Gynecologic Questions
1. My daughter is 16. When do I need to bring her in for a PAP smear?
Answer: Usually for a virginal female, it is recommended to have a PAP smear by 21 years of age. However, a young woman should have a gynecological exam when she becomes sexually active no matter how old she is at the time. Many parents feel that a visit to the gynecologist when the menstrual cyclestarts is most beneficial. The doctor will be able to answer questions and have a discussion with the young teenager regarding premenstrual syndrome symptoms, abdominal or pelvic pain and cramping, and remedies for these symptoms. This will usually reduce fear and anxiety the young teenager may have about seeing the gynecologist. Furthermore, parents feel a discussion regarding sexual activity and the risk of getting pregnant is important prior to her starting to date. Young teenagers also need to be informed about sexually transmitted diseases and that the only way to completely eliminate the risk is to be abstinent. I also like to warn about the risks of date or acquaintance rape. It is heartbreaking to hear the statistics regarding these problems and any chance to reduce the numbers with a firm nonjudgmental discussion with a young teenager is rewarding.
2. What should I do if I miss a birth control pill?
Answer: Most birth control manufactures provide instructions regarding their brand and it is recommended that you see their specific instructions. However, in most cases of a 28-day pill cycle, if you miss one of the active pills (1 through 21), you can take the missed pill when you remember. Then take the next pill at the regular time. You may end up taking two pills in one day. Usually you do not need a back-up method of birth control with one missed pill, but to be sure—use one for the rest of that cycle.
Obstetrical Questions
1. I’m 8 months pregnant. What can I do or take for a backache?
Answer: During pregnancy you may experience many discomforts. Simple backache or low back pain is common because of the extra weight gain and the pregnancy. The body’s center of gravity moves forward by several inches late in pregnancy. This causes a strain on the back muscles and spine. First, I recommend that you keep your weight under control with diet and exercises including stretching. Next, consider soft sole shoes and a pregnancy girdle or sling. The neoprene/Velcro athletic supports purchased at a sporting goods store is a less expensive alternative. Be cognizant of maintaining good posture and avoid standing for long periods of time. Avoid lifting heavy objects. In addition, consider massage therapy and seeing a licensed chiropractor. Finally, analgesics may be needed with or without narcotics. Acetaminophen (Tylenol) is a routine start. Always consult your obstetrician for confirmation that your symptoms are not a more serious problem.
2. What can I do for indigestion and heartburn during pregnancy?
Answer: Pregnancy causes an elevated progesterone level. Progesterone is a hormone that relaxes smooth muscle. The smooth muscle band between the stomach and esophagus does not hold down the stomach contents as well during pregnancy and this allows stomach acid to go back up the esophagus.This causes the indigestion and heartburn. In addition, the stomach is pushed up by the growing pregnancy. For palliative treatment, don’t eat spicy or fried foods and eat smaller meals, especially before going to bed. Sleeping with your head elevated on pillows or propping the head of the bed up on blocks to avoid lying flat may help. Next, try over-the-counter medicines like Tums, Rolaids, or Mylanta. If symptoms are still unrelieved, be sure and discuss this with your doctor. Your doctor may recommend or prescribe a medication used safely during pregnancy.
3. I travel for my job. When should I stop traveling during my pregnancy?
Answer: Restriction on travel during pregnancy is variable. If you have complications, travel is not advised even in early pregnancy. However, if you have an uncomplicated pregnancy, traveling up to the 36th week is usually ok. Then restrict travel to within 2 hours of the hospital where you plan to deliver. Most commercial airlines have restrictions and you should check with your carrier when making reservations. Some commercial airlines require a written note from your obstetrician prior to boarding. Always remember to drink plenty of water and to stretch frequently to avoid leg cramps and development of blood clots in the legs. If you must travel during your pregnancy please let your doctor know prior to your trip. Ask for a copy of your prenatal records with laboratory results to take with you. Emergencies happen and if you have to be seen by another physician during your trip, providing a copy of your records will allow the doctor and staff to take better care of you.
Fertility Questions
1. I’m 38 years old. Am I too old to have children now?
Answer: Most women who are in good health do well with pregnancy even into the forties.Pregnancy does take time, energy, and a toll on your body, but solid preparation with diet and exercise can help. Planning is so important. If you do have medical problems, see your doctor before you attempt pregnancy. Many medical problems can be safely controlled and monitored during pregnancy to reduce the risk and assure a successful outcome.
