Monthly topic #8: Gyno Anxiety

A regular PAP smear is a good start, but really looking after yuor body requires more intimate knowledge. If you've been guilty of complacency about your reproductive health, stop cringing, uncross those legs and read on...

Below The Belt

Scan any office, bus or shop and you'll see women going about their daily business. Outwardly, all look normal but, inside, those women could be itching like mad with thrush, growing cysts on their ovaries or harbouring a lump in their breasts. These are "women's problems", usually discussed in hushed tones with eyes downcast. Well, not here. We're talking loud and proud about the things that can go wrong with your "girlie bits", so you'll be able to recognise if a problem strikes - and take action. Here's a guide through the maze of problems that affect the health of those body parts specific to women - the vagina, cervix, uterus, ovaries and breasts. Any one of us could be affected, at any time. Yep, that includes you. So read on.

Thrush

What is it? Basically, a thrush is an overgrown yeast fungus. Candida albicans is a fungus present in small amounts on your skin and in your mouth, bowel and vagina. Usually, your body's defences keep it in check, but sometimes circumstances allow it to flourish and it starts to attack the tissue under it, causing inflammation - that is candidiasis or thrush. Factors include stress, taking the Pill, antibiotics, a high intake of alcohol, sugar and caffeine (especially in recurring thrush) and hot sweatiness around the vagina (often caused by tight pants and synthetic undies).

What does it feel like? In a word, itchy. It causes an intense itching or burning around your vagina and vulva, accompanied by a discharge that's often described as looking like cottage cheese, but can also be thin and clear. Some say it smells like bread or beer.

What can I do about it? Thrush is diagnosed by examination and sometimes a swab (to identify the yeast). You must have it diagnosed by a doctor, especially the first time, as there are other infections, such as bacterial and urinary tract infections, that can affect the area and produce a similar sensation. Treatment is via creams, pessaries and sometimes even oral treatments. You'd probably also be advised to wear cotton underwear, avoid soaps and perfumes, wash the area regularly, wipe your anus from front to back and use a condom when infected. If you have chronic thrush, try to change to an appropriate diet; taking lots of sugar and wine will increase candida's recurrence. Try eating acidophilus bacteria, which are found in some yoghurts or in tablets from health food stores. They should help clear it up.

Fibroids

What are they? Fibroids are benign (non-cancerous) tumours that grow in the wall of the uterus. They are made up of muscle and fibrous tissue. One in five women has fibroids, but as firboids are often symptoms-free, you could be that one-in-five and not even know it. No-one knows what causes them, but their growth seems to depend on the presence of hormones, mainly oestrogen. There are fibroids on record that weigh 10kg, which you can feel because as they grow, they enlarge and distort the uterus and can often be felt by pressing on the area. Fibroids are rare in women under 25.

What do they feel like? Usually, you won't feel a thing - but they can cause heavy periods or bleeding after sex and between periods. They may intefere with fertility by projecting into the uterus cvausing miscarriage or premature delivery, but this is not common.

What can I do about them? Treatment depends on fibroid size and whether the woman wants to keep her uterus. If you're 45, have had your babies and are sick of heavy periods, you may choose a hysterectomy. If you're 25, however, and the fibroids are thought to be interfering with your fertility, they may just cut out the fibroid. A naturopath will prescribe herbs to help regulate bleeding and to reduce fibroid size. You can also use dietary changes to control oestrogen levels, such as eating more soya products, increasing your protein intake and eating more vegetables from the cabbage family.

PMS

Short of beating your boyfriend with a rolled-up printable version of Mars & Venus... Actually, finding relief from PMS can be a bitch. The most common symptoms include a bloated abdomen, swollen, tender breasts and "mood changes". Add to this swollen ankles, skin disorders, headaches, backaches and hot flushes and it's no wonder that women who suffer badly from PMS may also be irritable, anxious, depressed or aggressive. Mainstream medical treatments include taking the Pill, using diuretics to help eliminate fluids from the body and taking supplementary vitamins, including B6 and B1. A healthy diet and lots of exercise are also highly recommended. Evening primrose oil, often suggested as a natural cure for PMS, is only suitable for mild cases while visiting a naturopath may provide more relief.

Ovarian Cysts

What are they? There are many different types of ovarian cysts. The most common are physiological cysts, also known as "simple" or "functional" cysts, because they form as part of normal ovarian processes. There are two types of simple cysts: follicular cysts, which form when an ovarian follicle (egg sac) doesn't release its ovum (egg) and fills up with clear fluid; and luteal cysts, which form in ruptured follicles and are more likely to cause spotting, heavy bleeding or early/late periods. Both follicular and luteal cysts usually disppear on their own. With polycystic ovarian syndrome, lots of little cysts form all over the ovary's surface. The first signs of the condition include heavy bleeding and irregular periods and, over time, these cysts can affect fertility. This condition is generally treated hormonally. Other benign cysts include hormone-producing cysts, serous and mucinous cystadenomas, fibromas and Brenner tumours. Most of these should be surgically removed once discovered. In all cases, irregularities in your periods are the giveaway.

What do they feel like? Generally, you won't notice an ovarian cyst. If it ruptures, however, it may cause pain, often on one side only. Pain during sex can also be a warning sign of cysts, as can a "bloated" or heavy feeling in the lower abdomen.

What can I do about them? Treatment depends on what it looks like on the ultrasound - how big they are, whether it's a 'simple' cyst or a 'complex' cyst, which can be malignant and usually needs to be removed. Ovarian cysts are usually considered to be a result of some abnormal tissue development. If there's even the smallest possibility that a cyst might be dangerous, surgery is a definite must.

From the totally weird file

There's a type of ovarian cyst, called a dermoid cyst, which forms when an egg begins to develop in a very abnormal way. So? Well, these cysts can be made up of all sorts of bizarre things, including hair, teeth, bones and skin fragments. This is because the cells that have gone mad are the ones that have the potential to create the different types of tissues normally found in your body. These cysts are best removed surgically - after all, who wants a set of teeth in their ovary?