Your annual visit to the gynecologist isn’t something you’re likely to get excited about. However, it is one of the most important events on your calendar in regards to your health.
“One of the things that we need to dispel is the myth that the annual visit is just the pap smear,” said Dr. Abike James, lead physician at Penn OBGYN Associates. “While the pap smear is no longer done every year, the annual visit is a critical appointment that can make sure your health needs are being met, as well as pick up conditions such as fibroids or ovarian cysts that you didn’t know you have.”
To better prepare you for your annual gynecologic appointment, we asked Dr. James for advice on how you can make the most of it — at all stages of your life.
Preparing During Adolescence
When teens and young women — younger than 21 — visit Dr. James, she thinks they should be prepared to address their menstrual cycles and their sexual health needs.
“Sometimes for a young woman, when she first starts having [menstrual] cycles, they are very irregular, and/or they are very heavy and painful,” Dr. James said. “She might not know what’s too irregular or too heavy. We can help her manage her cycle and intervene if we need to.”
Dr. James also encourages a discussion about the young woman’s desires regarding sexual activity.
“Even if they come with a parent, we will request alone time with them,” Dr. James said. “That’s their opportunity to talk about their sexual health, sexually transmitted disease prevention, and their contraceptive needs (if any).”
What to Address During Young Adulthood
In addition to your sexual health history and menstrual cycle, one of the major topics of conversation during annual appointments in your 20s, 30s and early 40s is pregnancy.
Dr. James asks women if they are interested in pregnancy. “If they are not, I will discuss contraceptive options with them,” she said. “If they are, we will discuss optimizing their health before conception, taking into account their specific health issues. There may be labs that need to be done and vitamins to start.”
And if you are interested in pregnancy but are having difficulties conceiving or do not have a partner, your gynecologist can discuss reproductive and fertility services, including preconception planning, in vitro fertilization, management of PCOS and endometriosis, egg donation and more.
What to Talk About During Perimenopause and Beyond
Women in their 40s and 50s who are in perimenopause – the transition phase right before menopause during which some of the symptoms commonly associated with menopause occur — should be prepared to address their menstrual cycles as well as bodily changes and sex drive.
“As their cycles are changing, they may start experiencing symptoms such as hot-flashes, vaginal dryness and mood changes,” Dr. James said. “They should discuss these symptoms with their provider who may be able to offer treatment.”
Sometimes, other-potentially embarrassing topics should also be reviewed during your annual visit.
“They might also have questions about libido that they don’t like to bring up,” Dr. James said. “Other things like incontinence — urinary leakage — or prolapse, when their reproductive organs are beginning to come out” should all be addressed.
If you are post-menopausal, be prepared to discuss health maintenance and cancer screening, including timing of mammograms, pap smears and bone density scans.
What to Note Throughout Your Lifetime
“The one thing we address with everyone is their menstrual cycle – whether there are problems with it, or it’s going fine,” Dr. James said, noting that many times women aren’t prepared to discuss the dates of their last period, its regularity and other basic information about their bodies.
“These days there’s an app for everything, including period tracking,” she said. “Wherever you are in your reproductive cycle – be prepared to discuss your period.”
You also should feel comfortable discussing anything related to your sexual health and wellbeing with your gynecologist.
“Your gynecologist’s office should be a safe space,” Dr. James said. “You can discuss anything with regards to your sexual history and your sexual identity. And certainly if there are any concerns of abuse, bring that up with your gynecologist.”
While some of what you’ll discuss during your annual visit can seem embarrassing, try to overcome any bashfulness. Chances are your gynecologist has seen and heard what you’re going to tell them before.
Remaining silent or withholding information could be detrimental to your health.
And remember, your doctor isn't there to judge you and your choices — she’s there to help keep you safe.