Women are often very good at putting up with symptoms. Periods change, bloating comes and goes, pelvic pain is blamed on a busy week, and unusual bleeding is sometimes dismissed as 'just hormones'. Most of the time, there is a simple explanation. But when a symptom is new, keeps returning or feels different from what is normal for you, it is worth talking to a gynaecologist.
Here are seven symptoms that women should not ignore:
Bloating that keeps coming back
Everyone gets bloated occasionally, particularly around periods or after certain foods. What deserves attention is bloating that is persistent, becoming more frequent or accompanied by abdominal or pelvic discomfort, early fullness or loss of appetite. These symptoms have many possible causes, including digestive problems, fibroids, ovarian cysts and other gynaecological conditions, but persistent symptoms should be assessed rather than repeatedly treated as indigestion.
Periods that suddenly become much heavier
A heavy period is not necessarily abnormal, but a noticeable change from a woman’s usual pattern deserves a conversation. Bleeding that lasts longer than usual, requires very frequent changing of pads or tampons, causes clots or leaves a woman tired and breathless can sometimes lead to iron-deficiency anaemia.
Fibroids, adenomyosis, hormonal changes and problems affecting the lining of the uterus are among the possible causes. The important point is not to simply accept a significant change in menstrual bleeding as something that has to be endured.
Bleeding between periods or after sex
A small amount of bleeding outside the expected period can have relatively simple explanations, including hormonal contraception or changes around ovulation. But recurrent bleeding between periods or bleeding after intercourse should be discussed with a doctor.
Sometimes the cause is an infection, a cervical polyp or inflammation of the cervix. Occasionally, further investigation is needed to rule out more significant abnormalities. Unusual vaginal bleeding, including bleeding between periods or after sex, is a symptom that warrants medical assessment.
Bleeding after menopause
Once periods have stopped for 12 months, any vaginal bleeding should be checked, even if it happens only once and is very light.
There are several possible causes, including thinning of the vaginal or uterine lining, polyps and hormone-related changes. But because postmenopausal bleeding can sometimes be an early sign of cancer of the uterus or other reproductive organs, it should never simply be assumed to be harmless.
Pelvic pain that keeps returning
Period cramps are common, but pelvic pain that is persistent, increasingly severe or occurring at times unrelated to menstruation deserves a closer look.
Endometriosis, adenomyosis, ovarian cysts, fibroids, pelvic infections and urinary or bowel conditions can all cause pelvic pain. The character of the pain matters too: pain during sex, while passing urine or during bowel movements can provide useful clues about its source.
Feeling full unusually quickly
Feeling full after a very large meal is normal. Feeling unusually full after only a small amount of food, particularly when this is new and accompanied by persistent bloating, pelvic or abdominal discomfort or loss of appetite, is worth mentioning to a doctor.
These symptoms are much more commonly caused by non-cancerous conditions, but persistent combinations of these symptoms can sometimes point towards an ovarian or other abdominal problem and should not be repeatedly dismissed.
Visible change in vaginal discharge
Vaginal discharge naturally changes through the menstrual cycle. What is different is a new change in colour, smell, consistency or amount, particularly when accompanied by itching, pelvic pain, pain during sex or bleeding.
Infections are a common reason, but persistent or unusual discharge may need an examination to establish the cause rather than repeated self-treatment.
None of these symptoms automatically means that something serious is wrong. That is an important reassurance. The reason to discuss them with a gynaecologist is not to assume the worst, but to understand what is different and why.
If a symptom is new for you, keeps coming back, is getting worse, or is interfering with everyday life, it deserves a conversation. Knowing what is normal for your own body makes it much easier to recognise when something has changed.
(The author is a obstetrics, gynaecology and laparoscopic surgeon at KIMS-Arete Hospital)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
