8 Vagina Red Flags to Get Checked Out ASAP
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8 Vagina Red Flags to Get Checked Out ASAP

Bleeding, burning, bumps and other reasons to call your gyno immediately.

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By Olivia DeLong

There's a lot going on in and around your vagina—like periods, queefs and squirting, just to name a few. And most of the time, those things are totally normal. But, some below-the-belt issues may mean you need to see your gynecologist.

From abnormal bleeding and discharge to constant itching, OBGYN Elizabeth Newell, MD, of Swedish Medical Center in Littleton, Colorado, gets real about the times you might need to book an appointment with your gyno—stat.

You have bumps or masses down there

2 / 9 You have bumps or masses down there

Bumps or lumps around your vaginal area can be a sign of something pretty harmless, but could also indicate something serious.  

The most common condition Newell sees is razor burn. “We call this folliculitis, where the hair follicle has become inflamed from shaving.” To avoid irritation, Newell recommends trimming or waxing; if you do want to shave, use a new and sharp razor, always apply shaving gel and make sure your skin is wet before you start. “The bumps can actually get infected and in very extreme circumstances, may require us to take out part of the vulva.”  

If you notice flesh-colored bumps that look similar to cauliflower, you may have genital warts, a common sexually transmitted infection (STI) caused by the human papillomavirus (HPV). Most people won’t notice their warts, though they can catch on underwear or clothing when you’re moving around or exercising, says Newell. Your gynecologist can cut, freeze or burn them off.

It burns when you urinate

3 / 9 It burns when you urinate

If you’re having trouble urinating, you feel like you have to pee often or it burns when you go, Newell says it’s best to book a visit with your gyno.   

It may be that your skin is irritated from scented products like soaps and perfumes. But, if you have a urinary tract infection (UTI), there's bacteria in your urine, and you’ll need antibiotics. “If UTIs are left untreated, they can cause kidney infections and make you very sick.” With proper treatment, UTIs usually clear up within one or two days, but kidney infections last longer and may require a hospital stay.

A yeast infection, or overgrowth of yeast in the vagina, can also cause urination discomfort. “The urine hits against the vulva where the yeast infection is, and causes pain,” says Newell. Yeast infections are simple to treat—over-the-counter or prescription antifungal medications can clear symptoms in three to seven days. For those that don’t respond to antifungals or return within two months after the first treatment, you may need stronger medications. 

You’re bleeding heavily after sex

4 / 9 You’re bleeding heavily after sex

Light vaginal bleeding or spotting is common after sex—especially if you haven’t done it in a while, you didn’t use lubrication or you’re about to begin or finish your period. But if you’re vomiting, have a fever or bleed so much you soak a sanitary napkin in an hour, Newell says it's cause for concern.

Causes of postcoital bleeding include:  

  • Cervical polyps: growths located on the cervix
  • Cervicitis: inflammation of the cervix triggered by STIs like chlamydia or HPV
  • Genital sores: lesions from STIs like herpes or syphilis
  • Vaginal atrophy: thinning, drying and inflammation of the vaginal walls  
  • Cervical cancer: cancer that begins in the cells lining the cervix

Treatment depends on your condition. Your gynecologist will perform a pelvic exam to look for polyps, inflammation or tears, and tests to look for STIs. Polyps can be removed via a simple procedure, while an STI may require antibiotics. Moisturizers, lubricants and estrogen replacement therapy can relieve symptoms of vaginal atrophy.

You have funky discharge

5 / 9 You have funky discharge

Vaginal discharge is tricky because there are so many types, says Newell. It’s normal to have discharge during sex, ovulation and pregnancy, as well as after giving birth. But other health conditions can bring about discharge that looks or smells funny:

  • Bacterial vaginosis causes thin, white or gray discharge that smells fishy; antibiotics will usually help clear up the infection.
  • Yeast infections produce thick, white, cottage cheese-like discharge with itching and burning; over-the-counter or prescription antifungal medications are used to treat these.

If you have discharge that is green or yellow and has a strong smell, you should see a doctor. In addition to discharge, itching, pelvic pain, bleeding or trouble urinating are also causes for concern. These symptoms could be a sign of certain STIs like:

  • chlamydia
  • gonorrhea
  • trichomoniasis
It feels like your vagina is swollen

6 / 9 It feels like your vagina is swollen

Vaginal swelling is uncommon, but not unheard of. “Sometimes, adolescents or young women who have just gotten their period for the first time can experience some swelling on both sides of the vaginal lips,” says Newell. This normal process is nothing to worry about.

But if your vagina is swollen or feels full, you may have a Bartholin gland cyst, a small, round sac-like structure near your vaginal opening. A large cyst can be irritating and cause pain when you're walking; if it becomes infected, it can turn into an abscess—a red, painful bump packed with pus. Your gynecologist can open up and drain cysts, and if they recur, a catheter may be inserted to create a permanent opening. An infected cyst may need antibiotics.

You have itching that just won’t go away

7 / 9 You have itching that just won’t go away

Most of the time, vaginal itching occurs because you use soaps, perfumes or fabrics that irritate your skin; this is called contact dermatitis. If this is a problem for you, try avoiding scented products. Bathing regularly and applying a thin layer of petroleum jelly can help relieve irritation, too.

If you’re still itchy, it could be something else like desquamative inflammatory vaginitis, a yeast infection or lichen sclerosus. Intense vaginal itching during menopause might indicate lichen sclerosus, a condition that causes the skin to thicken. You may notice small white spots that eventually form patches, and sometimes red or purple bruises. “Often with lichen sclerosus, you can get into what we call an itch-scratch-cycle where you scratch it, it becomes inflamed and then the inflammation makes you itch more, and the whole cycle repeats,” says Newell. Left untreated, these patches can scar, and while uncommon, Newell says skin patches scarred by lichen sclerosus are more likely to develop into skin cancer.

Strong cortisone creams or ointments can relieve the itch, but often these medications cause other issues like stretch marks, yeast infections and skin redness. So, other long-term treatments like retinoid topical creams and tacrolimus, an immunosuppressive drug, may be necessary.

Your menstrual bleeding is out of control

8 / 9 Your menstrual bleeding is out of control

Some women are destined to have heavier periods than others, but if you have heavy bleeding that lasts longer than seven days, you soak through a tampon or pad within an hour or you have blood clots at least the size of a quarter, it’s time to see your gyno. Here are some of the more serious causes of heavy menstrual bleeding:

  • STIs like gonorrhea or chlamydia
  • Irregular ovulation
  • Uterine fibroids and polyps
  • Medications such as blood thinners, aspirin and intrauterine devices (IUDs)
  • Endometrial, cervical or ovarian cancer
  • Endometriosis
  • Miscarriage
  • Pelvic inflammatory disease

For diagnosis, your gynecologist will discuss lifestyle factors like pregnancy history, medications and menstrual cycle, and then perform a pelvic exam and lab work to test for STIs. Depending on your symptoms and age, you may need an ultrasound, endometrial biopsy or other surgical management. 

Treatment options vary, but for conditions like endometriosis, irregular ovulation and fibroids, hormonal birth control options can regulate bleeding.

It feels like something is falling out of your vagina

9 / 9 It feels like something is falling out of your vagina

You read that right—if your vaginal region feels heavy, full or uncomfortable (as if it's pulling into the pelvis), you may be experiencing pelvic organ prolapse, or a condition that results from the weakening of muscles and connective tissue. When this happens, the uterus, bladder and rectum can drop down from their normal position and press against the vagina. In more serious cases, they may protrude out through the vaginal opening.

Prolapse is usually a result of stress and pressure on pelvic floor muscles. Vaginal child births, genetics, natural aging and prolonged jarring exercises like jumping and running can contribute.

Having symptoms? You'll be tested for pelvic floor strength and bladder function. Once diagnosed, the first line of treatment is usually Kegel exercises, during which you lift, then relax pelvic floor muscles. If these strengthening moves don’t help, surgical options include hysterectomy—removal of the uterus—or colporrhaphy, which tightens the front or back walls of the vagina.

Quick Kegel how-to: contract your pelvic muscles (as if you were holding in urine) for three seconds then release for three seconds. Repeat 10 times, up to three times a day.

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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