Visiting the gynecologist in one´s own country is never a walk in the park. Therefore it stands to reason that doing the same in a foreign country can be frightening to say the least. But lifestyle changes (a new diet, climate and sleep habits) can render your body vulnerable to various infections, while Prague´s famously liberal sexual mores and highly “social” nightlife can set the scene for risk-taking. In anticipation of these changes it´s important to find a doctor with whom you´re comfortable discussing the intimacies of sexual health.
If you previously suffered a gynecological condition (an ovarian cyst, cancer, etc.) it´s smart to bring your medical records to your first appointment. For those in relatively good health an annual pelvic exam is sufficient though anyone who experiences discomfort in the breasts, vagina, lower abdomen or bladder, period irregularities or seeks contraception should schedule an appointment as needed.
To help assuage your fears about going to the gynecologist in a foreign country we spoke with Dr. Jana Stejskalova of the Prague Women´s Health Center (Kartouzská 6, www.pwhc.cz). She gave us a number of valuable insights on the special health issues that women face and tips for keeping healthy in your adopted homeland.
Shopping for a Gynecologist
According to Dr. Stejskalova, the OB/GYN profession has been traditionally male dominated. But as with everything in the developing Czech nation, this will continue to change. If the gender of your doctor is important to you, our listings include a number of English-speaking female doctors.
Recommendations from friends should also play a part in your decision. Ask around. If you are new to Prague and don´t know many people your employer, co-workers, students, TEFL instructor or university are usually good resources. If else fails simply call an office or two—you can tell a lot about a practice and the type of care you can expect to receive by the receptionist´s phone demeanor.
Cost will likely be a factor in your decision-making process. Most OB/GYNs—whether private or state-funded—accept insurance. Your insurance company should also provide you with a list of caregivers. If you don´t have insurance a visit to one of Prague‘s English-speaking clinics can cost up to 2,500 CZK. A visit to a state-run gynecologist´s office may be cheaper but you´ll likely need an interpreter to make your appointment and accompany you to the doctor´s office.
Your First Visit: What to Expect
The standard gynecological examination you receive in Prague is very similar to what you´d encounter in the United States or the U.K., says Dr. Stejskalova. You will be asked to give your name, age, marital status and medical history. You will discuss any symptoms you are currently experiencing and your sexual history. The general examination includes a breast, abdomen and pelvic exam (yes, you can expect to meet with the dreaded speculum). A pap smear is taken if a woman is sexually active and has not had one for a year or more. (Dr. Stejskalova recommends a yearly pap smear). The pap smear can detect infections both minor (yeast or bacterial infections) and major (herpes, genital warts, etc.).
Women from western countries have become accustomed to a certain level of sensitivity and specialized health care. But while you may find differences in the areas of privacy, disrobing, etc.—for example you might be asked to wear a paper shirt instead of a gown and some doctors will have you sit in a chair instead of lie down—Czech doctors can be more open-minded than their counterparts in the West when it comes to frank discussions about your sexual health.
Common Problems, Prescriptions, Emergencies
Dr. Stejskalova notes that Czech clinics are equipped to provide ultrasound examination of the pelvis, blood work and specialized care for more serious types of gynecological illnesses like STDs. Unfortunately, there is no routine screening for cervical cancer, though a pap smear can detect abnormalities in the cervix. The U.S.D.A.-approved vaccine Silgard was introduced to the Czech Republic in December 2006. Usually administered to women under 26 who aren´t sexually active, the vaccine is said to protect against the human papilloma virus, the germ responsible for 99.5 percent of cervical cancer cases. The vaccine does not, however, safeguard against all viruses that cause cervical cancer. If you are at risk discuss screening options with your doctor.
Your gynecologist can also help you deal with an unwanted pregnancy. Termination of pregnancy is legal and safe in the Czech Republic. Abortion is an outpatient surgery and is performed at a number of clinics and hospitals throughout Prague. The abortion pill is not legal here but other forms of emergency contraception like the morning after pill are available from your gynecologist. Most offices give their patients a 24-hour emergency number for such circumstances.
Birth control pill, implants, uterine devices and a variety of other contraceptives are available by prescription from your gynecologist. For more information about contraception and abortion procedures and legalities in the Czech Republic, visit our article on the topic here.
Doctors recommend that women begin yearly mammogram screening for breast cancer at the age of 40. But you´re never too young to administer a self exam. Your gynecologist in Prague can provide you with the proper procedure for examining your breasts at home if you aren´t familiar with the self test. Every twelfth woman in the Czech Republic experiences breast cancer in her lifetime which means that diagnostic techniques such as mammography, magnetic resonance imaging and positron emission tomography, a scanning method still rare in much of Europe, are available in the Czech Republic.
To locate a radiologist´s office or for more information about the treatment and prevention of breast cancer visit www.mammahelp.cz (this site converts to English) or www.mamo.cz (this site is in Czech only).
Prenatal and pregnancy care
First things first: If you suspect you are pregnant, your gynecologist can help confirm or deny your suspicions or you can purchase a pregnancy (těhotenský) test at any lekarna. Second, you may be pleasantly surprised to discover that the Czech Republic has a relatively low infant mortality rate, second only to Japan.
Dr. Stejskalova also points out that beyond the usual obstetric care that´s common at any hospital, anywhere (see our article on giving birth in the Czech Republic here) the Women´s Health Center goes above and beyond your expectations by offering prenatal classes and weekend seminars on childcare for expecting parents. The Canadian Medical Center (www.cmc.praha.cz) also offers a breastfeeding consultant for first-time moms as well as prenatal classes. For a first-hand account of one woman´s childbirth experience in Prague click here.
Dr. Stejskalova notes that a woman’s risk of heart disease usually increases exponentially after menopause. Stroke rates also jump dramatically at this point in a woman´s life. The Prague Women´s Health Center offers menopause and postmenopausal management for the mature patient.
Complications after and during menopause are typically the result of poor lifestyle decisions. Dr. Stejskalova is quick to point out that we women, no matter what our age, hold the key to good health in our own hands. Continued wellness hinges on our attitude toward diet, exercise and a host of other healthy living choices.