The pros are here to help

When it comes to discussing our vaginas and vulvas, it’s safe to say there’s still some level of taboo. Many of us struggle to open up to our friends or seek advice on concerns we have around our vaginal health through fear of embarrassment and shame. Here at Boots, we believe no one should feel alone in their health hang-ups and want to encourage open conversation around all aspects of vaginal, vulval and women’s health.

With that said, we totally get that some people find it difficult to share their concerns, whether with a friend or a health professional. That’s why we reached out to three leading gynaecology experts to lift the lid on some of their most commonly asked questions, covering everything from menopause to contraception. Below, Dr Sarah Welsh, Hanx co-founder and gynaecology doctor, Dr Zahra Ameen, consultant gynaecologist and obstetrician at the Cadogan Clinic, and Dr Shree Datta, consultant gynaecologist and obstetrician at The Portland and Lister Hospitals share answers to the gynaecological questions we’re desperate to know the answers to.

10 of the most common questions gynaecologists hear:

• What can a gynaecologist help with?

• What are the signs that I need to take better care of my vagina?

• My smear test result shows HPV and abnormal changes, what does this mean?

• What can I do to look after my vagina after sex?

• If you have sex on your period, is it true you can’t get pregnant?

• Can you have sex on your period?

• Why have my periods changed?

• Does going through the menopause mean the end of my sex life?

• What can I do to help stop menopausal hot flushes and night sweats?

• I’ve had some bleeding in my pregnancy, what should I do?

What can a gynaecologist help with?

Dr Ameen: Women can book in with a gynaecologist either privately or by GP referral for any concerns relating to the vulva, ie, the area around the vagina, such as itching, ulceration and bleeding, vaginal pain, pelvic issues or abnormal bleeding, including irregular periods, bleeding between periods, bleeding after sex and heavier than usual bleeding during a period. This is in addition to regular smear tests.

What are the signs that I need to take better care of my vagina?

Dr Ameen: Personal hygiene for the vulval/vaginal area is imperative. Signs that you may need to take better care of your vaginal health are itching and irritation of the vulva, smelling vaginal discharge and pink vaginal discharge/spotting.

It’s very simple to look after our vaginal health. Clean the vulva (the area around the vagina) daily with water and preferably unperfumed soap, wear loose-fitting cotton underwear and change your underwear twice daily and definitely after working out! Finally, everyone should make sure they’re up to date on their smear tests and should attend once they receive a letter about it from their GP. Smears should usually be taken every three years, between ages 25-49 years and every five years from 50-65 years.

If you notice a change in discharge or spotting and are concerned, you should discuss your symptoms with your GP, rather than wait until your next smear test.

My smear test result shows HPV & abnormal changes, what does this mean?

Dr Datta: The cervical screening programme in the UK is designed to detect abnormalities in the cells of our cervix before cancer develops. HPV is a very common sexually transmitted infection – most people will have it at some point in their lives without knowing it. Usually, it goes away on its own, but in some cases it can be long-lasting and lead to abnormal cells in your cervix, particularly if you smoke or have certain medical problems. If you have a smear test result showing abnormal changes, you’ll be asked to see a gynaecologist in a specialist colposcopy clinic so that we can check on the nature of any changes to your cervix in more detail and decide whether any treatment is required.

What can I do to look after my vagina after sex?

Dr Ameen: I always advise my patients to pass urine after sex to reduce the chance of recurrent urine infections. During sex, bacteria can enter the urethra and passing urine helps flush the bacteria out. You should also gently clean yourself after sex, using unperfumed soap and water, to protect against infections, wiping front to back. Do not douche. This can lead to more infections as it upsets the natural balance of bacteria (vaginal microbiome) that protects the vagina.

If you have sex on your period, is it true you can’t get pregnant?

Dr Welsh: During, and just after, your period, you are at your least fertile. However, hardy sperm can survive in the reproductive tract for up to seven days, and sometimes menstrual cycles have unpredictable ovulation. You still need to use contraception for penetrative period sex if you want to prevent unplanned pregnancy.

Can you have sex on your period?

Dr Welsh: There is no medical reason not to have sex on your period. It might be a little messier than usual, but intercourse isn’t affected by menstruating. In fact, some people find they have a higher libido before or on their period. Pop a towel down and go for it.

Why have my periods changed?

Dr Datta: Our periods can change in many ways, including how often you get them, how heavy they are and how long they last. You may also notice breakthrough bleeding (spotting in between periods) or bleeding after sex.

It’s wise to see either your gynaecologist or your GP who can refer you if they feel it’s appropriate. We can find out more about your medical history and consider any medical problems you have, along with any medication you are taking, as these things can influence your periods. We can also examine you and request a scan to exclude problems, such as polyps or fibroids, in your womb. Blood tests may also be helpful in finding out why any changes have happened.

Does going through the menopause mean the end of my sex life?

Dr Welsh: Menopause can have a noticeable impact on sex, which has created the myth that sex is off the table for good, which simply isn’t true. During and postmenopause, hormone changes mean vaginal tissue can become dry and fragile, alongside a reduction in natural lubrication produced. This could mean you’re more susceptible to injury of tearing during sex and it might feel a little uncomfortable.

However, while this means we need to take a little more care of ourselves when we’re getting it on, it doesn’t mean sex is off the menu for good. Many people find that lubricant is helpful for reducing friction. Make sure to choose natural, water-based options, such as Hanx Vegan Lubricant, £14.99, which doesn’t contain glycerin, as this can trigger yeast infections, such as thrush.

What can I do to help stop menopausal hot flushes & night sweats?

Dr Datta: The average age for reaching the menopause in the UK is 51, but many women can experience symptoms several years before this. The most common symptoms of the menopause include night sweats, hot flushes, irritation, mood and memory changes, and vaginal dryness.

If your symptoms start affecting your lifestyle, it’s important to consult your GP or a private gynaecologist early so that we can consider any supplements, dietary changes and/or hormonal medication to help you. We may request blood tests and an ultrasound, as well as performing a general health check to monitor your blood pressure.

I’ve had some bleeding in my pregnancy, what should I do?

Dr Datta: There can be lots of different reasons for experiencing vaginal bleeding in pregnancy – for example, if you have a low-lying placenta or if you’ve recently had sex. It’s common and doesn’t always mean that there’s an issue, but it can be a sign that something may be wrong and so it’s important to speak to your GP or midwife as soon as you can as a first port of call to see what they would advise.

If you’ve just found out you’re pregnant or are at the early stages and don’t have a midwife, I always recommend contacting your GP or going to a hospital to get assessed, whatever the cause, as bleeding may signal a miscarriage or ectopic pregnancy.

Found this useful? Find out the answers to the most googled questions about sexual health, here.

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