Caring for a Woman's Body: What Every HIV-Positive Woman Should Know About the Care and Prevention of GYN Problems

How to Prepare for Your GYN Care Appointment: A Checklist and Questions for Your Provider

There are many things you can do to make your appointment with your GYN provider a smoother, easier, and more helpful visit.

Preparing Your Body

To get the best results from the physical exam part of your visit, it is important to do the following:

• Make sure you will not have your period during your visit; it is best to schedule your exam for one to two weeks after your period
• Do not douche or use other vaginal preparations for two to three days before your exam
• Do not have vaginal sex or sexual intercourse for 24 hours before your exam

Preparing for Your Provider's Questions

Your GYN care provider will ask you several questions about your sexual and medical history. These questions are not meant to pry or criticize, but to gather important information to make good decisions about your health. It may be helpful to think about your answers before your appointment. Be prepared to answer the following questions:

• When did your last period begin?
• How long do your periods last?
• How often do they occur or how many days between periods?
• When did you have your last GYN exam (if you are seeing a new GYN provider)?
• Have you ever had any abnormal Pap smears or Pap test results in the past? If you have, your provider will likely ask you when you had those abnormal test results, what those results were, and what treatments you received. You may find it easiest to bring copies of the reports. If you do not have copies of the reports, bring your previous GYN provider's contact information so that your new provider can get your past medical records from your old provider. You will likely be asked to sign a medical release form that gives your new provider permission to ask your old provider for your medical records.
• Have you noticed any changes in your menstrual cycle or periods (in amount, frequency, or duration)?
• Have you noticed any vaginal discharge?
• Have you had any lower belly or pelvic pain?
• Have you noticed any blood after sex or between periods?
• What other drugs and medications are you taking (including your HIV drugs)? For each drug, be sure to write down the name, dose, number you take, and when you take it. If you aren't sure about your list or you are running late, put all your medications in a bag and bring them to your appointment so your provider can see exactly what you are taking. Make sure you also tell your provider about any other treatments or remedies you are taking -- over-the-counter medications, herbal supplements, vitamins, teas, etc.

Preparing Your Questions

Whether or not you feel comfortable going to your GYN appointment, it is important that you write out a list of questions you want to ask your health care provider. Many women find it difficult to remember to ask their questions given all that goes on during the visit: the exam room, the change of clothes, the physical exam itself, and all the questions the provider asks! This is your opportunity to raise concerns and ask questions about the health of your body, so be ready with your list.

Things you may wish to talk about with your GYN provider:

• Getting vaccinated against Hepatitis A, Hepatitis B, or HPV
• Questions about birth control and contraceptive use
• How to improve the safety and satisfaction of your sex life
• Menstrual irregularities (amount, frequency, duration)
• Urinary incontinence or frequency (leaking urine or feeling that you need to urinate often)
• How having been abused or assaulted (sexually or otherwise) in the past might affect your health now; while a potentially very uncomfortable thing to talk about, mentioning past trauma may help your provider better understand your symptoms and history and make a more accurate diagnosis
• Things you can do to maximize your GYN and overall health
• How you will communicate with your provider after your visit, including if and how your provider will let you know the results of your exam

If you have just had your GYN exam, congratulations! You have just done one of the most important things an HIV+ woman can do to keep herself healthy. Regular GYN exams and Pap smears are crucial to your health since many GYN conditions do not have obvious symptoms and can get worse without your realizing it. Finding and treating GYN conditions in the early stages can prevent them from becoming more serious conditions later.

If your health care provider is not skilled in GYN care, or you would rather see a specialist, ask for a referral to a GYN care provider who is experienced in treating women with HIV. If you receive GYN care from someone who is not your HIV provider, be sure that your HIV provider is aware of results from your Pap smear, other GYN tests, and any treatments you might be taking for GYN conditions.