Ask a Gyno: Everything You’ve Ever Wanted To Know About Your Hoo-Ha
05.26.16
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Maybe it’s the lack of pants, the crotch-centric tightness of denim shorts or the maternal warning, first uttered in childhood yet ignored to this day, to “never hang out in a wet bathing suit,” but vaginas seem to be top of mind during summer. And who has time to go to their gyno in the summer, right??

You do. You definitely do. Health takes priority over swimming pools.

BUT LET’S JUST SAY you have some questions that you’d like vetted before you see your doctor/nurse practitioner. Ones that you’d like to arm yourself with so that when you enter her office you feel like you can talk the vagina talk just as much as you walk the vagina walk. Or maybe there’s something that you’re too embarrassed to bring up because you feel like at a certain age, you should know X by now?

Well guess what, Diva Cup? No question is a stupid question. Which is why…

We asked Dr. Suzanne Fenske, OBGYN, a full-time assistant professor in gynecology at Icahn School of Medicine at Mount Sinai who specializes in pelvic pain, sexual dysfunction, minimally invasive surgery and general gynecology, alllll about your hoo-ha.

Have more questions? Ask them in the comments below.

If all vaginas are different then how can you tell if yours is healthy?

Vaginas can be very different, varying in size, color and overall appearance. That being said, there are universal signs that something is wrong. If you are experiencing foul smelling vaginal discharge, irregular bleeding, pain, new bumps or ulcers, then you should see your gynecologist. These things are not necessarily signs of an STI, but they’re not normal.

I have never been to a gyno. Is that weird? When should I start going and how often?

The American Congress of Obstetricians and Gynecologists recommends a first visit between the ages of 13 and 15 for education and to assess development. The pap smear (cervical cancer screening test) is initiated at age 21 regardless of sexual activity. It would be best for a woman to see her gynecologist at age 13-15 or prior to becoming sexually active or if she believes something to be wrong. If nothing’s wrong, she should start seeing a gynecologist once she is sexually active or age 21 (whichever comes first).

Is it dumb that I haven’t gotten the HPV vaccine?

Human papillomavirus (HPV) is a sexually transmitted infection that can cause cervical cancer and genital warts. There are many members of the HPV family, but there are now vaccines that can help prevent you from getting some of the most common HPV types. Most recently, there is a vaccination that helps prevent getting nine common HPV types. Two of these HPV types account for 70% of cervical cancers.

The HPV vaccine is meant to be given to females between the ages of nine and 26. If you are in this age group and not pregnant, then you should get the vaccine and help protect yourself against cervical cancer and genital warts.

Do I really need to pee after sex? Why? For the frequent UTI-getters, is that the only way to prevent UTI?

The idea behind urinating after intercourse is that you will “flush out” the bacteria that can cause urinary tract infections. If you are one of the unfortunate women who get frequent urinary tract infections, then you should practice good hygiene and urinate after sex. In addition, you could consider being on antibiotic prophylaxis. (Ask your gyno to prescribe.) This means that you either take one antibiotic pill a day or take one pill around the time of intercourse to prevent getting a urinary tract infection.

To quote Hannah Horvath, “but what about the stuff that gets up around the side of the condoms?” But actually, what STDs do condoms NOT protect against, and how do I protect myself?

Do not stop using condoms because you think that they are not protecting you. Condoms decrease the transmission of sexually transmitted infections (STI). That being said, even with good condom use you can still be exposed to genital warts, HPV and herpes. These STIs can be on the base of the penis, the perineum, or any area in the male or female genital region not covered by a condom. If your skin comes into contact with that area, then you can still be exposed even though you are using a condom.

Other than abstinence, the only way to decrease the risk of getting a STI is condom use and making sure that you do not see any warts or ulcers. Even with these safety precautions, there is still a risk. For men who have intercourse with men, these same risks exists. Although men are not at risk for cervical cancer due to HPV, they are at risk for penile cancer, warts, anal and oropharyngeal cancer due to HPV. For women who have intercourse with women, STIs can be transmitted from skin to skin contact as well as sharing unwashed toys.

I had a one night stand, no condom. Now what?

Do not panic, but make sure that you always use a condom in the future. First, if you are not using another form of contraception (i.e. birth control pill, NuvaRing, IUD, Depo-Provera) and you do not want to become pregnant, then go to your nearest pharmacy and purchase Plan B. If this medication is taken within 72 hours of unprotected sex, then it can prevent pregnancy.

Second, see your primary care doctor, gynecologist or Planned Parenthood for STI testing. It is best to do this testing about a week after the event and you will need to repeat some of these tests six months later to ensure they are negative.

End this fight now! Can you or can you not get pregnant from pre-ejaculation fluid?

The answer is that it is unlikely, but possible. Pre-ejaculation does not usually contain a lot of living sperm, but there is a possibility of some and all it takes is one. In addition, you can get a STI from pre-ejaculation fluid. Therefore, it is important to use a condom before you initiate sex and keep it on until the end.

Can you get pregnant from ejaculation near or around but not inside the vagina?

Again, the answer is that it is unlikely but possible.

Do you have to go to a doctor for a yeast infection?

If you have vaginal itching or burning with associated thick white discharge, then you likely have a yeast infection. You can try an over the counter remedy like Monistat. If you do not have resolution of symptoms in 48 hours, then you should make an appointment to see your gynecologist. If you have a foul odor or green or gray discharge then it is best to immediately see your gynecologist as this is most likely not a yeast infection.

I’m on birth control but I don’t get my period. Should I be concerned? What’s the long-term health impact of not getting your period?

Do not be concerned. It is very common to stop getting your period when you are on birth control pills. One of the effects of birth control is that it makes the lining of uterus thin. By making the lining of the uterus thin, there is no extra tissue to slough off monthly. There are no long-term health impacts of not getting your period. This does not affect your fertility or increase your risk of cancer. In fact, by preventing ovulation and maintaining a thin lining of the uterus, birth control can decrease your risk of ovarian and endometrial cancer.

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Have more questions for a gyno? Send them to write@manrepeller.com with “Gyno” in the subject line.

Photographed by Krista Anna Lewis.

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  • Linnéa

    Love that you’re doing this and all, but it seems like you’ve forgotten about other sex than the penetrating kind/the pregnancy-making kind? Surely one can use some of this info even if one is not having sex with men, but still, include (or at least acknowledge) other kinds of sexual relations? Plzzzzzz. Maybe for a hoo-ha part 2!

    • Amelia Diamond

      We are counting on a hoo-ha part 2! This was a round up of most frequently asked. Ask questions here or email your q’s to write@manrepeller.com with “gyno” in the subject line

  • Education is always a great thing, so props to you guys for that!

    On a slightly unrelated note, I’ve seen several of these articles lately (like you said, summer makes vajayjay talk popular) and they all have different flowers in them. Do you walk into the florist and ask for the most vagina looking variety? “Why yes, I shall have a bushel of the labia snap dragon, please.” Haha

  • Harling Ross

    Reading this (especially the last question — which applies to me) has genuinely given me enormous peace of mind. I’m so happy I can stop stressing about it!! And focus on more important things, like what I want for lunch.

  • Leandra Medine

    WHERE THE FUCK IS MY PERIOD

    • sugar_magn0lia

      Are you preg Leandra?! If so a huge congrats!!! I know you’ve been trying and I’ve been wondering how your journey is going. Love to you

      • Leandra Medine

        I am not.

        • sugar_magn0lia

          I’m so sorry babe. That’s really tough

    • Greer Clarke

      I don’t know where mine is 3 out of every 4 months but then it visits and keeps sleeping on the couch for two weeks longer than I invited it, the bitch

    • Dani

      My period went to war and never returned.

  • ThisPersonSleeps

    Get the damn HPV vaccine while you still can!!!! No joke, you do not want to risk it.

  • Ellie

    So many vagina questions. PLEASE let us discuss IUD’s, especially the copper variety. Dr. Fenske contends that taking oral birth control decreases the chances of ovarian and endometrial cancer by thinning the lining of the uterus. By extending that logic: because the copper IUD makes your period heavier, does that mean it increases the probability of those cancers? Are IUD’s okay for women who haven’t had children yet? Why are there so many horror stories on the blogosphere of the internet, but positive votes of confidence from sources like the Atlantic and NY Times? Or is that just how the internet works…

    When I was on oral birth control, after two years I started to have spotting, or breakthrough bleeding, and I couldn’t get rid of it. What changed? Was it a hormonal shift, and does that mean I’m more prone to have issues with infertility? Does eating and exercise really play a role in menstrual/vaginal health? I feel like the answer to every frustrating gynecological visit I’ve ever had has had to do with “nothing is wrong” or “every vagina is different” but most of all “it might just be your hormones.” I don’t get hormones. What goes into them? How do you keep them at healthy levels, or is it out of our control? And on an emotional level, if it is out of our control, how are we supposed to contend with our own abnormalities?

    *asking for a friend*
    *just kidding*

  • Kristien

    I second Ellie’s questions about copper IUDs! Also, I went off my birth control pill last fall after being on it for 11 years. I didn’t get my first period for 3 months, then I had a regular one about 4 weeks after that, but then I didn’t have another one for 6 weeks after that, and now I’ve had another regular one after 4 weeks. What’s going on? I’ve tried going to my doctor, but they’ve been unhelpful. 🙁
    One more: is there a “preferable” age at which women should try to have children by, if they are having children? At 29, I’m still unsure, but my husband wants them and I keep hoping my “clock” will turn on and I’ll want them, but I feel like I’m running out of time. And now I feel like I want to cry.

    • sugar_magn0lia

      The worry about fertility drop off is actually a bunch of media hype. Fertility doesn’t start to decline until age 35 and for most women doesn’t significantly drop off until 40. I think this is more of a personal decision about what age you’d like to be a mother.

  • sugar_magn0lia

    Hi Amelia! You are totally missing information about bbt charting and fertility awareness method of birth control. As a 26 year old woman, this is what I am most interested as far as vaginas/sexual knowledge is concerned. I would like to see this covered more. It’s the most current and interesting form of birth control and self discovery I know of and am currently practicing.

  • YaasQueen

    Taking a daily antibiotic to prevent UTIs sounds a little extreme.

    Can using the diva cup contribute to UTIs?

  • gs

    commenting to say that if you aren’t getting your period when on birth control, it’s still worth asking your doctor about – I always had light/irregular periods, and a few years into birth control pills my period disappeared entirely. I asked my doctor about it and she said NBD, don’t worry about it. A few years later – after a few other health issues popped up, and after asking multiple times – I got my hormones tested and found out I have primary ovarian insufficiency, which accounted for my missing period and significantly reduces the chance of getting pregnant/involves other health risks. If you feel like something’s up, ask! And don’t be afraid to ask multiple times.

    thanks for this article!!

    • meme

      Did you realise that after you went off the pill again? Because as far as I understood how the pill works, your “period” when on birth control is not really a period, but the consequence of the placebo pills. This is because menstruation comes after you actually ovulate and you don’t ovulate on the pill. They call it “withdrawal bleeding”. (I actually went off the pill after I stopped getting my period because it was just the final straw in my not liking taking it, but I can’t say it was a rational reason).

  • Olivia Peake

    When should you become concerned about an irregular -or non-existent- period? I’m 24, not on hormonal birth control and I’m for sure not pregnant, but my (otherwise regular) period hasn’t visited for two months! Basically I’m asking if I should start freaking out yet.

    • Lara

      It’s usually recommended that if a cycle goes past 60 days long (so about 2 periods missed) to see a doc and get prescribed Provera. Not necessarily that anything is horribly wrong — could just be a wonky annovulatory, or late ovulation cycle due to many reasons, such as stress or sickness — but they can kick start it for you and get you back on schedule. If long cycles become the norm, then you may want a doctor to find out if there’s an underlying reason.

      **not a doctor, just unfortunately have had to learn this stuff :)**

    • MT

      My personal limit for a weird cycle is one. If I have one weird cycle, I take note but don’t wig, but if the next one is also weird, it’s to the doc for me. I don’t think freaking out, but definitely make an appointment and get checked out.

      That said, big changes in your body like weight gain or long term serious stress/grief can alter your period in surprising ways. I lost weight last year (45ish pounds) and while some of my cycles since I leveled out have been ~*~weird~*~ and my healthcare provider said that’s super normal reaction for your body to have in the circumstances.

  • Antonia Strachwitz

    D-MANNOSE TO CURE AND PREVENT (RECURRING) UTIs.

    It healed me after almost 3 years of suffering and panicking and multiple courses of heavy antibiotics.It’s not only natural, but also more efficient than antibiotics without the havoc they wreak. PLUS it’s a natural sugar that is not metabolized like normal sugar – so a healthy way to simply sweeten your morning tea/coffee while getting rid of UTIs for good.

    SAVED MY LIFE.

  • weirdquestion

    I have a weird one. If you touch the penis and then you help put on the condom, could some pre-ejaculation fluid get to the vagina that way and get you pregnant?

  • Hasilette

    Dear fellow vagina owners,

    Concerning the frequent bladder infections:
    Pleeeaaaase, don’t go on prophylactic antibiotics. It is not a solution for everyone!
    There are many other ways to treat. And I had at least 50 infections in my live.
    Treating to many the of them with antibiotics.
    They only help in very hard cases, when you already pee pure blood (sorry, thats how it feels and is)
    But often they don’t. They makeyour live worse.

    Since I found out that turning my pee alkaline, when it is acidic
    (after consuming alcohol for example)
    and going to the toilet after sex, it doesn’t occur anymore!!
    The acidic pee stimulates the bladder and can inflame it. Drinking bicarbonate of soda (used for baking, costs less then an euro/dollar) turns it alcaline and calmes it. It is sooo easy and helpful.
    And if it is not enough and the infection is caused by bacteria, I drink birch sugar (you can order it online or in a pharmacy)
    Birch Sugar was used to cure bladder infection before the pharmaindustry introduced antibiotics for everything.
    Actually the sugar of a birch doesn’t get absorbed by your body. So in the bladder there is sugary pee. The bacteria loooves sugar. The hold on to it and you just pee them out!!

    Girls,women, I wish I could tell this every women in the world. It helped to improve my live so much. Please spread the word. We all know somebody who suffers of the bladder infections!

    Thanks!!