When it comes to sexual and reproductive health, do you find yourself going back and forth with what’s “normal” or not? Sure, women display signs of hormonal changes now and then, but if you spot anything that might be signs of a potential health problem, it’s best to raise it to your gynaecologist as soon as possible. Often patients ignore warning signs early, so my advice would be to nip it in the bud when you can.
If you feel embarrassed, don’t be. As gynaecologists, we’ve seen and heard it all and are here to help you, not pass any judgement. Here are some common red flags you should always bring up to your gynaecologist:
1. Painful periods
For many women, getting your period includes unpleasant symptoms, such as cramps, sore breasts, fatigue and headaches. These are fine and normal, but for some women, their cramps get pretty severe. Of course, pain is subjective; but if you find that your cramps are so painful to the point that you feel faint or cannot walk properly, it is in your best interest to see a gynaecologist. Extremely painful periods or periods that get worse over time are usually signs of endometriosis or uterine fibroids or in the worst case scenario a tumour.
Recently, a 30-year-old patient who has been experiencing severe cramps since young came to see me. We did a few scans and checks and discovered that she had a malignant tumour which grew to 7cm in length. Fortunately, the cancer was in its early stages and we were able to remove it, but if she came any later the outlook might have been different. So please do not sit on anything that feels wrong!
2. Vaginal odour and/or itchiness
While vaginal odour or itching may be an embarrassing and uncomfortable topic, you should discuss with your doctor if you’re experiencing a fishy smell or itch down there that seems to be lasting for a few days. Keep a lookout for discharge that’s thick and clumpy too. Having vaginal odour is normal but any changes or foul smell that usually come with an itch and abnormal discharge may be a sign of bacterial overgrowth or vaginal infection.
3. Urine or feces leakage
Many women will experience urinary or fecal incontinence at some point in their lives, especially after childbirth — particularly if they gave birth to a large baby or had a vaginal delivery that required forceps or a vacuum. Urinary or fecal incontinence may worsen once women enter menopause. I understand that it can be very stressful and can even take a toll on your quality of life, so being open with a gynaecologist might take the burden off a lot better.
Depending on the incontinence, your gynaecologist would be able to determine the best treatment options for you, which can range from seeing a pelvic floor disorder specialist to surgical options.
4. Bumps or growths in your vagina
Is that bump down there a pimple, a cut from shaving, ingrown hair or something more concerning? While bumps are typically benign and nothing that cannot be fixed, it’s still important to see a doctor to perform an examination. This is because things like herpes lesions for example can take up to 2 weeks to heal, so it’s critical to nurse it when the outbreak is occurring.
5. Sexual discomfort
Sexual discomfort may be a personal issue and even mental for some. Are you experiencing sexual discomfort because physically there’s something to be concerned about, or is there a bigger issue at hand that a therapist is better equipped to handle? If you experience sexual discomfort, I recommend seeing a gynaecologist first to clear the physical aspect.
Some common concerns include:
Some women experience vaginal dryness during intercourse. Dryness is often dependent on many mitigating factors. For example, if a younger woman on birth control has this issue, it might be a sign of low oestrogen levels and she might need to change her birth control. A postmenopausal woman on the other hand might require prescribed vaginal oestrogen and more foreplay before sex.
Pain during sex
If you experience pain during sex which does not get better despite trying out different positions and lubricants to aid with vaginal dryness, you may need to speak with a gynaecologist.
Revealing your sex history to your gynaecologist
Women often worry about revealing information like their age when they first had intercourse, their sexual orientation or if they’ve had any sexually transmitted diseases to a gynaecologist. But it’s important to share these topics because:
- Having sexual intercourse younger than 18 puts you at risk for HPV because your cervical-vaginal junction is more pronounced when you’re younger
- Having multiple sexual partners increase your risk of HPV and STDs
- Some STDs increase your risk of infertility
- There are certain health concerns among the LGBT community according to research that LGBT individuals should be aware of
To sum up
Remember, your gynaecologist only has your best interest at heart and I hope this article will encourage you to step forward and take charge of your sexual and reproductive health.
- Kleinstäuber M. (2017). Factors associated with sexual health and well being in older adulthood. Current opinion in psychiatry, 30(5), 358–368. https://doi.org/10.1097/YCO.0000000000000354
- Baek, H. S., Kim, G. W., Sundaram, T., Park, K., & Jeong, G. W. (2019). Brain Morphological Changes With Functional Deficit Associated With Sexual Arousal in Postmenopausal Women. Sexual medicine, 7(4), 480–488. https://doi.org/10.1016/j.esxm.2019.06.013
This article was written and medically reviewed by Dr Tan Poh Kok (PK Tan), a Senior Consultant Obstetrician and Gynaecologist at PK Women’s Specialist Clinic.