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8 Secrets You Should Disclose to Your Gynecologist

It’s not uncommon to feel shy or uncomfortable during appointments with your gynecologist. But your hesitance to be honest about your reproductive health and sexual habits could put you at risk for a potential illness.

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Gynecologist, woman in hospital gown holding her lower abdomen

1. You experience pain during intercourse

“Pain during sex may occur initially with first sexual experiences, but should not persist over subsequent contacts,” says Dr. Wendy Wolfman, director of the menopause unit at Mt. Sinai Hospital, and professor of obstetrics and gynecology at the University of Toronto. On going pain during intercourse should be investigated. “Sometimes people have pain during sex because they have an infection, or something wrong internally, so a gynecologist should assess the problem,” she says.

Other causes of pain during sexual activity include vaginismus (a muscular issue that causes a woman’s pelvic muscles to tighten), and menopausal dryness and shrinkage of the vaginal opening. A talk with your doctor can help you find a solution. “There are many things we can offer women who have discomfort during intercourse,” says Dr. Wolfman. Pelvic physiotherapy can treat vaginismus, while local estrogen therapies, lubricants and dilators can aid menopausal sexual discomfort.

Here are 11 super common reasons for painful sex explained.

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Gynecologist, couple's feet in bed

2. Your number of sexual partners

Your gynecologist isn’t going to pass judgment on how many sexual partners you’ve had. She requires this information to ensure that you’re having safe sex, and are free from sexually transmitted infections (STIs) – infections that can cause pelvic pain and effect future fertility. “We want to make sure that you’re using barrier protection especially female or male condoms,” says Dr. Wolfman. Some STIs such as the human papillomavirus (HPV) can also cause cervical cancer. Using condoms during vaginal, anal and oral sex can help lower your STI risk.

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Gynecologist office, woman gesturing to doctor

3. Bleeding during sex

If you experience bleeding during, or after sex, it’s imperative that you inform your gynecologist. “Bleeding usually reflects a cervical problem such as inflammation, an infection, a cervical polyp, or even cancer of the cervix,” says Dr. Wolfman.

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Gynecologist, woman with menstrual cramps clutching stomach

4. Menstruation changes

Periods that become too long, short, or heavy, or disappear should be brought to the attention of your gynecologist. “In younger women we’re concerned about pregnancy disorders, or hormonal problems,” says Dr. Wolfman. “For example, if someone has abnormal bleeding, it could from a tubal pregnancy, or a miscarriage.” Fibroids, endometriosis and clotting disorders can also cause heavy bleeding. “It’s not normal to bleed heavily for 10 days,” says Dr. Wolfman. Not only can excessive bleeding lead to anemia, it can also seriously impact your quality of life. A menstrual cycle that vanishes can be related to pregnancy, polycystic ovarian syndrome (PCOS), a large weight loss, eating problems and over exercising.

In women over age 40, bleeding changes can be related to perimenopause. “Irregular unpredictable bleeding is one of its hallmarks. Everyone has a different pattern,” says Dr. Wolfman. Some women will have light periods that are further apart, and eventually stop, while 10 percent of women will have their menstruation stop suddenly. Perimenopausal women who have heavy periods that seem closer together should visit their gynecologist to rule out any problems. And “any bleeding that occurs a year after menopause needs to be investigated [to rule out malignancy],” says Dr. Wolfman.

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Gynecologist, couple cuddling in bed

5. You have unprotected sex

Not only does unprotected sex put you at risk for STIs, but it can also make you vulnerable for an unwanted pregnancy. “Our goal is for women to have planned pregnancies. Unplanned pregnancies have a profound affect on a woman’s education, socio-economic status, and life,” says Dr. Wolfman.

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Gynecologist, woman holding pregnancy test

6. Your reproductive plans

Thanks to popular culture, many women have unrealistic views about fertility. Celebrities over the age of 40 regularly appear in magazines unveiling the arrival of a healthy enfant. In reality “the risk of pregnancy complications increases over the age of 40,” says Dr. Wolfman. As you age the number of viable eggs in your ovaries decreases, so you’re more likely to have conception difficulties, miscarriages, and babies born with congenital abnormalities. Without full disclosure as to whether the celebrity’s child was conceived with a donor egg or surrogate, the myth that fertility continues through the 40s and 50s is perpetuated. “Fertility starts declining around age 35,” says Dr. Wolfman. Many women are devastated when they discover that they can’t have children. By being proactive and discussing your reproductive options, you can avoid future disappointment.

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Gynecologist, underwear hanging on a clothesline

7. You have discharge

Many women wrongly assume that every episode of vaginal discharge is a yeast infection, but STIs can cause discharge, too. If you don’t seek a proper diagnosis, and treatment you could prolong your discomfort, and damage your fertility. “A discharge that is profuse, smelly or bloody should be investigated,” says Dr. Wolfman. Don’t gamble with your reproductive health. Get doctor’s evaluation, and a targeted treatment.

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Gynecologist, birth control pill lying on a calendar

8. You forget the Pill

If taking the birth control pill slips your mind on a regular basis, your gynecologist can help you get back into the habit. “We’ll discuss lifestyle changes — putting the pills out by your breakfast every day,” says Dr. Wolfman. “If the person still doesn’t remember, we can suggest birth control that doesn’t require daily use.” The patch, vaginal ring, intrauterine devices (IUDs), and injections are contraceptive methods that can provide protection for weeks, or months (depending on the product), so they eliminate the worry if you’re forgetful.

Here’s everything you need to know about IUDs.