We are often labelled a “complicated” sex, and whether this is true or not of our psyche, I would certainly agree when it comes to our reproductive system. We are constantly balancing our delicate hormones to achieve harmony, and very often this equilibrium is thrown out of kilter. It is really important to know when these changes are normal, and when further investigation is needed. Unfortunately, I find too many women anxious and embarrassed about seeing their GP, suffering with issues that could have been easily treated or more worryingly, sitting on problems that may have serious implications. I cannot reassure women enough, that as GPs we have seen and heard it all, so if you are ever concerned or have any of the following symptoms, please see your doctor.
- Breast lumps
It can be difficult to know what all those lumps and bumps are in our breasts, but reassuringly only 10% of women who have lumps will have cancer. Usually it’s just normal connective breast tissue clumping together (called a fibroadenoma), or sometimes a benign cyst or fatty lump, but if you do ever feel a lump in your breast you should always see your doctor. It is fairly common to get cysts that come and go depending on your menstrual cycle, and if your GP thinks it feels benign they may suggest reviewing you to see if that lump persists after your period. However, if you are post-menopausal or your doctor is not sure what’s causing the lump, they will refer you to the breast clinic for more tests. A cancerous lump often feels hard and craggy, and doesn’t move easily under the skin when touched. There may also be lymph nodes in your armpits or a change in the overlying skin in the breast or to the nipple.
- Abnormal bleeding
There are lots of factors that affect our periods, including
weight loss, exercise and stress. Often it will correct itself and
treatment isn’t necessary, however if your periods continue to be irregular, heavier, or lasting longer than normal, you should discuss this with your GP. Furthermore, if you are getting any bleeding after sex, or between your periods, a visit to your GP is important as these can be signs of STDs or abnormalities to the cervix, womb or ovaries. If you have gone through your menopause and start bleeding again, you must also see your GP, as it is abnormal to bleed after the menopause and it may be a sign of a cancer in the womb.
Unfortunately, when it comes to ovarian cancer, the signs and symptoms can be very vague, and the primary symptom of bloating mimics other conditions like IBS or PMS. I suggest that if you have felt bloated most days for three weeks or more, then you should see your GP. They may ask about associated symptoms like pelvic pain, feeling full or having a loss of appetite, increased urinary urgency or frequency and weight loss, and then carry out an examination, blood tests or an ultrasound.
- PV discharge
Vaginal discharge is normal, and we need it to keep the vagina moist and to protect us from developing infections. It is meant to be clear or white in colour and shouldn’t be malodourous. It can vary in its thickness depending on when in your cycle you are. But, if this changes and it becomes a different colour, or becomes smelly or more profuse, it may be a sign of a problem. The causes can include common infections like bacterial vaginosis or thrush which can often be treated easily with over the counter medications. However, it may also be a sign of a sexually transmitted infection like chlamydia, gonorrhoea, herpes or trichomoniasis. If left untreated, these STIs can lead to pelvic inflammatory disease which is an infection of the reproductive organs, which can be serious and lead to infertility. If these infections are ruled out as a cause of your change in discharge, your GP may need to consider growths (including cancer) to the womb or cervix as a potential cause, so it is important not to ignore this symptom.