Women whispering secrets

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The Things Patients Don't Want to Discuss with a Doctor
These include the high-stakes secrets that women share only with their therapist (or their therapist-like best friend), like the fact that they're having an affair with a married man, sleeping with more than one guy or having unprotected anal sex.

Reasons to talk about this: There are over 40 kinds of STIs, and some can be life threatening if left untreated. Your doctor may notice something unusual during a pelvic exam or a Pap smear, but many STIs require separate tests, says Lauren Streicher, MD, assistant professor of obstetrics and gynecology Northwestern University's Feinberg School of Medicine. Contrary to popular belief, there's no one test that can "catch everything." You might need to get a swab for gonorrhea and chlamydia (which doesn't usually present obvious symptoms), or you may need a blood test for herpes, HIV, hepatitis and syphilis—and these aren't usually part of a wellness visit.
Embarrassed woman

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The Things Patients Don't Want to Discuss with Anyone, Ever
Pain during sex, urinary or fecal incontinence or uncomfortable anatomical quirks—these are all topics that some women are still loath to talk about, even in a world of way-too-intimate pharmaceutical commercials.

Reasons to talk about this: "All of these are treatable," says Streicher. Excruciating intercourse could due to vaginal dryness (this is the most common cause of painful sex in women of all ages), or a condition like vaginismus or vulvodinia, all of which may be helped by lubricants, prescription medication or pelvic floor physical therapy. Incontinence of any kind is a widespread problem, says Streicher, and gynecologists have several options for treatment, ranging from physical therapy to surgery. As for your unusual body issues, she's seen them all (even rectoceles—and if you don't know what these are, you should feel relieved), and most likely has the cure for your discomfort.

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The Most Dangerous Habit Patients Neglect to Mention
We're referring to what some of us do most Friday nights.

Reasons to talk about this: It's essential for your gynecologist to know if you smoke, says Streicher, even if you're more of a half-pack-one-night-a-week type than a pack-a-day type. Smoking is one of the main factors that affect whether HPV will progress to a form of cancer, she says. And as you already know (but may have forgotten), smoking is also associated with high risks for blood clots, heart attacks and strokes for women taking hormonal contraception, especially for women over 35. The World Health Organization has estimated that women who smoke cigarettes while taking the pill are 20 times more likely to develop heart disease than nonsmokers.

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The Most Common Things Patients Forget to Bring Up
Typical oversights tend to be how a patient's health or their family's health has changed since their last appointment; new medication (herbal remedies count, too); or whether any close blood relatives, including paternal ones, have developed breast or ovarian cancer.

Reasons to talk about this: Think beyond your lady parts and jog your memory for medical issues, says Michele Curtis, MD, professor of obstetrics and gynecology at the University of Texas at Houston. She recently had a patient who came to see her about breakthrough bleeding but neglected to mention that she'd been diagnosed with thyroid problems—which are commonly associated with irregular periods. If Curtis learns about new cases of cancer in the family, she may offer BRCA1 or BRCA2 genetic testing or other screening measures to make sure she helps catch problems as early as possible. Err on the side of oversharing and let your doctor tell you what's irrelevant.

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The Things Patients Believe Are Between Them and Their Partner
Discussion-worthy problems range from a distressing sexual slump to a violent situation at home.

Reasons to talk about this: Your gynecologist can be a good person to ask about orgasms—and why you're not having them, says Jan Shifren, MD, associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School. She might talk to you about potential anatomical challenges or refer you to a sex therapist, a women's health physical therapist, a couples counselor or other specialist. If you're in a dangerous or threatening relationship, Shifren wants you to know that your doctor has been trained to deal with these issues and has helpful resources on-hand—and she won't share this information with anyone without your permission.

Next: 19 questions to ask at your next doctor's appointment