Women’s Health Frequently Asked Questions (FAQ’s)
1. Do nurse-midwives only deliver babies?
Certified nurse-midwives take care of women throughout their lifecycle—from puberty through menopause. We do well-woman care including annual GYN exams and pap smears, birth control counseling and initiation, evaluation and treatment of sexually transmitted infections and vaginal infections, management of abnormal pap smears, interpretation of lab results, endometrial biopsies, IUD insertion and removal, evaluation and initial treatment of pelvic pain and infertility, among other things.
2. When should I have my first pap?
The American College of Obstetricians and Gynecologists recommend a first pap by the age of 21 or 3 years after first intercourse, whichever comes first.
3. How often should I have a pap?
You should have a pelvic exam every year and a pap every 1 – 3 years depending on your risk and human papilloma virus status.
4. What is the difference between a pelvic exam and a pap?
A pap smear is a test for cervical cancer; we need to use a speculum to collect the cells. A pelvic exam is when your provider uses their hands to feel your uterus and ovaries to check for any abnormalities.
5. What should I do if I miss one of my birth control pills?
You should take it as soon as you remember it and then take the next one at the next regularly scheduled time. If you miss 2 pills, then take 2 right away and one at the next scheduled time. Use condoms for the rest of the cycle.
6. I have pelvic pain every month. What should I do?
Keep track of your symptoms with the menstrual card; note what makes the pain better or worse, when in the month you have it, and if sex impacts the pain at all. Schedule an appointment for follow-up after collecting information for 3 months.
7. Is it OK to douche or use other “feminine hygiene products”?
We do not advise douching; it changes the pH of your vagina and makes you more susceptible to vaginal infection.
8. I was told that I had a “vaginal infection”; how do I know if it is a sexually transmitted infection? Are some infections not STI’s?
That is a good question for your provider at the time of your exam. Many women frequently have a vaginal yeast infection or bacterial vaginosis; these are not sexually transmitted. However, Chlamydia, gonorrhea, herpes, human papilloma virus (HPV), herpes (HSV), and HIV are STIs.
9. Why should I consider the Gardasil vaccine?
Gardasil vaccine is recommended for prevention of 4 strains of the human papilloma virus (HPV); there are many strains of the HPV virus, but these are the 4 most common types. High risk HPV viruses are responsible for the large majority of abnormal pap smears.
10. Which forms of birth control also provide some STI protection?
Barrier methods of birth control will provide some protection against STIs. Common barrier methods are condoms and diaphragm.
11. Which forms of birth control are safe with breastfeeding?
During breastfeeding the most common methods are “Barrier methods”, including condoms and diaphragm; hormonal methods that do not include estrogen which include the progesterone-only pill, Mirena or Paragard IUD, Depo-Provera injections and Implanon are commonly used.
12. I smoke, and after turning 35 my health care provider will not prescribe birth control pills anymore. Why is that?
The risk that you will develop blood clot increases significantly with smoking, especially as you get older and are on an estrogen containing product. Therefore, we will not prescribe estrogen-containing pills after the age of 35.
13. My husband dislikes condoms, and I have trouble remembering to take the pill. What other birth control options are available to me?
You might want to consider something long-term but reversible: the Mirena IUD, the Paragrad IUD, Depo-Provera injections, or Implanon.
14. I am having trouble getting pregnant. Can your practice help me with that?
We can initiate an infertility evaluation for you; the definition of infertility is no pregnancy after 12 months of regular intercourse and not using any type of contraception. For women over 35 we recommend beginning the evaluation after six months of not conceiving.
15. What vitamins or supplements should women consider?
A multi-vitamin with folic acid is a good vitamin and also elemental calcium 1200-1500 mg everyday.
16. What other routine health concerns can my nurse-midwife or OB/GYN physician see me for?
We normally evaluate and treat for urinary tract infections and other bladder issues. We commonly check for thyroid function, diabetes, and lipid panels. We often see women whose symptoms correspond with depression. We are not counselors or psychiatrists, but can initiate treatment and appropriate referrals.
17. My periods are normally regular, but sometimes I skip a period, have bleeding between periods, or have 2 periods in 1 month. What should I do?
First you should check a home pregnancy test, even if you are regularly contracepting; if the test is negative, then we recommend you keep track of your bleeding with a menstrual calendar for several months and then schedule a follow-up with your provider. It is not unusual to occasionally have some irregular bleeding.