Amanda N. Thomas, M.D.
OB/GYN visits are important for women at every age.
For many women, making an appointment with an obstetrician/gynecologist can be intimidating. Some women may even delay their first visit because of fears, anxieties or misconceptions. The truth is, visiting an OB/GYN is important for women at every age, and the earlier a woman gets started with her annual visits the better.
“There are lots of reasons to see a gynecologist annually,” says Dr. Amanda Thomas, an OB/GYN at East Jefferson General Hospital. “OB/GYNs are trained to treat and diagnose problems that other doctors may not be trained to recognize. By starting early and continuing with annual checkups, you are allowing a baseline to be established that will ensure your future gynecological health. With a baseline, any changes or areas of concerns are more likely to be revealed during your annual checkup. If there is a problem, early detection is often critical to successful treatments.”
At EJGH, Dr. Amanda Thomas is part of a team of seven other physicians and a Nurse Practitioner who treat adolescent to post-menopausal women for OB/GYN care. “We see women though all stages of their lives, and, on average, we deliver around 700 babies per year,” Dr. Thomas says. “One of the things that is unique about being an OB/GYN is that you have the opportunity to build long-term relationships with your patients. Women want to find someone they can trust to discuss very personal issues. Once this trust is established, it may span generations in the same family.”
Here, Dr. Thomas provides a breakdown of the how OB/GYN’s treat women at every stage of their lives on what she refers to as a continuum of care.
The Early Years: Ages 13 to 21
“We recommend that young women start having an annual visit with an OB/GYN between the age of 13 and 15, although it is not unusual for me to see women in their 20s for their first visit,” she says. “From ages 13 to 21, the annual visit is usually more of a conversation than an exam. In most cases, a pelvic exam is not necessary.”
During these early years, your OB/GYN may discuss contraception and sexually transmitted infections.
“Regardless if the patient is sexually active or not, it is important that young women are given the knowledge they need to protect themselves from infections and unplanned pregnancy,” Dr. Thomas says. At age 21, it is recommended that women have their first Pap smear. Between the ages of 21 and 30, it is recommended that women get a Pap smear every three years to test for cervical cancer.
The Family Planning Years: Ages 22 to 44
Starting at this stage, the annual exam includes a breast exam, an abdominal exam and a pelvic exam. “The majority of my patients in this age group are interested in pregnancy prevention or becoming pregnant,” Dr. Thomas says. “At the annual visit, we’ll talk about contraception options, fertility options, preconception counseling, and what will work for them according to their stage of life and their lifestyle. During this annual check-up, we will check a woman’s vital signs and give the patient a physical examination to check for any abnormalities, such as lumps or painful areas. We will also discuss nutrition, exercise and weight management.”
Starting at age 30, it’s recommended that women start getting tested for human papillomavirus. The HPV test can be done at the same time and from the same sample as the Pap smear. Under current guidelines, the test can be done every three to five years as long as the Pap smear remains normal and HPV is not present. If there are any abnormalities with the Pap smear, the doctor will determine how often the patient should come back for testing.
“If we feel a cyst or lump in your abdomen during your pelvic exam, we will do an ultrasound to determine what it is,” Dr. Thomas says. “Ultrasounds can be done abdominally (outside the body) or transvaginally (inside the vagina). We like to wait until after your cycle to perform an ultrasound because there could be some functional cysts, which may disappear after your cycle. If it is after your cycle and we find a cyst, this could be a sign that there a more significant problem.”
Starting Menopause: Ages 45 to 54
The American College of Obstetrics and Gynecology and the American Cancer Society recommend starting routine mammograms between the ages of 40 and 45. If there’s a strong family history of breast cancer, such as a mother or sibling, the recommendation is to start mammograms roughly 10 years prior to the age the relative had breast cancer.
The average age of menopause is 50 to 52. At this stage in life, many women are having irregular or heavy periods. Their hormones may be fluctuating, leading to typical menopause symptoms, such as night sweats, mood swings and hot flashes. “We’ll talk through all those issues at your annual visit and determine the best course of action to treat your symptoms,” Dr. Thomas says. “We may suggest lifestyle changes (diet and exercise), medication or hormone replacement therapy.”
Age 55 and Onward
Women often encounter more issues with hormone changes at this age range. Vaginal dryness and decreased sexual desire are common. During the annual visit, a woman’s vulva will be examined closely in order to treat and manage skin conditions and potentially detect early stage cancer.
OB/GYN visits should start well before family planning and should not end after the reproductive years. It’s vital for women to pay attention to their health needs to promote wellness through all stages of life. “I find that when women have a relationship with their OB/GYN, it creates a comfortable environment in which patients are able to communicate their health concerns and issues without fear or anxiety,” Dr. Thomas says. “This creates the foundation for good medical care.”
Medical School: St. Louis University School of Medicine
Residency: Obstetrics and Gynecology, LSU, Chief Resident
Memberships: American Medical Association, Junior Fellow American Congress of Obstetricians and Gynecologists, Louisiana State Medical Society
Amanda N. Thomas, M.D.
4228 Houma Blvd., Ste. 410
Metairie, LA 70006