There are certain health issues that most people would rather not discuss—even in the exam room. But trust us: Your doctor has heard it all. She's not the least bit fazed when you bring up a strange below-the-belt smell, or the fact that you sweat so much your socks get soaked.
"I hear embarrassing questions all day long," says Lauren Streicher, MD, associate clinical professor of obstetrics and gynecology at Northwestern University and author of Sex Rx. "Answering them is my job so I can help my patients find a solution and feel better."
Detailing the pain you feel while pooping may be enough to make you want to crawl behind the adjustable table. But no topic should be off-limits when it comes to your health and well-being. Here are six symptoms that are especially smart to speak up about.
|Your nipples are leaking|
It could mean… Your pituitary gland is secreting excess prolactin, a hormone that stimulates the mammary glands to produce milk. Assuming you're not pregnant or nursing, you may have a condition called hyperprolactinemia, says endocrinologist Shlomo Melmed, MD, dean of the medical faculty at Cedars-Sinai Health System in Los Angeles. Untreated, it can lead to irregular periods, infertility and a higher risk of osteoporosis.
The Rx: Your doc might test for hypothyroidism (an underactive thyroid can result in overproduction of prolactin). She may also check for a prolactinoma, a benign tumor on the pituitary gland. "It sounds scary but is easily treatable with medication," Dr. Melmed says.
|You sweat through your shirt, every day|
It could mean… Your sweat glands overreact to stimuli (heat, hormones, emotions) and "get stuck in the 'on' position," says David Pariser, MD, a dermatologist at Eastern Virginia Medical School. When excess sweating, aka hyperhidrosis, strikes in adulthood, it's often a side effect of a prescription drug or a symptom of another condition, ranging from an infection to diabetes.
The Rx: It's not as simple as using a prescription-strength antiperspirant. Your doctor needs to discover and treat the underlying problem, Dr. Pariser says. Be sure to tell her about everything you're taking. Even supplements like zinc and iron can trigger heavy sweating.
|You have no interest in sex—like, zero|
It could mean… A variety of things: "Libido is complicated because it's both physical and psychological," Dr. Streicher says. Many women experience low libido during perimenopause, when the effects of falling estrogen levels (including vaginal dryness) dampen desire. But depression is another common cause. "Dopamine is essential to feelings of lust. Often when you're depressed, dopamine levels are decreased," Dr. Streicher explains. "Many of my patients don't put two and two together." What's worse, some antidepressants kill libido—a double whammy for your mojo.
The Rx: When your gynecologist asks how you're feeling, she really needs to know. Clinical depression doesn't always mean that you can't get out of bed. Some patients have aches, trouble sleeping or digestive issues without experiencing feelings of sadness or hopelessness. If your doctor detects that you're in a rough patch, she can help you find the best treatment, which might involve talk therapy or a medication without sexual side effects.
|Going no. 2 is so painful, you avoid it|
It could mean… You have swollen hemorrhoids or small tears in your anus called fissures. When extra stool moves slowly through your digestive tract, your colon ends up absorbing too much water, making your poop hard and dry. Straining on the toilet can lead to tissue trauma, and "painful BMs might cause you to put off going to the bathroom, which just makes the problem worse," says Robynne Chutkan, MD, a gastroenterologist in Chevy Chase, Md., and author of Gutbliss. Another possibility: If the pain you feel comes with backache, pelvic discomfort or heavy periods, that could indicate uterine fibroids, benign tumors that can put pressure on your rectum when you go.
The Rx: Pooping fewer than three times a week? Drink more water, exercise, eat fiber-rich foods and take 1 tablespoon a day of a fiber supplement like Metamucil. These simple remedies should restore regularity and give hemorrhoids and fissures a chance to heal. If you continue to have a lot of pain or see spots of blood, however, your doctor may suggest using a cream or ointment.
See your physician right away if you suspect that you've got fibroids. There are many treatment options, including medication, ultrasound and minimally invasive surgical procedures.
|There's a weird odor down there|
It could mean… The pH of your vagina is too high, which allows "bad" bacteria to proliferate, Dr. Streicher explains. The technical term is bacterial vaginosis, and it can be triggered by anything that makes the vaginal environment less acidic, including semen, menstrual blood and douches. Burning and itching are other symptoms.
The Rx: You should definitely mention the smell to your gynecologist. It will help her rule out STDs and a yeast infection (which is associated with odorless discharge). She may prescribe an over-the-counter vaginal gel or an antibiotic.
|The big O in your bedroom stands for 'Ouch'|
It could mean… Your body isn't producing enough lubrication, and nothing zaps a frisky mood faster than too much friction. If it happens once in a while, it's nothing to worry about; stress or rushed foreplay can keep you from getting fully aroused. But if sex has started to feel like death by sandpaper, you can probably blame a drop in estrogen, Dr. Streicher says. This usually occurs after childbirth, during breast-feeding and in menopause—though certain medications, including antihistamines and some birth control pills, can have the same effect. The hormonal dip causes vaginal tissue to be thin and dry, hence the burning and soreness.
The Rx: If you're not already using one, a good lube can do wonders, Dr. Streicher says. She recommends silicone-based products, which may require visiting an erotica store; drugstores typically sell less slippery water-based lubes.
If you're going through menopause, your doctor may suggest a vaginal estrogen treatment (either a cream or suppository) or Replens, a vaginal moisturizer that you can buy over the counter.
However, if the pain feels deeper and more intense in certain positions, it could be a sign of a problem elsewhere in your pelvis, such as endometriosis (when uterine tissue grows outside the uterus), or even irritable bowel syndrome. Treating that issue should make doing the deed a lot more fun, too.