Many women consider gynaecological issues – those involving the urogenital system – a taboo. They are often ashamed to visit a physician, waiting for the problem to go away by itself or ignoring bothersome symptoms. Yet lower abdominal pain, breakthrough bleeding or discomfort during sexual intercourse may all be symptomatic of a disease affecting health or fertility. We invited Professor Grzegorz Jakiel, gynaecologist and Zdrowa ONA programme expert, to help explain which gynaecological issues are the most common and why it is so important for every woman to monitor her health condition.

A healthy lifestyle involves more than eating right or regular physical exercise. It is also about monitoring any changes to the body and not neglecting medical checkups, including gynaecological visits. Remember: so-called female issues may affect women regardless of age, sexual intercourse frequency, or history of past diseases. Getting rid of shame and fear of “bad news” may help prevent unpleasant symptoms, or even diagnose a potential disease. There are many treatment options today (surgical and pharmacological alike) – which is why I always encourage my patients to visit their doctors regularly and talk to them openly about their medical conditions, says Professor Grzegorz Jakiel.

Common female problems

• Vaginal bacterial infections – most common female issues include vaginal itching and discharge. Most frequent symptoms include a change in the appearance and odour of vaginal fluid. Antibiotics, infections of other organs, and improper hygiene are all conducive to such issues. As infections may recur, self-treatment is not advisable: a woman should visit her gynaecologist who will recommend treatment depending on symptom severity and reasons for inflammation.

• Endometriosis – growth of endometrial (uterine) tissue beyond the uterine cavity, usually in the peritoneal cavity, ovaries, and fallopian tubes. Symptoms frequently include pain – usually during menstruation, sexual intercourse and/or urinating – and infertility. Moreover, other strongly non-specific issues may occur, such as nausea, general weakness, and/or severe PMS. Endometriosis and related symptoms withdraw during pregnancy, to vanish altogether during menopause. Patients are usually treated pharmacologically or surgically (e.g. to remove intrauterine adhesions making conception potentially difficult).

• Polycystic Ovary Syndrome (PCOS) – symptoms include menstrual disorders, unusual hair growth, skin issues, and – occasionally – excess body mass. The illness may also cause infertility for reasons of permanent or periodical absence of ovulation. Treatment depends on individual circumstances, the patient’s life plans always taken into account (pregnancy, menstrual cycle correction, cosmetic effects, etc.). Yet common solutions involve symptom-based treatment and hormonal pills, as well as surgery in case of conception issues.

• Uterine myomas – benign growths in the uterine lining. While they may appear in isolation, the usual condition involves several or even more than ten myomas. Depending on the location, they are classified as submucosal, intraluminal, and subserous. They are frequently found by chance, during a uterine USD exam. Their location determines all symptoms and choice of treatment. Leiomyomas usually cause pain and discomfort of the pelvis, heavy or prolonged menstrual bleeding, and/or fertility disorders.

Treating uterine leiomyomas is always an individual decision, determined by a variety of factors – the patient’s age, her reproductive plans, and growth location. If the tumours are small and causing no issues, they might be left in situ with no treatment applied. Yet when causing discomfort, pain, or conception problems, they may be removed surgically, myomectomy the most common method. Nonetheless, the latter requires the patient to be hospitalised, with no guarantee that growths will not recur. A worthwhile solution involves the use of pharmacological treatment (with ulipristal acetate). Ulipristal acetate-based medicine reduces myoma growth, the effect permanent also once treatment is discontinued. The method is particularly recommended for future mothers trying for a baby. While the treatment is not yet refunded in Poland, asking a gynaecologist about all treatment options available is definitely worthwhile, adds Professor Grzegorz Jakiel MD, gynaecologist and Zdrowa ONA programme expert.

Health under control

Every woman would like to be able to control her health. This is not always easy, as sometimes we cannot influence this particular aspect of our lives. In order to enjoy sound health as long as possible, we should never forget regular medical checkups. Their type and frequency are determined by age and past medical history. Basic tests all women – especially over fifty – should undergo include regular gynaecological checkups, uterine USG, cytology and mammography screening tests, and blood and urine tests. All tests should be annual; in case of any worrying condition, a physician should be consulted as soon as possible.