As a Gynecologist in Colorado Springs, it is my job to help educate and clarify questions my patients may have. Gynecology is the branch of medicine dealing with a woman’s reproductive system. In the gynecology division of my practice, we are treating patients’ fertility, menstrual cycles, problematic periods, breast issues, and more.
When Should A Woman First See A Gynecologist?
So when should you go see a Gynecologist for the first time? The answer has changed in the last decade. The recommendation used to be that a woman needs first to see a gynecologist by her 18th birthday, or when she becomes sexually active, whichever comes first.
Now, the new studies seem to indicate some time in the early to mid-20s, or sexual activity, whichever occurs first, is when a woman needs to come in for her gynecologic exam.
The Exception
Now, the exception would be adolescents that are having problems with puberty or problems with their period. It’s very common for an adolescent woman to have irregular periods, heavy periods, or even painful periods. These are all issues that I am able to address and treat effectively. In these cases, patients should come to see me much sooner than the typical recommendations.
The First Gynecology Visit
To walk through an appointment from the beginning; a patient will come into the office and first meet with my Medical Assistant (MA).
My MA will take the patient’s weight, blood pressure, vital signs, as well as some of a patient’s medical history.
After that, I come into the exam room.
I will start my time with my patients with a simple conversation.
We go over their medical history and any relevant medical problems that they may have. I specifically ask questions about periods. How often? Are there any problems? Additionally, I will ask questions about sexual activity and talk about any needs for family planning or contraception that a patient may have.
I also ask about self-breast exams and see if there are any breast problems present. Together we concentrate on the family history–on areas such as breast cancer, ovarian cancer, or recurring pregnancy problems that may exist in the family history.
After we finish our discussion I leave the room and have the patient change clothes to prepare for the exam. When I return to the room with my Medical Assistant, we begin with a head and neck exam–checking things like the thyroid gland. We also perform a breast exam–looking for any potential lumps.
We also do an abdominal exam, and then we’ll do the pelvic exam. The pelvic exam consists of a speculum exam. With this exam, we’re able to obtain the Pap smear, which tests for cervical health, and then we finish the exam with what’s called a bimanual exam–ensuring that the uterus and the ovaries feel normal.
The entire exam literally takes only a few minutes.
At this point in my career, I’ve exceeded tens of thousands of exams. It’s very common for a patient to be nervous, especially the first time and that’s understandable. But rest assured, it’s certainly just a day at the office for ObGyn docs, very routine after many thousands of exams over 26 years. Philosophically, I believe in keeping the exam simple and to the point in order to provide the best care.
At the end of the exam, we talk about any findings that need to be further worked up or any problems that need to be followed in the future. We also discuss any treatment options we decided to initiate.
The total time in the office will usually be anywhere from 30 to 45 minutes, depending on the complexity of what they came in for.
Common Gynecology Topics By Age
The specifics of appointment discussions are quite often influenced by my patient’s age and her stage of life.
I talk about family planning and preconception counseling with patients who are ready to pursue becoming pregnant. For patients who don’t want to become pregnant, I provide contraceptive counseling.
As a woman moves into her 30s and 40s, I’ll talk more about breast health and the changes of the cycles that will occur in the perimenopausal period–typically, which is typically about a five year period of time that occurs in a woman’s 40s. And I convey what a woman can expect in the changing of her cycles as she approaches menopause.
In a woman’s 40s is when I also start recommending doing mammograms for a woman’s breast health.
With a normal American diet, the average age of menopause is 51, and we define menopause as six months of no menstrual periods. That is when the ovaries are finally shutting down, and a woman’s entering down a menopausal stage of her life.
A lot of times, for those women, we talk about the changes
Somewhere in a woman’s 40s, 50s, and 60s is when I start seeing other kinds of gynecology needs. It’s not uncommon for these to be surgical needs such as prolapse symptoms or problems with bladder control. Women in their 60s and 70s and beyond are still in need of annual breast exams and gynecology exams.