Other common gynaecological conditions

Although the community pharmacy may not always be the best place to go to for diagnosis, treatment and or advice the location of a community pharmacy and its accessibility means that the community pharmacy team is ideally situated to offer simple treatments, provide basic guidance, and signpost patients to professional advice and support. Depending on the severity of the condition the pharmacy could offer treatment options e.g., lubricating jelly, symptomatic relief e.g., simple analgesia and specific products e.g., sanitary towels for a variety of other gynaecological conditions.

The below list is not exclusive but some common gynaecological disorders include:

• Dyskaryosis. Refers to the change of appearance in cells that cover the surface of the cervix. Usually because of an abnormality of the nucleus (central part) of a cell. It is often reffered to as pre-cancerous cell changes. Most women who undergo a cervical screening will return with a normal result. However, around 1 in 20 smear test results will come back as abnormal. This does not necessarily mean cervical cancer, but rather that there are potential pre-cancerous changes in the cervical cells which need investigating. A cervical screening test is essential for detecting cell changes that could lead to cervical cancer. Smear tests identify these changes in cervical cells and help identify potentialy abnormal and pre-cancerous cells which can help prevent cervical cancer. It is quite normal for women to experience this at some stage in their life and it does not typically allude to anything serious. In fact, a test (or cervical screening) should be viewed as a preventative step as a mutation (however small) can be addressed before any serious complications arise. It’s why we recommend that all women over the age of 25 should book a cervical screen test.
• Bladder problems. These are common and can be very embarrassing, affecting a woman’s quality of life, confidence, and relationships. These problems should not be regarded as a normal part of ageing, as there are many treatments which can produce excellent results. A common example is urinary incontinence. This a condition which may affect many women, particularly after childbirth or the ageing process. There are several types of urinary incontinence, including:
  • Stress incontinence – when urine leaks out when the bladder is put under pressure from physical movement or activity, such as laughing, sneezing, coughing, or running. Despite the name, it is not linked to psychological stress.
  • Urge incontinence – a sudden, intense urge to pass urine which is then followed by the involuntary passing of urine. People with urge incontinence usually urinate frequently, such as at night. It can be caused by infections or more serious conditions, such as diabetes.
  • Overflow incontinence – often or constant dribbling of urine because the bladder has failed to empty fully.
  • Functional incontinence – physical or mental condition is stopping you from going to the bathroom on time. This could be severe arthritis, for example.
  • Recurrent urinary tract infection that persists for a long period of time, typically at least three times in a six-month period
• Early pregnancy problems. Aside from the most common signs of early pregnancy (i.e., cessation of periods, nausea with or without vomiting, breast tenderness, urinary frequency, and fatigue), other symptoms can be a little more worrying. These include vaginal bleeding and abdominal pain or discomfort.
• Fibroids. These are often referred to as uterine myomas, fibromas or leiomyomas, fibroids are benign (non-cancerous) growths that develop in or around the womb. They are firm, compact tumours that consist of muscle cells and fibrous connective tissue within the uterus and they can vary in diameter, from the size of a pea to the size of a small orange. Fibroids are a very common issue. Some reports claim that 30% to 77% of women will develop fibroids during their reproductive years. However, many women are unaware that they have fibroids because they simply don’t experience any symptoms. Moreover, only 1 in 3 fibroids are large enough to be detected by a healthcare professional during an examination.
• Ovarian cysts. These are fluid-filled sacs or pockets within or on the surface of one of the ovaries. Many women will develop them at some time during their lives and they are usually discovered during routine pelvic examinations. Most ovarian cysts are painless and cause no symptoms, usually disappearing on their own without the need for medical attention.
• Pelvic pain. This is much more common in women than men and can be caused by various health conditions or diseases. It is felt in the lowest part of the abdomen and pelvis, below the belly button and is normally accompanied by back pain and other pelvic area symptoms. A woman may briefly experience a dull or sharp pain, which comes on suddenly and is severe (acute pelvic pain), or as a constant or intermittent pain which lasts for six months or longer (chronic pelvic pain). Often women describe it as a sharp pain in the anus and lower abdomen or, more broadly, lower back and pelvic pain. Pelvic pain and lower abdominal pain can also vary in their severity. Sometimes it is so intense that it feels like a hot poker is inside the vagina. In any scenario, the severe pain may also transfer to the lower back, buttocks or thighs.
• Polycystic ovary syndrome (PCOS). This is a common condition which affects around a fifth of all women. It is a chronic, long-term condition in which there is no cure. PCOS affects the way in which a woman’s ovaries function and is, therefore, the most common cause of infertility in women. When a woman has PCOS, her ovaries will contain a large number of small harmless follicles (fluid-filled sacs) up to 8mm in size; twice the number of follicles that normally exist on the ovaries. These follicles are often unable to release an egg which means that normal ovulation cannot occur. Polycystic ovary syndrome usually manifests during adolescence and results in a hormonal imbalance. In all women, testosterone is produced by the ovaries in small amounts, but this is higher than normal in women with PCOS, which can cause several problems, such as irregular periods, weight gain and excess bodily hair. The exact causes of PCOS are unknown, though it is very usual for the condition to run in families.
• Physical Problems after Childbirth. A woman will notice significant changes to her body following the birth of a baby. Many of them will experience physical problems relating to the pelvic floor muscles, which are the group of muscles holding in place the pelvic organs (uterus, vagina, bowel, and bladder). The function of the pelvic floor muscles is to support the bladder and bowel, enabling us to control our urination.
• Pelvic prolapse. This and pelvic floor problems are very common conditions that affect millions of women. They are associated with childbirth and menopause and can be a cause of discomfort, embarrassment and loss of self-esteem. Prolapse can affect urinary, bowel and sexual function, therefore significantly affecting a woman’s quality of life
• Sexually transmitted infections (STIs). These are infections which are passed from one person to another by sexual contact. STIs do not always produce obvious symptoms, but several can cause long-term complications such as pelvic inflammatory disease, chronic cystitis, infertility or abnormalities of the cervix. All sexually active people should be encouraged to undergo regular sexual health screenings, particularly if they have recently had unprotected sex, are experiencing unusual symptoms, or are changing partners. It is important to note that many STIs show no symptoms, so they could still have an infection without knowing about it.
• Vaginal atrophy. This is the thinning, drying and inflammation of the vaginal walls, sometimes called vulvovaginal atrophy (VVA). Atrophic vaginitis is a common symptom of GSM (Genitourinary Syndrome of Menopause), which refers to the symptoms associated with the later years of menopause. This can occur around three years into menopause but can start earlier than that. Around a half of all women experience symptoms of vaginal atrophy when the cells in the vagina are most lacking in hydration and cervix lubrication decreases. The symptoms can include vaginal discomfort or soreness, burning sensation, itching, and bleeding. It can also lead to urinary tract issues like recurrent cystitis. Whilst atrophic vaginitis is a common menopausal symptom, the condition is not widely discussed, and as such, few seek treatment. Many women believe it is a normal consequence of menopause and resign themselves to suffering in silence. However, if left untreated atrophic vaginitis can lead to more severe symptoms like frequent urinary tract infections and higher chances of vaginal infections. Therefore, as well as simple treatments like lubricating jelly there is a lot of support the community pharmacy team can offer the patient. Vaginal dryness is not usually a sign of a serious medical condition. However, the symptoms of vaginal atrophy can be difficult to deal with. They can cause considerable discomfort and impact a woman’s mental and emotional state, as well as their lifestyle.