Mayo Clinic News Network
With several choices in health care providers and specialties, determining who to see and when can be confusing.
“As an OB-GYN provider, one of the most common questions I hear from patients is, ‘What are the differences between the services offered by a gynecology provider versus a family medicine provider?’” says Becky DeLuca, an OB-GYN nurse practitioner at Mayo Clinic Health System. “The second most common is, ‘When should my daughter start seeing a gynecology provider versus her pediatrician or family medicine provider?’ Both of these are excellent questions. However, the answers are not as straightforward as one might hope.”
FAMILY MEDICINE OR GYNECOLOGY?
Both the family medicine and gynecology departments can complete preventive health exams for women. Both departments can screen for health disease. So when do you see a gynecologic provider and when should you see a family medicine provider?
DeLuca says family medicine is best suited if:
• You have a chronic medical condition that requires medication or regular lab work (e.g., diabetes, high blood pressure or cholesterol, and chronic pain).
• You have an acute condition that might require antibiotics (e.g., ear infections, strep throat, cellulitis or upper respiratory symptoms).
• You have any new onset of pain or recent injury.
She says gynecology is best suited if:
• You have any questions or concerns regarding the female reproductive system, including breasts, uterus, ovaries and vulva. It also can include some urological or gastrointestinal symptoms.
• You have any menstrual, pregnancy, fertility or contraception questions or issues.
• You have any sexual health concerns (e.g., libido, pain or abuse).
• You are seeking a preventive health exam and age-appropriate screenings.
“There is some overlap in services provided by family medicine and gynecology,” adds DeLuca. “Examples can include birth control, thyroid disorder and mood changes. In these cases, it’s best to start with whomever you feel most comfortable with, and then that provider can guide you further if they cannot fully address your concerns.”
AT WHAT AGE SHOULD A FEMALE SEE A GYNECOLOGIC PROVIDER?
“Between the ages of 11 and 18, a female could potentially see a pediatrician, a family practice provider and/or a gynecology provider,” says DeLuca.
Most health care needs can be addressed by Family Medicine or pediatric providers. However, DeLuca there are instances when it would be appropriate to have a younger patient see a gynecologic provider, such as:
• Delayed puberty (no breast tissue changes before 14) or delayed menarche (no menstrual cycles prior to 16)
• Painful menstrual cycles, especially if missing school or activities due to symptoms
• Unable to wear a tampon
• Any sexual health concerns or contraceptive needs
WHEN TO BEGIN PAP SMEARS
It’s important to understand Pap smear screening recommendations have changed numerous times over the past decade. As a result, many mothers remain uncertain as to when their daughters should begin screening. The current recommendation is to begin Pap smear screenings at 21, regardless of sexual activity or birth control needs.
“There are times when a pelvic exam (evaluation of the genitalia) might be warranted, but this is not for Pap smear screening purposes,” says DeLuca. “Additionally, the HPV vaccination is recommended during the teenage years to help prevent cervical cancer in the future.”
Your health care provider can give you more information regarding HPV vaccination at your appointment.