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Sexual & Reproductive Health

7 Things You Should Always Discuss with Your Gynecologist

Talking to your gynecologist about odors, growths or sexual health may seem embarrassing, but it can be vitally important for your overall health and well-being.

Young woman conferring with female doctor

When it comes to sexual and reproductive health, it can be hard to know what's "normal" and what may be a sign of a potential health problem. Even if you feel embarrassed about certain issues, your gynecologist has seen and heard it all and is there to help you, not to pass judgment.

Here are seven things you should always discuss with your gynecologist:

1. Painful Periods

For many women, getting your period is an unpleasant time. Cramps, breast soreness and headaches are just a few of the most common menstruation symptoms. But for some women, period pain goes beyond cramps and can be incredibly severe. If your periods are very painful or have been getting worse over time, it can be a sign of endometriosis or uterine fibroids. "It's important to speak with your doctor about this, as there are many solutions that can make these conditions more manageable. You don't need to suffer in silence," says Shari Lawson, M.D., a Johns Hopkins gynecologist.

2. Vaginal Odor

While vaginal odor can be an uncomfortable topic, it's important to talk to your doctor if there is a foul or fishy smell, or if there's a change from your normal smell that seems to be lasting for a few days. "While having an odor is normal, any changes or foul smells may be a sign of bacterial overgrowth or vaginal infection," Lawson explains.

3. Swelling Bumps or Growths "Down There"

Noticing a growth in your vagina or around your labia can seem worrisome. Is it an ingrown hair, a pimple, a cut from shaving or possibly something more concerning? Bumps are often benign, but it's important to have your doctor perform an examination when you feel something. "Genital warts may be visible for some time, but herpes lesions can heal over seven to 14 days, making it important to be seen when the outbreak is occurring," Lawson says.

4. Sexual Discomfort

It's very important to talk to your doctor about sexual discomfort. You may be uncomfortable bringing it up, but your gynecologist can help explain and treat your concerns.

  • Vaginal dryness: Many women experience vaginal dryness during intercourse. Dryness can often be dependent on a woman's age and mitigating factors in her life. If a younger woman has this issue and has been on birth control for a long time, there may not be enough estrogen present, and she may need to change her birth control. For a busy mom, she may not be taking enough time to engage in foreplay and arousal before sex, leading to dryness. If a woman is postmenopausal and has dryness, it can be due to low estrogen, and her gynecologist can prescribe vaginal estrogen.
  • Pain during sex: If you're experiencing pain during sex, try different positions to find one where you feel comfortable. Sometimes you still may need to speak with your doctor, though. "It's important to talk to your doctor if you're having pain with intercourse in any position you try, lubricants do not help with vaginal dryness and you have bleeding after intercourse," explains Lawson.

5. Sexual History

Women often worry that their gynecologist is judging them if they ask how many partners they've had, how old they were when they first had intercourse, if they've had any sexually transmitted diseases (STDs), or about sexual orientation and gender identity. These topics arise for several important reasons:

  • To determine risk factors for cervical dysplasia and HPV infection. Having intercourse younger than 18 can sometimes make you more susceptible to HPV because the cervical-vaginal junction is more pronounced when you're younger. Having more partners can also increase the potential for exposure.
  • To discuss potential ramifications of past STDs. "Some STDs can increase the risk for infertility, so physicians want to provide appropriate counseling if that situation arises," says Lawson. "For STDs like herpes, for example, we also like to provide counseling, since this is a lifelong condition and you may experience outbreaks in the future."
  • To ensure that a patient is receiving the best possible care. Though LGBT communities are diverse, research shows that there are certain health concerns among lesbian and bisexual women and trans men that are important for LGBT individuals and health care providers to be aware of. Learn more about where to find knowledgeable, supportive and compassionate providers.

6. Urinary or Fecal Leakage

Experiencing urinary or fecal incontinence can be very stressful and take a toll on your quality of life. Many women will experience these symptoms after childbirth, particularly if they had a large baby or a vaginal delivery requiring forceps or a vacuum. When women enter menopause, these symptoms may worsen. Lawson says: "Depending on the nature of the incontinence, there may be medical or surgical management options available. By talking with your gynecologist, she or he can determine the proper treatment protocols and refer you to a pelvic floor disorder specialist if necessary."

7. Low Libido

While having a low libido is more common than many women realize, it's important to speak with your gynecologist to discover the cause of your concern. Libido can sometimes be affected by medications you take, or it may be a sign of an underlying medical condition or a side effect of a known condition. In these situations, your gynecologist can determine what medical interventions may be necessary.

For other women, though, their low libido may be related to the nature of female sexuality — sometimes, your desire to have sex or be intimate can be affected by things outside of your control, like stress or work. Women in long-term relationships are also less likely to be spontaneously aroused compared to the early stages of their relationship.

In these circumstances, your gynecologist can make recommendations to help you naturally increase your libido and/or refer you to an appropriate counselor. Lawson explains: "I tell my patients that the more frequently you attempt to have sex, the more frequently you will want to have sex because of the endorphins released during intercourse. This will make you feel more intimate toward your partner." 

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