People can be very shy about their vaginas. Whatever your reasons for that might be, there’s one person you should totally not feel shy about discussing your vagina with at all. And that’s your doctor.

Yet according to a new study, nearly two-thirds of women dealing with some type of vulvovaginal issue related to menopause (like vaginal dryness, soreness, itching, and the like) didn’t discuss it with their doctor at their annual well-woman visit.

The research, which will be presented during the North American Menopause Society Annual Meeting in Chicago this week, surveyed 1,500 postmenopausal women. Of them, 45% reported some type of vulvovaginal issue, but just 39% of those who did have such an issue talked to their doctor about it. To make matters worse, doctors also weren’t asking about vaginal health either—when conversations about it did take place, the doctor had initiated that talk in just 22% of cases. Of women who did not talk to their doctors about their vaginal health, 74% were experiencing vaginal dryness and 20% were experiencing itching in and around their vagina.

What’s the deal?

There are many possible reasons women aren’t having these conversations with their doctors. Folks with vaginas might be more likely to be self-conscious about their bodies and the ways in which they fall short of bizarre cultural ideals; meanwhile, we also see so few examples of actual vulvas and vaginas in pop culture and in our daily lives, it might be harder to tell what’s “normal.” Some people might also see vaginal health as inherently tied to sex, and they might see sex as something that should be kept private. Add that to the lingering judgment some communities might still have about women having sex at all, and we create a situation where people can be pretty uncomfortable discussing anything even vaguely related to their vaginas. And that can pave the way for a lot of health issues going unchecked.

“People are always shy to talk about any sexual issues with their physicians,” board-certified obstetrician-gynecologist Lakeisha Richardson, FACOG, recently told mbg. “I wish patients would definitely be more open about any health problems that they are having. I see too many women who suffer in silence.”

Here’s the thing: When women did talk to their doctors about their vaginal issues, 83% of them were satisfied or very satisfied with the results of the conversation.

“Overall vaginal health can be tackled with various easy (and natural) approaches,” OB/GYN Anna Cabeca, D.O., writes at mbg. “Don’t be embarrassed, and do proactively bring up all of your symptoms. Research shows women routinely do not discuss vaginal dryness with their doctor. In one study…75% of these women had experienced their symptoms—without trying to do anything about them—for at least a year.”

Other recent research also suggests not feeling comfortable talking about your vaginal health with your doctor may be one of the underlying reasons women’s sex lives become less satisfying as they get older. Meanwhile, talking regularly about your vaginal health and sex life has been linked to having better sex.

Even if you don’t care about sex at all, there’s no reason you should have to put up with a perpetually uncomfortable vulva or vagina when many conditions are totally treatable. If you’re experiencing any kind of discomfort or pain down there (including pain during sex—that should not be a thing!), talk to your doctor about it.