6 Scary Things You Might Hear at Your Next OB-GYN Visit
#1: "You have a backwards uterus."
Why you can relax a little: All this means is that the uterus, which is normally in a straight, vertical position, is tipped toward the back of your pelvis. On its own, it doesn't usually interfere with fertility or pregnancy. In fact, carrying a baby can tip the uterus into the "middle," or normal, position (or, in a woman whose uterus is already in the typical spot, pregnancy can tip it out of alignment). Many women go their whole lives without knowing about their skewed womb. However, some women with this anatomical quirk report pain during their period or while having sex. Your doctor may be able to recommend exercises or other treatment. Surgery is an absolute last resort.
One more thing: Experimenting with different sexual positions that don't put as much pressure on the rectum and ligaments of the tailbone often alleviates the pain, so feel free to get creative.
#2: "This sounds like polycystic ovary syndrome. I'm going to order a few lab tests."
Why you can relax a little: You may have heard PCOS referred to as the most common cause of female infertility. Here's the deal: PCOS is a common hormonal disorder that affects between 1 in 10 and 1 in 20 women of childbearing age. Most women with it have small cysts along the outer edge of each ovary, which are a result of not ovulating. The condition may also come with a bunch of unpleasant symptoms: Erratic periods (or none at all), excessive hair growth, acne and obesity. In the past, doctors would surgically remove the cysts, but these days, the condition can be managed through medication (thanks, science!). Your doctor will probably put you on birth control pills (or the ring, or the patch) to regulate your hormones, your period and other related issues, says Lauren Streicher, MD, an associate clinical professor of obstetrics and gynecology at Northwestern University’s medical school. Then, when you're ready to get pregnant, she'll take you off the pill and, if you need it, put you on a fertility drug like Clomid—Streicher says that most patients respond beautifully.
One more thing: An encouraging new study from Israel of fit women with PCOS suggested that eating a big healthy breakfast and a smaller lunch and dinner can alter hormone levels in a favorable way and improve fertility.
#3: "You tested positive for herpes."
Why you can relax a little: Your scarlet letter "A" really stands for "About Average." Though exact numbers are complicated, a significant percent of the population is similarly marked with one or both types of herpes (HSV 1, usually oral, or HSV 2, usually genital). For example, in the U.S., about one in six people ages 14 to 49 has genital herpes (about 50 million), and as many as 90 percent do not know it, says the American Sexual Health Association. In the past, herpes had to manifest itself to be diagnosed, rearing its head in the form of an oral or genital blister. Now doctors can administer a simple blood test to see if you've ever been exposed to the herpes simplex virus. This means you can test positive for herpes even if you've never had an outbreak. Doctors are duty-bound to tell you the results, and there's no sugarcoating the news. When patients panic about how they'll break the news to a future partner, Streicher reminds them that the only people who are immune to STDs are those who have never had sex—and data shows that only about 2 percent of people are virgins when they get married.
One more thing: You can decrease the chances of passing on the infection by using condoms and taking an antiviral medication, says Streicher (and, of course, by abstaining when—or if—you experience an outbreak).
#4: "Your birth control increases your chance of a blood clot."
Why you can relax a little: Even if your ob-gyn downplays the risks, you may have heard terrifying news accounts of young women on hormonal birth control dropping dead from blood clots. It's true that any hormonal contraception that contains estrogen (and especially those with a high concentration of estrogen, the synthetic progestin called drospirenone, or both) increases your risk of a blood clot (technically: a venous thromboembolism), which can break off, travel to other parts of the body and potentially cause lethal complications. But your risks of developing one are higher during and right after pregnancy—the very thing you're taking the pill to prevent. To put it in perspective: The likelihood of a blood clot while taking birth control pills is 3 to 9 for every 10,000 women, says Streicher. During pregnancy, that increases to 5 to 20 for every 10,000 women; immediately postpartum, it's 40 to 65 for every 10,000 women. In all cases, surges in estrogen are partly to blame; genetic predisposition, smoking and obesity are other major risk factors.
One more thing: For women who have a family history of clotting (or who are simply skittish), Streicher recommends a progestin-only pill or an IUD (which also only contains progestin).
Next: "Wait, I have two what?!?!"
#5: "You have two vaginas."
Why you can relax a little: This condition, also known as uterus didelphys, isn't common—it occurs only in about 1 in 3,000 women, according to the World Health Organization—and it isn't usually serious. It's a developmental abnormality in which two tubes in the reproductive tract (next to the fallopian tubes) don't fuse into a single vagina but instead remain separate. So you end up with two vaginas—and two uteruses and two cervixes, too.
One more thing: While it may present some fertility challenges, it doesn't mean you can't have children—one woman reported having two kids, a few years apart: one in each uterus.
#6: "You tested positive for HPV."
Why you can relax a little: HPV, also known as human papillomavirus, is like the common cold of STDs. There are more than 40 different types of HPV, and it's become so prevalent that nearly all sexually active men and women get it at some point in their lives. While HPV can lead to cancer of the cervix, genitals or throat, the infection goes away in 90 percent of cases (usually within two years). Your OB-GYN will probably recommend regular screenings so she can monitor you. Women in their 20s and 30s, who are the most likely to get HPV, are also the most likely to clear it without any additional treatment, says Streicher.
One more thing: Cervical cancer, like most forms of cancer, is most treatable when caught early. That's why it's crucial to keep in touch with your gynecologist until your HPV tests come back negative.
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