Once you've had a baby, you're used to baring it all with your ob-gyn. Yet if you're like many women, you're still shy about sharing everything with your doctor. One survey of more than 3,000 American patients found that half keep important information from their health-care provider and nearly 40 percent minimize their symptoms.
We get it. No one likes a lecture, and certain topics can be rather embarrassing to discuss. However, staying mum can be hazardous to your health. This is when it's time to tell the whole truth and nothing but.
1. "Sex really hurts."
Does even the thought of it make you wince? One in three women experiences some degree of discomfort during intercourse, found a study in the Journal of Sexual Medicine. The months after childbirth may be particularly difficult. "Your fluctuating hormones cause vaginal dryness, especially if you're breastfeeding," says Parents advisor Laura Riley, M.D., director of labor and delivery at Massachusetts General Hospital, in Boston. "Plus, it takes time to heal from a C-section, an episiotomy, or vaginal tears." But if you're well past your postpartum days and still experiencing discomfort of any kind, you should talk to your doctor. "Painful intercourse isn't the norm. It shouldn't be something you have to grin and bear," says Dr. Riley.
After performing a pelvic exam, your doctor might prescribe an estrogen cream to alleviate any vaginal dryness. If that's not the issue, there may be other possible causes of your pain or discomfort, including tightening of your vaginal canal as the result of healing. Pain during sex could even be from a lack of desire or arousal—so if you think that could be a factor, discuss it with your doctor.
2. "I'm not bonding with my baby."
The all-consuming demands of caring for a newborn, including those endless diaper changes, constant feedings, and sleep deprivation, can take their toll. Most women will experience some feelings of sadness or mood swings within the first week or two following childbirth, and it's even normal to have days when you start to question whether you're cut out for parenthood at all.
But if those emotions linger, you could be suffering from postpartum depression, a more serious mood disorder that affects up to 20 percent of new mothers. Letting your doctor know about what you're feeling is critical for your well-being, as well as your baby's. "Depression, whether it occurs right after you give birth or not until years later, usually isn't something that will get better on its own," says Dr. Riley. Counseling, behavioral interventions, or antidepressants are all options that can help you start feeling healthier and happier.
3. "I'm beyond tired."
Moms always struggle with exhaustion at points, but extreme fatigue accompanied by dry skin, constipation, weight gain, or feelings of depression could be a sign of hypothyroidism, an autoimmune condition in which the thyroid gland doesn't produce enough hormone. The National Institutes of Health estimates that up to 10 percent of women develop some type of thyroid disorder within a year after giving birth.
Because most doctors don't typically screen for thyroid issues, it's important that you let your physician know when you're feeling out of sorts. One sign that something may be amiss: You struggle to lose your baby weight despite eating a healthy diet and exercising regularly. If blood tests show that your thyroid is underactive, you'll take a synthetic hormone in the form of a daily pill. In 80 percent of women with postpartum hypothyroidism, their thyroid gland will begin functioning properly again within 12 to 18 months of starting the medication. However, some moms require lifelong treatment.
4. "I wet my pants every time I sneeze."
Nearly half of all women who are of childbearing age suffer from some urinary incontinence. A vaginal delivery puts a lot of pressure on your pelvic-f loor muscles and weakens them. But simply carrying a baby for nine months also strains these muscles, which is why women who deliver by C-section aren't leakproof either. "Urinary stress incontinence is absolutely treatable, yet many women think it's a condition they have to live with," says Meadow Maze Good, D.O., assistant professor of obstetrics and gynecology at the University of Florida College of Medicine, in Jacksonville. Kegel exercises are often all that you need to rehabilitate your pelvic muscles and stop urine leakage. However, if you've tried those but still regularly dribble a little, you're probably not doing them correctly. "Your doctor can teach you the proper technique so you're tightening only the pelvic muscles and actually getting results," explains Dr. Good.
5. "When it comes to birth control, sometimes we wing it."
You aren't the only couple rolling the dice. Slightly more than half of all pregnancies in the U.S. are unplanned, according to The Guttmacher Institute. And a survey from Teva Women's Health found that two out of five women of childbearing age regularly skip contraception, in part because they underestimate their chance of getting pregnant. "You might think, 'Oh, we're not having sex that often.' But it only takes one time without protection," says Dr. Good. It's possible to get pregnant as early as four weeks after giving birth, so new moms aren't "safe" either. And if your period hasn't resumed yet, there's no real way to know when your fertile days might be.
Yes, condoms can kill the mood, and that daily pill isn't always easy to remember. "There are so many birth-control options available these days. Often, it's just a matter of finding the right one for you," says Dr. Good. For instance, IUDs have a less than 1 percent failure rate, are effective for three to ten years, and require virtually no effort aside from a monthly self-check to ensure that the device is in place. Plus, if you're ready to add to your family, your doctor can easily remove it.
6. "I haven't exactly kicked the habit."
An occasional cigarette might not seem like a big deal, but research shows that one to four per day triples your risk of a cardiovascular event such as a heart attack or stroke. "Nicotine contributes to high blood pressure and it may affect your artery walls as well," explains J. Joseph Speidel, M.D., codirector of the University of California San Francisco's Bixby Center for Global Reproductive Health. The estrogen found in certain birth-control pills, the patch, or the vaginal ring increases your risk even more. When your doctor knows about your habit, she may suggest estrogen-free contraceptives like the progestin-only mini pill, an implant, an IUD, or the DepoProvera injection. You can also discuss a smoking-cessation method that will work best.