Important Questions to Discuss With Your Gynecologist

January 4, 2011

For most women, the ultimate goal for your gynecological exam is to get in and out as fast as humanly possible; you likely grit your teeth and fantasize about an island vacation during the pelvic and pap smear and cross your fingers behind your back as you blithely fib about your last breast exam. Many of us justify our rush through the dreaded gynecological exam by telling ourselves the doctor is in a rush to get to the next patient anyway, so we're just helping out. The truth is, however, that most doctors truly want to give their patients the very best care possible, and, in any case the doctor can't address what you don't tell him. Potentially crucial women's health issues can be easily lost in the shuffle unless you take the time to discuss the most important gynecological questions with your doctor.

Should I Be Tested for STD's?

Most doctors wish their patients would be completely open and honest about their sexual activity, even if-or maybe especially if-they have engaged in risky sexual behaviors. In this day and age, "risky" can almost be categorized as anything other than abstinence or a long-term monogamous relationship. If you give your doctor a reasonable "heads-up" on your sexual past, he can be on the lookout for symptoms of chlamydia, gonorrhea, pelvic infection or syphilis, and will likely increase the frequency of your Pap smears. He can also recommend HIV or hepatitis C testing when appropriate.

Should I Change My Contraceptive?

Many of us treat our contraceptive like our hairstyle-it worked fine fifteen years ago, why change now? Just because a certain contraceptive worked well for your health and your lifestyle in the past, doesn't automatically make it the best choice now. Perhaps the pill has caused symptoms you're unhappy with, or, as you've gotten older you are more concerned about the possible side effects. There are many types of contraceptives such as the patch, IUD's, condoms and diaphragms, all of which can be right for you now.

What Can I Do About Incontinence?

You may be surprised to know that up to 20 percent of women experience urinary incontinence at some point by the time they reach thirty-after that the numbers rise significantly. Yet few of those women raise the issue with their doctor. If you have had children, then you know that childbirth weakens the urethra's sphincter muscles, then any type of external pressure such as a sneeze or cough can cause leakage. There are also "triggers" which can exacerbate the problem of incontinence such as artificial sweeteners, stress, caffeine, iced drinks or hot peppers which can cause the nerves which control the bladder to set off a spasm. The good news is that your bladder can be effectively retrained through Kegel exercises, medications and some alternative treatments, so put aside your shyness and discuss the issue frankly with your doctor.

Why am I Having Irregular Periods?

Women's cycles will fluctuate throughout the years for various reasons. When women are young they tend not to pay much attention to their periods other than making sure they are not pregnant, yet few realize that even with a negative pregnancy test a missed period or spotting can be a sign of a potentially dangerous ectopic pregnancy. Irregular periods or an especially light period can be a sign of infection, thyroid disease, endometriosis, fibroids, hormonal disorders, or even cancer of the cervix or uterus. While light or missed periods generally mean little beyond hormonal fluctuations due to stress, they can be more serious and deserve a mention to the doctor.

What if I am Having Sexual Problems?

This one in particular makes women of all ages squirm. The good news, however, is that most problems in this area can be successfully addressed by your OB/GYN. Whether you are experiencing low libido, or discomfort or pain during intercourse, your gynecologist is likely to be able to determine the reason, then treat. For example, many anti-depression and anti-anxiety drugs can cause loss of libido, as can certain oral contraceptives. Intercourse discomfort or pain can be caused by endometriosis, pelvic inflammatory disease, or something as simple as a yeast infection.

Beyond these very important questions, you should be able to discuss any pass sexual assault or abuse with your doctor as it could be important to your present medical issues. Ask about your test results and have your doctor explain them in detail to you. Your lifestyle choices, such as smoking and drinking can also have negative effects on your sexual and reproductive health, so be honest with your doctor regarding your day-to-day actions. If you can communicate openly with your doctor, your health will be the winner.

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