"I have a patient who has been
coming to me for 30 years, since she was a teenager,” said Dr. Brooke Trenton,
Medical Director at Ryan Health | Women and Children’s. “Now I’m seeing her
daughter too!”
Dr. Trenton’s story underscores the importance Ryan Health places on developing a relationship with your provider throughout your life. That is especially true with the broad field of women’s health.
Puberty and the Teen Years
“Women’s health” begins at age 8 or 9 for many girls, with the onset of puberty. A pediatrician sees girls at that age, but that’s where conversations about the changes that a girl’s body will experience start. Our doctors want the parents or caregiver and the girl to know what to expect when she starts having her period. Making sure all are comfortable with the child’s physical development is important.
When a girl turns 13, she is
slightly more autonomous in her relationship with our providers. During visits,
we’ll ask the adults to step out of the room so our providers can ask about
contraception, mood changes, friends, and relationships — things that a teen
might not be comfortable discussing with the adults in her life. These are
conversations in which the topics are eased so we can explore their knowledge.
Discussions of sexual relations
and STIs are developmentally appropriate. Providers will access the teens’
knowledge and questions regarding sexual health and related issues. Our goal is
to gently navigate where they are in their lives so they are comfortable asking
questions.
Teenage girls should know that
they don’t have to be a Ryan Health patient to see our providers. They can walk
into any of our centers to seek help.
We will discuss sexual issues and
birth control throughout their teen years when it is appropriate. There is
long-term birth control products and procedures that eliminate the need for
daily pills, and those may be a better option for them.
Also, many women experience heavy
or irregular bleeding during their periods or pain during menstruation.
Historically, women will suffer for years without knowing there are procedures
or medications to ease the pain. We want women to know we will treat the
underlying cause to make their period more manageable.
Young Adulthood and the
Reproductive Years
At age 21, women no longer see a
pediatrician but rather the OB-GYN. They will receive an annual PAP smear to
check for cervical cancer. Throughout their reproductive years they’ll also
have their gynecological exam and check on their periods. For many women, this
is the only healthcare they get or need — the OB-GYN is their primary
healthcare provider.
“Most women ask for a female
OB-GYN,” says Cathy Mota, Director of Women’s Health at Ryan Health | Women and
Children’s, NENA, and West 97th Street. “All of our providers,
whoever they are, deliver expert care and understand the specific needs of our
female patients.”
Ryan Health providers will always
ask women about contraception and family planning. Preconception counseling is
not something that many women know about, but our providers will help guide
them with advice and resources. The “best” time for pregnancy varies for
everyone. However, being pregnant is complicated and requires a lot of give and
take with where women are in their lives.
Menopause
One of the most daunting phases
of life for women is menopause. It’s not something to be afraid of, however.
There are many symptoms and changes in the body, including discomfort. But
medications can help alleviate some of the pain. Menopause varies from woman to
woman. There will be changes to their period; some women will experience hot
flashes or sexual dysfunction due to vaginal dryness or have trouble sleeping.
These changes happen due to the hormones in the body being suddenly withdrawn.
Talking about menopause is key. Many women are unaware of vaginal estrogen, which
can relieve the symptoms of sexual discomfort.
Gender Affirming Care
Another key aspect of Ryan Health
is our focus on gender-affirming care. We can provide that care beginning with
pediatrics and at the onset of puberty. People transition throughout their
lives when comfortable, so we understand the time it takes to get there. We are
one of the few centers that provide care to trans men who are pregnant. Several
providers throughout New York City refer their trans patients to us because we
are unique in providing this service.
Ryan Health understands that
healthcare is most useful when people know what to expect about their bodies
and life stages. These are natural processes that should not have shame or
stigma attached to them.