Gynecology
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Top 7 Questions Women Ask Their Gynecologist

You’re not the only one wondering.

1 / 8

By Rose Hayes

Unpredictable periods, vaginal changes, how to avoid STIs … you’re not the only one who’s wondering—or worrying—about women’s health issues like these. If you’re experiencing new or worsening symptoms your OGBYN should know about, make an appointment to get answers specific to you. But, in general, you’re probably curious about some of the same questions other women have.

Allison Giles, DO, an OBGYN associated with Henrico Doctors' Hospital in Richmond, Virginia, shares the questions she gets asked most often, plus the answers every woman should know. 

Can you get tested for every cancer?

2 / 8 Can you get tested for every cancer?

There are three main gynecological cancers we think about: ovarian, uterine and cervical cancer, says Dr. Giles. We don’t have a reliable screening test for ovarian cancer, but we can use an ultrasound to look for abnormalities on your ovaries. There’s also a blood test that can detect tumor markers—but neither of these methods is 100 percent reliable for diagnosis. That’s why it’s so important to tell your doctor ASAP if you notice any ovarian cancer symptoms.

What about the other cancers?  

  • Uterine Cancer: There’s no screening test, but your OBGYN will check for suspicious symptoms during routine exams. “If you have bleeding after menopause, for example, we’ll perform an endometrial biopsy to test for uterine cancer,” she says. “That involves taking samples of uterine tissue to see if it contains abnormal or cancerous cells.”
  • Cervical cancer: We use the Pap test to screen for cervical cancer, says Giles, which can detect two things. “One is the presence of abnormal cervical cells; the other is the Human Papilloma Virus, which causes cervical cell changes. If you’re at low risk for cervical cancer, you don’t need an annual Pap. Women ages 21 to 30 at low risk should have one every three years (and you don’t need to get the HPV test during Pap smears until age 30). After age 30, we do Pap smears every five years if you’re low risk and you’ve had normal screenings in the past.” 

Even if we don't perform a Pap test every year, you should still see your OBGYN annually, she adds. You should have a yearly visit so they can perform a full physical exam, including pelvic and breast exams.   

Are my periods “normal?”

3 / 8 Are my periods “normal?”

“There’s a wide variety of ‘normal’ periods,” says Giles. “A lot of women think theirs are too heavy or too light, when really, they’re fine. A normal menstrual cycle can be anywhere from 21 to 35 days long, and a period may last anywhere from one to seven days. Blood flow is usually heavier at the beginning, and then lighter towards the end. But even that’s not true for everybody.”

How can you help your doctor determine if your period’s normal? Dr. Giles recommends using a period tracker app, such as Pink Pad. “These apps help me get a snapshot of what's happening with your menstrual cycle. Instead of trying to piece together a pattern based on memory, they let me see exactly what you’ve experienced over recent months.”

In addition to tracking how long and heavy your periods are, take note of any symptoms you have. Tell your doctor if they’re severe or interfere with your daily activities; conditions such as premenstrual dysphoric disorder and endometriosis are often incorrectly brushed off as PMS or heavy periods.

Are periods even necessary?

4 / 8 Are periods even necessary?

“Another question I get asked is, ‘are periods medically necessary?’” says Giles. “And the answer is no, they’re not. Some people like to see them every month to know they're not pregnant. Others are happy to let their periods go—both options are safe.”

There are several birth control methods (such as intrauterine devices) that can help to either lighten your periods or get rid of them all together, for as long as you're on the medication, she explains.

Another perk to kissing Aunt Flow goodbye? Ovulating less over the course of your reproductive years may help lower ovarian cancer risk. So birth control methods that prevent or reduce ovulation may offer some protection. That can include certain hormonal birth control pills, as well as some of the no-period methods. 

What’s the best birth control?

5 / 8 What’s the best birth control?

“People want to know; is this the best birth control for me? And I won't have an answer unless you come in and chat with me,” says Giles. “Then, we can figure out your specific needs. But, in general, we’ve seen a surge in people interested in long-acting, reversible contraceptives, such as intrauterine devices (IUDs) and implantable devices like Nexplanon.”

Reversible devices are extremely safe, effective and can be removed when you’re ready to start a family, she explains. Nexaplanon is a tiny rod we place in your arm, which can last for three years. An IUD is a small device that’s placed in the uterus. IUDs come in two varieties: ones with hormones, and ones without, she continues. The hormone-free one, ParaGard, is made of copper and can last up to 10 years. IUDs with hormones include Mirena, Skyla, Kyleena, and Liletta. These all have a form of the hormone progesterone, which makes uterine lining thin, so periods are lighter.

There are also pills that offer different hormone levels. You and your doctor need to make an individual decision about which pill might be best for you. “And then there’s the vaginal ring, which is a flexible device you place in your vagina,” Giles says. “You leave it in for three weeks, take it out, get a period, and then put a new one in. It’s a nice middle ground between remembering the pill every day and long-acting reversible contraceptives.” 

How do you deal with vaginal dryness?

6 / 8 How do you deal with vaginal dryness?

During menopause, many women notice vaginal irritation and dryness due to decreasing estrogen levels, says Giles. “There are many different options, including lubricants, medications and noninvasive procedures to help cope with this.”

“Lubrication is a must at this age, both for pleasure purposes, and also safety,” she says. “Dry vaginal tissue is more prone to injury during intercourse, so it's important to maintain lubrication.” (Find out which type of lube is right for you.)

Post-menopausal women may also benefit from topical estrogen cream. “Topical estrogen is safe for the majority of women because it’s not absorbed into the blood stream as much as the oral formulations can be. It stays in the area it's applied—in this case, the vagina—and helps to increase the blood flow to and the health of those tissues. ”

There are also non-hormonal moisturizers, such as Replens, which you can find over the counter. Noninvasive procedures like ThermiVa can help women regain vaginal elasticity and comfort, as well, and require little-to-no downtime. 

Can you cure my STI?

7 / 8 Can you cure my STI?

“Sexually transmitted infections (STIs) are common, and a lot of people want to know, is this the type that’s with you forever, or is it the type that can be cured with antibiotics?” says Giles. “The STIs that can be treated with antibiotics, and cleared up completely, are gonorrhea, chlamydia and trichomoniasis. Syphilis is also treatable with antibiotics. The ones that will stay with you for life are herpes, HIV and Hepatitis B.”

Hepatitis C, which is transmitted by blood-to-blood contact, has traditionally been an illness that stays with you for life. However, it’s now considered curable with new (and expensive) medications. Learn more about living with and treating Hep C.

If you’re considering HIV testing, or you’ve been recently diagnosed, here’s what you need to know.

Can oral sex spread STIs?

8 / 8 Can oral sex spread STIs?

“People often wonder if oral sex is really a way to transmit diseases. And certainly, the answer is yes,” says Giles. For example, herpes, chlamydia, syphilis and human papilloma virus (HPV) can be transmitted via oral sex, among many others.

“HPV can cause cervix changes, as we mentioned before, but when spread through oral sex, it can result in throat cancer as well,” she explains. “There’s a vaccine to help protect against the cancer-causing strains of HPV, so all young boys and girls should get the full series of shots from their pediatrician.”

Always ask new male partners, or those with unknown STI statuses, to wear a condom during oral sex; female partners should wear dental dams. Find out about free, fast and confidential STI testing near you.

Read more from Dr. Giles.

Gynecology

Gynecology

There are many key areas in the field of female reproductive system health, including menstruation, pregnancy, fertility, and menopause. As a woman, you may be concerned about other issues related to your sexual health, including ...

genital problems and sexually transmitted diseases. If you are a female that is sexually active, or over the age of 18, it is important to begin seeing a womans' health specialist in order to make sure that your reproductive system stays healthy. Before that, any concerns with menstruation should be addressed with a physician. As you get older, most women become concerned with issues pertaining to avoiding or achieving pregnancy, until menopause begins around age 50.
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