If we're taking care of certain body systems, we don't want to ignore all the rest. Sometimes there's an overlap between PMS and anxiety and depression, and it's hard to tell. So it's OK to bring it up and help tease out whether it seems to be PMS or an ongoing kind of problem.
What does your reproductive healthcare provider need to know about plans for pregnancy?

Before you plan on getting pregnant, it's good to discuss that with your gynecologist. We'd like to know before you're pregnant that you are immune to German measles. It's also important that you take a multivitamin at least a month prior to contraception.

Folic acid can decrease the risk of certain spinal cord and brain abnormalities. We also will usually go over a genetics questionnaire about your family and your partner's family history, looking for things that might be passed along to your child. There are different tests that can be done prior to pregnancy to see if you're at risk of certain gene mutations such as cystic fibrosis and sickle-cell anemia, for example.

Choosing the best possible birth control method

It's really a combination of individual preference and the individual's history and other health issues. It's important that a woman evaluate all the different methods that are available to her.

If you have trouble remembering pills, or if you have a history of blood clots or high blood pressure, then it's not going to work real well for you. For people who have trouble remembering pills, there are patches or vaginal rings, which give them the option of the same hormones without having to take a pill. Some people are very happy with condoms, and if used correctly and consistently, they are a good option.

For people who are pretty sure they don't want a pregnancy in the next five to 10 years, but want to keep their options open, there are good long-term methods, such as IUDs.

And there are permanent methods for people that are really sure they never want to get pregnant. So you have to look at the individual, and how they like to space pregnancies or to prevent them.

A woman should also be aware of the option for emergency contraception to be used if you have unprotected sex or a condom breaks or falls off, so you should preplan for that during the visit.

Do women ever bring up issues pertaining to libido?
I'd say after vaginal infections, it's the most common thing that is discussed. The birth control pills, or estrogen hormones in older women, can decrease libido. When you add that to a very hectic lifestyle, it can be a real problem. So it's important to bring it up.

When should you discuss menopause?

Perimenopause is the time of irregular periods before your periods stop. So if you're having irregular periods, hot flashes or night sweats that are bothersome, it's time to bring that up. If symptoms are interfering with your sleep or your function at work, and if it's a problem for you that you might want to do something about, then it's time to talk to the gynecologist.

Do you have any overall advice for a woman who is preparing for her GYN visit?

Try to schedule routine exams for about the middle of a cycle, usually two weeks after a period starts. If you're having some vaginal discharge or irritation, we need to know that before we do the speculum exam. If you are having any bleeding, or if you've had recent intercourse or put vaginal medicines in the vagina, it may affect the quality of the Pap smear, which is a test to detect cancer or pre-cancerous changes, sexually transmitted diseases or other infections. So basically, it's best to have nothing in the vagina for several days prior to your routine visit. And don't douche, because that washes out cells and other things that we need to see.

I think it's a good idea for every woman to write down when she has periods, so she knows what her cycle length is: how long from the first day of one period to the first day of the next. I think it's important to be sure you write down symptoms and bring them up at the beginning of the appointment rather than after the exam. If you're preparing for your yearly checkup, it's good to write down if you're having any questions. It's very common to get into the doctor's office and kind of forget the little things that you were also needing to bring up. It's not uncommon for somebody to have their exam, be dressed and say, "Oh, I forgot to ask you about.."

The other is to find out how you're going to get the results. What's the practice of the office that you're visiting? Do they always call you with the results? Do they mail you results? Should you call them? If you should call for the results, you should know what time frame to make sure you get the results. Every office is a little bit different, but you want to make sure you understand what to expect.

It's also important to be realistic about what you can take care of at your yearly checkup. You may want to have a separate visit to deal with bigger issues and not try to squeeze it into your yearly checkup.

Christine Haran has been a health journalist for more than seven years, and her work has appeared in Woman's Day, MAMM Magazine, Bride's Magazine, Publishers Weekly and other publications. In 2003, she received an Excellence in Women's Health Research Journalism Award from the Society for Women's Health Research. Haran has a master's degree in journalism from New York University and a bachelor's degree in English from Skidmore College.

Copyright © Christine Haran. Permission to republish granted to Pregnancy.org, LLC.