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i have a gynecologist appointment

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Many of us handle our yearly checkups like a literal checklist and move on with our lives. We report for duty, let our doctors do their things, and walk off, not giving it another thought. We answer their pre-loaded questions about our drinking, smoking, and exercise habits. We tell them what medications we’re taking and any surgeries we’ve had, but we don’t put much thought into specific events or symptoms that have occurred. Of course, a lot of time could have passed between the day something weird happened with your body and the time your checkup takes place. At that point, you don’t remember. And when the issue came up, you told yourself, “It’s probably nothing,” and so long as you felt better again, you filed that away as a non-issue.

These are just some of the ways in which we don’t make the best use of doctor’s visits. Why not really get your money and time’s worth? Once your doctor is standing in front of you, you have a wealth of knowledge at your fingertips. But the visit is only as useful as you make it, and while some doctors are fortunate to ask the perfect specific question to a question you had but didn’t ask, you won’t always be so lucky. We spoke with Dr. Lorie Johnson (pictured below), a board-certified OB/GYN and the owner of Just For You Women’s Healthcare, a private practice in Atlanta, about things your gynecologist wishes you’d keep in mind to bring up for your next appointment.

Dr. Lorie Johnson

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Unusual pain during or after sex

As women, we can grow to associate sex with a bit of discomfort, especially if our partners aren’t great at/generous with foreplay. It shouldn’t be that way, but for many women, a little discomfort is not something that gives them a cause to worry. Dr. Johnson says that some cramping after an orgasm can be normal since the uterus is a muscle that contracts during the climax, which can cause the feeling of cramps. However, if you experience painful penetration or extreme dryness, you should bring this up to your doctor. Irregular spotting or bleeding during or after sex should also be reported.

i have a gynecologist appointment

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What are some causes of discomfort?

Dr. Johnson says that dryness in older women can be a result of normal bodily changes that come with hormonal shifts. That being said, women don’t need to live with those and there are medications that can treat that discomfort. Just because your body says it’s done making babies doesn’t mean that you need to be done having a pleasurable sex life.

In younger women, if dryness occurs, that can be a bit more cause for concern as it can be a sign of infection (such as a herpes outbreak), or it may be due to a hormonal imbalance. Sometimes the pill can cause dryness, too.

i have a gynecologist appointment

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Your psychiatric history

We may not think our gynecologist needs to know anything about our mental health. Our vaginas and our brains are so far apart, after all. But Dr. Johnson says that you should report your psychiatric health to your gynecologist. One reason for this is that certain birth control can interact poorly with medications you could be taking. Furthermore, some psychiatric medications might impact a woman’s cycle. Keeping in mind that some emotional symptoms associated with hormonal changes can be similar to those associated with psychiatric medications or conditions, it’s important that your gynecologist knows the full picture in order to give you the best treatment.

i have a gynecologist appointment

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Your psychiatric health and pregnancy

Your gynecologist also needs to know about your psychiatric history if she’ll be treating you throughout pregnancy. Dr. Johnson says that it’s very important that a woman not stop any psychiatric drugs abruptly. This can lead to negative side effects. That being said, some psych drugs are not safe to take while pregnant, so if you want to become pregnant, you and your doctor will need to make a plan before you conceive surrounding your prescription. It’s important that, should you change medications, this is done gradually, and that you give your body time to adjust well before you conceive.

i have a gynecologist appointment

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More on your psychiatric care and pregnancy

Dr. Johnson says women also need to be aware of how certain psychiatric drugs can affect a growing fetus. Anything the mother takes is passed through the placenta to the fetus, and some drugs are dangerous to a growing baby, in some cases causing seizures. She also notes that psychosis can happen for pregnant women, even when they don’t have preexisting mental health issues, and become more likely when there are co-occurring psychiatric issues. Abruptly going off psychiatric medication can trigger that, and not only cause a pregnant woman to experience withdrawal symptoms but also cause her fetus to, as it was also getting the drug through the placenta.

i have a gynecologist appointment

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What about family history?

It’s important to note that no information is too much information, according to Dr. Johnson. Tell your doctor everything you know about your family’s medical history. The worst that can happen if you give TMI is you provide info she doesn’t need. But if you withhold information the effects can be much more severe, so gather knowledge from your relatives if you can. She specifically mentions noting any cancers that have occurred in your family – not just in the women in your family but also the men. It’s also important to report to your doctor if blood clots run in your family.

i have a gynecologist appointment

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Abnormal birth control side effects

Some nausea can be expected with birth control, says Dr. Johnson, but there are certain symptoms you should report to your gynecologist right away. One of these (that women often don’t think to share with their OB/GYN) is pain or cramping in the legs. This can be a sign of blood clotting, which can be caused by some birth control, like the pill. Severe headaches or migraines are other symptoms to report right away, as they can be signs of blood clotting in the brain or hypertension brought on by birth control. If you have any visual issues, communicate those as well.

i have a gynecologist appointment

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IUD side effects

Keeping in mind that some IUDs release hormones and some don’t, Dr. Johnson says that the hormone-releasing ones will typically cause your period to stop. Speak to your doctor about your IUD, and what you can expect surrounding your menstrual cycle. But a copper IUD should not cause changes in your period. If there is a sudden change in your cycle or severe pain after you’ve had an IUD put in, report this to your gynecologist. This could be a sign that the device has fallen out of place, which puts you at risk for pregnancy and is of course uncomfortable.

i have a gynecologist appointment

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Preparing your body for pregnancy

Many people don’t realize the importance of getting a handle on any preexisting health conditions before getting pregnant. If you only address some conditions once you’re already pregnant, you could put both your health and your baby’s at risk. Dr. Johnson says that women who are obese should try to lose their excess weight before conceiving. She mentions psychiatric issues again, saying you should address and manage those before getting pregnant. If there is a history of seizures, it’s also aimportant to manage those with a doctor before trying to have a child. “All of your chronic medical issues should be in as good of control as possible prior to conceiving,” she says.

i have a gynecologist appointment

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What about the pill and pregnancy?

Dr. Johnson addressed the rumor that being on the pill for a long time makes it difficult to become pregnant, stating that that’s only the case when women have been on the pill for many years – like 10 to 15 years. That being said, with reports showing that 16 is the average age when teenagers start taking the pill and 28 as the average age women start having kids, it’s very possible someone has been on the pill for over a decade before wanting to conceive. In that case, Dr. Johnson advises going off the pill for at least a year before wanting to have children, as that’s how long it can take for your cycle to become normal. Women who get the birth control injection can take up to two years to become pregnant after quitting birth control.

i have a gynecologist appointment

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Plastic surgery and pregnancy

“I’ve seen more recently women doing plastic surgery and then getting pregnant.  It’s not the smartest thing to do,” says Dr. Johnson. “It’s not particularly harmful to the baby. It’s just more uncomfortable to the mother during pregnancy. After a tummy tuck, the muscle is designed not to stretch anymore. With pregnancy, you’re trying to stretch a muscle that’s not designed to stretch. I don’t recommend women doing a tummy tuck until they’re done with having children.” As for breast implants, she did state that those don’t interfere with the milk ducts, so they shouldn’t impact a woman’s ability to breastfeed.

i have a gynecologist appointment

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Ask about your options

Dr. Johnson emphasizes the importance of knowing that you don’t have to accept the first treatment you hear. You always have options.

“I wish women would ask about their other options. They hear what a doctor has said and take it at face value.  I always encourage women to ask if there are any other options they can pursue instead of…surgery for instance,” she says. This is a big thing with fibroids for example. “Women of color, in particular, have higher incidents of fibroids. We are seeing them at younger and younger ages. A lot of times doctors will only offer a hysterectomy to treat the fibroids, but there are other options that can be done that can preserve fertility. But sometimes, it’s all they get offered.”

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