5 things you've always wanted to ask your gynaecologist

Mind

We know, we know – feet in stirrups, someone poking around down there, and suddenly you’re mortified to ask the questions you’ve written down for your annual gynae visit. While you should never be too embarrassed to discuss your lady parts with a doctor, we put some of the trickier topics to Dr Alex Eskander from the The Gynae Centre

Can rough sex be too rough on my vagina?

It’s normal for the vagina to be a little tender after penetrative sex – but with rough sex, just like any other part of your body, if it’s exposed to rough treatment it can feel bruised and sore after. You may also experience light spotting due to minor vaginal tearing or an inflamed cervix. This should heal on its own but if the soreness is still present a couple of days later, it’s time to see your gynaecologist. At the time of sex you can try to prevent some of the soreness by extending foreplay and using plenty of lubricant.

If I come to you for a problem and my vagina is looking unusual and/or smelling unpleasant what will you be thinking?

Gynaecologists see many patients with a wide ranging variety of problems. Many vaginal health problems involve changes to the appearance of the vulva area and unusual smells as these are some of the most common signs that indicate something is wrong. Most experienced gynaecologists have seen thousands of patients and it takes a lot to shock us. We go into the field to help women feel better and so if we come across something unusual, our main concern is in ascertaining what is causing the problem and providing effective treatment.

Is my vagina normal-looking? Do you compare my vagina to your other patients?

As gynaecologists we genuinely have no opinion whatsoever on what your vulva looks like and whether you’ve shaved or not. We see thousands of women and just like faces, each and every woman’s vulva is slightly different. Our focus is on assessing, diagnosing and treating you so you’re back to full health as quickly as possible.

I’ve noticed a weird discharge and have no idea what it is, what are common problems?

It’s normal for women to have vaginal discharge which changes in consistency throughout the month. However, when there is a change to your normal discharge, for example, an unusual smell, change in texture, colour or amount of discharge, this could indicate an underlying problem. Some of the most common reasons for changes to vaginal discharge include STIs, vaginitis and bacterial infections. If you’re experiencing any unusual changes you should see your gynaecologist.

My vagina leaks post sex, is that normal and why does it happen?

What goes in must come out! When your partner ejaculates inside the vagina, a small amount of the sperm will make its way into the uterus, but the rest of the seminal fluid will leak out as it doesn’t get absorbed into the body. It’s completely normal for fluids to leak out the vagina after sex and in addition to seminal fluid this includes vaginal secretions (which increase during sex), and any lubrication you’ve used.

And if you’re not sure where to start with your gynae, check out the below advice from the in-house experts at female health app Clue

What is a gynaecologist for?

In the UK, your local GP is likely to perform any routine checks, such as pelvic exams and smear tests, as well as advise you on, and prescribe, contraception. You can also ask your GP to refer you to a gynaecologist for any further examinations, or you can make an appointment at a sexual health clinic.

What to expect

When getting ready for your appointment, have a think about the things you want to discuss with your doctor – whether you just want to have a regular check-up, discuss your contraception or if there are any changes that you are particularly concerned about. In addition to answering any queries you might have, your doctor will also ask some general questions about your health and family history – they might ask if you are sexually active, if you have a family history of breast or gynaecological cancers, if you currently have or have had any sexually transmitted infections, if you’d like an STI screening, and if you are currently on any form of birth control. Don’t be embarrassed about answering these questions – your doctor won’t judge you and won’t disclose anything you’ve mentioned during your appointment to anyone else.

Examinations performed

Once you’ve answered the doctor’s questions and raised any concerns that you might have, the doctor will perform a pelvic exam. For a pelvic exam, you will need to remove your trousers/skirt and your undergarments. A pelvic exam is an inspection of your external and internal genital areas, and an assessment of the health of your reproductive system and organs. A smear test could also be performed, and will test for any cancerous changes to your cervix. The NHS starts cervical screening tests for women from the age of 25, and recommends that these are performed every 3 years, until the age of 50, after which the screening is performed every 5 years.

A pelvic exam usually involves three parts:

– A visual and physical inspection of the external genitalia (your entire vulva, including your labia, pubic hair, and the opening of your vagina).

– A speculum exam, when a speculum (a medical tool that is used to gently widen the vagina) is inserted into your vagina to allow your healthcare provider to see and assess the health of your cervix and vagina. Sometimes a sample may be taken in and around your vagina and cervix and to check the acidity of your vagina, and assessed for the presence of infections or changes in your cervical cells.

– A bimanual exam, in which your healthcare provider inserts two fingers into your vagina and places their other hand on your abdomen to assess the size and mobility of your uterus and ovaries. This may sound daunting at first, but shouldn’t be painful.

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