11 things your gyno really wants you to know

When you meet with your gynecologist, it should be a productive partnership—you want them to be approachable, attentive and knowledgeable, and they want you to be proactive in your own self-care.

To get some insight into what gynos wish their patients knew about preventative care, we spoke to Elizabeth Newell, MD, an OBGYN with Swedish Medical Center in Littleton, Colorado.

The vagina is a pretty self-sufficent part of your body—it naturally regulates healthy bacteria that help protect it from infections and irritations. Douching, a practice that involves squirting a mixture of fluids like water and vinegar into the vagina, can actually encourage the growth of harmful bacteria. And even though health experts recommend that people skip douching, which can do more harm than good, about 1 in 5 people with a vagina use douches.

The risks can be pretty serious. If you already have a vaginal infection, douching may push the bacteria into your uterus, fallopian tubes or ovaries. Bacteria in these areas could lead to pelvic inflammatory disease, an infection of your reproductive organs.

If you’re pregnant or are planning to become pregnant, douching can increase the risk of preterm birth or ectopic pregnancy (when a fertilized egg grows somewhere outside of the uterus, most commonly in a fallopian tube). Douching may also increase your susceptibility to contracting sexually transmitted infections, including HIV. Excessive douching may also lead to vaginal irritation and dryness.

Newell notes that douching can also put you at risk for bacterial vaginosis and yeast infections. Your vagina naturally makes mucous to clean away any blood, semen or discharge, so as long as you’re taking regular showers or baths with warm water, your vagina will clean itself.

Even if you’re not due for your next Pap smear or cervical cancer screening, you should still check in with your gyno for an annual checkup, says Newell.

These yearly appointments—which may or may not include a pelvic exam—are important because they give you and your gynecologist the opportunity to discuss sexual activity, vaccinations, your menstrual cycle, and any pregnancy or birth control plans. Your gyno may also suggest other potentially life-saving screenings, adds Newell. “We’re doing a lot more genetic screening for certain cancers like Lynch syndrome, uterine cancer, ovarian cancer and breast cancer,” she says. Also on the agenda: any updates to your family history and conversations about how you can adopt healthy habits as you age, including getting regular exercise and eating a well-balanced diet.

While you’re there, ask about the best schedule for your cervical cancer screenings. Current guidelines say that  women between the ages of 21 and 29 should have a Pap smear every three years. Women between the ages of 30 and 65 should have a Pap smear and an HPV test together every five years, a Pap smear alone every three years, or HPV testing alone every five years. After the age of 65, women can stop screening depending on whether they have had abnormal results from past Pap smears. And, of course, if you experience symptoms such as heavier-than-normal menstrual bleeding, pain, dizziness or unexplained discharge, check in with your gynocologist right away.

Newell points out that doctors see a many different types of bodies all day long, and they give little thought to whether their patients have shaved their legs, waxed their bikini lines, or have tattoos. So if you’re avoiding an appointment because you’re worried what your provider will think, rest assured that their main concern is your health. (However, as a tip, Newell does recommend trimming or waxing rather than shaving the pubic area, since shaving sometimes raises the risk for folliculitis and blisters.)

Most sexually transmitted infections (STIs), including chlamydia, human papillomavirus (HPV) and herpes, have mild symptoms such as abnormal vaginal discharge or pain when urinating. And many times, they can have no symptoms at all. But left undetected and untreated, STIs can potentially lead to infertility issues or even cervical cancer down the road. This is why it’s a good idea to talk with your provider about getting tested (which may involve a pelvic exam, blood or urine test, or tissue sample) when you’ve been with a new partner, says Newell.

Find yourself up at night, Googling symptoms like itching, frequent urination or funky discharge? It’s completely understandable to want to get an idea of what’s causing your symptoms before you have the chance to stop at a health center. But your at-home research should always be followed up by a visit to a real-life doctor, who can narrow down a diagnosis with an exam and testing.

Because even if you’re sure you have, say, a yeast infection, you could actually have another condition with similar symptoms, and if you take the wrong over-the-counter medication, it won’t work, says Newell. Urinary tract infections (UTIs), kidney stones, and ovarian cysts all have similar symptoms that can be misdiagnosed by Dr. Google.

So, next time you experience unusual symptoms, schedule a doctor’s appointment—and be prepared to provide a sample—so a professional can properly treat your issue.

If a surprise visit from your period has you reaching for the phone to reschedule your gyno appointment, that’s totally fine—but it’s not necessary.  “We still want women to come in when they have their period,” Newell says. “We can still get a pretty good sample during the Pap smear.” She adds that doctors are used to seeing people who are menstruating or having spotting. In fact, she says it’s rare that your provider won’t be able to get a proper sample.

If you’d prefer to see your provider when you’re between periods, consider tracking it and scheduling appointments 10 to 20 days after you expect your period to start.

One of the most helpful things you can do for your own health is to ask your parents about theirs (and while you’re at it, ask about grandparents, aunts, and uncles, too).

“New cancers in the family or someone in the family passing away from a heart attack are good things for us to know,” says Newell. Your gynecologist will use your family history to make recommendations about screening for things like heart disease, uterine cancer, colon cancer and breast cancer.

You can make a project out of this by creating a health-focused family tree. Include the date of birth, date of death (if applicable) and any medical conditions or surgeries your family member has had. You can share this with parents and siblings, as well as grandparents, aunts and uncles, nieces and nephews, children and grandchildren. And if anything changes, keep your providers updated as you have more info.

It can be incredibly frustrating when you’re sitting in the waiting room at 11:30, still waiting to go in for your 11am appointment, but consider what may be causing the delay: “Sometimes we have to give bad news to someone, spend time with someone who is critically ill or who just had a miscarriage or found out they’re pregnant,” says Newell. “That extra 30 minutes of comfort really helps them.”

It’s typical to experience a few physical or mental changes leading up to your period. But, if month after month, you’re experiencing symptoms that interfere with your daily activities, you may be experiencing premenstrual syndrome (PMS). Some symptoms of PMS include, but are not limited to:

• Depression or anxiety
• Insomnia
• Food cravings
• Bloating and weight gain
• Headaches
• Fatigue

Mild and moderate cases of PMS can usually be addressed with lifestyle changes such as exercise, relaxation therapy and diet tweaks. Severe PMS symptoms, however, may require medications such as antidepressants, nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics, otherwise known as “water pills.”

You should always talk to your doctor about any symptoms you have related to your period—they can assess those symptoms and suggest treatment options that may give you some relief. In some cases, certain symptoms like severe cramping—appearing in combination with spotting between periods, infertility or stomach issues—could indicate more serious health conditions such as endometriosis, which would require additional testing or treatment.

If winding down with a luxurious bath feels like one of life’s great pleasures to you, be sure to choose products that will be gentle on all parts of your body, especially your vaginal area. Soaps, lotions, or bubble baths (and even tampons and pads) that are scented can up your risk of yeast infections or bacterial vaginosis. When it comes to cleaning your vaginal area in the bath or shower, a little mild, unscented soap works just fine. If you have sensitive skin, skip the soap—warm water is all you need.

Remember that your gyno has probably seen—and heard—pretty much everything. So if you’re nervous about discussing your reproductive and sexual organs, or your sexuality, or asking questions about birth control, fertility, STIs, painful sex, period cramps, anal intercourse and other sexual habits, you can rest assured that your doctor talks about these things all day long-- and is there to answer your questions. You can also ask questions about menopause, breast health, tobacco or alcohol use, and other health conditions you may be wondering about. And if you’re worried you’ll draw a blank when you’re in the exam room, write yourself notes before your appointment.

“I think patients either forget to ask questions or they’re too embarrassed to ask them,” says Newell. “We want our offices to be safe spaces for people, places where they feel like they’re accepted,” she adds. If your sexual preferences change, your gyno understands that, too