Discharge, smells and swollen lips. This is what every woman should know about her vagina...

Let's talk about your ta-ta.

20 Dec 2018

Despite the cutesy names we give our vaginas, sometimes our downstairs department can be far from adorable. But just because it bleeds, smells, itches and oozes every now and then, doesn't mean we can't talk about it. If anything, it means we need to talk about vaginas more.

It can be so easy to ignore any changes or new symptoms, for fear of embarrassment and judgement. But really, we should all pay close attention to our parts, and listen to what our bodies are saying.

Because although some symptoms can be unpleasant and uncomfortable to talk about, knowing the difference between a harmless change and a serious one, could save you from more serious medical problems down the track.

We grilled some of the top gynaecologists in the business on all things 'down there' to help you navigate every nook and cranny of your vagina...

What does creamy, white discharge mean?

"It is normal to get creamy whitish discharge, which can increase at certain times during the menstrual cycle", says Mr Narendra Pisal, Consultant Gynaecologist at . "However, ‘normal’ can mean different things to different women and if your discharge has changed, you should see your GP. Excessive amount of discharge can be caused by some common and benign conditions such as cervical polyp and cervical ectropion."

What does watery discharge mean?

"Clear watery discharge is a normal, healthy vaginal discharge. This fluid acts to keep the vagina clean and free from infection by flushing away harmful bacteria and dead cells," says Claire Bailey
Consultant Gynaecologist, Spire Parkway Hospital, Solihull. "It also acts as a natural lubricant for the vagina during sex, preventing pain and friction."

"Discharge can increase with the female hormone oestrogen and so amounts of discharge can vary in a cyclical pattern during a monthly menstrual cycle. After the menopause, oestrogen levels are much lower and this leads to vaginal atrophy (thinning of skin within the vagina). This condition of atrophy can also produce a watery discharge."

What does green discharge mean?

"A green vaginal discharge can be a sign of infection. There are several infections that can be passed on during sex that can cause a green discharge,", says Claire Bailey, Consultant Gynaecologist. "It is always worth seeing a doctor about green discharge as swabs from the cervix and vagina can diagnose conditions such as chlamydia or gonorrhoea. These infections can be effectively treated with antibiotics."

What does smelly discharge mean?

“Bacterial vaginosis (BV) is a harmless and easily treated infection of the vagina, most commonly recognised by a “fishy” smelling vaginal discharge. It can occur when there is a change in the natural balance of bacteria in your vagina, but it is important to be aware that it is not a sign of poor hygiene", says Dr Christine Ekechi, Consultant Gynaecologist at the Portland Hospital, part of HCA UK.

"You are at a greater risk of BV if you have had a change of partner and are sexually active, you have an IUD (commonly known as ‘the coil’), or you have used perfumed products in or around your vagina. It can also worsen if you’ve been on antibiotics or are stressed. Treatment for BV can come in the form of antibiotic tablets or gels. Although it is an infection which can cause embarrassment, treatment is effective and works quickly. It will also not lead to any long-term problems in regard to your sexual health or fertility.”

What does it mean if my vagina lips are swollen?

"The lips around the opening of the vagina are called the labia minora. There is no ‘normal’ size or shape to these lips, every woman has an appearance that is individual to them. Swelling of the labia minora rarely occurs in isolation and is usually accompanied by itching, soreness, skin splitting or redness. It can indicate an infective or inflammatory process on the vulva", says Claire Bailey, Consultant Gynaecologist.

"When skin is inflamed and irritated, it is important to avoid potential irritants. Stick to cotton or silk underwear and avoid wearing pantiliners as much as possible. Do not be tempted to use perfumed or soapy products on the vulva and keep clothing loose (avoid jeans, leggings, tights and pyjamas). Treat any thrush infections with over the counter medications but if these simple measures are not improving your symptoms, consult your doctor."

What does a painful abdomen (not caused by period) mean?

“If you are experiencing pain in the lower back and abdomen, a change in discharge or pain with sex, it could be a sign of Pelvic Inflammatory Disease (PID)," says Dr Christine Ekechi, Consultant Gynaecologist at the Portland Hospital, part of HCA UK.

"PID is an infection of the female upper genital tract including the womb, ovaries and fallopian tubes. Although characterised by the above symptoms, alongside pain during urination and bleeding after sex, symptoms do vary between individuals and can often be vague. This means that symptoms experienced could be indicative of something else.

"PID is caused by a bacterial infection that’s spread from the vagina or the cervix to the reproductive organs higher up. This can include normal bacteria that lives in the vagina or those transferred in sexually transmitted diseases such as chlamydia or gonorrhea. If found early enough, PID can be treated by antibiotics for 14 days. A mixture of antibiotic injections and tablets will be prescribed to ensure all the likely infections are targeted.

"Serious complications can arise from PID if not found early enough. Fallopian tubes can become scarred and narrowed, making it hard for eggs to pass from the ovaries to the womb, increasing the risk of ectopic pregnancy. In extreme cases of late treatment, it is estimated that 1 in 10 women with PID become infertile. Therefore, if you’re worried about any of the above symptoms, it’s important to visit your GP.”

What are the symptoms of thrush and how do I know if I have it?

“Thrush is one of the most common infections, affecting both men and women, which often people aren’t aware of. Thrush is harmless, though it can be uncomfortable and can come back time after time. Symptoms include white discharge, that doesn’t often smell, itching and irritation around the vagina and soreness and stinging during sex or urination – so if you’re noticing any of these changes, take a visit to the GP," says Dr Christine Ekechi, Consultant Gynaecologist at the Portland Hospital, part of HCA UK.

"Causes of thrush are not a result of sexually transmitted infections, although it can be triggered by sex and occasionally passed on through sex. It is caused by a fungus called candida which grows when the skin is irritated or damaged, you have a weakened immune system, or you have poorly controlled diabetes. Treatment of thrush includes antifungal medicine in the form of a tablet you either take orally or insert into your vagina; and a cream to relieve the irritation.

"It is important that both partners are treated to stop the infection returning. Symptoms should be relieved within a week but if you have recurring thrush then medication might need to be taken for around 6 months.”

What does it mean if you bleed after sex?

“If you’re experiencing bleeding after sex and in between periods, this could signify an abnormal change to the cervix, particularly if you don’t have any other symptoms. These can often be explained by early cell changes that will most likely go away on their own. However, in rare cases untreated changes could develop into cancer of the cervix," explains Dr Christine Ekechi, Consultant Gynaecologist at the Portland Hospital, part of HCA UK.

"Even though it might be rare, screening for cervical cancer is needed for all women even if they are feeling fine. Two types of cervical cancer screening include the Pap test and the HPV test. The smear test is easy and quick to perform. If you do experience any symptoms mentioned above, it is crucial you are assessed by a gynecologist.”

What does it mean if you have a burning sensation when you wee?

“As a type of urinary tract infection (UTI), cystitis is the inflammation of the bladder commonly caused by a bladder infection. The main symptoms of cystitis include pain, burning or stinging during urination, needing to urinate more often, urine that is dark, cloudy or strong smelling or generally feeling unwell, achy, sick and tired," says Dr Christine Ekechi, Consultant Gynaecologist at the Portland Hospital, part of HCA UK.

"Causes of cystitis are thought to occur when bacteria that live harmlessly in the bowel get into the bladder through the urethra. This could be caused by having sexual intercourse, inserting a tampon or using a diaphragm for contraception. It is more common for women to get cystitis compared to men because their anus is closer to their urethra, as well as their urethra being much shorter, allowing bacteria to get into the bladder more easily. Pregnant women or women going through menopause are also at greater risk of developing cystitis.

"Often mild cases will get better without any treatment, however those who experience episodes of cystitis more frequently may need regular or long-term treatment. Treatment from home can include paracetamol or ibuprofen, drinking plenty of water and avoiding sex. If you seek treatment from your GP they will often prescribe antibiotics which should take effect within a day or two.”

What does it mean if you experience a burning sensation during or after sex?

"Vulvodynia is a condition where a woman experiences a burning pain
around the opening of the vagina during sex or touching (including
inserting a tampon). It is diagnosed when the other causes of burning pain have been excluded by your doctor (infections, menopausal lack of
oestrogen, nerve disorders, inflammatory conditions or pre-cancer)," says Claire Bailey, Consultant Gynaecologist.

"Vulvodynia is a complex pain disorder and the symptoms may be overlooked due to the absence of any abnormalities on examination of the vulva. If left undiagnosed and untreated, it can have a huge impact on an individual’s ability to have a normal sex life and have a detrimental effect on relationships. If you have vulvodynia, you should be referred to a specialist in vulval disease."

Hopefully this handy guide beat the taboos surround your lady parts; if you're experiencing any of the above, book an appointment with your GP now.

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