Even when you're well into adulthood, the female reproductive system can feel mysterious. So much can change in your body in just one month, and those changes only increase as you age or go through new phases (like pregnancy), making it hard to tell what's actually cause for concern. Many symptoms that would worry a gynecologist are surprising; you might have some issues you should check in about and not even realize it.
Part of the difficulty of knowing if something is wrong or not *down there* is because the same symptoms can mean nothing or mean something really bad in two different people. Cramps could be a sign of ovulation in one person, and an indicator of endometriosis in another. Basically, only a doctor can give you a clean bill of health, so it's best to see a gynecologist if you notice anything abnormal.
But determining what exactly is "abnormal" is hard when it comes to gynecological health, so Romper spoke to Mary Jane Minkin, M.D., a clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine via email about what you should be looking out for. Read on to find out what symptoms you should probably make an appointment to discuss.
Most women experience occasional spotting between periods, but frequent bleeding when you aren't on your period can be cause for concern. "In general, bleeding between periods should be reported — although if one is on birth control pills, it is most likely just breakthrough bleeding," says Dr. Minkin. But "spotting" can also be a sign of an STI, endometriosis, certain cancers, or more. It could even be implantation bleeding, an early sign of pregnancy as Medical News Today reports. Basically, spotting once every few months most likely isn't a big deal, "but recurrent bleeding should be evaluated," per Dr. Minkin.
2. Painful Sex
Painful sex is incredibly common — the American College of Obstetricians and Gynecologists reports that 3 out of 4 women will experience painful intercourse in her lifetime — so it's pretty unlikely you'd think to go to a doctor about the issue. Most often, painful sex stems from vaginal dryness. "If you are a breastfeeding mom or a post-menopausal woman suffering from vaginal dryness, I would suggest trying a lubricant for sex, and a vaginal moisturizer on an ongoing basis," Dr. Minkin tells Romper. However, she also pointed out that painful sex can be associated with STIs, as well as a symptom of endometriosis or ovarian cysts. Sex should never be painful, and only a doctor can confirm why you're experiencing pain during intercourse. Definitely make an appointment if it's an ongoing issue.
3. Itchy Nipples
All skin gets itchy sometimes, but feeling the need to scratch your nipples can be a bad sign. As Dr. Minkin explains, "although the majority of the time, nipple itchiness will be associated with something like eczema, it rarely can be associated with a tumor. So if it persists, do check in with your provider." You'll definitely want to make an appointment if the itchiness comes alongside any other symptoms of breast cancer, like nipple discharge, changes to the appearance of your breasts, the development of lumps, or unusual breast pain, as the Center for Disease Control lists.
4. Weird Discharge And Odor
Again, discharge is a pretty common occurrence for women, but there are some kinds that are cause for concern. Vaginal discharge and odors are typically a result of an infection in the vagina, like a yeast infection. Vaginitis is the most common type of infection that causes discharge, but discharge can also be a symptom of a sexually transmitted infections like chlamydia and gonorrhea according to Dr. Minkin. If your discharge is a strange color, like yellow or brown, and if it has an unusual odor, it's best to see your doctor sooner rather than later.
5. Itchiness Down There
Itchiness in your genitals can be caused by yeast infections, but STIs and other more serious infections could be to blame. The conditions present similarly despite the differences in severity, making it difficult for women to differentiate between them and treat themselves properly. "In a study done many years ago," says Dr. Minkin, "when women first were able to 'self-treat' for 'yeast infections' (with over the counter meds), about a third of the women actually had a yeast infection; a third had another type of vaginitis; and a third has an allergic reaction to irritants (bubble baths, detergents, etc)," demonstrating just how hard it can be to tell what's causing your itchiness if you aren't a medical professional. Seeing a doctor is the best call.
6. Swollen And Red Breasts
Discolored and engorged breasts are the norm when you're breastfeeding, but they're something a doctor would want to take a second look at if you aren't nursing. In particular, inflammatory breast cancer can give breasts this appearance, due to cancer cells blocking your skin's lymphatic cells as Mayo Clinic explains, so be sure to get a mammogram or see your OB-GYN if you notice your breasts swelling, changing color, or becoming more tender.
7. Bleeding After Sex
Occasional bleeding after sex is normal, whether it be caused by a lack of lubricant, the beginning or end of your period, or general spotting. But Dr. Minkin cautions that bleeding after sex can sometimes be a sign of precancerous changes in your cervix, which is why you'll want to see a doctor if you notice you're bleeding after sex frequently. It's unlikely for young women to have cancer, but postcoital bleeding can also be a result of vaginal infections, genital sores, and other issues with your cervix according to WebMD, all of which require medical attention. So in Dr. Minkin's words, "if one has recurrent bleeding after sex, I would want her to report it."
Keep in mind that a lot these symptoms may seem harmless, which is why you might not think to talk to a professional about them. But only a doctor can tell you if any of your body's changes are something to worry about, so it's best practice to make an appointment any time you notice something new.