Most of the time, pelvic pain, spotting, itching, and other symptoms don't turn out to be serious, according to Holly Puritz, MD, FACOG, an obstetrician and gynecologist at The Group for Women in Norfolk, Va.
Even a normal process, such as ovulation, can cause pain.
Pelvic pain, if you can pinpoint the timing of it, can actually reassure you, Puritz
If you have pelvic pain that persists or doesn't ease with simple home treatment, call your doctor, Puritz
Or, get to an emergency room if you can't reach your doctor.
Possible serious reasons for pelvic pain can include:
Fibroids/Endometriosis/PID: When a woman has chronic pelvic pain, doctors will check for benign uterine fibroids and endometriosis.
They will also look for pelvic inflammatory disease, which usually appears as a triad of pelvic pain, vaginal discharge, and fever, Puritz
Ovarian Cancer: Fortunately, most pelvic discomfort isn't related to ovarian cancer, but women should know the disease's unremitting "constellation of symptoms," Puritz
"If you have two weeks of bloating, pelvic pressure, and urinary frequency - and every day, you have it - that's a potential sign that you should be checked for possible symptoms of ovarian cancer."
2. Irregular Bleeding
Irregular bleeding "covers a host of things," Puritz
says: periods that last longer than normal, bleeding mid-month, having two periods per month, bleeding after sex, and other unusual patterns.
Though birth control pills can cause spotting that isn't serious, you may still want to discuss your prescription with your doctor.
"But if you're not on any kind of birth control and you have irregular bleeding that lasts for more than a month or two, I think it should always be checked, even though the odds are, we won't find anything bad," Puritz
But irregular bleeding could also signal:
Perimenopause/Fibroids/Polyps: Abnormal bleeding may stem from multiple causes that aren't serious, among them, perimenopause or uterine fibroids or polyps.
Thyroid problems can affect the menstrual cycle, too, Puritz
Cervix Infection/STDs: In nursing mothers and postmenopausal women, vaginal dryness, combined with friction, can cause spotting after intercourse.
But if you bleed every time after sex, "that's a worrisome sign that the cervix is being easily irritated and usually, there is a cervix infection involved," Puritz
Also, sexually transmitted diseases, such as gonorrhea or chlamydia, can cause cervical lesions that bleed with sex.
Uterine Cancer: If you're postmenopausal, be especially vigilant about any vaginal bleeding; it's a potential sign of uterine cancer.
"You should be seen right away," Puritz
"Uterine cancer, compared to ovarian cancer, is extremely treatable.
It's very curable because it's generally found in an early stage and it has an early warning sign, which is postmenopausal bleeding."
Besides postmenopausal bleeding, any vaginal bleeding before puberty or during pregnancy should be checked out, too, Puritz
3. Abnormal Vaginal Discharge
With vaginal discharge, "abnormal is what the woman decides is abnormal," Puritz
"Women know their bodies pretty well."
Abnormal symptoms include a strong odor; an unusually large amount of discharge; accompanying itching, burning, or irritation; unusual color; or blood in the discharge.
These symptoms can be the result of:
Common Infections: Most causes of abnormal discharge are minor, Puritz
Women may have itching without discharge, a problem that Puritz
sees frequently when patients use perfumed soaps or personal care products -- especially perfumed lubricant jellies.
"Just about all perfumed lotions and potions can wreak havoc," she
says, "especially if you have sensitive skin, that can cause a lot of itching and irritation."
Although genital itching isn't likely to be serious, it's still a good idea to tell your doctor if it's bothersome.
The fix might be simple.
However, "if it's itching and there are skin changes, that would be a worrisome sign," Puritz
Potential serious conditions can include:
Lichen Sclerosus: For example, a skin condition called lichen sclerosus can cause itching and small, white spots on the vulva.
The spots grow into bigger patches that turn thin and crinkled.
Lichen sclerosus is an uncommon problem that tends to affect older women, Puritz
"It's something that needs to be medically treated," she
Vaginal Atrophy: But "vaginal atrophy is really important to address, especially for postmenopausal women," Puritz
Because older women have less estrogen, their vaginal tissue thins or atrophies and becomes dry and irritated.
Not only does vaginal dryness make sex painful, but vaginal thinning also leaves women more susceptible to infections.
Women shouldn't be embarrassed to mention vaginal dryness to their doctors, Puritz
Women may find relief with estrogen creams, rings, or tablets that are applied or inserted directly into the vagina.
6. Sores or Lumps
Some women develop sebaceous cysts and skin tags in the groin area, or a pregnant woman may get varicose veins that feel like a lump on the vulva when she
"All would be very benign things," Puritz
But some lumps or sores can be serious, so it's prudent to have your doctor examine them to rule out:
Herpes/Cancer: Sores in the genital area may point to herpes or cancer, Puritz
Symptoms of cancer of the vulva include unusual lumps, wart-like bumps, or red, flat sores that don't heal.
Sometimes, the flat sores turn scaly or discolored.
Melanoma: Also, melanoma, a form of skin cancer, can occur on the vulva, Puritz
Symptoms include bluish-black or brown, raised moles in the genital area, including the opening to the vagina.
Patients are often surprised by the disease, she