Dr. Grace Chen, Gynecologist at ParkwayHealth, answers 5 questions you may be too embarrassed to ask.
1. What is causing my unusual gynecological symptoms?
Several conditions can lead to unusual gynecological symptoms. If you’re concerned about a symptom, always speak to a doctor.
Here’s what your symptoms could mean:
Unusual vaginal discharge: Vaginal discharge is your body’s way of cleaning the vagina. Common conditions like thrush (a yeast infection) can alter its volume, consistency, color or smell, and make the entire area feel itchy or uncomfortable. More serious conditions like cervical cancer can also cause unusual discharge. Bloodstained vaginal discharge is worrisome for cancers and you need to see your doctor if it occurs.
Frequent urge to urinate: One of the most common causes of frequent urination is a urinary tract infection (UTI), and this commonly occurs after sexual activity (which is why it’s also known as honeymoon cystitis). However, it could also be a sign of other gynecological problems like uterine fibroids (benign tumors in the uterus that can compress on the bladder).
Bleeding between periods or unusually heavy bleeding: Stress, hormone imbalance, an infection – there are many possible causes for changes to your menstrual cycle and irregularity in your periods. More serious conditions, such as endometrial polyps, uterine fibroids, cervical cancer or uterine cancer,
could also be responsible.
Pain during sex: Just a lack of lubrication can be enough to cause pain during sex. Other causes could be an infection like thrush, vaginismus (vaginal muscle spasms), or endometriosis (a condition where endometrial tissue grows outside of the uterus).
Bleeding after sex: Many women experience bleeding after sex at some point as a result from vaginal dryness or vigorous sex. However, it is also a common symptom of cervical polyps or cervical cancer.
Unexplained pelvic/back pain: This is another symptom that could have several gynecological explanations, such as endometriosis, pelvic inflammatory disease (uterus infection), ovarian cysts, uterine fibroids, cervical cancer or ovarian cancer.
Bleeding after menopause: If you’ve gone through menopause, you shouldn’t bleed at all. Your gynecologist will check for polyps (non-cancerous growths), endometrial atrophy (thinning of the uterine lining), endometrial hyperplasia (thickening of the uterine lining) and cancer from the cervix or endometrium.
With so many possible causes for most gyne problems, you should always visit your gynecologist for a proper assessment. In some cases, you may be recommended for a Pap smear (to screen for cervical cancer) and an ultrasound (to check for problems arising from the uterus or ovaries).
2. I don’t have any symptoms, so how often should I see a gynecologist?
Pap smear screening is very important. Human papillomavirus (HPV) causes the majority of cervical cancers. This viral infection has over 100 strains and is passed through skin-to-skin contact, so you don’t actually need to have sexual intercourse to contract it. It is found present in 70% of normal couples and most people will get some variety of it at some point.
Many HPV infections go away on their own without causing problems. However, some high-risk HPV strains can lead to abnormal pre-cancer cell changes in your cervix, which don’t cause symptoms. Left untreated, these abnormal cells can develop into cervical cancer. That’s why regular Pap smears are so important.
You should go for a Pap smear every 3 years from the age of 25 or every 5 years if your high-risk HPV test is negative( but more regularly, if you have symptoms or have previously been diagnosed with abnormal pap smear or positive HPV).
If your gynecologist discovers pre-cancerous cells, they may remove them using cryosurgery (destroys the cells using liquid nitrogen), laser surgery (burns the cells away) or a loop electrosurgical excision procedure (removes the cells using a heated wire loop).
Your gynecologist may also perform an ultrasound, blood tests and a vaginal examination to check for ovarian cancer, as it is another condition that doesn’t always cause symptoms.
3. How are cervical and ovarian cancers treated?
Treatment of cervical cancer depends on the stage of the disease. If cancer is caught in the early stages, you may only need a radical hysterectomy (surgery to remove uterus and cervix). With more advanced stages of cervical cancer, you may need a combination of chemotherapy and radiotherapy to destroy the cancerous cells. In selected cases of very early cervical cancer, treatment may involve cone biopsy or radical trachelectomy (to remove the cervix and parametrium) for women who intend to preserve their fertility.
“As ovarian cancer is often not caught until the later stages, treatment usually involves a combination of chemotherapy and surgery to remove the uterus, cervix, tubes and ovaries and omentum.”
Many gynecological surgeries can now be performed using minimally invasive surgery, so you can recover faster with less post-operative pain and shorter hospital stay than with traditional open surgery.
4. What are uterine fibroids and how are they treated?
Uterine fibroids are non-cancerous tumors that grow in the myometrium.
While many women who have fibroids experience no symptoms at all, they can sometimes cause heavy and painful periods, pelvic/lower back pain and increased urination.
If you have fibroids, your gynecologist may prescribe you medication. If you have several or they are excessively large, your doctor may recommend surgery to remove them.
The number and location of the fibroids, and whether you intend to get pregnant, may affect the type of
surgery you can. If you have had a previous pelvic surgery or infection, minimally invasive fibroid
surgery may be more difficult and could increase your risk of injury to the bowels and bladder. In these
cases, your doctor may recommend a robotic-assisted keyhole surgery, which offers more flexibility and
range of movement.
If your fibroids are small and don’t cause symptoms, you probably won’t need any treatment at all as most fibroids shrink when menopause sets in.
5. Can I ask for a female gynecologist?
It’s understandable if you want a female doctor to perform your gynecological examination, or if you feel more comfortable voicing your symptoms to a female rather than male.
If you would prefer to speak to a female doctor, don’t be afraid to ask. Regardless of gender, a good doctor will want you to feel at ease and explain what the examination involves to help you relax.
If you’ve more questions about women’s health, speak to a gynecologist. For more information or to make an appointment, please contact 400.819.6622.
Article reviewed by Dr.Grace Chen, Gynecologist at ParkwayHealth.
Copyright: Health Plus an online health and wellness web resource developed by Parkway Singapore
References:
- Cafasso, J. & Gabbey, A. (2017, May 9). Human Papillomavirus Infection. Retrieved 26 June 2018 from https://www.healthline.com/health/human-papillomavirus-infection
- Macon, B. L. & Yu, W. (2018, February 6). Fibroids. Retrieved 26 June 2018 from https://www.healthline.com/health/uterine-fibroids
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