Tag Archive for: STI

Posts

The Truth About Infections During Pregnancy: What Every Mom-to-Be Needs to Know

, ,

You’re expecting—congratulations! For some women, pregnancy is an exciting time full of magic and wonder. For others —and let’s face it, for most women — pregnancy also brings up questions and worries, including infections during pregnancy.

As your body goes through pregnancy changes, your immunity is lowered, making you more prone to infections. The good news is most common infections during pregnancy are harmless. But some — especially if left untreated — can be dangerous. The key is knowing which infections are most likely, how they can affect you and your baby, and what you can do to prevent them.

In this article, we’ll walk you through the truth about infections during pregnancy—what’s normal, what’s not, and when you need to call your doctor. Arming yourself with the facts will help you have a happy, healthy pregnancy.

Most Common Infections During Pregnancy

The most common infections are urinary tract infections, yeast infections, and bacterial vaginosis (BV).

Talk to your women’s physician or OBGYN provider right away about any concerns. Prevention, early detection and proper treatment of infections will help ensure you both stay as healthy as possible. Some infections can also be prevented with vaccinations.

Urinary Tract Infections (UTIs) During Pregnancy

Pregnancy already puts enough stress on your body — you don’t need an infection on top of it. Unfortunately, urinary tract infections (UTIs) are common during pregnancy for a few reasons. As your uterus grows, it puts pressure on your bladder and ureter, making it easier for bacteria to travel up the urinary tract. Hormone changes also slow the flow of urine, giving bacteria more time to grow.

UTI Symptoms

Some signs you may have a UTI during pregnancy include:

  • Needing to pee frequently, even when just a little comes out
  • A burning feeling when you pee
  • Lower abdominal pain or pressure
  • Cloudy, foul-smelling, or bloody urine

If you experience these symptoms, see your doctor right away for a urine test. Left untreated, a UTI can lead to a kidney infection and potentially preterm labor.

UTI Treatment and Prevention

Your doctor will likely prescribe a course of oral antibiotics that are safe during pregnancy to clear the infection. Be sure to take the full course of medication as prescribed to avoid the infection coming back.

To help prevent future UTIs:

  • Drink plenty of water to flush out your urinary tract. Six to eight glasses a day is a good target.
  • Urinate when you feel the need. Don’t hold it.
  • Wipe from front to back after using the bathroom.
  • Take showers.  If you prefer a bath, rinse with clean water after washing and avoid sitting in soapy water.
  • Wear cotton underwear and avoid tight-fitting clothes that can trap moisture. (Sorry, yoga pants!)

While inconvenient, UTIs are usually not dangerous if caught and treated early. By understanding the signs and taking preventive steps, you can avoid complications.

Vaginal Infections During Pregnancy

Vaginal infections are common during pregnancy and nothing to be ashamed of. The normal changes in your body can make you more susceptible, but the good news is most are easily treatable.

Yeast Infections

The most common vaginal infection is a yeast infection, caused by a fungus. You may notice a thick, white discharge, intense itching, and irritation around the vagina. Yeast infections are usually treated with over-the-counter (OTC) antifungal creams. However, during pregnancy, you’ll need a prescription medication, as some OTC treatments may be unsafe. Oral fluconazole is often used and considered safe for most women in the second and third trimesters.

Bacterial Vaginosis

Another common infection is bacterial vaginosis (BV), caused by an overgrowth of normal bacteria in the vagina. Symptoms include a thin, white or gray discharge, fishy odor, irritation, and itching. BV is treated with oral antibiotics, typically metronidazole. Left untreated, BV may lead to complications, so see your doctor right away if you notice symptoms.

While uncomfortable, neither yeast infections nor BV will harm your baby.

Sexually Transmitted Infections (STIs) in Pregnancy

Sexually transmitted infections (STIs) during pregnancy require close monitoring and treatment. As an expectant mom, you’ll be screened for some of the most common STIs, such as syphilis, HIV, hepatitis B, chlamydia and gonorrhea. If detected and treated early, most STIs won’t harm your baby. However, some STIs can be passed to your baby during pregnancy or childbirth if left untreated.  There are potential serious consequences for your baby.

Syphilis

Syphilis is an STI caused by bacteria. If untreated, it can cause serious health issues for you and your baby. The good news is syphilis can be cured with antibiotics. You’ll be tested for syphilis during your first prenatal visit. If detected and treated, there’s little risk to your baby. However, without treatment, syphilis can lead to premature birth, stillbirth or birth defects. There has been an increase in cases of syphilis in Wisconsin.  Your doctor may recommend retesting for syphilis at 28 weeks and when you are in labor.

HIV

HIV, or human immunodeficiency virus, is a serious but manageable infection. Fortunately, with proper treatment and care, the risk of transmitting HIV to your baby can be very low. You’ll be offered an HIV test in your prenatal visit. If it is positive, your OBYGN will refer you to an expert who can discuss treatment options to keep you and your baby healthy. Be sure to follow your doctor’s recommended treatment plan.

Hepatitis B

Hepatitis B is a liver infection caused by a virus. If you test positive for hepatitis B, your baby will receive vaccinations and treatment to help prevent infection. Work closely with your doctor to monitor your hepatitis B levels during pregnancy and make a plan to reduce risks to your baby.

The most important thing is not to panic if you test positive for an STI during pregnancy. With prompt diagnosis and treatment, the risks to you and your baby can be minimized. Be open and honest with your doctor about any concerns you have regarding STIs or possible exposure.

Gonorrhea and chlamydia can be passed to the baby during birth.  It is important to test and treat for these infections if detected.

TORCH Infections During Pregnancy

You may have heard of “TORCH” infections—they should be on every pregnant woman’s radar. TORCH stands for toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes. They are all infections that can be passed from mother to baby during pregnancy and cause serious health issues.

Cytomegalovirus (CMV)

CMV is a common virus in the herpes family that often causes few or no symptoms in adults. However, if a woman contracts CMV for the first time during pregnancy, it may be transmitted to the baby. It could potentially cause hearing loss, vision problems, and developmental delays. Unfortunately, there is no vaccine for CMV, so prevention is key. Practice good hygiene like washing your hands frequently and avoiding contact with the saliva or urine of young children. If CMV is detected during pregnancy, your OBGYN will request additional ultrasounds to monitor the baby’s growth and development.

Toxoplasmosis

Toxoplasmosis is an infection caused by a parasite found in cat feces. Pregnant women can contract it by cleaning a cat’s litter box, gardening, or by ingestion of undercooked meat or unpasteurized milk. To avoid toxoplasmosis, have someone else change the litter box during pregnancy. Always wear gloves when gardening. Avoid ingestion of unpasteurized milk and undercooked meats.  If toxoplasmosis is caught early, a short course of antibiotics can help prevent transmission to the baby. However, toxoplasmosis acquired early in pregnancy poses the greatest risk, so prevention is best.

Other TORCH infections like rubella (German measles) and herpes can also be harmful during pregnancy. If you experience symptoms like fever, rash, or genital lesions (sores), be sure to talk about them with your OBGYN. We can help reduce the risks to your baby with prompt diagnosis and treatment.

Staying Healthy During Pregnancy

Taking some simple precautions can help you avoid many of these common infections.

Practice good hygiene

One of the best ways to avoid infections during pregnancy is through good hygiene.

  • Wash your hands frequently, especially after using the bathroom or touching raw meat.
  • Wipe from front to back when using the bathroom to avoid spreading bacteria.
  • Drink plenty of water.

Be cautious with cats

Stay away from cat feces, as toxoplasmosis infection can be passed to your baby. Have someone else change the litter box during your pregnancy or wear gloves if you must do it yourself.

Also, avoid unwashed vegetables and undercooked meat, which may contain toxoplasma parasites.

Get tested

Ask your doctor about being tested for STIs like chlamydia, gonorrhea and syphilis. Left untreated, these infections can harm your baby. Get vaccinated for the flu and whooping cough, and ask about the Tdap and flu vaccines. Some viral infections like CMV often cause no symptoms, so talk to your doctor about testing if you’re at high risk.

Monitor symptoms

See your doctor right away if you notice symptoms like frequent urination, abdominal pain, foul-smelling discharge or fever. While infections are common during pregnancy, early diagnosis and treatment are key. Don’t delay if something feels off.

By taking good care of yourself, avoiding harmful exposures and watching for signs of infection, you can lower risks to yourself and your baby.

Dr. Karla Dickmeyer M.D. Founding partner of Madison Women's Health OBGYN ClinicDr. Dickmeyer has been providing healthcare for women in the Madison area since 1998 and is a founding member of Madison Women’s Health. Her specialties include minimally invasive surgical techniques, high and low risk obstetrics, pelvic floor disorders and postmenopausal medicine.

/by

Why STI Testing Should Be Part of Your Self-Care Routine

, ,

What Are STIs and Why Should You Get Tested?

STIs, or sexually transmitted infections, are infections passed between partners during sexual contact.

While “STDs” or “sexually transmitted diseases” used to be the common term, STI is now preferred because these infections can often be cured or managed with treatment.

As a sexually active woman, STI testing should be an important part of your self-care routine. Many STIs don’t show symptoms, so the only way to know if you have one is through testing. If detected and treated early, most STIs can be cured or managed well with antibiotics or antiviral medication. However, without treatment, STIs can lead to long-term health issues like infertility, cancer, liver disease, and even death.

You should get tested after every new partner, or at least once a year. Getting tested and encouraging your partners to get tested too shows you care about your health and the health of your community. Testing is often free or low-cost at clinics. Home test kits are also available, though less accurate.

The Most Common STIs: Symptoms, Testing, Treatments

The most common STIs are chlamydia, gonorrhea, herpes, HPV, syphilis, and trichomoniasis.

These infections are common, but the good news is that most are curable if caught early. At Madison Women’s Health, we recommend our patients get tested for chlamydia, HPV, gonorrhea, and trichomoniasis as part of their annual exam or Pap test.

Early detection of these infections is key to preventing long-term health issues.

Chlamydia

Chlamydia is a common STI that is caused by bacteria. It is often asymptomatic, meaning you may not notice any symptoms. If symptoms do appear, you may experience abnormal discharge from the vagina or penis, pain during urination or sex, and lower abdominal pain.

If left untreated, chlamydia can lead to pelvic inflammatory disease, which may cause permanent damage to your reproductive organs.

Chlamydia is diagnosed with a urine test or swab and cured with a round of antibiotics. To avoid reinfection, sexual partners should also be treated.

HPV

The human papillomavirus or HPV is an extremely common viral STI. There are over 100 strains of HPV, some of which are low-risk and cause genital warts, while high-risk strains may lead to cervical cancer in women. HPV often has no symptoms, so the only way to detect it is through routine Pap smears and HPV testing.

While there is no cure for HPV, the good news is most infections clear up on their own. However, certain high-risk HPV infections require close monitoring or procedures like colposcopy to check for precancerous cell changes.

Treatment for HPV warts includes freezing, laser therapy or topical creams.

The Gardasil vaccine protects against cancer-causing HPV strains. The CDC recommends all girls and boys get vaccinated by age 26. When administered to children, it is a two-vaccine series. The Gardasil vaccine is also available for men and women through age 45. A three-vaccine series is administered to adults.

Hepatitis C

Hepatitis C is a viral infection that causes inflammation of the liver. It is often asymptomatic for years but can eventually lead to serious liver damage if left untreated. Common symptoms include fatigue, nausea, muscle aches, and jaundice (yellowing of the skin).

Hepatitis C is most commonly spread through contact with contaminated blood, though it can also be transmitted sexually. Treatment typically involves antiviral medications to clear the infection, slow damage to the liver or, in some cases, even cure the infection.

Gonorrhea

Gonorrhea is a common bacterial STI that can affect both men and women. Symptoms in women include unusual discharge from the vagina, pain during sex or urination, and bleeding between periods. In men, symptoms include discharge from the penis, pain during urination or soreness in the testicles.

Gonorrhea can usually be cured with antibiotics, though treatment may require a longer course of medication if it has been present for some time. Without treatment, gonorrhea can lead to pelvic inflammatory disease, infertility and pregnancy complications.

Trichomoniasis

Trichomoniasis usually causes symptoms like itching, burning, redness or soreness in the genital area and an unpleasant-smelling discharge. Diagnosis and treatment are the same as for chlamydia and gonorrhea—trichomoniasis is tested using a genital swab or urine sample and treated with a prescription medication.

If left untreated, it may lead to pregnancy complications, so testing is especially important for pregnant women.

Syphilis

Syphilis is highly contagious. It is caused by a bacteria, which produces a painless sore on the genitals, rectum, or mouth. There has been an uptick in the number of cases of syphilis in the past decade. Syphilis is typically treated with penicillin.

HIV

HIV can cause major health problems and even death by weakening the body’s immune system. Traditionally, the only way to prevent transmission of HIV was to use condoms. Now, a medication is available to use prior to exposure to HIV: PrEP. PrEP stands for pre-exposure prophylaxis.

If your partner is HIV positive, a medication called Cabotegravir can help prevent you from getting HIV-1 through sex. It is administered either by injection or a daily pill. This medication must be taken as directed for it to be effective.

Prevention 101: Safe Sex and Vaccinations

Use Protection Every Time

Condoms are your best defense against STIs. Use them for any sexual contact—not just intercourse. Don’t rely on the pull-out method or any other method that doesn’t provide a physical barrier.

Get Tested Regularly

Many STIs don’t show symptoms, so the only way to know for sure if you have an STI is through testing. The CDC recommends getting tested at least once a year, or more often if you have multiple partners.

Tests for STIs include:

  • Blood tests: Check for HIV, syphilis, and hepatitis.
  • Urine tests: Screen for chlamydia and gonorrhea.
  • Swab tests: A sample is taken from the cervix or urethra to test for chlamydia, gonorrhea, herpes, and HPV.
  • Physical exams: Doctors check for signs of infections, genital warts, and discharge.

At-home tests are available for some STIs but may be less accurate than tests done by a doctor. See your doctor for the most reliable results. Testing is often free, confidential, and can provide peace of mind.

Consider Vaccination

Vaccines are available for some viral STIs, including HPV, hepatitis A, and hepatitis B. The HPV vaccine is recommended for all preteens at age 11-12, but can be given up to age 26. It protects against the HPV strains most likely to cause genital warts and cervical cancer. Hepatitis vaccines are also routinely given to infants but should be considered for at-risk adults.

Where to Get Tested for STIs in Madison

Getting into a regular habit of STI testing — especially if you have new or multiple sexual partners — is one of the best ways to take control of your reproductive and sexual health. There are several options for confidential and low-cost (or free) testing right here in Madison.

  • Madison Women’s Health: As a women-owned clinic focused on caring for the community, Madison Women’s Health provides discreet STI testing for people of all genders. We offer screening for common infections like chlamydia, gonorrhea, herpes, HPV, syphilis, and HIV.
  • First Care Clinic: First Care Clinic’s medical professionals can provide STI testing for women, free of charge.
  • Public Health Madison & Dane County (PHMDC): For those without health insurance, PHMDC provides low-cost STI testing through their Sexual Health Clinic. They offer screening for chlamydia, gonorrhea, syphilis, herpes, and HIV, with results available during your visit or within a few business days. The clinic staff understands that anyone can be at risk for an STI, so they aim to provide judgment-free care for people of all backgrounds.
  • At-home test kits: While convenient, at-home STI test kits may not be as accurate as testing done by a healthcare provider. Results can be difficult to interpret without professional guidance. However, for those unable or unwilling to visit a clinic, at-home tests do provide an option for screening. Look for test brands that analyze samples at a certified lab for the most reliable results. Be aware that at-home tests typically do not screen for all STIs. No test is 100% accurate, so follow-up testing at a clinic is recommended if you receive a positive result.

For the most reliable results, get a full STI screening that includes:

  • A pelvic exam for women, which allows the doctor to check for any abnormalities.
  • Urine, blood, and swab samples to test for chlamydia, gonorrhea, syphilis, herpes, HIV, and hepatitis B and C.
  • A Pap smear to screen for HPV and cervical cancer. The latest HPV tests can detect 14 high-risk HPV strains.
  • Additional testing for symptoms like genital sores, rashes, or discharge.

How to Bring Up STI Testing With Partners

Bringing up STI testing with a new partner can feel awkward, but it’s an important conversation to have. At Madison Women’s Health, we strongly advise all our patients to get tested regularly, especially for those who have multiple partners or are starting a new relationship.

The good news is, there are some tips to make this talk a little easier.

Frame it around health and caring for each other.

Let your partner know you want to make sure you’re both safe and healthy before becoming intimate. This approach feels more positive and less accusatory. You might say something like, “I care about you and our health, so I think we should both get tested for STIs before we have sex.”

Discuss getting tested together.

Offer to accompany your partner to get tested, and get tested yourself at the same time. This shows you’re in it together and can help put them at ease.

Be open and honest about your concerns.

Don’t be afraid to voice why STI testing is important to you, especially if you’ve had experiences with STIs in the past or a previous partner. However, be sensitive about how you frame it. Focus on the present and future, not on past relationships. Let your partner know you want to build trust and intimacy in a healthy way.

Talk about the specifics of what you want tested.

Discuss which STIs in particular concern you, based on your risks and experiences.

Discuss what you’ll do if there are positive results.

This is an important part of the conversation, even if it’s uncomfortable. Talk about the treatment options, the need to notify past partners, and using protection like condoms during treatment and recovery. Having a plan in place will make dealing with positive results much easier.

Do it with empathy, honesty and care for your partner and relationship.

Turn it into an opportunity to build trust and set a foundation of good health and open communication.

While it may feel awkward, the benefits to your peace of mind and intimacy will make this difficult conversation worth it.

Conclusion

Getting tested for STIs should absolutely be part of your regular self-care routine. Your sexual health and well-being deserve the same level of care and attention as your physical and mental health. While it can feel uncomfortable or embarrassing, STI testing is a critical way for you to take control of your health and your body.

Knowing your status gives you the power to make informed choices about safe sex practices and to get treatment right away if needed.

Make that appointment today—your future self will thank you!

Dr. Karla Dickmeyer M.D. Founding partner of Madison Women's Health OBGYN ClinicDr. Dickmeyer has been providing healthcare for women in the Madison area since 1998 and is a founding member of Madison Women’s Health. Her specialties include minimally invasive surgical techniques, high and low risk obstetrics, pelvic floor disorders and postmenopausal medicine.

/by

How to Prepare Your Teen for her First Gynecological Appointment

, ,

For many teen girls, going to their first gynecology appointment can seem a little scary or embarrassing. As her mom (or dad or aunt or friend), the support and advice you give could ease her anxiety so she has a positive first experience. Help prepare your teenager for her first gynecological appointment by helping her choose when and where to go, and by giving her an overview of what she can expect at the appointment.

But wait!

Before you tell her all about your first experience, make sure you’re up to date with the current recommendations. Chances are, her first appointment will be very different than yours was!

When Should Your Teen Should Have Her First OBGYN Appointment?

Encourage your teenager to schedule her first OBGYN appointment if:

  • she has questions about the changes her body is going through
  • she has periods that seem unusual
  • her periods are getting in the way of her daily life
  • she no longer feels comfortable with her pediatrician
  • she wants to learn about birth control options
  • she is sexually active
  • or she is moving away after graduating high school and needs to find a new medical provider.

The American College of Obstetricians and Gynecologists (ACOG) recommends young women have their first gynecology appointment between the ages of 13-15. However, many adolescents continue seeing their pediatric providers until they are 18 unless they have menstrual concerns, birth control questions, or other concerns best addressed by an OBGYN.

Where to Go for a first OBGYN Visit

The next step is choosing an OBGYN clinic near you and making an appointment.

And yes, she can schedule an appointment on her own! In fact, making her own appointment is an important step in taking ownership of her health as a young adult. This is a great time to explain how your healthcare plan works and what to look for in an OBGYN provider.  You can tell her why and how you chose your primary care physician and offer to help her choose an OBGYN from within your covered provider network.

It’s also important to recognize that she doesn’t need her parent’s permission to seek care, including care related to contraception, a pregnancy test, or sexually transmitted infections (STI).

Just as you want a provider you can trust, your teen will also want a provider she feels comfortable with. Here are some ways you can help her choose a provider who is within your healthcare plan:

  • Look at the provider’s website together. Most providers will include their bios. Learn about the experience and specialities of Madison Women’s Health female gynecologists and nurses.
  • Ask for a referral from her pediatrician.
  • Ask for a referral from your network of friends and family.
  • Read online reviews together.
  • Offer to meet with the provider with her for the first time.

How to Ease Your Teen’s Nerves

Most teens are nervous about their first OBGYN appointment. You can ease your teenager’s nerves by:

  • Assuring her that it’s normal to feel nervous about a new experience, going to a new place, or meeting a new person.
  • Encouraging her to share with her doctor or nurse that she feels nervous. Her OBGYN is accustomed to meeting new patients and knows how to put them at ease.
  • Remind her that just because she’s going to the OBGYN, it doesn’t mean she will have an invasive exam every time.
  • Let her know that she can have someone else with her, like another nurse or a family member.
  • Encourage her to write down questions or topics she wants to discuss with her OBGYN, and that anything she shares with her provider will be confidential.

Common Questions From Teens to Gynecologists

Common questions that teens ask their gynecologists are:

  • Are my periods normal or irregular?
  • How much should I cramp or bleed during my period?
  • Do I have to have my period every month?
  • Does my body look normal?
  • What can I do about acne?
  • How does birth control work?
  • When do I need STI testing?
  • How can I best take care of my health?
  • Is it normal to feel this way about school, friends, or myself?

What to Expect at the First Gynecology Appointment

Here is what to expect at her first gynecology appointment. The first visit is typically 20-30 minutes long.

It is an important time for her to get to know her provider. We believe it’s important to establish a trusting relationship with our patients from the beginning—and it’s much easier to do this when the patient feels comfortable. That’s why at Madison Women’s Health, anyone’s first OBGYN visit is more of a talk than an invasive physical exam.

During the first OBGYN appointment, we’ll talk about her:

  • Personal health history
  • Family health history
  • Menstrual cycles: how often they occur, what the bleeding is like, whether she has cramps. Her OBGYN can help if her periods are interfering with her daily life.
  • Diet and exercise: Adolescence is an important time to develop healthy eating and exercise habits, as well as a healthy body image.
  • Sexual activity: Everything she tells her OBGYN is confidential. It’s important that she is honest about any sexual activity so that she can be given the appropriate STI testing and birth control options.

During the first OBGYN appointment, the physical exam will cover:

  • Height and weight measurements
  • Blood pressure
  • Pulse and respiration
  • Heart and lungs

Did you spot a difference from your first gynecological appointment?

The biggest change in the last 15 years is that we don’t perform a pelvic exam at every OBGYN appointment. The guidelines have changed because we have learned more about cervical cancer and what causes it. Now, cervical cancer screening is no longer done before the age of 21.

Read more in our article When Should You See Your OBGYN.

If your teen needs further physical examination, the reasons and methods used will be explained to her. She’ll have a chance to ask her OBGYN any questions at this point. She can also request to have another person in the exam room with her.

The physical exam MIGHT also include:

  • External genital exam
  • Breast exam
  • Pelvic exam to check the vagina, cervix, uterus, and ovaries. A speculum would be used to complete this portion of the exam.
  • STI (sexually transmitted infection) screening: this can be done with a urine test or a vaginal test (swab).

Before age 21, a pelvic exam is typically only performed if she has very heavy periods or pelvic pain. A pelvic exam is not a requirement for beginning birth control or for many STI tests.

STI, HPV and Cervical Cancer Screening

  • STI testing is recommended annually if she is sexually active. Adolescent women typically don’t have symptoms until the infection is advanced, which is why regular STI testing is so important.
  • HPV screening starts at age 30 unless your Pap test is abnormal.
  • Pap smears for cervical cancer screening start at age 21 and, if they are normal, are every 3 years.

Who Should Go to the First Exam?

Privacy and confidentiality are important aspects of every OBGYN visit. It is routine to extend these rights to teen patients. Who else should be present at the exam depends on how your teen feels. Some things to consider:

  • Teens are more likely to give an accurate health history to their OBGYN when a parent is not present.
  • Teens need to get used to talking to providers on their own behalf as they take charge of their health.
  • Some teens may feel uncomfortable asking their OBGYNs questions when another adult is present. Privacy gives them the space to speak candidly with a health care expert who has been trained to answer their concerns.
  • Some teens prefer to have a trusted adult with them during new situations. She can certainly invite you to remain with her during the exam.

Helping your teen have a positive first experience with her gynecologist is one way you can put her on the path toward a healthy lifestyle. If you have other questions about how to get the best healthcare for your daughter or teen, please let us know. We are happy to help.

Our goal is for every woman to be the happiest, healthiest version of herself that she can be!

Shannon Wixom, A.P.N.P. - Female gynecologistShannon Wixom is a board certified Nurse Practitioner and Lactation Consultant. She earned her Bachelor of Science in Nursing from Edgewood College in 2005. After graduating nursing school, she enjoyed 13 years caring for women as a labor and delivery nurse. She obtained her Master of Science in Nursing from Concordia University and began her career as a Nurse Practitioner in 2018. Her experience in primary care and passion for women’s health led her to Madison Women’s Health. Her areas of special interest include preventive health, pregnancy and reproductive health care.

/by

Gynecologist Exams, Prenatal Care and More: When Should You See Your OBGYN?

Gynecologist, obstetrician (OBGYN), or primary care physician — which doctor should you see and when?

To know which type of physician you should visit, it’s important to understand the difference between them and what they specialize in.

What is a primary care provider?

A primary care provider is focused on the whole patient, specializing in family medicine, internal medicine or pediatrics. They are often at the center of your health journey and will refer you to other specialists as needed.

What is a gynecologist?

A gynecologist is a primary care physician who specializes in women’s health needs, reproductive health, and women’s health after menopause. Gynecologists also perform minimally invasive surgeries including hysterectomies, removal of ovaries or ovarian cysts, tubal ligation, removal of polyps and fibroids from the uterus, treatments for precancerous changes of the cervix such as LEEP, and other surgical procedures.

What is an obstetrician (OBGYN)?

An obstetrician (OBGYN) is a physician who has received specialized training in the care of women who are pregnant. They care for women throughout their pregnancy, delivery, and into their post-partum period. While they are primarily focused on women’s health and reproductive health, they can also help women manage other health issues.

Which One Should I See?

Many women choose an OBGYN to be their primary care provider so that all their care is through the same person. This is a common choice, especially with younger women who have uncomplicated medical needs. However, older women and women with complex medical problems should continue to have both a Primary Care Provider and a separate OBGYN or gynecologist.

Most of the physicians at Madison Women’s Health are OBGYNs. If you are already a patient at Madison Women’s Health and wonder if you should see an OBGYN or your Primary Care Provider, send us a message through MyChart. We’ll be able to tell you who would be the most appropriate physician for your unique situation.

Reasons You Should See Your OBGYN or Gynecologist

There are many reasons to visit your OBGYN or gynecologist. Below are the typical reasons someone would come in for an appointment at Madison Women’s Health.

    • Birth control: Discuss the many different contraceptive options that are available to you, how they work, how often you need to take birth control, and what kind of birth control would be best for your lifestyle and needs. Read more about birth control options.
    • Pre-pregnancy planning: Learn how to have a healthy lifestyle that will support a healthy pregnancy and delivery. Read more about preparing for pregnancy.
    • Pregnancy: Call us as soon as you find out you’re pregnant, which is usually around 8 weeks pregnant (or 3-4 weeks past your missed period). At your first prenatal visit, we’ll do an ultrasound to establish a due date and confirm viability of the pregnancy. You’ll meet with a nurse to learn about what to expect over the next 30 weeks. Read more about our pregnancy services.
    • Changes in your menstrual period: If your period is different than it was before — heavier, lighter, more prolonged, more irregular — then it’s a good idea to see your gynecologist or OBGYN. Changes in your period could be caused by a variety of factors, such as hormonal imbalances, stress, weight loss or weight gain, infections, abnormal cervical changes, presence of an ovarian cyst, and development of fibroids or polyps in the uterus.
    • Unusual vaginal discharge or odors: It’s important to know what is causing pain, irritation, discharge and odor so you can treat it. These things could be caused by a yeast infection, vaginitis, or STI. Read more about our well woman care services.
    • Pain while going to the bathroom (urinary tract infection)
    • Age-related screenings for breast cancer, colon cancer, osteoporosis, and bone health.
  • Pap smear and pelvic exam
  • HPV screening beginning at age 25

If you have other health symptoms or concerns, such as questions about skin issues, painful joints and aching muscles, anxiety and depression, postpartum depression, it is perfectly fine to ask your OBGYN about them. As a primary care provider, your OBGYN can give you care and write prescriptions. They will also refer you to other specialists as needed.

How Often You Should Receive an HPV Screening/Pap smear and Pelvic Exam

Several years ago, women received annual pelvic exams and Pap smears to screen for cervical cancer. We’ve since learned that the presence of certain types of HPV (human papillomavirus) is what increases your risk of developing cervical cancer. The changes to the cervical cells that lead to cancer take a number of years to develop. We know that HPV causes the cells to become abnormal.  For that reason, HPV screening is routine alone, or in conjunction with a pap smear for women 25 and older.  If you test negative for HPV, the pelvic exam may not be needed as often as previously recommended.

Pelvic exams are done along with HPV screening and pap smears,  typically about every 3-5 years unless you have had an abnormal pap smear or positive HPV test, or if you have concerning pelvic symptoms. A pelvic exam is one way your gynecologist can screen you for infectious diseases, cancers to the reproductive system, or other conditions like endometriosis and pelvic floor dysfunctions.

During a pelvic exam, your gynecologist will look at your vulva, vagina, and cervix. They do this by gently inserting a speculum, which widens the vagina so they can see the vagina and cervix. They will also check for any changes in your other organs, the uterus, fallopian tubes, ovaries, and bladder. Samples needed for HPV screening or a Pap smear are taken during the pelvic exam while the speculum is inserted. Your gynecologist will use what looks like a long popsicle stick and brush shaped like a mascara brush to swab the cervix, collecting a sample of cells which will be used for testing.

Most women ages 21-65, regardless of sexual history, should receive HPV screening and or a pap smear every 3-5 years to test for the presence of abnormal cells that could lead to cervical cancer. Some women may be more at risk of developing cervical cancer, such as women with HIV, those with a weakened immune system, or those who have had treatments for pre-cancer or cancer. These women would be screened more frequently, on an individual basis.

HPV screening detects whether the HPV virus is present. If HPV is detected in the sample, then the remaining cells from that sample are sent in for cytology (Pap smear) to see if they are pre-cancerous or cancerous. If the test for HPV is negative, you won’t need another screen for 3-5 years.

How to Prepare for Your Exam with a Gynecologist

It’s important that you feel comfortable and listened to at your gynecological exam. The best way to have a good exam is to relax and remember that your doctor is on your side. We want to help you be the very best version of yourself!

You might be surprised to hear this, but as OBGYNs, we’re really not worried about whether you shaved your legs or waxed your bikini line. You don’t need to do anything special ahead of time. We’re here to take care of you just as you are!

We generally don’t recommend douching because it throws off your vaginal pH, which can cause bacterial imbalances which can lead to or predispose to infection.

Questions to Ask at Your Next Gynecologist Exam

Never be afraid to ask your doctor anything! We care about you as a whole person, so we’ll ask you a lot of questions that cover many aspects of your life. If we haven’t covered something in our conversation with you, please feel free to ask us.

Here are the most common questions we’re asked. If it helps, write a list ahead of time of questions you’d like your doctor to answer (or screenshot ours).

  • Do I need birth control? How does it work?
  • Is my period normal?
  • Do I have to be in so much pain every month?
  • Do I have to have my period every month? Is it too heavy? Too light?
  • How often should I consider sexually transmitted infection (STI) screening?
  • What should I expect about perimenopause and menopause?
  • How can I reduce perimenopause and menopause symptoms?
  • How can I reduce mood changes associated with my menstrual cycle?
  • I have a family history of chronic illnesses, like diabetes, heart disease, and thyroid disorders. How can I reduce my risk of living with these disorders?

Preparing Your Daughter for Her First Gynecological Exam

Moms, we strongly encourage you to openly discuss reproductive and sexual health with your daughters. We’re here to help you with that discussion and process! We have pamphlets at our office that you can use to talk to your daughters about what to expect.

A common question we’re asked is, “When should I bring my daughter in for her gynecological exam?” You may be surprised to hear the answer because many of the recommendations may have changed since you were a teenager.

If your daughter doesn’t have a particular concern regarding her period, risk for sexually transmitted infection,  or need for birth control, she may not need a pelvic exam and HPV screening until she is 21.  If she is using birth control for contraception or periods, she should have a visit at the doctor’s office, but she may not need a pelvic  exam until age 21. Urine tests for STIs can be done without the need for a pelvic exam. If she does need a pelvic exam, reassure her that even though it is awkward, it’s not painful. The exams are very brief, and if it gets uncomfortable, we always stop and readjust.

What To Expect at a Well Woman Exam

Even though you do not need a Pap test or HPV test every year, it’s important that you continue scheduling your annual Well Woman Exam. Your Well Woman Exam is an essential part of your ongoing health maintenance, and is usually covered 100% by your insurance.

At your Well Woman Exam, your doctor will screen you for chronic, preventable diseases such as cardiovascular (heart) disease and diabetes by checking your blood pressure, weight, cholesterol, and glucose levels. You’ll be able to talk to your doctor about other symptoms you may have, such as allergies, migraines, low libido, depression / anxiety, and more. You’ll also discuss whether you need refills for specific medications, or whether you should be seen by a specialist. Your doctor will also make sure you feel safe in your home environment.

Because a Well Woman Exam is more for preventative care and routine health maintenance, the assumption is that you do not have a specific medical problem or condition. If you have specific concerns, you may need to make an additional, separate appointment to talk about your symptoms in more detail with your doctor.

Depending on your age and health history, you may also receive a pelvic exam, mammogram, Pap smear, HPV screening, STI testing or other tests.

Beginning at age 40, you should have mammograms every few years. If you have a history of breast cancer in your family, you may be screened more regularly.

For women 50+, a colon cancer screening is recommended. This is done with either a colonoscopy or an at-home Cologuard test.

As women get older, they’ll also be screened for osteoporosis and bone health.

Woman getting ultrasound at OBGYN clinic

What to Expect at Your Pre-Natal Appointments

At Madison Women’s Health, much of what our OBGYNs do involves pregnancy care and delivering babies. If you become pregnant, we’ll be seeing a lot more of each other!

Set up your very first prenatal visit as soon as you find out you’re pregnant. For most women, this happens around week 8, when they’re about 3-4 weeks past their missed period.

First Appointment: 8 Weeks Gestation

At your first visit, we’ll do a transabdominal and transvaginal ultrasound. This will help us establish a due date and check for a heart beat. You’ll meet with a nurse to go through your medical history. You’ll learn all about exercise, diet, and ways to manage morning sickness. We’ll cover any changes you may need to make to your medication as well. After you’ve had some basic lab work done (blood and urine tests), your OBGYN provider will meet with you to answer any questions you may have.

12 Weeks – 32 Weeks Gestation: Appointments every 4 weeks

Some women choose to have genetic screening done at about 12 weeks. As part of the genetic screening, you will have another ultrasound and you’ll be able to see all the growth and changes that have happened in just 4 weeks. At 20 weeks, you’ll be able to find out the sex of your baby if you desire to do so.

You’ll continue to come in at 4 week intervals until you reach 32 weeks (about 7 months). If your pregnancy is higher risk, you may see your OBGYN more frequently.

33 – 36 Weeks Gestation: Appointments every 2 weeks

Once you reach 7 months, or 33 weeks, you’ll see your OBGYN every two weeks. Your weight and blood pressure will be monitored. And you may receive testing for gestational diabetes.

37 Weeks until Birth: Appointments every 1 week

In the final weeks leading up to your baby’s birth, you’ll come in for an appointment every week. Your blood pressure will be monitored, and your OBGYN will check the positioning of your baby.

Our Gynecologists and OBGYN Providers Are Here for You

At Madison Women’s Health, we’re committed to treating you as the WHOLE person you are. We want to help you be the happiest, healthiest version of you that you can be! Don’t hesitate to reach out if you have any questions about how we can help you.

Dr. Karla Dickmeyer M.D. Founding partner of Madison Women's Health OBGYN ClinicDr. Dickmeyer has been providing healthcare for women in the Madison area since 1998 and is a founding member of Madison Women’s Health. Her specialties include minimally invasive surgical techniques, high and low risk obstetrics, pelvic floor disorders and postmenopausal medicine.

 

/by

5801 Research Park Blvd, Suite 400, Madison WI 53719

608-729-6300

Reviews
SCOPE Certified logo