Sexual FAQs – IV

Q. When do I need to see a gynecologist?

A. Pay attention to your body. If you notice unusual gynecological symptoms, make an appointment with your health care provider at once. You might have an easy to treat infection or a maybe a more serious problem. The sooner you catch it, the better. Reasons to see your doctor or health care provider right away include:

• If you have been a victim of rape or sexual abuse
• Vaginal discharge that’s heavier than usual or has a strong odor or color
• Genital lumps or sores
• Vaginal redness, itching or burning
• A breast lump, abnormal nipple discharge, pain or change in breast contour
• Abdominal pain aside from your usual cramps
• Changes in your period after you’ve been menstruating for more than a year
• See your gynecologist for an annual Pap smear and STD tests. Early treatment can cure many STDs and reduce the impact of others.

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Q. Can having a Pap test during menstruation effect the results? I’ve heard not to get one during this time. Can it cause abnormal results? Why is this?

A. You’re right about what you’ve heard: women don’t usually have Pap tests done during their periods. Menstruation itself does not cause abnormal Pap smear results but, menstrual blood makes abnormal cervical cells difficult to see. (You see a lot of blood cells instead).

It’s recommended that women schedule a Pap test between ten and twenty days following the start of their periods. It’s also important not to douche, apply vaginal medication, and/or insert spermicide (as foam, cream, jelly, film, suppository, or tablet) for about two days before the exam because they may remove or obscure abnormal cells, preventing the most accurate test reading.

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Q. How many eggs does a woman have when she is born?

A. Unlike men, who produce new sperm daily throughout most of their lifetime, women are born with a finite number of undeveloped eggs — around one to two million — in their ovaries.

When women reach puberty and start menstruating, only about 300,000 immature egg cells, or follicles, remain. Some of these begin to develop with each monthly cycle, but during this time, only one follicle matures into an ovum (egg) and bursts from an ovary into the fallopian tubes, initiating ovulation.

Through a process known as atresia, many of the follicles that don’t develop into mature egg cells degenerate. As a result, only a few hundred remain at menopause, which usually begins at around forty-five or fifty years of age; however, because of the hormonal changes that accompany menopause, the remaining follicles are unlikely to mature and become viable eggs. But this does not mean that women going through menopause cannot get pregnant.

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Q. What is “Torsion of the Testicle ?”

A. Perhaps the most common testicular problem is torsion of a testicle. This is when it spins around on the spermatic cord, which carries the spermatic artery, and cuts off its own blood supply. This is a medical emergency and usually requires surgery within four hours if the testicle is to be saved. Sometimes the doctor will stitch it in place so the torsion doesn’t happen again. This can be a very painful experience. As the testicles’ blood supply is reduced, they gradually turn red, then purple and eventually blue. The pain is excruciating and medical help is essential. This is not to be confused with ” blue balls“.

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Q. What can I do about recurring urinary tract infections (UTIs)?

A. Urinary tract infections can affect both men and women. New or recurrent, UTIs need to be diagnosed and treated medically. (Some can be treated without antibiotics, but I will include that in “Bladder Infections“.

Friction, usually by the penis during intercourse or by masturbating, seems to be a main cause of UTIs. A change of position may make a difference in the prevention of UTIs. In addition, drinking lots & lots of water sometimes helps flush out the urethra. Urinating immediately after intercourse, for both men and women, may help flush out the urethra of semen, diaphragm jelly, nonoxynol-9, and/or bacteria. (Semen can get into a woman’s urethra if no condom is used during sex. This is because of the close proximity of all these organs during intercourse.)

Often, UTIs occur following intercourse, especially after first intercourse (the nickname, “honeymoon cystitis” was what they used to call it ) or after one has not had intercourse for a while and then begins to have it again.

Just to emphasize, medical attention is important, especially with recurrent UTIs, because left untreated chronic infections may result in kidney infections and even damage. You don’t necessarily have to go to a GYN for this, you can go to your family doctor for treatment.