Aside from an annual checkup, many women, including brides-to-be, don’t often think too much about their female reproductive system when it comes to overall health. Yet, for brides about to embark on the next chapter of their lives, it’s incredibly important to be on top of, and educated about, your health. To learn more, we chatted with Yelena Havryliuk, Assistant Professor of Obstetrics and Gynecology, and Assistant Attending Obstetrician and Gynecologist at NewYork-Presbyterian/Weill Cornell Medicine, for her expert insight.
Musts to Discuss
Most of the time, brides-to-be have two paths for discussion with their ob-gyn: planning for pregnancy or planning for contraception. Take time out to schedule an appointment to discuss and learn your options.
Understanding the family-planning timeline before and after the wedding is important, according to Havryliuk. “If your goal is not to get pregnant, contraception is an important topic, and you should focus on that," she says. "If you’re getting ready to start for pregnancy shortly after the wedding, focus more on that.”
Knowing and understanding your body is extremely important. Prior to family planning, “understand your cycle: the length, duration, and flow patterns, and if they’re normal or abnormal,” says Havryliuk. Additionally, it’s imperative to share your past history with your physician; STIs, STDs, Pap-smear abnormalities, cysts, fibroids, etc., are all important information to share with your doctor, as everyone needs to be on the same page for effective care.
Preparation is key, especially if you’re planning on starting a family. Any concerns over past medical histories or any unusual symptoms should be reported and discussed at a preconception appointment. Havryliuk remarks that in addition to reviewing any history, “heavy periods, painful sex, bleeding after sex, prior surgeries for cysts or ectopic pregnancies, or any abnormal findings from exams” should be noted and explored, and "it’s reasonable to have a bit of a workup to understand what’s going on.”
Sometimes, screenings or adjustments should happen before starting a family too. “While there’s no particular screening I’d absolutely recommend or prefer," says Havryliuk, "it’s reasonable to consider a few things based on history.” These types of screenings include recent testing for STIs that should be treated and can really affect reproductive organs. Additionally, routine screening for thyroid disease, autoimmune disorders, and/or diabetes, based on symptoms or family history, could also be a good idea for some women.
Genetic testing and screening is also an option. In the past, these tests were often ethnic-specific, yet it is now becoming increasingly difficult in a multicultural environment to accurately identify patient ancestry. A fairly new recommendation from the American Congress of Obstetricians and Gynecologists (ACOG) is that genetic screenings be offered more broadly. “Ideally, it’s a prepregnancy carrier screening that allows partners to be tested before pregnancy to understand reproductive risk, and it’s important,” says Havryliuk. After you've completed such screenings, if you find you have or carry the same condition as your partner, then you can understand and explore your options, which could include fertility treatments such as preimplantation genetic diagnosis (PGD). While you can also obtain these screenings once you are pregnant, “in an ideal world, this should be done ahead of time. It’s not mandatory, but it’s something to discuss as an option, especially for those with risk factors or unknown medical histories. Talking and learning and thinking are very important,” she explains.
In general, most pregnancies are still unplanned. So even if you’re planning ahead for a baby, it’s important to assess certain lifestyle habits and other factors that could play a role in pregnancy. When speaking with your ob-gyn, you might be counseled about weight—carrying excess or being underweight, as they can both affect a healthy pregnancy. Additionally, lifestyle habits such as smoking, drinking, drug use, and fitness routines should all be discussed, as well as improvements, cessations, and changes to make prior to conception. The doctor suggests, “Make healthy changes before conception so that they become habits and your body gets used to it. Weight control and exercise ahead of time is critical.”
It’s also important to disclose any other medical conditions and medications that are common, such as for diabetes and depression, as you may need to make changes or alterations in medication. Doing so pre-pregnancy, instead of during, is ideal. Additionally, folic acid and prenatal vitamins prior to pregnancy are essential. Those with dietary restrictions, such as vegetarians or vegans, may consider an iron supplement too. Also, make sure your vaccinations are up to date, as not all are safe to get when you're pregnant.
“Most couples find out they are pregnant when they are already pregnant, and organs are formed (or forming) at that time,” says Havryliuk, so being as prepared as possible can go a long way in fostering a healthy pregnancy.
Know Your Cycle
A basic understanding of your reproductive cycle is important to all women, regardless of plans. “Many people are unaware of their menstrual cycle and how it’s tracked and when ovulation happens,” explains Havryliuk. “It’s good practice to track your periods and understand ovulation patterns. Normal cycles are 24 to 25 days, and most people have periods that last three to five days, and no longer than six. Anything too short or too long should be addressed.”
Also, remember that timing is everything when it comes to tracking. “Day one is the first day of menstruation," says Havryliuk. "A lot of women think day one starts at the end of your period, and it’s a common myth.” Ovulation (your fertile time) happens approximately two weeks before your next menstrual cycle, so “if our cycle is 28 days, you ovulate around day 14. If it's shorter, maybe cycle day 10. If longer, it could be day 19 or 20. Smartphone apps help to track your cycles and are an easy way to know your body,” she suggests.
When it comes to your body and your health, knowledge is power. Regardless of your goals, be sure to discuss any and all questions and concerns with your doctor, and stay on top of your health.