Ten Things Your Gynecologist Wants You to Know

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Art Credit: Bruce Guenter

When it comes to understanding what womanhood means, your gynecologist might be one of the most influential guides you'll have. Think about it. You two will talk about all the nitty-gritty stuff that you might not have even discussed with your own mom. From pregnancy to menopause, your gynecologist will be providing medical guidance for life-changing periods, and your relationship will probably get pretty intimate. Yet it can be hard to understand the ins and outs of certain consultations or what certain conditions really mean. To start you off, here are ten things that your gynecologist wants you to keep in mind.

01. NORMAL DISCHARGE IS DIFFERENT FOR EVERYONE

Vaginal discharge is one of the most revealing elements of your reproductive health—in essence, it’s a byproduct of your vagina cleansing itself. Some women have discharge every day, while others only have it during certain times of their menstrual cycle. In healthy vaginas, discharge is often clear or cloudy white. Basically, the “normal” amount and kind will differ from woman to woman. But A. Nicky Hjort, M.D., OB-GYN offers a general rule of thumb: Has this been normal for you? Has anything changed?

Things such as pregnancy or hormonal changes before ovulation or menopause can cause more discharge. If you experience a sudden increase in amount accompanied by color or odor changes, see your OB-GYN as soon as possible. Hjort stresses that an appointment is even more urgent if there’s vaginal irritation, pain, or itching.

02. NOT ALL BUMPS ARE EQUAL

Just like any other physical feature, not all bumps are the same. If you notice one, don’t freak out. It’s easy to think the worst (e.g. STD or cancer), but keep in mind that the area “down there” is still skin and hair. Ingrown hairs, which form in hair follicles, occur when a hair grows backwards into the skin instead of outwards. Pimples and sebaceous cysts, which can form on any part of the body, can also develop from a damaged or infected hair follicle. These are more likely to happen when sweat and moisture build up, so skip those skinny jeans every now and then, and opt for more roomy, breathable material.

All these bumps can be the result of shaving, tight clothing, or poor hygiene. Sometimes, they just happen at random. The best bet is to not pick at anything and let your skin run its course. If the bump gets worse or persists after a week or two, it’s time to make an appointment.

03. ITCHINESS IS NOT NORMAL

Feeling itchy “down there” is a sign that something isn’t quite right. Sometimes it could just be due to hair growth or sensitivity to a new body wash, but intense burning or itching is enough to warrant a check-up. If you’re sexually active, an STD test will narrow down the causes, but remember that bacterial imbalances can also cause itchiness and other symptoms similar to those from STDs. Depending on what your gynecologist diagnoses, you may need antibiotics to fix the issue. However, if you’ve already taken antibiotics, there’s a good chance that the itchiness is from a yeast infection. When antibiotics kill off the bad bacteria, they take down the good guys too, creating the perfect environment for yeast overgrowth. In this case, your doctor can recommend an antifungal medication.

04. UNUSUAL SMELLS ARE ALSO NOT NORMAL

While a strange odor can raise a red flag, it might just be hormonal changes before and after your period. Because you have the front row seats to what's happening in your body, it’s a good idea to pay attention to what is normal for you, and what isn’t. If you do notice a funky smell, visit your OB-GYN and tell her about it, as well as any other symptoms. It could be a bacterial infection, an STD, or nothing at all. Hjort offers a simple phrase to remember: “When in doubt, check it out.”

05. PAP SMEAR GUIDELINES HAVE CHANGED

Speaking of Pap smears, did you know that the recommended frequency changed in 2012? Before that, guidelines urged women to get a Pap smear every one to two years. Now, several medical groups, including the American Congress of Obstetricians and Gynecologists, advise getting one every three to five years. This new recommendation is for women who have had normal Pap smears without any lifestyle alterations. So why the change? Experts worry that more frequent Pap smears come with more false positives, potentially leading to unnecessary interventions.

That said, if you do have HPV and/or have had an abnormal Pap smear, these guidelines won’t apply to you. Your OB-GYN will request that you have more frequent Pap smears, usually about every six months. Talk to your OB-GYN if you’re unsure about how often you should get one.

06. YOU DON’T NEED TO HAVE INTERCOURSE TO GET HPV

It’s the most prevalent STD in the United States, and studies estimate that more than 80 percent of sexually active women will get HPV before they turn 50. But contrary to popular belief, human papillomavirus (HPV) can spread through any kind of sexual contact—not just intercourse. While the latter is the most common way that HPV is spread, any skin-to-skin contact can do the trick, so be sure to get a Pap smear if you haven’t in a while. A Pap tests for cervical cell abnormalities, some of which may be caused by HPV and can indicate cervical cancer. However, it’s possible to still receive a normal diagnosis from your Pap smear even if you have HPV. Because every Pap smear doesn’t automatically include an HPV test, you may have to ask your OB-GYN for one.

07. NORMAL PMS SYMPTOMS ARE UNCOMFORTABLE

When Aunt Flo’s on the way, you can be sure she’ll let you know. This is where PMS comes in. Affecting more than one in three women, PMS is a medical condition that occurs when hormones fluctuate before menstruation. It’s often characterized by symptoms such as bloating, mood swings, headache, and acne, and can be quite unpleasant. While some (lucky) women experience less intense symptoms, a general feeling of discomfort and anxiety is normal. The number one thing to remember is that you’re not “going crazy.”

So what’s a girl to do? Try focusing on stress relief and eating PMS-fighting foods. You’ll get through this. We promise! That said, if you experience something out of the ordinary before your period, consult your doctor. It could be nothing, but it might also be a sign of an underlying, more serious condition.

8. LOW LIBIDO ISN’T ALWAYS BECAUSE OF HORMONES

Have you ever heard of female sexual dysfunction (FSD)? Yep, it’s a thing. Characterized by a low libido (sexual desire), FSD can make things rocky with your significant other. Because a high libido is often associated with hormones, it’s no surprise that we assume the same for a low one. But while hormones can cause it, medical conditions like high blood pressure and diabetes can also be the culprit, and anxiety, stress and exhaustion are other potential causes. Medicine can also throw off your libido, just like it can mess with your period. Underlying issues with your significant other can inhibit sexual desire as well.

9. 30 ISN’T THE CUT-OFF FOR PREGNANCY

When it comes to having a baby, we’ve all heard about our “biological clock.” And with society placing pressure on the big “3-0,” it’s no wonder that many of us assume it will be significantly harder to conceive once we turn 30. It’s true that a woman’s fertility starts to decline around 30, but most fertility problems such as unhealthy eggs or miscarriage risk have a greater chance of showing up around 35 and increase at a faster rater versus your early thirties. But that doesn’t mean natural pregnancy is impossible in your later thirties and forties. The ACOG recommends maintaining a well-rounded, healthy lifestyle to increase your chances for pregnancy.

10. THIS IS A JUDGEMENT-FREE ZONE

Any good OB-GYN will not judge your sexual activity or lack thereof. Whether you’re a virgin or sexually active, it’s vital to share this information with your doctor. Of course, it can be scary to talk about something so personal. Don’t forget, though, that she’s there to help you out. “If we don’t understand a patient’s lifestyle, we can’t properly counsel her,” Hjort says. And as with any doctor, having an honest conversation will only benefit you, because knowing your history will help her assist you in the best way possible. Hjort also assures us that gynecologists see patients along every imaginable scope of the spectrum. But if you do feel judged or disrespected, it may be time to find a new gynecologist.

We hope these facts help you better understand how important your OB-GYN is for your reproductive health. Remember, you don’t have to figure it out by yourself. “We are here to help,” Hjort says. “Please let us!”