The 10 Top OB/GYN Questions People Ask Their Gynecologist
Since 1997, Mid-Atlantic Women’s Care, the premier OB/GYN group in Hampton Roads, has been providing superior healthcare for women of all ages. Consisting of over 70 physicians dedicated to establishing trusted patient-doctor relationships, Mid-Atlantic Women’s Care offers comprehensive women’s health services ranging from Pap smears and mammograms to infertility issues, menopause, and disorders affecting the female reproductive system.
Patients have asked our OB/GYNs hundreds of different questions over the years, but there are ten questions we get asked more frequently than others. If you don’t find the answers you’re looking for here, or if you need to schedule an appointment, don’t hesitate to reach out to Mid-Atlantic Women’s Care today.
1. How Can I Protect Myself From HPV, Herpes, and Other Sexually Transmitted Infections?
While abstinence is the best way to avoid an STI, that’s not really a viable option. The best protection against contracting an STI is learning as much as possible about STIs, symptoms of STIs, and why it is important to get the HPV vaccine.
Correct use of polyurethane or latex condoms when having vaginal, oral, or anal sex is extremely effective for reducing the risk of a sexually transmitted infection. Condoms incorporating a silicone-based or water-based lubricant work well to prevent condom breakage.
Female (internal) condoms are both contraceptive devices and STI preventatives. The FDA-approved, pre-lubricated FC2 female condom is safe for women with rubber latex allergies to use and is the only kind of female condom currently available.
The human papillomavirus (HPV) is responsible for the majority of cervical cancers among women between 25 and 50 years old. HPV is also considered a sexually transmitted infection that affects men as well. Anal, penile, throat, and vulvar cancer are possible risks of contracting HPV. It is not uncommon for someone with HPV to remain asymptomatic until the infection is in its latter stages.
Gardasil 9 is an FDA-approved HPV vaccine that can be administered safely to boys and girls as young as 11 years old. The U.S. CDC recommends children receive two HPV vaccinations at least six months apart. However, older teens and young adults will need three doses of the vaccine to optimize effectiveness.
Tests for STIs
Getting tested for STIs regularly not only reduces the risk of unintentionally spreading an STI to a partner but also facilitates the implementation of early treatment. Detecting gonorrhea or Chlamydia involves a simple urine test, while blood tests are needed to detect Hepatitis B, syphilis, HIV, and herpes. HPV is found via PAP tests, colposcopies, or HPV DNA tests.
2. How Often Should I Get a Pelvic Exam or a PAP Smear?
PAP smears detect the presence of abnormal cells within the cervix. In some cases, cellular abnormalities may predict the possible development of cervical cancer. Women between the ages of 21 and 29 should get a PAP smear at least once every three years. Women over 30 are recommended to keep getting a PAP smear every three years unless they test positive for HPV. More frequent PAP smears would then be necessary to monitor the treatment response to HPV.
Women who do not receive abnormal PAP smears should still continue getting a PAP smear every three years until they are 65 years old. Alternately, post-menopausal women with a history of abnormal PAP tests and/or cervical cancer should continue getting PAP smears until their OB/GYN says otherwise. If you have had a complete hysterectomy at any age, you probably don’t need to get a PAP smear unless you’ve had at least two abnormal PAP tests over the past 15 to 20 years.
Pelvic exams allow an OB/GYN to evaluate the condition of the uterus, vagina, Fallopian tubes, ovaries, bladder, and rectum. During a pelvic exam, physicians use special medical tools to detect signs of infection, uterine fibroids, ovarian cysts, or reasons for abnormal bleeding and pain. Before a woman can get a prescription for a diaphragm or IUD, she will need to undergo a pelvic exam.
The Cleveland Clinic recommends that women should start having regular pelvic exams at age 21. PAP smears are often done during a pelvic exam. Adult women who are not pregnant and asymptomatic of STIs or other infections can have a pelvic exam once every three to five years. Women with a family history of medical issues affecting the reproductive organs should consider more frequent pelvic exams. Doctors also recommend regular pelvic exams for women who have had complete or partial hysterectomies.
3. Which Contraception Has Fewer Side Effects: Birth Control Pills or IUDs?
Birth Control Pills
Common side effects of birth control pills are temporary and include:
- Sore breasts
- Nausea (little to no vomiting)
- Spotting between periods
- Changes to menstrual cycle start and end times
Side effects typically disappear within two to three months. Women over 35 who smoke and take birth control pills should consider using another type of contraceptive due to being at risk for myocardial infarction and stroke.
Intrauterine Devices (IUDs)
An IUD is a T-shaped device made of flexible plastic inserted into a woman’s uterus by a gynecologist. Hormonal IUDs (Mirena, Skyla) continuously secrete small amounts of the hormone progestin to prevent pregnancy. Different brands of hormonal IUDs need to be replaced at different times. For example, Mirena prevents pregnancy for seven years. Skyla works to prevent pregnancy for three years before it needs to be replaced.
Common side effects of hormonal IUDs include:
- Backaches and cramps for several days after insertion of the IUD
- Spotting between periods
- Irregular/missed periods
These side effects usually disappear within three to six months. Alternately, some women report having no side effects after insertion of an IUD.
Paragard is the only non-hormonal IUD available for women who do not want to use hormones for contraceptive purposes. It is also T-shaped but wrapped in a thin copper layer that prevents pregnancy for as long as 12 years. Side effects of Paragard include:
- Spotting between periods
- Longer and/or heavier periods
- Increased cramping before and during periods
- Backaches and cramping for a few days after insertion
You can learn more about the advantages and disadvantages of using an IUD by visiting our blog here.
4. How Can I Make My Menstrual Cycle More Manageable?
Cramps, bloating, moodiness, headaches — all women dread dealing with symptoms of PMS every month. While ibuprofen and diuretics may relieve head pain and water retention for a few hours, premenstrual aches, pains, and mood swings often continue for several days after the start of your period. What can you do to relieve menstrual cycle misery before it arrives?
Take Control of Your Lifestyle
Making these permanent changes to your lifestyle can help make that one week out of every month much more manageable:
- Exercise, even though you don’t feel like it. Take a walk, ride a bicycle, paint the bathroom — any kind of physical activity increases the release of endorphins, a hormone made by your body that relieves pain and improves your mood.
- Avoid drinking alcohol and caffeinated beverages. Both induce water retention and worsen headaches and cramp pain.
- Don’t smoke. Nicotine and other tobacco chemicals appear to destabilize hormone levels and lower vitamin D levels. Some studies suggest vitamin D supplements may reduce cramping.
- Avoid salty foods. Craving salty or sugary food is a classic symptom of premenstrual syndrome. Salt, like caffeine, is an anti-diuretic that promotes bloating. If you can’t fight a salt craving, eat low-salt snacks or use a salt substitute to flavor food.
Ouch, Those Cramps!
Is it possible to relieve period cramps without taking OTC pain medication? Cramps are caused by the uterus contracting to shed and expel its lining. However, severe cramps should be evaluated by your OB/GYN. They may be a sign of endometriosis, uterine fibroids, or infection.
Some women get relief from cramps by soaking in a hot tub, placing a heating pad on their lower abdomen, or applying a heat patch used to alleviate muscle pain. Although some women swear by certain herbal supplements for cramp relief, there is only mixed clinical evidence regarding the effectiveness of supplements.
5. Is It Normal to Smell Down There?
Vaginal odor can be attributed to many things that have nothing to do with cleanliness or infection. Wearing tight-fitting pants, obesity, leaking urine, and your menstrual cycle may make you wonder what’s going on “down there” smell-wise. Bacteria, sweat, and hormones are the three primary reasons why your vaginal area may smell bad one day but not the next day.
When a strong vaginal odor is accompanied by itching and yellowish discharge that smells like fish, it could be bacterial vaginosis (BV). An easy-to-treat bacterial infection, BV is not an STI but tends to affect more women who are sexually active. The CDC states that douching too much and having multiple sex partners can cause an imbalance in populations of vaginal bacteria. Some women are more prone to BV infections than others, and doctors aren’t sure why. Treatment for BV involves antibiotics, not douching, and avoiding sex with multiple people.
One of the most common and easily curable STIs is trichomoniasis, an infection caused by a protozoan parasite. Symptoms of trichomoniasis include:
- Burning, itching, and soreness in and around the vagina
- Painful urination
- Mucous-like vaginal discharge that may be greenish, yellowish, or creamy
- Discharge emits a strong fishy odor
About half of all women and men with trichomoniasis will not have symptoms. Without treatment, a trichomoniasis infection may last for years. Getting regular pelvic exams is the best way for women to detect trichomoniasis in its early stages.
If you are concerned about vaginal odor, please call Mid-Atlantic Women’s Care to make an appointment with a gynecologist.
6. My PMS and Cramps Are Unbearable? At What Point Is This a Sign of a Serious Medical Condition?
Menstrual cramps should not make you double over in pain and prevent you from working or doing daily tasks. When cramp pain is intolerable and unresponsive to pain medication, you should visit your physician as soon as possible. You may have one or more of the following conditions:
Many women have small uterine fibroids that do not impact their overall health. However, some larger fibroids can increase the size of the uterine lining, causing severe cramping and excess period bleeding.
Ruptured Ovarian Cyst
Debilitating cramps accompanied by nausea, vomiting, and sharp pains on one side of your lower abdomen may indicate an ovarian torsion. A ruptured cyst demands emergency medical attention to determine if the condition needs surgery or less invasive treatments.
Endometrium tissue normally lines the interior of the uterus. However, some women experience growth of tissue similar to the endometrium outside the uterus. Symptoms of endometriosis include dysmenorrhea (severe menstrual cramps), pain during intercourse and urination, infertility, and excessive bleeding. A minimally invasive procedure called laparoscopy is typically used to diagnose and treat endometriosis.
7. I’m Going Through Menopause. How Do I Manage Weight Gain, Hot Flashes, and Low Libido?
Although estrogen loss during menopause is the primary reason for low libido and hot flashes, gaining weight is attributed to menopausal women becoming more sedentary due to age-related health problems. In addition, both women and men experience diminishing muscle mass after age 40. Lack of muscle not only slows metabolism rate but makes it easier for fat deposits to accumulate in the hips, abdomen, and thighs.
Managing menopausal symptoms by exercising regularly, eating healthy foods, and getting enough quality sleep is recommended by OB/GYNs. However, managing hot flashes and low libido requires a different approach.
The North American Menopause Society (NAMS) suggests the following to address low libido:
- Blood pressure and antidepressant medications may reduce your desire for sex. If you take medications known to reduce the desire for sex, talk to your doctor about possible alternative drugs or lower dose amounts.
- Vaginal dryness due to menopause can make sex uncomfortable and even painful. Consider trying OTC vaginal lubricants or vaginal estrogen cream to increase lubrication during sex.
- Sex counseling/therapy can help educate and instruct couples on how to use devices designed to arouse libido.
Frequent, severe hot flashes are generally treated with hormone therapy. However, hormone therapy carries some risks, such as an increased chance of blood clots and heart disease for some women. Medications that do not contain hormones may be prescribed for hot flashes. Anti-seizure drugs like Lyrica have been shown to relieve hot flashes. A medication used to treat overactive bladder called Oxybutynin may help some women manage severe hot flashes.
8. What’s the Difference Between Regular Vaginal Discharge and a Yeast Infection?
Most women have multiple vaginal yeast infections throughout their lives. The vagina contains a delicately balanced combination of bacteria types that perform different functions. Lactobacillus (L. Bacillus) prevents excessive amounts of yeast from proliferating in the vagina. Certain medical conditions or medications can reduce the population of lactobacillus, allowing an overgrowth of yeast.
Yeast infections are often caused by:
- Uncontrolled diabetes
- Frequent antibiotic use
- Autoimmune diseases
- Taking birth control pills or hormone therapies that increase estrogen levels
Symptoms of a vaginal yeast infection include:
- Itching in the vulva and vagina
- Burning sensation while urinating and having sexual intercourse
- Swelling and redness of the vulva (typically happens due to constant scratching)
- Rash around/on the vagina
- Discharge that can be whitish and watery
- Discharge that resembles cottage cheese in thickness and appearance
Yeast infections are odor-free, which is why they are often mistaken for normal vaginal discharge. However, normal vaginal discharge won’t be itchy, cause swelling, or make it uncomfortable to urinate or have intercourse. Don’t hesitate to schedule an appointment with a gynecologist if you suspect you have a yeast infection. Antifungal medications are available that can clear up most yeast infections in three to four days.
9. Do I Have a High Risk of Developing Breast Cancer or Cervical Cancer? How Do I Stay Healthy?
A woman’s risk for cervical cancer increases if they:
- Have multiple sexual partners
- Were previously infected with HPV
- Have an impaired immune system
- Experienced three or more full-term pregnancies
- Have taken birth control pills for more than 10 years
The best way to detect cervical cancer in its earliest stages is to visit your gynecologist regularly for a PAP smear and pelvic exam.
Getting mammograms and learning how to perform a breast self-exam to detect lumps before they metastasize prevents thousands of women from dying of breast cancer annually. When caught early, breast cancer treatment like breast-conserving surgery prevents the need for a mastectomy, radiation therapy, and chemotherapy.
10. What Other Cancers Should I Be Aware Of?
For post-menopausal women, vaginal bleeding is one of the first symptoms of ovarian cancer. Other symptoms affecting reproductive-age and menopausal women include pelvic area pain, back or abdominal pain, constipation, and more frequent urination.
PAP tests cannot detect ovarian cancer. Gynecologists urge women to remain vigilant for early warning signs of ovarian cancer and follow their doctor’s orders if they suggest a transvaginal ultrasound or special blood tests to diagnose ovarian cancer.
Uterine cancer is also called endometrial cancer because cancer cells typically begin growing in the endometrium. Women at risk for uterine cancer are over 55, obese, and have been on hormone replacement therapy for more than two or three years.
Symptoms of uterine cancer include pelvic pain, vaginal bleeding, difficulty urinating, and painful intercourse. Getting regular pelvic exams can detect early-stage uterine cancer that may not require surgery.
Do You Have a GYN Question?
Mid-Atlantic Women’s Care is here to help you stay as healthy as possible throughout the many stages of your life. Please contact us with questions, concerns or to schedule an appointment with one of our caring gynecologists. Call our experienced physicians at 757-455-8833 or use our online contact form, and we’ll be in touch right away!