Important questions to ask your GYN, at every stage of life

[5 min read]

• At every stage of life, there are important topics to cover with your gynecologist.
• You should consider taking your child for their initial gynecologist visit when they are between the ages of 13 and 15. 
• Some concerns, like sexually transmitted diseases and cancer, are important topics to cover with your GYN throughout life.
• A Providence Swedish expert has guidance to help patients of every age get the most out of their gynecologist visits.  

Providence Swedish offers extensive services for every phase of a woman’s life, whether that’s menopause care at our Women’s Specialty Wellness clinic or cutting-edge care at the Providence Swedish Cancer Institute. Our caregivers are committed to providing every woman who comes to us with the best, most innovative and sometimes lifesaving care.

Regular visits with an OB/GYN are vital to maintaining optimal health throughout life and especially for preventive care. GYN care is critical for teen health, though getting started with “the talk” might leave some parents and their kids feeling a little squeamish.

For some advice to help women and girls get the most out of their OB/GYN visits, we talked to Reena Vasavada-Parikh, M.D., a gynecologist at our Swedish Gynecology Specialty Center in First Hill.

When should I consider taking my daughter for her first GYN visit? Can her pediatrician/family doctor do this?

We recommend an initial reproductive visit between ages 13 to 15. This is an opportunity for general education and to  provide preventative health services. This can be done with a primary care physician based on their comfort level. It also allows us to screen for potential issues. For example, blood clotting disorders may be diagnosed based on heavy periods at menarche.

What are some tips for making my child’s first GYN visit easier? 

For a lot of teens and adolescents, reassurance that we do not perform a pelvic exam unless absolutely necessary is a big one. For the most part, we can diagnose and treat based on history. We can even screen for sexually transmitted disease (STDs) using urine. And if an ultrasound is needed, this can be done abdominally. Cervical cancer screening (with Pap smears) starts at age 21, so those are not necessary for patients in this age group. And some teens might prefer to speak to the provider one-to-one, and it helps if the parent is aware of this prior to the exam.

What are some important questions or issues to discuss at this stage of life?

An important one is human papilloma virus or HPV vaccination, if your child hasn’t already had one, as well as the prevention of STDs and contraception. I also encourage discussion about menstruation and what is or is not normal. Sexuality is a really important topic as are other health issues like stress, diet, nicotine and other lifestyle factors affect gyn health.

Oftentimes, questions that come up during a visit can spark a discussion between teens and parents regarding family health history and how that could impact future health issues.  For example, a child may not even know about a family history of diabetes, which could mean that they might be predisposed to polycystic ovary syndrome or PCOS, which would cause irregular periods. It’s important information for them to have, especially for health care decisions later on in life.

What are the important issues for patients in their 20’s and 30s?

Cervical cancer  screening with Pap or HPV starts at age 21. Reproductive issues are important including prevention of pregnancy or optimizing health for pregnancy.  It is also important to discuss painful or irregular periods, both for treatment and for diagnosing other conditions such as endometriosis, uterine fibroids, PCOS and even uterine cancer (which we are seeing at younger ages.) STD screening is important for this age group, especially as we have seen an increase in syphilis.

I’m in my late 30’s or early 40’s and I am done having kids. What are the most important issues for this age group? Is there anything I should talk about if I haven’t had kids and don’t plan on having them?  

Periods can change during this time and as above should be worked up (see above).  If you are done having kids or not planning to have any, contraception is an important topic.   Contraception can help decrease your risk of cancer (such a removing the fallopian tubes which decreases the risk of ovarian cancer) While important at all ages, understanding the role of lifestyle and effects on gyn care. Cervical screening should continue, however after the age of 30 can be done every 5 years with HPV testing. We normally recommend breast cancer screening with mammograms to start at age 40. Perimenopause can start 10 years before then end of periods and symptoms  ( anxiety, mood changes, hot flashes, insomnia, decrease in libido) can be present during this time. Urinary issues such as pelvic organ prolapse or incontinence can also be present in this time. Patients should also continue STD screening as needed.

What are the primary issues for patients in menopause or who are postmenopausal? Do I still have to go to the GYN if I am postmenopausal? 

 Absolutely. Any post-menopausal bleeding needs to be evaluated and you should be seen if you are having urinary issues or suspect vaginal prolapse. Vaginal dryness or irritation can be evaluated and treated. More OB/GYNs are developing an interest in menopausal medicine including starting hormone replacement therapy. If you have any gynecological concerns or issues in menopause, you should definitely address them with either with your primary or an OB/GYN.

And what about those in their 50s and beyond. Why is it important to continue regularly scheduled GYN visits for this age group?

As I mentioned earlier, for those in this age group it’s important to have any vaginal bleeding be evaluated. Ovarian cancer can also present abdominal pain and bloating. If you are not sexually active with a new partner and if you have had negative HPV and Pap smears, you can discontinue Pap smears at age 65. If you have a new partner, remember to continue STD screening. Vaginal dryness and urinary issues can be treated with vaginal estrogen. Lastly, women can develop skin conditions (including cancers)  on their vulva and labia. If not performing regular self-checks, they  should be screened every couple of years. 

Learn more and find a physician or advanced practice clinician (APC)

If you need a gynecologist, women's health specialist or primary care doctor, Swedish is here for you. Whether you require an in-person visit or want to consult a doctor virtually, you have options. Contact Swedish Primary Care to schedule an appointment with a primary care provider. You can also connect virtually with your provider to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. You can use our provider directory to find a specialist or primary care physician near you. 

Information for patients and visitors 

Additional resources

What is pelvic floor dysfunction and how is it treated?

New Swedish Gynecology Specialty Center brings a host of women’s health services under one roof

You can thrive, not just survive, during perimenopause and menopause

Fibroids 101: A common condition with many treatment options

There's a new treatment for urinary tract infections. What should you know?

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.

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About the Author

Whether you are seeking gynecological advice, need help navigating your way through the menopause stage of life or researching a recent breast cancer diagnosis, the Swedish Women's Health Team is committed to helping women find the information they need to live happy and healthy lives.

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