QUESTIONS YOU MUST ASK YOUR GYNAECOLOGIST
Bringing a child into this world is the most wonderful gift any mother would get from God. It is for this particular reason that women’s reproductive organs are very delicate and complex hence requiring regular medical check-ups and special care.
- Do I have a sexually transmitted infection?
It is essential for the gynaecologist to rule out clinically that you do not have a sexually transmitted infection. If necessary, further tests should be done to exclude Gonorrhoea, HIV, Chlamydia and Syphilis. If a sexually transmitted infection is confirmed, the treatment must include the partner to prevent re-infection. The annual gynaecologist check-up for a woman provides a wonderful opportunity to determine her HIV status.
- Is the contraceptive method I am using the most suitable for me?
When visiting a gynaecologist, a woman should review her contraceptive option. If it has negative side effects such as abnormal weight gain or weight loss for some hormonal based contraceptives, excessive or irregular menses, loss of libido or non-complicity for the daily intake pill, then that method is definitely not for you. Granted, it is difficult to predict one’s response to a particular method. However, it is worthwhile to discuss other options available and change the method if necessary. For those who have attained their desired family size, permanent methods of bilateral tubal ligation or vasectomy for the male partner may be considered.
- What is urinary tract infection?
UTI is any infection of the urethra and bladder (lower urinary tract) or ureters and kidney (upper urinary tract); put simply any infection in the urine and expelling system in the body. This system is usually sterile i.e. it is not colonised by any bacteria or germs. Two factors commonly make a female prone to UTIs are:
- The urethra which is a small pipe connecting the bladder to the outside at the vulva is short hence any contaminating bacteria may find easy access to the bladder.
- The urethra opening is close to the vagina and anus. Remember, the urethra is sterile but vaginal and anal openings are not for they harbour millions of normal bacteria. Hence contamination of the urethra may occur easily. The symptoms of UTI include frequency and pain in passing urine. At worst, when the infection has reached the upper urinary tract; fever, chills and pain in the flanks may feature prominently. UTI is not a sexually transmitted infection! However, it may be facilitated by sexual activity because of the increased chances of injuring the protective lining of the urethra and contamination.
- Are my menses normal?
The pattern of menstrual bleeding varies with individuals. However, the duration should be 2 to 7 days. The interval between the menses i.e. cycle length, should be between 21 days and 35 days. The interval is the period from the first day of one menstrual bleeding to the first day of the next menses. The blood should not be dark in colour and should not clot. Most women have a regular pattern in the characteristics of their menstrual flow. Any deviation from this regular pattern warrants evaluation by the gynaecologist.
- What can I do about loss of libido?
A lot of women are reluctant to share their experiences of sexual difficulties. Most of these problems can be addressed by a gynaecologist. The common causes of low libido among young women are medications, particularly the anti-depressants and anti-anxiety drugs. Other women report decreased libido from the contraceptive method they are using. Discomfort or pain during intercourse can lead to sexual problems and the underlying cause can range from serious medical issues such as endometriosis or pelvic inflammatory disease to simple issues like vaginal yeast infection or cyclic fluctuations in vaginal lubrication. Your gynaecologist is a smart choice to initiate a referral to a sex therapist.
- Does a history of abuse- sexual or otherwise have effect on my reproductive health?
Sexual abuse in children and young adults is increasingly being reported in many countries. Research studies point more to close relatives as the culprits of these crimes. There could be permanent physical scars from these encounters, but more hidden are the psychological effects that manifest themselves later as physical illness. A victim tends to hold her anxiety and depression about it and then develop physical symptoms, frequent pelvic pain that reflects her mental pain. Mentioning past sexual trauma can be extremely helpful to your gynaecologist in making a diagnosis. If no mention is made, a woman may consult widely and many tests conducted with normal results, but if a physician is aware of a past assault, he or she can counsel the patient directly or refer her to a psychotherapist and meanwhile prevent more procedures or tests form being done.
- Does smoking cigarettes and drinking alcohol affect my reproductive health?
Smoking cigarettes is a risk factor for developing cancer in both males and females. Smoking during pregnancy cause pre-term delivery, low birth weight, premature rapture of membranes, miscarriage and even neonatal death. Use of combined oral contraceptive pills and smoking increases further risk of heart attack and stroke. Women who smoke and delay child birth are putting themselves at risk of future infertility than non-smokers. Women smokers are also likely to experience earlier menopause than non-smokers. Heavy drinking of alcohol interferes with growth and development at puberty. It disrupts menstrual cycling and reproductive function. Drinking alcohol may cause infertility, spontaneous abortion and abnormal foetal growth and development.
- How often should I do Pap smear?
Pap smear is a test for detecting signs of cancer of the cervix. Cancer of the cervix is the second leading cause of deaths in women after breast cancer. However it can be prevented by early detection and treatment of pre-cancer abnormalities at pap-smears. Ideally, all women in the reproductive age group who have experienced sexual intercourse should have Pap smear done every year. However, if Pap smear done consecutively for three years is normal, then it may be repeated within three years thereafter. Only women who have had total removal of their uterus for reasons not related to cancer of the cervix are exempted from doing Pap smears.
- What causes cancer of the cervix and is there a vaccine to prevent it?
It is now known that cancer of the cervix is usually caused by Human Papilloma Virus (HPV). HPV is a common virus. Of the many different types of HPV, some are harmless and others can cause diseases of the genital areas. While most people clear the virus, those who do not can develop cervical cancer, precancerous lesions, or genital warts. Recently, vaccines capable of preventing cancer of the cervix, by preventing HPV infection, have been developed.
One such vaccine is called GARDASILTM [Quadrivalent Human Papillomavirus (types 6, 11, 16, 18) Recombinant vaccine] developed by MSD. The other one is called CERVARIXTM (HPV 16 and 18) developed by GSK.
The vaccines may also not fully protect everyone who gets it and hence it is important to continue with regular PAP SMEAR TESTS.
- How often should I have breast examination?
Breast examination is important in detecting swellings which may be cancerous. One should perform self-breast examination at least once every 3 months. In addition, you should have a breast examination performed by a doctor once a year. This is necessary to pick out any abnormality which may have been unnoticed by the individual. It is recommended that women over 40 years of age undergo mammography annually.