Gynaecologist reveals the 10 most commonly asked questions in her clinic

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A gynaecologist has revealed the 10 most commonly asked questions in her clinic – and explains why it is not uncommon to find sex uncomfortable. 

During lockdown, many people have reported struggling to book in a video call with their GP and other medical practitioners.

London-based obstetrician and gynae Dr Shree Datta told how patients frequently want to know if they should shave before an appointment and if their vaginal discharge is ‘normal’. 

Many also quiz her about their periods, and often ask how they can ‘fix’ their heavy flow. 

Here Dr Shree – the in-house expert for feminine intimate healthcare brand INTIMINA – shares the advice she regularly dishes out to women concerned about intimate issues with FEMAIL.

How do I know if my vaginal discharge is normal?

‘Discharge is actually a very good sign of your vaginal health – clear or milky discharge is completely normal,’ Dr Shree explained. 

‘It is needed to make sure your vagina is healthy, clean and keeps the bacterial balance in check.

‘For that reason internal douching of the vagina isn’t recommended as this can actually alter the natural bacterial balance you have in your vagina.’ 

She added: ‘Using soap and water on the outside skin is absolutely fine. The type and amount of discharge you pass can depend on where you are in your menstrual cycle – for example, it’s often thicker and more jelly-like in the second half of your cycle.

‘However, if you experience a persistent change in colour, consistency or smell of discharge, it’s worth getting checked over by your gynaecologist.’

My periods are super heavy – what causes this and how can I fix it?

According to Dr Shree, the frequency and duration of periods varies from person to person, so it’s worth monitoring what’s ‘normal’ for you.

She advised keeping a record of the number of sanitary products you require and if you are leaking through them, and said menstrual cups are a good indicator to check. 

‘Having long heavy periods – with flooding, clots or heavy bleeding with hourly or two hourly changes – would suggest it’s a good idea to get checked over by your gynaecologist,’ she said.

Dr Shree identified fibroids and polyps, which can grow in your womb, as potential causes for heavy periods. 

‘Sometimes you may be on medication which can alter the flow of your periods, or have a hormonal imbalance in your thyroid, so these are other things we would check for,’ she added. 

Why is it painful to have sex?

It is not uncommon to find sex uncomfortable at times, and there’s a pretty long list of possible causes, according to Dr Shree.  

The expert revealed that it could be caused by a range of factors including sex for the first time with a new partner, feeling stressed, or trying a new position. 

Dr Shree said: ‘You might find sex more uncomfortable at certain points of your menstrual cycle, or need more lubricant. 

‘Medical problems such as infections, fibroids or endometriosis may also cause sex to be painful, so it’s important to see your doctor if sex is persistently uncomfortable. 

‘If sex has always been problematic, it’s worth seeking help to see whether there is an underlying physical or emotional connection.’

Why do I need to pee so often?

Multiple toilet trips and having to urinate more than eight times in a day can be incredibly disruptive to your lifestyle. 

If this sounds familiar, Dr Shree said: ‘Firstly, I would take a look at how much alcohol and caffeine you’re taking in, as well as how much water you’re drinking.

‘Remember, if you don’t drink enough water, your urine is more concentrated and this can irritate the bladder, leading you to go to the toilet more often.’

Dr Shree said having to pee more can also be caused by a urinary tract infection or an overactive bladder, but can be affected by certain medicine or conditions like constipation having an effect. 

‘As well as this, anything that puts pressure on your bladder – a fibroid in your womb or pregnancy, for example, can also lead to frequent urination,’ she added.

Dr Shree revealed how strengthening your pelvic floor muscles, which support the bladder, bowel and affect sexual function, can be improved by doing regular Kegel exercises. 

I keep getting bleeding in between my periods and after sex – what is going on?

The expert explained how there are many reasons why bleeding in between your periods or after sex may occur. 

She advised keeping track by noting down when you are experiencing the bleeding, how heavy it is and how long it lasts in relation to your periods. 

‘Remember, it’s not uncommon to get bleeding if you’ve changed your contraception to a new pill or coil and for some women, a slight bleed at the point of ovulation (mid cycle) can be normal,’ Dr Shree said  

The gynaecologist said some sexually transmitted infections, stress or pregnancy may all cause bleeding unrelated to periods.   

Dr Shree added: ‘When consulting your gynaecologist, we’ll also explore whether you would benefit from an ultrasound scan to look for fibroids or polyps in your womb, which can affect your period length, frequency and heaviness as well as bleeding in between periods.’ 

Why do I need to have a smear if I’ve had the HPV vaccine?  

Human papillomavirus (HPV) is a common sexually transmitted infection, with over 100 different types, which can cause genital warts and cervical cancer. 

While infection with HPV doesn’t usually cause any symptoms, often those with HPV don’t know they have the infection and it generally takes 18-24 months to clear. 

Dr Shree said the vaccination programme, although effective, does not protect against all of the strands of HPV which can cause cervical cancer, and you must complete the course of vaccinations on time. 

She said: ‘As the vaccine does not protect against all types of HPV, it’s still important to go for cervical smears once you reach the age of 25. 

‘Remember, it’s free and it can help detect any problems early, so it’s worth attending – you will usually receive a reminder from your GP to attend every three years until the age of 50, after which it’s every five years.’ 

I haven’t had a period for three months but my pregnancy test is negative – now what?

There are many reasons why periods can stop aside from pregnancy, Dr Shree explained. 

She told how a gynaecologist will always go back to reviewing your period cycle and whether they were regular before they stopped as well as checking your hormones to ensure it is not a sign of early menopause.  

‘Periods can stop for a number of reasons including a change in hormonal contraception – for example, the Mirena coil can lighten and even stop periods for some women – and stressful life circumstances, such as finals exams or a divorce,’ she explained. 

‘This can often affect your weight, which believe it or not, has a massive impact on your periods.’ 

She added how sudden weight loss, doing too much exercise or being significantly overweight can also impact your cycle. 

‘Medical problems such as poorly controlled diabetes or an overactive thyroid can also influence whether you get periods and how frequently,’ she said.

‘Having an early menopause is uncommon – only one per cent of women go through the menopause under the age of 40.’ 

I keep getting pains in my lower tummy which are worse leading up to my periods –  what is going on?

While period discomfort is not uncommon, pelvic pain in the second half of your menstrual cycle and painful periods can suggest endometriosis.

Endometriosis is a medical condition where the womb lining is found elsewhere – often in the ovaries and around the womb – as well as within it. 

While the exact cause is unknown, Dr Shree explained how the condition is hormone dependent and runs in families.  

It can cause regular pains which get progressively worse leading up to and during your period. 

Dr Shree added: ‘Pain can also be due to infection or IBS, so it’s important to see your doctor to make sure the correct diagnosis is made so that we can give you the right treatment. 

‘In the first instance, keep a diary of your pain, in relation to when you are getting your periods – if the pains are not related to your periods, causes of your pain could include an ovarian cyst or IBS.’  

I’ve got polycystic ovaries – does this mean I won’t be able to have children?

Dr Shree said it is true that polycystic ovary syndrome can affect periods and in some cases fertility – but not always.  

PCOS affects between two and 26 women per 100 and relates to the number of fluid-filled follicles you have in your ovaries. 

She said: ‘You may not have symptoms even if you do have PCOS. Things to watch for include irregular or no periods, acne, or an increase in facial or body hair. 

‘Being overweight can also be associated with PCOS, but diagnosis depends on your menstrual regularity, blood tests and an ultrasound scan.

‘In the longer term, PCOS can be related to other medical conditions such as diabetes, high blood pressure and changes to your womb lining, so it’s important to seek advice from your gynaecologist.’ 

Should I shave if I’m seeing a gynaecologist?    

Dr Shree said: ‘There is no need to shave or wax your pubic hair if you are coming to see us as we’re able to examine you with or without pubic hair. 

‘The only time we may consider removing hair is if we are performing an operation on the skin around the vagina – and even then, we will only remove hair in the operating zone as is needed.’