The questions you were too embarrassed to ask – answered by a gynaecologist

While we know we shouldn’t be embarrassed to discuss certain topics with our doctors, some questions are just embarrassing to ask. But there’s no need to turn to infamously unreliable Dr Google. Instead, we’ve asked a gynaecologist and sexologist Dr Mpume Zenda – also known as Dr Gynae – to answer all the questions that you were too embarrassed to ask.

How often can I (safely) take the morning after pill?

The morning after pill – also known as emergency contraception – is one of the methods that can be used to prevent an unintended pregnancy after unprotected intercourse, inadequate/failed use of current method, or in the case of sexual assault. Although it’s not advised, it can safely be used more than once in the same menstrual cycle without serious adverse effects. If you find yourself using emergency contraceptive pill more than once per cycle, I encourage you to speak to your gynae/doctor/nurse about a more consistent and reliable method for the following reasons:

• The morning after pill is not as effective in preventing pregnancy as using daily contraceptive pills
• it is generally more expensive per dose than daily contraceptives
• can cause an irregular cycle and spotting
• using a reliable method of contraception significantly decreases anxiety during intercourse therefore improve the quality of the experience.

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Do we really need pubic hair? Is it safe to wax or shave it off completely?

Pubic hair is certainly there for a few good reasons, namely:

• It reduces friction during sexual intercourse
• Traps germs and bugs, therefore reducing your risk of infections including sexually transmitted infections
• Traps pheromones, which are believed to play a role in sexual attractiveness
• Maintains genital temperature

Pubic hair is NOT unhygienic – this is a myth. Pubic hair grooming is purely a preference and, with it, brings its own risk of injury, burns, infections, rashes and itching.

What are the bleached patches in my underwear?

Every woman has experienced this phenomenon. It’s markedly visible on darker underwear and is quite normal. Those bleached patches on your underwear are due to the normal acid ph. of the vagina that ranges between 3.5 – 4.5. Good bacteria called lactobacilli maintains this healthy ph., and when it is disturbed it may results yeast infection (thrush) and/or bacterial vaginosis. So, rest assured there is nothing to worry about.

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Can I fall pregnant during my period?

It’s possible but unlikely. The most fertile period in a woman’s reproductive cycle is during ovulation, when the egg is released. This occurs on around day 14/15 on average, in a regular 28-day cycle. The egg lasts 12 to 24 hours after ovulation and sperm can survive for up to 5 days after intercourse. Women with shorter or irregular cycles where ovulation may be more difficult to predict are more at risk of falling pregnant during their period. While some women may feel less anxious about having unprotected intercourse during menses, because of this lowered chance of conception, this is certainly not a reliable method of preventing pregnancy.

Is it normal that my vagina has an odour? What should a vagina smell like?

A vagina is not meant to smell like strawberries, neither is it meant to be dry. Contrary to the message we’re often bombarded with that we need to buy a range of products to clean our vaginas, the vagina (the canal behind the hymen) is self-cleansing, the vulva (the outer part) needs basic cleaning and grooming. Sadly, many women have become suspicious of even normal changes in the colour, odour and consistency of their vaginal discharge, which naturally changes at different times of the cycle due to hormonal influence.

Post period, you may have a slight odour due to menstrual blood resulting in a shift on pH. Yeast infection presents with an odourless cottage cheese-like discharge and bacterial vaginosis has a white-with-a-greenish-tinge discharge, may smell a bit fishy. Both a yeast infection and bacterial vaginosis are very common and easily treated. When there is an out-of-the-ordinary strong odour associated with copious amounts of discharge, itching, irritation or even pain, it is a sign to see your healthcare practitioner immediately, especially when there has been a recent history of unprotected sexual intercourse.

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Does the contraception I use affect my fertility or ability to have children later on?

The short answer is NO. Fertility refers to your ability to conceive and this is affected by age, genetic factors, hormonal factors (ovulation), underlying medical and gynaecological conditions (like PCOS, endometriosis, fibroids, sexually transmitted infections), environmental toxins, lifestyle habits (such as smoking, use of alcohol /drugs, obesity) and factors relating to male partners.

That said, hormonal contraception such as The Pill, patch, ring, injectables and implants predominantly work by suppressing the release of an egg (ovulation). The intrauterine contraceptive devices work more locally on the womb by making the cervical mucous thicker than usual, making fertilisation (the meeting and fusing of egg and sperm) difficult and making the inside of the womb unsuitable for implantation. With most contraceptive methods, the return to cycle/fertility occurs within 3 to 6 months (it can happen earlier) but injectables take the longest at up to 6 to 12 months. So, please be sure to get a full assessment first and look out for other causes that may be affecting your fertility.