You just never seem to be in the mood these days. Or the last few times you had sex, it hurt. Maybe you have some discharge that’s different from the norm.
But how do you know which signs might signal a bigger problem with your health? Jennifer Lang, MD, a gynecologic oncologist in Los Angeles, says knowing that involves paying attention to your body on a regular basis.
“How can you know what abnormal is if you don’t know what normal is?” she asks.
Lang says it’s a good idea for a woman to examine her vagina with a mirror and light each month, just as you do a regular check of your breasts.
If something just doesn’t seem right or it’s bothering you, don’t feel embarrassed to bring it up with your doctor. “You deserve to have a healthy sex life,” Lang says. “And your doctor is there to help you realize that.”
Here are the top symptoms that doctors say you should bring up when they happen.
By far the most common sexual health issue for women is low desire, says Maureen Whelihan, MD. She has a private practice in gynecology in Palm Beach County, FL.
If low desire doesn’t bother you, it’s not a problem, Whelihan says. But if it’s causing you distress (and it’s lasted for at least 6 months), you can talk to your doctor to find out what may be going on.
Hypoactive sexual desire disorder, the medical term for a low sex drive, can have many different causes -- physical, emotional, cultural, or a combination of those, Whelihan says. It could come from a hormone problem, such as estrogen or your thyroid hormone. It could happen because of other health conditions you have, like diabetes, anxiety, depression, or sleep disorders. It may be a side effect of a medication you take, like antidepressants or birth control pills. Even smoking and alcohol can affect desire. Or it may have to do with the quality of your relationship with a sexual partner.
Your doctor or another health professional in the office may ask you some questions to figure out what’s going on. You can also find screening tools online to help you decide if you need more help with low desire. Figuring out what may be causing the problem can help you and your doctor come up with the best solution.
Pain and Discomfort
You’re not alone if sex hurts. Nearly three out of four women will have pain during intercourse at some point. It could be in the vagina and the area just outside of it, called the vulva. But some women feel pain inside their pelvis, too.
Sometimes sex is uncomfortable when you’re not aroused enough, or you have a vaginal infection or a skin condition, like allergies or psoriasis. But pain during sex can also be a sign of serious conditions like pelvic inflammatory disease, endometriosis, fibroids, ovarian cysts, or cancer. So if it happens often or is severe, see your doctor -- they’ll want to rule out any serious health issues that could be causing it.
If you’ve reached menopause, painful sex may be caused by vaginal atrophy. That’s when the tissues around your vagina and vulva dry up because of the loss of estrogen. To treat it, your doctor may prescribe a cream with estrogen that you apply directly to the skin in that area.
If you feel a bulging sensation around your vagina and have trouble peeing, it could be a sign that your bladder or other organs in your pelvis have dropped from their normal place and are pushing against your vagina. That’s called a pelvic organ prolapse, a problem that becomes more common with age. Treatments include Kegel exercises, physical therapy, and surgery.
If you’re past menopause and you have bleeding from your vagina, see your doctor as soon as possible. They’ll need to make sure you don’t have a serious problem, like an infection, uterine fibroids, or cancer.
If you’re still having periods, watch for any spotting, bleeding between periods, bleeding after sex, or periods that are heavier or last longer than usual.
Call your doctor if you have these symptoms. They’ll check you for a few different conditions, including ectopic pregnancy, infection, fibroids, polycystic ovary syndrome, and some cancers.
Is there a change in the color, amount, or smell of your discharge that lasts more than a few days? Let your doctor know.
You may have something that’s simple to treat, like a bacterial or yeast infection. But some discharges may be a sign of sexually transmitted diseases like gonorrhea or chlamydia. Watery or bloody discharges may be due to cancer.
Lumps and Bumps, Rashes and Sores
If you notice any changes in your skin below your beltline, like a mole that looks different or is new, or a bump that itches or hurts, tell your doctor.
These spots can have many different causes, from an ingrown hair to an STD like genital warts or herpes. More serious is vulvar cancer, a rare condition that can show up as a lump, bump, or sore. It may cause itching or tenderness.
No matter what symptoms you’ve noticed, when something doesn’t feel or look right to you, don’t worry that you’re making a big deal out of nothing. “Run it by your doctor just to get a reassuring word,” Lang says. “So you don’t have to worry.”