The 5 embarrassing health symptoms NO woman should ignore

July 28, 2015  22:50

Writing for Healthista, doctor Deyo Famuboni reveals her ultimate guide to what’s normal, what can go wrong and what can be done about it...

PAINFUL SEX

The vagina can become painful during sex - a condition known as superficial dyspareunia which usually occurs when the vagina is too dry or inflamed because of an infection. Foreplay and lubrication helps. 

As opposed to superficial dyspareunia which is felt in the entrance or wall of the vagina, deep dyspareunia is pain in the lower abdomen or pelvis during sex and this can happen due to several conditions including endometriosis and fibroids. 

If you are concerned you have an infection or get deep dyspareunia, see your healthcare professional. Swabs and possibly a pelvic ultrasound can then be organised.

Sex can also be painful because of a condition called vaginismus. 

This is due to the muscles around the vagina going into spasm on attempted penetration. 
If severe, it can even happen on inserting a tampon. It is good to discuss it with your doctor so that causes of this can be explored and treatment to gradually desensitise the vagina, such as dilators, is readily available. 

Also known as vaginal trainers, dilators are rod shaped instruments which come in graduated sizes. 

Used as part of a holistic treatment for vaginismus, it can help improve control of the pelvic floor reflexes and muscle tightening that contributes to vaginismus.

BLEEDING

Taking the combined contraceptive pill irregularly can cause bleeding or spotting in between your periods. If it persists after taking it regularly then a visit to your doctor is warranted.

Other forms of contraception such as the mini-pill (the one with one hormone), the injection, the implant (the one in the arm) and the intra-uterine system (known as Mirena) can cause your periods to be irregular.

As long as there no concerns regarding infections and scans, if indicated are normal, this tends to settle over time.

Bleeding after intercourse also needs a review as it could be due to a polyp – this is a benign growth and easily removed.

Other causes include changes on the cervix and cervical or rarely, vaginal cancer. With these, in addition to bleeding after intercourse, you may get copious amounts of discharge.

A one off mild bleed after a particularly rough episode of intercourse is probably no cause for concern.

DISCHARGE

From puberty to menopause, having some vaginal discharge is normal. 

The quantity can vary from person to person and throughout our cycle. 

The first few days of the cycle is your period, following this, the discharge can be white, creamy or yellow, thick and sticky. 

Ovulation then occurs and the discharge changes to slippery, clearer, stretchy and wet. 

Following this, if you don’t fall pregnant, it then changes to thick and sticky, becoming hostile to sperm. 

Discharge becomes abnormal if there are other symptoms with it or the colour and amount changes, for example, becoming chalky white with candida or frothy yellow or green with trichomonaisis, a sexually transmitted infection. It is therefore important to be sexually responsible. 

Hormonal contraceptions and having a condition where the inner lining of the cervix protrudes outward (called, ectropion) can also change the discharge so it becomes copious. .

Other causes of an increase in the amount of discharge include cervical polyps (a non serious growth on the cervix which can easily be removed), forgotten tampon, douching, allergic reaction for example to a spermicide, and rarely, a connection between the bladder or bowel and the vagina (a fistula). 

A condition we worry about is cancer and if affecting the vagina, cervix or lining of the womb, can also cause an increase and change in the type of discharge such that it becomes thinner and blood stained. 

Should this happen, see your health care professional, who would offer a vaginal examination to ensure it looks healthy and onward referral if required.

Just like the armpits, the skin around the labia has a lot of sweat glands. 

The vagina also produces fluid to keep it healthy and maintain balance at an acidic level. 

With exercise, it is normal to sweat more in these areas, so dont be alarmed if the crotch of your gym wear is damp after exercise. It is a good thing as it prevents friction, chaffing and overheating.

LUMPS AND BUMPS

Most commonly due to an ingrowing hair, this is more common in those with elliptical shaped hair shafts. 

Shaving or waxing contributes to this and can be best prevented by shaving or waxing in the direction the hair grows. 

Hair removal using a depilitator or laser by a trained professional also helps. Depilitators, however, can make the vulva skin dry and irritable. 

Other non-worrying lumps are remnant of the hymen (redundant, irregular bits of skin), which may become more obvious with weak pelvic floor muscles (causing a prolapse), or glands on either side of the vagina called bartholins which produce bits of mucous. 

These can become infected so if painful and swollen, require medical attention and drainage. Keep up with the pelvic floor exercises (kegels). 

Just like with any part of the body, sebaceous cysts (fluid filled sac that is not infected or painful), warts, boils or abscesses can also occur around the vulva. 

A review by your doctor is warranted should these occur as if infected, would need treatment. 

The surface of the vaginal wall can also feel bumpy as it is made of tissue which can retract and expand when needed.

ITCH

The most common, familiar reason for this is thrush, which is often accompanied with a chalky discharge. 

Easily treated by over the counter antifungals such as as Canesten, if this is the first time or not settled with treatment, it is worth seeing your healthcare provider to rule out other causes. 

We can easily disrupt the normal vagina flora and protective layer of outer skin by using scented products, douching and over drying. 

This can lead to dermatitis- inflamed skin.

Other skin conditions can also affect areas around the vagina and cause itch. 

This includes eczema, lichen planus (itchy and sore white streaks or patches with discharge around the vulva and vagina) and the vulval dystrophies (disorders of the skin growth around the vulva.

It can also be caused by lichen sclerosus - an itchy, sore area around the vulva which then changes to a pale colour and the skin looks shrunken. 

These can be treated by vulval dermatologists, specialists in conditions affecting the skin around the vagina, which you can ask your GP for a referral to.

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