The Health Advice Your Gyno Gives Her Friends
"I talk my patients through all of their birth control options," says gynecologist Liz Lyster, MD, MPH, FACOG. "But I tell my friends to mess with their hormones as little as possible. Many are afraid of IUDs because the ones that were used 40 years ago—and eventually banned—let bacteria in and caused major complications." But the ones today are safer, she says. In fact, a 2013 poll published in the journal of the American Congress of Obstetricians and Gynecologists (ACOG) found that ob-gyns were three times more likely to choose an IUD for themselves over other forms of birth control. There's a reason for that: Not only are they 99 percent effective, but IUDs can provide relief from heavy periods and menstrual cramps, and they release hormones locally, not systemically, like oral contraceptives do. Unlike the pill, says gynecologist Alyssa Dweck, MS, MD, FACOG, a co-author of V is for Vagina, which can wreck havoc on your libido, the localized dose of hormones in IUDs tend to keep your mood and sex drive stable. Plus, it's a set-it-and-forget-it mentality: There's no having to remember to take a pill every day; some IUDs can last up to 10 years, so they're ideal for longer-term birth control. (If you're planning to have kids in the near future, it might not make sense to go through the process of having an IUD inserted and subsequently removed.)
Do Less of This...
"A topic that comes up at parties all the time? Yeast infections," Dweck says. "And yet, my patients don't talk to me about them; they just go and treat their symptoms." Which can be a mistake. "Many women think that any irritation, itch, discharge or odor is a yeast infection," she says. "Instead of asking me about it, they go to the drugstore and pick up one of those over-the-counter one-day treatments. They end up feeling worse because they actually have a different infection, like bacterial vaginosis, or an STD like trichomoniasis or chlamydia, that's being left untreated." Not only does she recommend always getting checked out by a doctor first, but even if yeast is the culprit, Dweck advises patients to try a 3- to 7-day treatment before jumping to more intensive 1-day treatments: "They're very strong and not every woman can tolerate them." That said, if you do get frequent yeast infections, know the symptoms and understand what treatment works for you. Lyster tells her friends to keep one Diflucan pill on hand, and then go refill it immediately for next time. "Most doctors aren't going to tell their patients to do that," Lyster admits. "But let's face it: If you get a yeast infection on Friday night and can't get a prescription until Monday, you're in for a long weekend."
Do More of This...
"This isn't something my patients bring up often, probably because they're embarrassed," Lyster says. "But it's definitely fair game with my friends!" According to her, the longer you go without sex, the more uncomfortable it will be when you start having it again. That's because the tissue becomes slack and blood flow to the area decreases when your body isn't in the habit of preparing for and having intercourse. (Like exercise, this activity is also easier when you're in the habit.) This can happen to women of any age. Dweck offers another perk: Sex and orgasm have been linked to a host of health benefits, including a stronger immune system and improved cardiac health. And if it has been a while? "Use lube," she suggests. (If you're not in a relationship? Solo sex offers many of these mood and health benefits.)
Rethink Your Pap Schedule
The latest guidelines from ACOG recommend that most women be screened for cervical cancer no more than once every three to five years and that women under 21 and over 65 not be screened as part of a regular checkup. Your ob-gyn is likely to follow those guidelines—Dweck and Lyster do—but both agree that it's smart to be your own advocate. Think you might be at risk? Make the investment to be screened more frequently. "If a woman has a new sexual partner, I would say it's worth paying for a Pap more frequently than every three years," Lyster advises. Ditto if she has a partner that she suspects may have been unfaithful and exposed her to HPV or other STDs. "I happen to think that peace of mind is worth paying for."