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Women’s reproductive health: What every woman needs to know about common gynaecological issues

Staying informed about prevalent gynaecological issues is paramount for maintaining overall well-being during the reproductive years.

ByDr Pruthviraj MO

Published May 30, 2024 | 2:23 PM ⚊ Updated May 30, 2024 | 2:23 PM

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Image of a healthy female reproductive system. (iStock)

Women’s reproductive health involves a range of important issues that deserve close attention. From menstrual irregularities to infections, staying informed about prevalent gynaecological issues is paramount for maintaining overall well-being during the reproductive years.

This article delves into some of the most encountered challenges and the diagnostic strategies employed to address them effectively. The most common gynaecological problems women encounter during their reproductive years are:

Urinary Tract Infection (UTI)
White Discharge from Vagina
Irregular Periods
Heavy Menstrual Flow
Painful Menstruation (Dysmenorrhea)
Understating the conditions, symptoms and diagnostic approaches

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Urinary Tract Infection (UTI)

Urinary tract infections are prevalent among women due to various factors such as anatomical differences and external influences. The proximity of the anus to the urethra, coupled with a shorter urethral length compared to males, makes women more susceptible to UTIs.

Symptoms

Fever
Burning sensation during urination
Increased frequency of urination

Recommended tests

CBC
Urine routine microscopy
Urine culture sensitivity
Ultrasound KUB
CT Plain KUB, if required

White discharge from the vagina

White discharge is normal in many instances and can be seen in women before or after menstruation. Women should be evaluated for potential infection if they experience any of the following symptoms, to rule out the causative organism.

Symptoms

Vulval itching/ burning sensation
Profuse discharge
Painful sexual activity
Lower abdomen or pelvic pain
Pain during periods

Recommended tests

Per Speculum examination
Co-testing Pap smear (LBC) with High-risk HPV DNA from all above 21 years to 65 years
Vaginal swabs for culture sensitivity
Fungal cultures
Extended sexually transmitted infections panel if needed

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Irregular periods

Menstrual irregularities can signal hormonal imbalances or underlying health issues, particularly in cases where cycles deviate significantly from the average 28-day cycle. However, a cycle ranging from 21 to 35 days, with a deviation of 7 days plus or minus, is also considered normal.

For women with PCOS (polycystic ovarian syndrome), having 8 cycles in a year, which would be approximately once every 45 days, is still considered within the normal range. If they miss periods or experience frequent missed periods, this should be evaluated for possible hormonal imbalance.

Symptoms

For those nearing menopausal age with symptoms such as hot flashes, sweating, palpitations, and dry vagina, along with potentially elevated levels of serum FSH and serum estradiol

Recommended tests

For individuals in the reproductive age group who are sexually active, pregnancy should be ruled out through a serum beta hCG blood test.

For assessing hormonal imbalance, it is recommended to undergo thyroid function test and serum prolactin.

If PCOS is suspected, along with thyroid and prolactin tests, consider Oral glucose tolerance test with 75g, Fasting insulin, Total testosterone (in special cases) and Serum DHEA (in special cases).

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Heavy menstrual flow

A flow lasting seven days in total, with the need to change 20 pads (resulting in 80 ml blood loss) inclusive of these seven days, and the passage of small clots, is considered normal.

Symptom

If menstruation lasts for more than 7 days, requires changing pads every 2-3 hours, leads to waking up overnight for pad changes, or significantly affects work, necessitating taking leave, these symptoms require evaluation.

Recommended tests

Serum beta hCG is recommended to rule out pregnancy in the reproductive age group. Even if family planning surgery has been performed, this test is recommended due to the minimal risk or failure of sterilization procedures.

Thyroid and prolactin tests as well as Imaging study includes a transvaginal ultrasound scan of the pelvis to rule out structural abnormalities such as polyps, adenomyosis, fibroids, or malignant features.

Painful Menstruation (Dysmenorrhea)

Referred to as Dysmenorrhea, some amount of pain, cramps, and discomfort are considered natural to occur during menstruation. However, if there is a need to take pain medications on the majority of flow days and regularly during every period, the cause of the pain needs to be investigated.

Recommended tests

Per speculum and per vaginal examination
Pap smear to rule out cervical infections
Vaginal swab culture
Transvaginal ultrasound scan of the pelvis

Bottom line

Awareness of these common gynaecological issues is crucial for timely diagnosis and appropriate management. Women are encouraged to seek medical advice if they experience any concerning symptoms, as early intervention can significantly improve outcomes and overall well-being.

(The author is an obstetrics and gynaecology consultant at Manipal Hospital, Varthur)

(Edited by Shauqueen Mizaj)