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6 Things To Tell Your Ob/Gyn

ByJacqueline Sanchez, MD

So you’re going to the Ob/Gyn and don’t really know what to say. You’re not alone! Many times I have patients who come into my office for their annual check-up with nothing to talk about.

“Oh, I’m just here for my Pap smear,” they’ll say. Or, “I was told I should come and see a gynecologist, but nothing is bothering me.”

But the truth of the matter is that I want to know about everything, and definitely not in a creepy way! Not only do I want to know what questions you have, or what your concerns are, but here are 6 things I believe you should be talking to your Obstetrician Gynecologist about during every visit:

1. Concerns about your vulva and/or vagina.

While my expertise encompasses much more than just your vulva or vagina, it can unfortunately be pretty taboo to voice your concerns. I stress to all my patients that my exam room is a safe space, and nothing you want to talk about is forbidden or off limits.

Let’s review: the vulva is the outer part of the female genitals (the opening of the vagina, the labia majora [outer lips], the labia minora [inner lips], and the clitoris) and the vagina is, well, the vagina.

So what are some things that you should tell your Ob/Gyn?

  • Dryness or itching: Vulvar dryness is a common symptom of menopause that can easily be treated with application of estrogen. Itching can be a symptom of an infection (like yeast) or an inflammatory skin condition.
  • Abnormal discharge (whatever that means to you): Abnormal discharge can signal a change in pH and an infection with bacterial vaginosis, or an infection with a sexually transmitted infection such as Chlamydia, Gonorrhea or Trichomoniasis.
  • Painful sex: This may be a symptom of vaginal dryness or a persistent pain syndrome like vulvodynia.
  • Changes in skin — changes in color, new sores: Changes in skin could alert us to new Herpes infection, or to an inflammatory skin condition like lichen sclerosis, lichen planus, or lichen simplex chronicus.
  • Burning during urination: Burning during urination can not only alert us to a urinary tract infection, but also postmenopausal vulvar dryness and even a sexually transmitted infection.

After we talk about your concerns, a pelvic exam should direct care. Whether that be performing a culture to rule out infection, or confirming a condition for which medication is prescribed.

2. What your comfort level is regarding the pelvic exam.

While a pelvic exam is par for the course when you go to an Ob/Gyn, it is in no way 100% mandatory. Though we may ask to examine, especially if you have a complaint, you have every right set boundaries or flat-out decline the exam.

For your comfort, I like to go incredibly slow and verbalize everything that I am doing. We can also use a mirror so you can watch the exam, and/or you can insert the vaginal speculum yourself. Frankly, you can forego the vaginal exam altogether, and just have your doctor examine externally.

It should not need to be said, but I’ll go ahead and say it anyway: if your Ob/Gyn has objections or is bothered by your boundaries or requests, find another physician.

3. Details about your periods.

The very first thing you are going to be asked at your Ob/Gyn appointment is about the first day of your last period. But that shouldn’t stop you! We literally want you to go wild. Tell us everything.

Basic things to tell us: when you first got your period (AKA menarche), how often do you get your cycle (normal is every 28-35 days), and how many days they last.

Make sure to explain in detail, however, if your periods have changed or have become concerning. Are they skipping months, or coming to frequent? Are you having heavier bleeding than you have in the past, or bleeding in between periods? These concerns, all describing a condition called Abnormal Uterine Bleeding, should motivate your Ob/Gyn into investigating whether you have new structural causes of abnormal bleeding (endometrial polyps or fibroids), are going through hormone changes like menopause, or whether medications or other causes can be contributing.

One last thing about vaginal bleeding. If you are postmenopausal and begin to have your period again, you should make an appointment with your Ob/Gyn pronto! While it could be a polyp or vaginal atrophy causing bleeding, it could be a sign of something more sinister.

4. Your fertility plans.

Whether you’re trying to conceive, or trying to prevent it, your Ob/Gyn can help! We not only can evaluate you for infertility and direct your to an infertility specialist, but we have a boatload of birth control options if having a baby is not yet (or ever!) in your cards. And! For those patients who are looking for permanent solutions, we can always schedule you for a bilateral salpingectomy and you’ll never have to worry again. Though, a vasectomy is always the safer and cheaper option!

5. Changes with your breasts.

We recommend having yearly breast screening with a mammogram starting at the age of 40. But, unfortunately, breast cancer can creep up at any time. So if you’re having any of these changes, you need to seek attention soon. Your Ob/Gyn will do an exam and send you for appropriate evaluation, whether that be with mammogram or breast ultrasound (or both).

  • New lump or bump
  • Pain
  • Axillary (armpit) lump or pain
  • Nipple discharge
  • Nipple retraction
  • Skin changes (puckering, scaliness, thickened skin, sores that won’t heal)
  • Sudden asymmetry from other breast

6. Your family’s cancer history.

In keeping with the cancer theme, your Ob/Gyn should be updating your family’s cancer history yearly. In particular, we want to know about new breast, ovarian, colon and pancreatic cancers. It’s always good to also note any members with endometrial and cervical cancers. We ask so that we can identify patients who would benefit from hereditary screening, or screening for genes that could predispose to cancer. Common ones are BRCA and Lynch.

In conclusion:

You may be going into your Ob/Gyn appointment with seemingly nothing to talk about, but there are so many things we want to know about! Like I said earlier, my office and exam room should feel like safe spaces. There should never be any judgment from your doctor for any question, concern or boundaries you may have. And if there is, run!

If you’re in the Miami area and are looking for a new Ob/Gyn to talk to about these 6 topics, you can always make an appointment with me by calling the clinic or booking online. I explore this and other subjects on my Instagram, so make sure to follow along!

Disclaimer: All content is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis or medication treatment of a qualified physician. Should the reader have any health concerns, promptly seek a consultation with your physician.