8 Things Your Ob-Gyn Wants to Tell You
By Alexandra Gekas
Going to the gynecologist is something every woman has to do. But considering how personal it is, it's no wonder many of us feel nervous or self-conscious when it's time for the yearly exam. Though shyness is perfectly normal, it can also hold you back from asking important questions or sharing information that your doctor needs to treat you. From menstrual cycle issues to sexual history, discover what your gynecologist is really thinking during your annual check-up.
1. Don't feel shy about your body.
Your doctor is just that-a doctor. So believe it or not, when she is looking at you "down there," it really is just like looking at any other part of your body. "There's very little we haven't seen and almost everything is normal, so don't be afraid," says Mary Jane Minkin, MD, clinical professor at Yale School of Medicine's Department of Obstetrics, Gynecology and Reproductive Sciences and author of A Woman's Guide to Sexual Health. If you're particularly shy around men, Dr. Minkin suggests that a female doctor might be best. "Sometimes women are worried about their appearance, but there's all kinds of variation [in our bodies]," says Pamela Berens, MD, University of Texas-Houston Medical School professor in obstetrics and gynecology. As long as you're not in pain or discomfort, Dr. Berens says, there's nothing to worry about.
2. Your doctor is not judging your "number."
When your ob-gyn asks how many sexual partners you've had, "it's not something we're asking out of some morbid curiosity or in a judgmental way. We just need to know so we can plan the best healthcare for you," Dr. Berens says. "I do find that women are occasionally resistant to give that information…but we're just trying to plan your screening. We're not even going to remember that about you." As hard as it may be to admit, this also applies if there have been any indiscretions in your relationship. If sex has occurred outside of a monogamous relationship, it can influence which tests you need. "I might suggest an annual pap smear [instead of every three years] as well as testing for gonorrhea and chlamydia," Dr. Minkin says. "Not because I'm judgmental, but because it's important for your health."
3. Pap smear guidelines have changed.
There's no doubt about it: A Pap smear is an important test, since cervical cells are swabbed and tested for many conditions, including cervical cancer. The question is how often you need one. This is why it's vital to tell your doctor as much as possible about your body, history and lifestyle. "The screening guidelines have changed, so how often you need a Pap smear depends on your last results and your personal history," Dr. Berens says. But, she adds, even if you don't need a Pap test every year, "that doesn't mean you can skip your annual exam."
4. There's no such thing as birth control with no side effects.
Though there may be one kind of birth control that works best for your body, there's no such thing as birth control with zero side effects. "All forms of birth control have side effects, as does no birth control-the side effect of that is pregnancy!" says Dr. Berens. With this in mind, give your body plenty of time to adjust to a new treatment before deciding it doesn't work. "If we could tell which was best for you by looking at you, that'd be great, but we need to give it a fair trial," Dr. Berens says. "You need at least three months to get used to it." It's important to remember, however, that even though fertility decreases as you get older, you can still get pregnant until menopause. However, if you're over 40 and condoms are your only form of birth control, you should be OK. "Condoms alone are pretty good for a woman in her 40s. Her rates of pregnancy are pretty low, so as long as she uses a condom reliably, I'm OK with that."
5. Medical intervention for your delivery shouldn't be taken lightly-or overlooked.
One thing Dr. Minkin sees routinely that concerns her is "section on demand"-an elective, prescheduled cesarean. "If you have a breech or something like that, it's another story. But if you just feel like having a C-section, it's plain crazy-especially if you're planning on having more than one child," she says. "If you've had one C-section and you get pregnant again, your chances of having complications are much higher." Another issue is electing to have a baby preterm. "There are a lot of women who want the baby out early because they don't want their body to stretch. Or they're tired of being pregnant," Dr. Minkin says. "But barring a medical condition, don't induce your baby two, three or four weeks early. Let Mother Nature do her thing." Conversely, Dr. Berens urges women not to feel guilty if they do need medical intervention once they finally go into labor. "All deliveries that end with a healthy mother and a healthy baby are success stories. So please don't feel like you're less of a mother because you need pain medication or a cesarean," she says. "A lot of patients come to me and believe they'll have natural childbirth, but then they'll want pain medication during labor and sometimes they'll feel bad about that. Plenty of women who've had medication or epidurals have wonderful children."
6. A low sex drive is rarely a hormonal problem.
During a doctor visit, many women bring up the topic of low libido. However, it's most likely tied to lifestyle rather than biology. "It's not related to hormones; it's generally related to emotional issues," says Cindy Basinski, MD, an ob-gyn in Indiana. "Maybe you just had children and you're exhausted; or maybe you and your spouse are having issues with the relationship, and you feel like he's not paying enough attention to you." The only exception is menopausal women, who may notice a decreased sex drive. However, Dr. Basinski says, even then it varies. "Plenty of women in menopause have excellent sex drives and excellent sex lives," she says. If a low sex drive is affecting your relationship, "it's definitely worthwhile to see a therapist because we don't want that to happen," Dr. Berens says. "But we also don't want women to think they're abnormal. They're not alone, and it's not unusual."
7. Don't stress if the date of your period fluctuates.
Even the healthiest women experience some menstrual variation. So when your doctor asks if your periods are regular, unless they're completely unpredictable, you're probably fine. "Sometimes people say they're irregular because they don't come on the exact same day of the month, and sometimes they will say they're irregular because it's a different color. These things mean nothing," Dr. Berens says. But your actual flow is another matter. "Your doctor wants to know if…it's heavier than usual, as in soaking a pad in an hour or much bigger clots." If you experience more cramping, bloating or breast tenderness than normal, try taking ibuprofen. If that doesn't help, then talk with your doctor.
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8. Pay attention to abnormal discharge.
Two non-sexually transmitted infections that women commonly experience are yeast infections and bacterial vaginosis, yet the symptoms-and the treatments-are different. "They are separate vaginal infections, caused by different organisms," Dr. Berens says. "Yeast infections are caused by yeast or candida, and will cause an itching or burning feeling. And depending on how bad it is, it can give you a discharge that's thick and watery at the same time, like cottage cheese." Bacterial vaginosis, on the other hand, is caused by an imbalance in your body's natural bacteria. "Usually those women will describe a 'fishy' odor and the discharge will be grayish or yellowish. Usually it is an odor issue as opposed to an itching issue," she says. If you notice these types of symptoms, follow up with your doctor. Although vaginosis can clear up on its own, it's most often treated with antibiotics. Yeast infections, however, can often be treated with over-the-counter medication, but only if you've had them in the past and are familiar with the symptom. "If [it's] like what you've had before, then I think it's OK to use over-the-counter treatments," Dr. Berens says. "Only contact your doctor if it doesn't work or if it's the first time you've had an infection."
Original article appeared on WomansDay.com.
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