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What Do I Discuss With My Gynecologist?

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There's no way around it: gynecologic and sexual health can be uncomfortable topics to discuss with a medical professional. It isn't always easy to know what's normal and even when something just doesn't seem right, it can be difficult to tell your doctor.

As an obstetrician-gynecologist (OB-GYN), I'm best able to serve my patients when they're open about their health, symptoms, and history. And even though an individual might find a topic awkward, or even embarrassing, I want them to know that I’m here to help them without any judgment. My goal is simply to listen to patients’ concerns and find the best way to help them.

Talking openly about gynecologic health not only allows for a conversation about preventative measures, but it can help to catch potential problems sooner, when they’re often easier to treat.

If you're wondering what's fair game for discussion with your OB-GYN, the short answer is: everything. Here are some of the most important topics that I often discuss with my patients.

Your health, family, and medication history. When I meet a patient for the first time, I want to get up to speed on their background. To deliver the most effective care, it helps to know about any diseases or conditions a patient has, whether they're currently taking any medications or supplements, or if they're using contraceptives. If a disease or condition runs in a patient's family, that's important to know as well.

Discussing a patient's sexual history is important too. We understand that these are personal details, but knowing the number of sexual partners someone has had and their age when they first started having sex can inform their risk for sexually transmitted infection (STIs). It can also help me determine how often a patient should consider getting screened for STIs.

Your screening test needs. Screenings can help patients stay on top of their health and even save lives. If you have a uterus, it's generally recommended that you come in for a pelvic exam every year starting at age 21. We will screen you for cervical cancer with a Pap test (also known as a Pap smear), a test for the human papillomavirus (HPV), or both tests. HPV is associated with cervical cancer and other cancers of the vulva, vagina, penis, anus and back of the throat. Patients and I can discuss which guidelines make the most sense for them, as it usually varies per patient.

Even though gynecologic care is my primary focus, for many patients, I'm also the starting point for conversations about screening for breast cancer. People of average risk for breast cancer should start yearly mammograms around age 40, but those at higher risk may need to be screened more often and sooner. Together we can assess your family history and other risk factors to decide on a comprehensive screening plan for you.

Your options for safe sex and birth control. Methods for preventing pregnancy and reducing the risk for STIs aren't “one size fits all.” Barrier birth control methods, like condoms; birth control pills; and long-acting contraceptives, like IUDs, can all be effective. But the right choice depends on a patient's sexual activity and age, their lifestyle, and if and when they plan to try to conceive. Be open about your needs and your preferences, and we'll find the best contraceptive choice for you.

Any uncomfortable or unpleasant symptoms you may have. I tell patients that in my office, no symptoms or problems are off-limits. The body isn't something to be ashamed of, and the more candid a patient can be, the better able I’ll be to help. It's always worth speaking up about symptoms such as:

  • Irregular or painful periods. The average menstrual period occurs roughly once a month and lasts for 3 to 5 days. Some days may be lighter or heavier; some may be accompanied by mild cramps, back pain, or mood changes. If a patient's periods fall far outside of this realm, are interfering with everyday life, or are accompanied by spotting or bleeding in between periods, they should tell me. In some cases, these may be signs of conditions that need treatment.
  • Unusual vaginal odor. A smell that's different from what you normally smell like could mean you have a bacterial overgrowth or a vaginal infection, especially if the odor seems foul or fishy.
  • Bumps around the genitals. Sometimes bumps or growths around the labia are simply ingrown hairs or pimples. But they also have the potential to be more significant conditions, and it's important to know the difference.
  • Urinary or fecal incontinence. Leaking urine or feces or having to urinate more often than usual can be embarrassing to talk about. But for me, it's a matter-of-fact issue that can be addressed with medication, lifestyle changes, surgery, or pelvic floor therapy so a patient can have a better quality of life.
  • Painful sex or low sex drive. It's common for patients to undergo changes at different stages of life that can make sex uncomfortable or less appealing (or both), especially in the years leading up to menopause and afterward. But often these problems can have fairly simple solutions. Sexual discomfort caused by vaginal dryness can be eased with vaginal estrogen, for instance.

Preparing for pregnancy

If a patient tells me they're planning on trying for a baby in the near future, I encourage them to start thinking about their fertility now.

Often, I often recommend stopping hormonal birth control for a few months before the patient actively begins trying to conceive. That can help them get acquainted with their body's fertility window to figure out when they're ovulating each month, making it easier to pinpoint the best days for intercourse and increasing their chances of getting pregnant.

Take charge of your gynecologic well-being

It’s important to see an OB-GYN at least once a year. Your routine visit is a good time to discuss any concerns you may have about your gynecologic health, including your sexual health.

Schedule an appointment or call 800-TEMPLE-MED (800-836-7536) to meet with a Temple Health OB-GYN.

Helpful Resources

Looking for more information?

Enrique Hernandez, MD, FACOG, FACS

Enrique Hernandez, MD, FACOG, FACS, is a J. Robert Willson Professor and Chair of Obstetrics and Gynecology, and a Professor of Pathology and Laboratory Medicine at the Lewis Katz School of Medicine at Temple University. He has been distinguished with multiple awards, such as the 2018 CRISTOL AWARD of the Philadelphia County Medical Society and 2015 Citizen of the Year Award from Concilio (Council of Spanish speaking Organizations of Philadelphia). He has also been named one of the Top Doctors by Philadelphia Magazine from 1991-2022. 

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