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Looking after your gynaecological health

Your body is amazing, and to keep it running as it should, it’s important to understand the basics of gynaecological health. Here, the consultant gynaecologists from Nuffield Health Bristol Hospital breakdown some of the issues you should be aware of to keep your body in good working condition.

Menstrual health
Periods will generally last for between 3 to 5 days, and occur every 21 to 35 days. Just over a third of people will develop period problems during their lifetime. Although longer or heavier than usual periods are not a sign of a problem, it needs to be assessed further, and bleeding in between periods, with intercourse or after menopause, could be a sign of cancer and medical advice should be sought promptly.

Premenstrual syndrome (PMS) occurs due to the hormonal changes prior to periods and can result in significant emotional changes, which may also require specialist input. Some mild discomfort is common, but if you are experiencing severe pain with your periods (dysmenorrhoea) you may want to speak to your doctor.

Hormonal contraception can affect periods in various ways, and if required could also be used as a method of treatment. Most period problems can be evaluated during a consultation with a gynaecologist by reviewing your past medical history, performing an examination, and potentially including an ultrasound scan and biopsies.

Gynaecological cancers
Up to two thirds of gynaecological cancers can be prevented by risk reduction, screening and vaccination programme, and it’s important to remember that the outcome of a cancer diagnosis can be improved by earlier detection.

Ovarian cancer can be silent, but symptoms such as weight loss, nausea, vomiting, persistent bloating, abdominal distension or difficulty in breathing could all be a sign and should be taken seriously. Initial investigation requires an ultrasound scan and a CA125 blood test.

Womb cancer generally causes post-menopausal bleeding which should always be investigated. Outcomes of womb cancer are relatively good if detected and treated in the early stages. Ovarian and womb cancer can be hereditary, and if you have a strong family history of these types of cancers, as well as bowel or breast cancer, you should contact a specialist to discuss gene testing and prevention surgery.

Most cervical cancer occurs between the ages of 30 and 40 years. Not taking part in a screening programme when invited is the biggest risk of developing cervical cancer. Screening is important, even for people who have received the HPV vaccine. Most cervical cancer presents with bleeding in-between periods or after sex. Vulval cancer is relatively uncommon. Any ulcer, lump or bleeding from vulval skin should be promptly assessed. Precancer changes can cause soreness and itching and should also be checked by a specialist.

Menopause
Menopause occurs when the ovaries stop producing eggs, reducing levels of oestrogen hormone. The average age is 51 with a quarter of people experiencing severe symptoms. It occurs naturally or resulting from treatment, e.g. for cancer. Treatment is based on symptoms which can include hot flushes, insomnia, fatigue, joint ache, painful sex, anxiety, and forgetfulness.

There has been much publicity about the risks of HRT (oestrogen replacement). HRT can increase the risk of breast cancer if used for 5 years, but this risk is lower than being overweight or excess alcohol intake.

HRT has considerable benefits too. Heart disease accounts for more deaths than cancer and starting HRT before age 60 is protective. Oestrogen can reduce the risk of dementia and protects the bones, reducing the risk of fractures due to osteoporosis. Not everybody needs HRT, however, individualised help is available for those who do.

At Nuffield Health Bristol Hospital, our team of Consultant Gynaecologists – Dr Jo Bailey, Dr Suvarna Mahavarkar, Miss Naomi Crouch and Mr Amit Patel – work closely together to offer a comprehensive service for our patients. As well as treating general gynaecological conditions, they each have their own specialties. Dr Bailey and Mr Patel both specialise in gynaecological cancers, while Dr Mahavarkar specialises in the treatment of related skin conditions, and Ms Crouch in adolescent gynaecology.

If you would like to book an appointment with a Consultant Gynaecologist at Nuffield Health Bristol Hospital, call 0117 911 5339, or visit our website: nuffieldhealth.com/hospitals/bristol

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