Reproductive Functions

late menopause
late menopause

Sexual problems are more common in postmenopausal women, which suggests that menopause can reduce libido.

The reduced sex drive is often caused by decreased estrogen levels, which can dampen arousal and result in sex being more painful.

In this article, we look at how menopause might affect someone’s sex drive, along with what can be done to improve libido.

Menopause and libido

What is menopause?

Menopause refers to when a woman stops having her period permanently, but it can affect more than a woman’s menstrual cycle.

Menopause can cause physical and emotional changes that impact a woman’s life, including her sex life.

Some symptoms and side effects associated with menopause include:

  • anxiety
  • bladder control issues
  • decreased sex drive and desire (libido)
  • depression
  • difficulty sleeping
  • thinning hair
  • weight gain

Each of these effects can impact a woman’s quality of life and relationship with her partner.

What is libido?

Libido refers to sexual interest and sexual enjoyment.

Some women going through menopause report reduced libido, but the causes vary from person to person.

According to one review, the reported rates of sexual problems in postmenopausal women are between 68 and 86.5 percent.

This range is much higher than in all women in general, which is estimated to be between 25 and 63 percent.

Why does menopause affect libido?

Decreased estrogen levels can result in reduced blood flow to the vagina, which can cause the tissues of the vagina and labia to become thinner. If this happens, they become less sensitive to sexual stimulation.

Decreased blood flow also affects vaginal lubrication and overall arousal. As a result, a woman may not enjoy sex as much and may have difficulty achieving orgasm. Sex may be uncomfortable or even painful.

Fluctuating hormone levels during perimenopause and menopause can also affect a woman’s mental health, which in turn, may cause a decrease in her libido.

Stress can also impact a woman’s libido, as she may be juggling a job, parenting, and be caring for aging parents. The changes in hormone levels a woman may experience during menopause may make her irritable or depressed, so dealing with everyday stress may feel more difficult.

According to an article published in the Journal of Women’s Health, women who have more significant side effects associated with menopause are more likely to report lower libido levels.

Examples of these side effects include hot flashes, depression, anxiety, trouble sleeping, and fatigue.

Other factors that make a woman going through menopause more likely to experience a reduced libido include:

  • history of chronic health conditions, such as heart disease, diabetes, or depression
  • history of smoking
  • engaging in low levels of physical activity

A woman should talk to her doctor about how these conditions could affect her sex drive.

Tips for improving libido

There are several steps a woman can take to increase her libido. These include medical treatments, lifestyle changes, and home remedies.

Medical treatments

middle aged couple enjoying a bike ride
Spending time together on shared hobbies, exercising, and planned dates will help increase a couple’s intamacy.

If a woman experiences changes to her vaginal tissue, such as thinning and dryness, she may wish to consider estrogen therapy.

Prescription estrogen can be applied directly to the vagina in the form of creams, pills, or vaginal rings. These usually contain lower doses of estrogen than regular birth control pills.

Some women may wish to take estrogen pills that contain higher levels of hormones. This treatment, known as hormone replacement therapy, might help reduce symptoms, such as hot flashes and mood changes, but may also carry risks.

A woman thinking about hormone replacement therapy should discuss it with her doctor before starting to take any medication.

One study found that women using hormone therapies reported higher levels of sexual desire compared with women who did not.

Less commonly, a doctor may prescribe testosterone therapy. However, not all women respond to this treatment, and the United States Food and Drug Administration (FDA) do not approve it for treating sexual disorders in women.

A woman may not experience any changes in her sex drive after using estrogen or testosterone therapies.

A woman may also choose to see a therapist who specializes in sexual dysfunction or enhancing sex. Sometimes, couples may want to attend therapy together.

Lifestyle changes

Some women may benefit from using water-soluble lubricants during sex. These can be purchased over-the-counter at most drugstores.

However, women should avoid non-water soluble and silicone-based lubricants, as these can break down condoms used to protect against sexually transmitted infections (STIs).

Increasing physical activity, such as getting 30 minutes or more of exercise on a routine basis, may help reduce menopause-related symptoms, including a low libido. Eating a healthful diet can also enhance a person’s overall sense of well being.

Changing sexual habits

There are many ways a person can foster a sense of intimacy with their partner, including:

  • Changing sexual routines: Try spending extended periods on foreplay, use vibrators or other sex toys to enhance an intimate experience, or engage in sexual activity or touching without the goal of orgasm.
  • Relieving stress together: There are many stress-relieving techniques a couple can do outside of the bedroom to increase intimacy. Examples include going on planned dates together, taking a walk, or spending time doing hobbies together, such as exercise, crafts, or cooking.
  • Practicing masturbation: Spending time alone and exploring what types of touch and sexual stimulation work well for an individual can help them talk to a partner about their needs and preferences. It can also help a person feel more comfortable with sexual activity without the pressure of a partner.

Natural remedies

Some women use natural supplements to try to increase their libido. It is important to keep in mind that the FDA do not regulate herbs and supplements, so women should be sure to choose a reputable brand.

Some natural remedies used to increase libido in women include:

  • black cohosh
  • red clover
  • soy

A woman should discuss these remedies with a doctor before taking them to ensure they will not interact negatively with other prescriptions and supplements she may be taking. Soy contains estrogen, so it may react with other estrogen therapies.

When to see a doctor

A woman should speak to her doctor whenever perimenopause or menopause is having a significant impact on her day-to-day activities, including sexual activity.

Sometimes, a doctor can recommend changes in health habits as well as discuss whether prescription medications may help relieve the symptoms, including a low libido.

Speaking with a doctor can also rule out any other underlying medical conditions that may cause a reduced libido. These conditions include urinary tract infections, uterine prolapse, endometriosis, or pelvic floor dysfunction.

Outlook

While some women do experience a decreased libido in menopause, others do not.

Some women may even experience a heightened libido after menopause. This can be due to reduced stresses over pregnancy and fewer child-rearing responsibilities.

If a woman’s libido is impacted after menopause, she should talk to her doctor about treatments that could enhance her quality of life.

Tap water may be the cause of one in 20 cases of bladder cancer in Europe each year, a major study suggests. Researchers have linked drinking, showering and bathing in the water to more than 6,500 cases of the disease in 26 countries across the continent.

They estimate 1,356 bladder cancer diagnoses in Britain since 2005 were caused by contaminated water, making up a fifth of all cases in the European Union (EU).

Long-term exposure to a group of chemicals called trihalomethanes (THMs) is thought to be the cause. The chemicals, shown to be carcinogenic in animal studies, are formed as an unintended byproduct when water is disinfected with chlorine at supply plants.

As well as being drunk, steam given off in the shower can allow tap water to seep into people’s pores, and so too can prolonged periods in the bath. Earlier research has found an association between THMs and bladder cancer, but this is the first to estimate the scale of the problem. Some 10,000 people are diagnosed with bladder cancer each year in the United Kingdom (UK), making it the tenth most common form of the disease.

The latest study estimates nine per cent of them are caused by exposure to water contaminated with THMs.The findings are published in the journal Environmental Health Perspectives. Scientists from the Barcelona Institute for Global Health (ISGlobal) set out to analyse the presence of the chemicals in drinking water in all 28 EU states between 2005 and 2018.

They did this by sending questionnaires to bodies responsible for the national water quality. Data was obtained for 26 countries – all except Bulgaria and Romania. The scientists probed levels of THMs in water at the tap, in the distribution network and at water treatment plants.

To make estimates as accurate as possible, the researchers also used other sources including open data online, reports and scientific literature. The findings revealed considerable differences between countries. Average THM levels were above legal levels in nine countries – Britain (24.2ug/l) , Spain, Portugal, Poland, Cyprus, Estonia, Hungary, Ireland and Italy.

The European Union has said the maximum limit is 11.7 micrograms per litre (ug/L). The European Union has said the maximum limit of THMs in water should be 11.7 micrograms per litre (ug/L). Researchers estimated the number of attributable bladder cancer cases using incidence rates and levels of THMs.

Analysis suggested Cyprus had highest percentage, with a quarter of diagnoses linked to the chemicals. Joint second-wort were Ireland and Malta, where one in six bladder cancer patients (17 per cent) are thought to have developed it from exposure to tap water.

Spain (11 per cent) and Greece (10 per cent) were not much better. At the opposite extreme was Denmark, where less than 0.1 per cent of cases were caused by THM water contamination. In Holland it was just 0.1 per cent of cases and Germany 0.2 per cent. THMs could be blamed for 0.4 per cent of cases in Austria and Lithuania. In total, the researchers estimated that 6,561 bladder cancer cases per year are attributable to THM exposure in the European Union.

The study authors say if the 13 countries with the highest averages were to reduce their THM levels to the EU average, 2,868 annual bladder cancer cases could be avoided.

Chloroform is the most infamous type of THM, which the World Health Organisation (WHO) describes as ‘probably carcinogenic to humans’.Co-study author Manolis Kogevinas, a researcher from ISGlobal, said: “Over the past 20 years, major efforts have been made to reduce trihalomethanes levels in several countries of the European Union, including Spain.

“However, the current levels in certain countries could still lead to considerable bladder cancer burden, which could be prevented by optimising water treatment, disinfection and distribution practices and other measures.”

A spokesperson for Britain’s Department for Environment, Food and Rural Affairs said: “This Government takes the safety of our drinking water extremely seriously, and have a robust monitoring regime in place which tests for a wide range of chemicals, including trihalomethanes, to ensure the public can have absolute faith in the water coming from their taps.

“The latest figures from 2018 found only four samples out of 11,900 exceeded the legal limits, and firm action was taken in each of these four cases.”

A study in September last year discovered 22 carcinogenic substances in water across the United States (U.S.).Despite the fact that most of the water systems they tested were within federal limits on each of these toxins, the scientists estimated that their cumulative effects could be dire over the course of Americans’ lifetimes.

Exposure to arsenic, products of disinfectant chemicals and traces of radioactive chemicals like uranium and radium had the most substantial effects on cancer risks. Over 1.7 million new cases of cancer are diagnosed in the US each year. In the same time period, over 600,000 people die of the disease.

Better prevention strategies, earlier detection and better treatments – like the immunotherapies that are revolutionizing the disease’s future – have driven cancer mortality down dramatically. Yet the disease’s elimination is no where in sight. In part, this is because its roots are many, and difficult to control.

Rather than being triggered by any one thing, genetics, what you eat, where you live, how you eat and, of course, the water you drink all play roles in raising or lowering cancer risks.

Some chemicals, like arsenic are nearly impossible to keep out of water in certain places. For example, in some areas of Illinois, the soil is rich in arsenic, a toxic, carcinogenic heavy metal, linked to liver and bladder cancers.

Arsenic seeps into the ground water, and winds up in our bodies. It also leaks into the water supply from many types of manufacturing plants.US water systems treat drinking water with chlorine – a non-carcinogenic cleaning chemical – in an attempt to reduce or eliminate the metal.

Certain foods and drinks contain compounds that may improve vaginal health and symptoms of vaginal conditions. These include probiotics, prebiotics, and fermented food and beverages.

The vagina uses natural secretions, immune defenses, and “good” bacteria to keep itself healthy. Eating a healthful, balanced diet might also further prevent infections and improve vaginal conditions.

This article discusses what little research there is into the effects of diet on vaginal health, looks at dietary choices for common vaginal conditions, and identifies other ways to improve vaginal health.

People should speak to a doctor before using diet to address any health concerns.

Balancing pH levels

The vagina is a moderately acidic environment with a pH of around 4.5. This acidity helps healthful bacteria to grow and prevents harmful microbes from developing.

Some good bacteria, such as probiotics, may help balance vaginal acidity levels.

Probiotics

Lactobacillus species bacteria is the most dominant type of “good” bacteria found in a healthy vagina.

Research has suggested that Lactobacillus could benefit vaginal health in the following ways:

  • regulating the microflora in the vagina
  • improving the vagina’s acidity levels
  • stopping harmful microbes from attaching to the vaginal tissues
  • working with the body’s immune system

2016 study indicated that using vaginal Lactobacillus supplements after taking antibiotics hindered bacteria growth in people with bacterial vaginosis (BV), and significantly reduced vaginal pH.

2015 review study found “no significant evidence” that probiotics were more beneficial than using a placebo or no treatment. However, the authors noted that due to a lack of evidence, “a benefit cannot be ruled out.”

Probiotic supplements are available, but some nutritionists recommend getting them from fermented foods and drinks, such as:

  • yogurt and kefir
  • kimchi and sauerkraut
  • pickles
  • tempeh
  • kombucha

Prebiotics

Prebiotic compounds may also help stabilize vaginal pH by promoting the growth of healthy bacterial populations. Foods rich in prebiotics include:

  • leeks and onions
  • asparagus and Jerusalem artichoke
  • garlic
  • whole wheat products
  • oats
  • soybeans
  • bananas

It is important to note that prebiotics can worsen bowel conditions, such as irritable bowel syndrome (IBS).

Preventing UTIs

Urinary tract infections (UTIs) occur when bacteria enter parts of the urethra, bladder, or kidneys, causing symptoms such as burning or pain during urination and bad smelling or cloudy urine. According to the Urology Care Foundation, about 60% of women will experience a UTI at some point.

Drinking lots of fluids might help prevent a UTI.

Cranberry juice

According to the Urology Care Foundation, drinking cranberry juice or taking cranberry tablets may prevent UTIs from developing.

Research supports this idea — in a 2016 study, researchers found that drinking 8 ounces (oz), or 240 milliliters (ml) of a 27% cranberry juice drink each day for 24 weeks lowered the rate of UTIs in adult women who had recently had a UTI.

Cranberries are rich in antibacterial compounds that kill bacteria. These include antioxidants and organic acids, such as:

  • proanthocyanidins and anthocyanins
  • organic and phenolic acids
  • vitamin C
  • flavanols and flavonols

Research into diet and UTIs has mainly focused on cranberries, but many fruits, especially citrus fruits and berries, are also rich in antioxidants and may have similar effects.

Reducing candida infections

Candida infections, or yeast infections, are the second most common cause of vaginitis, or vaginal inflammation.

There is no scientific proof that any foods can reduce candida infections. However, some foods contain ingredients that the fungus uses to grow. These ingredients include refined sugar, preservatives, yeasts, fungi, allergens, and trace antibiotics. People may benefit from avoiding these foods.

Researchers are studying the possible benefits of natural remedies with antifungal, anti-inflammatory, or antioxidant properties for candida infection, including tea tree oil, coconut oil, and garlic.

Other ways to improve vaginal health

Regularly eating a healthful, balanced diet that contains fermented products with probiotics and prebiotics can improve vaginal health.

Following some of these lifestyle habits might also help:

  • cleaning the genital region with mild, unscented soap before rinsing well and patting dry daily or as needed during menstruation
  • wiping from front to back
  • using antibiotics appropriately and only when necessary
  • reducing sweat around the vagina
  • exercising regularly
  • maintaining a healthy weight
  • staying hydrating
  • reducing stress
  • wearing loose-fitting cotton underwear

Avoiding or limiting things that can imbalance the body’s systems or irritate the vagina can help, such as:

  • douching
  • holding in urine or rushing urination
  • personal care products with dyes, flavors, or fragrances
  • spermicidal foam or diaphragms
  • tight pants or underwear
  • smoking
  • prolonged exposure to moisture
  • alcohol
  • processed or heavily refined foods
  • foods or drinks with artificial hormones

Summary

Many nutrients contribute to vaginal health. Eating a healthful, nutrient-rich diet can improve all body systems.

Certain nutrients, antioxidants, and probiotics may have particular benefits for vaginal health. However, researchers need to do more studies to work out which nutrients help boost vaginal health and prevent vaginal infections.

Fish Oil supplements could make men’s testicles bigger and boost their sperm count, a study claims.Men who took the pills, which contain omega-3 fatty acids, were found to have testicles 1.5ml larger and to ejaculate 0.64ml more sperm, on average.The men, who had an average age of 18, were included as regular supplement-takers if they had consumed fish oil for at least 60 out of the past 90 days. Larger testicles and more sperm creation are linked to higher testosterone levels and better fertility, although the study did not test how fertile the men were.

The research was published in the journal JAMA Network Open, by the American Medical Association. The experiment was described by scientists as ‘well-conducted’ and ‘insightful’ but it was clear that it did not prove fish oil makes men more fertile. Researchers from the University of Southern Denmark did their study using 1,679 young Danish men going through military fitness testing.

In Denmark military service is mandatory for all healthy men over the age of 18, so the men in the study were not yet soldiers. Each of the men was screened for Sexually Transmitted Infections (STIs), had physical exams, gave sperm samples and then answered questions about their diets and lifestyles. If someone was considered a regular fish oil supplement user, the research found, they produced millions more sperm in an average ejaculation.

The researchers wrote in their paper: “Fish oil supplements were associated … with higher semen volume and total sperm count, and larger testicular size.”Ninety-eight men in the study said they took fish oil supplements regularly, while another 95 took vitamin D or C supplements. Men in the fish oil group were less likely to have fertility problems, which were judged against the World Health Organization’s low sperm count limit of 39 million sperm per ml of semen.

The scientists found that 12.4 percent of the men who took fish oil supplements (12 out of 98) had sperm counts below the World Health Organisation’s (WHO’s) measure. This compared to 17.2 percent (192 out of 1,125) men who took no supplements. And the longer someone had been taking supplements for, the more sperm they were likely to produce.

The researchers added that, based on a model fit and healthy 19-year-old: “Total sperm count was 147million for men with no supplement intake, 159million for men with other supplement intakes, 168million for men with fish oil supplement intake on fewer than 60 days, and 184million for men with fish oil supplement intake on 60 or more days.”

The study did not give exact measurements for men’s testicle volume or sperm volumes – they only compared the two groups. And the scientists could not explain why – if it was true – the fish oil improved sperm quality.It was also not clear whether increased sperm volume was caused by – or caused – the change in testicle size. Scientists not involved with the research said the study had been well-conducted but it didn’t say how much fish oil the men took.

And nor did it reveal the men’s diets, which may have shown they were getting omega-3 from other sources such as fresh fish.Professor Sheena Lewis, reproductive medicine expert at Queen’s University, Belfast, said: “This is a large well-designed study and the association between fish oil intake and improved semen quality is compelling.

“However, the study focuses on healthy young men; mostly with sperm counts already in the fertile range.“There is no evidence from this study that infertile men with low sperm counts benefit from fish oil.”Dr. Frankie Phillips, of the British Dietetic Association, said missing information about the men’s diets did make the study’s results less convincing.She added: “Antioxidants, including vitamin C, selenium and vitamin A, as well as zinc and omega-3 fats all have a role in the production of healthy sperm.

“There is much focus on the diets of women who are trying to conceive, ensuring that they are in the best possible position to achieve a healthy pregnancy, but diet might also be a factor involved in men’s reproductive health.“Omega-3 is present in a both animal and plant derived foods, but oily fish stands out as an excellent source of long chain omega-3, and the UK population currently consume way below the recommended ‘at least one portion of oily fish per week”.

“So including omega-3 is already part of current dietary recommendations – this study on its own can’t prove that upping omega-3 will itself improve testicular function.”Also, according to researchers, women who have sex every week may have a lower chance of an early menopause. University College London experts asked nearly 3,000 women – who were tracked for 10 years – about how often they had sex. Women of any age who had sex each week were less likely to have been through the menopause, compared to those who did so less than once a month.

For example, those who had regular sex were 28 percent less likely to have entered the menopause at age 51, compared to their counterparts. Sexual activity included full-blown intercourse, oral sex, touching and caressing, or self-stimulation. Scientists said if a woman is not having sex and there is no chance of pregnancy, the body ‘chooses’ to stop investing energy into ovulation.

Instead, their bodies may decide to invest energy elsewhere, such as in looking after grandchildren. The theory, known as the grandmother hypothesis, says the menopause evolved to help mothers have more children. It suggests that grandmothers would aid their offspring to have more of their own children by caring for the existing grandchildren. A woman’s immune function is hampered during ovulation, making the body more susceptible to disease.

And so if a pregnancy is unlikely because of a lack of sexual activity, the body would divert its focus from a costly process to aiding existing relatives. The menopause is when a woman stops having periods and is no longer able to get pregnant naturally. The process is a natural part of ageing and usually occurs among women between 45 and 55. Researchers used data collected from 2,936 women who took part in the Study of Women’s Health Across the Nation (SWAN) in the United States (U.S.).

The women, an average age of 45 at the start of the study in 1996, were asked if and how often they had had sex in the past six months. They were also asked whether they had oral sex, sexual touching, or engaged in self-stimulation in the last six months. The researchers found that the most frequent pattern of sexual activity was weekly (64 percent). None of the women who took part had already entered the menopause, but 46 per cent were starting to experience symptoms (known as peri-menopause). Fifty-four per cent were pre-menopausal, meaning they had not yet displayed any symptoms and were still having their periods.

Interviews were carried out both when the women first took part and then ten years later. Women who had sex weekly were less likely to experience the menopause, compared to those who had sex lass than monthly. And women who had sex monthly were less likely to experience menopause at any given age, compared to those who had sex less than monthly. Prof. Ruth Mace, who co-authored the study, said: “The menopause is, of course, an inevitability for women, and there is no behavioural intervention that will prevent reproductive cessation.“Nonetheless, these results are an initial indication that menopause timing may be adaptive in response to the likelihood of becoming pregnant.”

How can a man’s diet affect his fertility?
The body must get all the chemicals it needs from the diet, meaning what you eat controls your health. Certain foods can improve – or worsen – a man’s fertility. The general rule is that a healthy, balanced diet is better for fertility than one too high in sugar or fat.

Fruits and vegetables are good
Fruit and veg are rich in nutrients such as vitamins C and A, polyphenols, magnesium, folate and fiber, which act as antioxidants in the body. Research has suggested a direct association between the production of reactive oxygen species in sperm cells and intake of antioxidants, which help to reduce this damage by neutralizing them.

Eat foods rich in zinc, selenium and vitamin C
Zinc can be found in foods such as meat, cheese, shellfish wholegrain cereals and nuts. Inadequate intakes of zinc in the diet have been linked to low sperm count and reduced testosterone levels. Selenium can be found in foods such as brazil nuts, fish, poultry and eggs. This mineral is required for normal sperm production and development and men should aim to get 55mcg per day. Vitamin C is thought to help prevent sperm cells clumping together (common with infertility) and men should aim to get 80mg per day.

Limit dairy foods
Intake of dairy foods in association with sperm production is somewhat controversial but the theory goes that as around 75 per cent of the milk we consume comes from pregnant cows, there may be a high level of naturally occurring oestrogens, which could affect sperm production.

Limit meat intake
Although not fully proven, it has been suggested that meat and processed meats may impact on fertility in men by way of xenobiotics (mainly xenestrogens) used in the farming process. Over-exposure to these compounds, which have estrogenic effects in the body, may play a role in the decline of sperm quality in men.

Avoid excessive amounts of sugar
Excessive intake of sugary foods may lead to overweight and obesity, driving insulin resistance, which may negatively influence sperm quality as a result of inflammation and oxidative stress. Diets high in sugar can also lead to blood sugar imbalances, which may disrupt the hypothalamic-pituitary-testicular axis impacting on sperm production.
*Culled from Daily Mail UK

Adnexal masses are lumps that occur in the adnexa of the uterus, which includes the uterus, ovaries, and fallopian tubes. They have several possible causes, which can be gynecological or nongynecological.

An adnexal mass could be:

  • an ovarian cyst
  • an ectopic pregnancy
  • a benign tumor
  • a malignant tumor

A family doctor can usually manage benign masses. However, prepubescent and postmenopausal individuals will need to see a gynecologist or oncologist.

Malignant adnexal masses require treatment from a specialist.

In this article, we discuss the characteristics of adnexal masses. We also review how doctors diagnose and treat adnexal them.

Symptoms

People report different symptoms, depending on the cause of the adnexal mass.

People with an adnexal mass may report:

  • severe lower abdominal or pelvic pain that is usually on one side
  • abnormal bleeding from the uterus
  • pain during sexual intercourse
  • worsening pain during a period
  • painful periods
  • abnormally heavy bleeding during periods
  • abdominal symptoms, including a feeling of fullness, bloating, constipation, difficulty eating, increased abdominal size, indigestion, nausea, and vomiting
  • urinary urgency, frequency, or incontinence
  • weight loss
  • lack of energy
  • fatigue
  • fever
  • vaginal discharge

Different causes of adnexal masses may have similar symptoms, so doctors usually conduct further investigations to determine the exact cause.

Once the doctor has worked out the cause of the adnexal mass, they can recommend treatment and management.

Causes

Adnexal masses include a variety of different conditions that range in severity from benign growths to malignant tumors.

The cause of adnexal masses could be gynecological or nongynecological.

Some of the causes of adnexal masses include:

  • Ectopic pregnancy: A pregnancy where the fertilized egg implants somewhere outside the uterus.
  • Endometrioma: A benign cyst on the ovary that contains thick, old blood that appears brown.
  • Leiomyoma: A benign gynecological tumor, also known as a fibroid.
  • Ovarian cancer: These tumors of the ovary may be ovarian epithelial cancers that begin in the cells on the surface of the ovary or malignant germ cell cancers that begin in the eggs.
  • Pelvic inflammatory disease: Inflammation of the upper genital tract, which includes the uterus, fallopian tubes, and ovaries. It occurs due to an infection.
  • Tubo-ovarian abscess: An infectious adnexal mass that forms because of pelvic inflammatory disease.
  • Ovarian torsion: A gynecological emergency involving a complete or partial rotation of the tissue that supports the ovary, which cuts off blood flow to the ovary.

Diagnosis

A doctor may diagnose an adnexal mass by:

  • taking a complete medical history
  • asking questions about symptoms
  • conducting a physical examination
  • obtaining blood samples

Most of the time, people will need a transvaginal ultrasound to allow doctors to evaluate the characteristics of an adnexal mass.

Females who have had a positive pregnancy test result and report abdominal or pelvic pain and vaginal bleeding might have an ectopic pregnancy. An ovarian torsion causes sudden, severe pain with nausea and vomiting. Immediate medical attention is necessary to treat both an ectopic pregnancy and ovarian torsion.

People with pelvic inflammatory disease or a tubo-ovarian abscess may experience gradual pelvic pain with nausea and vaginal bleeding.

Early ovarian cancer may sometimes present with nonspecific symptoms. Sometimes, doctors may only detect cancer when the tumor has become malignant.

Malignant tumors may have one or several of the following characteristics:

  • a solid component of the tumor
  • parts of the tumor have thick divisions larger than 2–3 centimeters separating them
  • they are present on both sides of the reproductive tract
  • the presence of fluid filled lumps

Treatment

A doctor will choose the most appropriate treatment depending on the cause of the adnexal mass. Women with an ectopic pregnancy will have to end their pregnancy. A doctor may choose one of the following procedures:

  • the administration of a single or two-dose intramuscular methotrexate
  • laparoscopic surgery
  • a salpingostomy or salpingectomy, which are surgical procedures involving the fallopian tubes

Doctors have not yet determined the optimal management of an endometrioma, according to a study that featured in Obstetrical & Gynecological Survey.

Currently, the possible treatments for an endometrioma include:

  • watchful waiting
  • medical therapy
  • surgical intervention
  • inducing ovulation and using assisted reproductive technology in females with infertility

People with pelvic inflammatory disease will require courses of intravenous antibiotics, which may include:

  • cefotetan (Cefotan)
  • cefoxitin (Mefoxin)
  • clindamycin (Cleocin)

Some people can receive treatment outside of the hospital setting with oral doxycycline (Vibramycin) and intramuscular ceftriaxone (Rocephin) or another third generation cephalosporin antibiotic. In some cases, doctors will need to add oral metronidazole (Flagyl).

In the past, tubo-ovarian abscesses required surgical removal of the uterus, ovaries, and fallopian tubes. However, doctors can now prescribe broad-spectrum antibiotics. A person with a ruptured tubo-ovarian abscess may still require surgery.

Ovarian torsion is a gynecological emergency. The only treatment is surgery to prevent severe damage to the ovaries and fallopian tubes.

People with leiomyomas or fibroids may receive hormonal treatments or nonsteroidal anti-inflammatory drugs to control the symptoms. Once a person stops taking medication, the symptoms may return, and the fibroids may continue to grow. Surgery is the most successful treatment for fibroids.

The treatment options for ovarian cancer include surgery, chemotherapy, and targeted therapy. Oncologists will consider the following factors before recommending a treatment plan:

  • the type of ovarian cancer and how much cancer is present
  • the stage and grade of the cancer
  • whether the person has a buildup of fluid in the abdomen causing swelling
  • whether surgery can remove the whole tumor
  • genetic changes
  • the person’s age and general health status
  • whether it is a new diagnosis, or if cancer has come back

Risk factors

Risk factors depend on the cause of the adnexal mass. Females with ovarian masses have an increased risk of developing ovarian torsion. More than 80% of females with ovarian torsion have masses of 5 cm or larger.

Doctors diagnose fibroids in about 70% of white females and more than 80% of black females by the age of 50 years. Other factors may increase a person’s risk of developing fibroids, such as:

  • starting periods early in life
  • using oral contraceptives before 16 years of age
  • an increase in body mass index (BMI)

Ovarian cancer can run in families. People with a family history of ovarian cancer may have an increased risk of developing ovarian cancer. Other risk factors include:

  • inherited genetic changes
  • hereditary nonpolyposis colorectal cancer
  • endometriosis
  • postmenopausal hormonal therapy
  • obesity
  • tall height

The likelihood of developing cancer also tends to increase with age.

Summary

Adnexal masses are lumps that doctors may find in the adnexal of the uterus, which is the part of the body that houses the uterus, ovaries, and fallopian tubes. Not all masses are cancerous, and they do not all require treatment.

Different types of adnexal mass can share many of the same symptoms. As a result, doctors need to collect a full medical history and data from physical examinations, blood tests, and medical imaging, including transvaginal ultrasounds.

Doctors need to pinpoint the location and cause of an adnexal mass to determine the appropriate management and treatment.

New studies have shown that the ethanolic root bark extract of African cherry may damage fertility in men. African cherry is a plant, which has been used in traditional/alternative medicine in Nigeria to treat several health problems, as various parts of this herb have been proved to have a wide range of therapeutic effects.

The plant is a rich source of natural antioxidants, which have been established to promote health by acting against oxidative stress related disease such as; diabetics, cancer and coronary heart diseases.Its bark is used for the treatment of yellow fever and malaria while the leaf is used as an emollient and for the treatment of skin eruption, stomachache and diarrhea. The cotyledons from the seeds are used as ointments in the treatment of vaginal and dermatological infections in Western Nigeria and also possess anti-hyperglycemic and hypolipidemic effects, among other health benefits.

However, studies have shown that African cherry herbs can also have anti-fertility effects in men.Botanically called Chrysophyllum albidum, African star apple, which belongs to the plant family Sapotaceae is an edible tropical fruit known by various tribal names. It is called Utieagadava in Urhobo; Agbalumo in Yoruba; Udala in Ibo, Efik and Ibibio; Ehya in Igala, Agwaluma in Hausa tribes of Nigeria.

In southern Benin, it is called Azongogwe or Azonbobwe in local language.Several studies have been conducted to investigate the antifertility effect of the ethanolic root bark extract of C. albidum on the hormonal levels (pituitary-testicular axis) and caudal epididymal fluid parameters in wistar rats.

A study titled: “The effect of Chrysophyllum albidum fruit on testicular functions in rats” investigated the effects of C. albidum fruit methanol extract on the reproductive functions of male Wistar rats. Fifteen male Wistar rats were divided into three and received distilled water, which also served as control and extract respectively for 28 days via oral gavage.

The sperm count, motility, percentage sperm aberration, histology of testes and epididymides were examined by microscopy. The results showed the serum levels of luteinising hormone (LH), follicle‐stimulating hormone (FSH) and testosterone were quantified using ELISA. However, the sperm count significantly increased in, while the serum testosterone level decreased.

Findings from the study showed that the architecture of sections of testes and epididymides showed anomalies. C. albidum fruit adversely altered reproductive functions of male Wistar rat. Also, another study published in International Journal of Applied Research in Natural Products by Nigerian researchers validated the antifertility effect of extracts of African cherry in men.

The study is titled: “Antifertility Effects of Ethanolic Root Bark Extract of Chrysophyllum Albidum in Male Albino Rats. According to the researchers, the present study was conducted to investigate the antifertility activity of the ethanol root bark extract of Chrysophyllum albidum on sperm parameter and hormonal levels in rats. Eighteen male rats were divided into three groups of six animals each, as each group were administered distilled water that serve as control, ethanol root bark extract on a daily basis. The caudal epididymal sperm count; motility and sperm morphology were observed compared with the control.

The result showed that ethanol extract of the root bark of C. albidum suppresses the hormonal levels and sperm production in rats, according to the study.The researchers conclude that the study demonstrated that the root bark of ethanolic extract of C. albidum produces a pronounced inhibition of serum testosterone and gonadrophins concentration.

However, these extract had antifertility effect on the testes of albino wistar rats and could be further investigated for possibility of developing a cheap, acceptable and easy available male contraceptive.The researchers said: “The findings of the present study showed that the ethanolic root bark extract of C. albidum could significantly alter the fertility potential of male rats. The fact that there was significant increase in body weight

(p<0.05) on treated animals does not rule out the possibility of a systemic toxicity at the doses treated due to behavioral alterations observed within the treated groups which showed progressive decrease in agility. Furthermore, the significant increase in body weight (p<0.05) indicates that the extract may have toxic effect on the rats. The analysis of caudal epididymal fluids of these treated rats revealed a concomitant decrease in the sperm concentration which may be due to the inhibition in spermatogenesis which has been reflected here by the low count.” [ad] The researchers observed that the “present study also reveals a significant decrease in sperm motility, which focuses the direct effect of the extract on matured and stored sperm in epididymis, also increased abnormal sperm morphology.”Another study evaluated the effects of ethanolic leaf extract of Chrysophyllum albidum on hormones and sperm analysis of laboratory rats. The study titled: “Ethanolic Leaf Extract of Chrysophyllum albidum on sperm analysis, hormonal profile, SOD and testicular histology of adult male wistar rats” was published in the Agriculture And Biology Journal of North America. The researchers in their findings showed that “C. albidum leave extract reduced serum levels of gonadotrophins probably by affecting hypothalamic- pituitary-gonadal axis. The treatment does not cause suppression of spermatogenesis but decrease the hormonal profile. The researchers from Faculty of Basic Medical Sciences, Madonna University, River State concluded that the “C. albidum leave extract reduced serum levels of gonadotrophins probably by affecting hypothalamic- pituitary-gonadal axis. The reduced levels of FSH, LH and T do not have effect on the testicular spermatogenesis for 21 days. However there was an increase in the SOD enzyme activities above the control level thereby improving its antioxidative capacity.”

The muscles, ligaments, and tissues of the pelvic floor support the bladder, rectum, and sexual organs. When the supportive structures weaken or become especially tight, doctors describe it as pelvic floor dysfunction. It is a common health issue.

When a person has pelvic floor dysfunction, the organs in the pelvis may drop. They often press down on the bladder or rectum, causing a leakage of urine or stool. Or, a person with this condition may have trouble urinating or passing stool.

Keep reading to learn more about pelvic floor dysfunction — including the symptoms, treatments, and some exercises that may help.

What is pelvic floor dysfunction?

The pelvic floor is made up of muscles, ligaments, and tissues that surround the pelvic bone. The muscles attach to the front, back, and sides of the bone, as well as to the lowest part of the spine, called the sacrum.

The function of the pelvic floor is to support the organs in the pelvis, which can include the:

  • bladder
  • rectum
  • urethra
  • uterus
  • vagina
  • prostate

People with pelvic floor dysfunction may have weak or especially tight pelvic floor muscles.

When the muscles tighten, or spasm, people may have trouble urinating or passing stool. When they weaken, the organs within the pelvis may drop and press down on the rectum and bladder.

The table below outlines several common types of pelvic floor dysfunction.

Type of pelvic floor dysfunctionDescription
Obstructed defecationThis occurs when stool enters the rectum, but the body cannot fully evacuate the bowels.
RectoceleThis involves tissue from the rectum protruding into the vagina. Stool may get caught in this pocket, forming a bulge in the vagina.
Pelvic organ prolapseThis refers to the pelvic floor stretching and the pelvic organs dropping as a result of age, childbirth, or a collagen disorder.
Paradoxical puborectalis contractionThis involves a pelvic floor muscle called the puborectalis contracting. When it happens, trying to pass stool may feel like pushing against a closed door.
Levator syndromeThis involves the pelvic floor muscles spasming after bowel movements. It can cause lasting dull pain or achy pressure high in the rectum.
CoccygodyniaThis refers to pain in the tailbone that worsens during and after bowel movements.
Proctalgia fugaxThis involves painful spasms of the rectum and muscles in the pelvic floor.
Pudendal neuralgiaThis refers to irritation or damage to the pudendal nerves, which help the pelvis function.
UrethroceleThis refers to the urethra pressing into the vagina.
EnteroceleThis involves the small intestine descending and pushing into the vagina, forming a bulge.
CystoceleThis involves the bladder dropping and pushing into the vagina.
Uterine prolapseThis refers to the uterus descending and pushing into the vagina.

Symptoms

Pelvic floor dysfunction can cause a variety of symptoms, and some can interfere with daily life.

Depending on the type of pelvic floor dysfunction, a person may experience:

  • pelvic pain
  • pressure
  • a bulge somewhere in the lower pelvic region
  • stress urinary incontinence, which involves a small amount of urine leaking from the body due to an activity such as coughing
  • involuntary leakage of stool
  • incomplete urination
  • bowel movement dysfunction
  • pain during sexual intercourse

Also, some people who see their doctors about bladder overactivity find that pelvic floor dysfunction is responsible.

Causes

Many issues can cause the structures of the pelvic floor to weaken, including:

  • age
  • systemic diseases
  • lasting health issues that cause increased pressure in the abdomen and pelvis, such as a chronic cough
  • pregnancy
  • trauma during delivery
  • multiple deliveries
  • large babies
  • operative delivery

Research indicates that stress urinary incontinence, pelvic organ prolapse, or both occur in about half of all women who have given birth. These issues are closely associated with birth-related injury to the pelvic floor muscles.

The pelvic floor muscles can also stretch naturally with age. Stress urinary incontinence and pelvic organ prolapse become more common with increasing age in females, for example.

Collagen disorders can also affect the muscles’ ability to support the pelvic organs.

Meanwhile, coccygodynia usually stems from trauma to the tailbone, such as from a fall. That said, in about one-third of people with the condition, the cause of coccygodynia is unknown. The pain can make having a bowel movement difficult.

Exercises

Doctors recommend pelvic floor exercises in various situations.

They may particularly benefit pregnant women because the pelvic floor muscles can stretch and weaken during labor. Strengthening these muscles may help prevent incontinence after the baby is born. Some doctors recommend that women who wish to become pregnant start the exercises ahead of time.

Males can also benefit from pelvic floor exercises, though the dysfunction is more common in females. In males, these exercises can help prevent pelvic organ prolapse and urinary incontinence and improve sexual intercourse.

To exercise these muscles, a person should be sitting comfortably. Then, they should attempt to squeeze their pelvic muscles without holding their breath.

It is important to isolate the correct muscles without tightening those of the stomach, buttocks, or and thighs.

Doctors recommend that females aim to do 10 long squeezes — holding each for 10 seconds — followed by 10 short squeezes. However, initially, it may be a good idea to practice holding a squeeze for a few seconds at a time.

By practicing frequently, a person should be able to add more contractions to their routine week by week. It is important to do this gradually and to avoid overworking the muscles.

Within a few months, a person may notice a reduction in their symptoms. Even if symptoms resolve completely, a person should continue strengthening these muscles.

There are physical therapists who specialize in pelvic floor dysfunction. A person may find that consulting one of these professionals leads to a better outcome.

Treatment

Doctors determine the cause of pelvic floor dysfunction before recommending treatment because different types of dysfunction require different approaches.

The purpose of treatment is to relieve or reduce symptoms and improve the person’s quality of life. For some people, a combination of treatment methods works best.

Doctors may recommend:

  • Dietary changes: For example, eating more fiber, drinking more fluids, and taking certain medications can make bowel movements easier.
  • Laxatives: Taking a daily laxative may help people with pelvic floor dysfunction pass stool, but it is important to consult a healthcare provider first because not all laxatives are equally effective.
  • Pain relief: Some people require injections of pain relief or anti-inflammatory medication to relieve their symptoms.
  • Biofeedback: This involves electrical stimulation, ultrasound therapy, or massage of the pelvic floor muscles to help improve rectal sensation and muscle contraction.
  • Pessary: A doctor or nurse inserts a pessary into the vagina to support prolapsed organs. This type of device can help treat various symptoms of pelvic floor dysfunction, either as an alternative to surgery or while a person awaits surgery.
  • Surgery: When prolapse interferes with daily activities, a doctor may recommend surgery. Large rectoceles also require surgery if the person experiences symptoms.

Stem cell therapies

Researchers behind a 2016 study investigated whether a stem cell-based therapy could resolve pelvic floor dysfunction in rats.

The researchers engineered the stem cells to produce and release elastin and collagen into the pelvic floor and injected them into rats with pelvic floor dysfunction.

The elastin and collagen promoted the repair of pelvic floor structures and decreased signs of stress urinary incontinence.

In a final component of the study, the researchers developed stem cells that blocked a factor that stops the production of elastin. This promoted increased production and release of elastin into the pelvic floor.

With further studies, researchers may find that similar therapies are effective in humans.

When to see a doctor

Anyone who experiences painful bowel movements, difficulty urinating or passing stool, pelvic pain, or pain during sexual intercourse should speak with a doctor.

An unusual bulge in the lower pelvic region may also be a reason to see a doctor, though a bulge alone may not be a cause for concern.

People with pelvic floor dysfunction have plenty of treatment options. While the topic may be uncomfortable to bring up with a doctor, it is important to seek professional advice about these symptoms.

While some family doctors may not be familiar with pelvic floor dysfunction, specialists such as colorectal doctors, urologists, and gynecologists can help diagnose the issue and recommend the best course of action.

Summary

Pelvic floor dysfunction can affect anyone, but pregnant women have the highest risk.

The various types of pelvic floor dysfunction stem from different causes, and a doctor must identify the underlying issue before developing a treatment plan.

Exercises can help some people with pelvic floor dysfunction. Depending on the cause, a doctor may also recommend dietary changes, medication, a pessary, biofeedback, or surgery.

When faced with an unplanned pregnancy, some women might consider a home abortion. Online sources cite abortion home remedies that they claim are both safe and effective.

For example, some suggest consuming various fruits, herbs, or supplements in excessive quantities. Others recommend intense exercise or inserting implements through the cervix to the uterus to induce abortion.

None of these options is a good idea. Some are merely ineffective, while others are incredibly risky and could potentially lead to disability or death.

In this article, we discuss the risks of home abortions, which range from toxicity to life threatening infection. We also detail the alternative options available to those who wish to end a pregnancy safely.

The risks of home remedies

Some abortion home remedies, such as drinking certain teas, may seem relatively safe.

However, consuming everyday herbs in excessive amounts could potentially lead to toxicity. Some remedies can be fatal.

The World Health Organization (WHO) report that 47,000 women die every year due to unsafe abortions, and an additional 5 million develop a disability as a result.

The WHO state that it is possible to prevent almost all of these deaths and disabilities through accessing safe abortion, sex education, and family planning.

Potential risks of home remedies include:

An incomplete abortion

An incomplete abortion is one that was not fully successful. It occurs when the pregnancy ends, but some of the fetal tissue remains in the body.

It is necessary to seek immediate medical treatment for an incomplete abortion to avoid significant blood loss, severe infection, or death. However, a woman may not know if the abortion is incomplete until they develop severe symptoms, such as bleeding.

Toxicity

Taking herbal remedies or abortion pills purchased from unreputable online sources can have serious consequences.

Even natural remedies can be toxic, especially when people consume them in large amounts.

When people eat toxic amounts of something, the liver comes under pressure to filter the toxins from the body. In severe cases, this results in liver damage or liver failure.

Some websites claim to sell abortions pills online, but many of these pills are not genuine. In some cases, they could be harmful. Products from other countries can contain contaminants from heavy metals. The Food and Drug Administration (FDA) or other authorities do not monitor these products, which means the public is not protected.

Hemorrhaging

Hemorrhaging means major blood loss. While all surgeries, including surgical abortions, carry the risk of heavy bleeding, an abortion by an unqualified person increases that risk significantly.

Internal bleeding is life threatening and may go unnoticed until it is too late to stop it.

Infection and scarring

There is a risk of infection and internal scarring with surgical abortions, but this risk increases dramatically with at-home surgical abortions.

Inserting anything through the cervix to the uterus is extremely dangerous, as it can cause infection and scarring. Both of these outcomes can lead to infertility. Severe infections are life threatening.

At-home medical solutions

There is a safer alternative to home remedies for women who want to terminate their pregnancy at home.

A doctor can prescribe medication for a woman to take at home. This is known as a medical abortion. This option is becoming more common in the United States.

Typically, a medical abortion involves taking two medications, mifepristone and misoprostol, at different times. Mifepristone causes hormonal changes that allow the pregnancy to end, while misoprostol causes the uterus to contract and expel the uterine lining.

Medical abortion has a success rate of up to 99% for early pregnancy termination. Research indicates that it does not increase future pregnancy complications.

Medical abortions are an option for women who are up to 10–12 weeks pregnant or less, depending on local laws.

It is important to note that it is against the law to induce an abortion in many countries.

Surgical abortion

Doctors perform surgical abortions in situations where a medical abortion is not an option.

During a surgical abortion, also known as dilation and curettage (D&C), a surgeon will remove the fetus, using suction and a sharp tool called a curet.

In many areas, surgical abortions are an option for up to 24 weeks of pregnancy. After this time, options for terminating the pregnancy diminish. A doctor will typically only perform a surgical abortion if the pregnancy poses a risk to the life of the woman, or if there are issues with the baby’s development.

Women should talk to their doctor or midwife about how they feel about continuing the pregnancy.

Legal surgical abortions are relatively safe and effective. In rare cases, a D&C can cause scarring of the uterine wall, which is called Asherman’s syndrome.

Asherman’s syndrome may make it more difficult to get pregnant again, or it may increase the risk of miscarriage in future pregnancies.

Where to get help

People who have attempted a home abortion should seek medical help. It is essential that they get urgent attention if they have:

  • excessive bleeding
  • fever or chills
  • jaundice (yellow skin or eyes)
  • loss of consciousness
  • sweaty, cold skin
  • vomiting
  • other severe, persistent, or concerning symptoms

Women must tell their doctor what caused the symptoms. Giving as much information as possible will help the doctor to treat the issue correctly and promptly, as well as offer care and support.

People living in the U.S. who wish to have more information on accessing an abortion or on alternative options can get help from the following organizations:

Outside the United States, people may wish to contact:

Recovery

Recovery from a medical or surgical abortion usually takes a couple of weeks. During this time, a person may experience some cramps and vaginal bleeding. Sometimes, the bleeding can last longer than 2 weeks, and on rare occasions, it can last up to 45 days. Anyone with bright red blood or bleeding that continues longer than 2 weeks must see their doctor.

The medications a woman takes during a medical abortion may cause nausea and other short-term effects.

The anesthetics or sedatives a doctor administers during a surgical abortion may also cause nausea or other side effects.

After either type of abortion, a doctor will advise that women wait until the bleeding ends before having sex to reduce the risk of infection. In the case of complications, some women may need to wait longer.

Do not use tampons for 6 weeks; use only pads.

During the recovery period, women can take ibuprofen to alleviate pain. Heating pads may also be helpful for cramps.

Women should contact their doctor or the clinic if they experience heavy bleeding, smelly discharge, fever, or other signs of infection.

It is also vital to deal with any emotional distress following an abortion. Abortions affect everyone differently — all emotional responses are valid. A doctor or the abortion clinic can provide contact details for therapists who offer postabortion counseling.

Regular vaginal discharge is a sign of a healthy female reproductive system. Normal vaginal discharge contains a mixture of cervical mucus, vaginal fluid, dead cells, and bacteria.

Females may experience heavy vaginal discharge from arousal or during ovulation. However, excessive vaginal discharge that smells bad or looks unusual can indicate an underlying condition.

This articles discusses why someone may have heavy vaginal discharge and what they can do about it.

1. Arousal

Sexual arousal triggers several physical responses in the body. Arousal increases blood flow in the genitals. As a result, the blood vessels enlarge, which pushes fluid to the surface of the vaginal walls.

Arousal fluid is clear and watery with a slippery texture. This fluid helps lubricate the vagina during sex.

Other signs of female arousal include:

  • increased heart rate and breathing
  • flushing of the face, neck, and chest
  • swelling of the breasts
  • erect nipples

2. Ovulation

Cervical fluid is a gel-like liquid that contains proteins, carbohydrates, and amino acids. The texture and amount of cervical fluid both change throughout a female’s menstrual cycle.

For example, after menstruation, cervical fluid has a thick, mucus-like texture. It can be cloudy, white, or yellow.

Estrogen levels increase closer to ovulation. This causes the cervical fluid to become clear and slippery, similar to that of raw egg whites.

Cervical fluid discharge increases during the days leading up to ovulation and decreases after ovulation. Females may have no discharge for a few days after their period.

3. Hormonal imbalances

Hormonal imbalances related to stress, diet, or underlying medical conditions can cause heavier vaginal discharge.

Polycystic ovary syndrome (PCOS), for example, refers to a set of symptoms that occur as a result of hormonal imbalances. According to the Centers for Disease Control and Prevention (CDC), PCOS affects up to 5 million females in the United States.

Those with PCOS have higher levels of male hormones called androgens. Increased androgen levels can:

  • change the amount or texture of cervical fluid
  • cause irregular periods
  • prevent ovulation

Not everyone with PCOS will have increased vaginal discharge. Paying attention to other PCOS symptoms may help someone identify and seek treatment for the condition faster.

Some other symptoms of PCOS to look out for include:

  • fewer than eight periods in 1 year, or periods that occur every roughly 21 days
  • excess facial and body hair
  • thinning hair or hair loss
  • acne on the face and body
  • weight gain
  • darkening of the skin on the neck, groin, or breasts
  • skin tags on the armpits or neck

Hormonal birth control, such as birth control pills and intrauterine devices, can also cause increased vaginal discharge, especially during the first few months of use.

Excess vaginal discharge and other symptoms, such as spotting and cramping, usually resolve once the body adjusts to the hormonal birth control.

4. Vaginitis

Vaginitis refers to inflammation of the vagina, which can occur from an infection or irritation due to factors such as douches, lubricants, and ill-fitting clothing.

Vaginitis can cause thick vaginal discharge that may be white, gray, yellow, or green.

Other symptoms of vaginitis include:

  • foul vaginal odor
  • an itching or burning sensation in the genital area
  • redness or inflammation of the vagina
  • pain or discomfort when urinating
  • pain during sexual intercourse

5. Bacterial vaginosis

Bacterial vaginosis is a condition that results from an overgrowth of bacteria in the vagina. This vaginal infection is the most common among females aged 15–44 years.

The exact cause of bacterial vaginosis remains unclear. Females can develop bacterial vaginosis after sexual intercourse. However, this condition is not a sexually transmitted infection (STI).

According to the Office on Women’s Health, those who have bacterial vaginosis may notice a milky or gray-colored vaginal discharge. Some also report a strong, fishy vaginal odor, especially after sexual intercourse.

Bacterial vaginosis can also cause:

  • discomfort when urinating
  • painful burning or itching in the vagina
  • irritation of the skin around the vagina

6. Yeast infection

Vaginal yeast infections result from an overgrowth of the Candida fungus. Females of all ages can develop a vaginal yeast infection, and nearly 70% will have a yeast infection at some point in their lives.

The most common symptom of a vaginal yeast infection is an intense itching in the vagina and vulva.

Vaginal yeast infections can also cause an odorless vaginal discharge that looks similar to cottage cheese.

Vaginal yeast infections are treatable at home using over-the-counter antifungal ointments. Symptoms should improve within a few days. However, severe infections can last longer and may require medical treatment.

7. Trichomoniasis

Trichomoniasis is an STI caused by a parasite. Females can develop trichomoniasis after having sex with someone who has the parasite.

Although most people who have trichomoniasis do not experience symptoms, some may have an itching or burning sensation in the genital area.

Trichomoniasis infections can also cause excess vaginal discharge that has a foul or fishy odor and a white, yellow, or green color. It may also be thinner than usual.

What is healthy discharge?

Healthy vaginal discharge varies from person to person. It also changes throughout their menstrual cycle.

In general, healthy vaginal discharge can appear thin and watery or thick and cloudy. Clear, white, or off-white vaginal discharge is also perfectly normal.

Some females may have brown, red, or black vaginal discharge at the end of their menstrual periods if their vaginal discharge still contains blood from the uterus.

Natural hormonal changes during ovulation can cause an increase in vaginal discharge, which should return to normal after ovulation.

When to see a doctor

It is not always necessary to see a doctor about excessive vaginal discharge. However, a female may want to consider seeing their doctor if their vaginal discharge has an abnormal appearance.

Yellow, green, gray, or foul-smelling vaginal discharge could indicate an infection. Other reasons to see a doctor include:

  • itching or burning near the genitals
  • discomfort or pain when urinating
  • discomfort or pain during sexual intercourse

Possible treatment options

Treating excess vaginal discharge depends on the underlying cause.

People can reduce symptoms of vaginitis by avoiding the source of irritation. Doctors can treat bacterial vaginosis and yeast infections using antibiotics or antifungals.

Doctors can also treat trichomoniasis using antibiotics. The CDC recommend that females wait 7–10 days after receiving treatment before having sex.

Treatment for PCOS varies depending on the individual. A doctor may recommend a combination of lifestyle changes and medications to help people manage their symptoms and regulate their hormone levels.

Maintaining a healthy body weight and eating a varied diet low in added sugars may also help improve some symptoms of PCOS. Birth control pills that contain estrogen or progestin can help balance out excess levels of androgens.

Tips for managing heavy vaginal discharge

Even healthy vaginal discharge can cause discomfort at times. Here are some tips for managing heavy vaginal discharge:

  • Wear panty liners. However, be sure not to let them become too moist, as this can increase the risk of urinary tract infections and vaginitis.
  • Choose breathable underwear made from natural fibers such as cotton.
  • Avoid wearing tight pants.
  • Avoid using hygiene products that contain added fragrances, coloring agents, or other harsh chemicals.
  • Keep the genital area clean and dry.
  • Wipe from the front to the back when using the bathroom.

Outlook

Excess vaginal discharge can occur as a result of arousal, ovulation, or infections. Normal vaginal discharge ranges in color from clear or milky to white.

The consistency of vaginal discharge also varies from thin and watery to thick and sticky. Generally, healthy vaginal discharge should be relatively odorless.

A female can speak with a healthcare professional if they notice any symptoms of an infection. Some symptoms to look out for include:

  • yellow, green, or gray vaginal discharge
  • foul-smelling vaginal discharge
  • discharge that looks similar to cottage cheese
  • itching or burning in or near the genitals

Doctors can easily treat most vaginal infections using antimicrobial medications. Depending on the severity of the infection, people may see their symptoms improving within a few days to weeks.

Lower abdominal pain is pain that occurs below a person’s belly button. Bloating refers to a feeling of pressure or fullness in the abdomen, or a visibly distended abdomen. Sometimes, these symptoms occur together.

Though occasional lower abdominal pain and bloating are common, a person should speak to their doctor if it becomes a regular occurrence. In some cases, this combination of symptoms may indicate an underlying issue that requires medical treatment.

Keep reading for more information on some of the more common causes of abdominal pain and bloating. We also outline various treatment options for this combination of symptoms.

Causes of both abdominal pain and bloating

There are several causes of combined lower abdominal pain (LAP) and bloating. Some relatively harmless, or benign, causes include:

  • consumption of high fat foods
  • swallowing too much air
  • stress

In some cases, LAP and bloating can occur as a result of an underlying medical condition, such as:

  • constipation
  • food intolerances, such as lactose or gluten intolerance
  • gastroesophageal reflux disease (GERD), although this more commonly causes upper abdominal pain-gastroenteritis, which is inflammation of the gastrointestinal (GI) tract that causes vomiting and diarrhoea
  • diverticulitis, which is inflammation or infection of part of the large intestine
  • ileus, which is a condition that slows the function of the small and large intestine
  • delayed stomach emptying, or gastroparesis, which is a complication of diabetes mellitus
  • intestinal obstruction
  • inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

Other conditions that can cause LAP and bloating are specific to females. These include:

  • menstrual pain
  • endometriosis
  • ovarian cysts
  • pelvic inflammatory disease (PID)
  • pregnancy
  • ectopic pregnancy

LAP and bloating can also be due to conditions that do not necessarily affect the stomach, intestines, or reproductive organs. These conditions include;

  • drug allergies
  • side effects of certain medications
  • hernia
  • cystitis, or infection of the urinary tract infection
  • appendicitis, or inflammation of the appendix
  • kidney stones

When to see a doctor

If the cause of LAP and bloating is relatively benign, symptoms should go away within a few hours to days.

A person should see a doctor if:

  • their symptoms last longer than a few days
  • their symptoms begin to interfere with their daily life
  • they are pregnant and are unsure of the cause of LAP and bloating

People should seek immediate medical attention if vomiting or the inability to pass gas occur alongside LAP and bloating.

People who experience LAP and bloating along with one or more of the following symptoms should seek emergency medical attention:

  • sudden worsening of pain
  • fever
  • unusual vaginal discharge
  • bloody stool
  • unexplained weight loss
  • severe nausea and vomiting

Diagnosis

To make a diagnosis, a doctor will begin by carrying out a physical examination. An initial examination will involve applying pressure to the abdomen. This will help the doctor to check the location of pain and to feel for any abnormalities.

A doctor will also make a note of the person’s medical history, and any other symptoms they experience. They may also ask whether there is anything that triggers the pain or makes it worse.

Diagnostic tests, such as urine, blood, or stool tests, may also be necessary. These can help to identify signs of infection or other underlying conditions.

In some cases, a doctor may order one of the following imaging tests to check for abnormalities in the abdomen:

  • ultrasound
  • X-ray
  • CT or MRI

If the imaging tests come back normal, a doctor may perform a colonoscopy for a closer look inside the intestines.

Treatment

The following are some general home treatment options that may help to alleviate symptoms of LAP and bloating:

  • increasing fluid intake
  • exercising to help alleviate gas and bloating
  • taking over-the-counter (OTC) pain medications
  • taking OTC antacids

If home treatments do not work, a person should speak to their doctor about other treatment options. These will vary, depending on the cause of LAP and bloating. However, some examples include:

  • prescription medications to treat pain and bloating
  • antibiotics to help treat a bacterial infection
  • emergency surgery to remove a ruptured appendix

Prevention

There are some steps a person can take to help alleviate LAP and bloating. Two key steps include quitting smoking and avoiding trigger foods.

The following are examples of foods that may cause or contribute to LAP and bloating:

  • high fat foods
  • certain plant-based foods, such as cabbage, lentils, and beans
  • dairy products if a person is lactose intolerant
  • carbonated drinks
  • beer
  • chewing gum
  • hard candy

Also, people may benefit from increasing their intake of high fiber foods such as fruits, vegetables, and whole grains. This will help to prevent constipation and associated bloating.

If an underlying condition is the cause of LAP and bloating, then treating the condition should help to alleviate these symptoms.

Outlook

There are many potential causes of lower abdominal pain and bloating. Some causes are relatively benign and easy to treat, while others may be more serious.

Occasional lower abdominal pain and bloating are usually not a cause for concern. However, people should see a doctor if their symptoms worsen, last more than a few days, or disrupt their daily activities.

People who experience additional symptoms, such as vomiting, fever, or blood in the stool, should seek emergency medical attention.

In some cases, people can prevent lower abdominal pain and bloating by avoiding foods that may trigger these symptoms.