Earlier this year, we re-examined how we think about and talk about our vaginal health. First, we addressed how the language used to talk about the vagina can be problematic. Then, we delved into how our bodies give us important clues about our health if we approach these signs without judgment.
For the final part of this series, we share some actionable tips on how to regularly touch base with your body through a quick and easy sexual health self-check.
Young women the world over grow up learning how to do a monthly breast exam, but we are rarely taught to check in with our genitals. The good news? Many of the same reasons to check on your breast health also apply to your sexual health and wellbeing. Try going through these five steps below on a monthly basis.
NOTE: This self-check is not intended to replace regular checkups with an OB/GYN or general practitioner. Rather, it is a way to stay in tune with what’s happening with your intimate health and detect unusual symptoms if/when they first occur.
How to Perform a Sexual Health Self-Check in 5 Steps
Just like other routine self-checks such as a breast exam, we suggest starting your self-check by looking in a mirror. Conditions ranging from sexually transmitted infections (STIs) like herpes and human papillomavirus (HPV) to inflammatory skin disorders like lichen sclerosus can first show up as changes in the appearance of your genitals. If you get familiar with what your body looks like in its healthy state, you will be better able to detect if and when something unusual appears.
Whether you have a vulva or a penis, you’ll want to find a mirror and a comfortable place to either sit on the floor or stand with one foot up (such as on a chair or a closed toilet seat). Be sure to wash your hands and remove any undergarments beforehand. Once you’re situated, spread your legs, and using one hand to hold the mirror, carefully use your other hand to examine your genitals – including your vulva and inner labia, or penis and testicles, as well as anus.
Are there any unusual bumps, rashes, or discoloration on the skin? Do you see any changes from the last time you performed this check? Is there any abnormal discharge? If so, consider following up with a medical professional, especially if combined with other symptoms listed in this article.
Next, ask yourself if you’ve detected any abnormal or off-odors lately. Vaginas are meant to smell, for example, but it is usually a light smell – not one that is fishy, metallic, or otherwise abnormal for you. An easy way to get clued into your odor is to pay attention when you’re urinating or when changing undergarments. If you feel comfortable, you can talk with your partner for this step of the self-check as they may be aware of any unusual odors.
What to consider: If you get a period, where are you at right now during your cycle? Your scent can change as you move through the menstrual, follicular, ovulation, and luteal phases. Also, are you sexually active? A strong odor can be a sign of an infection, particularly if you engage in unprotected intercourse. Certain STIs such as trichomoniasis can cause an intense, unpleasant odor, and a condition called bacterial vaginosis (BV) can show up as a “fishy” odor.
If you have a vagina, you have most likely experienced your share of discharge (or fluids from your uterus, cervix, and vagina). Even those with penises can experience unusual discharge, and it is important to be aware of this as it is typically associated with STIs like chlamydia, gonorrhea, or trichomoniasis that will need to be treated by a medical professional.
Discharge in women can include menstrual “blood”, thicker mucus that accompanies ovulation, and lubrication from being sexually aroused. Cervical fluids can change throughout the month and may increase or decrease due to birth control, frequency of intercourse, or medications. For this reason, the presence of discharge is not necessarily alarming. It’s helpful, though, to check-in and ask what kind of discharge you’ve seen in the last month. Has there been more (or less) of it? Does it have an off look to it? Is it thicker or does it have an unusual color?
This is important because both yeast infections and bacterial vaginosis can produce atypical discharge. BV tends to result in a thin, gray, and foamy discharge; whereas the discharge from a yeast infection is likely to be white or cream-colored, and it will be thicker, with the consistency of cottage cheese.
As with odor, the key is to look for discharge that’s unusual for you. If you’ve had an infection before, you might think you can just treat it yourself and not worry about checking in with your doctor. However, in the case of BV and yeast infections, they may show similar symptoms, so it’s easy to start the wrong treatment and have to backtrack when the infection doesn’t go away, gets worse, or comes back soon after treatment.
Have you been experiencing any kind of discomfort in the past month? Take your time to consider all the symptoms that can make you uncomfortable like itching, painful erections, vaginal pain or pain with sex, dryness, or skin sensitivity.
Life-stage factors may play a role with these symptoms, like whether you’re going through menopause, pregnancy and post-partum, or menstruation. But itching and pain may also be a sign of a pH imbalance, STI, or vaginal microbiome imbalance. Even changes in urination – including painful urination – can be signs of infection.
Causes of discomfort for those with vulvas:
- Bacterial vaginosis
- Yeast infection
- Pelvic floor disorders
- Pregnancy and post-partum
Causes of discomfort for those with penises:
- Urinary tract infection
- STIs including chlamydia, gonorrhea, genital herpes, or syphilis
- Injury or trauma such as testicular torsion
- Peyronie’s disease
- Yeast infection
Your general practitioner or OB/GYN can help you determine the cause of these symptoms; they may recommend treatment with prescription medication or over-the-counter products that are pH-balanced and body-friendly. You may also be referred to a specialist depending on the root cause.
5. Mood and Libido
Lastly: A good place to end this self-check is to take stock of your overall mood when it comes to your intimate life. Are you feeling interested in sex? Has your level of interest changed since the last time you checked in? If you've noticed a change, is it occasional or is it significantly impacting your libido or sex life?
We know that psychological stressors and issues can manifest themselves in physical ways, including erectile dysfunction or performance anxiety, as well as what's called “arousal non-concordance” – or difficulty matching up your mental and physical arousal signs.
Many of us have experienced an occasional mismatch between our physical and mental readiness for sex. In these situations, we may be mentally aroused but are not experiencing signs of physical arousal. Or the opposite might happen – our body may become aroused at a time when we're not interested in sex. This can cause serious frustration when you're feeling ready to get down with your partner, but find your body just isn't there yet.
You may also be experiencing a fluctuation in sexual desire as a result of a medication you take, such as SSRI anti-depressant medications, or hormonal birth control. If you suspect your medication is impacting your libido, you can talk with your doctor about trying to a different anti-depressant or method of birth control. Even switching to a different type of hormone can have a significant impact on your mood and sex drive.
I Detected an Unusual Sign or Symptom. Now What?
Our bodies communicate with us regularly, but it’s important to remember that what you see from above or with a hand mirror – often at an awkward angle – may not be a holistic view of what’s happening. Even doctors are rarely able to draw conclusions on appearance and symptoms alone. They frequently rely on important screening tools and take samples that can be evaluated under a microscope or processed at a lab.
If you complete this self-check and discover any unusual symptoms, we recommend checking in with your medical provider.
How to Make This Sexual Health Self-Check a Part of Your Routine
Try carving out time by adding a recurring appointment to your calendar and setting a date with yourself. You can add it to your regular self-care routine. One idea: if you perform a monthly breast self-exam, you can take care of both at the same time and turn it into a ritual with a favorite cup of tea and glass of wine.
We believe your health is worth the time spent on this regular self-check. As you get more and more familiar with what’s “normal” for you, you'll be able to better detect when something needs your attention.