Approximately 19 million American women, or about 18 percent of the adult female population, receive annual pelvic exams, according to a study published in the September 24, 2007, edition of the “Archives of Internal Medicine.”
But that number is small compared to the number of women who put off seeing a gynecologist, despite the vital role annual gynecological exams play in maintaining good health.
Avoiding a pelvic exam may be easy when things are going well, but you can’t avoid it when your body starts sending you distress signals.
Some signals, which often present themselves in the form of pain or illness, may point to cancer, sexually transmitted disease, pregnancy complications or the onset of menopause.
Not every signal requires a visit to the emergency room. Some may mean you should call your doctor for the next available appointment.
Here are five signs that warrant a doctor’s opinion:
— Painful blister-like lesions on the vagina or rectal areas. This could be an indication of herpes, said Dr. Terry Hoffman, an obstetrician and gynecologist with Mercy Medical Center in Baltimore, Md., and a junior fellow of the American College of Obstetrics and Gynecology. Your doctor can administer a blood test that can determine if this is a new incidence of the disease or if you’ve had it for some time. If it is new, you need to begin taking anti-viral medication and to inform your sexual partners.
— Significant vaginal bleeding. Hoffman describes this as a menstrual flow that soaks through two to three sanitary napkins every one to two hours. If this is accompanied by a rapid heart rate and shortness of breath, it could be a sign of anemia. In the worst-case scenario, which is rare, extreme blood loss could result in the need for a blood transfusion. The only way to determine the correct course of action is to discuss the symptoms and their severity with your doctor.
— Sudden, intense belly pain. If this is accompanied by light-headedness and shoulder pain, it could be a warning sign of a ruptured ectopic pregnancy, said Dr. Mary Jane Minkin, a Yale clinical professor of obstetrics and gynecology.
An ectopic pregnancy occurs when the fertilized ovum implants itself in tissue other than the tissue of the uterine wall. Most ectopic pregnancies occur in the Fallopian tube. When it ruptures, blood in the Fallopian tube tracks up under the diaphragm. “The brain translates diaphragmatic pain as shoulder pain,” she said. You need to go to the emergency room if you cannot reach your doctor, because surgery may be necessary.
All women of child-bearing age who are sexually active should take these symptoms seriously, even if they do not think they are pregnant, Minkin said.
— Post menopausal bleeding. Minkin said that most women aren’t aware of what she calls “the ovaries’ big hurrah.” By that she means having a period up to one year after going through menopause. However, she also said that post-menopausal bleeding can be a sign of cervical or uterine cancer. In most instances, the bleeding is caused by factors like benign polyps, or a condition known as hyperplasia, the overgrowth of benign tissue. Still, you shouldn’t put off being evaluated, she said.
— New breast lump. If you discover a lump during your monthly breast self-examination, then you need to contact your doctor. It is even more critical if it is accompanied by a bloody discharge from the nipple that isn’t trauma-related. These could be warning signs of cancer. “Most likely it isn’t cancer, but you need to be seen and start the evaluation,” Hoffman said.
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