8 Questions Gynecologists Wish You'd Ask During Your Annual Exam

Let's be honest: Your annual checkup with your gynecologist is anything but fun. Most of the time, you probably want to get in and out of there as quickly as possible. But rushing through your exam without discussing what's going on down there (or in your body overall) isn't a great idea.

While it can feel uncomfortable (or downright embarrassing) to ask questions about your most intimate, private matters (such as the sticky stuff in your underwear, your sex life or a vaginal infection), your reproductive health may depend on it.

Here, gynecologists share the top questions they wish patients would ask during their annual visit.

Many people don't know what a "normal" period is, says Mary Claire Haver, MD, a board- certified ob-gyn and creator of The Galveston Diet, an anti-inflammatory nutrition program designed for those in perimenopause, menopause and beyond.

"How much bleeding is too much? Too little? How often? All of these could be signs of something more serious going on," Dr. Haver says.

Angela Marshall, MD, a board-certified internist and the CEO of Comprehensive Women's Health, agrees that discussing your period with your doctor is of prime importance.

For example, many people aren't aware that skipping too many periods can be problematic. "It is important for menstruating people to shed their uterine lining at least every three months, except for when they're pregnant," Dr. Marshall says.

Doing so less frequently can lead to larger issues and may increase your risk of endometrial hyperplasia (a thickening of the uterus lining) and endometrial and uterine cancers, she explains.

On the other hand, bleeding too much or too often can be a concern. While many people accept this to be part of their normal period, a stronger flow could be an indicator of endometrial cancer, which causes heavy and prolonged bleeding, Dr. Marshall says.

All this is to say, it's paramount to talk honestly about your period with your doctor to ensure your overall health.

Every person produces a different amount of vaginal discharge, and it can vary daily based on where you are in your cycle.

"Oftentimes, people who have normal discharge [which tends to be clear or whitish] complain about it" simply because they're uninformed, Dr. Marshall says.

But when this fluid is flowing as it should, it's essential to your vaginal health. "Normal vaginal discharge is [your vagina's] way of natural exfoliation and cleaning," says Staci Tanouye, MD, a board-certified gynecologist.

But if your discharge is accompanied by pain or blood (that's not your period) and/or you experience changes in the amount, consistency, color or smell, it could signal an infection or other issue, according to the Cleveland Clinic. See your doctor if your discharge:

• Causes itching or swelling
• Has a bad odor
• Is green, yellow or gray in color
• Looks foamy or like cottage cheese

Dr. Haver believes this is an incredibly important topic, especially because there seems to be some confusion about what condoms can and can't do.

"While consistent and correct use of latex condoms reduces the risk of sexually transmitted disease (STD) and human immunodeficiency virus (HIV) transmission, condom use cannot provide absolute protection against any STD," Dr. Haver says.

That's in large part because different STDs or infections can be transmitted in various ways or via body parts that aren't covered (i.e., protected) by condoms.

For example, condoms "are likely to provide greater protection against STDs that are transmitted only by genital fluids (such as gonorrhea, chlamydia, trichomoniasis and HIV infection) than against infections that are transmitted primarily by skin-to-skin contact (such as genital herpes, human papillomavirus (HPV) infection, syphilis and chancroid)," Dr. Haver says.

When you're armed with the facts (by asking these questions), you're in a better position to make the safest decisions for yourself.

"This is an important question to ask because many people feel more comfortable having unprotected oral sex than other forms of penetrative sex," Dr. Marshall says.

However, "Many STDs and other infections are spread through oral sex," Dr. Haver says. These include:

• Chlamydia
• Gonorrhea
• Syphilis
• Herpes
• HPV
• HIV
• Trichomoniasis

Indeed, "anyone exposed to an infected partner can get an STD in the mouth, throat, genitals or rectum," Dr. Haver says.

That's why condoms and dental dams are also essential to use for protection during oral sex, Dr. Marshall adds.

While there's a lot of talk about menopause, perimenopause — the time during which your body makes the transition to menopause — is more of a mystery to many people, Dr. Haver says.

Often, folks struggle with the signs of perimenopause without even knowing it. "Perimenopause is marked by erratic fluctuations in estrogen and can last up to 10 years," which means it can begin in your mid-30s, Dr, Haver says.

What's more, identifying perimenopause isn't an exact science. "As health care providers, we do not have a great test to diagnose perimenopause," Dr. Haver says. "The diagnosis is usually made by listening to the patient's symptoms and ruling out other causes."

A change in your period is a frequent symptom: "Cycles may become longer or shorter than what is typical for you — you could start skipping periods, and the flow may grow lighter or heavier," she adds.

Other indications of perimenopause may include:

• Hot flashes
• Insomnia
• Weight gain
• Increased belly fat
• Hair thinning/hair loss
• Memory loss
• Vaginal dryness
• Bladder issues such as urinary incontinence
• Changes in sexual arousal and desire

Still, it's important to keep in mind that each person's perimenopausal experience is unique: "Some have no perimenopause symptoms or simply a few minor symptoms, while others experience a wide range of symptoms that can be quite severe," Dr. Haver says.

That's why it's imperative to probe your doctor about possible signs of perimenopause and proper ways to manage them.

This is a great question because often people think just because they're hot flash-free, they're not menopausal, Dr. Marshall says. "But this couldn't be further from the truth," she adds.

In fact, "many people go through menopause with no symptoms whatsoever," Dr. Marshall says.

So, while hot flashes are a hot topic when it comes to menopause, remember that every individual's experience will vary.

Too often people shy away from this topic out of embarrassment, but so many are dealing with it in silence.

Indeed, incontinence is incredibly common. A sample of more than 15,000 people assigned female at birth (AFAB) found that 53 percent experienced some form of urinary incontinence, according to a June 2021 study in ​The Journal of Urology​​.​

The involuntary loss of urine becomes more prevalent in people who've experienced pregnancy, menopause or weakened pelvic floor muscles (which often happens as we age).

That's why Dr. Marshall encourages you to discuss urinary leakage with your doctor: "This is important because there are so many options for incontinence treatment."

From medications, surgical procedures, physical therapy and behavioral changes, there are many strategies to improve urinary incontinence, so people shouldn't feel compelled to "just live with it," Dr. Marshall says.

This is a critical question for several reasons, Dr. Marshall says. First, "because many people feel they don't have to get mammograms [X-rays of the breast] if they have no family history [of breast cancer]," she says. ,

While genetics plays a role in your risk, it's not the only factor. That means a lack of breast cancer in your family shouldn't deter you from proper breast screenings.

Secondly, inconsistency among medical organizations about breast cancer screening guidelines also causes great confusion, Dr. Marshall says.

In other words, there isn't a general consensus among organizations about when to start (and how often to repeat) mammograms for early breast cancer detection, according to the Mayo Clinic.

For example, the Mayo Clinic recommends that screenings start at age 40 and continue annually, whereas the American Cancer Society supports optional breast cancer screening at 40 and encourages annual mammograms between the ages of 45 and 54 (with biannual or yearly screenings at ages 55 and older).

That's why it's best to discuss the issue with your doctor to determine what's right for your specific situation. Together, you can review your medical history, your family history and individual breast cancer risk to decide when you should begin regular mammogram screenings.