Hey, What’s It Like Being A Gynecologist?

After nine years at Brooklyn’s New York Methodist Hospital, OBGYN Josine Veca has seen it all. Here she gives The Frisky her diagnosis of what women want when they stop by.

What are common concerns for women when they come to see you?
It varies by age group. Younger patients, 30 and below, are usually concerned with STDs, birth control, or, if not, trying to prevent pregnancy. As the women get older and are approaching menopause, they’re worried about hot flashes, irregular periods, and symptoms that may be unusual. I’d estimate that 30 to 40 percent are concerned with a mixture of those issues.

How much prying do you have to do or do most women come in with their own specific questions?
A lot of women who come in with their own questions are very comfortable talking about sex. But if they don’t, the subject usually comes up when I’m interviewing them. At first they may be tentative, but the idea is to open communication
Do a lot of women come to you with problems about sex or intercourse?
It’s not a major concern with a lot of women, but some do have problems with sex, like discomfort, pain, or a lack of a sex drive. Sex drive is really hard to evaluate because there are lots of factors – sometimes, there might not be anything physical at play. If there are problems in the relationship itself, I refer them to a therapist. However, if a patient complains about experiencing pain during penetration, she may have a cyst or fibroid. One thing I get a lot of is questions about female Viagra. Unfortunately it doesn’t exist yet, but they are doing research.

What are the most common STD’s you see in women?
The most common STD’s are definitely gonorrhea and Chlamydia…mostly Chlamydia, and those are both treatable. Usually when I tell someone that they have one of those STDs, they initially suspect that their partner has cheated. But they’re always relieved to hear that they’re both treatable.

Are there any particularly unusual questions people have asked?
There was once this woman who put a clove of garlic in her vagina because she thought that was a good home treatment for a yeast infection – the truth is you’re supposed to eat it, not insert it! It’s actually a bit of an old wives tale. The best way to cure a yeast infection without medicine is to take acidophilus, because it repairs the imbalance in our vaginal bacteria. Yogurt has acidophilus in it as well, but it’s better to take the pill.

Do women come in for Plan B, the morning after pill?
Usually they’ll come in and ask for it because they don’t want to get stuck in a bind. We always counsel women not to use as a birth control method, and that it’s really only for emergencies.

What are some things women should know about Plan B?
Well women should know that the pill needs to be taken within 72 hours of intercourse and that it will make your period irregular and you might have some strong hormonal reactions.

Do you think most women are aware of their risk for cervical cancer and regularly get the proper test?
HPV and the HPV vaccine are both big issues with the younger population. The vaccine is now widely advertised and people are finally asking about it and seem much more aware of what HPV is. People more aware in general.

So, can you explain how a woman can get cervical cancer?
Well, the first sign is when a woman has abnormal pap smears which we know are attributable to HPV. The good news is we can now test for it. If you have HPV it can cause cervical cancer 15 or 20 years down the road, but knowing about the HPV means that you can treat and prevent cervical cancer by having very regular pap smears. Also, HPV can clear up on it’s own.

Let’s talk about breast cancer. At what age should women start getting mammograms?
There are different views on the subject but most agree that women should get mammograms every year after they turn 40, though some say ever two years. But if you have a family history, you should start getting mammograms at 35. Younger women don’t usually bother with mammograms because their breast tissue is denser so the test won’t penetrate as well.

What is the most common reason women come to see you?
Most women come in once a year for a pap smear and at that time we’ll also renew their birth control prescription. Usually, I’ll start them on a basic low dose pill and see how they respond. There are a lot of very good low dose pills that have a variety of benefits, like if a woman has severe premenstrual symptoms, I’d recommend Yaz.

Why did you choose to become an OBGYN?
I love it. I guess it came as a result of working for an inner city hospital and doing baby deliveries left and right. I had a lot of empathy and compassion for my patients and it was nice seeing those kids again over the years. I like taking care of people. I get to go to other countries to do medical work. It’s a great field. It’s a life-giving field. My older sister is a social worker who works with people who are close to dying. It’s an interesting contrast.

Do you think most women prefer having a male or female OBGYN?

A lot of women prefer to have a woman. Some older women are used to male gynecologists because that’s what they grew up with in the late 60s and 70s. But younger women are much more interested in seeing a female doctor, because they think women relate to them better. But there’s an increasing trend now of more women in the field and not as many men.