module menu iconTackling women's intimate health

Introduction

Understanding the issue

Treatment options

When to refer and where to signpost

Scenario

Test you knowledge

module menu icon Understanding the issue

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module menu icon Understanding the issue

Understanding the issue

There are a variety of women's intimate health issues to look at:

Vaginal dryness Thrush Cystitis Bacterial vaginosis

Vaginal dryness can affect women of any age, but is more common during and after the menopause. Symptoms include itching, burning and pain inside or around the vagina, as well as pain during sexual intercourse – sometimes with bleeding. In addition, there may be urinary symptoms, such as increased urgency, pain and recurrent urinary tract infections (UTIs). 

Thrush is a common infection caused by the yeast Candida albicans. If the balance of bacteria and yeast in the vagina changes, the yeast can thrive and cause thrush symptoms, such as itching and a thick white, odourless discharge. There may be a stinging feeling when urinating and the skin in the area might be itchy, red and inflamed. Thrush can be more common after a course of antibiotics, in women with diabetes and in pregnant women. Men can also be affected. 

Cystitis is an inflammation of the bladder. It is usually caused by a bacterial infection, but can be caused by irritation. Symptoms include needing to urinate frequently, pain and/or stinging when urinating, dark or cloudy urine and feeling generally unwell. It often resolves by itself within a few days, but causes discomfort. 

Bacterial vaginosis (BV) is another common condition that occurs as a result of changes in the balance of bacteria in the vagina. Symptoms include a vaginal discharge that might be thin and watery, grey/white in colour and have a strong fishy smell. However, many women with BV do not have symptoms. 

STI signs and symptoms

Some intimate health symptoms indicate a sexually transmitted infection (STI), while some STI symptoms are similar to conditions such as thrush (which is not necessarily transmitted during sex). Chlamydia is an STI that often doesn’t cause symptoms but can affect fertility if it is left untreated. 

Anyone who has symptoms such as blisters or sore spots around the genitals, yellow/green vaginal discharge, bleeding between periods and/or after sex, pain during sex or lower abdominal pain should be referred to the pharmacist. 

If customers are concerned that they might have an STI, you should refer them to the pharmacist or signpost them to a sexual health clinic or genitourinary medicine (GUM) clinic for further advice. 

The menopause

The menopause is when women stop ovulating and their periods stop. This means that a woman can no longer get pregnant and that hormones don’t fluctuate in the same way as they did during monthly menstrual cycles. The menopause usually begins between the ages of 45 and 55, and beforehand, periods may become less frequent before stopping. The average age for a woman to begin the menopause in the UK is 51.

Women going through the menopause have low levels of oestrogen, which can reduce the amount of natural lubrication produced in the vagina, causing dryness and discomfort. Other symptoms of the menopause include hot flushes, night sweats, low mood, anxiety, difficulty sleeping and loss of libido (sex drive). 

Tackling women's intimate health

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