Taboo Topics: Visiting the gynecologist

“Where do babies come from?”

The comical anecdote never seems to lose its humor. That is, until someone doesn’t actually know.

My mother likes to remind me of the time she told me that I was going to be a big sister again. My 8-year-old response was, “How did that happen?” We laugh about it now, but talking about sex can be uncomfortable.

Now, sex isn’t always done to make babies. I can’t explain to you why we do it, but we do, you know, do it.

Women are told that reproduction and reproductive health is a conversation between themselves, their partner and, when they’re young, their mothers. But there’s another party that can help women learn about their health in a professional and safe environment.

Gynecologists are physicians and surgeons who specialize in reproductive health in relation to caring for female genitalia, combating sexually transmitted infections and providing medication and advice about preventing pregnancies. Gynecology is related to obstetrics, which is the specialty involved with aiding pregnancy, birth and childcare.

These doctors are able to inform women about their bodies and answer questions they have about an array of hushed and sensitive topics that related to having babies and sex.

My mom is amazing and has guided me on a number of personal and physical issues. But when it came to saying, “Hey mom, I’m having sex. What should I be taking to make sure I don’t get pregnant and die?” she twinged a bit and told me I needed to start going to a gynecologist for yearly check-ups to make sure my lady parts were healthy and my mind was well-informed about my lady parts.

Not everyone is as open with their mothers about these issues, so I’m going to tell you what my mom told me: “It’s all about choices, find yourself a gyno to help you with those choices.”

So, I did. And the month before I turned 19 years old I went to Gynecology and Fertility for my first check-up.

I specifically chose Gynecology and Fertility, located at 1500 S 48th St. in Lincoln, because it’s an all-women’s clinic. I knew nothing about the doctor I wanted, but I knew that I would be more comfortable talking to a woman about my body than a man. I also am a liberal woman and didn’t want to be swayed by a doctor’s religious affiliations. That isn’t to say YOU shouldn’t go to a male doctor or a religiously affiliated clinic. Shopping around for a clinic that fits your own preferences in staff and office policies is important and your own choice.

Even after you find the right clinic or doctor you still might have questions about what will happen when you go to a gynecologist..

I remember sitting in the waiting room before my first check-up and feeling very uncomfortable and unaware of what I would encounter. Luckily, the nurses and doctors I interacted with were calm and walked me through everything that was going to happen.

Insight and information is one of the best ways to make people more comfortable in new situations. I sat down with Dr. Katie Fossen, a physician in gynecology and obstetrics at Gynecology and Fertility, to talk about what women can expect in the discussion and examination that happen within an annual check-up.

Daily Nebraskan: When should girls start going to the gynecologist?

Dr. Katie Fossen: What I normally tell my patients and mothers of my patients is “whenever you feel like she has questions.” If there’s something she’s worried about or if she’s having symptoms that she’s worried about. Sometimes, I’ll say 16 (years old) if a mom thinks her daughter is close to being sexually active. That can just be a good time for a discussion with a gynecologist, to come in and find out what we do and what we offer. The current recommendation is pap smears at the age of 21, so getting in by then is important. But if a woman ever has any questions about things that they’re experiencing, like pelvic pain or vaginal discharge, it’s important that they get in because things like sexually transmitted infections can sometimes affect future fertility. If there is anything that she is wondering about from a female standpoint, they should come in and see us.

DN: Is information disclosed to anyone outside of the medical provider?

KF: Any individual that comes in to my office and needs care has their information protected. So, even if they are a minor information is not told to the parents. Parents can’t come in or call to ask about what me and a patient were talking about. Especially in the college age where students have concerns about their parents finding out about things their student is partaking in, they can’t call in and ask what we talked about, even if they are on their parents’ insurance. So, if you ever have questions or concerns, you can air on the side of going to a physician and addressing whatever concerns you may have.

DN: What should women expect in a visit to a gynecologist?

KF: A routine annual examination if a woman was to visit me would start off with me talking to them. There is a list of questions we ask in the discussion portion. As far as the physical examination, we will start with a basic physical exam checking heart beat and things like that. We will check your thyroid, then do a breast exam and feel your abdomen to make sure nothing feels tender or strange or enlarged. And then also a pelvic exam. A speculum exam is the first part of that, which is where we use a speculum (a metal tool) that we place into the vagina to open the vagina to see the vaginal walls and the cervix. The cervix is where we get the Pap Smear from. A pap smear is just a brushing of the ?surfaces or cervix? for an oncologist to look at under a microscope at the cells and tell us if there is anything cancerous or pre-cancerous. Then we remove the speculum and then feel the uterus. To do that we place two fingers inside the vagina, feel for the crevice and have the other hand on top of their tummy to push the uterus up to the tummy hand to feel if the uterus and the ovaries are enlarged or not. Any swabs we take during the speculum exam ?are? to test for gonorrhea, chlamydia, vaginitis, yeast infections, those kinds of things.

DN: What are women going to be asked about when they go to the gynecologist?

KF: Things I’d like to talk about are their periods. Are they going well or are they too heavy or painful? Some women aren’t sexually active at the reproductive age but they can have mean, irregular periods or something like that. So we will talk about different treatments for those kind of issues. I also want to know if they are sexually active, and if they are, are they in a safe relationship? Are they in any physically or sexually harming relationship? Also are they smoking, using alcohol excessively or using drugs? Any kind of medical issues that can affect their reproductive health. Is their family history that specific or pertinent with things like ovarian cancer, breast cancer or uterine cancer? Are you exercising and eating healthy?. Do you have any concerns about vaginal discharge or itching, infection-like symptoms?

DN: What are some questions patients should feel comfortable sharing with their gynecologist?

KF: We will talk about sexual activity. I always say Captive Gynecologist because sometime women are embarrassed about asking questions about sexual health or intercourse itself. Sometimes they’ll have questions on things that seem kind of taboo like oral intercourse or anal intercourse or vaginal intercourse, things that women aren’t comfortable talking to their friends about, they need to be comfortable talking to me about. For a gynecologist, it’s hard to shock us. Regardless of what you have participated in or if you’re embarrassed about it, it’s still very important to get in and talk to your doctor about it. Especially when we are between the ages of 16 and 21, when we are young and might have more sexual partners then we will have later in our life, sometimes we are exposed to things that can have long lasting repercussions.

arts@dailynebraskan.com

Taboo Topics: Visiting the gynecologist