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5 signs that something might not be right down below, according to a gynaecologist

Unsure what’s normal and what’s not when it comes to vulval health?

Liz Connor speaks to consultant gynaecologist Anne Henderson.

Women’s intimate health can sometimes feel like an embarrassing topic to discuss – but experts say it’s vital to pay attention to what’s normal and what’s not, as serious conditions, like gynaecological cancer, can be easy to miss.

“One of the main reasons people don’t treat infections is because they don’t know they have one – mainly because they simply don’t know the symptoms,” says consultant gynaecologist Dr Anne Henderson.

She recommends checking your vulva regularly, to help understand any changes that may be happening. “Women should examine their vulva at least [every] two to three months,” she says. “You need to check for change in skin colour, anatomy and shape, and if you’re suffering with painful symptoms or bleeding, seek specialist help from your GP.”

Slim woman dressed in white panties, holding a red flower in her hands, close-up. Gynecology, menstruation, the concept of genital health

Do you keep a check on your intimate health?

Remember, it’s often a case of knowing what’s ‘normal’ for you, and most of the time if something does seem unusual, there won’t be anything seriously wrong – but it’s always best to get things checked out sooner rather than later.

Here, Henderson talks through a handful of intimate health warning signs that everyone should be aware of…

1. Discharge
A lot of women are concerned about their discharge, but Henderson assures that it is mostly a healthy and very normal bodily function, as it sweeps bacteria away from the vagina.

Nonetheless, problems with discharge can start when you have an overgrowth of certain bacteria or pathogens.

shorts in hands for laundry

Discharge is completely normal but a change in consistency could be a warning sign

“If you have a heavy, white discharge, this may be thrush presenting itself,” she says. “At the beginning, it often manifests as very thick, severe thrush that can be likened to cream cheese or cottage cheese. It can have also have obvious lumps in it.

“If your discharge is runny, watery or even has a greyish colour however, this may be an indicator that you are experiencing bacterial vaginosis (BV), which is caused by specific gardnerella bacteria,” she adds. “If you’re unsure what your discharge means, self-tests such as Canestest (£10.49, Boots.com) will help you quickly identify if your pH levels have changed and if you are experiencing thrush or BV. Once you have your diagnosis, you can effectively treat any changes.”

2. Itching
Experiencing an itchy vulva can indicate a number of possible problems. “These can range from an infection such as thrush, to a reaction to underwear or clothing- especially clothes made from synthetic fibres,” says Henderson. “Vaginal itching can also be caused by vaginal dryness, often onset by the menopause.”

If you have vaginal or vulval itching, Henderson recommends switching to cotton underwear rather than polyester, and try to use non-bio washing powders that won’t aggravate delicate skin.

“Think about the products you’re using in the bath or shower too, as this could be causing irritation,” she adds. “Finally, fragranced tampons can sometimes add to the irritation so I always recommend that women should consider using organic varieties, as these are less likely to cause further symptoms.”

3. Pain
Pain with intercourse is an important symptom which is easy to ignore, particularly if it’s never happened before. “If pain is unusual for you, it’s something that should definitely be checked out because it could be one of the first signs of a serious infection,” warns Henderson.

Woman holding heart

Pain should never be ignored, says Henderson

“If you’re experiencing pain due to vaginal dryness, meanwhile, this could be a symptom of the menopause or a hormonal imbalance due to a lack of oestrogen. This can be treated effectively with local oestrogen replacement.

“In some cases, pain during sex can indicate thrush, and if you’re experiencing pain and bleeding during intercourse, it may indicate an STI or even inflammation of the cervix,” she adds. “It’s always a good idea to seek advice from your GP if sex is causing discomfort.”

Pain can sometimes be associated with gynaecological cancers too – the best thing to do is make an appointment and get things checked.

4. Change in odour
When it comes to ‘down there’, everyone has a slightly different odour and what women find normal or abnormal is not the same for everyone.

“Your vaginal odour will change slightly through the month, largely because the pH level changes and the whole consistency of the mucus changes due to hormonal cycles,” says Henderson. “Getting to know what’s going on will help you understand what is normal for you. If you notice a dramatic change combined with an increase or change in discharge, it may represent a problem which needs to be checked out.

“A change in discharge combined with a ‘fishy’ odour, for instance, could likely be bacterial vaginosis. However, unlike thrush, it won’t cause discomfort.”

If you suspect you have BV, Henderson says you may be able to treat the symptoms quickly with a pH balancing gel, such as Canesbalance Bacterial Vaginosis Vaginal Gel (£13.49, Superdrug.com).

If symptoms persist though, see your doctor to get things checked.

5. Lumps
“Most lumps or bumps on the vulval area are benign and completely harmless,” says Henderson, “although they can catch on underwear and cause irritation or discomfort during exercise or intercourse. However, in very rare cases, new lesions can indicate more serious pathology, including vulval pre-cancer or cancer.”

Henderson says vulval cancer may present either as an ulcer or open sore, which is more common than a lump or cystic swelling. “The affected area can also be uncomfortable, with burning discomfort and itching, but some cases are asymptomatic.”

She stresses that if something feels wrong with your intimate health, it’s always a good idea to get a second opinion. “Changes such as this should always be checked promptly by your GP,” she says.

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