A cause for concern?
As a new campaign reminds women to get certain gynae changes checked out, Dr Anita Mitra tells LISA SALMON what to be aware of
EVERYTHING from embarrassment, to not knowing what’s normal can mean some women don’t seek help for gynaecological problems – potentially allowing symptoms to worsen or become much more serious.
In a bid to help women understand what gynaecological symptoms may need checking, The Eve Appeal and Dr Anita Mitra, aka the Gynae Geek (gynaegeek.com), have launched the new Be Gynae Aware campaign, sponsored by GlaxoSmithKline (GSK), which includes a checklist of issues it’s advisable to keep track of.
Here, Dr Mitra explains what’s on the Be Gynae Aware checklist...
Abnormal bleeding
“There’s no such thing as a ‘period’ after menopause, and this should always be investigated, as should bleeding after sex and between periods,” advises Dr Mitra, who says less sinister causes may be polyps, cervical ectropion (cells growing outside the cervix), or atrophic changes (thinning, drying and inflammation of the vagina related to lack of oestrogen).
Pelvic/abdominal pain
This may need investigating if it’s different from normal period pain. Common causes could be ovulation, endometriosis, adenomyosis, fibroids, cysts, pelvic inflammatory disease, or infections.
In the worst-case scenario it could be linked to cervical, endometrial and ovarian cancer.
Menstrual cycle changes
Changes in your menstrual cycle may relate to its length, volume of blood, or cramps. Dr Mitra says it’s worth seeing a doctor if periods become much heavier or much more painful.
Change in discharge
This may be a change in colour, blood-staining, itchiness, or a bad smell. “Again, it’s worth keeping a note if there are any connections to certain times in the menstrual cycle,” Dr Mitra advises. Changes in discharge are most commonly related to infections, but can be linked to cervical cancer.
Pain during sex
This may be superficial but may need investigating. Common less sinister causes could be endometriosis, fibroids, cysts, vaginismus, vulval skin conditions, or even constipation.
Worst-case scenario, it may be linked to cervical or ovarian cancer.
Itching pain/swelling of the vulva or vagina
Vulval itching can occur alongside or independent of skin changes, says Dr Mitra, and may also be associated with a change in discharge.
Common causes are thrush, infections or lichen sclerosus (a skin condition that can cause itchy white patches on the genitals). More rarely, these symptoms may be linked to vulval cancer.
Skin changes/lumps on the vulva
The vulval skin can become very pale, pigmented (coloured) in places, or become red or flaky, says Dr Mitra. Most commonly, such changes are linked to thrush, dermatitis, folliculitis, lichen sclerosus or atrophic changes. Rarely, they can be a sign of vulval cancer.
Persistent bloating
If your abdomen is constantly bloated, and doesn’t seem to change according to the time of day, or have any relation to food, Dr Mitra warns: “This can arise from big masses such as huge fibroids, cysts or tumours, but also if you have ovarian cancer because your abdomen can become full of fluid.”
Change in bowel/urine habits
“Our bowel and bladder lie next to the uterus and ovaries, so if there’s pressure from these things they can cause changes in the bladder or bowels, such as needing to pass urine more often, incomplete emptying of your bladder so you feel you need to go again right away, constipation or even diarrhoea.”
Common causes may include urine infections, IBS, large fibroids or endometriosis, and in the worst case scenario they could be linked to ovarian cancer.
■ The Eve Appeal’s free information service Ask Eve on 0808 802 0019, or email nurse@eveappeal. org.uk