No one should feel lost when it comes to their menstrual health worries. Much of this subject is still taboo, but at Yoppie, we believe no question should be too embarrassing or too silly!
Our in-house expert Dr Brooke Vandermolen, Obstetrics & Gynaecology specialist doctor, is here to answer some of the commonest concerns that women ask their gynaecologist
1. Is my discharge normal? 💦
Having vaginal discharge is a vital part of maintaining the overall health of the region. It is quite normal for your discharge to change throughout your menstrual cycle, from its colour to the consistency and smell.
This discharge serves many important functions including; cleansing the vagina, getting rid of natural bacteria and any dead cells and providing a natural lubrication to keep sex comfortable as well as preventing any skin irritation or discomfort. (1)
Pay close attention to your discharge, and if you notice it has an unusual colour or smell, or is blood-stained when it shouldn't be, seek advice from your doctor.
2. Why do I need to have a smear test? 🔬
Cervical cancer is an extremely rare, slow growing cancer. Doing a smear test, where a doctor or nurse takes a small sample of the cells in your cervix to be checked under a microscope is a very effective way of detecting abnormal changes in these cells, before they have a chance to become cancerous. It is not a diagnostic test for cervical cancer.
A new addition to the cervical cancer screening program is testing for the HPV human papillomavirus. This virus is known to cause 99% of all cervical cancer, so we now test every sample for HPV before the cells are checked under a microscope. (2)
Having regular smear tests means if there are any changes that develop, it can be caught and treated early without requiring any invasive treatment.
3. Do I need to shave before visiting the gynaecologist? 🤔
Definitely not! Gynaecologists are not particularly interested in what you chose to do with your pubic hair, and it makes no difference to the outcome of the examination. They will most likely have seen thousands of vaginas, so there is no need to be concerned or embarassed about the appearance of yours! Do whatever makes you feel most comfortable but of course it is perfectly normal to feel nervous before expecting an intimate examination.
4. Does it matter if my period isn't regular? 🙇🏽♀️
The average menstrual cycle lasts 28 days, although it’s normal for it to vary by a few days each month. You don’t need to get medical advice if you have always had slightly irregular periods or you’re still going through puberty.
It is a good time to seek advice if:
- Periods suddenly become irregular and you’re under 45
- Your cycle lies outside of the range 21-35 days
- Periods last longer than 7 days
- There’s a big difference (at least 20 days) between your shortest and longest menstrual cycle
- You have irregular periods and you’re struggling to get pregnant whilst trying to conceive for more than 6 months
There might not be anything wrong, but it’s a good idea to speak with your doctor and get checked out to see what the cause might be.
5. How much blood is normal to lose during your period? 🩸
Most women will lose around 80ml of blood during their period. Your period is described as heavy if you lose more than this amount, or your periods last for 7 days or longer.
However, what seems heavy for one woman may feel completely normal for another. Therefore to help you work out if your bleeding is generally considered excessive see if it fits with any of these issues:
- Having to change your sanitary products every 1-2 hours
- Passing blood clots larger than 2.5cm (about the size of a 10p coin)
- Bleeding (flooding) through to your clothes or bedding
- Needing to double up on sanitary products (eg tampons and pads)
6. How should I clean my vagina? 🧼
Simply put, all you need is warm water! People often describe the vagina as ‘self-cleaning’ because the environment itself, which includes friendly bacteria and a naturally low pH as well as the lubrication of the vaginal discharge all help to prevent infections and get rid of old cells and debris. Fragranced soaps, or even vaginal ‘douching’ disrupt this delicate environment and actually increase the likelihood of infections occurring. You should never wash inside the vagina with soap or any other gels or antiseptics.
If you want to clean the outside, known as the vulva, you can use gentle, unfragranced soap and warm water daily as part of your normal bathing routine. (3)
7. What should my vagina smell like? 👃🏼
A healthy and clean vagina has a certain natural scent and taste that should not be unpleasant. You should get to know your ‘normal’ smell so you can understand when something is up. You may notice the smell change at different times of your cycle, such as during your period.
Factors that affect the odor of the vagina include antibiotic use, douching, spermicide, new sexual partners, and frequency of sex. Your diet, such as eating garlic, onions, brussels sprouts and red meat, can create a different odor in the vagina. Hormonal changes caused by pregnancy, breastfeeding, or menopause can also alter your scent.
If you or your partner notices an offensive, fishy, yeasty, or foul odour, it is a good to speak to your doctor who may recommend a swab to check for any infections.
8. My bowels go weird around my periods - why is that? 🧻
It’s probably not talked about enough, but important period symptoms also include digestion; specifically abdominal bloating and diarrhoea which you may experience around the time of your period.
During menstruation, your body releases chemical-messengers called prostaglandins, which stimulate your uterus to contract, which helps encourage the shedding of the uterine lining (the period). These prostaglandins are suggested to be responsible for increasing gastrointestinal side effects around this time, by having an effect on the gut tissue. (4)
Not everyone may notice this shift in stool patterns, but if you already suffer from conditions like IBS you may be more susceptible to these changes.
9. Can I have sex during my period? 🍆
Yes, you certainly can have sex when you're on your period. However, apart from the mess there are also some risks to be aware of; HIV and other sexually transmitted infections (STIs) may be passed on more easily therefore so you should always use a condom.
Also, while it's very unlikely, it's still possible to get pregnant if you have unprotected sex during your period. This is because some women ovulate early, and sperm can survive inside a woman's body for up to 7 days.
10. How do I avoid getting infections like thrush? 👀
>Infections like thrush and bacterial vaginosis are very common for women of all ages. At best they can be a bit of a nuisance, and at worse they can seriously impact on your ability to lead a normal life.
There are lifestyle and hygiene changes that you can make to lower your risk of developing thrush, as well as keeping you in good health. It may surprise you to know that your diet can have an impact on your vaginal health, so you can support your immune system and keep the friendly bacteria in balance.
Other precautions you can take against thrush include:
- Washing your underwear in gentle and fragrance free detergent
- Having showers rather than baths
- Avoid perfumed soaps when washing the vagina, and never use soaps or douches internally
- Making sure to dry your genitals properly after washing
- Wearing light-fitting cotton underwear and avoid wearing tights or tight jeans
If you experience recurrent infections, avoid the temptation to self-treat each time with over-the-counter treatments. Instead pay a visit to your doctor who can confirm the infection with a swab and prescribe different or longer-term treatment.
- Ceccarani, C., Foschi, C., Parolin, C. et al. Diversity of vaginal microbiome and metabolome during genital infections. Sci Rep 9, 14095 (2019). https://doi.org/10.1038/s41598-019-50410-x
- Burd, Eileen M. “Human papillomavirus and cervical cancer.” Clinical microbiology reviews vol. 16,1 (2003): 1-17. https://doi:10.1128/cmr.16.1.1-17.2003
- Bernstein, Matthew T et al. “Gastrointestinal symptoms before and during menses in healthy women.” BMC women's health vol. 14 14. 22 Jan. 2014, doi:10.1186/1472-6874-14-14