A visit to a gynaecologist is a necessary part of the female existence but it can be unnerving and, dare we say, a little awkward to ask questions and speak frankly about your vaginal health.
Legs mid-air with a stranger in your business, your mind might be racing with questions like “is this discharge colour normal?” or “is it supposed to smell like that?”.
These questions are normal and your gynae’s office is a safe space. And chances are, your doctor has already heard them before, says Cape Town gynaecologist and obstetrician Dr Malikah van der Schyff.
We asked van der Schyff a few common questions many women are afraid to ask:
I’m nervous about having to strip down for my visit. What can I do to feel more at ease?
Many patients verbalise their anxiety or nervousness for the examination during the consultation and this affords me the opportunity to reassure them. There are two key factors. As practitioners, we will always endeavour to protect modesty and dignity during examinations. It is always a very clinical event and although we examine the anatomy, we often do not judge or even remember it later. I hope that this can provide some ease. Communication is key as well.
I am 23 and have never seen a gynaecologist. Is that careless?
A trip to a gynaecologist’s office need not be limited to only a PAP smear. It is a comprehensive health check; it is diagnostic, therapeutic and preventative.
I wish to dispel the myth that you must be sexually active before seeing one of us. This leaves room for young girls who are suffering with very abnormal or painful periods to miss the opportunity for treatment.
The American College of Obstetrics and Gynaecologists recommends that girls first see their gynae between the age of 13 and 15.
This gives the gynaecologist the opportunity to do a health check and the opportunity to educate both patient and parent.
Diagnosing certain gynaecological conditions such as endometriosis and polycystic ovarian syndrome early in a woman’s life is essential to prevent long-term complications.
How often should a woman get a pelvic exam and a Pap test?
The ideal answer to this is yearly. This may not be possible in the public sector due to the demand on the public healthcare system. Please do not hesitate to ask your gynaecologist what the ideal timing of your health assessments should be.
“Is it normal for my vagina to have an odour?”
Should a healthy vagina have any smell at all? Normal vaginal discharge has an odour. It’s often not an unpleasant one; maybe even a mild musky scent. This means that a very slight smell can be normal. Any malodorous, foul or bad and strong smell, or a smell that is unusual, is a sign that things are out of balance and that you should get yourself checked.
Does my vagina look normal?
This is a very common question that gynaecologists face daily. Many women are often fearful to ask if their perineum or vagina is normal. The answer is almost certainly yes, your vagina does look normal.
I’m on my period. Can I see my OB/GYN or should I wait?
Ideally, we would prefer to perform your well-woman check when you are not having your menstruation. There are various reasons for this, including that it may well be more painful during your menstruation.
Should you have an abnormally prolonged or abnormally heavy cycle, and you are not feeling well, please do not hesitate to go to your gynaecologist as soon as possible. They are then still able to institute treatment to manage abnormal or abnormally heavy bleeding.
I sometimes experience itching down there. Should I be alarmed?
There are a variety of reasons for vaginal itching. It may be anything ranging from a reaction to products used such as detergents or soaps or underwear. It may also be a sign of a fungal infection, candida or thrush. This could be easily treated.
Itching may also occur close to menopause and can be a sign of a lack of oestrogen or, more seriously, it may be because of a dermatological disorder that would require long-term treatment. Do not hesitate to mention this to your practitioner so they can investigate further.
I don’t ever seem to be in the mood anymore. Why is my libido low?
Many women are often embarrassed to discuss this with a gynaecologist. I would actively encourage you to inform your gynaecologist that this may be a problem and they will explore the various causes and treatments that can be instituted to assist.
How often should I be tested for sexually transmitted infections (STIs), and for which ones?
If you’re sexually active, you should be tested for STIs at least yearly. If you have more than one partner, share intravenous (IV) needles, or don’t always practice safer sex by using a condom each time you have intercourse, you should be tested every three to six months.
Also, if you are suspicious of having contracted an STI, please go see your practitioner within a few weeks after exposure. Your practitioner will discuss all the available tests and how they will be performed.