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This week, the Sexpert interviewed Margaret Nachtigall ’84, MD, an obstetrician and gynecologist based in New York City. She majored in biology at Princeton and went to medical school at NYU. She did her residency in obstetrics and gynecology at NYU and then had a fellowship at Yale in reproductive endocrinology, and she was kind enough to answer some questions relevant to college students.

Sexpert: What is your specialty?

Dr. Nachtigall: I do obstetrics and gynecology, specifically reproductive endocrinology.

S: When would you recommend that a person with a cervix begins to see a gynecologist?

Dr. N: The American College of OB/GYN recommends that a person start a relationship with a gynecologist first between ages 13 and 15. However, it is not necessary to have a Pap smear until age 21. This means that a pelvic exam is not necessary at every visit. If a person is having any abnormal bleeding or irregular discharge then an exam should be done prior to age 21.  In other words, the first GYN visit should occur before age 21, but varies from person to person. If a person is sexually active, then they should begin seeing a gynecologist.

S: How often do you need to see a gynecologist? Are there any “emergencies” for which you would recommend seeing a gynecologist as soon as possible?

Dr. N: Usually it is recommended that people see a gynecologist once every year. However, there are instances where it is important to increase that frequency. For instance, if a patient has irregular bleeding or pelvic pain or a vaginal discharge. GYN emergencies do exist. Some examples of situations where a person should seek immediate care include the presence of pelvic pain and/or abnormal bleeding or a suspicion of pregnancy. If a person is pregnant and has pelvic pain or irregular bleeding I would recommend seeing a doctor immediately.  One should seek medical attention if they are suspicious of an infection.

S: Do college students need to have their own gynecologist outside of school, or are checkups with a school’s health center sufficient?

Dr. N: Most student health centers do a very good job of screening for sexually transmitted infections and routine GYN care. However, many people prefer to have their own gynecologist outside of school. As long as the patient is comfortable asking questions and having regular exams either option is appropriate. 

S: What do you think that every college student should know about sexual health?

Dr. N: Be safe! Use a condom [or other barrier method]. I think every college student should know that there are always people available who can answer their health as well as sexual health questions 24 hours a day and no person should be afraid to ask any questions at any time. I think that college students should never feel pressured into having intercourse or any sexual act. Students should avoid sexually transmitted infections and using a condom is a great way to accomplish this.

S: For the medically-minded, what makes your job so rewarding to you?

Dr. N: My job is so incredibly rewarding because I get to meet new people every day. And it is so rewarding to be able to have relationships with my patients and watch them grow over time. It is amazing to be able to help someone get pregnant when they want to, avoid getting pregnant when they do not want to, treat an infection, or correct an underlying hormonal imbalance. It is a great feeling to be able to diagnose and treat an individual’s problem and see a huge improvement. I have an amazing job where I'm able to help people all day long. 

*Please note that while this interview is with a gynecologist, Pap tests and other sexual and reproductive health examinations can be performed by healthcare providers with a variety of credentials, including nurse practitioners.

The Sexpert also wants to remind readers that condoms (both internal and external) are the only forms of protection that lower risk of sexually transmitted infections as well as pregnancy. Other barrier methods, such as dental dams, gloves, and finger cots, can lower risk of STI transmission when used during various sexual activities, including oral sex and manual stimulation.

To read more from The Sexpert, visit thesexpert.princeton.edu. To submit a question, email The Sexpert at sexpert@princeton.edu.

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