Being in college means growing up, right? You’re responsible for getting balanced, nutritious meals. You’re responsible for showing up to class with your assignments. You’re also responsible for taking care of your Pikachu.
No, I’m not talking about the cartoon Pokémon. I mean your vagina.
If you’ve gone to see a “lady doctor” before, it might have been with your mother, and you probably had to awkwardly ask (or shout at, in my case), “Can you please leave?!” when the doctor asks you to strip and get settled in those stirrups.
But on your own, just how good are you at navigating the OB-GYN?
While you can and should rely on your doctor to guide you through the visit, it doesn’t hurt to know what to expect from your gynecologist. I consulted with Elizabeth Eden, M.D. to pick her brain about how we should be approaching our visits to the OB-GYN.
Q: Most young women go to an OB-GYN on their own for the first time when they are in college. What should they expect on a typical checkup? What questions should they be asking?
A: Colleges are great because they have health centers there to take care of you, but if you have health insurance that allows you to go off-campus to a private practitioner, that may be better in the long run. It’s not to say that doctors at student health centers are bad, but you most likely will see a different doctor each time you go. Continuity is key to building a good doctor-patient relationship. [I’ll be doing this from now on!]
As for what you should expect/ask, you should expect that a good doctor will be asking the questions. They should get your medical and surgical history. This includes information on your menstrual cycle, any health problems, STDs, medication, cigarettes, alcohol, drugs, relationships, etc. It’s the doctor’s role to ask the questions and the patient’s role to be as honest as possible. [This is also why Dr. Eden stresses how important a strong doctor-patient relationship is. You build confidence and trust!] If you have any issues about contraception or infections, bring them to the table to consult with your doctor.
Q: How/when should girls test for things like HIV, STDs, and cervical cancer?
A: Everyone is different – it just depends upon your sexual life. There are guidelines that obstetricians and gynecologists follow, but a lot is based on the patient’s history and symptoms. For example, if a woman is sexually active but not using protection, like a condom, I’d screen her for gonorrhea, chlamydia, and HPV – for most other things, women become symptomatic, which points us in the direction for other screenings.
HIV is a blood born disease, so I’d check to see if my patient has been exposed to “high-risk” populations, which includes homosexual men, bisexual men, people who have been incarcerated, prostitutes, and intravenous drug users who share needles. Therefore, if a patient has been exposed to these populations, I’d test for HIV. I test my patients after their exposure, again in 3 months, and again in 6 months to prove they are negative, since HIV antibodies can take time to show up. In general, if you are not sexually active, there is no need for a HIV test or pap smear to test for HPV.
Even though most women have had the Gardasil shot, it only covers some strains of HPV, not all. In college, there is generally more sexual activity, and men can carry HPV and not know they have it/have any symptoms. In my opinion, an annual pap smear can help detect early signs of precancerous cells in the cervix, which is ideal because then we can treat it before it gets worse.
Q: What about the birth control options out there?
A: Oral contraceptives are extremely safe and widely prescribed, and they have many benefits beyond preventing pregnancy like a decrease in menstrual pain, blood flow, acne, and ovarian cancer. However, not everyone is a candidate for the pill (e.g. if you smoke or have liver disease). Mirena, an intrauterine device, is a safe option for people who can’t be on traditional birth control. It’s a progesterone only IUD (it uses small amounts of synthetic progestin hormones) that’s inserted into the uterine cavity and can stay in up to 5-6 years. Consulting with a healthcare professional is key to choosing the right form of birth control.
It’s important to remember that birth control does not protect you from HIV or STDs. So no glove? No love.
Q: Any advice for girls who are nervous about seeing a gynecologist?
A: It’s hard to say because everyone’s situation is different, but ask your friends and people you trust who they trust and have been to. Once you find a doctor that you feel comfortable with on a communicative and physical level, you can start to build a great relationship. Again, continuity of care usually means better medical care. That same person gets to know you, and then you can develop and maintain trust and confidence.
One of my favorite things she said?
“If you go [out] to a party and something happens, you should be able to call your doctor the next day and confide in them.”