In the past, it used to be that women only visited their gynaecologist when they got pregnant, as they needed antenatal care for their pregnancies. As women get more educated with greater awareness of the importance of their gynaecological health however, this no longer holds true.
In the present day, I see women in all different stages of their lives in the gynaecology clinic.
Who should see a gynaecologist?
| Teenagers/adolescents |
- Typically brought in by their parents as they begin their menstruation.
- Common to experience period problems at the start of their reproductive lifespan.
- Teens may experience irregular periods or find difficulty coping with painful or heavy/prolonged periods, and these can significantly impair their ability to perform well in school.
|
| Women planning for pregnancies |
- They are interested in finding out about their baseline fertility health and to get advice on what they should be looking out for.
|
| Women trying to conceive naturally by themselves for some time but have not been successful |
- They suspect they have some fertility issues which require further testing by the gynaecologist.
|
| Women in the reproductive age group who have no desire for fertility but are encountering issues with their periods or sex life |
- These issues include irregular, heavy, painful, prolonged, frequent periods or unscheduled bleeding either in between their periods or after sexual intercourse, or suffer from painful sex and/or inability to consummate their marriage.
|
| Women who wish for contraceptive advice |
- They are looking for a suitable method of birth control to suit their family planning needs and lifestyles.
|
| Women who come in simply for regular surveillance of their gynaecological health |
- Regular breast or cervical cancer screenings.
- Regular pelvic ultrasounds so as to pick up common gynaecological conditions such as endometrial polyps, uterine fibroids, endometriosis or ovarian cysts early.
|
| Women transitioning into the peri-menopausal or menopausal period |
- During this time it can be common to experience disturbances in the menstrual cycles corresponding to hormonal fluctuations towards the end of the reproductive lifespan.
- These include irregular periods with lighter flow, all the way to having frequent prolonged bleeding.
- Women who experience post-menopausal bleeding, which is an abnormal symptom, should also see their gynaecologist.
|
| Pregnant women |
- The gynaecologist is able to provide good antenatal care throughout the pregnancy, oversee the childbirth process and continue the woman’s journey into the postpartum period.
|
When should I see a gynaecologist for period problems?
Many women ask me how they are supposed to know if they are having period problems. It is never easy to discern if you are the one having period problems as it is not a common topic around the dinner table, but here are some things that you should look out for and be concerned enough to make a trip to the gynaecologist’s office:
Heavy periods
- Having to change pads or tampons on an hourly basis
- Having to wake up at night just to change your pads
- Experiencing flooding or staining your clothes/bedsheets frequently
- Needing to wear 2 pads at the same time
Irregular periods
- Having an interval (counted from the first day of one period to the first day of the next) that is less than 21 days or more than 35 days
Read: Are your irregular periods a sign of PCOS?
Light periods
- Bleeding only lasts for less than 2 days
- There is no bleeding per se; your period just consists of spotting
Prolonged periods
- Bleeding that lasts beyond 7 days
Painful periods
- Experiencing pain that is not relieved by usual painkillers, or pain that extends beyond your period and interferes with your ability to carry out daily activities
Unscheduled bleeding
- Bleeding that occurs in between your periods (when you are not supposed to be bleeding i.e. intermenstrual bleeding), or after sexual intercourse (i.e. post-coital bleeding)
What to expect at your first gynaecology visit
The first time at your gynaecologist’s can be awkward especially if you have no idea what to expect. In general, you can expect the following:
Questions about your medical history
- This includes a review of your period patterns so do bring along your menstrual diary with the relevant dates to save time.
Physical examination
- This typically involves an abdominal and pelvic/vaginal examination - the latter will be omitted if you are a virgin.
- There is no need for any special grooming “down below” before you see your gynaecologist - we don’t register if you are hairy or clean shaven below, and we don’t know if you have had sex the night before so don’t worry and go ahead to take the first step in visiting your gynaecologist!
- A pelvic/vaginal examination usually starts off with a visual inspection of the external genitalia whilst you are lying down on your back in a comfortable position with your legs drawn up, apart and bent at the knees, followed by a vaginal speculum check - this is typically a small duck-bill medical tool made of plastic that is inserted (with gel lubrication) into the vagina and used to gently part the vaginal walls so as to allow the gynecologist to examine the health of the vagina and visualize the cervix.
- A Pap smear or HPV test may be taken if you are not up-to-date with your cervical cancer screening, or depending on your symptoms that you have presented with.
- This is also the time that samples of vaginal discharge can also be taken to send for testing, if needed.
- After that, the speculum is gently withdrawn and removed and the gynaecologist will proceed for a bimanual palpation. This is where he/she inserts 2 fingers into the vagina and places gentle pressure on the lower half of the abdomen in order to check for the size, mobility and tenderness of your pelvic organs (like your uterus and adnexa).
- It is vital for you to stay relaxed throughout the examination so that there is minimal discomfort and the examination can proceed smoothly - a typical pelvic/vaginal examination does not require more than a few minutes to get done, and can be performed regardless of whether you are having your periods that day, unless the aim of the examination is for your cervical cancer screening, which in case it would be better to do this at least a week after your period is over.
Should I still see a gynaecologist if I’m not sexually active?
If you have never had sex in your life, there is no need to do cervical cancer screening as it is highly unlikely that you would have been exposed to HPV. If you have had sex only once/ very few times, or the last time you had sex was years ago - you will still need to do your cervical cancer screening at regular intervals as it takes many years to develop.
However, at the end of the day, cervical cancer screening is but one of the many reasons why you should see the gynaecologist, as highlighted earlier in this article.
Do you have any questions about clinic visits? Feel free to drop me a message!
