Our blog this month aims to summarise alert signs and symptoms that may indicate a more serious underlying health problem.
BLEEDING AFTER THE MENOPAUSE
You have gone through the menopause or considered post-menopausal if you have had no periods for at least 12 months. Any vaginal bleeding that occurs after this time, requires further investigation. A large majority of women will not have serious disease, but it is the commonest first symptom of endometrial cancer (which is a cancer of the inner lining of the womb), so speak to your doctor.
This is a feeling of fullness or distension. It is commonly caused by lots of gas in the gut, but can also be caused by constipation, irritable bowel syndrome, food intolerances and coeliac disease. Persistent bloating can be a sign of something more serious such as a cancer of the ovary, so it’s important to speak to your doctor to get this checked.
Most, but not all, cases of ovarian cancer are diagnosed in women over the age of 55yrs, so more commonly in women who have gone through the menopause. It’s important therefore to be aware, that if you haven’t had a period for a year or more, symptoms that would normally be associated with menstruation, such as bloating, pelvic pressure, constipation, new lower back pain, passing urine more often, require further attention. A constant dull abdominal ache, or new acid reflux can also be a common first symptom in women with ovarian cancer.
BLEEDING AFTER SEX
There are many reasons why bleeding can occur after sex. Causes include, a sexually transmitted infection, pelvic inflammatory disease, trauma to the vagina, vaginal dryness related to the menopause, non-cancerous growths on the cervix, and a cervical ectropion (To read more about cervical ectropions, visit our blog page at www.2meclinic.com). Bleeding after sex can be a sign of a serious condition such as a cancer of the cervix, or vagina. Bleeding between periods can also be a symptom of a more serous problem affecting the cervix, inner lining of the womb (endometrium), vagina or vulva, so it’s important to speak to your doctor about any changes in your bleeding pattern.
Changes in the breast can be warning signs of breast cancer. These changes include:
Skin: dimpling/puckering, peau d’orange (orange peel) appearance, redness, flaking,
Nipple: nipple inversion (turning inward or pulling in), nipple discharge or ulceration
Breast: a new lump in the breast or armpit, change in the size or shape (breast pain is a less common symptom of cancer)
Glands: prominent glands in the armpit, or glands above or below the collar bone
ACUTE PELVIC PAIN
This is pain in the pelvis lasting less than 3 months. It is very common as there are a number of other organs within the pelvis which can potentially contribute to the development of pelvic pain such as the uterus, fallopian tubes, ovaries, bowel, and bladder. Some causes of acute pelvic pain that require urgent assessment include: an ectopic pregnancy (where a fertilised egg implants and grows outside the main cavity of the uterus, commonly in the fallopian tube), a strangulated hernia or a hernia that gets ‘stuck’ (resulting in the blood supply to the neighbouring tissues being cut off), an appendicitis, acute pelvic inflammatory disease, and rupture of an ovarian cyst.
ABNORMAL VAGINAL DISCHARGE
Vaginal discharge or mucus is an important result of fluctuations in hormone levels that occur throughout your menstrual cycle. Around mid-cycle, you will notice that your discharge is clear, watery, and more abundant. After mid-cycle, just before your next period, the discharge is thicker and may have a milky white/yellow colour. Around the menopause, vaginal discharge can change to a thicker or watery/runny consistency. Some women even describe it as being like a ‘water-period’ or a ‘no-blood period’. Changes in discharge that are not typical for you should be checked as they can be a sign of a more serious problem such as an infection or less commonly, a cancer.
You can read more about causes of vaginal discharge by visiting the ‘2Me Clinic Waiting Room’ on the homepage of our website: www.2meclinic.com
BLOOD IN URINE
Blood in urine should always be checked by your doctor. It is commonly caused by a urine infection, particularly where other symptoms are present such as pain on passing urine, passing urine more often, or lower abdominal pain, but blood in the urine can be caused by a more serious problem such as a cancer. So, if there is no evidence of an infection, you will need to be referred for further investigation with a specialist.
It is important to remember that around the time of the menopause, falling oestrogen levels cause changes that make it more likely to develop a urine infection and for some women this can be a recurrent problem. Hormone replacement therapy can help in this situation, but it is important that if you experience recurrent urine infections, your doctor should consider referral to a specialist for further investigation to exclude any other potential problem that could co-exist within the urinary system.