Heavy bleeding, painful periods and pelvic problems are all issues that seriously affect women – the Nuffield Hospital in Ipswich can tell you why you don’t need to suffer in silence
Nearly half the women in the UK will at some point in their lives experience a gynaecological problem and almost two million* will be diagnosed with endometriosis – which illustrates how big an issue women’s health is. But many of us suffer in silence or just ‘put up’ with problems to avoid a trip to the GP or to avoid discussing them with a partner.
“The most common gynaecological problems I treat are period problems like heavy, prolonged bleeding or painful periods, bleeding after menopause, pelvic pain, pelvic floor prolapse, urinary incontinence, along with early pregnancy problems,” says Mrs Nippani, Consultant Obstetrician and Gynaecologist at Nuffield Health Warwickshire Hospital.
Endometriosis is first diagnosed when a woman notices that she is experiencing painful periods with a heavier bleed than normal and painful sex. It isn’t clear how it occurs, but it’s thought that cells from the lining of the uterus (the endometrium) grow in the pelvic area and on other internal organs. These cells undergo changes cyclically with the menstrual cycle, stick together and create sticky adhesions on organs like the bladder and bowel, and larger patches form cysts. Some women have worse symptoms than others but it usually affects women aged between 30 and 40 and settles after the menopause.
“Depending on where the endometriosis is present and has struck, it can present with a variety of symtoms, eg as cystitis or as painful defecation or mimic symptoms of Irritable Bowel Syndrome. The symptoms usually follow a pattern with the menstrual cycle,” explains Mrs Nippani.
Your gynaecologist may initially prescribe the combined oral contraceptive pill to treat the condition.
“Another method if symptoms are severe, is to induce a menopause with hormone treatment which suppresses the ovary. Surgically, the simplest method is to cauterise the patch, where safe, through keyhole surgery. A final procedure would be the removal of the ovaries to achieve menopause,” explains Mrs Nippani.
Heavy period bleeding, known as menorrhagia, is a major problem for many women and although it can vary depending on your age, for some women it is a lifestyle issue and needs treatment. And what is heavy bleeding to some, may not be to others. How do you know when you have a serious problem and when to seek help?
“If there is a significant change in your periods and it’s leading to anaemia, you need to seek professional help. If you are passing large clots or are experiencing ‘flooding’ where blood soaks through all layers of your clothing suddenly, then that is regarded as menorrhagia,” explains Mrs Nippani.
Treatment is varied and can range from the combined oral contraceptive pill to a hormonal-containing coil (Mirena). Surgical treatment is an option for some as Mrs Nippani explains: “Endometrial ablation to permanently destroy the lining of the uterus is a common interventional procedure, but is reserved for those women who have completed their family”.
Another common women’s health problem is prolapse whereby one of your pelvic organs, like the womb, bladder or rectum slips down into the vagina, as the supportive muscles and tissue have grown weak. Women who suffer with this condition describe it as a feeling of fullness and experience urinary incontinence.
“Usually, it’s a feeling or awareness of ‘something coming down’ in the vagina, a dragging sensation, and may be accompanied by urinary frequency and a sense of incomplete emptying,” says Mrs Nippani. “Some women may also have repeated urinary tract infections or difficulty in emptying their bowels.”
If the prolapse is mild in nature, pelvic floor exercises and weight loss may be sufficient in alleviating the problem. Where it is more significant, and surgery is not the preferred choice of treatment, pessaries can be used. Surgical option might be considered, although a recurrence after surgery is hard to predict.
“Different types of pessaries can be used to lift the prolapse, but these have to be changed every four to six months for the rest of a patient’s life. They can used temporarily during pregnancy or while waiting for surgery, too,” says Mrs Nippani.
To keep your body healthy and to reduce your risk of gynaecological problems, keep an eye on your weight as obesity can affect your periods. Also regularly exercise your pelvic floor (squeeze and relax several times a day). And most importantly, don’t skip any health screenings – they may pick up on something you hadn’t noticed.
Should you wish to arrange for a consultation with one of our specialist consultants, please do not hesitate to contact us via the telephone on 01473 279100.
Wellbeing of Women Charity (www.wellbeingofwomen.org.uk)