9 Things You're Not Telling Your Gyno—But Should
If, like most of us, you show up to your annual gyno exam having done zero preparation, we have to say you can't really expect much out of that appointment. After all, there's no way your doc can magically address all of your needs in 15 minutes. "It's important to really give some thought to your visit beforehand," says Lauren Streicher, M.D., associate clinical professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine and author of Sex Rx.
But where do you even begin? Dr. Streicher suggests targeting six or seven issues that are most important to you, writing them down, and actually handing the list to your doc at the beginning of the visit. Keep in mind, though, that your annual exam isn't the same as a problem exam, so you might need to set up a separate visit to talk about major issues (like a fertility plan, for example). Still, it's a great way to make sure your doc is aware of all the concerns you'd like to be addressed. Plus, it eliminates having to remember everything on the spot.
The other way to make the most out of your annual visit? Actually talking to your gyno. It's all too easy to clam up—either because you're embarrassed or don't think it's important—but staying silent about certain issues could be detrimental to your health. Here, Dr. Streicher lays out the most important topics to bring up next time you hit the stirrups.
1. You want to be tested for STDs.
News flash: STI testing is not automatic. While every woman who walks in the door should be asked, it isn't always the case, says Dr. Streicher. Another misconception: That all docs have a standard STI screening. Unfortunately, it's just not the case. While one gyno might test for gonorrhea and chlamydia, another might include herpes and syphilis—but you don't know which you're getting unless you ask, she says. So don't be afraid to voice your specific concerns based on possible exposure (like, your last boyfriend had herpes and you want to know if you carry the virus). "Part of the reason people don't ask to have an STI screening is because they think they need to go into confession mode," says Dr. Streicher. But beyond sharing info about specific symptoms you may be experiencing, or an infection you think you may be at risk for, you don't need to talk about how many partners you've been with, she says.
2. You want to be tested for HPV.
"The fact that a test for HPV is automatically included with a Pap smear is one of the biggest misconceptions about visiting the gyno," says Dr. Streicher. While all the major scientific organizations currently recommend co-testing—a procedure that requires one swab but tests for both abnormal cervical cells and the presence of an HPV virus—you can't assume that your gyno is following that protocol, says Dr. Streicher. "It's incumbent upon the woman to be her own advocate and actually say, 'I would like the pap plus HPV instead of just a pap test'," she explains. "If you're going to go to the effort of taking off your pants and putting the speculum in, you might as well get the best test!" (Here, we break down what your pap and HPV test results really mean because, yes, they're confusing as hell.)
3. You're experiencing a major relationship change.
It may not seem worth mentioning your changed Facebook status, but if you've gotten into or out of a serious relationship since your last appointment, it's worth bringing up to your doc so he or she can help you figure out the right birth control or STI screening that you need, says Dr. Streicher. It's also important to mention if you're considering starting a family, so you can plan a dedicated pre-conception visit to go over family history and set up the proper tests, she explains.
4. There's something you don't want to talk about.
It may sound strange and counterintuitive, but if there's a topic you don't want to discuss with your doctor, you shouldn't be afraid to voice that, says Dr. Streicher. For example, "if a patient is over their healthy body weight, I'm always going to bring it up," she says. But, it's your appointment. If there are other issues you'd rather discuss in that time, you get to decide that, she says. (You also don't have to step on the scale in the first place if you'd rather not.)
5. Sex is painful.
A lot of people don't bring this up, usually because they're embarrassed, or don't think it's fixable, says Dr. Streicher. But if you're in your 20s or 30s (or haven't yet gone through menopause) and are experiencing dryness, that's a sign of a problem that needs to be addressed. For example, there's a small percentage of women who take a low-dose birth control pill that can experience extremely uncomfortable vaginal dryness and pain. The solution for these women is simply going off the pill and using another method of contraception. Another possible culprit for painful sex is endometriosis. Frankly, there are a lot of reasons why young women might have painful sex (here are eight possible ones), so it's likely your doctor has seen it all, but bringing it up is the only way to get to the root cause.
6. You're not using condoms.
This is the number one thing that women don't share with their docs because they know they're supposed to being using them, says Streicher. Bottom line: Talking to your doc about any risky behavior or possible exposures is crucial to make sure your health is taken care of and you're getting the right tests. So fess up already.
7. You've never had an orgasm.
"A lot of women in their 20s and 30s have the expectation that an orgasm is supposed to happen during intercourse," explains Streicher. "If it doesn't happen, they assume something is wrong with them and don't bring it up because they're mortified." And, unfortunately, it's unlikely that your doctor will be the first to bring it up. It's important to cut to the chase, though, because "90 percent of the time, all they need is for me to pull out the map and show them where their clitoris is and introduce them to a vibrator," says Streicher. Hey, a little education can go a long way. (Speaking of, here are 5 vibrators that are disguised as everyday objects.)
8. There's a funky odor happening down there.
So many women are self-conscious about vaginal odor and don't say anything in their appointment because they're embarrassed, says Streicher. "But if there's an unpleasant odor, there's a reason for it." The most common is a bacterial infection (which may need to be addressed with antibiotics), but there could be a tampon in there since your last period, says Streicher. (You'd be surprised how many women forget about 'em.) Whatever the reason may be, a funky odor isn't normal and has nothing to do with how clean you are, so always bring it up to your doc to find out what the reason may be.
9. You're having anal sex.
Many women keep quiet about sexual preferences that they feel are taboo, but remember that your doctor isn't there to cast judgment—she's there to keep you safe. So if you're experimenting with a new style of sex, like anal, and are experiencing pain or bleeding, you should always speak up, Dr. Streicher says. That way they can provide potential solutions, and help keep you healthy in the same way they'd address any issues you're experiencing during vaginal sex. (Here, 12 Anal Sex Facts From an Insider.)
