A Lifelong Relationship

OBGYN_fatwireMany women see their OB/GYN visit as an annual event of discomfort and awkwardness, and women who have yet to make their first visit often continue to postpone it instead of taking care of themselves. Dr. Sabrina Wyatt, MD, UAB Obstetrics and Gynecology says that most women miss their appointments because they are too busy taking care of everyone else.

“We take care of everybody else first, and we’re the last one on the list,” says Wyatt. “I don’t think it’s so much that they’re afraid to come in as much as they just don’t make the time to care for themselves.”

The Best Age to Start
Wyatt says that with teenagers on the verge of their first visit, it is a different story. Many are afraid of the routine pelvic exam and think that in order to get a prescription for birth control, an exam is required, which is not true.

Another common concern gynecologists see are mothers who worry about what is the most age-appropriate time to bring their daughters in for their first gynecologist visit. She says that there is no such thing as too young, and that since many moms are nervous to have the important conversation about contraception and sexually transmitted diseases with their daughters, the doctor is more than willing to help mom through that discussion.

As far as the best time to make a first OB/GYN appointment, current recommendations say any time between the ages of 13 and 15, whether or not they are sexually active. Wyatt says the purpose of the visit at such a young age is to open the door for them to ask questions; get counseled on STD prevention, contraception, and HPV vaccine administration; and make them aware of what they need to know as they progress into womanhood. This visit does not have to include a pelvic exam, as long as she is not experiencing any problems such as vaginal discharge or pelvic pain, Wyatt says.

New Guidelines
Starting at age 21, regular Pap smears are recommended, though the frequency of these tests has changed over the last few years.

“We actually found that those don’t have to be done quite that frequently, so in our 21- to 30-year-old patients, they only really need one every three years if screening has been adequare and everything is negative. Our 30 years and up patients actually can go out to every five years if everything is negative; however, they still recommend coming in yearly because there are other things we are looking for besides cervical dysplasia [abnormal cell growth on the cervix that can be a sign of cervical cancer], which is what the Pap smear screen is for,” says Wyatt.

Wyatt says that aside from the cervical dysplasia, doctors are also performing routine screening for other gynecologic malignancies, as well as continuing health maintenance including mammograms, blood work, and colonoscopies.

When it comes to patients, Wyatt says she sees a range of cases from minor issues like vaginal discharge to patients that want to be screened for sexually transmitted diseases. She says that if patients are experiencing a problem, there is no reason not to have it checked out.

“I think just knowing that something has been checked out and that it’s not anything ‘bad’ makes patients feel a lot better even if they don’t necessarily get relief from a symptom,” says Wyatt. “If you’re having pain or pain with intercourse, if you’re having issues or concerns where you feel like you need to be screened for STDs, these are things to tell me, and I can help you through those,” says Wyatt.

The Contraception Conversation
Wyatt says that when it comes to contraception, patients should feel comfortable talking to their doctor about their wants and needs. “We’ve all needed birth control at some time in our life,” Wyatt says. “Those are conversations I think a lot of people don’t just have out in public, and your gynecologist is a person who won’t be judgmental. There is just, ‘Let’s take care of you and get you where you need to be.’”

For women who are interested in birth control, there are many different types available besides the standard birth control pill. UAB offers the Mirena IUD, which is an intrauterine device that lasts for five years. It can be removed at any time, allowing the patient to get pregnant as quickly as within the month. UAB also offers a new subcutaneous implant called Nexplanon, which is good for up to three years.

First Visit Advice
Before coming in for a first visit, Wyatt recommends preparing questions for the doctor, and approaching the visit with an open mind. For teenagers, she says to look at it as an opportunity to ask all the questions they feel they cannot ask mom, and as a chance to be honest with the doctor and themselves. For the pelvic exam itself, Wyatt recommends that patients should relax, because the more they tense up the more uncomfortable it is. For patients in their 20s and beyond who have had Pap smears in the past and are switching doctors, Wyatt says to share those results with the doctor so they can determine how much screening the patient needs and how often.

This is also the age range more likely for contraception and childbearing. Wyatt says that women considering having a child should consult with their physician before coming off their contraceptive to make sure they are following the most effective methods to reach their goal of conception.

A Lifelong Relationship
Wyatt says that forming a strong relationship with your gynecologist is beneficial from the get-go, because women will have someone there for life, from their fertile years onward. Because it is a lifelong relationship, Wyatt recommends finding a doctor that you feel comfortable with, because every patient’s and doctor’s personality is different.

“I’ve had many patients laughingly say they would change husbands before they would change gynecologists because it’s such a personal relationship,” says Wyatt.

The Benefits of UAB
Wyatt says the great thing about UAB is that women’s services are located under the same roof, and the specialists see each other every day. From maternal-fetal medicine to gynecologic oncology, every doctor is comfortable with each other. Wyatt says that if she—or any of her colleagues need a second opinion, there is always someone there to provide it. “You’re not just getting your doctor, you’re getting the expertise of all the other excellent doctors at UAB,” says Wyatt.

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