5 Things You’re Too Embarrassed to Tell Your OB/GYN
Let’s be honest—it can be awkward, uncomfortable, or downright embarrassing to ask the doctor about what’s really going on ‘down there’ during an annual gynecological exam:
- “Is this smell normal?”
- “Oh no, a bump! What is it?”
- “And why can’t I sneeze without peeing my pants?!”
“By all means, you should ask,” says Stacy McCrosson, MD, Virtua obstetrician and gynecologist. “In my practice, women often come in for their yearly exams saying there are no problems. Then, when I’m ready to leave the exam room, often with my hand literally on the doorknob, they’ll have ‘just one more question,’ something they felt funny asking about before.”
Let’s get that conversation started now, shall we? Dr. McCrosson has plenty to say about five of the most common blush-inducing issues.
"Typically a strong vaginal odor is a sign of an infection,” says Dr. McCrosson. “But that doesn’t mean it’s a serious infection, or a sexually transmitted one. Bacteria lives all over our bodies—on our skin, in our gastrointestinal tract, inside our vaginas. When there’s an overgrowth of that bacteria, it can cause odor.” Bacterial vaginosis is the most common vaginal infection, and it’s easily treated. You can also take steps to prevent bacterial infection by avoiding clothing or activities that stimulate bacterial growth. Wearing thongs, soaking in a bathtub, and douching, for example, will all increase bacterial growth inside the vagina.
The vagina is constantly cleaning itself, and vaginal discharge simply consists of dead cells exiting the body. That said, the amount of discharge produced can vary widely from woman to woman. “I’ll hear women say things like, ‘I need to wear a pantyliner every day, but my friend doesn’t,’” says Dr. McCrosson. “But what’s normal for them might not be normal for you.” That said, depending on color, consistency, or other accompanying symptoms (odor, itch, or discomfort), discharge may also be a sign of an infection. With a simple pelvic exam, your doctor can tell you whether your discharge is normal or requires medical treatment.
Lumps and Bumps
“Women tend to freak out any time they feel a lump or bump down there,” says Dr. McCrosson. “They often jump to the conclusion that they have a sexually transmitted infection; while they sometimes do, they also might have something totally benign—an ingrown hair, an inflamed hair follicle, a blocked sweat duct, or a pimple.” Keep in mind that bumps surrounding hair follicles are more common if you remove hair from your bikini area. If you shave your pubic hair, for example, do not use the same razor you use for your armpits. “You are transferring bacteria from one part of your body to another, and that can cause problems,” warns Dr. McCrosson. “Also, be sure to replace the razor you use for your pubic hair at least once every three days to reduce the risk of infection.”
Leaking urine between trips to the bathroom (incontinence) becomes more common in women as we age and have babies. The drop in estrogen in post-menopausal women and the loosening and weakening of pelvic floor muscles after pregnancy are both common culprits. “I often say I can pick out a mom from across the room, because when she sneezes she crosses her legs,” says Dr. McCrosson. Mention this issue to your doctor and s/he can determine what type of incontinence it is (stress incontinence or urge incontinence) and whether it can be treated with exercises alone or whether medical intervention might be needed.
Oh, and a Bit about the Bedroom
“Low sex drive, inability to orgasm, and pain during intercourse are all common issues with the women in my practice," says Dr. McCrosson. "I wish my patients would talk about them more. There can be lots of potential causes, and most of them are treatable.”
Keep in mind that you don’t have to wait for your annual exam to address any of these concerns. Make an appointment at any time; if you do decide to wait for your routine visit, be sure to mention to the office staff ahead of time that you’re having a problem you’d like to discuss with the doctor. “You don’t have to tell the person on the phone what the problem is, but chances are if they know there’s an issue beyond a routine checkup, they’ll allot extra time for your appointment,” says Dr. McCrosson. “You can also ask for the first or last appointment of the day, which tend to be when doctors have the most time to talk.”
It’s okay to be a little embarrassed about these issues—go ahead and tell the doctor you’re embarrassed, even. But talk to your doctor. Be careful with self-diagnosis, and when in doubt make an appointment to be evaluated. “So often my patients come in fearing the worst,” says Dr. McCrosson, “when their issues are, in fact, totally benign.”
Updated June 6, 2016