When Is It Time To See A GYN Specialist?
It is vitally important for women to see a gynecologist throughout their lives. But how often should they go? What is a pap smear? And what are some of the best ways to maintain a healthy reproductive system? Hear the answers to these questions and more from UM Capital Region Health's Dr. Briana Walton.
Featured Speaker:
Dr. Walton offers her patients compassionate care and individualized treatment plans for a wide range of conditions including overactive bladder and urge incontinence, bowel leakage and fecal incontinence, pelvic organ prolapse, fibroid complications, and urinary tract infection.
Briana Walton, MD, MPS BAD, FACOG
Dr. Briana Walton attended medical school at the University of Cincinnati College of Medicine. She trained at the University of Cincinnati College of Medicine for her OB/GYN residency where she developed a particular interest in treating patients with pelvic floor disorders. She completed Urogynecology and Pelvic Reconstructive Surgery fellowships at Harvard Medical School.Dr. Walton offers her patients compassionate care and individualized treatment plans for a wide range of conditions including overactive bladder and urge incontinence, bowel leakage and fecal incontinence, pelvic organ prolapse, fibroid complications, and urinary tract infection.
Transcription:
When Is It Time To See A GYN Specialist?
Maggie McKay (Host): Welcome to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical system. We put knowledge and care within reach, so you have everything you need to live your life to the fullest. This episode is sponsored by UM Capital Region Health, the largest healthcare provider in Prince George's county, dedicated to enhancing the health and wellness of the community by providing high quality accessible patient care. UM Capital Region Health, changing up healthcare in Prince George's County.
Today, we're talking about when it's time to see a GYN special. I'm your host. Maggie McKay. Joining me today is Dr. Briana Walton, urogynecologist at UM Capital Region Health. Welcome, doctor. It's so good to have you.
Dr Briana Walton: Thank you, Maggie. I appreciate you having me.
Maggie McKay (Host): What an interesting topic. Doctor, what is a GYN specialist and how do we know when we need to see one?
Dr Briana Walton: Well, as you mentioned, I'm a urogynecologist. And so I deal with what I usually describe as the Bs, the bladder issues, bowel issues, and the bulging issues below the belt. But there are other GYN specialties that I should mention just quickly. So, minimally invasive GYN surgery really deals with women who are going to have some sort of surgical intervention and don't want to have a large incision. We also have a subspecialty for women who are unfortunately dealing with cancer, so a GYN oncologist. And if women are having problems with pregnancy, a reproductive endocrinologist. So those are the subspecialties of gynecology.
And your question was when should woman see one of us? Well, I think it really depends on her symptoms. It depends on the comfort level of her referring gynecologist. It depends on availability. Not every city, location has a specialist. One of the advantages of telemedicine now is that most of us are accessible through that portal, and so we can be reached even if someone is in another city or state.
Maggie McKay (Host): Great. Pap smears were once recommended annually. But more recently, the CDC advises having a Pap smear once every three years. Which advice is correct?
Dr Briana Walton: Maggie, that's a great question. I get that a lot for women, a lot from family members. Like, "Why is it three years now? Is it just that they don't want to see us anymore?" It's based on the science and one of the things that we've seen over time, so for my training, back in the '80s, we were doing annual pap smears because the accuracy of a Pap smear was limited. How well you could detect the disease and/or rule out cancer was somewhere between 50% to 90%. And so you had to do annual screenings in order to figure it out. It's like taking a photograph instead of shooting a video. You only get a snapshot of what was going on inside of the vagina and the cervix. When you look at the newer testing and you add to it the ability to detect HPV, human papilloma virus, which is the virus that changes the cervix into more prone, especially if you have a high risk strain. The two of those together really reported out 99% screening sensitivity and specificity, meaning that they're really good at figuring out if you do have or you don't have the disease, so it becomes less necessary to do that part of your screening every single year.
Maggie McKay (Host): Is there any harm in doing it every year? Because I know some old school doctors are still doing it annually.
Dr Briana Walton: I think there's no harm from the standpoint of risk. A lot of concern is if you're overscreening, well, you find something abnormal, and then someone has to have more intervention related to it. Do they have to have a colposcopy? Which is a microscope that you use to see the cervix better. Will they have to have a surgery because of that? And that doesn't usually bore out. The concern is that a lot of insurance companies now are not paying for annual Pap smear screening, so there's out-of-pocket costs to the patient. So I think that's one of the things that we have to start considering in terms of our patients and the women we serve.
Maggie McKay (Host): Right. Well, other than having a Pap smear, what are some other reasons why women should see a GYN specialist?
Dr Briana Walton: Yeah, it's a great question. So I am a doctor and I went to med school, but I went to med school and I said, "I know one thing, I don't want to be an OB-GYN because I don't want to be doing Pap smears all day long." So like, you know, you come in with this concept in your head of what a gynecologist is, but we deal with so much more. Women who have abnormal bleeding, women who have problems with discharge and infections and inflammation. There's more than 8 million women going to the ER or some sort of provider every single year, because they have problems with discharge, whether they have pelvic pain, if they need birth control. Those are a number of issues for our general gynecologist.
In my world, I mentioned urogynecology deals with the Bs. So bladder issues. So if a woman is having urinary leakage or she's going to the bathroom too often, or she can't urinate, or if it's coming out at inopportune times or when she's jumping on the trampoline with her kids, those are reasons for her to see me. If she's having problems with her bowel control, or if there's a change in the anatomy. A lot of women after having a baby experience changes in their vaginal anatomy and they're uncomfortable. They're not feeling the way that they did prior to having their child. And they're wondering, "What is it? What's going on? Why do I feel this way?"
Maggie McKay (Host): So what's the difference between an OB-GYN and a gynecologist?
Dr Briana Walton: So an OB-GYN really still does practice obstetrics, meaning the care of women who are trying to get pregnant or are pregnant, where gynecologists limit their practice to just taking care of women who are not going to have children or not having children at that time. And for many of the symptoms that we talked about before, they manage those problems.
Maggie McKay (Host): Okay. Generally speaking, Dr. Walton, what are some of the best ways to maintain a healthy reproductive system? Because it's so complicated. There's so much involved.
Dr Briana Walton: I would agree. I think the advantage that we have today is that a lot of information is out there on the internet. And you don't hear a lot of doctors promoting "Go on the internet." But I think for women who are curious about what's happening, I have had a number of patients, older women who said, "Doctor, I felt this. I went on the internet and I think I have this problem," and they're right. So the validation of what people are feeling and/or complaining of is part of what we are supposed to do. So being curious, investigating, asking questions, I think that's the first line of defense for a woman to maintain health. And that is not apropos to her reproductive system, it's for anything. But I think they also need to ask more questions when they're in their provider's office about not just "What do I do if I have a problem?" "How do I prevent problems from occurring? What do I do to help my kids make sure they don't get these problems?" So I think asking more critical questions is a really important concept that we continue to encourage.
Maggie McKay (Host): I know every time I go to -- not every time -- but I try to remember to take a written list, because I know once I get in there, I forget half of what I wanted to ask. You know, it's just like, "Oh," and then and I'm like --
Dr Briana Walton: You'll be happy to know so do I.
Maggie McKay (Host): It doesn't hurt to be prepared, right? Dr. Walton, are there any other takeaways that you'd like to share with our audience that you think they need to know?
Dr Briana Walton: Well, I think what you just said is really important. Come in with a list of questions, because we are sometimes in those screening environment, when those appointments are relatively short. You don't have a long time to address a lot of things. And so to be able to write them, those questions, so that your provider can answer them. And if sometimes they don't have time, because of our portals and our electronic records, we can send the information back to you in a protected environment where people can get sensitive questions answered. So I would just say continue to be a good steward of your own space by asking really good questions about your body.
Maggie McKay (Host): And also maybe don't be embarrassed. I've heard people say they don't go to the gynecologist that often, because they're just too embarrassed to ask certain questions and I think, "No, You have to go."
Dr Briana Walton: You are so right. You are so right. And I think that's my goal is when I come in a room, I'm trying to disarm somebody and make them feel so comfortable because I don't want them to feel like it's just an exam room. I want them to feel like it's a sacred space and they can say anything they want to.
Maggie McKay (Host): That's awesome. Thank you so much, Dr. Walton, for being here today and sharing your expertise. This has been so informative.
Dr Briana Walton: Thank you very much, Maggie, for having me.
Maggie McKay (Host): Absolutely. That's Dr. Briana Walton, urogynecologist at UM Capital Region Health.
Find more shows like this at umms.org/podcast. Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again. I'm Maggie McKay. Be well.
.
When Is It Time To See A GYN Specialist?
Maggie McKay (Host): Welcome to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical system. We put knowledge and care within reach, so you have everything you need to live your life to the fullest. This episode is sponsored by UM Capital Region Health, the largest healthcare provider in Prince George's county, dedicated to enhancing the health and wellness of the community by providing high quality accessible patient care. UM Capital Region Health, changing up healthcare in Prince George's County.
Today, we're talking about when it's time to see a GYN special. I'm your host. Maggie McKay. Joining me today is Dr. Briana Walton, urogynecologist at UM Capital Region Health. Welcome, doctor. It's so good to have you.
Dr Briana Walton: Thank you, Maggie. I appreciate you having me.
Maggie McKay (Host): What an interesting topic. Doctor, what is a GYN specialist and how do we know when we need to see one?
Dr Briana Walton: Well, as you mentioned, I'm a urogynecologist. And so I deal with what I usually describe as the Bs, the bladder issues, bowel issues, and the bulging issues below the belt. But there are other GYN specialties that I should mention just quickly. So, minimally invasive GYN surgery really deals with women who are going to have some sort of surgical intervention and don't want to have a large incision. We also have a subspecialty for women who are unfortunately dealing with cancer, so a GYN oncologist. And if women are having problems with pregnancy, a reproductive endocrinologist. So those are the subspecialties of gynecology.
And your question was when should woman see one of us? Well, I think it really depends on her symptoms. It depends on the comfort level of her referring gynecologist. It depends on availability. Not every city, location has a specialist. One of the advantages of telemedicine now is that most of us are accessible through that portal, and so we can be reached even if someone is in another city or state.
Maggie McKay (Host): Great. Pap smears were once recommended annually. But more recently, the CDC advises having a Pap smear once every three years. Which advice is correct?
Dr Briana Walton: Maggie, that's a great question. I get that a lot for women, a lot from family members. Like, "Why is it three years now? Is it just that they don't want to see us anymore?" It's based on the science and one of the things that we've seen over time, so for my training, back in the '80s, we were doing annual pap smears because the accuracy of a Pap smear was limited. How well you could detect the disease and/or rule out cancer was somewhere between 50% to 90%. And so you had to do annual screenings in order to figure it out. It's like taking a photograph instead of shooting a video. You only get a snapshot of what was going on inside of the vagina and the cervix. When you look at the newer testing and you add to it the ability to detect HPV, human papilloma virus, which is the virus that changes the cervix into more prone, especially if you have a high risk strain. The two of those together really reported out 99% screening sensitivity and specificity, meaning that they're really good at figuring out if you do have or you don't have the disease, so it becomes less necessary to do that part of your screening every single year.
Maggie McKay (Host): Is there any harm in doing it every year? Because I know some old school doctors are still doing it annually.
Dr Briana Walton: I think there's no harm from the standpoint of risk. A lot of concern is if you're overscreening, well, you find something abnormal, and then someone has to have more intervention related to it. Do they have to have a colposcopy? Which is a microscope that you use to see the cervix better. Will they have to have a surgery because of that? And that doesn't usually bore out. The concern is that a lot of insurance companies now are not paying for annual Pap smear screening, so there's out-of-pocket costs to the patient. So I think that's one of the things that we have to start considering in terms of our patients and the women we serve.
Maggie McKay (Host): Right. Well, other than having a Pap smear, what are some other reasons why women should see a GYN specialist?
Dr Briana Walton: Yeah, it's a great question. So I am a doctor and I went to med school, but I went to med school and I said, "I know one thing, I don't want to be an OB-GYN because I don't want to be doing Pap smears all day long." So like, you know, you come in with this concept in your head of what a gynecologist is, but we deal with so much more. Women who have abnormal bleeding, women who have problems with discharge and infections and inflammation. There's more than 8 million women going to the ER or some sort of provider every single year, because they have problems with discharge, whether they have pelvic pain, if they need birth control. Those are a number of issues for our general gynecologist.
In my world, I mentioned urogynecology deals with the Bs. So bladder issues. So if a woman is having urinary leakage or she's going to the bathroom too often, or she can't urinate, or if it's coming out at inopportune times or when she's jumping on the trampoline with her kids, those are reasons for her to see me. If she's having problems with her bowel control, or if there's a change in the anatomy. A lot of women after having a baby experience changes in their vaginal anatomy and they're uncomfortable. They're not feeling the way that they did prior to having their child. And they're wondering, "What is it? What's going on? Why do I feel this way?"
Maggie McKay (Host): So what's the difference between an OB-GYN and a gynecologist?
Dr Briana Walton: So an OB-GYN really still does practice obstetrics, meaning the care of women who are trying to get pregnant or are pregnant, where gynecologists limit their practice to just taking care of women who are not going to have children or not having children at that time. And for many of the symptoms that we talked about before, they manage those problems.
Maggie McKay (Host): Okay. Generally speaking, Dr. Walton, what are some of the best ways to maintain a healthy reproductive system? Because it's so complicated. There's so much involved.
Dr Briana Walton: I would agree. I think the advantage that we have today is that a lot of information is out there on the internet. And you don't hear a lot of doctors promoting "Go on the internet." But I think for women who are curious about what's happening, I have had a number of patients, older women who said, "Doctor, I felt this. I went on the internet and I think I have this problem," and they're right. So the validation of what people are feeling and/or complaining of is part of what we are supposed to do. So being curious, investigating, asking questions, I think that's the first line of defense for a woman to maintain health. And that is not apropos to her reproductive system, it's for anything. But I think they also need to ask more questions when they're in their provider's office about not just "What do I do if I have a problem?" "How do I prevent problems from occurring? What do I do to help my kids make sure they don't get these problems?" So I think asking more critical questions is a really important concept that we continue to encourage.
Maggie McKay (Host): I know every time I go to -- not every time -- but I try to remember to take a written list, because I know once I get in there, I forget half of what I wanted to ask. You know, it's just like, "Oh," and then and I'm like --
Dr Briana Walton: You'll be happy to know so do I.
Maggie McKay (Host): It doesn't hurt to be prepared, right? Dr. Walton, are there any other takeaways that you'd like to share with our audience that you think they need to know?
Dr Briana Walton: Well, I think what you just said is really important. Come in with a list of questions, because we are sometimes in those screening environment, when those appointments are relatively short. You don't have a long time to address a lot of things. And so to be able to write them, those questions, so that your provider can answer them. And if sometimes they don't have time, because of our portals and our electronic records, we can send the information back to you in a protected environment where people can get sensitive questions answered. So I would just say continue to be a good steward of your own space by asking really good questions about your body.
Maggie McKay (Host): And also maybe don't be embarrassed. I've heard people say they don't go to the gynecologist that often, because they're just too embarrassed to ask certain questions and I think, "No, You have to go."
Dr Briana Walton: You are so right. You are so right. And I think that's my goal is when I come in a room, I'm trying to disarm somebody and make them feel so comfortable because I don't want them to feel like it's just an exam room. I want them to feel like it's a sacred space and they can say anything they want to.
Maggie McKay (Host): That's awesome. Thank you so much, Dr. Walton, for being here today and sharing your expertise. This has been so informative.
Dr Briana Walton: Thank you very much, Maggie, for having me.
Maggie McKay (Host): Absolutely. That's Dr. Briana Walton, urogynecologist at UM Capital Region Health.
Find more shows like this at umms.org/podcast. Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again. I'm Maggie McKay. Be well.
.