Gynaecologists: when should I see one?

Seeing a gynaecologist is essential for women at every stage of life, from managing contraception to navigating pregnancy and beyond. Here’s why it matters.

A gynaecologist is a doctor who specialises in women's health and reproductive organs. Dr Mohamed Ghodhbani, an obstetrician and gynaecologist at Mediclinic Upington, suggests several reasons why someone would consult a gynaecologist:

• Preconception visits: preparation for pregnancy
• Pregnancy follow-ups and delivery
• Routine check-ups and screening for gynaecological conditions and cancers
• Surveillance of a condition, treatment or contraceptive method
• Complaints, including pain, bleeding, infection, infertility, and menopausal symptoms.

When should I first visit a gynaecologist?

Dr Ghodhbani says it’s unnecessary for women to see a gynaecologist as soon as they start menstruating if there are no unusual concerns or symptoms. However, once they become sexually active, they should schedule a check-up to discuss contraception options.

Your gynaecologist can help you choose the right contraception for your needs. Options include the pill, long-term methods like a hormonal IUD, or permanent options like female sterilisation or male vasectomy. Regular check-ups are important to identify any possible issues.

“Women should have their first annual Pap smear when they become sexually active,” says Dr Ghodhbani. This procedure checks cells from the cervix for signs of cervical cancer or early changes that could lead to cancer. If abnormal cells are found during your Pap smear, they can be monitored or treated to prevent cancer. A Pap smear also helps your doctor check for infections or any discomfort you might be having.

“After age 65, if a patient has been properly screened throughout her life with negative results, Pap smears are no longer necessary,” Dr Ghodhbani adds.

Gynaecologists may also suggest a more expensive screening test for human papillomavirus (HPV) for sexually active women over age 25. If the test is negative, it can provide reassurance that they are likely to be free of cervical cancer for the next three to five years.

"For patients with a history of high-risk pregnancies or previous surgeries or gynaecological conditions, it's important to see their gynaecologist at least three months before trying to conceive. This allows time to prepare for the pregnancy and manage any existing conditions, like diabetes, to ensure the best care," says Dr Ghodhbani. Before conception, your gynaecologist can advise on lifestyle changes, supplements, a consultation schedule, and what to expect and watch for during the pregnancy.

What to expect at your first consultation

During your first general gynaecology consultation, your doctor will take your medical history and do a physical exam. “We put our patients at ease and encourage them to be accompanied by their partners during these examinations if preferred,” says Dr Ghodhbani.

“The examination will include a general and gynaecological check-up, starting with a breast exam, followed by a visual inspection of the vulva, using a speculum to examine the vagina and cervix, feeling the uterus and ovaries both inside and outside, and performing a Pap smear if needed."

Swabs may be taken if there is an infection, and STD screening will be done if needed. An anal exam may also be performed if there is concern about conditions like endometriosis or cervical cancer.

Your doctor will also do a vaginal ultrasound unless you’re not sexually active, feel too uncomfortable, or if the uterus is too large for a vaginal scan. After the exam, you’ll change back into your clothes and meet with the gynaecologist to discuss the results and treatment plan.

Not all gynaecological exams involve the pelvic/genital area, notes Dr Ghodhbani, for example, checking of the patient’s glands and weight distribution. Gynaecologists can also prescribe medication for hormonal problems and check for signs of conditions like polycystic ovary syndrome (PCOS) or insulin resistance, which can affect hormone levels and fertility.

Talk to your gynaecologist

If you’re a parent to a girl, remember that a gynaecologist can see patients of any age. They can help with issues like bleeding, infections, or pelvic pain and provide advice on early or delayed puberty, says Dr Ghodhbani.

It’s important to be open with your gynaecologist, especially about infections during pregnancy. Issues like sexual problems or bladder control can often be treated if you talk about them.

• To book an appointment with a gynaecologist, contact our Mediclinic Engagement Centre via WhatsApp 087 240 6367 or click here for alternative contact options.