Women's Health Basics:

A Q&A With Dr. Corey Babb



Hello!

My name is Corey Babb, and I’m an OB/GYN with OSU Physicians, as well as the Director of the Oklahoma State University Center for Women’s Sexual Health. Over the next four weeks, I’ll  be writing a series of blog posts covering everything from pap smears to low sex drive, and finishing up with some information on age-appropriate ways to talk to your children about sex and sexuality. 

In this week’s blog, we’re going to be discussing the basics of women’s health.  In Q&A format, I’ll highlight some of the most common questions I’m asked as a women’s health practitioner.  Obviously, if you have questions that are not answered in this blog, or want to know more, please discuss them with your healthcare provider.  So without further ado, let’s get started!

Q:  When should women first establish care with a women’s healthcare provider?

A:  Well, there’s not a clear-cut answer.  According to the American College of Obstetricians and Gynecologists (ACOG), women as young as 14 years of age can benefit from seeing a gynecologist.  Questions regarding puberty, sexual development, contraception, and more can be addressed at that visit.  In fact, unless there’s a problem, the entire visit can be performed without any type of internal exam.  In most cases, pediatricians are comfortable handling routine women’s health issues until the age of 18.  For more specific concerns, most gynecologists are are comfortable seeing adolescents, and some may even see children.  In my opinion, it’s a good idea to establish care with a gynecologist at the onset of sexual activity, when problems arise, or at age 21, whichever comes first. 

Q:  What exactly is a pap smear?

A:  Many women mistakingly think that any type of internal vaginal exam, especially if swabbing is performed, is a pap smear.  We often see women who have presented to the emergency room and had a vaginal exam think they “had a pap.”  In reality, a pap smear (short for Papanicolaou - the doctor who invented it) is a screening test used to detect cervical cancer.  It’s accomplished by brushing the cervix - the part of the uterus that sits within the vagina - with a special brush, and examining those findings under a microscope.  If abnormal cells are detected with the pap smear, further testing may be performed to determine the exact type of “dysplasia,” a fancy way of saying “abnormal cellular growth and arrangement.”   In addition to checking for cervical dysplasia, pap smears can also detect the presence of the human papilloma virus (HPV), the virus that is responsible for the majority of cervical cancer cases.  As a side note, ACOG now recommends that pap smears should be performed no earlier than 21 years of age (with a few exceptions).

Q:  How often should I see my gynecologist?

A:  Every year!  Now, while we recommend an annual visit, for women between the ages of 21 and 65, pap smears need only be performed every three or so years if you’re in a “low-risk sexual relationship.”  Women with multiple sexual partners, immune conditions such as HIV, or with a history of previous abnormal pap smears should have more frequent testing.  Now you may be asking yourself, “If I don’t need a pap, why should I go every year?”  Well, there are many questions, problems, or other issues that can be addressed at that annual visit, and women can still benefit from an annual physical exam, even if a pap isn’t performed.   Obviously if you’re having issues related to abnormal periods, pelvic pain, urinary tract infections, or any other problem related to your reproductive system, get in sooner - don’t wait for that year appointment! 

Q:  What are my options for birth control (BC)?

A:  This could be a blog of its own!  First of all, a disclaimer.  Due to the nuances of contraception, I recommend a specific visit with your provider to discuss which type of birth control is right for you.  Certain medical conditions, allergies, or medications may make certain forms of contraception unsafe, so spend some time talking with your provider, and don’t just tack on an “oh by the way” at the end of a visit.  Now, to answer the question posed, here’s a chart that differentiates types of BC depending on whether or not they contain hormones.

Hormone-Free

Hormone-Containing

Abstinence

Oral contraceptive pills “The Pill”

Rhythm-methods/Fertility Awareness, Natural Family Planning

Transdermal Contraception (patches, intravaginal ring)

Condoms (male and female)

 

Injectable/implantable Contraception (The Depo-Provera shot, Nexplanon)

Diaphragm

 

Hormone-containing IUD (Mirena, Skyla, Liletta, etc…)

Copper IUD (Paragard)

Morning-after pill

Surgical Sterilization

 

Some specific points about the methods listed above.  Hormone-containing BC can be used to help with abnormal periods, acne, PMS, as well as a number of other hormone-related issues.  Abstinence and condoms are the only types of contraception that prevent the spread of sexually transmitted diseases like gonorrhea, HPV, or HIV.  Also, both the morning-after pill, AND the copper IUD are indicated for emergency contraception, but the copper IUD requires a provider to insert it. 

As you may imagine, there’s a lot to talk about when it comes to contraception!  If you have questions, or would like to know more about specific types, schedule an appointment with your provider. 

Q:  What’s the deal with self-breast exams?  Do I really need to do them?

A:  Yes!  Self-breast exams can pick up cancerous or precancerous changes in the breast itself or surrounding areas.  As a gynecologist, I have personally seen a number of women under the age of 40 with breast cancer, so just being “young and healthy” doesn’t protect you.  In addition, if you’re only getting a breast exam once a year, you may be going months with an undiagnosed tumor.  I know it stinks to do a monthly exam, so here are some tips for maintaining a SBE schedule.

  • Do your SBE at the same time each month.  That could be the first of the month, the first day of your period, or whenever you like.  The “when” is not that important, the consistency is.
  • If you don’t like doing your SBE, have someone help you out!  There’s nothing wrong with involving your partner.
  • If you’re not sure how to perform a SBE, many clinics offer instructional guides on performing a SBE, or there are lots of resources online. (http://www.nationalbreastcancer.org/breast-self-exam and http://ubcf.org/your-health/self-breast-exam/, among others/)
  • As a general rule, if you feel something that is painful to touch, moves freely, and is on both sides, it’s probably not cancer.  If a lump feels stuck, doesn’t hurt, and is only located on one breast, definitely get it checked out. 
  • Don’t forget to check your armpit!  Breast tissue extends all way up into your armpit, and is often a primary site for cancers in young women. 

 

Well, that about wraps it up for the blog this week.  Next week I’ll be addressing the physical, emotional, and hormonal changes that occur postpartum, and ways to help navigate issues that may arise after childbirth.  Thanks for reading!  I have additional resources online at my Facebook page, @DrCoreyBabb, where I do Facebook Live videos, answer questions, and post links to relevant women’s health issues.  Remember you are your best advocate, so take charge of your own health!


Dr. Corey Babb is a graduate of the Oklahoma State University College of Osteopathic Medicine, and completed his postgraduate training in Obstetrics and Gynecology at the University of Oklahoma-Tulsa, as well as Oklahoma State University Medical Center. He is board-certified in Obstetrics and Gynecology, and is a fellow of the American College of Osteopathic Obstetricians and Gynecologists, the International Society for the Study of Women’s Sexual Health, and is a North American Menopause Society Certified Menopause Practitioner. His practice is devoted to the evaluation and treatment of female sexual dysfunction, and he is the only physician in the state of Oklahoma that specializes in women’s sexual health. He is currently an assistant professor of Obstetrics and Gynecology at the Oklahoma State University Center for Health Sciences, and is the director for the Oklahoma State University Center for Women’s Sexual Health.

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