- 7 Questions That All Women Need to Ask the Gynecologist
- 1. What are my birth control options?
- 2. Why don’t I ever feel in the mood?
- 3. How do I perform a self breast exam?
- 4. Should I be worried about irregular periods?
- 5. What screenings or tests should I get?
- 6. What can I do to prevent leakage?
- 7. Is there anything I can do to minimize pain during sex?
- 13 Questions You’re Too Embarrassed to Ask Your Ob-Gyn
- My Guy Says I Smell “Funny.” Should I Be Worried?
- Is It Safe to Have Sex During My Period?
- When Should I Worry About Itching Down There?
- What’s the Difference Between Normal PMS and Unhinged, Need-Meds PMS?
- How Much Daily Discharge Is Normal?
- Do I Really Have to Wait to Have Sex After Waxing?
- I’m Never in the Mood. What Could Be Causing My Low Libido?
- How Much Discharge Is Normal During Sex?
- So There Really Is Such a Thing As Female Ejaculation?
- Can I Safely Have Sex During Pregnancy?
- When Should I Worry About a Painful Bump Downstairs?
- Is There Less Risk of Pregnancy If I Have Sex Within the Few Days After My Period Ends?
- Why Are My Nipples So Tender All the Time?
- 13 Important Questions You Wouldn’t Think to Ask Your Gynecologist But Should
- “Why am I having such a hard time losing weight?”
- “There is cancer in my family. Should I have genetic testing?”
- “Is my discharge normal?”
- “Is it normal for PMS to cause intense irritability or depression?”
- “Do I clean my vagina or not?”
- “Where can I find my G-spot?”
- “Can I get pimples on my vagina?”
- Top 10 Questions to Ask Your OB/GYN
- Make the Most of Your First Prenatal Appointment
- 21 Questions For Your First Prenatal Visit
- Congratulations! Time to Get Ready for Your First Prenatal Visit.
- The New Normal
- Genetic Testing
- How to find a good OB & Questions to Ask BEFORE You Hire Them
- Where to look first
- Your health history
- Physician’s philosophies
- Male or Female
- VBAC/C-Section Rates
- Hospital Policies
- Office Protocol—Questions to Consider
- Interview Questions for Potential Obstetricians
- What to Expect During Ob-Gyn Visits
- What I Wish I Knew Before My First Gyno Appointment
7 Questions That All Women Need to Ask the Gynecologist
No woman actually enjoys her annual visit to the gynecologist, so most ladies speed through the process silently in the hopes of getting out the door as quickly as possible. What this gains in time, it definitely lacks in appointment quality because it doesn’t fully take advantage of the doc’s knowledge. Gynecologists spend years studying the ins and outs of the female reproductive system, which means they have the answers to just about everything. And yes, you really should ask about anything you’re concerned with or need clarified. If you haven’t covered these questions, get ready for a Q&A session the next time you visit your gynecologist.
1. What are my birth control options?
Know your different birth control options. | iStock.com
The pill remains the most popular form of birth control in the U.S., but times are changing. According to the Centers for Disease Control and Prevention, female sterilization comes in at a close second. These two methods barely scratch the surface of what’s available, though. Healthline outlines a whole host of options, including injections, patches, IUDs, and more.
That’s not to say the pill isn’t a good choice, but there might be something better suited to your specific situation. Some women find they have trouble remembering to take birth control every day while others have no issues. If you never plan to have children, sterilization might be the better choice. To find out what’s best for you, you need to talk things through with your gynecologist.
2. Why don’t I ever feel in the mood?
Ask your gynecologist about your low libido. | iStock.com
Low libido is pretty common, even for young women. And there are a lot of reasons why you might not want to be intimate, ranging from medication interference to a hormonal imbalance. A drop in desire is also pretty common for those going through menopause. This doesn’t mean you’re doomed to never enjoy sexual activity again, though. Talking with your doctor about how you feel and any specific symptoms will help pinpoint what might be wrong, enabling them to make appropriate recommendations.
3. How do I perform a self breast exam?
Know how to examine your breasts for any abnormalities. | iStock.com
If the only time you ever get a breast exam is at your annual appointment, you’re putting your health at risk. According to the American Cancer Society, breast cancer is the second most common type of cancer among women. Mammograms usually aren’t necessary for women under age 40 (more on this in a bit), but even young women wind up with the disease. Since early detection is the best defense against cancer, you really need to know how to check for irregularities on your own.
If you’re at all unsure about how to perform an exam by yourself, just ask your gynecologist. He or she will be happy to walk you through the steps. You can also check out some pointers from the National Breast Cancer Foundation. And remember, this should be a monthly self-exam.
4. Should I be worried about irregular periods?
Ask about your monthly cycle. | iStock.com
In most cases, a menstrual cycle that doesn’t stick to a rigid, 28-day schedule is just fine. Women to Women says even a missed period or two isn’t typically a cause for concern. The story also explains a lot of lifestyle factors can influence your cycle. Even stress makes a difference. These issues are usually easier to manage, so that’s where your doctor is going to start.
If your ob-gyn rules out the usual suspects, he or she may want to look into conditions like polycystic ovarian syndrome or a hormonal imbalance. For the latter, your doctor may prescribe birth control pills.
5. What screenings or tests should I get?
Ask your doctor about tests you should be getting. | iStock.com
Everything from age to your sexual history plays into the specific tests you need to get. For example, pap smears are usually required once every three years. If you have an abnormal screening, though, your doctor will likely recommend getting a follow-up pap in the near future. Specifics also matter for mammograms. There’s some disagreement among different organizations about the ideal time to begin screening for breast cancer, but Mayo Clinic recommends age 40. Even still, this depends. According to a piece penned by Dr. Stacey Vitiello, who specializes in breast imaging, women with a strong family history may need to start even younger.
And don’t forget about STI screenings. The U.S. Preventive Services Task Force says women under the age of 24 should be checked annually for chlamydia and gonorrhea, but also acknowledged this varies for individuals. The recommendations are helpful, but they make assumptions about sexual behavior as it relates to age, so you really need to get specific guidelines from your doctor. This means you have to be honest with any and all questions he or she asks you.
6. What can I do to prevent leakage?
Urinary incontinence is a common problem. | iStock.com
Usually considered a problem only mothers experience, urinary incontinence can also strike women who’ve never been pregnant. One Australian study found the condition may affect up to 13% of women who’ve never given birth. While it might be an embarrassing topic, it’s one every gynecologist has talked about before. The simplest solution is usually performing kegel exercises, but surgery may be required in some cases.
7. Is there anything I can do to minimize pain during sex?
Don’t be too embarrassed to ask. | iStock.com
The answer to this question is usually yes, but it depends on your specific circumstances. The American Congress of Obstetricians and Gynecologists reports three out of every four women will experience painful intercourse at some point during her life, and the list of possible reasons is pretty lengthy. In order to pin down what could be amiss, you’ll have to chat with your ob-gyn about the exact pain you feel. In some cases, the solution may be as simple as using a lubricant to minimize dryness.
For some women, the problem is more complex. Everyday Health explains pain during sex is very common for women with endometriosis, a condition where the lining of the uterus begins to grow outside the uterus. Again, you have to start a conversation with your doctor before considering treatment options.
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There are so many changes taking place in a girl’s body during adolescence and early adulthood that she may feel awkward and at odds with her body. Throw “visiting the gynecologist” into the mix and you have the recipe for a potential case of the jitters. However, we all know how important it is to take care of our health, and regular visits to your AOA gynecologist are simply an essential part of growing up and taking responsibility for your health.
If you are a young woman contemplating her “first time” or a mother looking to set her daughter’s mind at ease, we’ve provided an overview of what to expect during your first visit to a gynecologist, along with some helpful hints on how to prepare yourself beforehand. Relax, put your feet up (not in the stirrups quite yet) and let us demystify the experience and reassure you that there is nothing to fear.
Why it’s Important to Have Regular Gynecological Exams
Regular gynecological exams serve at least three main purposes:
- Information. You can get accurate information and confidential answers to any questions you may have concerning sex, sexuality, your changing body, and menstruation.
- Prevention. You can learn about pregnancy prevention, sexually transmitted diseases, and healthy lifestyles.
- Treatment. For women who experience missed periods, pain, or other reproductive problems, the doctor can look into why the problems are occurring and offer treatment. This includes both you and your AOA doctor becoming more familiar with your family medical history. Before you go for your first visit to the gynecologist, you should find out as much as you can about the medical history of other females in your family. Have they had painful periods? Endometriosis? Ectopic pregnancies? Surgeries? Anemia? Cancer? Diabetes? Other chronic illnesses?
Before the Exam
When you decide to make an appointment for a gynecological exam with your AOA doctor, make sure to schedule it to take place during the middle of your menstrual cycle. Avoid sexual intercourse, having a vaginal douche, or putting anything (such as tampons) into your vagina for two days before the exam.
Think ahead about the questions you’d like to ask your AOA doctor during the visit. Writing the questions down will make it easier to remember. Some areas where you may have questions include birth control methods, common infections, irregular periods, painful periods, and mood swings related to your periods.
Again, gather your family medical history, especially your mother’s history and if you have older sisters, you’ll want to know about them as well.
On the Day of the Exam
On the day of your scheduled exam you do not need to do anything special. Shower normally with soap and water, but avoid using powders or creams, since they can affect test results. Wear comfortable, uncomplicated clothes in order to feel calm when it comes time to undress.
Before your examination a nurse may ask for urine and blood samples. The nurse will also weigh and measure you and take your blood pressure.
The nurse will then ask you to undress and will then leave you alone in a room for a while. You will be given a hospital gown and/or drape sheet, which will help you feel more comfortable and relaxed.
Once you are undressed and in your gown, your AOA healthcare provider will come back into the examination room and talk for a bit. The doctor will ask questions about your previous medical history, your family history and past surgeries. He or she will ask you to remember when your first period was and tell them what it is like – whether your menstrual cycle is regular, how long it lasts, etc. Also, it is important to tell your doctor whether you are sexually active or not. Your AOA doctor is a partner in your health care, so feel free to ask any questions you may have. Remember that anything you say in privacy with the doctor is kept strictly confidential.
After you are ready, the doctor will ask you to sit on the examining table, putting your feet in the foot rests/stirrups. This can feel a bit invasive, but keep in mind that these exams are necessary and important for keeping you in the best of health. There is no need to feel embarrassed. Just remember the vast majority of adult American women have these exams regularly.
Physical and External Genitalia Exams
Physical examination includes palpation of the breasts to check for any abnormalities, as well as pelvic, abdominal and manual exams. You AOA physician will examine your external genitalia with latex gloves on and will examine your vulva for any pathologic symptoms. Physical examination should not be painful but if it is, you should tell your doctor right away, since this could be a sign of certain pathology.
After examining you externally, your AOA gynecologist will insert a lubricated speculum into your vagina to check for any abnormalities like cysts, erosions, or irritations. Before the speculum is inserted the doctor will first slip a finger into your vagina to find the cervix and detect the vaginal angle. The doctor will then insert the speculum into your vagina and click it into an open position. Again, this is not painful, but it might feel a little strange at first. Remember to just breathe and relax.
Once the speculum is in place, the doctor will take a Pap smear. This means that a few cells of your cervix will be swiped with a brush or spatula. This is not painful, but may cause a slight pinch or sensation and it may cause some spotting afterwards, which should not be painful either and will not last. The doctor will then collect samples for sexually transmitted diseases tests. Then the speculum will be gently removed from the vagina and this portion of the examination will be over.
During this part of the examination, your gynecologist will lubricate her/his two (second and third) fingers and insert them into your vagina. The doctor will put another hand on your abdomen in order to palpate the uterus and ovaries and check for any swelling or growths.
The bimanual exam ends the gynecological examination, which normally takes no longer than 5 minutes. You will then be able to remove your legs from the stirrups and get up from the examination table and get dressed.
After the Exam
An AOA office nurse will follow up with any test results, either by phone or by email.
Helping You Feel Comfortable and Well Informed
Your AOA physician and office staff will go out of their way to make sure you understand the elements of the exam and feel as comfortable as possible. Be sure to ask if you have any questions or concerns.
Learn more about getting your first gynecological exam:
- Your Daughter’s First Gynecological Exam
- Your First Pelvic Exam
- Visiting the Gynecologist
Real talk: This part can be kind of weird. “Most people are uncomfortable with the speculum,” Mary Jane Minkin, M.D., professor of obstetrics and gynecology at Yale School of Medicine and creator of MadameOvary.com, tells SELF. Pro tip: Speculums come in different sizes, so if you’re worried about it hurting, you can let your doctor know and ask them to try something smaller. “And if you feel pinching or pain, you can say something,” says Dr. Streicher. The good part is that a speculum only needs to be in your vagina for around a minute for a doctor to perform a thorough exam, William Schweizer, M.D., clinical associate professor of obstetrics and gynecology at New York University Langone Health, tells SELF.
Once that’s done, your doctor will conduct a bimanual exam to study your reproductive organs. With a hand on your lower abdomen, they’ll insert one or two of their gloved, lubricated fingers into your vagina and feel around to make sure your uterus and ovaries are healthy. This is another part that can make people anxious, but it also only takes around a minute, Dr. Schweizer says.
4. Even without a pelvic exam, you can still get birth control.
Most doctors don’t require a pelvic exam to prescribe birth control—they’re able to make an informed decision based on your medical history and personal habits. If you’re curious about birth control options, they’ll start by asking questions about your behavior and preferences to help figure out what’s best for you. For example, pills might not be a great option if you know you’re super forgetful, Dr. Minkin says, so your doctor may recommend a “set it and forget it” method like an IUD or an implant that can last anywhere from 3 to 10 years, depending on the type. For some methods, you can usually walk out of the office with a prescription that day.
5. Don’t worry about how you look.
Though you might feel exposed during your first gyno exam, remember that your doc isn’t judging any aspect of your body, whether it’s your pubic hair or the length of your labia. Their purpose is to evaluate you medically, full stop. “We really don’t care, we’ve seen it all, and honestly, we barely notice,” says Dr. Streicher. If you’re able to, you can shower and rinse your labia with water before an appointment (no douching or perfume, though, because that can boost your risk of irritation or infection). If you can’t do this, it’s so not a big deal.
You also don’t need to worry about being on your period unless you’re specifically going to have your doctor examine your discharge, adds Dr. Streicher. Having your period may also affect the results of your Pap test or any STI testing, so you should give your doctor’s office a call to see if it still makes sense to come in or if you should postpone your appointment.
6. Be prepared to talk about your menstrual cycle—and your sex life.
You’ll need to know the first day of your last period, so make sure you’re keeping track of that in the month leading up to your exam. You should also mention any pain, cramps, heavy bleeding, irregularity, or mood changes you get with your period. Your ob/gyn can prescribe birth control to help with period symptoms or look for signs of conditions like endometriosis, a condition that can cause pain, heavy periods, and trouble getting pregnant.
Your doctor will also ask about your sexual activity. Don’t be afraid to be open and honest here—your ob/gyn will keep everything confidential and won’t judge you. “It’s their job to support you. You have to answer honestly because STI screening will be based on that,” says Dr. Schweizer. Keep in mind that your oral sex and anal sex history count here, too, as both can lead to STIs. If you’re worried you might be pregnant because you’re sexually active and you’ve missed a period, be honest about that, too, and ask your doctor for a pregnancy test.
7. Know your personal and family medical history.
Your doctor will ask you about any medical conditions you have, medications you’re on, and past surgeries. That stuff can be hard to remember, especially when you’re nervous, so it can help to write everything down beforehand, says Dr. Streicher. That includes any relevant dates.
13 Questions You’re Too Embarrassed to Ask Your Ob-Gyn
Coming in for your annual women’s health exam can be anxiety-inducing itself, and speaking up about a nonexistent libido, sex on your period, or how you smell down there is even more uncomfortable (and sometimes scary). While you should never stay mum when it comes to your health, you can make your next convo with your gynecologist easier by coming armed with the following knowledge about common womanly concerns.
RELATED: Get natural, DIY remedies for common health problems in The Doctor’s Book of Natural Health Cures!
My Guy Says I Smell “Funny.” Should I Be Worried?
We all smell differently. “Everything we consume-food, drinks, medication, drugs, alcohol-change our vaginal secretions and men’s semen,” says Justine Shuey, Ph.D., a professor of human sexuality and certified sex educator. If you’re self-conscious about your odor, try drinking more water, eating more fruits and vegetables (other than cruciferous veggies, as their sulfur compounds can give you that distinctive rotten-egg smell), and cutting back on alcohol since it can increase sweating in your crotch. And-no-brainer-quit smoking; the smell permeates everything-and we mean everything.
However if your scent suddenly varies greatly from your normal for no apparent reason, comes with a lot of discharge, or turns “fishy,” see your doctor, as all of these are signs of infection. One possible culprit: your birth control method. “Both hormonal and non-hormonal IUDs have an increased risk of bacterial vaginosis, which is characterized by a fishy smell,” says Colette Brown-Graham, M.D., a board-certified ob-gyn and diplomat of the National Board of Medical Examiners. If you’re prone to infection but don’t want to change to another birth control, eating a healthy, well-rounded diet and supplementing with a probiotic can help.
Is It Safe to Have Sex During My Period?
There aren’t any unique risks about having sex during your red week, except that the chance of pregnancy is more complicated, Brown-Graham says. If you have a 28-day cycle, you ovulate 14 days before the onset of your next cycle, so you would be relatively “safe” from pregnancy. But if you have a 22-day cycle and therefore ovulate on day eight, having intercourse immediately after your period would be decidedly more “risky.” “No time is ever perfectly safe, but many women who understand their ovulatory pattern can tell when they have more or less risk of becoming pregnant,” Brown-Graham adds. Of course if you use condoms or another form of birth control, you should be fine, and since some women report increased sensation and pleasure during that time of the month, you may want to consider it.
When Should I Worry About Itching Down There?
Image zoom Thinkstock
Since itching down yonder can happen due to anything from sexually transmitted infections or yeast infections to too-tight pants or staying in damp gym clothes for too long, it can be hard to know when to worry, says Allison Hill, M.D., a board-certified ob-gyn and co-author of The Mommy Docs’ Ultimate Guide to Pregnancy and Birth. If you’re not sure of the source and the itching persists after you shower, she recommends making an appointment with your doctor, stat.
What’s the Difference Between Normal PMS and Unhinged, Need-Meds PMS?
Moodiness is a common part of PMS, says Gail Saltz, M.D. a psychiatrist and author of The Ripple Effect: How Better Sex Can Lead To a Better Life. What’s uncommon, however, is anxiety that makes functioning in your daily life difficult or depression that leaves you highly irritable such that you are exploding at others or feeling hopeless and crying. These symptoms could indicate premenstrual dysphoric disorder (PMDD). If your PMS is interfering with your life, talk to your doctor, as PMDD can be treated with lifestyle changes, therapy, and medications.
How Much Daily Discharge Is Normal?
Forget “normal,” Hill says. “The amount of vaginal discharge varies from woman to woman, and the color and consistency change as you progress throughout your cycle.” What’s more important is to know what is normal for you. If you notice any sudden change in your discharge, make an appointment with your doctor to identify what may be going on, such as a vaginal infection.
Do I Really Have to Wait to Have Sex After Waxing?
You may have heard that you need to nix nookie for 24 hours after your Brazilian because the micro-tears created during the procedure make you more susceptible to infection. However Hill says the risk is minimal. “You can have sex anytime after waxing.” So go for it if you’re not too sensitive and can’t wait.
I’m Never in the Mood. What Could Be Causing My Low Libido?
“There are so many possible reasons-psychological, relational, and physical-that you have no desire that it can be hard to know where to start,” says Stephanie Buehler, PhD., a sex therapist and author of What Every Mental Health Professional Needs to Know About Sex. Sometimes it’s just where you are in life, such as if you’ve recently had a baby or are going into perimenopause, which can begin as early as your 30s.
But if the issue lasts more than a few months, it’s a good idea to see your doctor to rule out physical problems such as low estrogen or hypothyroidism. Be sure to mention any medications you are taking, as many prescription drugs (particularly antidepressants) and supplements come with decreased libido as a side effect.
If everything checks out normally, Buehler recommends talking to a sex therapist. Your nonexistent drive may simply be a result of settling into a long-term relationship: The first heady rush of lust has abated, and now your desire may be more responsive and not kick in until after you start foreplay with your partner.
How Much Discharge Is Normal During Sex?
Vaginal lubrication and secretions are a totally normal-and necessary!-part of having sex, and every woman is different. “Some women have a lot of secretions during sex, and some have more when they get very aroused during foreplay or when they orgasm. Some women even ejaculate,” Shuey says. As long as you feel fine, forget about it so you can focus on how good sex feels. If you really care, you can always put down a towel to protect your sheets.
So There Really Is Such a Thing As Female Ejaculation?
Men aren’t the only ones who can ejaculate. Some women also squirt as a result of g-spot stimulation, Shuey says. “The fluid is most similar to prostate fluid in men. It builds up in the skene’s glands and exits through the urethra during orgasm,” she explains. Although not all women experience it, most women likely can learn to ejaculate if they are confident and comfortable with experimenting, Shuey adds. But just like an orgasm, there’s no reason to try and force it, especially if doing so will distract you from enjoying the moment.
Can I Safely Have Sex During Pregnancy?
As long as you don’t have a medical complication like a placenta previa, cervical incompetence, or unexplained vaginal bleeding, Hill says it’s totally fine to go for it in whatever way is coziest for you and your partner.
While most women are comfortable in a variety of positions for the first two trimesters, by the third you may need to be strategic. Hill says the majority of women find that lying on their side is easiest, but try a variety of positions and use pillows to find what works best for you and your man. Just be careful of lying on your back, as doing so can cause some pregnant women to become dizzy and nauseous-not exactly that loving feeling!
When Should I Worry About a Painful Bump Downstairs?
“An aching bump in the vaginal area is most likely a pimple or ingrown hair,” Hill says. Both of which are not dangerous and will often resolve on their own. See your doctor for an exam if the bump persists for more than a few days or you can’t figure out what it is, as it could also be a Bartholin’s cyst, herpes, or genital warts.
Is There Less Risk of Pregnancy If I Have Sex Within the Few Days After My Period Ends?
The days right after and before your period are your least fertile, so if you have regular menstrual cycles, then you can use the rhythm method to avoid pregnancy, says Hill, who recommends using a period tracker app to take any guessing out of the equation. Of course-as with any birth control method-there’s still a risk of pregnancy with natural family planning, especially if you’re not good at keeping accurate records or have widely varying cycles.
Why Are My Nipples So Tender All the Time?
Thanks to the thousands of nerve endings in the nipples, it’s completely normal for them to be sensitive throughout your entire cycle, Hill says, although for many women they’re most sensitive just before your menstrual cycle due to the sharp drop in progesterone.
If this sensitivity is a new development, you may want to run to the drugstore for a pregnancy test since it could be an early sign of a baby on board. Similarly, because of the change in hormones, new birth control and menopause can also cause sore nipples.
- By Charlotte Hilton Andersen
13 Important Questions You Wouldn’t Think to Ask Your Gynecologist But Should
Along with dread from the obvious discomfort, the annual trip to the gynecologist is often met with anxiety. Is everything normal down there? Should I be worried about cervical cancer? What’s the deal with that lingering bump? OMG—is it an STI? Speaking up about an itchy bump, strange smell, or a nonexistent libido is no doubt uncomfortable, but gynecologists cannot stress its importance enough. Though it may seem embarrassing, docs ensure us that there is no such thing as a stupid or shocking question when it comes to the health of your lady parts. Here are some important questions gynecologists wish their patients were less reluctant to ask. Take note for your next visit.
“Why am I having such a hard time losing weight?”
At first thought, this might not seem like a question for someone who is an expert in human sexuality, but in many cases your OB/GYN can serve as your primary care provider. “If your BMI is greater than 25, your doctor can discuss possible medical causes and the potential consequences of excess weight to your overall health and risk for certain cancers,” explains Brandye Wilson-Manigat, M.D., an OB-GYN in Pasadena, California. “In addition, he or she may be able to recommend some strategies to increase your metabolism and decrease your weight in a healthy and safe manner.”
“There is cancer in my family. Should I have genetic testing?”
If you have a strong family history of breast, ovarian, uterine, colon, or melanoma this should be reviewed with your doctor. “Based on your personal history or family cancer pattern, genetic screening for cancer-related genes may be offered to help you make decisions about further testing and intervention,” says Kameelah Phillips, M.D., an OB-GYN in New York City. “There are significant implications to this type of testing and your gynecologist can help you make decisions regarding your risk factors.”
“Is my discharge normal?”
This is certainly not the most comfortable topic of conversation, but your gynecologist can help differentiate what’s normal from what’s not better than a quick Google search. “The vagina is equipped with over 30 organisms that help keep it pH balanced and free of infection,” explains Sherry Ross, M.D., an OB-GYN in Santa Monica, California and author of She-ology. “These organisms produce secretions to naturally cleanse the vagina, much like the mouth does with saliva and the eyes do with tears.” Depending on the time of month, it is normal for vaginal discharge to change in consistency, texture, and smell. “It helps to know what your range of ‘normal’ is to avoid the unnecessary use of soaps, douches, and creams meant to correct what you perceive is a problem,” adds Dr. Phillips.
“Is it normal for PMS to cause intense irritability or depression?”
Emotional upheaval is commonly associated with PMS. “Symptoms can include extreme depression, fits of anger and overwhelming anxiety,” says Dr. Ross. “Crying spells, angry outbursts and feelings of worthlessness are all part of the mood swings that typically occur one to two weeks before your period.” If the emotional chaos ends at the start of your period, there is no cause for concern. But if these emotional changes continue beyond your period, Dr. Ross notes that this may suggest more concern of an underlying psychological dysfunction that should be discussed with your doc.
“Do I clean my vagina or not?”
This is one of the most controversial topics when it comes to vaginal health. Shelves are lined with products for feminine hygiene, but we are often told to avoid these aisles and let our lady parts self-cleanse. “You may have heard that the vagina is ‘self-cleaning’ and it sort of is, but using fragrance-free soap and water on the vagina is okay, safe, and recommended,” says Dr. Ross. “As a gynecologist, I suggest that you clean your vulva and labia every day as if it were any other part of your body.” Her suggested method: Using two fingers, swipe your knuckles along the labia with a gentle, non-fragrant soap. Avoid scented cleansers and cloths, freshening sprays and talc powders.
“Where can I find my G-spot?”
“There is an ongoing debate as to whether the G-spot actually exists,” says Dr. Ross. “For those believers, myself included, the G-spot is located one to three inches on the top or anterior surface of the vagina. When a woman is sexually aroused, the G-spot fills with blood, giving it a swollen feeling.” Dr. Ross notes that not all women respond sexually to stimulation of this area, so don’t worry if you’ve tried and failed to locate it. “It is not a magic button, rather another avenue in achieving sexual pleasure,” she says.
“Can I get pimples on my vagina?”
“Like the face, the vagina has sweat glands and hair follicles that are prone to dirt buildup,” explains Dr. Ross. That’s why it’s important to keep the area fresh and dry. Make sure the skin is clean before hair removal, whether you use a razor or wax. To helps prevent acne and ingrown hairs during the regrowth process, exfoliate the skin on the days following hair removal.
Here’s our roundup of the top 10 questions to ask your OB/GYN at your first prenatal appointment.
Top 10 Questions to Ask Your OB/GYN
1. Are there changes I should make to my diet? Throughout your pregnancy, try to consume a wide variety of foods, including lean meats, whole grains, fruits, vegetables and unsaturated fats. Many women also take prenatal vitamins. Talk to your doctor about specific dietary recommendations.
2. What foods should I avoid during pregnancy? To reduce the risk of foodborne illness, consume only meat, fish, eggs, and poultry that are fully cooked. Avoid unpasteurized dairy products. Avoid soft cheeses (Brie, feta, Camembert) unless the label clearly states it’s made from pasteurized milk. Thoroughly rinse fresh fruits and raw vegetables under running water (about 30 seconds) before eating. Avoid eating raw sprouts. Do not eat refrigerated smoked seafood, unless cooked in a casserole. Canned or shelf-stable smoked seafood may be eaten.
3. How much weight should I expect to gain during my pregnancy? Healthy weight gain ranges depend on your pre-pregnancy BMI. Your doctor will help you establish healthy weight gain goals.
4. How much should I be exercising? Regular exercise can reduce or prevent back pain, prevent excessive weight gain, and reduce the risk of gestational diabetes and high blood pressure. However, pregnant women should avoid activities with a high risk of falling or abdominal trauma, exercise at high altitudes, and scuba diving.
Looking for ideas? Check out these 5 Safe Fitness Activities During Pregnancy. Ask your doctor if you have questions about specific activities.
5. Can I travel during my pregnancy? Many pregnant women drive throughout their pregnancies, and wearing a seatbelt is recommended. Many women also fly until late in their pregnancies, and most airlines allow travel up to 37 weeks gestation. Talk to your doctor about safety measures to take when travelling.
6. Will I be able to work throughout my pregnancy? Although you may need certain adjustments to your work style, in general, women can plan to work throughout a pregnancy. Talk to your doctor about strategies to stay comfortable at work, and what to do if you need special accommodations.
7. Can I continue taking my current medications? Your medications may need to be stopped, adjusted, or switched. Very few drugs have been approved as absolutely safe during pregnancy. However, many medications have good safety records and do not increase risk for birth defects or adverse pregnancy outcomes when taken as directed. Some medications should be avoided in the first trimester, but may be okay to take later during pregnancy. It is important to weigh the severity of your symptoms against the possible risks to your baby. Ask your doctor for more information about specific drugs, whether they are prescription or over-the-counter.
8. When will my next appointment be? For an uncomplicated pregnancy, women should plan to see their provider every 4 weeks through 28 weeks, every 2 weeks between 28 and 36 weeks, and weekly from 36 weeks to delivery. Your doctor may wish to see you more frequently if you have a high-risk pregnancy. Talk to your doctor about a plan for your prenatal care during this first appointment.
9. Do you recommend any type of prenatal screening or testing? Depending on factors like your age, family medical history and your ethnic background, your doctor may recommend prenatal screening or testing. The decision to pursue prenatal screening or testing is personal, and there is no one right path. Your doctor will help you make an informed decision that is right for you.
10. Do you recommend any prenatal classes? To prepare for delivery, you may also want to take a prenatal class. There are many different options for delivery, so you’ll want to choose a class that fits your needs. Ask your doctor about finding the right class for you.
Make the Most of Your First Prenatal Appointment
What else can you expect at your first prenatal appointment? What documents do you need to bring?
This guide will help you make the most of your first prenatal visit, and get the care you and your baby need and deserve.
21 Questions For Your First Prenatal Visit
Congratulations! Time to Get Ready for Your First Prenatal Visit.
It’s hard not to get giddy about your first prenatal visit—that first ultrasound picture, hearing your baby’s heartbeat for the first time. I found myself in the same position when I was pregnant. Even as an OB/GYN who has performed countless ultrasounds, I was overwhelmed with the excitement of my first glimpse.
But beyond the excitement of seeing your baby for the first time, your first prenatal visit is an important time to meet your doctor, midwife, or nurse practitioner and get all your initial questions answered. With so much to accomplish in that one visit, it can help to come prepared with the most important questions you want answered.
Your first prenatal visit is an important time to meet your doctor, midwife, or nurse practitioner and get all your initial questions answered.
But where to start? Here are some helpful tips and questions you might want to chat about in your first prenatal visit.
How often do I have appointments? Does the frequency change with each trimester?
Most clinics want to schedule appointments with you regularly throughout your pregnancy, with the frequency increasing the further along you are in pregnancy. For instance, in the first trimester, you may go several weeks between visits, but by the final month of pregnancy, you may find yourself in that clinic waiting room every single week!
If you have not chosen a provider or are looking to change, this article covers how to find the right provider to fit your birth plan needs and goals.
How to Find the Right Prenatal Care Provider.
When am I due for important prenatal tests? Does your clinic have a calendar or other system for reminding me when I’m due for testing?
Certain tasks like genetic testing and first and second trimester blood work must be done within certain windows of time in order for the results to be accurate. With all the bustle of preparing for a baby, it’s easy to lose track of those dates or have trouble scheduling if you wait too long to make an appointment. Many clinics can send you automatic reminders or prepare an overview calendar to help you keep track of testing dates. If the clinic doesn’t have a scheduling system, set your appointments right away and put the date in your calendar with reminders.
Getting my questions answered
Where do I call or email if I have a non-urgent question about my pregnancy?
Instead of going to Dr. Google, it’s always best to ask your care provider questions about your pregnancy. They know you best and can make sure you get the most accurate and up-to-date information.
It’s helpful to know how to schedule your appointments, keep track of them, and know who to talk to if you have any questions or if anything comes up.
In case of emergency
Where do I call or go if I have a medical emergency? Do I call or go to different places depending on how far along in my pregnancy I am?
In cases of emergencies, some hospitals send you to different locations (such as the ER versus the Labor and Delivery Triage) depending on how far along your pregnancy is. Having this answer in your head early on can help if you find yourself needing emergency assistance later.
Is there anything I should change about my lifestyle immediately?
Some lifestyle changes must be made ASAP once you know you are pregnant (for instance, cutting out alcohol), so it can help to start this conversation with your provider early.
Should I change my eating habits in any way? What foods or drinks should I avoid? What are the specific risks of eating each food?
The list of foods to avoid in pregnancy (deli meats, unpasteurized cheese, high mercury fish, and more) is not always obvious. Most doctors can give you a written list of the foods and drinks that are most important to avoid during pregnancy and can explain exactly why each category of food is on that list. Knowing why you are skipping your favorite foods can make it a little easier to avoid the temptation.
Does my work environment present any risks to my pregnancy?
Some women who work around chemicals or other toxins require accommodations in their work environment, even early in pregnancy. For instance, some women must wear a respirator mask or change their duties at work in order to protect the pregnancy. Your care team can help you assess your risk but if you work in an environment you might consider risky, you could also reach out to a safety manager on site (e.g. Environmental Health & Safety if you work in a laboratory).
What kind of exercise can I do during pregnancy?
Over 600 scientific studies support the fact that exercise during pregnancy is not only safe, but extremely healthy and beneficial. Certain exercises and stretches can even help to make pregnancy more comfortable and prepare your body for labor. You and your care team know you best, so it’s always worth a conversation if you have specific questions.
Reach out to your care team if you have any questions about how to keep baby and yourself safe throughout your pregnancy.
The New Normal
What are warning signs that should trigger me to call your office or go into the hospital? What are some common signs and symptoms that women experience in early pregnancy that I shouldn’t worry about?
The body goes through many changes that can be completely normal but feel very strange throughout all of pregnancy. During pregnancy, the new “normal” can change every week! Asking your doctor ahead of time what signs and symptoms are dangerous versus normal may help in the future if you happen to experience them.
During pregnancy, the new “normal” can change every week!
What are my genetic testing options? What conditions are covered by each option? How accurate are the tests? What is the risk of a false positive or false negative?
What kind of prenatal genetic testing you undergo- and whether you chose to do any at all- is an extremely personal decision. It can help to start the conversation by clarifying your goals and then choosing the right genetic testing options to match your preferences.
What risks do I face from the tests themselves? What are the risks if a test has a false positive?
Some tests have inherent risks: amniocentesis, for instance, may carry a small risk of miscarriage. However, other tests carry no inherent risk but can lead to other tests- if you get a false positive – that are risky. For instance, a blood test poses zero risk to the baby, but a false positive could lead to further invasive testing that does carry risk.
You might not need to bring up all of these questions, of course, but spending time before your first prenatal appointment can help ensure that your most pressing questions are addressed. Doctor’s appointments often feel rushed, so a little bit of prep can pay off in a big way to get your pregnancy (and the relationship with your prenatal care provider) off to a great start!
BONUS! Looking for a better week-by-week pregnancy newsletter?
Check out our Baby Building Blocks Newsletter — the what, when, why and how of prenatal nutrition tailored to your pregnancy!
How to find a good OB & Questions to Ask BEFORE You Hire Them
Where to start in finding the OB that’s just right for you? You’ll definitely want someone you feel completely comfortable with, and that you trust to take care of you and your baby. This is your life (and emotional well-being) and your baby’s health in someone else’s hands, so it’s a big deal. Here’s some ideas to help you get started.
Where to look first
Ask around. Your best bet is going to be word-of-mouth. Talk to everyone you know and trust about their OB/GYNs. What things did they like/dislike about them? What was their prenatal care like? How was their delivery experience? Would they go back to this same person? The more details the better, just start asking. Of course it’s important to keep in mind that not everyone wants the same type of birth experience so the doctor that was a good fit for your sister may not be right for you.
Join Facebook groups in your area. There are many Evidenced Based Birth local groups that you can join where the admins and members are knowledgeable about the OBs in your area and which ones follow evidence based practices. What is Evidence Based Birth?
If you don’t know many recent moms personally, get in touch with your hospital’s Childbirth Educator. She or He should be familiar with doctors and nurses at the hospital, and know the ins and outs of the kind of care they give (and their bedside manners). She’d be able to give a few recommendations that you can then do more research about. Of course keep in mind that they work for the hospital so may not be able to be completely forthcoming.
Ask for statistics. Hospitals keeps track of things like induction rates, episiotomy rates and cesarean rates so asking for these facts will give you a good idea of hospital practices. Unfortunately, even if you love your OB sometimes the hospital policies limit their ability to provide the care that you may be imagining.
Do you currently have a gynecologist that you like? Do they practice obstetrics as well? Asking a few additional questions can help you get a feel for if it would be a good fit or not. If they don’t deliver babies, they could recommend some colleagues to you, that you could then check out. Keep in mind that prenatal and birth care is MUCH more involved than an annual exam so don’t just go with your current doctor because it’s convenient. You want to make sure it’s a good fit and that their maternity care is in line with what you want for your birth.
Once you have a few names of potential doctors, there’s a lot of things to mull over before the interview process.
Here’s a few considerations:
Your health history
Do you have specific concerns about your pregnancy that not every doctor would have experience with? Plus-size pregnancy, previous recurrent miscarriages, diabetes, or trying for a VBAC (Read more in our post What you need to know about VBAC?) can be uncharted territory for some practitioners. Look at the websites and reviews of doctors to find out if they have specific experience in the areas you are concerned about.
What does the provider value? What is their overall outlook on pregnancy, birth, and labor? Are they super medicalized or do they lean toward the more natural route—and which do you prefer? What are their opinions on certain medical procedures like continuous electronic fetal monitoring, scheduling inductions, episiotomies, and epidurals? Do they tend to take control of how a labor is progressing, or allow the mother to take the lead? How pushy will they be?
Male or Female
Think about your past interactions with doctors and whether you’ve been more comfortable with a male or female physician. It may not matter to you, but if it does, then you can quickly narrow your search down as most health insurance databases have the option to filter your search results based on gender.
Do you click? Do you feel comfortable? I had a friend who went in for a breast exam and the doctor chatted for a few minutes and then said, “Okay, flash me.” That exchange made her feel so uncomfortable she never went back. Bedside manner and professionalism matter! Do you trust their experience and judgement? Do they listen to your concerns and questions or just plow through the appointment as fast as possible? Are their credentials up to date? What does your gut say?
Are they supportive of you having a doula with you during labor/delivery? How comfortable are they with extra people in the room in general, and does your partner get a good vibe from them as well?
This is public information that you can request from your hospital. However, doctors don’t usually post their own personal stats. You can get an idea of how things go by calling the front office and asking some questions. Many offices don’t give out specific numbers, or may not even keep track, but you can get an idea by saying something like, “Out of the last 10 deliveries this provider performed, how many ended up being c-sections?” Or “Out of the last 10 attempted VBACs, how many were successful?” Get an idea of how willing they are to work with you. Keep in mind that specific hospital rates are higher than others for cesarean. Which brings us to our next item…
What are the c-section stats? You can search online to find this info. In general, what is the hospital like? Do they have natural birthing accommodations and tools if you’d like to go that route? Birthing tubs to labor in? Is the hospital friendly to natural delivery? Do they require IVs, continuous electronic fetal monitoring? Do they have VBAC policies? What are their standard procedures right after the baby is born? Do you get to have skin-to-skin bonding for a while? Does the baby get to stay in your room? Calling the Labor and Delivery floor is your best bet to getting answers to these questions. A nurse can help you out, or refer you to someone else who knows the specifics. Nurses generally want you to be informed about the hospital policies so that there aren’t any surprises when you come in.
Office Protocol—Questions to Consider
- What is the OB clinic experience like?
- How easy was it to get an appointment?
- How many doctors are in the practice?
- Are you a number who is shuttled through the routine, or are you treated like an individual?
- How long do you typically wait in the office?
- What are the after hour policies?
- Will your OB be the one to deliver you, or do they rotate who is on-call, and will that bother you?
- Is there an on-call nurse that is available to answer questions?
- What is the staff like?
Think about how you feel about all of these things.
Once you’ve thought about all of these issues, and researched a few doctors, narrow it down to a couple. You can either take the plunge and make your first appointment with the one you want, or you can be even more thorough and schedule a consultation, where you can bring your list of questions.
Above all else, keep in mind that you are not stuck once you make your choice. If at any time you start to feel uneasy about your care giver, or feel like you don’t align with their philosophies, shop around. It’s completely acceptable, and it happens all the time. If you feel uncomfortable firing your OB, simply call the front desk and ask them to transfer your files to your new doctor. You don’t even have to speak to the doctor you are leaving. This experience will be one of the most important of your life, and you deserve to feel as safe and as comfortable as possible. Follow your gut!
Interview Questions for Potential Obstetricians
- What is your general philosophy on pregnancy, labor, birth, and postpartum care?
- What is your role as physician? What is your role during labor and delivery?
- How long have you been practicing? How many births have you performed?
- How many births do you anticipate attending month? Is there a limit to the number of patients you take on?
- What is the chance of you delivering my baby? Who delivers when you are not available?
- What is your c-section rate?
- If there is a complication beyond your expertise, who would you refer me to?
- What is your after-hours policy? Are you reachable during an emergency?
- How often am I required to meet with other doctors?
- How much time do you spend with each patient during an appointment?
- Are you available in between visits if I have a question or concern?
- What is your view on nutrition and weight gain?
- What prenatal tests do you require and/or recommend?
- What childbirth education resources do you recommend?
- How do you feel about birth plans? Do you help with writing them?
- What experience do you have with high risk pregnancies?
- What would the procedure be if I become high risk?
Labor and Delivery
- When will you arrive on scene? Who will support me in the meantime? How often will you be with me during labor?
- If you have two simultaneous labors/deliveries, what do you do?
- How do you feel about a support team? A doula? Other friends and family?
- What if I approach my due date without going into labor? How long will you let me go past? What is your induction policy?
- Do you ever recommend induction for an estimated large baby?
- How long will I be able to labor after my water breaks if no signs of infection?
- What routine policies during labor do you recommend/require? What does the hospital require? (Continuous fetal monitoring, IVs, etc.)
- Am I allowed to move around during labor? Eat and drink?
- What are your views on pain management during birth, both medicated and unmedicated? Will you recommend different positions and coping techniques?
- What percentage of your patients deliver without an epidural? What resources are available to me, should I want to labor without drugs?
- What percentage of your patients get epidurals? What is your view on epidurals?
- How do you handle a “stalled labor”? What do you consider a stalled labor?
- What birthing positions do you allow for labor and delivery? What is most common for you?
- Do you perform episiotomies? How often? How often do you use forceps or vacuum extraction?
- Do you encourage and support VBACs? How many VBAC attempts have been successful? (60-80% is norm). What is the hospital policy for VBAC?
- At what point in labor do you recommend c-sections?
- Have you ever performed a vaginal breech birth? Twins?
- What procedures do you perform on the baby? What can wait?
- Is delayed cord clamping okay?
- What happens if there is postpartum hemorrhaging?
- Will I have uninterrupted skin-to-skin bonding time immediately following birth? For how long?
- Will the baby stay with me in my room?
- Do you assist in breastfeeding? Is there someone else available to help me?
- What if I hemorrhage?
- Can my partner stay in my room?
Questions to ask yourself after the appointment
- Do I feel comfortable with this person? Are they flexible?
- Do our philosophies line up? Or are they willing to work with me? (You want them to enthusiastically support your wishes not just be “willing to let you try that”)
- Do we have a mutual respect?
- Do I trust their expertise and judgement?
- Is the office staff friendly and helpful?
- What was the wait time? Did I feel rushed in and out?
This guest post was written by Austyn Smith.
What to Expect During Ob-Gyn Visits
When should you start seeing an ob-gyn? The American Congress of Obstetricians and Gynecologists (ACOG) recommends that girls have their first ob-gyn visit when they’re 13 to 15 years old or they become sexually active, whichever comes first. The first visit for teens may just include a talk with the doctor and no exam.
Try to avoid having sex or douching within 24 hours of your appointment. Sexual activity could irritate the tissue of the vagina and affect your Pap test results.
Your appointment will usually start with a general health check. The nurse will weigh you and take your blood pressure. You may have blood and urine tests done, too.
Then it’s time for the physical exam. The nurse will take you into the exam room and ask you to undress completely. You will be given a gown that opens to the front, and a sheet to cover your lap.
Your ob-gyn will probably start by asking you some general questions about your personal and family health history. A nurse or other health professional might stay in the room with you and the ob-gyn for the pelvic exam.
The doctor will first examine the outside of your vagina, which includes the vulva area and vaginal opening, for abnormalities. The doctor will then examine your reproductive organs from the inside. While your knees are bent and your feet are in stirrups to keep them apart, the gynecologist will use a speculum — a device that holds the vagina open — to view the inside of your vagina and cervix (the opening to your uterus). You might feel some pressure during this exam, but it shouldn’t be painful. Your ob-gyn will also examine the walls of the vagina and cervix.
A Pap test is often done during the pelvic exam. Your ob-gyn will remove a sample of cells from your cervix using a small brush. Those cells will be sent to a lab and checked for cervical cancer, possibly the human papillomavirus (HPV) and other abnormalities.
If you have been sexually active, the doctor might also test you for sexually transmitted diseases (STDs) like gonorrhea, chlamydia, syphilis, and HIV. To test for STDs, the ob-gyn will take a swab of tissue during the pelvic exam and/or check blood tests.
What I Wish I Knew Before My First Gyno Appointment
The more invasive and scary-sounding pelvic exam and pap smear tests aren’t needed until you become sexually active or turn 21 (whichever comes first), explains Cheryl Iglesia MD, director of female pelvic medicine and reconstructive surgery at MedStar Washington Hospital Center.
It’s totally normal to be nervous, even scared, the first time you go in for these screening tests — but it doesn’t have to be that way. Like any doctor’s visit, you’ll feel more comfortable if you’re more prepared for what’s going to happen.
For the pelvic exam, the doctor will use a speculum (the duck-billed device illustrated above) to look at your vagina and cervix. She will insert one or two gloved fingers to feel your cervix while pressing down gently on your abdomen with her other hand. For the pap smear, she will use a swab to grab cells from your cervix that she can send to the laboratory to be checked for abnormalities.
All of the above is what any gynecologist will tell you. To help you feel even more prepared, though, we asked a few women to share with us what they wish they’d known before their first appointment. Their experiences, plus the advice we got from Dr. Iglesia, should help you feel as comfortable as possible as you sit waiting in that paper dress.