Spotting. Itching. Tenderness. When below-the-belt symptoms crop up, your first impulse is probably to slip into a pair of pyjamas and curl up on the couch. Holing up for a night or two is fine, but what if your symptoms last for weeks or even months?
“When it comes to gynaecological issues, many women adopt a grin-and-bear-it mentality,” says Dr Fred Howard, chief gynaecologist at the Rochester Endometriosis and Pelvic Pain Centre in the US. Often they’re simply too embarrassed to tell anyone — even their doctors — about a problem. “But left untreated, some can lead to more serious illnesses,” he says.
Even when you do confess, receiving the proper care can be tricky: Many of the symptoms are often vague and can be easily confused with other conditions. In fact, research reveals that it can take years for physicians to arrive at an accurate diagnosis.
But the sooner you take charge of your health, the sooner you’ll feel better. That’s why we’ve asked experts to decipher common down-there symptoms and treatments — so you can get off that couch already!
YOU HAVE: Heavy and/or painful periods that last for at least seven days; abdominal pain
ASK YOUR DOCTOR ABOUT :Uterine fibroids
You may be one of the 40 percent of women with fibroids, or non-cancerous growths that are usually found on the wall of the uterus. “Most people think of it as a condition that affects older women,” says fibroid specialist Dr Bruce McLucas. “But the truth is that fibroids are most common among women in their 30s and 40s.”
The majority of these tissue masses measure about four centimetres in diameter (picture a golf ball), but some can balloon to the size of a grapefruit. About 75 percent of women with fibroids don’t experience any problems and, in most cases, won’t need treatment. But when symptoms show up, they can be very uncomfortable and affect the quality of your life.
“Heavy bleeding may occur because fibroids distort the uterine wall, causing more of the lining to shed,” says Dr McLucas. In serious cases, this bleeding can lead to anaemia. Fibroids that block the Fallopian tubes, womb or birth canal may lead to infertility, miscarriages and premature birth.
WHAT CAN HELP
The most common treatment for fibroids used to be having a hysterectomy — a surgery to remove the uterus. Today, there are less invasive options which may be better suited to your lifestyle and needs. For example, if you still want to get pregnant, your best choice is myomectomy. This surgical removal of the fibroids is the only treatment that’s known to preserve fertility.
“If a hysterectomy if not right for you, discuss the availability of new uterus-preserving procedures which are being introduced to clinical practice. Uterine artery embolisation, or UAE, may be available through an interventional radiologist where, guided by X-rays, the doctor injects particles into the arteries leading to the fibroids, blocking blood flow and shrinking them. A newer technique which zaps the growths with a high-intensity ultrasound beam may offer another option in the near future. The fibroids are broken down and reabsorbed by the body allowing most patients to return to work in a day or two.
If the fibroids are not too big and their position in the uterus allows for it, heavy periods can still be treated with a hormonal intra-uterine device or with one of a number of different endometrial (lining of the uterus) cauterising techniques. Remember to ask your doctor about the different types of hysterectomy if that is your best option. For example, a sub-total hysterectomy (preserving the cervix) reduces operation hazard and recovery time, and preserves the vaginal support system; and a vaginal hysterectomy avoids abdominal wall incisions and accelerates recovery, explains Cape Town gynaecologist and obstetrician Dr Philip Zinn.
YOU HAVE: Painful intercourse; severe cramps starting a week or two before menstruation; bloating
ASK YOUR DOCTOR ABOUT: Endometriosis
“There’s a misconception among women, and even some doctors, that it’s normal to have extreme discomfort during your period,” says Dr Howard. But severe cramps may signal endometriosis, a condition in which the endometrium, or tissue that lines the uterus, grows outside of the uterine walls.
Although there’s no definitive cause, some experts believe that menstrual blood may carry endometrial cells to other sites in the body — most commonly, the ovaries, Fallopian tubes or the lining of your pelvis. During your monthly cycle, hormone fluctuations cause the endometrium to thicken, break down and bleed. But since there’s no place for the blood to drain, it becomes trapped, irritating the surrounding tissue. Over time, it can lead to cysts, scarring and infertility.
WHAT CAN HELP
Taking oral contraceptives continuously (skipping the placebo pills) to stop your period can relieve symptoms. Ask your gynaecologist about extended-cycle options. Progesterone-only pills are another option, which restrict the development and growth of endometriosis — a similar effect, giving sustained relief, to that of pregnancy — says Dr Zinn. Prescription drugs called gonadotropin analogs stop the ovaries from producing oestrogen, causing temporary menopause.
If you’re trying to have a baby, ask your doctor about the surgical removal of the errant tissue; studies show that this procedure decreases pain while increasing your odds of conceiving. “Schedule the surgery about six months before you want to become pregnant,” says Howard.
YOU HAVE: A frequent need to urinate; pelvic pain
ASK YOUR DOCTOR ABOUT: Interstitial cystitis (IC)
You have the telltale signs of a urinary tract infection, yet no amount of anti-biotics seems to do any good. Sound familiarc You may be one of the thousands suffering from IC (also known as painful bladder syndrome). “This condition may be caused by a small hole in the protective lining of the bladder that allows toxic substances in urine to seep out and irritate the outside of the bladder,” says urologist Dr Kristene Whitmore. A urologist can perform a cytoscopy, a procedure that uses a tiny camera to examine the inside of your bladder for IC-related haemorrhages.
WHAT CAN HELP
Unfortunately, there’s no simple cure; most sufferers try a combination of treatments. Ask for your doctor’s recommendation. This may include a procedure, anti-inflammatory medication or physiotherapy.
YOU HAVE: Vaginal itching; a milky discharge; a fishy odour
ASK YOUR DOCTOR ABOUT: Bacterial vaginosis (BV)
Only one in five women who purchased an over-the-counter yeast infection remedy actually had BV, finds a study from the Medical College of Georgia in the US. Caused by an overgrowth of anaerobic bacteria in the vagina, this condition strikes thousands of women a year. “Having the infection can raise your risk of contracting sexually transmitted diseases, such as HIV, chlamydia, and gonorrhoea,” says Dr Jeanne Marrazzo, an associate professor of medicine in the US.
WHAT CAN HELP
See your gynaecologist, who may prescribe a course of antibiotics.
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