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Don't be Afraid to Talk to Your Gynecologist

Oftentimes, women only see a gynecologist because something...isn’t right... down there. Yeast and bacterial infections are extremely common, whether you’re having sex or not. Many sexually transmitted infections are also very common.  Despite the commonality of these conditions, it is not always easy to have an open dialogue, with a stranger, about something so private.  The thought of someone thinking that you are “dirty” is one of the reasons that society is so against having any constructive dialogue on vaginal and reproductive health. Because anything “wrong” down there carries a stigma that there is something inherently wrong with you: with the way you maintain cleanliness, with the way you have sex, with the way you are. In truth, our vaginas are extremely sensitive to the world around them. Any fluctuation in the pH can cause an array of discomforts. Simply getting your period can ruin your pH balance and send you into a downward spiral of pain and stress. In addition to the vagina’s ambiguous stasis, genetics also play a role, as some people are more susceptible to infection and disease. It isn’t their fault. It’s just the way things are. 

Vaginas aren’t talked about enough. We have always been taught that our private parts are just that...” Private.” It is already bad enough that you must remove your clothes and change into a flimsy paper dress, that you worry about ripping, as you hoist your legs up into stirrups, putting everything on display, for a stranger.  Not to mention gritting your teeth as strange objects are inserted inside you and gloved fingers poke into places that you would prefer, they didn’t. 

Let’s be honest. Going to the gynecologist can be such an awkward experience. You get the most sensitive and private parts of your body examined by a virtual stranger, sometimes, with an assistant...or worse...a medical student, as an audience. You answer embarrassing questions about your sex life, vaginal discharge, and anything unusual that may be going on with your reproductive health. It’s no wonder that so many women feel like they want to get the experience done and over with as soon as possible. 

Regardless of how uncomfortable it may be, it is imperative to ask, and get answers to all of your questions regarding your reproductive health. This applies to all people, assigned female at birth, whether you plan to have children or not.  No matter how cringe-worthy you may think your question may be, your OB-GYN has already heard it...multiple times...I promise...just try to surprise us...I dare you.  

Just to give you a head start in gathering that collection of long-awaited inquiries for your next GYN visit, here is a list of questions that most women have, but very few ask.   

1. Does my vagina look normal?

Vaginas are like snowflakes.  There are no two the same.  Not only that, but they change in size, shape, and color with things like pregnancy, childbirth, aging, and menopause.  The vagina can look a variety of different ways, but they are all considered “normal.”  Some women have longer labia majora than others. Some women's clitoris is more prominent. Color is also another variable. Anywhere from pink to dark brown is part of the spectrum.  Don’t be afraid to ask for a mirror and allow your gynecologist to educate and familiarize you with your lady parts. 

2. Does my vagina smell?

Yes, it does smell. A healthy vagina has a pH balance of 4.5. When healthy, it i1s supposed to have a slightly sour odor. The smell is going to be heightened if you are on your period or after working out. This is no reason for concern.  If the odor becomes foul, however, or is accompanied by unusual discharge, it could be a sign of an infection.  It is important that you tell your gynecologist all of your symptoms, so that you can get the most effect treatment for your problem.  

3. How much discharge is normal?

Just as with the look of a vulva, vaginal discharge varies from one person to the next. It also changes throughout your menstrual cycle or life stage. You will have more discharge when you are ovulating, sexually aroused, pregnant, or breastfeeding. The color and consistency also change throughout your cycle.  You should only be concerned if it looks yellow, greenish, or gray, if it looks like cottage cheese, comes with itchiness, smells like fish, or has blood in it.  Be sure to talk to your provider about the color, consistency, and odor of your discharge, as well as take note of how long you have been experiencing the unusual odor.  Tell your provider if there have been any changes in your normal routine (new soaps, detergents, underwear, new sexual partner...etc.). 

4. Why do I feel pain when having sex?

Sex shouldn’t be painful, so if you’re experiencing discomfort, bring it up with your doctor. It could be one of many reasons — inadequate lubrication, a retroverted uterus, pelvic inflammatory disease, an infection, vaginismus, or psychological factors. Regardless of the reason, the only way to solve it is to talk with your OB-GYN about it so that you can obtain adequate treatment. 

5. Why is it so difficult for me to have an orgasm?

This could be due to stress, orgasmic dysfunction, a history of sexual abuse, medications you are taking, fundamentalist religious beliefs, not enough clitoral stimulation, being mentally checked out, or anorgasmia, among others.  Talking to your GYN, about difficulties reaching orgasm, can not only help you feel happier about your sexual experiences, but could also help rule out or diagnose an underlying health condition. 

6. Do I have an STD?

Don’t go in assuming that if you have a sexually transmitted disease, your doctor will tell you. Sometimes, the answer can be obvious — such as if you’re having a herpes outbreak or have genital warts. However, there are plenty of STDs that do not have apparent signs — such as HIV, Hepatitis B, gonorrhea, chlamydia, or latent stage syphilis. During a routine annual exam, your GYN collects sample cells for cervical cancer screenings. If you have a specific concern about a sexually transmitted disease, talk to your doctor. Whether it’s because of unprotected sex or you’ve been a victim of sexual assault your GYN will have the resources to help you. 

7. What if I’m gender non-conforming?

 Transgender men who have a cervix still need to get their annual screenings to ensure the health of their reproductive organs. However, trans men often experience gender dysphoria during visits to their gynecologist. To make the appointments more comfortable, call ahead to ask about whether the clinic has an inclusive policy — whether they use the correct pronouns and identifiers on patients’ medical files, they have experience with hormone therapy and management, and the availability of resources for patients who are experiencing depression or anxiety. 

Discussing these sensitive subjects with your doctor can be intimidating, but the providers at Premier Obstetrics and Gynecology are here to listen to your concerns, without judgement or bias...and don’t worry. We put you in soft, comfy robes, not humiliating paper dresses.     

Valerie Ramsay, CNM Valerie Ramsay, CNM, is a board-certified nurse midwife at Premier Obstetrics and Gynecology in Maitland and Oviedo, Florida. She is proud to empower women and encourage them to be active participants in their own healthcare. She is extremely excited to be a part of the Premier OB-GYN family. Valerie graduated from Valencia College in Orlando with her associate degree in nursing, where she earned an award for the highest overall GPA. Valerie then pursued her bachelor’s degree in nursing from Polk State College in Winter Haven, Florida, where she earned cum laude honors. She received her master’s degree in nurse-midwifery from the University of Cincinnati in Ohio in 2019. Valerie has worked as a nurse in the obstetric field for the past 15 years and considers it her passion and personal calling. She chose to pursue midwifery because she felt a deep passion to care for women and their families. Valerie is happily married and is the proud mother of two beautiful children, Paige and Jacob.

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