By Dr. Tena Kovacevic*

When was the last time you visited your gynaecologist?

If you are older than 21 and it has been more than a year since your last visit, now might be a good time to schedule an appointment.

Women often ask me when they should see me and what would be the best time to bring their daughters for a consultation. The American College of Obstetricians and Gynaecologists recommends the first visit between 13 and 15 years. While pelvic examination is rarely required during the first few visits, the annual examination that starts early in life helps to establish a close doctor-patient relationship. Women, regardless of their age, should be encouraged to openly discuss with their doctor about their menstrual cycle, methods of birth control, how to protect against sexually transmitted diseases, etc.

Screening tests begin at the age of 21, and every woman aged 21 or older should see a gynaecologist to evaluate symptoms or concerns as well as get screened for cervical cancer by a simple, quick procedure called Pap test and for genital tract infections.

Traditionally, an annual pelvic examination (with or without ultrasound), combined with a Pap test, has been a standard practice for all adult women. But in recent times, the goals and outcomes of an annual pelvic examination in women with no symptoms have been questioned. While Pap test guidelines have changed, and many women require screening for cervical cancer only once every three to five years, an annual pelvic examination should not be equated with a Pap test. A Pap test comprises only one small component of the pelvic examination.

Women should be encouraged to have at least a brief consultation with their gynaecologists every year, irrespective of whether they are due for a Pap test. In fact, any gynaecological problem is often first detected in an annual examination.

A woman should see her gynaecologist if she has an irregular menstrual cycle, if her periods have stopped or last for many days, if she gets painful cramps or if sex becomes painful. A routine ultrasound can identify the underlying cause.

Vaginal discharge is also something to keep an eye on. A bad odour or discharge from the vagina is a sign of infection and if left untreated, or is self-treated, the problem can quickly get worse. It is always smarter to visit a gynaecologist rather than treat infections by yourself.

If you are sexually active and are not planning pregnancy, contraception is one of the topics that need to be discussed with your gynaecologist. Every woman is different and there are plenty of options today, so contraceptive counselling and individualised selection of “the best fit” contraceptive is an important matter to be discussed with your gynaecologist rather than picking it out by yourself.

Regarding breasts, breast examinations are mostly recommended for women above 40, although earlier examinations are needed if a history of breast cancer runs in the family. A regular breast examination is crucial for early detection of breast cancer. Every woman should be aware that diseases such as breast, cervical and ovarian cancer have few obvious symptoms, and earlier detection increases the chances of survival.

In conclusion, avoiding routine yearly gynaecological examinations increases the risk of unintended pregnancy and pelvic infections and might potentially delay infertility treatments and pregnancy. While recent trends suggest that annual pelvic examination is now a thing of the past for some women, one must realise that annual appointments with your gynaecologist are still important.

It may not be every woman’s favourite appointment, but a pelvic examination is indispensable to a woman’s overall health. – Family Medical Practice Vietnam

* Dr. Tena is board certified in Obstetrics and Gynecology. She came to us after 6 years of practicing in Croatia and after additional trainings in London and New York. She  started seeing patients at Family Medical Practice Hanoi from the beginning of 2018. She is eager to meet her new patients in Hà Nội, and we are thrilled to have her on board.

For more advice on any medical topics, visit Family Medical Practice Hanoi at: 298 I Kim Mã, Ba Đình. Tel: (024) 3843 0748.  E: hanoi@vietnammedicalpractice.com.

FMP’s downtown Hồ Chí Minh location is: Diamond Plaza, 34 Lê Duẩn, District 1; 95 Thảo Điền Street, District 2. Tel: (028) 38227848. E: hcmc@vietnammedicalpractice.com

FMP Đà Nẵng is located at 96-98 Nguyễn Văn Linh Street, Hải Châu District, Đà Nẵng. Tel: (0236) 3582 699. E: danang@vietnammedicalpractice.com