Get Your OB-GYN Questions Answered with Dr. Lane!

Do you have questions about women’s health care? Check in with the amazing Dr. Anthereca Lane, an OB-GYN here at TriHealth Finneytown, as she answers some commonly asked questions about OB-GYN care! 

Q: How often should I schedule a visit with my OB-GYN? 

A: I encourage all women to visit their OB-GYN at least once a year. In the past, women tied their annual exam to the pap smear. Once we stopped checking pap smears annually, many women thought that they had no reason to come to the OB-GYN. There is so much that occurs during an OB-GYN visit. 

For many women, the OB-GYN is the only doctor that they see during a year. The annual visit is an opportunity to check blood pressure and weight which can be potential risk factors for chronic illnesses such as Diabetes and Heart Disease. The OB-GYN also performs a clinical breast exam which is a necessary component of breast cancer screening. A pap smear may or may not be performed but a pelvic exam is always performed. A pelvic exam is the external and internal evaluation of the female genitalia and anatomy including a review of the skin of the vulva, evaluation of uterine size and evaluation for the presence of adnexal masses and evaluation for signs of prolapse. Additionally, the OB-GYN is often the gateway to mental health management and referrals. An OB-GYN visit should be viewed as a comprehensive, wholistic evaluation of women. 

Q:When should I first visit an OB-GYN? 

A: The first OB-GYN visit can start between the ages of 13-15 years old. Usually, this visit does not require an internal pelvic exam, unless there is a specific concern that would warrant that level of evaluation.

Pap smears are not performed until the age of 21. However, the OB-GYN visit is more than the pap smear. 

Q:What questions should I ask my OB-GYN during my annual visit? 

A: Questions during OB-GYN visit will vary depending on the age of the patient. 

Questions may include topics related to menstrual periods and menstrual abnormalities, pelvic pain, family planning, fertility/infertility, sexual dysfunction, and questions related to general health promotion and disease prevention. 

Q: How can my OB-GYN support my comprehensive health? 

A: OB-GYNs can support a patient’s comprehensive health by encouraging her to establish care with a primary care physician, encouraging screening for breast cancer, colon cancer, cervical cancer, inquiring about mental health concerns, inquiring about social determinants of health such as financial well-being, stress reduction, housing stability, food insecurity and providing resources when necessary. OB-GYNs understand that a wholistic approach is essential to managing the health of our patients.

Q: Can my OB-GYN treat other health conditions, i.e. hypertension?

A: OB-GYNs may or may not treat hypertension. If a patient does not have an established relationship with a primary care physician (Family Medicine or Internal Medicine), the OB-GYN may provide an initial prescription until the patient establishes an appointment. This is up to the OB-GYNs discretion. 

OB-GYNs usually manage diabetes in pregnancy but do not typically manage diabetes in the nonpregnant patient. 

OB-GYNs partner with a variety of specialties to care for women; however, we also rely on their expertise to address those medical conditions that are outside the scope of obstetrics and gynecology. 

Q: From your experience what are the most common reproductive issues women should be concerned about? 

A: 

• Screening for sexually transmitted infections. Chlamydia and gonorrhea are the most common sexually transmitted infections in the United States. According to the CDC, in 2020, 1,579,885 cases of chlamydia and 677,769 cases of gonorrhea were reported to CDC. If untreated, chlamydia and gonorrhea can lead to severe pelvic infection referred to pelvic inflammatory disease. PID can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. This can lead to infertility¹. 
• Cervical Cancer Screening. All women should have pap smears every 3 years or according to the specific plan outlined by their doctor according to previous results. If a woman is older than 30 years old, she will also receive testing for the human papilloma virus simultaneously with the pap smear. HPV is the most common cause of cervical cancer. The HPV vaccine has been instrumental in reducing incidence of cervical cancer⁴. 
• Breast Cancer Screening. 30% of all cancer diagnosed in the United States is due to breast cancer. In the United States, a woman’s lifetime risk of breast cancer is 12%. There are 3.5 million women leaving with breast cancer in the United States². Black women still have a 4% lower incidence rate of breast cancer than White women but a 40% higher breast cancer death rate. All women should engage in breast cancer screening³. This can include self-breast exam, clinical breast exam and breast imaging. All women should be offered mammogram at the age of 40. Mammogram should continue yearly. 
• Family planning and contraception. Prevention of unplanned pregnancy is one of the main topics and one of the most important topics of discussion in an OB-GYN office. There are a variety of contraceptive methods that are available.The choice of contraception will be determined by a variety of factors that will be considered during an appointment with an OB-GYN. 

Q: Do I still need to visit my OB-GYN after menopause? 

A: Women should be encouraged to continue visiting the OB-GYN after menopause. The OB-GYN visit is more than the pap smear. The beauty of the OB-GYN is that the OB-GYN is trained to care for women from adolescence until the end of life. After menopause, the focus of the visit changes from reproductive management and menstrual flow abnormalities to the management of signs/symptoms of menopause, evaluation of vulvar skin disorders and management of vaginal and urinary tract infections and continued promotion of preventive strategies for breast cancer and cervical cancer. 

Q: What cancers are associated with a women’s reproductive system and what are some of the warning signs? 

A: Breast Cancer: 

A new breast lump or mass is the most common signs of breast cancer. Other symptoms include nipple discharge, nipple pain, skin dimpling or swelling. It is important to continue monthly self breast exams. I also recommend annual mammograms starting at age 40. If you have a family history of breast cancer, discuss your screening plan with your physician. 

Cervical Cancer:

Initially, there may be no symptoms of cervical cancer. However early-stage cervical cancer, according to the national cancer institute, include symptoms such as vaginal bleeding after sex, vaginal bleeding after menopause, vaginal bleeding between periods or periods that are heavier or longer than normal, vaginal discharge that is watery and has a strong odor or that contains blood and/or pelvic pain or pain during sex. 

Endometrial Cancer: 

Abnormal bleeding is the most common sign of endometrial cancer. In fact, the American Cancer Society states that 90% of women with endometrial cancer have abnormal uterine bleeding. Abnormal discharge and spotting between periods can also be a symptom. If you have experienced menopause (1 year without a period) and you start bleeding again, seek immediate medical attention. 

Ovarian Cancer:

According to the American Cancer Society, symptoms caused by ovarian cancer can be caused by benign diseases as well. However, if you find that you have these symptoms more often than normal or at least 12 times a month, you should seek medical evaluation. These symptoms may include bloating, pelvic or abdominal (belly) pain, trouble eating or feeling full quickly and/or urinary symptoms such as urgency (always feeling like you have to go) or frequency (having to go often). 

Q: In your opinion how has science advanced the treatment of women’s reproductive systems and what further advancement still need to be made?

A: Current technology continues to offer opportunities to improve the quality of life of women in this country. Minimally invasive surgery such as hysteroscopy offers an effective mechanism to evaluate and treat abnormal uterine bleeding. Robotic assisted laparoscopic surgery has revolutionized the hysterectomy procedure. We are currently in the midst of providing cutting edge procedures for the treatment of uterine fibroids. Advances in reproductive technology for the management of infertility makes parenthood a possibility when there previously was no hope. 

We are now, more than ever, in need of advancements that will reduce the health disparities in this country. These will include advancements in technology but also advancements in our medical training, clinical practices, health care system policies and protocols and diversification of the physician and health care provider workforce. 

Sources: 

1. https://www.cdc.gov/std/infertility/default.htm 
2. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/07/breast-cancer-risk-assessment-and-screening-in-average-risk-women 
3. https://www.cancer.org/latest-news/breast-cancer-death-rates-are-highest-for-black-women-again.html#:~:text=Black%20women%20still%20have%20a,higher%20breast%20cancer%20death%20rate 
4. https://www.cdc.gov/cancer/cervical/basic_info/index.htm#:~:text=Long%2Dlasting%20infection%20with%20certain,person%20to%20another%20during%20sex