Gynaecological problems risk getting worse if they're not seen, but a quarter of women feel unable to seek care because of embarrassment according to new research.
Figures from the Royal College of Obsetricians and Gynaecologists shows more people have been avoiding their GP because of the pandemic.
In a bid to help people understand what gynaecological symptoms, the new Be Gynae Aware campaign includes a checklist of gynae issues you're advised to keep track of, Wales Online reported.
It's understandable for women or people assigned female at birth to hesitate to get something checked out, but putting off gynaecological problems can cause symptoms to worsen or become more serious.
The campaign is by the charity The Eve Appeal, GlaxoSmithKline (GSK) and Dr Anita Mitra, aka the Gynae Geek.
"There's a huge lack of knowledge around gynaecological anatomy and symptoms – women are often woefully unaware of what's going on inside their own pelvis and between their legs," said The Eve Appeal chief executive Athena Lamnisos.
Dr Mitra added: "We aren't really taught a great deal about gynae health, so if something changes or doesn't seem quite right, it can feel overwhelming."
When it comes asking about problems down there, you're not alone in feeling embarrassed or not knowing what's normal.
Here, Dr Mitra talks us through what's on the Be Gynae Aware checklist…
Nine gynaecological problems to recognise
1. Abnormal bleeding
"There's no such thing as a 'period' after the menopause, and this should always be investigated, as should bleeding after sex and between periods," advises Dr Mitra.
She says less sinister causes of abnormal bleeding may be polyps, cervical ectropion (cells growing outside the cervix), or atrophic changes (thinning, drying and inflammation of the vagina related to lack of oestrogen).
In the worst case scenario, abnormal bleeding could be linked to cervical or endometrial cancer.
2. Pelvic/abdominal pain
This may need investigating if it's different from your normal period pain.
Dr Mitra says: "Pelvic pain can be sporadic or associated with certain activities, such as sex or going to the toilet. It may happen at certain times in your menstrual cycle, so it’s worth keeping a note of this.”
Common causes could be ovulation, endometriosis, adenomyosis, fibroids, cysts, pelvic inflammatory disease, or infections. In the worst case scenario it could be linked to cervical, endometrial and ovarian cancer.
3. Menstrual cycle changes
Changes in your menstrual cycle may relate to its length, volume of blood, or cramps.
Dr Mitra says it’s worth consulting a doctor if your periods become much heavier or much more painful.
"Having to change your period product (eg. pad, tampon, cup, etc) every hour for several hours on end is a sign the bleeding’s very heavy, although there’s no real limit to what’s defined as 'heavy'," she explains.
"Even if it’s not heavy enough that you need to change your pad that often but it’s affecting your life, I think it’s worth speaking to your doctor, and also if your periods are much shorter or much longer than normal, or become erratic."
Common causes of menstrual changes may be polycystic ovarian syndrome, endometriosis, adenomyosis, polyps, or the menopause. In the worst case scenario, it could be linked to cervical or endometrial cancer.
4. Pain during sex
The Gynae Geek explains that pain during sex may be superficial – for instance, on the outside, making penetration painful or impossible, or deep on the inside during or after penetration.
But either way, it may need investigating.
Common less sinister causes could be endometriosis, fibroids, cysts, vaginismus, vulval skin conditions, or even constipation. Worst case scenario, it could be linked to cervical or ovarian cancer.
5. Change in discharge
Dr Mitra says this may be a change in colour, blood-staining, itchiness, or the discharge may smell bad.
"Again, it's worth keeping a note if there are any connections to certain times in the menstrual cycle," she advises.
Changes in discharge are most commonly related to infections, but can also be linked to cervical cancer.
6. Skin changes/lumps on the vulva
The vulval skin can become very pale, pigmented (coloured) areas may arise, or it can become red or flaky, says the doctor, who warns women not to ignore such changes, or any lumps in the area.
"Lumps or bumps may be felt, and these can bleed or have discharge coming from them," she explains.
Most commonly, such changes are linked to thrush, dermatitis, folliculitis, lichen sclerosus or atrophic changes. Rarely, they can be a sign of vulval cancer.
7. Itching pain or swelling of the vulva or vagina
Vulval itching can occur alongside or independent of skin changes, says Dr Mitra, and may also be associated with a change in discharge.
Common causes are thrush, infections or lichen sclerosus. More rarely, these symptoms may also be linked to vulval cancer.
8. Persistent bloating
This is when your abdomen is constantly bloated, and doesn’t seem to change according to the time of day, or have any relation to food.
She warns: "This can arise from big masses such as huge fibroids, cysts or tumours, but also if you have ovarian cancer because your abdomen can become full of fluid."
9. Change in bowel/urine habits
Symptoms linked to the bowel and bladder aren’t always immediately thought to be connected to gynae health.
However, Dr Mitra explains: "Our bowel and bladder lie right next to the uterus and ovaries, so if there's pressure from these things they can cause changes in the bladder or bowels, such as needing to pass urine more often than normal, incomplete emptying of your bladder so you feel like you need to go again right after you’ve already been, constipation or even diarrhoea."
Common reasons for such changes may include urine infections, IBS, large fibroids or endometriosis, and in the worst case scenario they could be linked to ovarian cancer.
If you have concerns about seeing a doctor about a gynaecological problem, contact The Eve Appeal's free information service Ask Eve on 0808 802 0019, or email nurse@eveappeal.org.uk.
