How to Make The Most of Your Annual OBGYN Visit

When I was doing my undergrad at Johns Hopkins, I planned to become a gynecologist. But my plans changed when I was diagnosed with PCOS and I threw myself into researching nutrition, supplement, and lifestyle biohacks to ease my symptoms. Western medicine didn’t have the tools that would address the root causes of a chronic condition like PCOS, so I struck out on my own.However Western medicine still has important things to offer. Gynecologists bring a set of skills to the table, which are very valuable indeed. I recommend that every woman has a gynecologist and gets an annual checkup. I do.No, you won’t likely hear nutrition and lifestyle advice that is foundational for healing your hormones in the gynecologist’s office (unless you find a very unique integrative practitioner), but you will gain other incredibly valuable things, like access to (and advice on) biometric testing, regular screenings for serious gynecological conditions, and have someone you know, trust, and can get in to see ASAP if a serious problem ever crops up. .To get the most out of your annual visits, however, there are some key things to know before you go.Here’s a step-by-step guide to maximizing your gynecology visits:Step 1: Take the “annual” part of “annual visit” seriouslyIf you’ve decided that a visit once every two or three years is fine enough, think again! Yes, some experts have said that a pap smear might not be necessary every year (and whether you need one annually or not is a decision for you and your doc to make together ), but that is not the only testing that MDs can run, and it is some of the other key tests that make your annual trip worthwhile. (More on those tests in a minute.) So if you’ve been skipping your annual appointment, it’s time to get back on your doctor’s schedule.Step 2: Find the right gynecologist for youThis might be the most important step in this whole list. That’s because the degree of benefit you get from your annual visit is directly related to the relationship you have with your doctor. When it comes to compatibility, it’s essential to raise your expectation on what you deserve. Your doctor might be the smartest person you’ve ever met and also the nicest, but if you have different values when it comes to how you approach health care, don’t hesitate to look for a new practitionerThe first question you want to ask when looking for the right gynecologist for you is: Does this person value what I value? What’s her personal self care practice? For example, some docs are drug-forward. If you also believe in meds as a first approach, this could be a good fit. But if you’re not keen to use pills to address hormonal health issues (and there are good reasons to be skeptical of using pharmaceuticals when addressing hormone issues), you’ll want to look for someone else. In a professional relationship, you are looking first and foremost for someone who shares your values and is interested in taking an approach that you agree with in reaching your health goals.And if you’ve been looking for a doc who is open to non-drug choices but haven’t found one yet, don’t give up. You can find gynecologists who believe that it is your body and your choice, so if you don’t want pills, that’s great. There are docs who will support your desire to work on your symptoms naturally.Step 3: Run some key testsHaving some key tests run every year is one of benefits of your annual visit to the gynecologist. Here are my tips for effective testing:

• Ask your OBGYN for a hormone panel test that includes estrogen, progesterone, FSH (follicle stimulating hormone) and LH and (lutenizing hormone).
• Get the hormone panel test taken during the first few days of your cycle (day 3), if possible.
• Female hormone testing is not reliable if you are taking hormonal birth control! You must be off the pill for at least three months before getting this test
• Have your doctor run a thyroid panel, including TSH, T3, T4, and reverse T3. Most doctors will just test TSH unless you press them to do a more complete panel.
• Get a fasting glucose test and HbA1c, both of which measure how your body handles sugar. Knowing your blood sugar status is critical for healing your hormones.
• Test vitamin D3. Robust levels of vitamin D in the body are required for optimal hormonal health
• Ask for a complete blood panel (the kind you often get an annual physical). This will look at key biomarkers like iron saturation, anemia, red blood cell status, and more.
• Get a C-Reactive Protein test, which indicates levels of inflammation in the body.

It’s important to note that the reference ranges you will see on your test results are often wider than the optimal ranges. So you will want your numbers to be in the quadrant closest to the ideal numbers for that test. For example, many standard HbA1c test results indicate that a number under 5.7 is fine, but many functional and integrative practitioners consider that number prediabetic or diabetic. So if your number is 5.5, for example, that is okay, but if it is 5.1 that is better, and if it is 4.8, you’re a balanced blood sugar superstar.You may also be curious about newer types of tests—for example, stool tests that measure the different types of bugs in your gut or breath tests for small-intestinal bacterial overgrowth (SIBO)—and these tests can be really helpful if you are having specific gut problems or issues where your microbiome might be affecting your hormones. But be aware that these tests must typically be ordered by doctors, but you are on the hook for conducting them at home and paying for them.Step 4: Use tests to track your progressIf you have an active hormone imbalance, I recommend running these key tests every six months so you can track your progress and monitor how the nutrition, supplement, and lifestyle changes you’ve made are moving the needle on your numbers. If your hormone health is stable, I recommend getting tested every year for maintenance. If your doctor balks at running these tests every year, you can order many of them from direct-to-consumer lab services like Quest labs.Step 5: Don’t become obsessed with the numbersYes, data is good—especially when you have a hunch that something is off in your system and you’re being dismissed), but it can be easy to get fixated on the numbers—and before long they are more a source of anxiety than a helpful measure and tool for guidance. My advice is to treat the numbers more as a guide in helping you become an active listener to your own body. Remember that you are getting the data so you can begin to make diet and lifestyle changes so you can see those numbers change!Think of testing as a helpful guide and a great way to validate and affirm the progress you’re making by using the Cycle Syncing method.Step 6: Let testing become less important over time, as you learn to listen to your bodyIf you keep listening to your body, you may need to rely less on testing over time. At the same time, you may want to continue annual testing even if your numbers have been stable for a long time. This allows you to take action right away if your numbers start to trend in an unhealthy direction.For example, when you first start running tests, you might discover that something is off with your system because the test said so. But, over time, you’ll be able to tell that something is off in your system because you are in tune with your body. You can feel that something off. Then you validate your feelings with testing.Sometimes the changes you’ll see in the numbers will be small, but they give you a warning sign to take action now before things become a crisis. When you see the numbers in black and white, you can take action right away by cycle syncing your food, supplements, and lifestyle. You can get in front of the 8 ball.Simply put, regular testing allows you to better understand how your body works and to respond sooner.Step 7: If you experience a sudden or dramatic change in hormonal health status, call your gynecologist ASAPFood and lifestyle biohacks can be used to address most hormonal health imbalances, but if you suddenly experience shooting pains, or if you feel a mass in your abdomen or have other dramatic symptoms, this isn’t a time for magnesium supplement! It’s time to schedule an appointment with your trusted gynecologist. My greatest hope is that trouble like this never strikes, but if it does, it can make a huge difference to have someone you already know and trust in your corner.Always remember, that once you have the right information about how your body really works, you can start making health choices that finally start to work for you! You can do this – the science of your body is on your side!

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