Zika Pregnancy Updates for 2019: Yes, it’s still a thing

We’re still talking about Zika?

Yes. Yes we are. But for some reason, people have forgotten about how important the discussion is. I don’t blame you. The news has been inundated with other topics. #TheWall.

But at least weekly I meet a new pregnant patient who has either recently traveled to a Zika endemic area or is scheduled to go to one. I find myself either trying to convince ladies not to go or surprising them with the info that they now need Zika testing because they conceived too close to their Zika trip.

Zika can be contracted from mosquito bites AND sex and can be passed from mother to unborn child.

Here are your TOP FIVE Zika rules for pre-pregnancy and during pregnancy.

  1. If you are pregnant, DO NOT travel to a Zika endemic area (an area or region where the Zika virus is present.)
  2. If you have traveled to a Zika endemic area, DO NOT conceive (get pregnant) until at least 3 months after your return.
  3. If you find out that you are pregnant in a Zika endemic area and can’t leave immediately, USE MOSQUITO REPELLENT.
  4. If your partner travels to a Zika endemic area, either make sure he is tested and is negative for Zika or DO NOT have unprotected intercourse for at least 3 months.
  5. If you are pregnant and have had potential exposure to Zika within the last 3 months, get your BLOOD TESTED for Zika exposure.

Even if you don’t have definite mosquito bites, you could still have been possibly exposed. It is possible to have a small mosquito bite that you don’t notice that can lead to infection.

It’s a bite. Get it?

Also, most people who contract the Zika virus do not have symptoms. But, even if the mother has no symptoms, she can still have a baby who is affected by the virus. We don’t know all of the possible effects of the Zika virus either. Everyone knows about anencephaly, but milder disease may lead to less visible affects, but developmental delays that can affect that child forever.

The Center for Disease Control says this:

“Babies who were infected with Zika before birth may have damage to their eyes and/or the part of their brain that is responsible for vision, which may affect their visual development. Both babies with and without microcephaly can have eye problems.

A recent study in Brazil found that at 19-24 months, babies with congenital Zika virus infection exhibited challenges with sitting independently, feeding, and sleeping. The babies also experienced seizures and hearing and vision problems, such as not responding to the sound of a rattle and not being able to follow a moving object with their eyes. It is important to note that babies affected by Zika virus will continue to require specialized care from many types of healthcare providers and caregivers as they age.”

From the CDC

You don’t want those kind of problems. I don’t care if you DO lose your deposit, DON’T GO.

Originally, everyone had their eyes on Mexico and the Carribean. Now areas in India and many countries in Africa are also on the Zika list. (Click here to check if the place you are thinking about going to is on the Zika Map. It’s a searchable map.)

But what about the people who live in those countries?

I get asked this question at least quarterly, as though we shouldn’t worry because some people live in the Zika risk territories and are “fine”. Stats that report Zika cases globally aren’t easy to find. I did find US and US Territory numbers, though.

From the CDC, 2018 counts so far are as follows:

In the US States:
– 64 Zika virus disease cases reported

– 64 cases in travelers returning from affected areas.

In US Territories:
– 116 Zika virus disease cases reported 0 cases in travelers returning from an affected area
– 116 cases acquired through presumed local mosquito-borne transmission

The Center for Disease Control

So where can I go that is Zika-free if I am pregnant or want to be pregnant.

If you need some advice, THIS ARTICLE will show you places to travel free of Zika. Always check the CDC map before you go, though.

Click the picture to be taken to a Business Insider article about Zika-free travel locations

For more about Zika, visit the CDC website by clicking here. As always, thank you for reading and following The Gyneco-bLogic.

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Five Reasons To Not Buy A High Tech Baby Monitor

Technology is everywhere.

Phones are getting smarter. Computers are getting smarter. Even eye glasses are getting smarter.
But in the space of caring for growing babies, technology is not always a parent’s friend. Human nature says get the highest tech device that will keep my growing or newborn baby as safe as I can. This logic is flawed though and can actually lead to more harm. I’ll tell you why.

First, what kind of high tech monitors am I talking about?

This cease and desist on baby tech goes out to the following.
  1. Fetal heart dopplers for listening to the baby’s (fetus’s) heart rate while in the uterus.
  2. Infant heart rate and vitals monitors worn in cribs while the baby is sleeping.
  3. Pressure monitors that assess the breathing and movement of a baby.
Regarding the external monitors for newborns, I am ONLY speaking about term babies who have cooked in the uterus long enough and are NOT sent home with MEDICALLY ISSUED monitors. The babies who have physician recommended monitors are not the ones who I worry about overuse of baby-tech.

Technology is not always a parent’s friend.

Back in MY day (10 years ago), my husband and I had an audio-only monitor with one end in the baby’s room and 2 handheld monitors which we would leave in common areas of the house. When I would move from one area to another, I’d bring the audio monitor with me. I’m sure that when I was a baby, my parents just listened out for my cries. Or maybe they tied a tin can to a string in my room and held the other tin can in whatever adjacent room they were in, playing a version of infant telephone. I wouldn’t be surprised. The American Association of Pediatrics and the CDC provide the following recommendations to prevent SIDS and other scary and dangerous events in the early infant months:
  • Place your baby on his or her back for all sleep times—naps and at night.
  • Use a firm, flat sleep surface, such as a mattress in a safety-approved crib, covered by a fitted sheet.
  • Keep your baby’s sleep area (for example, a crib or bassinet) in the same room where you sleep until your baby is at least 6 months old, or ideally, until your baby is one year old.
  • Keep soft bedding such as blankets, pillows, bumper pads, and soft toys out of your baby’s sleep area.
  • Do not cover your baby’s head or allow your baby to get too hot. Signs your baby may be getting too hot include sweating or his or her chest feels hot.
  • Do not smoke during pregnancy, and do not smoke or allow smoking around your baby. For help quitting, see How to Quit Smoking.
  • Do not drink alcohol or use illegal drugs during pregnancy.
  • Breastfeed your baby.
  • Visit your baby’s health care provider for regular checkups. Your baby will receive important shots to prevent disease. Remember, vaccines do not increase risk. Evidence supports that infant scheduled vaccines DECREASE SIDS risk.
  • Offer your baby a pacifier at nap time and bedtime. If you are breastfeeding your baby, you may want to wait to use a pacifier until breastfeeding is well-established.

So what is the problem with having a high tech baby monitor?

It can only help keep baby safer, right? Wrong. From the Washington Post:
Parents might assume that a monitor that measures vital signs could prevent their baby from dying of sudden infant death syndrome, or SIDS, but there’s no hard evidence for this. And studies from the 1980s and 1990s of hospital-grade heart-rate and breathing monitors prescribed for home use for babies thought to be at high risk for SIDS found that the monitors didn’t reduce babies’ risk of dying of SIDS. These older monitors were more cumbersome — not wireless like the commercial monitors available today — but they collected similar data, and some studies reported that their use increased parental stress and fatigue.
Pediatrician, Dr. Victoria Rodriquez, recommends:
“… not to bother with vital-signs monitors because they ‘don’t seem to prevent bad things from happening and can cause emotional distress for families.’”

Baby tech monitors may actually make infants LESS SAFE by offering false reassurance.

Also from the Washington Post:
Some pediatricians worry that home use of vital sign monitors might falsely reassure parents about SIDS, defined as a sudden death with unexplained cause during the first year of life, and other sleep-related deaths such as those caused by suffocation. “Parents may become complacent if they are using a monitor and figure that, since the monitor is on the baby, it’s okay to place the baby on her stomach to sleep or to otherwise not follow the safe sleep recommendations,” Rachel Moon, a professor of pediatrics at the University of Virginia School of Medicine, wrote in an email. She was the lead author of the AAP’s policy statement on safe sleep.
Pregnant woman
As an Obstetrician, the question I hear often is:
“Doc, should I buy a doppler to listen to the heart rate on my own?”
The answer is always the same. No. But why? For the same reason that newborn monitors are ill advised. If a woman can’t hear the heartbeat, which is not always easy to find, more stress and evaluation can ensue. Conversely, when the time comes in the pregnancy where kick counts are important, if a woman doesn’t get her kick counts, more evaluation may be necessary. More than just a few seconds of doppler monitoring, that is. A baby with a heartbeat can still be in distress.

In Summary,

More baby tech is not necessarily better, and in fact, it is likely worse. The irony is that many people buy these monitors to be more safe, when in fact they can absolutely cause more harm than good, both physically and emotionally for parents and baby. Enjoy your pregnancy and baby. Leave the non-medically-issued lack-of-supporting-evidence tech out of it. If you are worried, own your concern, ask questions, and find ways to manage anxiety. It’s okay to feel some level of worry about your baby. Welcome to parenthood.

How to help someone quit smoking AND vaping… and why you should keep trying.

Youth and young adult E-cigarette use increased more than 10-fold within the last decade. Harmless, right? I mean, they aren’t cigarettes. They are much safer, right?


I’m not trying to be killjoy, but this one needs a serious look. Especially since it is so popular with teens and young adults. This post will give you good reason and tactics to try to curb e-cigarette AND traditional cigarette use. I will also offer ways to encourage and support someone who embarks on the journey toward quitting.

Reason #1 to stop using vape pens:

Vaping pen increases the chances of starting traditional cigarette use over time.

From the surgeon general: 

Early e-cigarette use and nicotine addiction can harm brain development and increase the risk of young people smoking cigarettes.

2. The doses of nicotine are amplified with the use of vape pens

[A] study found that 63 percent of JUUL users did not know that the product always contains nicotine, even though all types of JUUL sold on the market, including mint, mango, creme brulee and cool cucumber flavors, have nicotine in them. In fact, a single JUUL cartridge is equal in nicotine content to an entire pack of cigarettes.

3. The contents of the various liquids are not standardized, so longterm safety is in question.

4. Masking feelings with dependence is as unhealthy as downing a double cheese burger, fries and a milkshake when your emotions are riding high. It may feel good in the moment, but unchecked, this practice will harm you.

5. Even if you are an adult, people are influenced by what they see. Whether you have 10,000 followers or 10 friends, you are an influencer. I take that responsibility seriously. If I stop smoking or vaping and that leads someone else to do the same, we all win.

So that friend, coworker or loved one has been saying no for years. So what? Studies show people do still quit, even after many MANY years or smoking.

Also, for those grandparents or parents who smoke and tell you that it is fine because the do it outside, remind them of this:

It’s not just about smoking near the baby or children. The sediment on your clothing can be harmful.

Asthma, allergies and even sudden infant death syndrome (SIDS) are all more common in households of smokers even when direct smoke exposure is restricted. Clothing can be to blame. 

There are stages of quitting. Just because you want that person to quit doesn’t mean they are ready to do so. Asking them to quit, offering love and support throughout the process and reminding them of the benefits of quitting can help sometimes. Every cancer risk is higher with smoking. Life expectancy goes down with smoking. Skin ages faster as well.

What if that person does say that they are ready? How can you help?

Borrowing from Cancer.org,  here are some do’s and don’ts for friends and loved ones:

Do respect that the quitter is in charge. This is their lifestyle change and their challenge, not yours.

She may look cool, but she is about to lose something that means a lot to her when she quits.

Do ask the person whether they want you to ask regularly how they’re doing. Ask how they’re feeling – not just whether they’ve stayed quit.

Do let the person know that it’s OK to talk to you whenever they need to hear encouraging words.

Do help the quitter get what they need, such as hard candy to suck on, straws to chew on, and fresh veggies cut up and kept in the refrigerator.

Do spend time doing things with the quitter to keep their mind off smoking – go to the movies, take a walk to get past a craving (what many call a “nicotine fit”), or take a bike ride together.

Do try to see it from the smoker’s point of view – a smoker’s habit may feel like an old friend that’s always been there when times were tough. It’s hard to give that up.

Do make your home smoke free, meaning that no one can smoke in any part of the house.

Do remove all lighters and ash trays from your home. Remove anything that reminds them of smoking

Do wash clothes that smell like smoke. Clean carpets and drapes. Use air fresheners to help get rid of the tobacco smells – and don’t forget the car, too.

Do help the quitter with a few chores, some child care, cooking – whatever will help lighten the stress of quitting.

Do celebrate along the way. Quitting smoking is a BIG DEAL!

Don’t doubt the smoker’s ability to quit. Your faith in them reminds them they can do it.

Don’t judge, nag, preach, tease, or scold. This may make the smoker feel worse about him or herself. You don’t want your loved one to turn to a cigarette to soothe hurt feelings.

Don’t take the quitter’s grumpiness personally during their nicotine withdrawal. Tell them that you understand the symptoms are real and remind them that they won’t last forever. The symptoms usually get better in about 2 weeks.

Don’t offer advice. Just ask how you can help with the plan or program they are using.

If your ex-smoker “slips”

Don’t assume that they will start back smoking like before. A “slip” (taking a puff or smoking a cigarette or 2) is pretty common when a person is quitting.

Do remind the quitter how long they went without a cigarette before the slip.

Do help the quitter remember all the reasons they wanted to quit, and help them forget about the slip as soon as possible.

Do continue to offer support and encouragement. Remind them they’re still a “quitter” – NOT a smoker.

Don’t scold, tease, nag, blame, or make the quitter feel guilty. Be sure the quitter knows that you care about them whether or not they smoke.

If your quitter relapses

Don’t give up.

Research shows that most people try to quit smoking several times before they succeed. (It’s called a relapse when smokers go back to smoking like they were before they tried to quit.) If a relapse happens, think of it as practice for the next time. Don’t give up your efforts to encourage and support your loved one. If the person you care about fails to quit or starts smoking again:

Do praise them for trying to quit, and for whatever length of time (days, weeks, or months) of not smoking.

Do remind your loved one that they didn’t fail – they are learning how to quit – and you’re going to be there for them the next time and as many times as it takes.

Do encourage them to try again. Don’t say, “If you try again…” Say, “When you try again…” Studies show that most people who don’t succeed in quitting are ready to try again in the near future.

Do encourage them to learn from the attempt. Things a person learns from a failed attempt to quit may help them quit for good next time. It takes time and skills to learn to be a non-smoker.

Do say, “It’s normal to not succeed the first few times you try to quit. Most people understand this, and know that they have to try to quit again. You didn’t smoke for (length of time) this time. Now you know you can do that much. You can get even further next time.”

It’s a new year. Embrace a new you. Add value to someones life and don’t give up hope that they will one day quit. It’s not about being pushy or naggy either. It is about loving that person enough to remind them that there is a healthier way to live.

As always, thanks for reading and following The Gyneco-bLogic!

Is The Pill Making You Crazy? Here’s how to find out…

If you are like me, and many women, you probably started birth control when you were an adolescent or young adult. The pill is commonly used to manage heavy or painful periods, especially the crazy ones that can go along with the beginning of women’s periods.

Simultaneously, adolescence brings about new emotions of its own.

I like to call them, the “bitchy years.” Actually, I don’t call them that, but you know what I mean. Teenagers can easily go from being super sweet and thoughtful to wanting nothing to do with their parents or guardians. Emotions are high. Feelings are on sleeves. It’s a tender time.

Fast-forward to one’s 20s. I know I was a proverbial book-worm during a large portion of my 20s. I was so laser focused on school, I don’t know if I really noticed a change in my emotions due to birth control.

I didn’t realize the effect birth control had on MY temperament until I came off of it.

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It really wasn’t until I came off of birth control in pursuit of pregnancy that I realized how unbothered I now was with little things that used to REALLY bother me. Critiques that used to get under my skin or little chores that I used to DESPISE were no longer that big of a deal. I had multiple revelation moments like this:

“Doc, don’t be mad. We made a mistake on your schedule. Can you see this patient even though she isn’t on the books?”

“Yeah, sure. No problem. Just put her in a room.”

*Thinking* Wow, these mis-schedule patients would have made me so irritated 3 months ago. Why am I so chill right now?

I still don’t think I REALLY put 2 and 2 together until I went back on the pill and found myself more irritable and tearful at things that I had become accustomed to not being bothered by. It became clear to ME that combined oral contraceptives (Estrogen and Progestin containing pills) and I do NOT get along.

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Ironically I have a lot of patients who say that birth control IMPROVES their mood.

I was just talking to a lady this week who said her anxiety and tearfulness is much BETTER when she is on birth control or when she is pregnant. She says it “evens her out.” She is not alone.

Personally, I am in a much better emotional place with my IUD. My progestin-containing IUD makes me feel how I feel OFF of birth control. Even though it still has a hormone in it, the amount is much less than what is in the pill. I know that I am different emotionally because I can still reflect on years of being annoyed by things that presently have me unbothered. Maturity has done some of that, but I KNOW my hormones are part of the change.

The take-home message is that we are all different.

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How we feel emotionally can be affected by our hormone status. Some ladies don’t report ANY mood changes from one birth control option to another or without birth control. Others will cope with day-to-day stresses very differently on the pill versus off.

Don’t be afraid to do your own self-assessment or to try different options. Just be safe and don’t leave your fertility un-controlled while you try to figure it out. Surprise pregnancies have their OWN VERY PROFOUND AFFECT on mood. IJS

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Now You AND Your Sons and Daughters Can Get the HPV Vaccine up to age 45. Here’s why you should…

On October 5th, 2018, the FDA approved the HPV vaccine for men and women between the ages of 27 and 45.

That is in addition to the already established population and youth and young adults between the ages of 9 and 26 regardless of gender.

But recently I came across THIS post on Instagram:

Before getting your daughter or son vaccinated, read this book [The HPV Vaccine on Trial: Seeking justice for a generation betrayed.] It’s a real page turner. This vaccine can severely disable young people and even result in infertility and death. Side effects are very under reported. I have been speaking out about this since the vaccine was fast tracked. Here’s the proof.

I was especially shocked that this post was written BY A GYNECOLOGIST!

The HPV vaccine should not be feared.

Rather it is many boys’ and girls’ first line of defense against a virus that is literally around practically every corner.trust-tru-katsande-501831-unsplash

HPV, or human papillomavirus, is a sexually transmitted virus that can cause many types of cancer.

Yes, HPV is the cause of 75-95% of all cervical, vulvar and penile cancers. (Source: The CDC.)  Not only is HPV the cause of most cervical cancers and GENITAL WARTS, but most people in their lifetime will also be exposed to HPV during sexual intercourse. Quoting a Pubmed article from the Journal, Sexually Transmitted Diseases from 2014:

We estimated the average lifetime probability of acquiring HPV among those with at least 1 opposite sex partner to be 84.6% (range, 53.6%-95.0%) for women and 91.3% (range, 69.5%-97.7%) for men. Under base case assumptions, more than 80% of women and men acquire HPV by age 45 years.

“More than 80% of woman and men acquire HPV by the age of 45.”

That. Is. A. Lot.


While that number seems high, many will never know they have the virus. Our immune system in many cases is strong enough to fight off the HPV virus.

Now, to be fair, vaccines work best before a person is exposed to whatever the vaccine is for. Like if you get the flu, the ACTUAL FLU, the flu vaccine afterward will likely do you no good. Likewise, if you have already been exposed to a strain of HPV, the vaccine won’t protect you against THAT strain. The current HPV vaccine, however, has 9, yes 9 strains of HPV in it. That means, if you haven’t yet been exposed to all 9 of those strains, you will still benefit from it.

Side effects can occur with ANY medication.

What The Hair

Many HPV vaccination nay-sayers quote adverse events that have occurred with the vaccine. Regarding the safety of the vaccine, the CDC says:

More than 80 million doses of HPV vaccine have been distributed since the vaccine was introduced in 2006.

The most common side effects associated with HPV vaccines are mild, and include pain, redness, or swelling in the arm where the shot was given.

All vaccines used in the United States, including HPV vaccines, are required to go through years of extensive safety testing before they are licensed by the U.S. Food and Drug Administration (FDA). During clinical trials conducted before they were licensed:

  • 9-valent HPV vaccine was studied in more than 15,000 males and females

  • Quadrivalent HPV vaccine was studied in more than 29,000 males and females

  • Bivalent HPV vaccine was studied in more than 30,000 females

Each HPV vaccine was found to be safe and effective.

In 2014, CDC published a report analyzing health events reported to VAERS following Gardasil vaccination from June 2006 through March 2014. About 92% of the Gardasil reports were classified as non-serious. (Source: CDC.)

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Here’s to those who saw this change coming before the benefit to people over the age of 26 was established. If I had a nickel for every time someone has asked me,

Doc, I know I am over the age to get the HPV vaccine, but should I get it anyway?

… I would have… maybe 50 cents. So, I guess people don’t ask me a lot about vaccines that they don’t qualify for, but the handful of times the subject has come up, I have always thought that it would be beneficial. At least in theory.

If I were you, I would give it a couple of months before asking your doctor for the vaccine. I only say that because sometimes it takes insurance companies some time to recognize guideline changes and to cover them. Also, check out this post I wrote about Abnormal Pap Tests and what they mean.

Thank you for reading.

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That’s What’s Pap-pening!


Something Is Growing On My Vagina: Here Is Your Top 10 List

Don’t worry, I won’t get graphic.

Photo by Alexander Krivitskiy on Pexels.com

Descriptive yes, but not overly striking images of lesions will be found here. I will leave it to Google Images to show you the absolute worst case of any disease, because that is what Google is good for: Making sure that you know that you could drop dead at any given moment. #ThanksGoogle

Back to the lesson at hand…

Imperfection needs inspection so I’m’ma let ’em understand.

From a Gyn-NE’s perspective,

Every lesion has a reason, look for classic signs and symptoms.

Sidebar- I actually can appreciate the fact that Snoop Dogg included contraceptive use in Nuthin’ But A “G” Thang back in the day. These rappers these days could take a lesson in that, cause ain’t no lovin’ good enough to get burnt while… you know the rest.

Ending that LONG parenthetic pause, again, sometimes even I don’t know what a lesion is until I swab it or take a biopsy. There are some rules of the road that can narrow suspicion though. I am going to try break the top 10 down in systematic way so as to help you know how concerned you need to be, or how far out you can chill.

Ask yourself the following questions. Your answers will narrow down the diagnosis.

  1. Does it hurt?
  2. How long has it been there, and how long did it take to go away if it went away?
  3. Has it changed in appearance or color or multiplied?
  4. Are you sexually active, especially unprotected, and especially with a new partner? (Though things can be transmitted even if you have had the same partner for a long time and use condoms consistently.) 
  5. Is your groin sore/are lymph nodes swollen and tender right in that crease between your legs and your pubic region? 

I tried to color code a key for ease in matching symptoms with the alleged diagnosis, but the complexity was blocking my greatness and giving me a headache. Text colors- back to black for you. 

Here are some common causes of growth on the vagina/vulva as well as their various characteristics.

Get out your handheld mirror and let’s get started.

1. Folliculitis or hidradenitis- aka an ingrown hair or infected sweat gland


These are ingrown hairs and infected hair follicles and sweat glands, classically known as boils. If you have course curly hair, shaving can increase your risk for ingrown hairs. You may need to use an electric hair clipper instead so as to not cut the hair beneath the skin. This doesn’t leave you skin super smooth, but you have to choose which is worst: Stubble or numerous puss filled painful bumps. Being overweight can also increase the risk of developing infected sweat glands that will classically grow and cause pain, prior to rupture. Weight loss can decrease their frequency and severity. These can be treated with warm compresses twice daily and baths. If that doesn’t help, you may need to have them drained by a doctor. Put the needle away, lady. Occasionally I have women use topical or oral antibiotics as well. Let your doctor make that call.

2. Skin tag

Skin tags are fleshy, not painful, small growths that show up usually slowly, and then just stay. They don’t usually enlarge over time, but a person can develop multiple, much like a person can develop multiple moles over time. Skin tags aren’t dangerous but can sometimes be annoying if they get caught in clothing or jewelry. There is nothing wrong with showing them to your doctor to make sure that’s what they are. Biopsies are last resort for any lesion to confirm the diagnosis. Often that is not needed for a skin tag.

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3. Genital warts

Caused by the HPV virus and often sexually transmitted, painless, genital warts also grow slowly but multiply more rapidly than skin tags. They may even grow on top of each other like broccoli or cauliflower. They are also flesh colored but often slightly harder than skin tags. They are not always easy to distinguish from molluscum (next possibililty) even by a trained eye. This is where biopsies come back into the conversation. The skin can be cleaned, numbed and a scalpel can be used to remove a sample. Pathologists can then look at the tissue and tell me what it is. Genital warts are usually pretty easy to treat with medication or manual removal. The pathologists also help to make sure no advanced precancer or cancer is present in the lesion.  #ilovemypathologists

4. Molluscum contagiosum

Constipation Wash Your Hands Small

This is another virus that is transmitted by skin contact and can lead to painless fleshy growths. Biopsies are often necessary to confirm this diagnosis, and these can also be removed in  the office by a gynecologist or dermatologists. In the genital region, these often are sexually transmitted, but they can be present on any part of the body and passed from any skin to skin contact. Hand washing is extremely important with any contact with the genital region. SIDEBAR: LADIES, PLEASE stop showing me your new lumps or bumps by touching your genital region, then without any involvement of soap and water, touching your hair, your phone, my doorknobs in the office etc. Just because you are comfortable with your body, doesn’t mean you need to share that love all around the office. Wash your hands or just tell me where your area of concern is and let me find it without you bare-finger touching the area and carrying on like it’s a regular day. I wash my hands like I have OCD and wear gloves for a reason. I don’t want my pen that you want to borrow to be an unsuspecting vessel for your personal places. 

5. A Mole

A pigmented mole that has any irregularity or is changing in any way should be evaluated for possible melanoma or any other abnormality. If you have had that same pigmented or non-pigmented mole forever and it never has changed, leave that bad boy alone. It isn’t bothering anybody. If it really bothers you, it can be removed, but the likelihood of danger in a painless stable lesion is slim to none.

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6. Herpes

Herpes hurts. An initial outbreak is usually the cause of significant pain and swollen, tender inguinal lymph nodes for days to weeks. Recurrences are usually not as significant. They can cause more mild tenderness, small lesions, itching or tingling. This is where that mirror can come into play. When I diagnose a person with herpes who is having an outbreak but didn’t know she even had the disease, it is usually someone who thinks she just has a yeast infection or “scratched” herself, but never looked down there to see if there was any localized skin break. If you see a small cluster of clear vesicles, or even a single tender pimple like structure or open sore, it is probably worth seeing your gynecologist right away to check it out and run some tests.

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7. Yeast or Candidiasis:

If you are itching and nothing seems to help, the cause may be yeast. Itching is the hallmark. Abnormal smell is an uncommon symptom. Some can develop small bumps from yeast. This is not a common symptom, but I have definitely seen it. I don’t fault a woman for trying an over the counter yeast medication prior to coming in to see her gynecologist. I am not a huge fan of the 1-day over-the-counter meds. I like a 3-day or longer treatment for the best possible chance of treatment.

8. Syphilis

Though it sounds like a diagnosis of yesteryear, it is not. Syphilis is still an STD that is alive and well. If you have a painless ulcerated lesion that is not easily explained or swollen lymph nodes without a good cause (what is a good cause for swollen lymph nodes?), call your Gyne and come in for testing. This lesion could last for 3-6 weeks without treatment but then resolve. That, unfortunately, is the 1st of the 3 stages of syphilis. The good news is that this disease is curable with antibiotics, but the diagnosis needs to be made first.

9. A Tick Bite

You would be surprised how easy it is to not realize that you have a tick that is stick and burrowed into your skin. This can cause a sore lesion with a black scab-like thing in the middle. That “thing” will have legs at first, but then the legs will burrow under the skin along with the head. The problem with pulling ticks out on your own is that the head can break off and stay in your skin. That needs to be removed to avoid infection, and any other tick-bite repercussions need to be monitored for. You won’t find me camping again after it happened to me in elementary school that ONE GOOD TIME. One got me on my torso by my bottom rib. Talk about wanting to jump up out of your OWN SKIN. Ughhhh (as I shake in my seat almost 3 decades later).

10. Bartholin Gland cyst or abscess


This is a painful enlargement of the labia on one side or the other caused by either a blocked or both blocked and infected Bartholin gland. With a mirror, one side of the labia will appear significantly swollen and asymmetric. This is not just a pimple or small lesion. These can sometimes resolve on their own with warm compresses and warm baths. Sometimes, they need to be drained by a doctor and antibiotics may be necessary. Again, PUT THE NEEDLE DOWN. In extreme and recurrent cases, a small catheter needs to be placed inside of it to allow complete drainage or the entire gland needs to be removed. These extremes are infrequent, so starting with tolerable heat twice daily down below is a great first step to try to stop it in it’s tracks. 

If you were looking for more details, feel free to take your curiosity back to Google. Enter Images at your own risk. Better for you to stick with this general guideline and call your doctor for an ASAP appointment if you need more answers to your specific issue.

Don’t worry, you can’t gross me out. I’m a GYNECOLOGIST.

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Take care of her

Photo by Samay Bhavsar on Unsplash

Photo by Warlen G Vasco on Unsplash