Most women have a special and unique relationship with their gynecologist. During the annual examination, you may feel hurried, but there are some important medical issues you’ll want to discuss. Here is a starter list of health topics to consider. Be certain to jot them down on a piece of paper and take them to your next medical visit. Note, sometimes you may need to schedule a follow up visit to address concerns.

Have your periods changed?

Are your periods regular? Has the bleeding pattern changed? Is it heavier or lighter? Are your periods now coming earlier and are more frequent? It’s important to discuss any pain and or duration changes.

Sometimes these changes can signal some underlying hormonal changes. Pain during your period, or dysmenorrhea,  can be safely evaluated and effectively treated. Discuss this concern with your gyno, who can provide some guidance, and some potential solutions.

Are you experiencing a sexual problem?

Sexual health is often linked to general health and overall life happiness. Sexual slumps and other problems are not uncommon. Changes in sexual desire, arousal, or orgasmic complaints are not infrequent. Many report suffering from recurrent vaginal dryness which can lead to painful intercourse. Sex should NOT hurt. There are many reasons you could have painful sex and a simple solution could be to try a personal lubricant.

There are many treatable medical, hormonal, or psychosocial conditions that can assessed and treated. While many women experience problems achieving orgasm, others say it takes more time to achieve substantial arousal and they say they have lowered intensity or strength of orgasms. Other women report declining sexual interest or changes in their libido. Sexual problems are real medical conditions which can be treated. Become empowered and discuss any sexual concerns you may have.

Do you have a vaginal odor?

Women often report vaginal odor concerns. Discuss any change in vaginal discharge (color, consistency, or odor) to your healthcare professional. This change may mean that your vaginal acid base balance or pH is altered. You could have an underlying vaginal infection. For example, a foul smell may mean you have an infection! Thick, white discharge accompanied by itchiness could be a yeast infection. Sometimes a change in odor can indicate that there is a foreign body, or a part of a tampon or condom left in the vagina. Ignoring a vaginal odor can lead to more serious pelvic infections, so please seek help and advice!

Give an honest and complete sexual history

Remember, health care professionals are required to offer privacy and confidentiality. Trust your gynecologist! Disclose, how many sexual partners you have had, if you have had same sex intimacy, or if you are having unprotected intercourse. A frank and honest discussion will help develop a comprehensive understanding about contraceptive options, HPV, and sexually transmitted disease risk. If you feel embarrassed or are concerned about your protected medical health information, it may be time to consider a new gynecologist! An open dialogue with your healthcare professional will help you get the specialized medical care and attention you require.

Discuss any abuse or harassment

Abuse comes in a variety of forms. Many times, it may be subtle and unrecognized. Discuss any sexual, emotional, physical, or domestic violence that you have experienced. Verbal abuse, name calling, or being isolated from family and friends can also be considered abuse. Any discussion of abuse is a sensitive and delicate topic but may have overall effects on your medical and mental health.

While it is very difficult to disclose this information, your healthcare professional will safeguard the information and provide guidance. The information will help your medical professional take care of you as a complete person. They may offer suggestions, specific treatments or give you a referral to a specialist who may better assist you in coping with these problematic issues. If you’re experiencing abuse or know someone who may be in a dangerous situation, there are resources available through the National Domestic Violence Hotline.

Making that trip to a gynecologist can be intimidating, but they’re there to help you and answer your questions. Don’t hesitate to use their medical knowledge to your advantage.

Michael Krychman
Michael L. Krychman, MDCM, is the Executive Director of the Southern California Center for Sexual Health and Survivorship Medicine located in Newport Beach California. He is the former Co Director of The Sexual Medicine and Rehabilitation Program at Memorial Sloan-Kettering Cancer. He also is a clinical sexologist and has completed his Masters in Public Health and Human Sexuality. Dr Krychman has a degree in Erotology, Sexual Education and Forensic Sexology. Dr Krychman is also an AASECT certified sexual counselor. He is an Associate Clinical Professor at the University of California Irvine, Division of Gynecological Oncology and the Medical Director of Ann’s Clinic, a high-risk program for Breast and Ovarian Cancer Survivors.

His special interests include menopausal health, hormone therapy, sexual pain disorders, and loss of libido, chronic medical illness and medical devices and their impact on female sexual function. He is a well-known speaker who is featured locally, nationally and internationally. He has published many articles in peer-reviewed journals and has been featured in many scientific journals and lay magazines. Dr Krychman is an active reviewer for the Journal of Sexual Medicine. He was the Scientific Chairman for the 2010 International Society for the Study of Women’s Sexual Health annual educational meeting. He is an active member in good standing in North American Menopause (NAMS), International Society sexual Medicine (ISSM), European Society Sexual Medicine (ESSM), International Society Study of Women’s Sexual Health (ISSWSH), American Society of Sex Educators, Counselors and Therapists (AASECT) and American College of Obstetricians and Gynecologists (ACOG). He was a member of the Standard Committee for ISSM and has been a guest professor at the ESSM Sexual Medicine Summer School in Oxford, England. He was the creator of the recent WISH Initiative (Women’ Initiative on Sexual Health: and the 2013 recipient of the WISH Outstanding Achievement award given by the ISSWSH. He is also on the professional advisory board for the Patty Brisben Foundation.

Dr. Krychman’s has published 7 books including his most recent one: The Sexual Spark, 20 Essential Exercises to Reignite the Passion, 100 Questions & Answers for Women Living with Cancer: A Practical Guide to Female Cancer Survivorship has been recently published, 100 Questions and Answers about Women’s Sexual Wellness and Vitality and Breast cancer Sexuality, Sensuality and Intimacy. He has been featured on the Today show and in the New York Times and US News and World Report World Report, The Wall Street Journal, New York Times, Health Magazine and many others. He was named one of Orange County Top Doctors for 2015 and 2016 in Menopause, Sexual Dysfunction and Vulvar Pain. In 2019 and again in 2020, he has been named an Orange County Physician of Excellence by Orange Coast Magazine in Survivorship, Sexual Medicine and Menopause.