Women's Health Online UK

Women's Health

What is Bacterial Vaginosis?

A healthy vagina has bacteria. However, if the balance between the different types of bacteria that are in the vagina is disturbed, the conditions for bacterial vaginosis can develop.

What is the cause of bacterial vaginosis?

Bacterial vaginosis (sometimes simply called “BV”) is a bacterial infection that occurs when the different types of healthy bacteria in the vagina are out of balance and proliferate. It is usually caused by a bacteria called Gardnerella vaginalis, which is the most common type of bacteria in the vagina.

Any factor that modifies the pH of the vagina, such as douching or using vaginal deodorants and other irritants, can interfere with the levels of bacteria and lead to infection.

What is HRT?

Hormone replacement therapy (drugs that contain female hormones to replace those the body no longer produces after menopause) is often used to treat common menopausal symptoms, such as hot flashes and vaginal discomfort.

Additionally, hormone therapy has been shown to prevent bone loss and reduce the risk of fractures in postmenopausal women.

Along with the benefits, there are risks associated with the use of hormone therapy. These risks depend on a few factors, such as the type of hormone therapy, the dose, and the length of time the drug is taken. For best results, hormone therapy should be tailored to each person and re-evaluated from time to time to ensure that its benefits still outweigh the risks.

What are contraceptive methods?

Birth control is any method used to prevent pregnancy. Another way of saying birth control is "contraception."

If you have sex without birth control, there is a chance that you could get pregnant. This is true even if you have not started having menstrual periods yet or if you are nearing menopause.

The only sure way to prevent pregnancy is not to have sex. But finding a good birth control method that you can use every time can help you avoid an unplanned pregnancy.

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Bacterial Vaginosis BV Bacterial Vaginosis BV

What is bacterial vaginosis?

Bacterial vaginosis (BV) is an infection caused by an excessive amount of certain bacteria that changes the normal balance of bacteria in the vagina.

How common is bacterial vaginosis?

Bacterial vaginosis is the most common vaginal infection in women ages 15 to 44.

How does bacterial vaginosis spread?

Researchers do not know what causes bacterial vaginosis (BV) or how some women get it, but what we do know is that the infection commonly occurs in sexually active women. Bacterial vaginosis is associated with an imbalance of "good" and "bad" bacteria, which are normally found in a woman's vagina.

Having a new sexual partner or multiple sexual partners, as well as douching, can upset the balance of bacteria in the vagina and put women at higher risk for bacterial vaginosis

We also don't know how intercourse contributes to bacterial vaginosis. There is no research work that shows whether a woman will contract this infection or not, in the event that her sexual partner is treated. Having bacterial vaginosis can increase your chance of getting other sexually transmitted diseases (STDs). Bacterial vaginosis rarely affects women who have never had sex.

People cannot get bacterial vaginosis from contact with toilet seats, bedding, or swimming pools.

How can I avoid getting bacterial vaginosis?

Doctors and scientists do not fully know how bacterial vaginosis spreads, and there are no better ways to prevent it.

The following basic prevention measures can help reduce your risk of bacterial vaginosis:

  • Not having sex.
  • Limit the number of sexual partners.
  • Do not douche

How do I know if I have bacterial vaginosis?

Many women with bacterial vaginosis have no symptoms. If you have symptoms, you may notice a thin, white or grey vaginal discharge, odour, pain, itching, or burning from the vagina. Some women have a strong fishy smell, especially after they have had sex. You may also feel burning when urinating or itching on the outside of your vagina or both.

How will my doctor know if I have bacterial vaginosis?

Your healthcare provider will examine your vagina for signs of vaginal discharge and take a sample of it for laboratory tests to determine if you have bacterial vaginosis.

Can bacterial vaginosis be cured?

Bacterial vaginosis sometimes goes away without treatment. But if you do have symptoms of this condition, you should get tested and treated. It is important to take all of the medications that are prescribed for you, even if your symptoms go away. A healthcare provider can treat bacterial vaginosis with antibiotics, but it can come back even after treatment. Treatment can also reduce the risk of some sexually transmitted diseases.

Male sexual partners of women who have been diagnosed with bacterial vaginosis generally do not need treatment. However, bacterial vaginosis can be transmitted between female sexual partners.

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Contraceptive Contraceptive

What Is An Oral Contraceptive?

An oral contraceptive, more commonly known as a birth control pill or simply ‘the pill’ is a medication that prevents pregnancy. Birth control pills work by stopping the process of ovulation (release of an egg from the ovary each month). Contraceptive pills are the most convenient and reliable methods of reversible contraception.

Contraceptive pills contain synthetic hormones that alter the physiology of the womb, making it less susceptible to support a fertilized egg. But keep in mind that birth control pills will not protect you against Sexually Transmitted Diseases (STDs).

How Does An Oral Contraceptive Work?

Pills contain two artificial versions of female sex hormones called oestrogen and progestogen. These hormones stop the release of an egg from the ovary each month and thicken the fluid (mucus) at the neck of the cervix, making it harder for a sperm to reach an egg. These hormones also make the endometrium (lining of the uterus) thin, making it less likely accept a fertilized egg.

Benefits of Oral Contraceptives

Combined oral contraceptives are not only helpful in preventing pregnancy but they have other benefits too. Some major benefits of birth control pills are:

  • They make your periods lighter and more regular.
  • They help with Pre-menstrual syndrome (PMS) and anaemia.
  • They relieve menstrual cramps.
  • They also reduce acne.

How to Use Oral Contraceptives?

Birth control pills are of different types with different methods of administration. You should always take your pills according to your doctor’s instructions.

Typical birth control pills are taken for 21 days straight. The remaining 7 days are pill-free. In pill-free days, withdrawal bleeding occurs. The doctor will ask you to start taking your pills on the first day of your period, which also the day 1 of your menstrual cycle.

Precautions

If you are using birth control pills as contraception, make sure that use the medication according to your doctor's instructions. If you don’t use the pills correctly, they will not work as a contraceptive and you’ll remain unprotected.

If you have a clotting disorder, or any other blood disorder make sure to tell your doctor, as birth control users are more at risk of developing a blood clot (thrombosis)

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Cystitis Cystitis

What is Cystitis?

Cystitis is the medical term for inflammation of the bladder. Most of the time, the inflammation is caused by a bacterial infection and is called a "urinary infection." A bladder infection can be painful and bothersome, and it can become a serious health problem if the infection spreads to the kidneys.

Less commonly, cystitis appears as a reaction to certain medications, radiation therapy, or potential irritants, such as feminine hygiene sprays, spermicidal gels, or long-term use of a catheter. Cystitis can also appear as a complication of another disease.

Antibiotics are a common treatment for bacterial cystitis. Treatment for other types of cystitis depends on the underlying cause.

What are the Symptoms of Cystitis?

Some of the signs and symptoms of cystitis are usually:

  • Constant and urgent need to urinate
  • Burning sensation when urinating
  • Frequent urination in small amounts
  • Blood in the urine (hematuria)
  • Cloudy and strong-smelling urine
  • Pelvic discomfort
  • The sensation of pressure in the lower abdomen
  • Low fever

For young children, having new bouts of accidental urination during the day can be a sign of a UTI. Bedwetting at night when alone is probably not associated with a urinary infection.

The urinary system includes the kidneys, ureters, bladder, and urethra. All of them are important in removing waste from the body. The kidneys, which are a pair of bean-shaped organs located toward the back in the upper abdomen, filter waste from the body and regulate the concentrations of many substances. Tubes called "ureters" carry urine from the kidneys to the bladder, where it is stored until it leaves the body through the urethra.

Bacterial cystitis

Urinary tract infections usually occur when bacteria outside the body enter the urinary tract through the urethra and begin to multiply. Most cases of cystitis are caused by a type of bacteria Escherichia coli (E. coli).

Bacterial bladder infections can appear in women as a result of sexual intercourse. However, even girls and women who are not sexually active are exposed to milder urinary infections, as the female genital area often harbours bacteria that can cause cystitis.

Non-infectious cystitis

Although bacterial infections are the most common cause of cystitis, various non-infectious factors can also cause the bladder to become inflamed. Some examples are the following:

  • Interstitial cystitis. The cause of this chronic inflammation of the bladder, also called "painful bladder syndrome," is unclear. Most cases are diagnosed in women. The condition can be difficult to diagnose and treat.
  • Drug-induced cystitis. Certain drugs, especially the chemotherapy cyclophosphamide and ifosfamide, can cause bladder inflammation when they’re broken down components are expelled from the body.
  • Radiation cystitis. Radiation treatment of the pelvic area can cause inflammatory changes in the tissue of the bladder.
  • Foreign body cystitis. Long-term use of a catheter can predispose you to bacterial infections and tissue damage, two conditions that can lead to inflammation.
  • Chemical cystitis Some people may be hypersensitive to chemicals in certain products, such as bubble baths, feminine hygiene sprays, or spermicidal gels, and have an allergic reaction that causes inflammation within the bladder.
  • Cystitis associated with other conditions. Sometimes cystitis can appear as a complication of other disorders, such as diabetes, kidney stones, an enlarged prostate, or spinal cord injuries.

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Hirutism Hirutism

What is Hirsutism?

Hirsutism is the growth of terminal hair in women following a male pattern of distribution, 2 in androgen-dependent areas: sideburns, chin, neck, mammary areoles, thorax, in the area immediately above or below the navel, as well as in thighs and back. It is frequently associated with acne, male pattern baldness (androgenic alopecia), and menstrual irregularities.

This condition affects approximately 10% of women of childbearing age, and can be mild, representing a variation from the normal growth pattern, and is rarely a sign of a serious underlying disorder.

It is usually idiopathic but may be related to excess androgens, such as polycystic ovary syndrome or congenital adrenal hyperplasia.

It is determined by the increase in the levels or response to the ovarian or adrenal androgenic hormones (testosterone) that in the hair follicle are transformed into dihydrotestosterone by the action of the enzyme 5-alpha reductase, facilitating the conversion of hair into terminal hairs of the hair follicles with sensitivity to androgens. The boundary between normal and pathological is not precise, given ethnic variations and family influences. It is more common in whites and rare in Asians.

The clinical manifestations of androgenization may be due to global production of available free androgens due to a decrease in sex hormone transporting globulin (GTHS), or to an excessive local response, thanks to a greater affinity of intracellular receptors to bind to the hormone. Therefore, the origin of the problem can be central or peripheral.

What is the cause?

Central: Depending on the source of androgens, it will be ovarian, adrenal or pituitary, and it may be the tumour or functional mechanism.

Peripheral: in this case, the disorder will be located in the target organ, peripherally, thanks to an increase in skin sensitivity or peripheral enzyme hyperactivity.

The ovary seems to be the main source of excess androgen secretion, and the most frequently associated ovarian pathology is that which corresponds to polycystic ovary syndrome (functional ovarian hyperandrogenism).

Other rare causes of undesirable hair growth are:

  • Use of phenytoin
  • Tumour or cancer of the adrenal glands
  • Ovarian tumour or cancer
  • Cushing's syndrome
  • Congenital adrenal hyperplasia
  • Hyperthecosis (a condition in which the ovaries produce too many male hormones)

Use of certain medications such as testosterone, danazol, anabolic steroids, glucocorticoids, cyclosporine, minoxidil, phenytoin.

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HRT HRT

What is Hormone Replacement Therapy?

Hormone replacement therapy (HRT), also known as menopausal hormone therapy (MHT) is used to treat symptoms associated with menopause. HRT medications contain combinations of female hormones called estrogen and progestogen. These hormones are produced less and less by the ovaries as a woman approaches menopause.

Types of Hormone Replacement Therapy

The primary focus of hormone replacement therapy is on replacing estrogen which is no longer produced by the ovaries after menopause. There are two types of hormone replacement therapy:

Systemic Hormone Therapy

In this type of hormone therapy, estrogen is taken in the form of patches, pills, rings, or spray. Systemic hormone medications contain estrogen in higher doses that treat menopausal symptoms throughout the body. The medications of systemic therapy also contain progestogen or progestin (progestogen-like medication), as estrogen alone can stimulate the growth of the endometrium (lining of the uterus), which increases the risk of endometrial cancer.

Low-dose Estrogen Vaginal Products

If you are only experiencing vaginal symptoms of menopause, the doctor will prescribe you low dose medications that can be directly applied to the vagina. They come in the form of a cream, tablets, or rings. In this type of estrogen therapy, only a minimal amount of estrogen is absorbed by the body so, progesterone does not accompany estrogen in vaginal products.

Women who have undergone hysterectomy (uterus removal) do not require progestogen in hormone replacement therapy.

Symptoms of Menopause

Following are common symptoms of menopause that indicate you should consider hormone replacement therapy:

  • Hot flashes
  • Trouble falling asleep at night
  • Night sweats
  • Decreased muscle strength.
  • Reduced sexual desire.
  • Exhaustion, low energy, and fatigue.
  • Weight gain, particularly around the stomach and midsection area.
  • Thinning hair.

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Morning After Pill Morning After Pill

What is Morning after pill?

The morning-after pill is a method of preventing emergency pregnancy (contraception). The purpose of emergency contraception is to prevent pregnancy after a woman has had unprotected sex or when her contraceptive method has failed.

The morning-after pill is intended as a backup contraceptive only and should not be used as a primary method of contraception. The morning after pills contains levonorgestrel (Plan B One-Step) or ulipristal acetate (Ella).

Levonorgestrel is an over-the-counter medication, while ulipristal acetate is only available with a prescription.

What is the purpose?

Morning-after pills can help prevent pregnancy if you had unprotected sex, whether it's because you didn't use birth control pills, skipped a birth control pill, were a victim of sexual assault, or your birth control failed.

Morning-after pills do not end a pregnancy that has been implanted. They work mainly by delaying or preventing ovulation.

Possible Risks

Emergency contraception is an effective option for preventing pregnancy after unprotected sex, but it is not as effective as other contraceptive methods, so its regular use is not recommended. Also, the morning-after pill can fail, even if used correctly, and offers no protection against sexually transmitted infections.

Morning-after pill is not suitable for everyone. Do not take a morning-after pill in the following cases:

You are allergic to any of the components of the pill.

You're taking certain medications that can make your morning-after pill less effective, such as barbiturates or St. John's wort.

If you are overweight or obese, there are some indications that the morning-after pill will not be as effective in preventing pregnancy as it is in non-overweight women.

Also, make sure you are not pregnant before using ulipristal. The effects of ulipristal on a developing baby are unknown. Using ulipristal is also not recommended if you are breastfeeding.

Side effects from the morning-after pill typically last only a few days and may include the following:

  • Nausea or vomiting
  • Dizziness
  • Fatigue
  • Headache
  • Tender breasts
  • Bleeding between menstrual periods or heavier menstrual bleeding
  • Pain or cramps in the lower abdomen

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