Everything You've Always Been Too Afraid to Ask the Gynecologist
A visit to the gynecologist -- what could be more embarrassing? You're asked to strip naked, sit down on what constitutes a piece of tissue paper, stick your feet in stirrups with your legs spread open and your genitals exposed, while someone prods your breasts for lumps, sticks a finger inside you to press your ovaries before following that with a cold, slimy speculum, kindly asking if you'd like to see your cervix.
Who could blame you for stuttering a barely audible, "Nuh-nu-no," before clamming up for the rest of the exam. On top of it, once you get your clothes back on, you can't quite get over the fact that you're looking into a pair of eyes that were so recently fixated on your crotch. So you decline to ask the list of questions you had ready before the humiliation began.
So we've taken the asking out of the equation.
Here are some that may have come to mind. They may not include every one you wanted to ask, but at least you didn't have to sit through the answers.
Q: I've been having painful intercourse. What could be the reason?
A: There could be several reasons. First, some of the more obvious reasons should be considered. "If a woman is in a new sexual relationship and having frequent sex -- or if her new partner has a large penis -- either of those could be the problem," says gynecologist Dr. Sheryl Ross, co-author of Expecting Fitness and Two At a Time: Having Twins.
"Probably one of the most common reasons is that the woman isn't well lubricated," she adds. Ross also suggests that there may not be enough foreplay or that the woman may want to evaluate whether the relationship is a good one, adding that emotional issues in a relationship can make themselves evident in this way.
"Painful intercourse can also be a sign of endometriosis, an infection," she advises. The question is a broad one, so a woman should always see her gynecologist to pinpoint the reason.
Q: I'm noticing that I sometimes have discharge. Does this mean I have an STD?
A: "You can have mid-cycle discharge that's different from the rest of your cycle," says Ross, "and that can mean you're ovulating. It doesn't necessarily mean you have an infection."
Whether you potentially have an infection depends on the color of the discharge and whether there is an odor associated with it. If it's gray, yellow or green, that could signal a bacterial infection. If it's thick and white -- like cottage cheese -- it's most likely a yeast infection, says Ross.
"If there is an odor, it could be due to your diet, but it's more likely to be some type of bacterial infection," she says, recommending a visit to your gynecologist if the discharge has a strange color or odor.
Q: Condoms make me itchy. Could I be allergic to them? Is there anything I can use instead, but still protect myself from infection?
A: "Yes, you can be allergic to condoms," says Ross. "Latex is a common allergic material for women, and I would recommend trying a polyurethane condom instead, though they can be difficult to find."
Ross also mentions that many condoms use nonoxynol-9, which may also cause an allergic reaction. So try switching to one that doesn't use this particular spermicide to see if the itching subsides.
"With condyloma (HPV) -- also known as genital warts -- and herpes, you can wear a condom and still catch both of those viruses," Ross adds. "That's why it's so important to emphasize knowing and trusting your partner and their sexual history."
Q: I have painful, heavy periods. What does that mean?
A: "Often, I think the best thing to do is to get a vaginal/pelvic ultrasound to make certain there is no reason for the heavy period, such as a uterine polyp or fibroid," suggests Ross. Both can cause heavy or painful periods, and an ultrasound can rule them out.
For those women who are simply prone to painful periods, there are medications that can help, such as Motrin or Motrin-type products -- such as Midol, Ross adds. "Birth control pills can also help lighten the period and help with the cramping, as well."
Q: My skin is inflamed and irritated down there. Why, and how can I make it go away?
A: "It could be due to infection or an allergic reaction to products through intercourse," says Ross, "or your clothing. Yeast is probably the most common infection associated with irritation."
Vulvodynia -- painful intercourse -- could also be the culprit. "It involves inflammation of the glands in the posterior part of the vagina at the very base," Ross explains. She recommends visiting your gynecologist for vulvodynia.
"If infection has been ruled out, we use hormone creams to help remedy the problem," she adds.
Q: My anus is itchy. Does this signify anything?
A: It could be from hemorrhoids or a yeast infection, says Ross. It could also be the result of constipation, or even diarrhea with a lot of straining or wiping.
Q: I just developed a bump on my vagina. What could this be? What if I squeezed it and white stuff came out?
A: There are many glands and follicles in the area, so you can still get acne-type bumps there, answers Ross.
"You can get ingrown hairs, sebaceous cysts and certainly -- if white stuff comes out of it -- it could be a boil or acne bump. It's always good to have it looked at," she says.
Ross doesn't recommend cutting into it or squeezing it out until you're certain what it is, because most -- including pressure abscesses and inflammation of the glands around the vagina -- will go away with time, sometimes just by soaking them.
"But you should still see your gynecologist," Ross recommends, "because it could be one of two conditions, the wart virus and another one gynecologists see called molloscum contagiosum -- a water wart." Water warts are bumps that can be spread through contact. Although children primarily contract them through use of public pools and sharing towels, adults can contract them through sexual contact, she warns.
Q: I seem to urinate more often than my friends. Should I be concerned?
A: If you have urinary frequency, you first want to make sure you don't have a urinary tract infection, advises Ross.
"The other thing that's very common with women is called interstitial cystitis," she says, "which is when you have urinary frequency without an infection. The doctor can rule that out by doing a urinary culture, taking your history and knowing how much water you take in."
Urinary frequency can usually be determined by how many times you have to get up in the night to use the bathroom. "You really should not be getting up more than once at night," adds Ross.
Q: If I had an STD in the past, does that mean I won't be able to have kids?
A: Not likely.
"If you had a chlamydia infection for a long time, it might affect your fallopian tubes and create scarring," says Ross. "But herpes is an STD, and it does not affect fertility. So it depends on the one you had, how long you've had it, whether you needed hospitalization or antibiotics, and how sick you got."
Ross adds that women who have scarring usually developed a severe case of pelvic inflammatory disease and may also have fertility problems. She recommends that all women under the age of 25 undergo a yearly STD screening, with chlamydia and gonorrhea being the primary diseases of concern.
Q: I have a new sex partner and I keep getting yeast infections. Why do I keep getting them and will they eventually stop?
A: "This is very common. It's two people exchanging their flora, and it's not unusual to get a yeast infection," says Ross.
There is not much you can do to prevent a yeast infection of this nature from occurring, but it helps to maintain good hygiene, Ross adds. "Often with new partners, you will get one and, with time, it will probably go away.
So there you have it -- a sizeable list of questions you didn't have to blush over! But don't forget if you have any suspicious symptoms, it is always best to make an appointment with your gynecologist.