“You should just look down there with a hand mirror,” my mother said. “Just stick it between your legs when you’re on the toilet.” My mom is not one to shy away from her own brand of gynecological advice, and I cannot count the number of times she has said this to me. I credit her for my lack of filter, but I suppose I can also credit her with my tendency to freak out when it comes to any potential vaginal or uterine concerns. “It’s probably normal, but…” is the standard follow up to the mirror comment. Given my pension for anxiety, you better believe that I’ve spent the majority of my adult life believing that I am on the “but” side of that scenario. In my mind, I am always on the precipice of a bizarre and untimely death from an unidentified abdominal cramp. The advent of Google did nothing to assuage my fears.
However, contrary to what you may be thinking, I’m a rational person. I’m a logical person, and I hate sounding like a hyped-up hypochondriac when I have my annual exam with my OBGYN. So I spoke with Dr. Amanda Underwood, a gynecological resident at the University of Indiana, to finally get to the bottom of things and figure out what is actually normal: what should I be looking for, paying attention to, and preparing for when it comes to my own health, and when should I freak out? Here’s what I learned:
The truth is that sometimes vaginal discharge is scary. You can see it right there in your panties – no mirror necessary. However, the existence of discharge is expected. It may be inconvenient at times, but typically it’s harmless. Dr. Underwood noted that women often come to her feeling concerned that they have discharge at all, but the reality is that vaginal discharge is not cause for concern. It cleans and protects the vagina, and if you’re trying to conceive, the consistency of your discharge can be a great indicator of ovulation and fertility. Dr. Underwood advises, “as long as it is clear or white, and you don’t have any associated vaginal itching, burning, or odor, it’s probably completely normal.” However, if you have a discharge that you feel is concerning, this is something to bring up at an annual exam. You can also schedule an additional appointment with your gynecologist to discuss this issue in particular.
If it looks like a cyst and acts like a cyst…
Over the years, I’ve had a number of friends struggle with abnormal and painful ovarian cysts. The fear of ovarian cysts is very real for many women (me!), and according to Dr. Underwood, the issue or concern about cysts is one that comes up quite a bit in her practice. However, every woman regularly has ovarian cysts because the ovaries are cyst-forming organs. Dr. Underwood explained that every month “a cyst forms at the site of the developing follicle, which is where the egg will be released. Sometimes there are a couple cysts that form. Sometimes they are a little bigger, sometimes a little smaller, and then this cyst ruptures to release the egg. It is a totally normal process.” If you think you’re having an increased or unusual amount of abdominal pain, you may have an abnormal cyst, but rest assured that not all cysts are bad. Your doctor should be able to assess the cyst on an ultrasound to determine whether or not it’s an unusual development. Don’t shy away from making a special appointment to ask about this issue if you’re in pain or have concerns.
What IS that?
Every time I have an ingrown hair, the only thing I can think is, “You will get chlamydia and die!” Of course chlamydia is a very real and common STD that requires medical attention and treatment, but it does not yield red bumps and is not directly fatal. An ingrown hair, on the other hand, is a skin irritation that often looks much more serious than it is. Ingrown hairs “produce a raised, red bump (or group of bumps) that looks like a little pimple. Sometimes an ingrown hair can form a painful, boil-like sore.” An inflamed ingrown hair looks very scary, and on more than one occasion I’ve been absolutely convinced that an ingrown hair was a cancerous lesion (I was wrong). You’ll notice that these hairs often have a white head on them like a pimple, and you can usually see the curled hair beneath the surface of the skin. My mom is actually really onto something when it comes to this particular issue. If you have an ingrown hair in your pubic area, the hand mirror is quite helpful. Most ingrown hairs can be treated or dealt with at home, but if the issue persists you may want to consult a dermatologist for some additional insight.
Family history matters
Family history is an important element of person’s health profile; however, according to Dr. Underwood, it’s not the be-all-end-all of risk factors. “The majority of women who are diagnosed [with breast cancer] do not have any unique identifiable risk factors.” In other words, familial histories of cervical cancer or breast cancer are worth a conversation, but not necessarily worth a freak out. That said, Dr. Underwood went on to note that “women with certain risk factors (such as multiple first degree family members with breast cancer diagnosed at an early age, or an inherited genetic mutation for breast cancer) have an increased lifetime prevalence of breast cancer compared with the general population,” so these women should be in conversation with their doctors about necessary testing and monitoring. Dr. Underwood advises that you bring up your family history concerns, especially as they related to pregnancy, miscarriage, and diseases like cancer.
As it turns out, my mother’s original advice is sound. There are a lot of women’s health issues that come up that are “probably normal,” but the reality is that it’s also appropriate and important to ask a doctor when we feel concerned. “I wish patients would ask the questions about the things that are important or bothersome to them,” Dr. Underwood said. Remember that your doctor is a resource available to care for you and help you do what’s best for your body, and in the meantime, you can always bust out a compact mirror and take a look for yourself.