By Caroline Olney
We’ve all sat through high school sex ed and we’ve all been subjected to the “birds and bees” talk, but judging from how many vague queries we’ve put to Google in our lives, that doesn’t necessarily mean we have a better idea of what exactly is going on in our uteruses and in the surrounding area.
We turned to some real-life uterus experts (aka OB/GYNs) and asked them what the most common questions are that they get from patients, and how they typically answer them.
“I’m tired all the time. What’s going on with me?”
Kecia Gaither, MD, OB/GYN, Director of Perinatal Outreach at Montefiore Medical Center and Albert Einstein College of Medicine in Bronx, New York, says she hears this question a lot, and the answer can vary a great deal from person to person.
“I get a blood count first, and then check their thyroid function,” Dr. Gaither says. “I’ll have them discuss what their interactions are at home and see whether or not there’s anything going on there, and ask them whether or not they’re feeling depressed.”
Though tiredness can be caused by a number of things, Gaither says she most often sees anemia, thyroid problems, heavy stress in their life, and depression.
“Urinary incontinence is normal if you’ve had kids and are getting older, right?”
“No, not right!” says Antonio Pizarro, MD, board-certified OB/GYN and Female Pelvic Medicine and Reconstructive Surgeon. Urinary incontinence (aka a leaky bladder) can worsen over time if it goes untreated, and it’s not necessarily a symptom of aging.
“Most patients do not require surgery for relief,” note Dr. Pizarro. “In rare cases, urinary incontinence can be a sign of serious conditions, including ovarian cancer.”
“Can heavy periods cause anemia, and is that normal?”
Yes, heavy periods can cause anemia, but no, that’s not normal, says Dr. Pizarro. “Anemia refers to low blood levels due to blood loss or other causes,” he explains. “Too many women tolerate heavy periods for too long, when they should seek care.”
There could be fixable reasons why a woman’s period is so dangerously heavy, or at the very least, birth control options to help control them.
“What if I’m constantly bleeding/always have to go to the bathroom/can’t control my bowel movements?”
Gaither explains that when she hears these issues, it’s typically from a patient with fibroids. “It’s a question of where the fibroids are and what they’re pushing into,” she says. “For example, a fibroid in the lining of the uterus makes you bleed.”
There are treatments and solutions to fibroids, depending on the degree of discomfort the patient is experiencing, and whether or not she’s anemic or interested in having more children.
“It hurts to have sex. Why is my vagina so dry?”
“I hear this most often among older women,” Gaither notes. “As you get older the lining of your vagina thins out, because your estrogen has decreased.” (Hormonal birth control can also do this.) While there are evaluations that can be done to test for infections, often the answer is to use lubricants while having sex.
“If I have a hysterectomy, will I go into menopause?”
“A hysterectomy is the removal of the uterus,” explains Dr. Pizarro. “Since it’s the ovaries that produce hormones, if a premenopausal woman undergoes hysterectomy and her ovaries are preserved, her hormone status will remain the same.”
So, no, a hysterectomy won’t cause menopause. Dr. Pizarro also notes that a hysterectomy is almost always a final option, and it’s really only considered when all other options for treatment have been explored.
“Do I need a pap test every year?”
“Women with no history of genital cancer, who have normal testing for HPV (the cervical cancer virus),and who have no history of abnormal Paps should receive routine pap testing three to five years, depending on risk factors,” Dr. Pizarro adds. That said, everyone’s different, so you should feel free to discuss with your doctor what is right for you.
“My breasts are tender, and I have a mass.”
Obviously, this is worrisome, but how Dr. Gaither proceeds depends on the patient’s history. With younger patients, there’s sometimes breast tenderness that’s related to their menstrual cycle instead of cancer.
“Certainly in older women, you have to be concerned with breast cancer,” Gaither said. “There are different kinds of breast cancer, but they do typically present themselves with a mass, redness, or shriveled-looking skin.”
Your doctor can do an examination, or send you for a mammogram or breast ultrasound. Depending on what’s found, you may or may not have to go in for a biopsy as well.