Gynecologists: When to visit and what to expect

Gynecologists are doctors who specialize in women’s health, with a focus on the female reproductive system. They deal with a wide range of issues, including obstetrics, or pregnancy and childbirth, menstruation and fertility issues, sexually transmitted infections (STIs), hormone disorders, and others.

In Kenya, some women prefer to visit a well-woman clinic rather than a family doctor for general health issues. The gynecologist may then refer the patient to another specialist.

A qualified gynecologist has at least 8 years of training and should be certified by an examining body, such as the American Board of Gynecologists (ABOG) and registered by a professional organization.

Fast facts about gynecologists:

What is a gynecologist?

A gynecologist treats patients with reproductive organs. To become a gynecologist, a person must train first as a doctor for 4 years, then specialize for another 4 years in the field of obstetrics and gynecology. Passing a further examination will enable them to be certified and registered.

When to see one

A visit to the gynecologist is recommended for annual screening and any time a woman has concerns about symptoms such as pelvic, vulvar, and vaginal pain or abnormal bleeding from the uterus.

Conditions commonly treated by gynecologists include:

• issues relating to pregnancy, fertility, menstruation, and menopause
• family planning, including contraception, sterilization, and pregnancy termination
• problems with tissues that support the pelvic organs, including ligaments and muscles
• STIs
• polycystic ovary syndrome
• urinary and fecal incontinence
• benign conditions of the reproductive tract, for example, ovarian cysts, fibroids, breast disorders, vulvar and vaginal ulcers, and other non-cancerous changes
• premalignant conditions, such as endometrial hyperplasia, and cervical dysplasia
• cancers of the reproductive tract and the breasts, and pregnancy-related tumors
• congenital abnormalities of the female reproductive tract
• emergency care relating to gynecology
• endometriosis, a chronic condition that affects the reproductive system
• pelvic inflammatory diseases, including abscesses
• sexuality, including health issues relating to same-sex and bisexual relationships
• sexual dysfunction

Gynecologists in Kenya frequently offer both gynecological and general health care, including preventive medicine for women and diagnosis and treatment of issues such as headache, low back pain, mood changes, and acne.

They may also treat:

• asthma
• psychiatric conditions such as depression and personality disorders
• cardiovascular disease
• diabetes
• thyroid disorders and other hormonal issues
• domestic violence and sexual assault
• osteoporosis

Preventive medicine may include lifestyle advice about issues such as smoking cessation and weight loss.

At what age can I see a gynecologist?

A gynecologist can treat a girl or a woman at any age.Most recommend starting to visit a gynecologist from the age of 13 to 15 years.

Building up a relationship with the doctor enables a girl or woman to be more comfortable asking questions about menstruation, sexuality and so on, and provides a point of contact if symptoms occur in future.

It also gives the doctor a chance to guide a woman’s overall welfare in the long term, through counseling on important health and lifestyle issues.

What to expect

What happens at the gynecologist’s depends on the reason for the visit and the individual’s situation.

If it is a young woman’s first visit, she may just have a chat with the doctor, get some general health information, and find out what to expect in the future.

At any visit with the gynecologist, it is worth remembering:

• An honest account of your health concerns and lifestyle gives the gynecologist a better idea of your situation and enables them to help you more.
• A gynecological examination, including a pap smear, may be uncomfortable, but it is not usually painful.
• It is not necessary to wax or shave before the visit.
• Bodily odor is natural. If it indicates a problem, the gynecologist needs to know.
• If you have a period when the appointment is scheduled, you can still go ahead with the visit, but it may be better to postpone, unless you have symptoms that need urgent attention.
• It is best to avoid sexual activity, using a vaginal douche, or using tampons for 2 days before a gynecological examination.

A patient can ask to have someone with them at the visit, either in the room or outside the door.

Screening

The ACOG recommend visiting a gynecologist at least once a year for an annual checkup.

This will include:

• screening, evaluation and advice
• immunizations based on age and risk factors
• a physical examination, which will include measuring standard vital signs, body mass index, palpating the abdomen and inguinal lymph nodes, and assessing overall health
• a pelvic examination and a breast examination, as appropriate for the patient’s age

You may have to give a blood or urine sample for a screening test.

Regular visits to a well-woman clinic enable the individual to keep up to date on how to maintain a healthy lifestyle and minimize health risks at each age.

Other yearly health assessments can include mammography, colonoscopy, blood pressure monitoring, immunizations, and advice about calcium and folic acid intake.

Common procedures

ABOG-certified gynecologists are trained to carry out certain diagnostic and surgical procedures.

Diagnostic tasks include:

• pap smear tests
• ultrasound scanning
• colposcopy, a microscopic examination of the cervix
• endometrial biopsy, or taking a sample from the lining of the uterus
• hysteroscopy, the use of an endoscope to see into the uterus

Surgical tasks include:

• preparing patients for surgery
• laparoscopy, a keyhole abdominal procedure. for both diagnostic and surgical purposes
• minor surgery, for example, sterilization
• major surgery, for example, removing fibroids in the uterus
• postoperative care, including treating complications

They can also become involved with other surgical conditions, such as small bowel obstruction

Qualifications

All gynecologists certified in the U.S. must first graduate from an “acceptable medical school.” This means they are fully trained medical doctors with a license to practice.

Fully qualified gynecologists have at least 8 years of medical study and training. To become a gynecologist, an individual must study 4 years at medical school, followed by a 4-year obstetric-gynecology residency program.

Specialty training includes:

• care of patients before, during, and after pregnancy
• genetics and genetic counseling
• female general health, including hormones, the reproductive system, breast health, and sexual function
• screening for cancers that affect women
• diagnosing and treating female hormone disorders and infections

Many gynecologists undergo surgical training to correct female pelvic, reproductive, or urinary tract problems, including cancers of the reproductive system.

Many women in the U.S. consult their gynecologists with questions about their overall wellbeing, and gynecologists are trained to carry out:

• routine examinations and health screening
• immunizations
• overall medical care for women, whether or not it relates to the reproductive system

Further specialization can take 3 years. Options include gynecologic oncology, pediatric gynecology, and maternal fetal medicine, among others.

What is a board-certified gynecologist?

A further examination enables a gynecologist to achieve full certification from the ABOG and to be listed by ACOG.

This involves two tests:

• a written, multiple-choice test covering conditions commonly treated by gynecologists
• a half-day oral test, including a selected review of the gynecologist’s first year of clinical cases

This means that fully qualified, board-certified gynecologists have spent 9 years training and gaining experience in their field. Some go on to specialize further.

The American College of Obstetricians and Gynecologists (ACOG) maintain an online directory of gynecologists who have have an active license to practice medicine, and ABOG certification in the U.S.