OB/GYN Dr. Raquel Ton brings her listening skills, as well as her medical expertise, to all of her appointments. That’s because Dr. Ton knows a good conversation with the women she sees will go far in helping her understand each woman’s stage in life, goals, and health concerns.
“I just love connecting with other women and becoming an advocate for them,” she said. “I love that we see women through all phases of life—from puberty, through pregnancies and deliveries, and then get to watch their children grow up. We see them through their later years in life, too—even sometimes getting to see their children, aunts, grandma, or sister. That’s really exciting.”
But exactly how does the team at Hancock OB/GYN handle so many different women in various stages of life? Dr. Ton explained and answered a few more questions.
Q: Gynecology and obstetrics are usually lumped together. What’s the difference?
A: Obstetrics is the care we provide women during their pregnancy, including preparing their bodies, the entire pregnancy, delivery, and the postpartum period. Gynecology is every other time in a woman’s life when she’s not pregnant. That starts in puberty and goes through menopause and beyond.
Q: It seems like you do this mostly through annual exams. Why is getting an annual exam important, whether a woman is getting a Pap test or not?
A: It’s the same thing as an annual physical exam with a family doctor. There’s a lot more to it than just the Pap test, which screens for cervical cancer. Your annual exam is really a comprehensive exam. We always do a breast exam, making sure there aren’t any developments or lumps or masses within the breast—because, even though women might be getting their mammograms annually, we can catch things. We also do a pelvic exam to make sure the anatomy looks like it should. It’s also a good way to check in with a patient year-to-year as things change.
Q: How often do you do Pap tests?
A: They usually start at age 21, and then women get one every three to five years, depending on whether the test results are normal. If not, we treat that issue and also do more frequent Pap smears to make sure everything is okay.
Q: Since Pap smears begin at age 21, a lot of people think that’s the best time in a woman’s life to begin seeing OB/GYNs. Is that true?
A: It’s a good time. But starting care when a girl goes through puberty can be beneficial. I think a lot of parents are hesitant because they associate OB/GYN care with pregnancy, so it has a little bit of a stigma. From our perspective, it’s about making sure her transition into adolescence is a good one. If I’m lucky enough to see a patient before she starts her menstrual cycle, then I usually talk to her about the changes in her body as she’s going through puberty, what to expect in terms of breast development, and changes to her vagina, mood, and hormones. I also explain the process of getting her first period and how it’ll feel.
Q: It sounds like your appointments with adolescents include a lot of talking.
A: They do because these changes can be overwhelming for a young woman. I ask about her mood and hormones and if she’s noticed any changes in terms of her relationships with her parents and friends, how she’s dealing with classes and grades, and school. I just gear it to each patient individually and have a conversation with them.
Q: Why are those conversations important?
A: It’s important for young girls to know their bodies and have the power to be in charge of their own health. They can ask questions and realize that all girls are going through the same things.
Q: How do you handle patients in their 20s?
A: The years between 20 and 30 are pivotal. We start doing Pap smears, evaluating for cervical cancer. We also talk a lot about reproductive health. Many women during that time are either trying to get pregnant or thinking about it. So we’re taking the steps to make sure they’re healthy overall—whether that’s through diet, nutrition, weight loss, or taking care of any underlying medical condition like high blood pressure or diabetes. We also talk about contraception a lot with that group—if they’re interested, we talk about what their options are. Menstrual cycle regulation is also a big thing, and screening for sexually transmitted diseases.
Q: What about women in their 30s?
A: We’re still working with them around their reproductive health, pregnancy, and general health, including nutrition. But as they’re getting into the late 30s, a lot of women have had all the children they want to have. Then it’s transitioning them to long-term family planning. We also have a lot more menstrual cycle regulation with this group because a lot of women experience changes.
Q: Menstrual cycle regulation is something you work with women on throughout their reproductive years. What is it?
A: First, we make sure that patients are having monthly cycles. It’s important that they’re shedding that lining every, single month. We also make sure their pain during their cycles is manageable—that can mean trying different medications or sometimes doing surgical procedures.
Q: Moving on to the 40s. How do you work with women in that stage?
A: Now we’re in what we call the perimenopausal stage—these are the 10 years leading up to menopause. During that time, women tend to have another significant change in their menstrual cycle as their bodies transition to menopause. Sometimes it’s a heavier cycle, or sometimes it’s more irregular cycles. We work to manage that. We’re also preparing her for the transition—making sure she’s getting good nutrition, including vitamin supplements, and just preparing her for hormone changes. And we want them to start getting regular mammograms at age 40, too.
Q: The 50s?
A: The average age of menopause in the United States is 51. Everyone is different, but those years leading up to 51, and right after, are when women will start going into menopause and noticing they’re skipping periods or they’ve ended. The definition of menopause is having a full 12 months of no bleeding at all, so when a patient has met that requirement we categorize them as menopausal. During that time, the most important things we manage are menopausal symptoms such as hot flashes, night sweats, mood changes, decreased sex drive, vaginal dryness, and more. We’re also very interested in making sure they maintain good bone health, so we make sure they’re taking vitamin supplements with the right amount of vitamin D and calcium. They’ll also start getting colonoscopies and continue with annual mammograms.
Q: Do you still see women after menopause?
A: We do. We continue with pelvic exams, making sure everything is normal. Starting at age 65, if a woman has never had a history of abnormal Pap smears, we ask her if she wants to continue with them or not. It’s up to her.
Q: It seems like you really love your job. Could you talk a little about that?
A: I’m passionate about women’s health. As a woman, it brings me joy to be able to really understand my patients and what they’re going through because I’ve gone through a lot of the same issues. And being able to provide them with the resources that I wished I’d had, but didn’t, is a great feeling.
Q: Last question. Is there any myth about obstetrics and gynecology you’d like to dispel?
A: I want patients to know that an appointment with an OB/GYN is not scary. I think a lot of people associate it with discomfort and pain. But it’s really not about that. And I want women to know how important it is for them to take care of themselves. A lot of my patients end up coming to see me as a last resort. I wish women wouldn’t let it get to that point because it’s hard for them to be advocates, in the center of their families, when they’re putting themselves on the back burner. I want women to feel empowered to put their well-being first.
If it’s time for your annual exam or you have women’s health questions, you can contact Dr. Ton and Hancock OB/GYN at 317-477-6500.
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