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St. Clair Hospital's Dr. Paula Duncan: When to See Your OB/GYN
By Nancy Kennedy

Dr. Paula DuncanFor women, regular OB/GYN (obstetric/gynecologic) care is an essential aspect of a healthy life. OB/GYN physicians provide the preventive care and screenings that women need in order to remain healthy; they guide women through pregnancy, monitoring their health and helping them produce a healthy baby; and they treat a broad range of problems and disorders unique to women. A woman's relationship with her OB/GYN can be a key factor in her overall health and quality of life, throughout her life, from adolescence through her senior years.

There are several components to OB/GYN care for most women, says Paula Duncan, M.D., an OB/GYN who practices with the Paul M. Zubritsky and Patrick Christy Group at St. Clair Hospital. The first is an annual OB/GYN visit; the second is seeing her OB/GYN when problems arise or she experiences anything abnormal; and the third is a pre-conception visit, to prepare for becoming pregnant.

"Every woman should see her OB/GYN for an annual visit," Duncan says. "We want to first see a young woman when she becomes sexually active, or preferably before, so that we can discuss contraception and sexually transmitted diseases (STDs) with her. We recommend annual visits for all women beginning at age 21; according to the new guidelines, annual Pap smears are not necessary for everyone, but you should come in for an exam and counseling." Duncan says that for young women, an annual OB/GYN visit includes a breast exam, pelvic exam, STD screening and contraception counseling. For older women, it also covers screening for bone health, mammograms, colonoscopy and bladder problems. "It's a lot to cover, and each woman's needs are different. I'm interested in her overall health and well-being, including her emotional and sexual health. Sexual function is closely correlated with a woman's emotional health. I try to spend as much time as possible with each patient in the annual visit; I want to have time for a conversation, to find out what's going on in her life. Sometimes, there are concerns, but she may be unsure of how to bring them up. I've learned that I can ask indirect questions that bring these issues to the surface so we can talk about them."

When problems arise, Duncan says, women should call and make an appointment as soon as possible: "Don't let it go until you have your annual visit. If you do that, not only are you delaying care for something that may need immediate treatment, but you are also going to take away valuable time from the annual visit. A lot can be lost in the annual visit if we have to focus on a problem. Call and make a separate appointment; we can get you in quickly if you are experiencing a problem." Problems that require a separate visit include post-menopausal bleeding; recurrent post-coital bleeding; exposure to an STD; an unusual discharge, especially if accompanied by itching and burning; pelvic pain; any problem with the breasts; or a significant change in the pattern of the menstrual period.

Duncan and her colleagues strongly recommend a third type of visit: a "pre-conception" visit for women who are planning to become pregnant. "It's incredibly important to do this before you start trying to conceive. We can identify risk factors and can get you started on prenatal vitamins before conception. Research has shown that just 18% of women see the OB/GYN for a pre-pregnancy visit, so most women don't realize the value of this. Being pregnant and delivering a baby is one of the most important things you will ever do, and it's the hardest event ever for your body." Pre-conception visits are a way to help a woman get her body in the best possible shape for pregnancy. For some, this may mean addressing weight issues, which can affect fertility. "Extremes of weight – obesity and extreme thinness or low body fat - can both affect fertility," Duncan says. "A pre-conception visit is an opportunity to talk about that and offer counseling and referrals. We also discuss how long a couple should try to conceive before wondering if fertility might be a problem."

OB/GYN care is a combination of many things: primary care, preventive care and specialty care. Ideally, every woman should have "her" OB/GYN physician, with whom she has a relationship of mutual trust and respect. For Duncan, annual visits with her patients build and solidify that relationship. "I view my patients as partners, and I want to help them develop healthy habits, including preventive care and screenings, that will keep them as healthy as possible throughout the lifespan. In that spirit, I'm planning to begin teaching health education classes for women at St. Clair Hospital this year, to help women understand and appreciate their bodies and especially their reproductive systems."

To make an appointment with Dr. Paula Duncan, call one of the following office locations: Mt. Lebanon: (412) 788-1330, Robinson Township: (412) 788-1330 and Kennedy Township: (412) 331-1623

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