the prairie doc

Mentioning the unmentionables


Over the course of my career, I have performed countless pelvic exams on women of all ages from all walks of life. There are two common patient behaviors that I have observed. First, most women leave their socks on. This could be the fact that most stirrups are cold, but it also seems like one feels just a little less exposed when wearing at least one item of one’s own clothing. The other thing that almost every woman does in the exam room is hide her undergarments under her pile of clothes. It is interesting that almost everyone, me included, feels the need to cover and hide their “unmentionables” when they are about to bare the very areas normally covered by these garments.

Therefore, it is no surprise that it can be difficult for women to voice concerns when it comes to their “private areas.” These areas are just that, private! Women do not often visit with family or friends about incontinence, menstrual irregularities or pelvic pain. It may be easy to discuss gallbladder issues or a migraine headache, but it is much more embarrassing to ask a friend if she leaks a bit of urine when she sneezes, jumps or coughs, after birthing a child. This condition is common. It can be treated, but if we don’t talk about it, we may not realize when something is “normal,” or if it is something to be concerned about.

It is perfectly fine for us women to hide our underwear from our health care provider, but let’s not hide our concerns or be embarrassed about discussing the areas covered by these garments. If we choose not to talk about it, what may seem like a minor nuisance could lead to a bigger problem. For example, vaginal spotting or bleeding after menopause is never normal and should always be reported to your provider. It could be caused by harmless uterine fibroids, but it might also be a sign of uterine cancer. The sooner you discuss it with your doctor, the better.

Unfortunately, I have seen too many women who suffer in silence because they figure whatever is happening to them must be “normal” or just a sign of “getting older” or is the “price of having children.” Primary care providers and obstetrician-gynecologists are ready to help you talk about these sensitive topics. When you uncover and discuss your concerns, they will listen, diagnose and treat with care.

So go ahead, keep your socks on and hide your “unmentionable” clothing, but please, never hide your health concerns.

Jill Kruse, D.O. is part of The Prairie Doc® team of physicians and currently practices as a hospitalist in Brookings, South Dakota. Follow The Prairie Doc® at and on Facebook featuring On Call with the Prairie Doc®, a medical Q&A show celebrating its twentieth season of truthful, tested, and timely medical information, broadcast on SDPB and streaming live on Facebook most Thursdays at 7 p.m. central.


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