Health topics specific to females:
- Birth Control
- Breast Health
- Eating Disorders
- The Hymen
- Urinary Tract Infections
- Vaginal Discharge
- Vaginal Infections and Pelvic Inflammatory Disease (PID)
- Female Libido Enhancer
Leucorrhoea is the excess discharge of colorless or white mucus kind of material from vagina. Sometimes the discharge is thick and sticky. It can smell either normal or be odorless or bad in smell. Small quantities of vaginal discharge are normal in adolescent women but excess release of fluid can be caused by severe infection or some medical problem.
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Lady Care Capsule, the herbal leucorrhoea treatment corrects menstrual disorders such as dysmenorrhoea, menorrhagia, polymenorrhea, metropathic menses, oligomenorrhea and secondary amenorrhoea. It helps in relieving menopausal syndrome symptoms such as loss of appetite, body ache, pelvic pain, headache, backache, giddiness and hot flushes. This herbal leucorrhoea treatment is also helpful in nervous and psychogenic disorders such as hysteria, anxiety, neurosis, insomnia, apathy, agitation, irritability and fatigue.
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Vaginal discharge is normal and varies during your menstrual cycle. Before ovulation (the release of the egg), there is a lot of mucous produced, up to 30 times more than after ovulation. It is also more watery and elastic during that phase of your cycle. You may want to wear panty liners during that time.
The things to be worried about include if the discharge has a yellow or green color, is clumpy like cottage cheese, or has a bad odor. If worried, see a doctor.
- Different Types of Discharge
- Is this normal?
Different Types of Discharge
White: Thick, white discharge is common at the beginning and end of your cycle. Normal white discharge is not accompanied by itching. If itching is present, thick white discharge can indicate a yeast infection.
Clear and stretchy: This is “fertile” mucous and means you are ovulating.
Clear and watery: This occurs at different times of your cycle and can be particularly heavy after exercising.
Yellow or Green: May indicate an infection, especially if thick or clumpy like cottage cheese or has a foul odor.
Brown: May happen right after periods, and is just “cleaning out” your vagina. Old blood looks brown.
Spotting Blood/Brown Discharge: This may occur when you are ovulating/mid-cycle. Sometimes early in pregnancy you may have spotting or a brownish discharge at the time your period would normally come. If you have spotting at the time of your normal period rather than your usual amount of flow, and you have had sex without using birth control, you should check a pregnancy test.
Is this normal?
We receive many questions about vaginal discharge through our “Ask the Expert” section. Below physician assistant Steven Johnson, explains what is normal and when to see a health care provider.
One of the challenges to answering questions sent into a health care Web site is making sure that the person asking the question seeks the advice and care from her doctor when appropriate. There is often information not given that can really change the answer.
- How old are you (really)?
- Are you on medications or do you take herbs or vitamins?
- Do you have pain or itching?
- Are you pregnant?
- Do you have other health problems (like diabetes)?
An important question is sexual activity. Sometimes it isn’t accurate to simply say yes or no. Symptoms can depend on the number of sexual partners, kind of sexual partners, birth control, birth control failure, kind of sex you are having and if abuse is involved. I think you can see, it can get pretty complicated to get all the information needed to give the best answer possible.
With that said, here is my best answer to the common question of vaginal discharge.
A normal vaginal discharge consists of about a teaspoon (4 milliliters) a day that is white or transparent, thick to thin, and odorless. This is formed by the normal bacteria and fluids the vaginal cells put off. The discharge can be more noticeable at different times of the month depending on ovulation, menstrual flow, sexual activity and birth control.
It is not uncommon for the normal discharge to be dark, brown or discolored a day or two following the menstrual period.
If you are having any of the symptoms below see your health care provider.
- Rash or sores alone or with a vaginal discharge
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During the follicular phase of the menstrual cycle, the lining of the uterus thickens to prepare for pregnancy. An egg becomes ready to be released inside a sac (follicle) on the surface of an ovary. During the luteal phase, the egg is released (ovulation). If the egg is fertilized by sperm, it may attach to (implant in) the lining of the uterus, and pregnancy begins. If the egg is not fertilized or does not implant, the lining of the uterus is shed as blood during the menstrual period (below), and the cycle starts over.
Having a period is an important part of being a woman – it signifies that you are fertile or capable of creating and having a baby. Most girls start menstruating between the ages of 10 and 13. If you are worried about being early or late, talk to your parents or doctor. Everyone is different and what is “normal” for you may be different from what is normal for someone else.
An average cycle lasts 28 days, but it can fluctuate. Your cycle is controlled by hormones that prepare your body for a possible pregnancy every month. The first day of your cycle is the day you start bleeding. Your body is shedding the lining of blood built up in your uterus. This usually lasts two to seven days. The second day is sometimes the day that women bleed most heavily. While you only lose about 1/4 cup blood during your period, sometimes it can seem like more.
When the bleeding stops, your ovaries start preparing a new egg to be released, and your uterus starts building up another lining to support a pregnancy (if the egg is fertilized by the male sperm).
Sometime during your cycle, your body releases an egg into your fallopian tube, and it travels to your uterus. If it is not fertilized during this journey, your hormone levels drop and your body gets ready for another period.
The first changes of puberty are not visible ones. They are the changes in hormones resulting from activation of the hypothalamus — the regulator in the brain, and the response of the ovary with secretion of sex hormones. As experienced parents know, ‘moodiness’ occurs approximately one year before the obvious physical changes in puberty occur. Other early signs of puberty are body odor and vaginal discharge. Again, these early changes can occur a year or more before the appearance of secondary sex characteristics (i.e., breast development and pubic hair).
Breast budding is the first sign of puberty in 85 to 95 percent of girls and may initially start on only one side or the other. The ‘growth spurt’ of adolescence usually starts at the same time as the breasts start to grow. The appearance of pubic hair is common next. In a recent study of 8 to 9 year-old girls, 5% of white girls and 15 percent of African American girls had some breast development and 8 percent of white girls and 34 percent of African American girls had some pubic hair. Breast development before age 8 is considered early and should be checked out by a physician. At the other extreme, no breast development by age 13 is thought to be late and should also be evaluated.
Menarche (the first menstrual cycle) occurs approximately two to two-and-a-half years after the appearance of breast buds. The average age of menarche is the United States is 12.77 years. The decline in the age of menarche during the last hundred yeas has been attributed to improved nutrition. It is not expected that this age will continue to drop. Females with low weight and body fat tend to have delayed menarche.
The time from menarche to regular periods tends to be approximately 14 months, but some young girls start being regular at once. The time between menarche and painful periods (presumably ovulatory cycles) is about 24 months. This varies quite a bit and cannot be counted on as a method of birth control. Infrequent periods, especially when associated with sever acne and excessive body hair should be evaluated for the possibility of polycystic ovary syndrome. Periods which occur consistently less than every 28 days, excessively heavy bleeding, or periods which last more than seven days should also prompt a visit to the doctor.
You thought it was that time of the month, but your period did not arrive. Don’t panic! During the teen years, your period may not always arrive “on time” or regularly. In fact, it can take up to two years from the time you start menstruating for your body to develop a regular cycle.
Although it is important to remember that pregnancy can be a possibility if you are sexually active (and you should see a health care provider if you think you may be pregnant), there can be a simple explanation for your missed period.
If you participate in sports that require long hours of practice, are taking birth control pills containing synthetic hormones or your body is experiencing changing hormone levels typical for teenagers, it is not unusual to miss or skip a period.
Below are some reasons (other than pregnancy) that you may miss your period. However, it is always best to speak to a health care provider if you experience any sudden changes in your body.
- Excessive Exercise
- Birth Control
- Eating Disorders
While high school sports are a great source of exercise, female athletes can see a change in their menstrual cycle when they are training hard. You may experience less bleeding, shorter or less frequent periods, or your period may stop completely. This is how the body conserves energy during times of strenuous activity.
Usually periods return to normal several months after you have stopped strenuous sports participation. You should not be concerned if periods are infrequent, such as several times per year rather than once per month.
However, if periods have stopped completely for more than 6 months, you should be examined by a physician to rule out any medical condition. Absence of periods for more than one year can cause loss of bone density and increase the risk of stress fractures during sports. It can also increase the risk of osteoporosis later in life.
Although, birth control pills are often prescribed to regulate a women’s period, they can also cause you to miss your period. If you are using a hormonal method of birth control containing progesterone (such as Depo-Provera, Norplant, or mini-pills) you may miss or fail to have a period.
It is not abnormal to miss your period while on birth control. In fact, you may not experience any bleeding during the placebo week (the week that you take inactive pills) until you have stopped taking birth control completely. However, if you are concerned you may be pregnant, you should take a urine pregnancy test or speak to a health care provider.
If you do not get your period, a medical condition called amenorrhea could be to blame. Some women that have not started their period by age 16 may have amenorrhea-primary. Amenorrhea-primary has several causes. If you are concerned that you have not started your period and you are over age 16, see your health care provider.
Amenorrhea-secondary is a condition in which menstruation begins at the appropriate age, but later stops for six or more months. If you have not had a period in more than six months, see your health care provider.
While some stress is normal for teenagers, an excessive amount of stress can be harmful to your health. If you are under a large amount of emotional stress, either from school or your family, it can affect your period.
Each year, millions of people in the United States are affected by serious and sometimes life-threatening eating disorders. The vast majority — more than 90 percent — of those afflicted with eating disorders are adolescent and young adult women.
Approximately 1 percent of adolescent girls develop anorexia nervosa, a dangerous condition in which they can literally starve themselves to death. Another 2 to 3 percent of young women develop bulimia nervosa, a destructive pattern of overeating followed by vomiting or other “purging” behaviors to control their weight.
The consequences of eating disorders can be severe. Eating disorders are very damaging to the body because it believes it is starving. Your bodily functions slow down and may even cause your period to stop. If you think you may have an eating disorder, don’t hesitate to contact your physician to discuss the problem immediately.
PMS and Cramps
The hormones that cause periods can also cause PMS and cramps. PMS or premenstrual syndrome usually happens the week before your period starts and may include:
- Abdominal cramps
- Skin problems
- Mood changes
- Bloating and water retention (making you feel heavy and puffy)
The best things you can do to help alleviate these symptoms include:
- Regular exercise
- Plenty of rest
- Use less salt, sugar, and caffeine
- Try relaxation exercises like yoga, stretching, meditation, or massage
- Over-the-counter painkillers
- A hot water bottle or heating pad
A tampon is a plug of absorbent material inserted into a body cavity or wound to stop or absorb secretions. In the case of female menstruation, a tampon is inserted into the vagina to absorb menstrual blood.
Tampons are cylindrical in shape and typically come with a connected string (for easy removal) and sometimes an applicator. The tampon itself is usually made of cotton or rayon. An applicator allows you to insert the tampon into the vagina with greater ease. In the United States, tampon applicators are made of plastic or cardboard. The applicator design is similar to a syringe: a small tube slides up into a larger tube (where the tampon is located), and pushes the tampon into the vagina.
Tampons that don’t include an applicator are called digital tampons and are simply unwrapped and pushed into the vagina with the finger. They are smaller to carry, but require a little more effort to insert.
Despite a recent decline in teen pregnancy and birth rates, teen pregnancy remains a significant problem in this country.
- The United States has the highest teen pregnancy rate among developed countries.
- About 1 million teens become pregnant each year.
- Nearly 80 percent of these pregnancies are unintended and almost 50 percent end in abortion.
Having babies at such a young age comes with a number of possible physical problems. Younger mothers have, on average, more babies with a low birth weight, which can cause health complications for the child. Younger women also experience higher rates of infant death than women who have children at a later age. Many of these problems stem from the fact that a teen’s body is still developing, and the stress of pregnancy can cause complications.
This section provides information about teen pregnancy, how to prevent becoming pregnant and what you can do if you think you might be pregnant.
Toxic Shock Syndrome and Tampons
Toxic Shock Syndrome (TSS) is a disease that can kill you if you do not get treatment, although it is rare. TSS occurs when a certain kind of bacteria grows and produces toxins that poison your body. Anyone can get this disease, but your risk increases if you use super-absorbency tampons or leave a tampon in for too long. It also seems that women under the age of 19 seem more likely to get TSS.
The symptoms of TSS are sudden and intense. They include:
- A sunburn-like rash, and/or peeling skin
- A high fever
- Severe flu-like symptoms
- Headache or muscle aches
- Stomach cramps
- Sore throat
- Nausea or vomiting
- Dizziness, light headedness or confusion
- Pale, clammy skin
Abortion means ending a pregnancy before the fetus (unborn child) can live independently outside the mother. If abortion happens spontaneously before 24 weeks of pregnancy, it is called a miscarriage. An induced (or “therapeutic”) abortion is caused deliberately in order to end the pregnancy.
In the 1973 case of Roe v. Wade, the Supreme Court sanctioned a woman’s right to choose to terminate an unwanted pregnancy. Since that ruling, courts have upheld this decision, with certain modifications over the years.
The decision to have an abortion is extremely personal and varies drastically from individual to individual. If you are considering an abortion, think carefully about what is right for you before taking action. This includes not just how you feel now, but how this might affect you in the future. Consulting your parents, doctor or another trusted adult can help you with this choice. Counselors at women’s health clinics, such as Planned Parenthood, can provide information about different options (such as abortion, adoption or parenting) and the effect that each might have.
- About Abortion
- Medical Abortion
- Surgical Abortion
- Personal Experiences
Birth Control and Safe Sex
Effective contraception use generally requires planning and preparation prior to having sexual intercourse.
Condoms require the least amount of advance planning and are used more than any other method of contraception at first sexual intercourse. However, about 35 percent of first intercourse experiences take place without the use of any contraception at all.
If you are sexually active, you need to use an effective contraceptive and a barrier method to protect you from disease every time you have intercourse. You can get pregnant the first time you have sex and right after you finish your period.
- There is no evidence that combined hormonal contraceptives (the pill, patch, ring, IUD) cause weight gain.
- Birth control does not decrease fertility (your permanent ability to get pregnant).
- Hormonal methods of birth control reduce menstrual bleeding and cramps.
- Hormonal birth control does not protect you from sexually transmitted infections.
In addition, researchers are far along in developing male contraception. Although it does not protect against STDs, studies show male contraception does significantly reduce the chances of a woman getting pregnant. (In a recent study, only 1.3 percent of men on a certain male birth control regime were able to impregnate a woman).
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One out of every nine women in the United States will get breast cancer during her lifetime. Breast cancer is most common in women who are 40 years of age, and most typically women who are over 50. It can occur in younger women, but this is extremely rare, and is virtually unheard of under the age of 20. Still, it is very important that you get in the habit of doing a regular breast exam — cancer is easier to treat the earlier it is discovered.
Your doctor can give you information on how to do a breast self-examination. However, it is also important for your doctor to do an exam as well at your check-up.
Other things you can do to prevent breast cancer:
- Avoid heavy drinking
- Exercise regularly
- Eat a healthy low-fat diet
- Take vitamin D
If someone in your immediate family has had breast cancer, you may have a higher risk of getting it. Early checks are a good preventative measure. Talk with your doctor about your possible risk factors.
The hymen is a subject of confusion and “myth” for a lot of people. We get many questions about it in our “Ask the Expert” feature. The following is a summary of the basic medical facts about the hymen.
What is it?
The hymen is a piece of tissue that lines the vaginal opening. It has an opening that can be of any size — it can be thin or thick.
It should have an opening – otherwise your menstrual blood cannot come out and an opening would need to be created.
Typically, the hymen has an opening the size of your finger — or the size of a small tampon. It is normal for it to be uncomfortable to pass a tampon and it doesn’t mean that your hymen is gone if you can.
The hymen and virginity
You often hear about the hymen breaking with first intercourse. It can happen, but if a woman is relaxed during intercourse and has good lubrication and she or her partner has tried to stretch the hymen with fingers, then it likely won’t break.
So, you can’t tell if someone is a virgin if they have a hymen.
A vaginal exam and the hymen
You don’t need a pap smear until three years after you become sexually active or age 21, but your doctor will do one before you start on birth control, if you have already become sexually active. Your doctor will go through what will happen during your exam and if done gently, with a small speculum (which is inserted into the vagina to open it for the pap smear), then it won’t tear your hymen. It’s not a comfortable exam, but if done properly, will lessen your anxiety and discomfort.
Douching is a process in which a woman uses a container attached to a small hose or a bottle with a nozzle to flush water or some other solution into a her vagina. Years ago, women would do this after their period to clean themselves out. Women also used douching to prevent pregnancy.
However, we now know that douching actually wipes out the healthy bacteria that naturally exist in your vagina and increases the likelihood of getting sexually transmitted infections, as well as yeast infections. In addition, douching after intercourse may actually push sperm further up the vagina, rather than flushing it out.
Also, inexperienced women may actually traumatize the cervix or vagina by douching. Doctors generally do not recommend any kind of douching for this reason.
Each year, millions of people in the United States are affected by serious and sometimes life-threatening eating disorders. The vast majority — more than 90 percent — of those afflicted with eating disorders are adolescent and young adult women. One reason that women in this age group are particularly vulnerable to eating disorders is their tendency to go on strict diets to achieve an “ideal” figure. Researchers have found that such stringent dieting can play a key role in triggering eating disorders.
Approximately 1 percent of adolescent girls develop anorexia nervosa, a dangerous condition in which they can literally starve themselves to death. Another 2 to 3 percent of young women develop bulimia nervosa, a destructive pattern of overeating followed by vomiting or other “purging” behaviors to control their weight. Other common eating disorders include exercise bulimia and binge eating. These eating disorders also occur in men and older women, but much less frequently.
The consequences of eating disorders can be severe. For example, one in 10 cases of anorexia nervosa leads to death from starvation, cardiac arrest, other medical complications or suicide. Fortunately, increasing awareness of the dangers of eating disorders, sparked by medical studies and extensive media coverage of the illness, has led many people to seek help. Nevertheless, some people with eating disorders refuse to admit they have a problem and do not get treatment. Family members and friends can help recognize the problem and encourage the person to seek treatment.
What causes an eating disorder?
In trying to understand the causes of eating disorders, scientists have studied the personalities, genetics, environments and biochemistry of people with these illnesses. As is often the case, the more that is learned, the more complex the roots of eating disorders appear to be. Although there is a clear correlation between the portrayal of the “ideal” body in the media and eating disorders, it is not clear why some at-risk individuals develop eating disorders and others do not.
Endometriosis is a condition found only in females. The endometrium is the inside lining of the uterine cavity. Endometriosis occurs when some of the lining gets out of the uterus through the fallopian tubes and deposits in the pelvis or abdominal cavity. This happens because the fallopian tubes open into the pelvic cavity. Normally, when an ovary releases an egg during ovulation, it goes to the fallopian tube which “catches it” and then the egg travels down the tube to the cavity of the uterus. But this tube can also allow parts of the uterine lining to escape into the pelvis.
Endometrial deposits can be found anywhere in the pelvis or abdomen. Most commonly they are found on the outside of the uterus or ovaries. They can also be found on the bowel, bladder, lining of the abdomen, and ligaments of the muscles of the abdominal wall. Rarely, they are seen as high as the diaphragm.
Symptoms of endometriosis include severe pain during or between periods and sometimes, pain with intercourse. Periods usually stay regular. Sometimes there is a low-grade fever and fatigue during a particular part of the menstrual cycle.
Endometriosis is diagnosed by a person’s symptoms and what a doctor finds on the physical exam. The confirmation of endometriosis is only made during surgery, though, to actually see the deposits of the endometrium outside the uterus. This is often done laparoscopically, with a camera inserted into the abdomen, not with a full open surgery.
Surgery can also treat endometriosis. The surgeon can burn away the deposits of the endometriosis and this can be a cure! Other treatments include birth control pills or other hormones to suppress the activity of the endometrium.
Unfortunately, the endometriosis can recur, but typically resolves after menopause, because you don’t have periods anymore.
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Vaginal Infections and PID
Every woman has yeast in her vagina at all times. However, when yeast grows too much, it can cause burning when urinating, itching, and a heavy, clumpy kind of discharge — sort of like cottage cheese. Yeast infections commonly occur when a woman is taking antibiotics, because the medication kills off the bacteria that keep the yeast under control.
The term “nonspecific vaginitis” is used to describe a variety of bacterial infections in the vagina. Two of the names you will hear for bacterial infections are Hemophilus or Gardnerella vaginalis. Usually a heavy discharge from an overgrowth of some type of bacteria will be yellowish to greenish and runny, with a strong odor.
Illustration of the vagina
Pelvic Inflammatory Disease (PID)
PID is an infection of the reproductive organs in a woman. It is caused by different sexually transmitted diseases, usually untreated Chlamydia or gonorrhea. PID is very serious and can make it impossible for women to have children, or cause a tubal pregnancy (here the fetus develops in a fallopian tube instead of in the uterus).
PID seems to be more common in women who use an IUD to prevent pregnancy, have many sexual partners, and/or who douche.
Like other STIs, women may have no symptoms at all until the infection has gotten very bad. When there are symptoms, they may include:
- An unusual yellow or white discharge from the vagina
- Bleeding between periods and right after sex
- Pain during or after sex
- Pain during pelvic exams
- Heavy or painful periods (more so than usual)
- Cramps, fever, chills, and nausea
Urinary Tract Infections in Teens and Adults
Is this topic for you?
This topic is about urinary tract infections in teens and adults. For information about infections in babies and young children, see the topic Urinary Tract Infections in Children.
What is a urinary tract infection?
Your urinary tract is the system that makes urine and carries it out of your body. It includes your bladder and kidneys.And the tubes that connect them. When germs get into this system, they can cause an infection.
Most urinary tract infections are bladder infections . A bladder infection usually is not serious if it is treated right away. If you do not take care of a bladder infection, it can spread to your kidneys. A kidney infection is serious and can cause permanent damage.
What causes urinary tract infections?
Usually, germs get into your system through your urethra, the tube that carries urine from your bladder to the outside of your body. The germs that usually cause these infections live in your large intestine and are found in your stool. If these germs get inside your urethra, they can travel up into your bladder and kidneys and cause an infection.
Women tend to get more bladder infections than men. This is probably because women have shorter urethras, so it is easier for the germs to move up to their bladders. Having sex can make it easier for germs to get into your urethra.
You may be more likely to get an infection if you do not drink enough fluids, you have diabetes, or you are pregnant. The chance that you will get a bladder infection is higher if you have any problem that blocks the flow of urine from your bladder. Examples include having kidney stones or an enlarged prostate gland.
For reasons that are not well understood, some women get bladder infections again and again.
What are the symptoms?
You may have an infection if you have any of these symptoms:
- You feel pain or burning when you urinate.
- You feel like you have to urinate often, but not much urine comes out when you do.
- Your belly feels tender or heavy.
- Your urine is cloudy or smells bad.
- You have pain on one side of your back under your ribs. This is where your kidneys are.
- You have fever and chills.
- You have nausea and vomiting.
Call your doctor right away if you think you have an infection and:
- You have a fever, nausea and vomiting, or pain in one side of your back under your ribs.
- You have diabetes, kidney problems, or a weak immune system.
- You are older than 65.
- You are pregnant.
How are urinary tract infections diagnosed?
Your doctor will ask for a sample of your urine. It is tested to see if it has germs that cause bladder infections.
If you have infections often, you may need extra testing to find out why.
How are they treated?
Antibiotics prescribed by your doctor will usually cure a bladder infection. It may help to drink lots of water and other fluids and to urinate often, emptying your bladder each time.
If your doctor prescribes antibiotics, take the pills exactly as you are told. Do not stop taking them just because you feel better. You need to finish taking them all so that you do not get sick again.
Can urinary tract infections be prevented?
You can help prevent these infections.
- Drink lots of water every day.
- Try drinking cranberry juice or taking cranberry pills.
- Urinate often. Do not try to hold it.
- If you are a woman, urinate right after having sex.