Eight Questions to Ask Your Doctor About Gynecologic Cancer

You’ve likely heard that it’s important to see your gynecologist regularly – and you probably dread it every time. Visiting the gynecologist is not something many people with a female reproductive system look forward to doing. Besides, you may feel embarrassed to ask questions about certain symptoms. But what if they’re a sign of a potentially serious health problem – like gynecologic cancer?

Gynecologic cancer is a group of cancers that develop in the female reproductive system. It is expected to affect about 110,000 people in the U.S. this year, with about 30,000 people dying from it.

In honor of Gynecologic Cancer Awareness Month, this article will help put you in the driver’s seat of your health with 8 questions to ask your gynecologist.

1. Should I be worried about heavy menstrual periods?

While it’s very common, heavy menstrual bleeding is not normal. Losing too much blood during your menstrual periods can cause you to develop iron deficiency anemia, a condition that can lead to other health problems.

In addition, heavy menstrual periods can be a warning sign of a serious health condition, including endometrial cancer and cervical cancer.

It’s important to talk to your doctor about any irregular bleeding, like bleeding after vaginal sex, changes in your menstrual periods, spotting between your menstrual periods, or bleeding after menopause. That way, they can do tests to identify the cause.

2. When should I start screening for cervical cancer?

Screening for cervical cancer can begin as early as age 21. A screening test can catch signs of cancer before any symptoms develop.

Two tests are available as screening tests for cervical cancer: The Pap Test and the HPV test.

The Pap test can be done starting at age 21. If your results are normal, you can have a Pap test every 3 years. A Pap test looks for abnormal cells in the cervix that can potentially become cancer.

Starting at age 30, your doctor may talk to you about doing the HPV test in addition to a Pap smear. This is called co-testing and is done every 5 years if your results are normal.

The HPV test can detect if you have been infected with the human papillomavirus (HPV). This virus can increase your chance of developing cervical cancer, vaginal cancer, and vulvar cancer.

Your gynecologist may also recommend continuing to do a Pap test only every 3 years or an HPV test only every 5 years. Discuss cervical cancer screening with your doctor; it could save your life!

3. Is it normal to have pain during sex?

Painful sex can be a symptom of many gynecologic conditions. These can range from vaginal dryness to more serious conditions. Some people also experience pain during sex due to emotional reasons like a lack of sexual desire.

Pain during sex can also be a warning sign of certain gynecologic cancers like cervical cancer and vaginal cancer.

Although you may feel embarrassed to talk to your doctor about painful sex, it’s an important discussion to have. Your healthcare provider can do an exam and other tests to help determine the cause of your pain and provide treatment options.

4. Does gynecologic cancer risk depend on age?

In general, your risk of cancer increases as you get older. The same applies to many gynecologic cancers.

For instance, ovarian cancer occurs mainly in people 63 years or older. They tend to develop after menopause and are rarely found in people younger than 40.

Endometrial (uterine) cancer is most common in people who have gone through menopause, usually around age 60.

A type of vaginal cancer – squamous cell cancer – is most often diagnosed in older people, with about half of the cases occurring in people over age 70.

Invasive vulvar cancer tends to develop in people of an average age of 70.

That’s not to say you’re not at increased risk if you don’t fall in the age brackets above. Cancer can happen at any age, and you may have other risk factors.

5. I have a family history of ovarian cancer, what does that mean for me?

Some cancers are inherited – passed down in families. Ovarian cancer is one of them. This means if you are a person with a female reproductive system and you have a family history of ovarian cancer, you’re at increased risk of developing ovarian cancer yourself.

Knowing your family history of cancer is a crucial step in determining your risk. Once you gather as much information as possible regarding your family’s cancer history, share it with your healthcare provider.

Depending on your family history risk category, your doctor will help guide you about options to lower your risk. These can include seeing a genetic counselor and doing genetic testing.

6. It’s been itching “down there”, is that a big deal?

Itching in the outer part of your female genitals – called the vulva – can be caused by many conditions. Some include skin disorders like contact dermatitis, which can be easily treated.

But did you know vulvar cancer can also cause itching in your outer female genitals in addition to other symptoms like a lump or bump, a change in how the skin feels, pain, burning, or an open sore?

As uncomfortable as it may be, it’s always a good idea to mention to your doctor if you have vulvar itching and any unusual symptoms. It’s best to get these symptoms checked sooner rather than later.

7. I have pain in my lower belly and feel bloated most of the time. What can I do?

Often, certain conditions like lactose intolerance can cause you to feel pelvic pressure, fullness, or pain. You may even notice bloating – your belly is visibly larger in size.

Other more serious health conditions can cause you to feel bloated or have pain in your lower abdomen. For example, bloating and pelvic pain are common warning signs of ovarian cancer. So are other symptoms like having trouble eating or feeling full quickly.

In the advanced stage of endometrial cancer, you may feel pelvic or abdominal pain and bloating.

While pelvic pain and bloating can be caused by non-cancerous health problems, you should discuss them with your healthcare provider, especially if they happen frequently and are persistent.

8. Does a vaginal discharge mean I have gynecologic cancer?

A clear or white vaginal discharge that doesn’t smell bad is normal.

An infection – like a yeast infection – or other medical conditions may cause vaginal discharge that’s different in color or has a foul smell.

It’s important to note that a common symptom of cervical cancer is abnormal vaginal discharge. This may be a vaginal discharge that’s different in color, odor, or consistency. It may be watery, contain some blood, and may occur after menopause or between your menstrual periods.

Although a vaginal discharge may be normal or caused by benign (non-cancer) health conditions, it’s a good idea to see your healthcare provider if you notice anything different.

Conclusion

It can be difficult to know what’s normal and what may be a sign of a serious health problem. Symptoms like painful sex, heavy menstrual periods, vulvar itching, pelvic pain, or a vaginal discharge are often caused by benign conditions. Still, they can be warning signs for some gynecologic cancers. While it may be embarrassing to talk to your doctor about certain symptoms, remember that your doctor has seen and heard a lot and is prepared to help you. Ask questions and discuss any unusual change you notice in your body with your doctor who can investigate the cause and treat it if necessary.

Key takeaways

Talking to your healthcare provider about your symptoms – no matter how insignificant you think they may be – is vital.

You may be ashamed to bring up certain gynecologic symptoms to your doctor but remember that your doctor is there to help you stay healthy, not pass judgment.

Asking questions and bringing up concerns can alert your healthcare provider to potentially serious health problems.

Resources:

American Academy of Family Physicians. Vaginal Discharge. American Family Physician.

American Cancer Society. Cancer Facts and Statistics.

American Cancer Society. Ovarian Cancer Risk Factors.

American Cancer Society. Risk Factors for Vaginal Cancer.

American Cancer Society. The Pap (Papanicolaou) Test.

American College of Obstetricians and Gynecologists. Disorders of the Vulva: Common Causes of Vulvar Pain, Burning, and Itching.

American College of Obstetricians and Gynecologists. Endometrial Cancer.

American College of Obstetricians and Gynecologists. Ovarian Cancer.

American College of Obstetricians and Gynecologists. When Sex Is Painful.

Centers for Disease Control and Prevention. Basic Information about HPV and Cancer.

Centers for Disease Control and Prevention. Breast and Ovarian Cancer and Family History Risk Categories.

Centers for Disease Control and Prevention. Heavy Menstrual Bleeding.

Centers for Disease Control and Prevention. What Should I Know About Screening?

National Cancer Institute. Age and Cancer Risk.

National Cancer Institute. Endometrial Cancer Screening (PDQ)-Patient Version.

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