you see your primary care doctor for follow up or that you start tracking your blood pressure at home. To get an accurate measure, you’d want to get readings at several different times throughout the day.

If your OBGYN suspects you might have high blood pressure, she may recommend lifestyle changes to help control your numbers, including:

Medications may also be recommended in conjunction with these healthy lifestyle habits. Your OBGYN can discuss your options with you.

Chronic disease check-in

6 / 9 Chronic disease check-in

If you’re looking to become pregnant, it’s particularly important to let your OBGYN know about any chronic conditions you might have—such as diabetes, asthma or mental health disorders—and to fill out any documentation your OBGYN’s staff gives you. The information gathered by your doctor and staff can help guide treatment or management recommendations.

Whether you’re on a treatment plan already or you’re looking to start one, Shelton says you’ll want to get these conditions under control before trying to start a family.

Smoking cessation help

7 / 9 Smoking cessation help

Women who are interested in quitting smoking—especially those who wish to become pregnant—should also talk with their OBGYN.

“We can prescribe nicotine replacement or other medications that can help someone quit, and we can also discuss other tactics for quitting,” says Shelton.

Your OBGYN will ask you if you smoke and then talk through the reasons you should quit. These include lowering your risk of cardiovascular disease, cancer and respiratory disease and—for women who are pregnant—decreasing the chances of premature birth or intrauterine growth retardation. Your doctor will observe whether you’re ready to quit now or help you get ready to quit.

From there, you and your OBGYN will discuss your options. Some women are able to quit smoking without setting a plan first, while others will need to take more time to contemplate why and when they want to quit and to identify their smoking triggers.

Your OBGYN can discuss a realistic plan with you and suggest products that can help minimize cravings. Other medications like antidepressants may be recommended to help with cravings, too.

Bone health advice

8 / 9 Bone health advice

Osteoporosis—the thinning and weakening of bones—is five times more common in women than in men. That means women need to be especially aware of their bone health.

If you’re concerned, you can talk to your OBGYN about calcium and vitamin D supplements, or your doctor can order bone mineral density tests to look for signs of osteoporosis, says Shelton.

Menopausal women should be especially vigilant if they experience frequent fractures. Osteoporosis can also cause a slight curving of the spine or a decrease in one’s height.

It’s recommended that all women 65 years and older have a bone mineral density test. And if you’re younger than 65 but have had a bone fracture or an increased risk of osteoporosis, you should have a bone mineral density test, too.

You can talk with your doctor about improving the health of your bones, no matter what your age. But it’s especially important to do so if you are approaching menopause, since the ovaries produce less of the female hormone estrogen during the time, and that can lead to bone loss.

Activities like strength training, walking, yoga and tai chi can all help improve the strength of your bones, as well as your balance and posture. Foods can also help. Make sure you’re eating calcium-rich foods like leafy greens (think kale), low-fat dairy such as yogurt and fish such as salmon and sardines.

If your doctor finds thinning bones during bone density testing, she may recommend lifestyle treatments like the above or medications to reduce the risk of fractures.

Your OBGYN is there to help you

9 / 9 Your OBGYN is there to help you

Shelton wants you to know that regardless of what you’re concerned about, you should know that your OBGYN is there to help.

All good OBGYNs like to know what is going on with their patients. “But if we feel that a topic is outside of our scope of practice, we will refer you to another provider,” she says.

“I frequently have patients with low back pain who I refer to physical therapy,” Shelton says. “I also have patients who have concerns about their mood, who I evaluate and refer to counseling or—if the issues are more complex—to psychiatry.”

Bottom line: Make sure you speak up if a health issue is on your mind, gynecological or not. If your OBGYN doesn’t know the answer, she can refer you to someone who does.

Gynecology

Gynecology

There are many key areas in the field of female reproductive system health, including menstruation, pregnancy, fertility, and menopause. As a woman, you may be concerned about other issues related to your sexual health, including ...

genital problems and sexually transmitted diseases. If you are a female that is sexually active, or over the age of 18, it is important to begin seeing a womans' health specialist in order to make sure that your reproductive system stays healthy. Before that, any concerns with menstruation should be addressed with a physician. As you get older, most women become concerned with issues pertaining to avoiding or achieving pregnancy, until menopause begins around age 50.
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