For many women, the only thing more uncomfortable than issues below the belt can be talking about them with their doctor. At the Women’s Center of South Shore Medical Center, we see women of all ages and understand that while they may experience the same symptoms, the cause can be different depending on a woman’s age or unique medical history.
Here are three of the most common issues I’ve found that women experience down there, and their common causes.
Changes in Discharge
At least once a day, a patient comes in with vaginal discharge that she’s concerned about, usually because it’s different than her usual discharge in volume, consistency or smell.
Most women suspect an infection of some kind, as do doctors. Depending on other symptoms, we often immediately test for three conditions: Bacterial vaginosis, which is when too much “bad” bacteria are present in the vagina; a yeast infection; or a sexually transmitted infection such as trichomonas, gonorrhea or chlamydial infections.
Bacterial vaginosis and yeast infections are typically easily treated with either antibiotics or anti-fungal medications. Sexually transmitted infections can be a little more challenging, but your doctor can prescribe medications that can help.
It’s especially important to call your doctor for an appointment if the changes in discharge are accompanied by fever, chills, nausea, vomiting, abdominal pain or irregular vaginal bleeding. It’s also good to come in if your partner tells you he or she has a sexually transmitted infection so we can test you for the same condition.
Itching or Burning
Occasional itching down there can be normal. But if itching or burning of the vulva is so intense it’s keeping you up at night, it’s time to see a doctor.
“Vulvar dermatitis” is an umbrella term for itching or burning of the vulva caused by allergens, irritants or changes associated with age. Vaginal and vulvar irritation can be common in menopausal women as a result of lack of estrogen.
Women often try to solve the problem at home with over-the-counter ointments. If you’re still uncomfortable—or the itching or burning comes back once you stop using the product—check with your doctor. He or she can get to the cause of the symptoms and treat it, either with high potency steroid cream or, in menopausal women, vaginal estrogen.
Pain When Urinating or During Sex
The National Institutes of Health estimates that approximately 50 percent of women will have a urinary tract infection (UTI) in her lifetime. The frequent, painful urination that accompanies a UTI will have you in the doctor’s office pretty quickly.
Unfortunately, some women get UTIs frequently. Recurrent UTIs can affect women of all ages. In younger women who are sexually active, the motion of intercourse can drive bacteria into the urethra, causing infection. In menopausal women, the lack of estrogen can cause the vagina to become atrophic, making it easier for bacteria to enter the urethra.
This lack of estrogen can also make sex painful for older women. If your vagina is dry during intercourse and you notice that you and your partner have to use a lot of lubricant—or if you’re avoiding sex entirely because it’s painful or causes bleeding—call your doctor. There are treatment options available to improve your body’s response and make sex better for you and your partner.
Dr. Nina Nardello is an OB/GYN at The Women's Center of South Shore Medical Center in Weymouth and is currently accepting new patients. If you’d like to register yourself or a family member as a new patient, call 781-682-1686 or request a call from a new patient registration specialist.