For most women, a couple of irregular menstrual cycles or an occasional yeast infection are just an annoying part of life – nothing that time and/or a simple treatment won’t cure.
But some gynecological symptoms are mystifying, such as vaginal bleeding that always follows sex or unusual bumps or sores.
When should you call your doctor?
Most of the time, pelvic pain, spotting, itching, and other symptoms don’t turn out to be serious, according to Holly Puritz, MD, FACOG, an obstetrician and gynecologist at The Group for Women in Norfolk, Va.
Even a normal process, such as ovulation, can cause pain. Pelvic pain, if you can pinpoint the timing of it, can actually reassure you, Puritz says. If it always happens mid-cycle, lasts two to three days, and then goes away.
Likewise, abnormal vaginal discharge may signal a sexually transmitted disease, but often, it stems from infections that are easily treated.
Nevertheless, some symptoms can point to serious medical problems…
1. Pelvic Pain
If you have pelvic pain that persists or doesn’t ease with simple home treatment, call your doctor, Puritz says. Or, get to an emergency room if you can’t reach your doctor.
Possible serious reasons for pelvic pain can include:
Fibroids/Endometriosis/PID: When a woman has chronic pelvic pain, doctors will check for benign uterine fibroids and endometriosis. They will also look for pelvic inflammatory disease, which usually appears as a triad of pelvic pain, vaginal discharge, and fever, Puritz says.
Ruptured/Bleeding Ovarian Cyst: In some cases, strong pelvic or abdominal pain comes on quickly – which is a definite sign to call your doctor. A ruptured or bleeding ovarian cyst can trigger this type of pain.
Twisted Ovary: If a more severe attack of pelvic pain starts suddenly, the ovary may have twisted, cutting off its blood supply. Some women also feel nauseated or vomit.
Ectopic Pregnancy: In addition, abdominal pain and vaginal bleeding may signal an ectopic pregnancy, in which a fertilized egg implants outside of the uterus.
Ovarian Cancer: Fortunately, most pelvic discomfort isn’t related to ovarian cancer, but women should know the disease’s unremitting “constellation of symptoms,” Puritz says. “If you have two weeks of bloating, pelvic pressure, and urinary frequency – and every day, you have it – that’s a potential sign that you should be checked for possible symptoms of ovarian cancer.”
2. Irregular Bleeding
Irregular bleeding “covers a host of things,” Puritz says: periods that last longer than normal, bleeding mid-month, having two periods per month, bleeding after sex, and other unusual patterns. Though birth control pills can cause spotting that isn’t serious, you may still want to discuss your prescription with your doctor.
“But if you’re not on any kind of birth control and you have irregular bleeding that lasts for more than a month or two, I think it should always be checked, even though the odds are, we won’t find anything bad,” Puritz says.
But irregular bleeding could also signal:
Perimenopause/Fibroids/Polyps: Abnormal bleeding may stem from multiple causes that aren’t serious, among them, perimenopause or uterine fibroids or polyps. Thyroid problems can affect the menstrual cycle, too, Puritz says.
Cervix Infection/STDs: In nursing mothers and postmenopausal women, vaginal dryness, combined with friction, can cause spotting after intercourse. But if you bleed every time after sex, “that’s a worrisome sign that the cervix is being easily irritated and usually, there is a cervix infection involved,” Puritz says. Also, sexually transmitted diseases, such as gonorrhea or chlamydia, can cause cervical lesions that bleed with sex.
Uterine Cancer: If you’re postmenopausal, be especially vigilant about any vaginal bleeding; it’s a potential sign of uterine cancer.
“You should be seen right away,” Puritz says. “Uterine cancer, compared to ovarian cancer, is extremely treatable. It’s very curable because it’s generally found in an early stage and it has an early warning sign, which is postmenopausal bleeding.”
Besides postmenopausal bleeding, any vaginal bleeding before puberty or during pregnancy should be checked out, too, Puritz says.
3. Abnormal Vaginal Discharge
With vaginal discharge, “abnormal is what the woman decides is abnormal,” Puritz says. “Women know their bodies pretty well.”
Abnormal symptoms include a strong odor; an unusually large amount of discharge; accompanying itching, burning, or irritation; unusual color; or blood in the discharge. These symptoms can be the result of:
Common Infections: Most causes of abnormal discharge are minor, Puritz says. “Any sort of infection can cause a discharge.” Common ones include yeast infections, bacterial vaginosis, or trichomonas, she says. “They’re all easily treated.”
STDs: Because sexually transmitted diseases can also cause abnormal discharge, check in with your doctor to rule out the possibility.
Fallopian Tube Cancer: Also be sure to tell your doctor about any persistent, watery discharge, a classic symptom of fallopian tube cancer, which is rare.
4. Itching
Women may have itching without discharge, a problem that Puritz sees frequently when patients use perfumed soaps or personal care products — especially perfumed lubricant jellies. “Just about all perfumed lotions and potions can…