On Your Health

Check back to the INTEGRIS On Your Health blog for the latest health and wellness information for all Oklahomans, published three times a week.

10 Women's Health Questions, Answered.

In honor of Cervical Health Awareness Month, you asked INTEGRIS physician, Dr. Lacy Parker, women's health questions for our Ask the Doctor series. Here are her answers:

What is a normal smell for a vagina? When should I be worried? What can I do if I think I smell funny?

Vaginal odor can vary from person to person. However, a new or unusual odor can be a sign that you have an infection. Your doctor can perform a test to determine if you need treatment. I advise against douching, as it can disturb the normal acidity of your vagina and lead to infection.

Sometimes I know something is “off” down there, I feel dry and itchy and uncomfortable, but yeast infection medicine doesn’t work. What does this mean, and what can I do about it?

Itching and irritation of the vulva and vagina can be caused by a yeast infection, but other conditions can also cause these symptoms. When over-the-counter medication fails to provide relief, you should contact your doctor for an appointment. He or she can evaluate if you have an infection not caused by yeast, or if another process is the cause of your problem.

Is there anything I can do about PMS? I have terrible mood swings and feel really depressed for a week before my period.

One effective treatment for PMS is an antidepressant medication. Prozac, Zoloft, and Paxil have been approved by the FDA for this purpose.

Another strategy is to control the fluctuations in hormones that probably cause mood disturbances. This can be achieved by birth control pills, which provide a steady level of hormones throughout the month instead of the varying levels that occur naturally.

What's the protocol for pap smears after a hysterectomy?

We received several questions related to this topic:

1. Should I have a pap done if I've had a total hysterectomy 15 years ago? I'm 52 years old and a non-smoker.

2. If I have had a vaginal hysterectomy and no longer have my uterus and cervix but still have my ovaries do I still run a risk of getting cancer in my vagina and ovaries, and if so, what are the odds of it occurring? Do I still need to have a pap smear done yearly?

3. I have had a complete hysterectomy. Should I still get a pap smear, and if so, how often?

4. I have had a hysterectomy. I was only 35 so they left my ovaries. I have only had two pap smears since. Is there a reason to continue getting a pap smear? I am now 58. 

5. If a person had HPV virus and later had a hysterectomy but the ovaries were left is cancer still possible?

These questions involve a common theme: pap smears after hysterectomy. It is important first to understand female pelvic anatomy and different types of hysterectomies.

cervical-health-diagram

Hysterectomy means surgical removal of the uterus. It can be a total hysterectomy, which includes removal of the cervix and uterus together:

total-hysterectomy

Or a subtotal hysterectomy, which means the uterus is removed but the cervix is left intact. This is also known as a supracervical hysterectomy:

subtotal hysterectomy

Removal of the Fallopian tubes is called salpingectomy, and removal of the ovaries is called oophorectomy. If these two structures are removed together, the term salpingoophorectomy is used.

Takeaway: Pap smears are a screening test for cervical cancer. If your cervix is removed and you do not have history of cervical cancer, you do not need further pap smears. Ovarian cancer cannot be detected by a pap smear.

I’ve noticed some painful bumps down there. What are they, and how do I know if it’s something more serious?

It’s hard to know what these could be without doing a physical exam to look. I often see women who have irritation from shaving, but you can find out for sure by scheduling a visit with your doctor.

After multiple pregnancies I’ve developed a terrible case of hemorrhoids that won’t go away with home treatment. What can I do about it?

A general surgeon or a colorectal surgeon can determine if your hemorrhoids require surgical treatment or not. In the meantime, you can ensure that your hemorrhoids to not worsen by avoiding constipation. Staying hydrated, eating plenty of fiber, and taking an over-the-counter stool softener can help you achieve regular, easy bowel movements.

Do you have other women's health questions you want answered? Make an appointment at Lakeside Women's Hospital with Dr. Parker or any other INTEGRIS OBGYN clinic.

Dr. Lacy Parker earned her Bachelors of Science degree in biochemistry from the University of Arkansas in 2007 before returning to her home state of Oklahoma to complete her medical degree from the University of Oklahoma in 2011. She then completed her Obstetrics and Gynecology residency training at the Lankenau Medical Center near Philadelphia, Pennsylvania in 2015.

Dr. Parker joined Lakeside Women's Hospital in 2015 with special interests in obstetrics, adolescent gynecology, and minimally invasive gynecological surgery.

Dr. Parker is now accepting new patients. Please call 405-936-1000 to schedule your appointment today.

February is American Heart Month.  Submit your heart health questions to Ask the Doctor by February 19th.

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