6 things to discuss with your gynecologist

When it comes to sexual health, it can be hard to know what’s “normal” and what could signal a potential health problem. Even if you embarrass easily when discussing certain issues, you should know your gynecologist has seen and heard it all. She is there to help you, not pass judgment.

You should always discuss these six things with your gynecologist:

  1. Sexual history. Women worry their gynecologist is judging them when they ask the number of sexual partners they’ve had, how old they were when they first had intercourse, if they’ve ever had a sexually transmitted infection, or about sexual orientation and gender identity. There’s no reason for concern; these topics arise for several reasons:
  • To determine risk factors for cervical dysplasia and human papillomavirus infection. If you start having sex  when you’re younger than 18, you could be more susceptible to HPV because the cervical-vaginal junction is more pronounced when you’re younger. The greater your number of partners, the higher your potential risk for exposure.
  • To discuss potential ramifications of past STIs. Some STIs can increase the risk for infertility, so physicians want to provide appropriate counseling. Other STIs, such as herpes, last a lifetime and can be spread even if you’re not having an outbreak.
  • To ensure a patient is receiving the best care. LGBT communities are diverse, but research shows certain health concerns among lesbian and bisexual women and trans men are important for LGBT individuals and health care providers to be aware of if they’re treating you.

2. Vaginal odor. Discussing vaginal odor can make you feel uncomfortable, but 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 longer than a few days. Having an odor is normal, but changes or foul smells may be signal bacterial overgrowth or vaginal infection.

3. 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 something more serious? Bumps are often benign, but your doctor should perform an examination when you feel something. Genital warts may be visible for some time, but herpes lesions can heal in a week or so, making it important to be seen when the outbreak is occurring.

4. Sexual discomfort. If you’re experiencing sexual discomfort—pain during sex, vaginal dryness—tell your doctor. You may squirm while talking about it, but your gynecologist can treat your concerns.

  • Vaginal dryness: Vaginal dryness during intercourse 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. A busy mom may not take enough time to engage in foreplay, leading to dryness. If you’re postmenopausal and experience dryness, it can be due to low estrogen, and your gynecologist can prescribe vaginal estrogen.
  • Pain during sex: If sex is painful, try different positions until you find one where you feel comfortable. Sometimes you still may need to speak with your doctor, especially if the pain is there no matter what position you try, lubricants don’t ease vaginal dryness or you have bleeding after intercourse.

5. Low libido. Experiencing a lack of desire to get busy 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 or it may be a sign of an underlying medical condition. Your gynecologist can determine what medical interventions may be needed. For other women, though, a low libido may be related to the nature of female sexuality; sometimes your desire to be intimate can be influenced by things outside of your control, like stress or work. Those of us in long-term relationships are also less likely to be spontaneously aroused compared to how we were in the early days of our relationship. If this is the case, your gynecologist can make recommendations to help naturally increase your libido or refer you to a counselor.

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