1) “I've
been noticing a fishy smell ‘down there.’ What is it?”
A "fishy" odor can often be a symptom of a condition called
bacterial vaginosis (BV). BV occurs when the normal level of bacteria
in the vagina becomes imbalanced. The overgrowth of some types of
bacteria can cause an odor and sometimes also discharge. Don't worry
though—BV is not a sexually transmitted disease and can usually
easily be treated with antibiotics. Douching has been thought to
be a cause of BV and is not advised as a result.
2) “Why am I feeling pain during sex?”
Pain during sex is often multifactorial. Most commonly pain is due
to vaginal dryness. One way to avoid vaginal dryness is to make
sure to engage in adequate foreplay before and during intercourse.
Over-the-counter personal lubricants, available at the drugstore,
may help to alleviate vaginal dryness as well.
Pain associated with deep penetration may be indicative
of conditions such as endometriosis, infection, fibroids, ovarian
cysts or adhesions. Pain upon penetration at the entry of the vagina
could be associated with voluntary or involuntary muscle spasms,
infection or psychological causes. If pain persists during sex,
talk to your doctor so you can find a reason and solution for your
pain together.
3) “I leak urine!”
Urinary incontinence is the involuntary leaking of urine that may
occur for a variety of different reasons. It is a very common condition
that affects all age groups; however, it is particularly common
in the elderly. It is often an overlooked problem because women
are too embarrassed to discuss it. Women often live with incontinence
for years without knowing that it may be improved with simple methods.
There are many reversible causes of urinary incontinence,
including urinary tract infections, caffeine intake, medications
and diet. Often treating a urinary tract infection or limiting caffeine
intake can help alleviate the problem. Other medical conditions
such as diabetes or menopause may also be associated with urinary
incontinence. These issues should present themselves during a detailed
history intake with your doctor.
Urinary incontinence is sometimes due to a pathologic
overactivity of the bladder muscle. This type of incontinence, called
urge incontinence, may be controlled with medications. Timely emptying
of the bladder can help prevent overflow incontinence–which
is incontinence when the bladder is full. If urine leaks while you
are coughing or sneezing, you may require a simple outpatient surgical
procedure to correct the problem. Kegel exercises, which include
the tightening and relaxing of your pelvic muscles, may also help
urinary incontinence.
4) “Is it safe to have sex during your period?”
Absolutely. There are no health risks to sexual intercourse while
you are menstruating. However, HIV and other sexually transmitted
diseases can be transmitted through blood and semen. Therefore,
condoms should always be used during sex to protect against sexually
transmitted diseases.
5) “Is having vaginal discharge normal?”
Many women have vaginal discharge, and it can be totally normal.
It is normal to have discharge during certain times in your menstrual
cycle, especially mid-cycle when you are ovulating. However, vaginal
discharge can also be a sign of a sexually transmitted disease like
trichomonas, gonorrhea or chlamydia. Watch out for discharge if
it is persistent, excessive, itchy, foul-smelling or an unusual
color.
6) “Can a tampon get lost in the
body? What happens if it gets stuck? How long can a tampon be worn?”
A tampon cannot get lost in your body—it stays in the vagina
only. The vagina is a blind pouch that ends with the cervix. An
opening in the cervix, called the endocervical canal, opens into
the cavity of your uterus. The endocervical canal is very small
and will not allow a tampon to pass through. Do not panic if a tampon
does not come out immediately. Try to take the tampon out from different
positions, including squatting. Try pushing down like you are having
a bowel movement. If it still does not come out, call your doctor.
Ideally, a tampon should be removed and changed every four to six
hours, if possible, to reduce the risk of Toxic Shock Syndrome.
7) “Why is one of my breasts larger than the other?”
It can be normal, and it is quite common for breasts to be slightly
different sizes. If one breast is rapidly growing bigger than another,
it should be evaluated for a breast tumor or cyst. Monthly self
breast exams should be done to evaluate for any breast lumps. Usually,
breast asymmetry can be corrected with cosmetic procedures such
as augmentation of the smaller breast or reduction of the bigger
breast. Padded bras are often enough to conceal the problem.
On a final note, keep in mind that your doctor
will have the answers to your most mortifying queries—from
your period to your sex drive. Although you may be embarrassed by
your question, rest assured that anything you say will not surprise
your doctor. Your doctor has heard it all before and will not think
less of you for taking initiative about your own health. Just remember:
All you have to do is ask.
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