Your Child's First GYN Visit

For many young people with a uterus, the thought of seeing a gynecologist for the first time can feel scary or even embarrassing, but this should be a time when they feel comfortable and able to ask questions about development and body changes. We talked with Dr. Valary Gass of Women’s Care of Wisconsin to provide you with the information you need to help your child feel more positive and less stressed out about the first gynecologist visit.

At What Age Should I Schedule the First Gynecologist Visit?

“The American College of Obstetrics and Gynecology recommends that people with uteruses between the ages of 13-15 visit with a gynecologist,” Dr. Gass explains. “For many parents, a reasonable time to talk about scheduling this first appointment is after the first menstrual period. The real purpose of this appointment is to establish a relationship between your child and the gynecologist so they can feel comfortable asking questions and learn about what changes to expect as time goes on.”

Preparing for Your Child’s First Gynecologist Visit

The most important thing you can do to help ease your child’s nerves is talk about the visit. Explain why this visit is important and what can be expected. Having an open dialogue with your child will encourage questions and increase comfort about the experience.

It is also a good idea to have your child create a list of questions for the gynecologist before the visit. Sometimes being nervous can cause us to be forgetful, so writing these questions down on a piece of paper will help make sure everything is answered.

Common topics for questions include periods, hormones, birth control, sex, and sexually transmitted infections. These are all normal topics for your child to have questions about. Remind your child that anything discussed with the gynecologist is protected by privacy laws. The gynecologist should be a safe and judgement-free space, so your child shouldn’t feel embarrassed about asking questions.

What Your Child Can Expect During the Visit

“Most of the time, a child’s first gynecologist appointment does not involve a pelvic exam,” Dr. Gass says, “but it should include taking a careful medical history, addressing any concerns like bad periods, and considering things like HPV vaccinations.” During your child’s first gynecologist visit, expect to have a general physical exam where the nurse will record height, weight, and blood pressure. The gynecologist may then check for common health problems and talk about any medical history. Listening to heart, lungs, and feeling the abdomen should be expected. Sexually active persons under age 25 should have annual gonorrhea and chlamydia screening. This can be done at the visit with a simple urine test. The gynecologist will ask about sexual activity and address any need for contraception.

The most important thing to keep in mind is that this visit is an opportunity for your child to speak openly with the gynecologist and ask questions.

When Is a Pelvic Exam Necessary?

“The American College of Obstetrics and Gynecology suggests that most people with a cervix begin regular Pap smear screening at age 21,” Dr. Gass says. At that point, regular screening should continue every three years until age 30 when they can switch to having a Pap smear with HPV co-testing every five years. Your child most likely will not need a pelvic exam during the first gynecologist visit, unless there are complaints of lumps, bumps, pelvic pain, or abnormal discharge. In these instances, the gynecologist may decide a pelvic exam is necessary. Our office offers nitrous oxide to help patients relax during exams or procedures if needed.

When Should My Child Stop Seeing the Pediatrician?

Once your child is seeing a gynecologist regularly, you may wonder if they need to continue seeing the pediatrician. This is largely up to you and depends on the specific needs your child has as well as the gynecologist’s preference for their practice. It is perfectly normal for your child to continue seeing a pediatrician into college and it can be helpful with a complicated medical history. Just make sure your child continues the annual gynecologist visit as well.

For More Information:

https://www.acog.org/womens-health/faqs/your-first-gynecologic-visit

https://www.acog.org/womens-health/experts-and-stories/the-latest/should-my-teen-see-an-ob-gyn-heres-what-i-tell-parents

Schedule An Appointment

If you would like to schedule an appointment with Dr. Gass, please call or text us at 920.729.7105.

A Conversation About Fertility

Dealing with fertility problems is hard. About one in six couples are troubled with fertility issues, and it affects both men and women equally. 

Simply put, a lot goes into the conception process. There’s the egg, sperm, fallopian tubes, fertilization, the women’s embryo, hormones, and not to mention each of those pieces needing to be in a healthy state. All but one of those parts could function properly and infertility could still be the result. We at Women’s Care of Wisconsin are here for those times. We specialize in the diagnosis and treatment of infertility and will help you navigate this journey to make your dreams come true.

In having a conversation about fertility, here are some common questions regarding the process, treatments, and how we’re here to help.

How long do you wait before speaking with a doctor about possible fertility issues?

Fertility can happen at many points within a lifetime, and infertility issues differ at each of those points as well. A general rule of thumb is if you are over or under the age of 35. Couples under the age of 35 statistically have better chances of conceiving, yet should look into additional options after a year of actively trying (actively trying means you are having intercourse around ovulatory times month by month). Patients over the age of 35 should intervene just after six months.

Can you explain the difference between IUI and IFV?

The big technical difference is where the fertilization of the egg and sperm takes place. During IUI, the doctor inserts the sperm directly into the uterus to fertilize. With IVF, the egg and sperm are manually combined in a laboratory dish and then transferred to the uterus. We can facilitate any IUI treatments by providing medication, tracking cycles, and stimulating the ovulation cycle while collecting and processing the sperm to be placed in the uterus in our own office. If you were to choose the IVF route, we would be the helping hand in that process of referring our best local clinics in the area to take care of you, then assisting once you choose your preferred facility.

When would you recommend IVF to a patient?

We recommend each individual go through the initial testing and treatment options, then work in a conversation about additional options following those. Usually, we would like to start an IVF discussion with a patient after 3-4 rounds of insemination. However, time frames will be individualized to each couple depending on a multitude of personal factors.

So, no matter if you’re just starting to think of the conception process or you are months or years in, Women’s Care of Wisconsin is here to provide education, diagnosis, and treatments, and be with you every step of the way. It’s our goal to make your dreams of having a baby a reality. More information can be found in our fertility booklet.

To schedule your own personal consultation, call or text 920.729.7105 to set up an appointment with one of our three fertility specialists. Click on the provider names below to learn more about each.

Dr. Allison Brubaker 

Dr. Amanda Reed 

Dr. Sara Swift

Understanding Incontinence

Did you know that 50% of women have incontinence at some point in their life? Here’s what you can do to take control.

Incontinence is the loss of urine in an uncontrollable fashion. There are many reasons as to why people have it. Some of them are very easy to treat successfully and are easily cured, and some of them are very challenging to cure. But we can usually get significant improvement with treatment. Incontinence is one of my favorite conditions to see a new patient with; I can often cure them outright and almost always make a big improvement for them with fairly little intervention.

Most people put up with it and hope that it’s going to get better, or put if off until tomorrow, only to realize that several years have passed and it’s only gotten worse.

In generations past, people have looked at the loss of urine as a normal part of aging or normal consequences of childbearing, both of which I think are mistakes. What I would encourage people to think about is the fact that although incontinence is not painful, it’s not normal. People really don’t like to deal with it because it’s embarrassing. But they should realize, it’s very common, and often very easy to treat.

However, correctly treating incontinence means also that you have an understanding of what the true diagnosis is, very much like a headache. There are many different causes for it and the headache itself is usually a symptom of an underlying abnormality of some type, just as incontinence can be caused by many different things. 

Relief for women dealing with bladder control issues typically takes one of three routes:

• It can be as simple as a 10-minute outpatient procedure or a prescription for  medication.
• It may require a combination of therapies to get someone to a much better function.
• Sometimes we need to treat an underlying, undiagnosed urinary tract infection, which should be evaluated further, as it could possibly be a sign of other diseases such as MS or diabetes. 

There are varying levels of incontinence, all of which can be diagnosed and treated to help you return to a normal, active lifestyle.

Spasm and bladder irritability:

• Conditions where a person is urinating frequently and up a lot at night with a sudden sense of urgency (similar to the television commercials you see).
• Tends to be a neurologic, irritational aspect to the bladder.
• There are a handful of different medications that are typically used to treat this.

Stress incontinence:

• People leak a small amount of predictable urine every time they cough, sneeze, lift or jump.
• Will not get better with time.
• Often times this can be treated effectively with proper Kegel exercises, but a lot of times that treatment requires ongoing and continuous exercise by the person, and sometimes even then it won’t hold up over time.
• Should that fail, we can proceed with a small, 15-minute, outpatient procedure that is very successful (such as some type of sling procedure), which in the past was a very big surgery and nowadays really can be done quickly with a very fast return to full function status.

When incontinence affects how you function, what you’re doing, your clothing choices or travel plans, it’s just a shame not to get an evaluation and treatment—because so often, it is actually fairly easy to fix with many different treatment modalities. 

Suffice it to say, there are many treatments for many different causes in the many unique types of patients out there. But I would encourage readers to not for a minute think that this is a normal part of aging and something they simply have to “put up with.”  I would encourage them to seek medical evaluation and intervention, because if you’re thinking about the fact that you’re leaking urine, then it is probably affecting you on a daily basis.

Dr. Eric Eberts is an Obstetrician/Gynecologist at Women’s Care of Wisconsin.

The providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. And it begins with you.