Get the Most From a Doc Visit

Prevention (USA) - - CONTENTS - BY LAU­REN STRE­ICHER, M.D. Dr. Stre­icher is a clin­i­cal pro­fes­sor of ob­stet­rics and gy­ne­col­ogy at North­west­ern Univer­sity’s Fein­berg School of Medicine.

At least once a day a pa­tient apol­o­gizes to me for not hav­ing shaved her legs or got­ten a pedi­cure be­fore climb­ing into the stir­rups. Along with wor­ry­ing that I’ll find some dread dis­ease, pa­tients think

I’m judg­ing their hairy legs or chipped toe polish. It re­minds me: While it’s a very rou­tine exam for me, it’s any­thing but rou­tine for the pa­tient.

You can quit wor­ry­ing. As a gy­ne­col­o­gist, my only ex­pec­ta­tion is ba­sic hy­giene—a shower or bath dur­ing the pre­vi­ous 24 hours is ap­pre­ci­ated. Be­yond that, here are truths about three other is­sues that come up for women about goin’ to the gyno.

TRUTH #1

You can be ex­am­ined even if you’re bleed­ing

You sched­uled your an­nual gy­ne­co­logic exam four months in ad­vance and told your boss you needed the morn­ing off— but now your pe­riod has ar­rived three days early. Do you need to resched­ule? In gen­eral, no: A Pap test can be done un­less bleed­ing is re­ally heavy. The use of lu­bri­cant prior to a Pap is ac­tu­ally a much more com­mon rea­son for an un­sat­is­fac­tory re­sult. And if your bleed­ing is un­sched­uled or ab­nor­mal, it’s ben­e­fi­cial for your gy­ne­col­o­gist to be able to see where it’s com­ing from. There are ex­cep­tions, but if in doubt, ask; don’t as­sume you have to can­cel.

TRUTH #2

Get­ting weighed is not re­quired

Some women pre­fer not to be weighed be­cause they don’t want to get lec­tured—and they might skip a doc­tor visit just to avoid that. It is frus­trat­ing when a doc­tor is so fo­cused on your weight that your other con­cerns aren’t ad­dressed. But this isn’t the Army; no one is go­ing to force you to do any­thing. An ac­cu­rate weight is valu­able for ID’ing med­i­cal prob­lems, but

it’s much bet­ter to come and skip the weigh-in than not to come at all.

Your best bet for avoid­ing a dis­cus­sion about your weight? Start with “I know I need to lose weight, but since we have a lim­ited amount of time, I’d pre­fer to talk about my other health con­cerns to­day.” Then whip out your list and go for it.

If a pa­tient de­clines to be weighed, I’ll ask for a ball­park fig­ure. You also can ask to be weighed “back­ward,” fac­ing away from the scale. Rea­sons we will need your weight: Preg­nancy, cer­tain med­i­ca­tions, and surgery re­quire an ac­cu­rate weight. You do want to get the right amount of anes­the­sia, don’t you?

TRUTH #3

You need a pelvic exam even if it’s not a Pap test year

Women across the coun­try cel­e­brated when it was de­cided that a Pap test was no longer re­quired ev­ery year (for lowrisk women), which made it seem that they could skip the an­nual visit to the gy­ne­col­o­gist. I hate to burst your cel­e­bra­tory bal­loons, but a Pap test screens only for cer­vi­cal can­cer. It’s not a screen for uter­ine, ovar­ian, vul­var, or vagi­nal can­cer or for in­con­ti­nence, fi­broids, sex­u­ally trans­mit­ted in­fec­tions, pelvic or­gan pro­lapse, hor­monal changes, or ovar­ian cysts. A Pap test does not screen for sex­ual prob­lems or pro­vide con­tra­cep­tion.

In other words, if you are the proud owner of a vagina, vulva, cervix, uterus, or ovaries, you ben­e­fit from a gy­ne­co­logic exam ev­ery year even if you don’t need a Pap test. So get ready for those stir­rups, and take care of your health!

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