5 intimate symptoms you should never ignore
Many women endure problems that can be easily treated because they’re too embarrassed to talk to their GP. But it’s important to acknowledge intimate issues. Here’s my guide to the vaginal conditions you may be secretly concerned about.
1. You’re ‘leaking’
Stress incontinence is when there’s increased pressure on the bladder, causing you to leak urine, and can occur when a woman laughs, coughs or exercises. It’s not abnormal to occasionally pass a little urine when you do these things, but if it happens regularly, you should seek help.
The problem occurs when trauma to the area, most usually childbirth, weakens the pelvic floor muscles. If exercises really don’t help, stress incontinence can be treated with surgery, where synthetic tape is used to support the urethra and bladder neck and lift it into place.
2. It stings when you wee
There are a few types of cystitis, all with similar symptoms: stinging or pain on urination; needing to urinate often but only passing a small amount when you do; and sometimes, traces of blood. Your doctor will check your urine for infection and may treat with antibiotics if necessary.
If it isn’t an infection, drink lots of water, empty the bladder before and after sex, and use a lubricant as damage is more likely if the vagina is dry. Bruising of the urethra, often after sex, is another cause. Women in the menopause can be more prone, due to thinning of the vaginal skin.
3. You’re itchy and there’s discharge
Thrush occurs when bacteria in the vagina are disrupted, triggering an overgrowth of yeast that leads to a thick, curd-like, white discharge and itching. An over-the-counter tablet, pessary or cream will usually treat it, but about five in every 100 women suffer recurrences.
With recurrent thrush, changing your diet may help (sugar can feed the yeast bacteria), your partner may need treatment as they could be infecting you or vice versa, or it could be a sign of another health problem like diabetes (raised blood sugar level allows yeast to flourish). If necessary, see a gynaecologist.
4. There’s a strange smell
Another condition many women misdiagnose as thrush is bacterial vaginosis (BV), although symptoms are actually quite different. The discharge is grey, thin and watery; it may smell offensive (which thrush does not) and it doesn’t normally itch. Factors that increase risk of infection include douching, smoking, perfumed toiletries, feminine deodorants, strong chemical biological washing detergents and a new sexual partner.
BV can be treated with antibiotics, it isn’t normally dangerous and, unless symptomatic, can be left to clear up on its own. But it is important to get the condition treated if it appears in pregnancy as it has been associated with a higher risk of premature birth.
5. Sex is uncomfortable
Atrophic vaginitis, also known as vaginal dryness, occurs at or after the menopause and can worsen with age. As oestrogen levels in the body drop, the skin around the vagina is more prone to thinning.
Many women think this is a natural side effect of menopause but it can be tackled with vaginal lubricants, or oestrogen tablets placed in the vagina*. If there was one condition I wish more women knew could be helped, it would be this. Treating it can really change lives.
Nitu Bajekal is a consultant gynaecologist at Spire Hospital Bushey and the Royal Free NHS Trust (www.nitubajekal.co.uk).