Women's health month is good reminder

May is women’s health month and it is the perfect time to make a commitment to take care of your body. “You should promote wellness rather than treat illness by seeing a physician on an annual basis for a well woman check,” said Dr. Steven Palmer, chief medical officer and obstetrician/gynecologist at Family HealthCare Network.

The first gynecologic visit is usually around age eighteen or when the patient becomes sexually active, whichever comes first. The non-sexually active patient should communicate about delayed menstrual periods, developmental issues or other concerns. “Our county has one of the highest rates of chlamydia and teen pregnancy. If teens knew about it ahead of time, they would take steps to make sure they had less risk,” said Dr. Parul Gupta, obstetrician/gynecologist at Tulare Regional Medical Center.

Every visit starts with the basics. “A patient has her vital signs taken which are blood pressure, temperature, pulse, weight, height and changes in body mass index. We also do lab work for cholesterol and lipid screening depending on family history and age,” said Palmer. This is a good way to detect pre-hypertension and pre-diabetes. “Our county has a high risk of diabetes because of the various culturally diverse groups. I see a lot of girls come in with uncontrolled diabetes where if they knew ahead of time, they could have taken steps to correct it,” said Gupta.

Do not let the dreaded exam scare you away. “It used to be that we would start doing pap smears as soon as the patient became sexually active but now the American Congress of Obstetricians and Gynecologists and the American Cancer Society recommend that pap smears do not need to be started until a woman is twenty-one years old, regardless of sexual activity,” said Palmer.

Understand the purpose of the pap smear. “It looks for changes in the cells on the cervix which may be precancerous,” said Palmer. The recommendation was changed because the reported number of patients under age twenty-one who have cervical cancer is extremely low so the yield was not worth it. “A woman can also have changes to her cervix under age 21 due to infection with the HPV virus that will self-correct,” said Palmer.

The breasts are checked first for a baseline and later for unusual or new lumps or bumps. “You can do a self breast examination in the shower once a month right after your menstrual period. Not every breast is smooth and some have irregularities because of fibrocystic changes which are benign, so you should become used to the way your breasts feel,” said Palmer.

Eventually, family planning comes up. “The slightly older patients in their 20s and 30s who are going into the reproductive ages are coming in for pre-conception information, physicals and to find out about pregnancy issues,” said Palmer.

The female body is always transitioning. In their 30s and 40s, women may experience hormonal changes and even peri-menopausal symptoms. “By the time they are 50 and into menopause, the period has stopped or become irregular,” said Palmer.

At age 50, you should have a mammogram. “We used to advise women to get a mammogram at age 40 but because the yield of breast abnormalities that are significant begins at age 50, it was changed,” said Palmer.

Your obstetrician/gynecologist wants you to ask questions so he can educate you on appropriate topics. “If you have abnormal bleeding, urinary incontinence, hormone problems or issues with libido, you should talk with your health care provider to find out the steps and treatments you can take,” said Gupta.

Do your best to prepare for the visit. “I would suggest that patients have a little spiral note pad and jot down their questions before they come so they do not get white coat syndrome and forget everything they wanted to know,” said Palmer.

Try not to let fear refrain you from scheduling an appointment if you have not already been seen this year. “A lot of times you will find that if you go to your doctor, you will have more confidence in the fact that you will not hear bad things because you will be taking steps to prevent those from happening,” said Gupta.

Know that screenings can be lifesaving and you may not always know if something is abnormal. “Some things like ovarian cancer do not have symptoms until it is too late. That is why you should have a relationship with a provider and see him on an annual basis so he knows you, your medical history and can have more surveillance over things,” said Palmer.

Do not abandon your obstetrician/gynecologist after pregnancy. Know that he is a friend and partner in good health for life. “Being an obstetrician/gynecologist is not just about delivering babies. It is about taking care of the entire female patient,” said Palmer.