Does Your Gyno Have No Time-o for Questions?

Dr. Mache Seibel, author of The Estrogen Fix, offers up answers we could all use.

Sixteen minutes. ⏰

That’s the average length of time you have with your physician. That’s about the time it takes to make a smoothie, or maybe clean your bathroom. Yeah, not that long. 

It’s no wonder, then, that by the time the exam is over, you might feel you don’t have a chance to ask questions, even though we’re confident you have many. After all, our bodies are intricate wonders — anything but simple.

Familiar scenario during your GYN exam: You carefully extract your feet from the cruel stirrups (can’t someone come up with something better than what resembles torture devices?!) and sit up, ready to exhale and speak, when you realize that your doc has her back to you, already reaching for the doorknob.

Slam. Bam. Where’s at least the “Thank you, Ma’am?” 😉

Dr. Mache Seibel, OB/GYN and author of The Estrogen Fix, was generous enough to answer all the Pauser questions we always mean to ask in the exam room — even the most burning ones. 🔥

Here goes:

Q. I get infections all the time. But I never know if it’s a yeast infection or bacterial vaginosis (BV). What’s the difference — and what should I do in either case?

Dr. S. Yeast and BV are two of the most common vaginal infections in women. Yeast is usually a whitish-looking discharge and can resemble cottage cheese. It’s particularly common in women after taking antibiotics, or in women who have diabetes (although it can happen by simply sitting in a wet bathing suit or wearing occlusive garments such as non-breathable pantyhose). Treatments include anti-fungal medication. The most common being Monistat, though there are several other brands. 

By contrast, BV is usually caused by an over-growth in the so-called “bad” bacteria in the vagina due to an imbalance of pH. Normal vaginal pH is more acidic. When the pH gets more alkaline, the imbalance occurs. Usually there’s a fishy odor. Remedies that normalize the pH are available over the counter, such as RepHresh. (Women who have BV and are pregnant are at more risk of early delivery.)

Q. Why do I frequently experience vaginal dryness?

Dr. S. There are many causes of vaginal dryness. It may be due to taking birth control pills, antihistamines and asthma medications, cancer treatments, a lack of arousal, anxiety or low estrogen levels that occur in perimenopause and menopause. Some soaps contain irritating chemicals, dyes and perfumes that can also be an issue. Treatments include lubricants and  moisturizers such as Replens, which is over the counter, or vaginal estrogen.

Q. It’s embarrassing to admit, but sometimes I pee a little when I laugh.

Dr. S. That’s not so uncommon. Urine loss occurs in nearly half of women, and not just among older women; it can happen in the young as well. There are lots of reasons, but one of the most common is a weakening of the pelvic muscles due to childbirth or other causes. Talk with your doctor. There are a number of treatments. Many women are completely improved or extremely satisfied with non-surgical pelvic floor physical therapy. For some, surgery may be necessary.

Q. Ouch…Sometimes sex hurts.

Dr. S. Painful sex causes a real problem, but it’s one that can always be greatly improved. First, tell your doctor. There may be an infection, a cut or tear, or even an internal problem that is “hit” during sex. Often, the cause is low estrogen and insufficient moisture. In that case, vaginal moisturizers can be a first try. Local or vaginal estrogen is also very effective for women in menopause.

Q. Sometimes I experience a weird odor in my vaginal area.

Dr. S. There can be many reasons. The most common is a vaginal infection. See your doctor for an exam so you don’t overlook something that needs medical attention. Once the doctor looks at the vaginal secretions, the diagnosis can be made and the proper treatment offered. 

Q. Can I have a sexually transmitted infection (STI) if I’m not showing symptoms?

Dr. S. You don’t have to have any symptoms to have an STI. If you’re having unprotected sex — including oral sex — and you aren’t sure about the status of your partner, getting examined is always a good idea.

It’s also a good idea to come to your exam with your questions written down, so you don’t forget and you make those 16 minutes work for you. You’ll only get the answers you need if you ask the questions you want.

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For a Pause

  1. If you are lucky enough to have that rare doc who can spare some time, we wrote about how to do it right.

  2. Menopause causing some family friction? A Pauser addresses her angst in this newsletter from March.

  3. We all lose our mojo from time to time. For some motivation, here are three – just three! – steps to take to feel good/better about yourself.

  4. File under items we’re loving: The wine selection from Bright Cellars. Founded by two MIT grads intimidated by the vast world of wine (us too!), their approach is designed to help wine drinkers discover and learn about wine in a fun/interactive way. We’re checking it out too!

One More Thing

How many items can a today-teen can identify from her GenX mom’s own teen days? Spoiler alert: not many!

Stay healthy and see you next week!


One minute she says
She's gone to get the cat in
The next thing I know
She's mumbling in Latin
She’s Got a New Spell, Billy Bragg

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