"You should talk to your doctor about any issues that bother you," explains Robert Conatser, M.D. "They might be normal, but let us discuss it with you." The warning signs of potentially serious medical problems related to sex, he says, include bleeding after sex, significant pain with sex and pelvic pain and/or vaginal discharge.
A large part of determining where those problems stem from is patient history, which happens to be what we women tend to clam up about the most. Carrie Brooks, a 28-year-old who had a cervical cancer scare a few years ago, admits that speaking about her sexual activity to her doctor intimidated her at first.
"One thing I was always uncomfortable talking to my doctor about was 'the number,'" she reveals, referring to the number of sexual partners she has had. "But then again, I figured if it embarrasses me enough to bring it up, it's probably important enough to talk about."
According to Gweneth Lazenby, M.D., being honest about your sexual history, no matter how momentarily uncomfortable, is imperative. "Patients should be truthful about the number and types of sexual partners they have or have had," she elaborates. "This is critical in determining whether or not they need STD screening and which infections to screen for."
Risky sexual behaviors — which can include anything from having unprotected sex to S&M — nears the top of the list of topics women are frequently unwilling to bring up.
"These topics are very important to discuss with your physician, because frequently the complications arising from them are treatable," Dr. Lazenby says, "and, in the case of risky sexual behaviors, there are infections that can and should be prevented by modifying sexual behaviors."
Or, along the same lines, is it normal to pee myself a little bit sometimes? For many women, urinary incontinence is a real and frequent problem. And, unfortunately, many of those women are too embarrassed to bring the issue up to their doctor.
"Women are less willing to discuss problems surrounding bodily functions," Dr. Lazenby divulges. "However, many of the disorders we encounter in gynecology are treatable with medical or surgical therapies. It is best to disclose to your physician any concerns you have about your body rather than suffer through the condition."
Peeing too often or "leaking" falls in that category. Asserts Lazenby, "Urinary incontinence is a disorder that is very treatable, and women who suffer with this should feel comfortable telling their gynecologist their symptoms."
The hard truth about suffering through a few moments of potential embarrassment is that doing so could save your life or, in the very least, a lot of pain and frustration in the long run. Most doctors have a laundry list of patients they wish would have told them about pelvic pain when it first started.
For Dr. Conatser, it's a "long list" — one that includes a patient who secretly suffered with pelvic pain for a year before ultimately being diagnosed with late stage ovarian cancer. Another patient failed to mention she had been having pelvic pain and had skipped her period for five months. As it turns out, she was pregnant and had been drinking alcohol and taking medications that are harmful during pregnancy.
Whatever the issue, your doctor might be able to help. But there are other benefits to fessing up, too. "There is some comfort in getting something off your chest," Conatser posits.
Do you know how often you should be getting screened? Many women don't, and they don't bother to ask, either. "Many patients think that pap smears are done every year and, in fact, our national guidelines surrounding the frequency of pap smears have changed significantly," elaborates Dr. Lazenby.
Plus, there is something else women can do to be proactive when it comes to cervical cancer. Says Lazenby, "Women under 26 should inquire about HPV vaccination, if they have not already been vaccinated."
"It is very normal to have some fear asking questions," reassures Dr. Conatser. "That is why it is so important to form a bond with your physician so there is a level of comfort." And, he asserts, it may be time for a change if you and your doctor don't share an easy rapport. "You should seek out a physician whom you are comfortable with. It allows us to make better decisions regarding your health."
Marilyn Richardson, a 57-year-old mother of three and grandmother of seven, says that her longtime gynecologist is a treasured confidante. "When I went through my divorce, he gave me advice and even put me in touch with my lawyer," she reveals. "When I found love again and was considering re-marrying, he urged me to follow my heart."
What it all boils down to is trust. No matter what questions you're asking, what your doctor really wants is simply that — for you to ask. "I wish my patients would tell me what's bothering them," says Dr. Conatser. "I know that sounds simple and vague, but that's really what we as physicians want. We want to hear about the things that keep you up at night thinking… the aches and pains and feelings you've always wondered about. If it's bothering you, let us know, and we can reassure you or work to figure out what's going on and get it fixed."
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