Gynecologist Lyudmila Shupenyuk: Cervical cancer is a disease that primarily affects young women.

Where to begin sexual education for girls, how to track menstruation, how to prepare for a gynecologist visit, insights into women's intimate lives, and HPV protection were discussed in an interview with RBC-Ukraine by gynecologist Lyudmila Shupenyuk.

Lyudmila Shupenyuk is a gynecologist with over 30 years of experience. In 2013, she became the host of the medical TV project "I Am Ashamed of My Body," while continuing her practical work. In 2020, she opened her own women's health clinic.

Read about the level of sexual and reproductive awareness among Ukrainian women, the beginning of sexual education for girls, the first visit to a gynecologist, changes in menstruation, rules of intimate hygiene for women, safe and reliable contraceptives, HPV, and cervical cancer in the interview with Lyudmila Shupenyuk.

This is a condensed version of our conversation. The full version can be found on the RBC-Ukraine YouTube channel.

– How to choose a professional and evidence-based gynecologist?

– I generally say that a gynecologist is almost like your confessor because this person knows many things about you that a woman may not always want to share during confession, right?

I wouldn't even want to talk about professionalism because I believe there shouldn't be unprofessional doctors at all. In this situation, I would prioritize trust over professionalism. We all have different criteria for relationships and evaluations of a person. I'm not even talking about a specialist but about a person. There's someone you meet and think, "Oh, I'm ready to go through fire and water with them."

And then there’s someone who doesn’t even inspire you to talk. So, I think that first and foremost, it’s about finding the right human factor.

Today, the internet helps a lot with this because most clinics introduce us to their doctors through social media, even if the doctor doesn’t maintain a separate blog. You can observe how the doctor communicates, their smile, and whether they resonate with you.

As for professionalism, I wouldn’t even want to discuss it because that’s a given. It must be mandatory.

– Regarding, say, inappropriate phrases that gynecologists sometimes utter for some reason. Can we list some non-obvious ones that would immediately warrant leaving the office?

– Well, you know, I grew up in a family of doctors. I have many friends who are doctors. It’s hard for me to pinpoint specific phrases. I feel this is not just about medicine; it’s genuinely a human factor.

I think you also encounter situations where you can see an absolutely ridiculous statement on social media. I look at it and wonder how a doctor could even say such things. Some things offend me as a woman, and as a doctor, they evoke internal resistance. Yet, the person makes a splash and gathers audiences, views, and so on.

What is unacceptable for me might be completely normal for some patients. I detest aggression in medicine, especially when it concerns a pregnant woman.

There’s nothing absolute in medicine. Regardless of the situation, it’s always "the author sees it this way." We assess a situation within the limits of our knowledge and diagnostic capabilities, and it remains an assumption. You know, in medicine, there’s a saying that the final diagnosis is made by a pathologist, and we only try to answer some questions and make a diagnosis.

So, in my view, certainty and declarations are precisely what’s unacceptable for a doctor, and that would raise a red flag for me as a patient.

– What should a woman’s preparation for a gynecologist visit consist of?

– First of all, it starts with choosing a gynecologist. Secondly, there are two formulas when you go to a gynecologist. The first is when you go for an oncological screening. That is, you’re not experiencing any issues, but as a conscious woman, you understand that you need to undergo what is now fashionably called a "check-up" once a year.

You should remember your history, such as when your periods were, the nature of your menstruation, and if you have any examinations, they should be with you. Sometimes, it happens that in the 50 minutes I talk to a woman, she spends 20 minutes searching for her test results on her phone.

It’s preferable that it’s not during critical days, meaning it shouldn’t be during menstruation. What day of the menstrual cycle is it? In general, it doesn’t really matter. Secondly, there should be medical documentation if available.

Once, you needed to bring gloves and a disposable mirror, but that’s not necessary now. Especially if you’re going to a private clinic, they have everything. Many state clinics have these supplies as well.

And if we talk about the second formula, when a woman goes because she has certain complaints. I would generally advise a woman to write everything down because sometimes she might feel flustered upon arrival and then leave the gynecologist's office without asking the main questions.

So, it’s advisable to jot down your questions to get accurate answers. There’s no special preparation required.

– How do you assess the current situation with screenings? Are patients seeking preventive care more often, or is preventive medicine still not very developed?

– You know, back in the days of the USSR, when I started working, it was mandatory. You couldn’t see a therapist without first seeing a gynecologist. You couldn’t close a sick leave without visiting a gynecologist. It was a form of preventive medicine. Many people might not have gone willingly, but they came because it was necessary.

This isn’t about awareness; it’s more about the requirements of that time. Now the situation has changed. No one requires it. If you don’t want to go, you don’t have to. So now it’s more about awareness. At least, most of my patients are those who listen and want to know about their health.

However, today I had a woman who hadn’t seen a gynecologist in five years. A young woman, 44 years old. Moreover, she has complaints. Yet, she hasn’t been to a gynecologist in five years. So, such cases are unfortunate.

– What about sexual awareness among women, including girls before they reach adulthood? Has this level improved?

– You know, I would say it has increased. For instance, when I was in school, I thought that kissing could lead to pregnancy, but now that’s not the case. Despite growing up in a family of doctors, talking to parents was still difficult... And there wasn’t any literature at that time; no one spoke about it. Information came from friends on the street.

Now, for any age, starting from adolescence to menopause, you can find information that interests you.

The problem is that sometimes certain marketing ideas or personal views are presented as final opinions without room for discussion. They evidently still have an influence.

– Where do you suggest starting a girl’s intimate awareness?

– Probably not with a visit to the gynecologist. Although I had a rather interesting patient. An eight-year-old girl came to me with her mother, of course. She wanted me to explain menstruation to her. She asked her mom to bring her to my appointment.

The girl had several questions she wanted answers to. I’m amazed by such an approach. It seems to be upbringing. It’s not a common story, but the child came with clear questions that she wanted answered.

Some mothers say, "I want her to receive initiation from you because you will explain this gently, without scaring her." You know, the first examination and the first visit to the gynecologist is like first love: either you get scared for life and hate it, or you fall in love and understand that life is beautiful.

Certainly, it’s important to talk about these things before they occur. Before menstruation starts, before the first sexual act, before any problems arise. Because a person should be informed about these matters. And in such cases, if questions or problems arise, it makes sense to go to the gynecologist.

Once, I had a story where a mother brought her 13-year-old daughter. She wanted to put her on the chair so that she would know what it was like. She aimed to scare her daughter with the gynecologist, so she wouldn’t dare do anything anywhere because she thought that if you deal with doctors, they would practically torture you. This education should begin at home. Fortunately, I think we’re doing a little better now than before.

– How can parents overcome their embarrassment when discussing intimate matters with their children? Or, for instance, when parents initiate a conversation, and the child