The annual G.Y.N. visit for some women is worse than the dreaded trip to the dentist.  

In most cases this visit consists of a breast exam and a pelvic exam. It can be a very emotional and distressing time for a young lady, mature woman, or a new or even an established patient.  

As a gynecologist, however, I see this appointment as a way to keep women healthy while screening for breast and cervical cancer. The appointment is a time to review the latest recommendations regarding such subjects as exercise, healthy eating habits, seat belt use, calcium intake and smoking.  

It is also a time to ensure compliance with recommended screening exams (bone, breast, colon and eye). The appointment is also a time to follow up on last years’ recommendations; to evaluate emotional well being; bladder/bowel function; and sexuality. Lastly it is a time to share socially, to enjoy with my patients new additions to their family, a vacation experience, job successes, and also share life’s losses and challenges.

What follows may help prepare you for your next appointment:

• Know your last menstrual period (LMP)—the first day of your last menses. It is helpful to know the last two or three. This helps your gynecologist evaluate your menstrual pattern. If these dates are difficult to remember, get in the habit of using a calendar to jot them down monthly. It is then very easy to bring this calendar to your appointment.  

• Please bring questions.   Of course there may not be time to address all of the questions during your annual exam. Most questions may relate to other GYN problems or other health problems that may necessitate a second appointment, laboratory test, x-rays or a referral to the appropriate specialist. However, if not discussed, a small problem could eventually become worse.

Here are some frequently asked questions and answers:

I am finished having babies and my tubes are tied, do I still need to see an OB/GYN?
A resounding yes. It is still essential to take care of your breast and pelvic health. It is crucial to get pap smears at scheduled intervals and a yearly breast exam.

What is a pap smear?
A pap smear is a screening test for cervical cancer. This is usually done during the annual exam or more frequently if indicated. Every vaginal exam does not necessarily include a pap smear. This is especially true for women seen on an urgent basis in the emergency room.

When should I bring my daughter to the gynecologist?
Most young ladies under 18 can be evaluated by their pediatrician; however problems with menstrual cycles or desire for contraception can be addressed by the gynecologist.   As most of the younger patients are not sexually active, this appointment does not necessarily have to include a pelvic exam.

Do I need a mammogram every year?
Most women should get a mammogram yearly starting at age 40. Of course this may vary depending on family history. Mammograms can detect early cancers that are too small to feel during the breast exam.

I have a white vaginal discharge, is this normal?
A white creamy vaginal discharge is normal; however, if the discharge has an odor, a color or is clumpy, please see your gynecologist.

I was told I have a cyst on my ovary, is this a problem?
Most women who are still having menstrual cycles, and who are not on any form of contraception (ocp, depo provera, nuva ring, ortho evra patch), will form a large cyst or cysts on their ovary. This cyst usually occurs mid-cycle and indicates ovulation (when an egg is released). The cyst will usually begin to regress with menstruation. A similar process can occur every month thereafter until menopause. Ovarian cysts with certain characteristics can be problematic. Evaluation by a gynecologist is helpful.  

What is menopause and when will it happen?
Menopause is the cessation of menses for 12 months in a row. The average age for menopause to occur is 51. Menstrual changes, however, may occur as early as four to seven years prior. This time is commonly referred to as per menopause.

Other medical tidbits:

• A screening colonoscopy is recommended at age 50.
• Every female diet should include calcium 1000mg/day; if menopausal, 1500mg/day
• Sexually active women less than age 24 should be screened for Chlamydia (a sexually transmitted disease).