6 Questions for Your OB-GYN

Gynecologic problems can be embarrassing or scary, but it's important to talk about them

When it comes to your health, knowledge is power. The more you know, the better chances you have to prevent, control and treat any problems that arise. And one of the best ways to learn about your body is by asking plenty of questions at your doctors' appointments.

However, that can be easier said than done when addressing gynecologic health.

"Some women get embarrassed talking about problems with their periods, discharge or sex," says Allison Chen-McCracken, MD, an OB-GYN at Rush. "But remember, this is an environment where you can feel free to ask questions without any judgment. This is what we do as physicians; we're used to it, and you can ask us anything."

To help get these (sometimes awkward) conversations started, we asked Chen-McCracken to share — and answer — some of the most common questions she hears from her patients.

1. Is my discharge normal?

"It is completely normal to have discharge (fluid from the vagina)," she says. "It will vary in color and consistency throughout the month, depending on where you are in your menstrual cycle."

At the same time, changes in your discharge may reveal insight into your gynecologic health. For example, if discharge is accompanied by itching, irritation, a new or bothersome odor, or burning, it could signal a yeast infection or bacterial imbalance — both of which can be treated with medications.

Chen-McCracken also notes that discharge with the following risk factors could signal a sexually transmitted disease:

  • Having multiple sexual partners
  • Not using condoms with a new partner

2. Is it safe to use hormonal birth control to completely skip my period?

Several types of hormonal birth control not only prevent pregnancy, but also allow you to completely stop bleeding each month. And McCracken says this is an entirely safe way to use birth control.

Some contraception that prevents you from getting pregnant also prevents the lining from forming in your uterus — the way it does naturally (when you are not using birth control). So there is no need for your body to menstruate in order to flush lining, tissue and blood from your uterus each month.

"When you're not on birth control, getting a monthly period lets you know your hormones are communicating and that everything is functioning from a reproductive standpoint," says Chen-McCracken. "If your periods were normal before you start birth control, going on birth control does not change that — even if you don't bleed at all."

3. Why am I never in the mood?

Chen-McCracken notes that one of the hardest things for her patients to ask about is sex — specifically, problems with sex.

It is important to discuss pelvic pain or problems with intercourse," she says. "But it is equally as important to talk about sexual dysfunction, decreased libido and problems with orgasm. Those are the things women don't necessarily think they should bring up — but they absolutely should."

Decreased interest in sex is common, particularly as you age. For example, many women notice a drop in their libido after having children. This can be attributed to both hormonal fluctuations and significant lifestyle changes, such as increased stress and lack of sleep.

Additionally, some women experience increased vaginal dryness as they approach menopause if they have not been sexually active compared to women who are sexually active

"Unfortunately, a decreased interest in sex is not something where we can simply check your hormone levels and say, 'Here's the problem,' " says Chen-McCracken. "That's why it's so important to talk about. Once your doctor knows what's going on both physically and emotionally, we can help figure out what is contributing to the problem and start addressing the issue comprehensively."

During menopause, it is important to stay on top of your gynecologic health by regularly seeing an OB-GYN or a primary care physician experienced in women's health.

4. Why am I having urinary problems?

Age and pregnancy are the two most common reasons women start experiencing urinary problems, such as incontinence, frequent urination or overactive bladder.

"Although most urinary problems are not dangerous, they can have a significant impact on your quality of life," says Chen-McCracken. "How we treat the problems depends on not only why you are having the problem, but also how long you've been suffering and how bad your symptoms are."

Treatment options vary depending on how bad your symptoms are and how long you have been suffering. These are some options for treating urinary problems:

  • Lifestyle changes, such as limiting caffeine and timed voiding (using a clock rather than your body to tell you when to urinate)
  • Kegel exercises to help strengthen pelvic floor muscles
  • Pelvic floor therapy that utilizes physical therapy techniques to strengthen, relax and/or improve function of your pelvic floor muscles
  • Medications that can help improve bladder function by relaxing bladder muscles, increasing the amount of urine your bladder can hold and helping improve communication between the brain and the bladder
  • Surgery, which can include a sling placed around the urethra to support it and help with urine retention

5. Do I need any regular screening tests besides a Pap smear?

A Pap smear is certainly important, but it is not a comprehensive screening test. "The Pap just screens for cervical cancer," says Chen-McCracken. "A lot of women think it screens for more than that, but it doesn't. During a pelvic exam, we can also collect samples to test for STDs, like gonorrhea or chlamydia, but a Pap alone does not test for those."

Other important screening tests can include the following:

  • Pelvic exam to assess uterine, ovarian, vaginal and vulvar (the external skin around your vagina) health
  • STD screening, which includes cell and fluid samples from a pelvic exam, as well as urine and blood tests
  • Breast exam and, starting at age 40, routine mammograms

6. Do I still need to see an OB-GYN when I'm in menopause?

During menopause, it is important to stay on top of your gynecologic health by regularly seeing an OB-GYN or a primary care physician experienced in women's health.

You'll still need regular pelvic exams and sometimes Pap smears. And you should pay close attention to any new or unusual symptoms, such as postmenopausal bleeding or sustained pelvic pain.

"Once you've had your final period and you've gone 12 months with no bleeding, you shouldn't have vaginal bleeding again," says Chen-McCracken. "If you do, you should get it evaluated. While most women who have postmenopausal bleeding do not have a serious condition, it is the most common symptom of uterine cancer."

That is just one reason to continue asking questions and sharing your women's health concerns with your OB-GYN at all stages of your life.

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