If you were suffering from chronic back pain, you probably wouldn’t hesitate to visit your doctor. And yet often when it comes to vaginal dryness, infections such as thrush and bladder problems, we avoid getting help for fear of embarrassment. Dr Anita Mitra is an NHS Gynaecologist and author of The Gynae Geek: Your No-Nonsense Guide to Down-There Healthcare.
“I don’t think that we are brought up to talk about these things, so it becomes a taboo,” she says.
According to Dr Mitra, it’s not just broaching the subject, but how we talk about it. “I also find that women struggle to find the right words to describe what is wrong, or where exactly the problem is. But equally I don’t expect anyone to use any kind of fancy language. Just describe things in your own way and know that we’re not judging you.”
Issues such as vaginal dryness or pelvic floor weakness are very common, especially post-menopause, so don’t put off seeking help any longer. Here are some of the most common, and how to treat them.
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Vaginal dryness
A study in the journal Menopause revealed that 50 per cent of women suffering from vaginal dryness won’t go to their GP – but it makes sense to speak out. “It can be treated using topical oestrogens from your doctor or vaginal moisturisers and lubricants,” says Anita.
“A lot of women think it’s something they have to put up with; they tend to mention it off-hand while talking about something else.
“I’d prefer women to get a GP check-up rather than self-treat, especially if there’s a lot of itching, irritation, dry or cracked areas or everything feels very sore. There are skin disorders such as lichen sclerosus that are common and require different types of treatment, but should not be ignored.”
Pelvic floor problems
One in three of us suffers from bladder weakness – whether or not that applies to you, it’s worth keeping up your pelvic floorexercises. Practise gently contracting the muscles you would use to stop the flow of urine 10-15 times, or for more detailed advice and reminders, consider downloading the NHS app Squeezy.
“Symptoms of incontinence or prolapse can begin to become more apparent after the menopause due to changes in the structure around the vagina,” says Anita. “If you leak urine, or you have a feeling of pressure like something coming down, you should also speak to your doctor about how this can be managed because again, while it’s common, it’s not something that you just have to put up with.”
Thrush
Anyone can get thrush – which causes itching, soreness or an odourless discharge – but if you have a lowered immune system or diabetes you could be more prone. Pop to your chemist for an over-the-counter remedy.
Low libido
All of these issues can, unsurprisingly, put a dampener on your sex drive. “Sex can feel uncomfortable due to dryness and you may notice a change in your libido, because your ovaries also produce testosterone, and so levels will decrease with the menopause,” says Anita.
Again, it’s something to talk about, ideally with both your doctor and your partner. Boost your intake of chromium, zinc, magnesium and selenium as deficiencies have been shown to affect libido. Eat plenty of dark green leaves, nuts and beans.
Cystitis
Feel like you need to pee constantly, or experience a burning feeling? this may be cystitis, which means your bladder is inflamed, possibly as the result of an infection. there are remedies available at the chemist, but if these don’t help, visit the doctor, as antibiotics may be necessary.
Changes down below you should get checked
“If you have symptoms of abnormal discharge, abnormal bleeding, pain, lumps/ bumps/irritation, please go and see your doctor,” says Anita. “Most of the time it’s nothing sinister, but gynaecological problems can often go undiagnosed and untreated for longer than they need to because we tend to ‘keep calm and carry on’. I also want to stress that bleeding after the menopause (more than one year after your last period) always requires investigation.”
Everyday care
With a wealth of intimate washes and other products available, what exactly should you be doing to keep yourself clean and healthy? “You don’t need to clean your vagina, by means of steam, or any of the washes and wipes that are on the market,”says Anita. “Just use water. If you have irritation, it’s not due to poor hygiene – see a doctor.”
Worried about revealing your health concern in front of a queue of people?
Most pharmacies have a private room available, so you can always ask to pop into there for a more frank discussion. And don’t forget that whatever the issue, they’ll have seen it a hundred times before. Equally, when booking a GP appointment you don’t have to tell the receptionist what it’s for if you don't want to.
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