Dr. Aruna Muralidhar MD, MRCOG, FRCOG (UK), Senior Consultant Obstetrician and Gynaecologist, Fortis La Femme Hospital, Richmond Road, Bengaluru
A gynaecologist’s visit can be a bit daunting for many women. Women may feel uncomfortable revealing certain information about themselves to a total stranger. The prospect of an internal examination also may make you uneasy.
The way to overcome this initial anxiety is to choose a gynaecologist carefully. The gynaecologist must ideally be broad-minded, approachable, non-judgemental and above all empathetic to the woman’s needs. During the consultation, if the woman reciprocates with honest openness without having any preconceived notions and inhibitions, the consultation is likely to be more effective, holistic, and fruitful.
These are some of the important things that one must tell the gynaecologist.
A complete timeline of the existing problem with approximate duration is useful for a gynaecologist to understand the problem as a whole. If all the associated issues can be elaborated, it will add to the diagnostic accuracy. Talking about similar concerns in the past and the treatment taken during that episode will help the doctor understand what worked and what didn’t for your particular body system.
The menstrual cycle length, period duration, heaviness of the flow, presence of pain must be mentioned as accurately as possible. One of the important symptoms to be mentioned is the presence of pain and bleeding during and after sex. One should not withhold information about their personal hygiene, presence of abnormal vaginal discharge, etc.
Marital and sexual history
One must talk openly about their married life, any previous relationships, divorce, or separation. Although this may be considered irrelevant by some, it helps in certain situations like assessing the risk of STI (Sexually transmitted infections) and mental health risks etc. Any current relationship even if homosexual must be informed to the gynaecologist. Couples, even if married for a long time, sometimes do not reveal sexual problems. Being candid helps in solving problems early.
Urinary symptoms and bowel habits
This is another taboo topic for many women. Leakage of urine with coughing, sneezing, or exercise must be mentioned to the gynaecologist. Also, a feeling of pressure or a lump in the vagina may indicate prolapse and must be mentioned. Any recent changes in bowel habits or constipation etc must also be mentioned.
Mental health issues
Mental health is as important as physical health. Any symptoms or prolonged sadness affecting one’s life, inability to focus or enjoy things can be signs of clinical depression. Constant worry, feeling of helplessness or sleep disturbances, and a recent increase in stress levels can also cause or worsen gynaecological problems.
Previous health problems, medications taken, previous surgeries must be mentioned without fail as they can affect the current treatment. Any drug allergies and the severity of the reaction must be mentioned without any vagaries for improving the safety of prescription. Any vices such as any kind of smoking, alcohol consumption, and drug use must be mentioned to help aid deaddiction, reduce risks of other problems, and determine drug interactions, etc.
Health problems that run in families must be recollected accurately so that the screening for those problems can be done at regular intervals.
If the gynaecologist knows whether this is the first visit to a doctor for that problem or a second or even nth consultation, the consultation can be tailored accordingly to avoid duplication of records, tests, and also confusing opinions. Finally, expectations from the consultation must be clearly defined at the outset to avoid disappointment for the patient and dissatisfaction for the doctor. It always helps in agreeing upon a date for the follow-up to review symptoms and the effectiveness of the treatment. Honest and open feedback directly or online will help the gynaecologist improve her practice and if latter, help other needy women find a good gynaecologist.