Women's Health

The field of women’s health goes far beyond birth control and pap smears.  There are many things to learn and to do to keep you healthy.  Routine visits to your provider can offer information, screening, and early treatment for many of the health issues that women may experience.

This section has information about:

Vaginal and Urinary Tract Infections

Infections are the most common reason women seek gynecologic care.  Itching, burning, discharge and bumps “down there” can be scary and irritating at the same time!

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Vaginal Infections or Vaginitis

Vaginitis has many causes:

  • Yeast Infections
  • Bacterial Vaginosis
  • Trichomoniasis
  • Allergies or Irritation
  • Decreased Estrogen

 

Let’s look at each one:

Yeast Infections

Caused by an overgrowth of the normal yeast cells found in the vagina.

Symptoms:  

  • Vaginal itching and often a thick, white, clumpy discharge
  • The labia may become red and swollen
  • It might hurt to have sex or insert a tampon
  • Some women also experience frequency of urination or burning

Why did it happen?  

Overgrowth of yeast can happen with the use of some antibiotics and other medications, high blood sugar levels (diabetes), changes in your immune system or hormone levels, pregnancy, and a vaginal environment that is too warm and/or moist.

How can I tell?  

Your provider can diagnose yeast vaginitis with a brief exam in which samples of the discharge can be sent to the lab for evaluation.

How is it treated?  

There are over-the-counter vaginal crèmes that are effective.  Your provider can also give you a prescription for an oral pill that works very well.

What else do I need to know?  

Men can get yeast infections on the penis or scrotum.  These can be passed between partners but are easily treated and not considered an STD.  You can also get an overgrowth of yeast in the mouth or throat.

Bacterial Vaginosis

Find out more at our page about STD's.

Trichomoniasis 

Find out more at our page about STD's.

Allergies and Irritants

Caused by sensitivity to ingredients in a variety of products (douches, feminine hygiene sprays, scented toilet paper or pads/tampons, bath products, detergents and fabric softeners, latex, spermicide, lubricants, just to name a few!)

Symptoms

Vaginal itching, discomfort, redness or even pain.

How can I tell?  

Your provider can do an exam and ask you about the products you may be using.

How is it treated?  

Removing the offending product is the best way to treat it.  Your provider may prescribe medication to help reduce the irritation and keep you more comfortable.

What else do I need to know?

The vagina is a delicate environment.  Avoiding perfumed personal care products, douches and sprays, lets your body maintain its own “normal.”  Avoiding tight garments, sleeping without underwear, and getting out of wet bathing suits in a timely manner will help keep the vagina happy and in balance.

Decreased Estrogen

Caused by a decrease in the circulating estrogen (one of the main female hormones).  This can happen with some birth control pills as well as in breastfeeding and menopausal women.

Symptoms

A feeling of dryness, irritation, and often pain with sex.

How can I tell?

Your provider will do an exam to visually inspect the outer and inner tissues.

How is it treated?

Correcting the hormone levels with a stronger pill or topical cream will help.

What else do I need to know?

Some women experience a bit of dryness at certain times of their menstrual cycles.  This is normal and often corrects itself.  If it persists, see your provider for advice.

More information:

Check out Planned Parenthood's page about yeast infections.

Urinary Tract Infections (UTI’s or It Burns When I Pee!)

Most women will get at least one UTI (also called bladder infection or cystitis) in their lifetimes. 

A woman’s urethra (the tube where the urine comes out) is shorter and closer to the vagina and anus than a man’s, and can more easily be exposed to bacteria that can travel to the bladder.  Some STD’s can also cause UTI’s.

Symptoms

Burning with urination is the most common.  Many women will also experience frequent urination and the feeling that you need to urinate all the time.  Some women may leak urine or have lower abdominal or back pain.  Your urine may look or smell different.  If the infection isn’t treated promptly, it can go to your kidneys and result in fever, nausea, and vomiting.

How can I tell?

Your provider will order a urine test that can be done at the health center.  This will be examined for blood, bacteria, and other markers of infection. Sometimes the sample will be sent for a culture.

How is it treated?

There are several very effective and inexpensive oral antibiotics that can be used to treat the infection.  There is also a medication (AZO) that helps relieve the burning and discomfort. *Caution:  Do not take AZO just before you come to the clinic.  The dye in the medication will reduce the accuracy of the urine test!*

What else do I need to know?

There are several things you can do to prevent UTI’s.

  • After urinating, wipe from the front to the back ONLY.
  • Empty your bladder after sexual activity.
  • Drink plenty of water daily.
  • Wear cotton underwear and remove them at night.  Change daily.
  • Avoid feminine hygiene products and douches.

For more information, visit Planned Parenthood's page about Urinary Tract Infections.

Menstrual Problems

Having your menstrual period is a normal part of a healthy life.  But sometimes, things can go awry. 

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What’s normal?

If you are not on birth control pills:

  • Menstrual (vaginal) bleeding that occurs every 21-42 days.
  • Amount of bleeding will vary from heavy (8-10 pads or tampons per day) to light (1-2 pads or tampons per day).  Often will start heavy and taper off toward the end.
  • Color of bleeding can be bright red to dark red to pink.
  • Some cramping may occur.
  • Mild bloating and breast tenderness are common.

If you are on hormonal birth control:

  • Menstrual bleeding will usually occur every 4th week.
  • Periods are often lighter than before.  Some women may stop bleeding completely (and that’s OK!)
  • Bleeding may be pink to dark red.
  • Less cramping.
  • See Hormonal Contraception for more information

What’s NOT normal?

  • Cycles that are less than 21 days or more than 40 days.
  • Cycles that stop for 3-6 months at a time (and pregnancy has been ruled out).
  • Bleeding in the middle of the cycle.
  • Bleeding that lasts more than 10 days per month.
  • Excessively heavy bleeding.  Soaking a pad or tampon in an hour for more than 2 hours.
  • Cramping or pelvic pain so severe that makes you miss work or school.

What can cause changes in your period?

  • Hormonal Birth Control
  • Hormonal Imbalances
  • Some other medications
  • Illness
  • Excessive weight loss or gain, excessive exercise
  • Pregnancy
  • Poor nutrition
  • Stress
  • Travel
  • See your health care provider if your periods become abnormal.

The Well Woman Exam

The well woman exam is a very important part of your health care.  Reproductive and other health care concerns can be addressed and evaluated.

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Do I need a Pap Smear and Pelvic Exam?

  • In most cases, pap smears and pelvic exams may be deferred until age 21
  • Campus Health Services DOES NOT require Pap Smears and Pelvic Exams to obtain birth control
  • Pelvic exams may be done prior to age 21 if you have a gynecological problem that needs to be addressed
  • Pelvic exams are not always needed for STD screening

What does the Well Woman Exam include?

  • The nursing staff will measure your height and weight, take your blood pressure, pulse and temperature, and take you to the exam room.
  • Your provider will first review your health history (make sure you fill it out online before your appointment) and talk with you about any concerns you may have.
  • The components of the exam will be explained and may include:
  • Thyroid exam (for lumps or swelling)
  • Heart and lung exam (for heart murmurs and lung sounds)
  • Breast exam (for masses or changes)
  • Abdominal exam (for pain or masses)
  • Pelvic exam (for pap smear and vaginal exam)
  • Lower extremity exam (for vein problems)
  • Any other body parts of concern to you or your provider

What about the pelvic exam and pap smear?

It’s perfectly normal to be nervous about your first pap smear and pelvic exam.  It involves looking at and feeling a part of your body that is very private and protected.  Your provider will outline all the steps involved before doing the exam. 

The Pelvic Exam
  • You will be positioned on the table with your feet in stirrups to allow good visualization of your genital area
  • A light may be positioned to assist the provider in seeing the examination area
  • Wearing gloves, the provider will gently touch your vulva (the outer area) and move this tissue to inspect the area for discharge, lesions, or other abnormalities.
  • To inspect the inside of the vagina, the provider will first feel, with one finger inside the vagina, for your cervix
  • Then to hold the walls of the vagina open, a speculum is inserted.  You may feel pressure with the speculum inserted
  • After visualizing the cervix, the provider can obtain samples of the cells for the Pap Smear.  Samples for STD screening can be obtained at the same time if necessary 
    Pelvic Exam 1
  • The final part of the exam assesses the internal organs.  The provider will insert one or two lubricated and gloved fingers into the vagina while using the opposite hand to press gently on your abdomen.  This allows evaluation of the uterus, tubes, and ovaries
     Pelvic Exam 2
  • Rectal exams are rarely done.  Your provider will explain if one is needed
The Pap Smear

The basics:

  • Part of the well woman exam is the pap smear, the collection of cells from the cervix.  These cells can then be microscopically examined for changes that can be related to HPV or show early signs of cervical disease, which can lead to cervical cancer
  • Many young sexually active women carry the HPV virus, but only certain types can cause cellular changes that can later lead to cervical cancer.  Early detection and appropriate treatment are the best defense
  • Pap smears are now recommended starting at age 21.  Your provider will advise you on the current recommendations for repeating pap smears

What if my pap smear is abnormal?

  • Your provider will contact you if your pap smear is abnormal
  • In some cases, a secondary examination is recommended and can be scheduled at Campus Health Services
  • This exam, called colposcopy, examines the cervix under magnification to determine if there are areas that need to be sampled, or biopsied.  That tissue is evaluated by a pathologist to determine the type of changes.  The best treatment can then be offered
  • Many times, and especially in college age women, the best treatment is time and repeat pap smears at shorter intervals

How can I prevent cervical cancer?

  • Use condoms consistently
  • Consider getting the HPV vaccine
  • Get Pap smears done at the recommended intervals and followup with the recommendations of your provider
  • Stop smoking.  If you have HPV disease, smoking increases the chance of developing cervical cancer

What else do I need to know?

Visit Planned Parenthood for more information about Pap and HPV tests.

Sexual Assault and Relationship Violence 

If you have been the victim of a sexual assault, you have rights! You have the right to a comprehensive medical and forensic examination performed by a specially-trained medical professional in a safe and confidential environment. This exam may include treatment for prevention of STDs and pregnancy, treatment of injuries, and collection of forensic evidence. Even if you’re unsure whether or not you’d like to report the sexual assault to the police, you are still entitled to this exam!

Your Campus Resource

NAU Police:  523-3000

Flagstaff Resources

Rape is never your fault and it is never too late to seek help.