Experts recommend that all women who are sexually active have regular check-ups with a women’s health practitioner. This might be an obstetrician gynecologist (OBGYN), a gynecologist, a midwife, a nurse practitioner, or even your general practitioner.
The ACOG, in fact, suggests that girls between ages 13 and 15 have their first gynecologic visit, even if they aren’t sexually active.
Routine check-ups are an opportunity to learn what’s normal for you, so that when abnormal symptoms crop up, treatment can be started. Prevention is the best medicine, and the sooner abnormal symptoms are investigated, the sooner treatment can be started when something serious does go wrong.
Some symptoms that definitely warrant a call or visit to your provider include:
- Urinary Incontinence: If you’re afraid to laugh or cough because you might leak urine (or even worse, feces), then it’s time to visit your healthcare provider. While incontinence can sometimes be a symptom of infection, it is likely due to weak pelvic floor muscles. Your provider may suggest pelvic floor strengthening exercises, also called Kegels, or may even refer you to a physical therapist with expertise in women’s health issues.
- Period Changes: Bleeding that is heavier or lighter than normal, or occurs at unexpected times – such as mid-cycle – warrants a check with a doctor or midwife. While an absent period could mean you’re pregnant, it could also be the result of hormone imbalances. Periods that are very heavy, that last longer than expected, or that are very painful could be a sign of uterine fibroids, thyroid problems, or even some forms of reproductive cancer. If you find that your menstrual cycle is changing, keep track of your symptoms and days of bleeding to give your provider an accurate picture of what’s happening.
- Unusual vaginal discharge or soreness: Your vaginal discharge will change throughout the month and as you age according to the regular shifts in your hormones. These secretions help to keep your vagina healthy. But if they change in color, consistency or odor, it could be a sign of infection. You will especially want to let your provider know if itching, burning or sores accompany these changes. This information, along with a physical exam, will help your provider find the right course of treatment.
- Pain During Sex: Painful sex is something you might not bring up during a regular check-up, but it’s an important part of your life. As you age, your hormones change, causing a decrease in the production of natural vaginal lubrication. Your vaginal tissues atrophy as you get older, as well.
If you’ve recently had a baby, your lady parts need time to heal. If you’re breastfeeding, estrogen production is low which can lead to vaginal dryness. And even given time, some women who have had an episiotomy or tear during birth continue to experience pain at the incision site (sometimes for months or years later).
Your doctor or midwife can rule out any possible infections (such as a yeast infection, bacterial vaginosis, or even a urinary tract infection) and can help you find the best course of treatment to make sex fun again. Estrogen replacements and lubricants during intercourse are sometimes recommended.
- Abdominal Pain or Pressure: If you are experiencing regular abdominal discomfort or pelvic pain, keep track of the symptoms. Consider how the pain feels: is it constant? Is it dull? Is it midline, front, back, favoring one side or the other? Conditions that can cause pelvic pain include ectopic pregnancy, endometriosis, ovarian cysts, uterine fibroids, and more. Details about your symptoms, along with diagnostic testing, will help your healthcare provider pinpoint the correct diagnosis.
Pelvic organ prolapse shares symptoms in many of the categories mentioned above. Pelvic organ prolapse happens when one of your pelvic organs – such as the bladder or uterus – moves lower in your pelvis and presses against the vagina.
This may happen as a side effect of childbirth, or if pelvic muscles become weak from surgery or aging. Prolapse symptoms include a feeling that there is something in the vagina, a sensation of fullness in the lower abdomen, stretching or pulling in the groin or low back, incontinence, constipation and painful intercourse.
Treatments will depend on what organ has prolapsed, and how far the condition has progressed. Your healthcare provider may suggest Kegels (often with progressively heavier weights) to tone your pelvic floor muscles; however, if the prolapse is more severe, surgery may be necessary.
Trust your intuition. If it seems like something might be wrong, it doesn’t hurt to check in with your healthcare provider. Your gynecologist or midwife can help you sort through your symptoms, provide diagnostic testing and offer treatment options for any problems that are discovered.