Turning 21 involves two major milestones, one arguably more fun than the other: legally being able to drink and seeing your gynecologist for your first pap smear (via Mayo Clinic). By this age, women should be visiting the gynecologist annually. And according to Cornerstone Family Healthcare, women under 21 who are sexually active should also consider seeing their gynecologist once a year.
Of course, gynecologists aren’t only there for pap smears. They’re the go-to resource for medical questions regarding your sexual health, birth control, menstrual problems, and unexplained issues going on in your private areas. "Ob-gyns are the masters of the pelvis and associated organs — who better to ask?" Maureen Whelihan, an OB-GYN at the Center for Sexual Health & Education, told Glamour. "Our focus is on the health of women, which includes sexual health."
When issues arise, you don’t have to wait a whole year to see the doctor. Here are some cases in which you’ll want to book an appointment with a gynecologist ASAP.
Consult your gynecologist if you notice blood in your urine
Your urine says a lot about your health, so if there’s blood, that’s troubling. According to the Mayo Clinic, visible blood in the urine is called "gross hematuria," while blood that can only observed under a microscope is called "microscopic hematuria." These conditions occur when blood cells in the kidneys or other parts of the urinary system leak into urine, and both necessitate a visit to the doctor.
Urinary bleeding may be a side effect of aspirin or antibiotics such as penicillin, per the Mayo Clinic. But it could also be a sign of other health problems. A 2019 study in the journal Urology found 1.2 percent of over 2,000 patients with trace blood in their urine had bladder cancer.
Bleeding could also indicate a urinary tract infection, kidney disease, bladder or kidney stones, an enlarged prostate, or sickle cell anemia. Though rare, excessive exercising can also cause urinary bleeding. The Mayo Clinic says while this can impact anyone who exercises too hard, long-distance runners are the most affected.
If peeing is painful, make an appointment with your OB-GYN
When it burns to pee, you’ve got to see a doctor. Urinary tract infections (UTIs) are common; The Woman’s Clinic says 50 to 60 percent of women have experienced a UTI — but that doesn’t make the pain any less excruciating. UTIs are bacterial infections of the urinary tract and affect the urethra, bladder, uterus, and kidneys.
While a UTI is not dangerous, women should get checked out by a gynecologist if symptoms do not cease after a few days, The Woman’s Clinic explained. If left untreated, it could develop into a secondary infection in the kidneys.
Yeast infections could also be causing a burning sensation during urination. According to the Mayo Clinic, yeast infections are bacterial infections that also cause tremendous vaginal itching and a cottage-cheese-looking discharge. The Clinic recommends going to a doctor if you’ve had four or more yeast infections in under a year or if symptoms do not subside with over-the-counter antifungal treatments.
If sex hurts, see your gynecologist
Sex should be enjoyable, not painful. Unfortunately, though, this is a common problem among women. According to the American College of Obstetricians and Gynecologists, about 75 percent of women will experience unintentional pain during sex at least once in their lives. And there are several reasons for this.
Vaginal dryness is one contributing factor to painful intercourse. Although it’s most associated with menopause, the Cleveland Clinic says this health condition happens at any age. "People have a perception that if you’re young, you’re always vaginally lubricated, but that’s not always true," Jessica Shepherd, assistant professor of clinical obstetrics and gynecology and director of Minimally Invasive Gynecology at the University of Illinois College of Medicine at Chicago, told Glamour.
The American College of Obstetricians and Gynecologists say that going to your gynecologist is needed to rule out ovarian cysts or endometriosis since they can also cause painful sex. Additionally, you should go to the doctor if lube doesn’t help (via Healthline). Signs to watch out for include bleeding after sex, frequent vaginal infections, or worsening pain.
Changes to your menstrual flow may require a visit to your gynecologist
Aunt Flo’s visit is the gift that keeps on giving. While some periods are better than others, seeing drastic changes to your menstrual cycle can be a serious problem. "Heavy bleeding with big blood clots, like the size of a grape or apricot, would be an abnormal amount of blood flow," Sherry Ross, women’s health expert and author of She-ology, told Cheat Sheet. "In general, an abnormal period or menstrual bleeding is when you’re changing a pad or tampon every 30 to 60 minutes for three to four hours."
According to the Cleveland Clinic, having a heavier or lighter period than usual could be a sign of abnormal uterine bleeding or endometriosis. Your gynecologist can perform a physical exam, including a pelvic exam and pap smear, to investigate the cause. They can also prescribe contraceptives such as birth control pills or an IUD (intrauterine device) to release reproductive hormones that regulate heavy bleeding.
Depending on the severity of the bleeding, your gynecologist may recommend an endometrial ablation, a surgery that destroys the uterus’ lining. However, the Cleveland Clinic says this is typically a last-resort option.
Your gynecologist can help you with your painful cramps
If women were to narrow down one major thing they have in common, it would likely be hatred for period cramps. According to the Mayo Clinic, cramping pain comes from releasing a hormone called prostaglandin. Prostaglandin helps with muscle contractions to shed the uterine lining. And having high prostaglandin levels means more cramps.
Are your cramps starting to disrupt your life? This is a sign of abnormal periods, according to Verywell Family. The site recommends talking with a healthcare provider as severe cramping could affect fertility. According to John Hopkins Medicine, painful cramps could also be a sign of a chronic disease such as inflammatory bowel syndrome or scar tissue from a previous infection. And cramps along with bloating could be signs of endometriosis. For this reason, The Association for Women’s Health Care says it’s crucial to address with your gynecologist abdominal pain not related to digestion.
"Sometimes there isn’t a reason why some women have more painful periods than others, but often there is," Narendra Pisal, a consultant gynecologist at London Gynaecology, told Patient. "And even if everything is normal, we can always do something to help alleviate the pain."
See your OB-GYN if your period has gone MIA
Missing your period doesn’t always mean pregnancy or menopause. According to Healthline, feeling stressed out causes your body to go into "fight-or-flight" mode. When this happens, your brain sends a signal to release hormones most vital to surviving a threat. This causes your reproductive hormones to become temporarily repressed, putting a stop to ovulation until the stressor goes away.
Healthline further revealed that losing or gaining weight in a short period of time may cause hormonal imbalances in the body. Diets involved in limiting calories also disrupt brain signals to start producing reproductive hormones. Irregular of missing periods may also be a sign of underlying health complications, like hypothyroidism or hyperthyroidism. There’s also a risk of polycystic ovary syndrome.
According to the Mayo Clinic, women should see a doctor if they’ve missed three periods in a row or if they’re 15 years or older and have never had a period. Verywell Health explained that a missed period accompanied by breast milk secretion, vision changes, excess hair growth, or fever warrant immediate attention.
Bleeding between periods requires a visit to the doc
No one likes when Aunt Flo comes for her monthly visit, but some women see her more than once a month. According to Healthline, light bleeding outside of your normal menstrual cycle is considered "abnormal vaginal bleeding."
Birth control may cause spotting if you forget a dose, start a new type, or have been on birth control for a long time. Nevertheless, Healthline explained that birth control is an option to control other causes of bleeding between periods, and this should be a conversation between doctor and patient.
Your gynecologist can locate the source of abnormal bleeding through several exams. According to Healthline, pelvic exams help identify cervical polyps (small abnormal tissue growths), whereas uterine polyps are found through an ultrasound. Your doctor may also collect cervical cells to check for a sexually transmitted infection (via Mount Sinai). As bleeding between periods can be a sign of cervical cancer, your gynecologist can use a pap smear to verify, according to Medical News Today.
Don’t ignore bumps in the genital area
Unusual lumps or bumps in your private area can be scary. According to Healthline, vaginal bumps frequently happen in a woman’s childbearing years — although that doesn’t make it any less uncomfortable. Ingrown hairs are common culprits that can arise after shaving, waxing, or plucking pubic hairs. Ingrown hairs go away on their own or with treatment. Vaginal skin tags, extra skin that only becomes inflamed when they catch on to something, are also not uncommon. While typically harmless, a doctor can remove these using laser surgery.
Sores around the vagina may be a sign of a sexually transmitted infection. Healthline revealed that repeated outbreaks of genital herpes include itching, ulcers, and painful pimples or blisters. While one in five people have genital herpes, most people are unaware they have it due to only experiencing mild symptoms.
Going to a gynecologist is the best option in determining whether a lump or sore is harmless or cause for alarm. "Sores in your genital region can be so many different things, so self diagnosis can go very wrong and cause a delay in your actual diagnosis and treatment," Kameelah Phillips, an OB-GYN in New York City, told Cheat Sheet.
Book an appointment with your gynecologist if you notice a funky odor
The last thing you want to smell like is a dead fish, right? But even if you keep your genital area clean, a medical reason — bacterial vaginosis (BV) — could be causing the unfortunate scent. According to Healthline, bacterial vaginosis is caused by an overgrowth of anaerobic bacteria with a strong fishy odor. Other symptoms of bacterial vaginosis include colored discharge, vaginal itching, and burning when peeing.
"Education is key, because BV can cause a lot of emotional and psychological distress," Oluwatosin Goje, an OB-GYN and infectious disease specialist, told the Cleveland Clinic. While bacterial vaginosis doesn’t cause severe health complications, the smell can affect a woman’s body image and cause her to feel self-conscious towards sexual activities.
Bacterial vaginosis is thankfully treatable, which is why you’ll want to see your OB-GYN. The Cleveland Clinic says doctors can prescribe antibiotics. However, there is a risk of bacterial vaginosis coming back. "I tell my patients that 20 to 30% of women will come back in three months with BV, and 50% in 12 months," Dr. Goje revealed. Preventing recurrence includes avoiding douches and scented feminine hygiene products. You should also encourage your partner to wear condoms for about three to four months to "break the cycle of sharing the bacteria," according to the Clinic.
If you can’t retrieve a "lost" tampon, see your gynecologist stat
It’s technically impossible to lose a tampon, but it can get stuck (via News-Medical). According to Healthline, tampons can move far up the vagina and turn sideways, making it difficult for you to feel the string. The vagina’s elastic canal makes it possible to insert more than one tampon. And although you wouldn’t do this knowingly, plenty of women have forgotten to remove their tampon before putting in another.
"You would be surprised how often I see what is medically called a ‘lost tampon!’" Sherry Ross, a women’s health expert in Santa Monica, California, and author of She-ology, told the Cheat Sheet. "Often, women will notice a watery-brown discharge with a foul and pungent odor that’s different from a yeast infection or vaginal infection." Women may also experience vaginal itching, painful urination, cramps, redness around the genital areas, vaginal swelling, and a high fever.
Having a tampon in the vagina for an extended time increases the risk of toxic shock syndrome (TSS). While TSS is rare, Healthline says there’s a higher risk of developing it the longer a tampon stays in the vagina. If you have trouble removing a tampon by yourself, Healthline says you should see a doctor immediately to get it out and avoid further complications.
Consult your OB-GYN if you think you could have an STI or STD
Having unprotected sex carries a risk of a sexually transmitted infection (STI) or sexually transmitted disease (STD). In 2018, one in five people in the United States reported an STI, according to the Centers for Disease Control and Prevention. And the STD Center NY reports that in heterosexual sex, women are more likely than men to contract HIV, six times more likely to be infected with genital herpes, and three times more likely to get gonorrhea. Women also have an overall higher risk of getting chlamydia.
While visible wounds, lumps, and warts are warning signs for an STD, The Woman’s Clinic says you can have an STD and be asymptomatic. If left unchecked, STDs can cause pelvic inflammatory disease and harm your reproductive organs. Prolonged damage to reproductive organs affects your overall health and may develop into infertility.
According to the Cleveland Clinic, doctors can prescribe antibiotics to treat several STDs. Although some STDs, such as HIV, require lifelong treatment plans and maintenance. Make sure to see your OB-GYN at least annually to get screened for STIs and STDs.
Ask your gynecologist why you’re feeling faint during your period
Periods aren’t fun. There are many unpleasant but usual menstrual cycle symptoms — cramps, bloating, PMS, just to name a few. Fainting, however, is considered abnormal. According to Verywell Health, fainting happens when your brain isn’t getting enough oxygen. Fluctuating changes in a woman’s body during her menstrual cycle can increase fainting risk. Also, painful periods called primary dysmenorrhea might cause fainting due to high prostaglandin levels.
Prostaglandin is released in the second half of the menstrual cycle to remove the lining of the uterus. But at excessive amounts, prostaglandin causes vasodilation, or widening of blood vessels. Vasodilation causes a drop in blood pressure, which can trigger fainting. Verywell Health explained that taking ibuprofen or an anti-inflammatory drug can help reduce high prostaglandin levels and potentially decreases the risk of fainting.
According to the University of Michigan, losing a lot of blood from heavy bleeding can bring about feelings of weakness and tiredness from anemia. If you’ve been feeling lightheaded or fainting during your periods, consult your gynecologist to figure out the cause.
Don’t shrug off postmenopausal bleeding
Postmenopausal bleeding (PMB) isn’t dangerous in and of itself, but you should always check with your gynecologist to rule out endometrial cancer. According to Chicago Health, endometrial cancer affects 2 to 3 percent of women living in the United States. And a 2018 study in JAMA Internal Medicine found bleeding after menopause is a common symptom of endometrial cancer. "Early detection strategies focused on women with PMB have the potential to capture as many as 90% of endometrial cancers; however, most women with PMB will not be diagnosed with endometrial cancer," explained the study.
If postmenopausal bleeding continues to happen and you’ve already had a biopsy to rule out cancer, it may be worth getting a second biopsy some months later. "I don’t recommend waiting much more than six months," physician Ross Berkowitz told Chicago Health. "The vast majority of patients with endometrial cancer can be cured with surgery alone."
According to the Mayo Clinic, other causes for postmenopausal bleeding include uterine fibroids, noncancerous uterine polyps, pelvic trauma, infection of the uterine lining, and more. Depending on the diagnosis, WebMD says your doctor could recommend hysteroscopy or surgery to remove polyps. You may also be prescribed antibiotics to treat cervical and uterine infections.
Yes, you should talk to your gynecologist about changes to your sex drive
Talking about sex can be uncomfortable — especially with a stranger. But gynecologists are no stranger to the body and the problems associated with it. About 33 percent of American women report a low sex drive, per the Hormone Health Network. And one in three of those women are distressed about their low libido. "That’s about 10% of all women in the United States," the Network continued.
Talking with a gynecologist can help you determine if this will be a temporary or long-term issue. According to Women’s Health Magazine, having a low sex drive or a lack of orgasms could be due to a more serious neurological or hormonal issue. Hormone Health Network says low estrogen levels can be the culprit for vaginal dryness and painful sex. Estrogen levels decrease naturally as you age, especially when entering menopause. Taking prescriptions for local estrogen tablets or hormone therapy could remedy these issues (via Mayo Clinic).
Psychological factors such as anxiety or depression can also prevent orgasms. However, taking antidepressants with "selective serotonin reuptake inhibitors" can lead to having difficulty climaxing. Relationship and cultural factors can also influence an orgasm.