We often hear that women’s rights are human’s rights: this most definitely also applies to healthcare.

Improving women’s health depends on improving their rights and vice versa. This calls for widespread commitment on both fronts, involving health professionals, institutions, politicians, and NGOs. The aim is to remove the economic, ideological, and socio-cultural obstacles to implementing actions that can change women’s lives. “The health of women and girls is of particular concern because, in many societies, they are disadvantaged by discrimination rooted in sociocultural factors.” said the World Health Organization (WHO).

Among said factors are unequal power dynamics between men and women, inequality towards education and employment opportunities, an exclusive focus on women’s reproductive roles and increased vulnerability to physical, sexual, or emotional violence. Women also face increased vulnerability in less privileged parts of the world.

Regarding health-related inequalities, in sub-Saharan Africa, women, for example, represent a significant majority of HIV/AIDS victims (63% of new infections in 2021). Every two minutes, a young woman between 15 and 24 gets infected by HIV. These women (aged 15-24) are three times more likely to contract HIV than young men of the same age.

We need urgent and long-term care for women around the globe. Prioritizing women’s health to make a difference everywhere and around the world is our mission at FIGO.

Founded in 1954, FIGO brings together 135 learned societies of gynecology and obstetrics on every continent whose aim is to improve the status of women, girls, and families to enable them to reach their full educational, sexual, and reproductive potential in harmony with their professional fulfillment and personal well-being.

In its fight for women, FIGO is also partnering with Professor Denis Mukwege, a Congolese gynecologist and winner of the 2018 Nobel Peace Prize, to support the “Red Line Initiative,” which bans the practice of rape as a weapon of war and leads on global programme activities, with a particular focus on sub-Saharan Africa and Southeast Asia. We strive to promote women’s health and rights through four fundamental pillars: education, training, research, and advocacy.

To that end, health professionals and experts from all over the globe will come together at FIGO’s upcoming congress in Paris from October 9 to 12 to share their knowledge and learn about new progress that has been made for women’s health, and the goals that we all have yet to achieve.

One excellent example is the elimination of cervical cancer.

This aim, which will considerably impact women’s lives, is one of FIGO’s priorities. Today, a woman dies of cervical cancer every two minutes worldwide, even though it can be prevented. Prevention is based on vaccinating boys and girls, ideally, before they begin sexual activity, and on screening. Cervical cancer is caused by papillomaviruses, or HPV, a family of sexually transmitted viruses. Eighty percent of the sexually active population will encounter HPV at least once, but in 90% of cases, the human body will naturally fight it and eliminate it within two years. If not, the persistent virus can lead to precancerous lesions and invasive cancer. Vaccination can prevent 90% of HPV infections that cause cancers other than cervical cancer (ENT, vulva, anus, penis).

Recommended by all learned societies and the World Health Organization, implementation varies from country to country. Australia, for example, is a good role model with a rate of 90% of vaccinated young girls, and cervical cancer is expected to be eliminated by 2035. In the US, 63,8% of young girls and 59,8% of young boys are fully vaccinated.  Rwanda became the first African country with an HPV vaccination implementation strategy and now realizes that vaccination coverage reached 99% of those born in 2002.

After an initial catch-up campaign that targeted school grades and included older girls, the programme transitioned to an age-based approach, with routine vaccination of only girls aged 12 from 2015 onwards. More than 1.15 million girls in Rwanda received their first dose of the HPV vaccine in 2011–2018 as part of this programme. Population-level HPV vaccination coverage increased from 6% for girls born in 1993 to 99% for those born in 2002.

Other countries need to catch up for several reasons. In addition to some reluctance toward vaccination, smear screening progresses slowly, often due to a need for more awareness and information. Smear screening is essential to eradicating cervical cancer: the WHO recommends screening 70% of women in all countries.

Improving prevention and women’s health understandably requires deploying resources on a par with the expected ambitions and progress. Political commitment is imperative to remove the cultural and economic obstacles to improving women’s health.

Healthy women are the cornerstone of healthy societies.

Women often provide for their families, communities, and the people around them. If women are healthier, it impacts everyone around them and eventually leads to healthier newborns, children, families, households, and communities. Leaders who prioritize women’s health can overcome gender inequality and improve the overall population’s health.

To register for the FIGO Congress, Paris, 9-12 October 2023: https://figo2023.org/registration/

[Medika Life is honored to feature this exclusive Q&A feature authored by Jeanne Conry, MD, president, The International Federation of Gynecology and Obstetrics]

The post Why Improving Women’s Health Around the World is Urgent appeared first on Medika Life.

What is a hysterectomy?

A hysterectomy is a surgery to remove the uterus. Gynecologists perform hysterectomies for a variety of gynecologic conditions such as uterine fibroids, heavy periods, endometriosis, chronic pelvic pain, uterine prolapse, and gynecologic cancer.

During a hysterectomy, a surgeon removes the uterus. Gynecologists often recommend removing the fallopian tubes (bilateral salpingectomy) to reduce the risk of ovarian cancer. Some women will also need the removal of the ovaries (oophorectomy). Removal of the ovaries triggers hormonal changes. After a hysterectomy, a woman can longer get pregnant.

Gynecologists perform hysterectomies through a variety of techniques. The uterus’ size, the patient’s body type, and prior surgical history help determine the surgical approach. Techniques include:

1. Vaginal hysterectomy
2. Abdominal hysterectomy
3. Laparoscopic hysterectomy
4. Laparoscopic-assisted vaginal hysterectomy
5. Robotic hysterectomy

What are the advantages of vaginal hysterectomy?

Vaginal hysterectomies are performed through the vagina. The uterus is slowly detached from the pelvis and then removed through the vagina. There is only a single incision inside the vagina; there are no abdominal incisions.

Vaginal hysterectomy is a minimally invasive surgery that benefits patients by having only a vaginal incision, shorter hospital stay, faster recovery, reduced pain, and a shorter hospital stay.

The American College of Obgyn states that a vaginal hysterectomy is the preferred minimally invasive approach because it is associated with better outcomes. However, some patients may not be candidates because of uterine size or prior surgical history. Your doctor will determine which approach is most suitable for you.

Is a hysterectomy safe?

Hysterectomy is a very safe surgical procedure, and complications are rare. However, as with any surgery, problems can occur, such as:

• Fever and infection
• Heavy bleeding during or after surgery
• Injury to the urinary tract or nearby organs
• Blood clots in the leg that can travel to the lungs
• Breathing or heart problems related to anesthesia
• Death

Some problems are seen immediately, and some may not show until days, weeks, or even years after surgery. These problems include the formation of a blood clot, infection, or bowel blockage. Complications are generally more common after an abdominal hysterectomy and in women with certain underlying medical conditions.

How long will I be in the hospital?

Surgeons perform vaginal hysterectomies as an outpatient procedure (meaning the patient can go home the same day) or inpatient surgery with an overnight stay. Various factors, such as the patient’s underlying health status, surgical complexity, and physician preference, help determine the surgical plan.

Most vaginal hysterectomy patients can leave the hospital sooner than after an abdominal hysterectomy.

Can my family visit me?

A trusted family member should drive you to and from the hospital or ambulatory surgery center. Families are welcome to stay with you before and after surgery. Hospital visitor policies for overnight stays vary with the ongoing COVID-19 pandemic.

Does my procedure require an anesthetic?

A vaginal hysterectomy requires general anesthesia meaning patients will temporarily be put to sleep. The surgeon may also inject a local anesthetic into the incisions to decrease postoperative pain.

Why do I need a preoperative clinic visit?

Most surgeries will involve a preoperative visit with your surgeon to review the procedure’s risks and benefits and to answer your questions regarding the upcoming surgery. Because hysterectomies will eliminate the possibility of child-bearing, your doctor will confirm that you do not want children in the future.

It is essential to provide your doctor with an updated list of all medications, vitamins, and dietary supplements before surgery. This will help us carefully review your medications and plan when to stop certain medicines, when the last dose should be taken prior to the surgery and when to resume medications. This is particularly important for patients taking aspirin, blood pressure medicines, and diabetes medicines. Your doctor should review all medication and food allergies. We remind patients to avoid alcohol 24 hours before the surgery.

If any blood work or preoperative testing is required, it will be scheduled and confirmed. If appropriate, share any lab work, radiologic procedures, or other medical tests done by other healthcare providers with your surgeon before your surgery. Some patients may need to supply a surgical clearance letter from their primary care physician.

Finally, the doctor will give instructions regarding your diet before the surgery.

Try to avoid wearing jewelry, make-up, nail polish/acrylic nails on the day of surgery. If you wear contacts, glasses or dentures, please bring a case.

You should also confirm the date, time, and location of the surgery.

What happens after I check-in at the hospital?

After arrival at the hospital or Ambulatory Surgery Center, the staff will guide you to the preoperative holding area to change into a surgical gown and store your belongings. You will meet the nursing team who will provide care during your stay. They will review your medical history. The surgical consent form is also reviewed, signed, or updated with any changes. An IV will be placed at this time. You may be given special stockings to help prevent a blood clot.

The anesthesia team will come to interview you and answer questions. Typically your surgeon will also review any last-minute questions.

What happens in the operating room?

After the preoperative evaluation, the team will guide you to the operating room. You will move from the mobile bed to the operating table. Monitors will be attached to various parts of your body to measure your pulse, oxygen level, and blood pressure. Then the anesthesiologist will give medication through your IV to help you go to sleep.

The OR nursing team will cover your body with sterile drapes and apply an antibacterial fluid to your abdomen and vagina. After you are asleep, a tube called a catheter may be placed in your bladder to drain urine. The team then performs a “surgical time-out.” A surgical safety checklist is read aloud, requiring all surgical team members to be present and attentive.

The gynecologist will insert a speculum into the vagina to allow visualization of the cervix, the opening of your uterus located at the back of the vagina.

Once the speculum is in place and the cervix is visualized, the surgeon will grasp the cervix with an instrument called a tenaculum. This step helps us safely operate and avoid injury to surrounding tissue such as the bladder, rectum, intestines, and ureter.

Then we work to detach your bladder from the uterus. After the bladder is safely out of the way, we begin to gradually detach the uterus from the pelvis. The surgeon will first focus attention on the uterine arteries. These two blood vessels are the main blood supply to the uterus and travel over the ureters, which connect the kidney to the bladder. Once the uterine arteries are controlled, the surgeon then safely gradually separates the uterus from the body. If indicated, then the tubes and ovaries are also removed.

The uterus is delivered through the vagina and sent to the pathology lab for microscopic analysis. The surgeon examines all of the surgical sites for bleeding.

The surgeon then sews the edges of the vagina closed to form the vaginal cuff.

Once the procedure is complete, the surgical team completes a post-procedure review. All instruments and equipment are counted and verified. When finished, the anesthesiologist will begin to wake up the patient and then transfer her to the recovery room.

What happens in the RECOVERY ROOM?

Once the operation is over, you will be moved into the recovery area. This area is equipped to monitor patients after surgery.

Many patients feel groggy, confused, and chilly when they wake up after an operation. You may have muscle aches or a sore throat shortly after surgery. These problems should not last long. You can ask for medicine to relieve them. You will remain in the recovery room until you are stable.

As soon as possible, your nurses will have you move around as much as you can. You may be encouraged to get out of bed and walk around more quickly after your operation. Walking helps reduce the risk of blood clots. You may feel tired and weak at first. The sooner you resume activity, the sooner your body’s functions can get back to normal.

What preparations should I make for aftercare at home?

You should speak with your physician regarding the resumption of exercise and sexual activity. Sexual activity is typically restricted for 6–8 weeks to allow the vagina to heal. Do not insert anything into your vagina — no sex, tampons, or douching — until cleared by your doctor.

Most women can return to basic activities in one to two weeks. Generally, we recommend patients stick to light activity only for the first 4–6 weeks. Light exercise helps your body heal and prevents some postoperative complications. Be sure to get plenty of rest, but you also need to move around as often as you can. Take short walks and gradually increase the distance you walk every day. Avoid strenuous exercise and heavy lifting.

You may resume a regular diet on the day of surgery. It may help prepare some meals and do your grocery store shopping and laundry before surgery.

You will be given instructions to help control postoperative pain during healing. Some pain is expected for the first few weeks after the surgery. You may also have light bleeding and vaginal discharge for a few weeks. Sanitary pads can be used after the surgery.

Constipation is common after hysterectomies. Try a stool softener and fiber supplement. Some women have temporary problems with emptying the bladder after a hysterectomy. Some women have an emotional response to hysterectomy. You may feel depressed that you are no longer able to carry a pregnancy, or you may be relieved that your former symptoms are gone.

Your doctor will schedule a postoperative examination 4–6 weeks after the procedure.

After recovery, we recommend that continuing your annual routine gynecologic exams. Depending on your age and reason for the hysterectomy, you may still need pelvic exams and pap tests.

DANGER SIGNALS

Call your doctor or report to the ER if you experience:

• Pain not controlled with prescribed medication
• Fever > 101
• Severe nausea and vomiting
• Calf or leg pain
• Shortness of breath
• Heavy vaginal bleeding
• Foul-smelling vaginal discharge
• Abdominal pain not controlled by pain medication
• Inability to pass gas

This article was contributed by MacArthur Medical Center’s Dr. Reshma Patel 

The post Preparing for: Vaginal Hysterectomy appeared first on Medika Life.

A hysterectomy is a surgery to remove theuterus. Hysterectomies are performed for a variety of gynecologic conditions such as uterine fibroids, heavy periods, endometriosis, chronic pelvic pain, uterine prolapse and gynecologic cancer. 

During a hysterectomy, the uterus is removed. Obgyns often recommend fallopian tube removal (bilateral salpingectomy) to reduce the risk of ovarian cancer. Some women will also need the removal of the ovaries (oophorectomy). Hormonal changes only occur when the ovaries are removed.

Gynecologists perform hysterectomies through a variety of techniques. The size of the uterus, surgeon experience, the patient’s body type, and the prior surgical history help determine the proper surgical approach. Techniques include:

1. Vaginal hysterectomy
2. Abdominal hysterectomy 
3. Laparoscopic hysterectomy 
4. Laparoscopic-assisted vaginal hysterectomy 
5. Robotic hysterectomy robotic

What are the advantages of robotic hysterectomy?

Contrary to the name, robots do not perform the surgery. A human gynecologic surgeon attaches a surgical system to intraabdominal ports. While sitting at a surgical console, the surgeon controls the robotic arms while monitoring the surgical field in a 3D view..

Through 4–5 small incisions, the surgeon detaches the uterus from the surrounding tissues. Robotic surgery is a minimally invasive surgery that allows for faster recovery, reduced pain, and shorter hospital stay.

The American College of Obgyn acknowledges this type of hysterectomy’s growing popularity but recommends robotic hysterectomy be reserved for more complex cases that can not be safely completed through other minimally invasive techniques.

Experienced robotic surgeons prefer the precise control of the surgical arms allowing complex cases to be completed in a minimally invasive fashion. Patients benefit from small incisions, a short hospital stay, and a faster return to work, exercise, and everyday activities.

How long will I be in the hospital?

Surgeons perform robotic hysterectomies as an outpatient procedure or as an inpatient surgery with an overnight stay. Various factors, such as the patient’s underlying health status, surgical complexity, and physician preference, help determine the surgical plan.

Most robotic hysterectomy patients are able to leave the hospital much faster after a traditional abdominal hysterectomy. 

Can family visit me?

A trusted family member should drive you to and from the hospital or ambulatory surgery center for a robotic hysterectomy. Families are welcome to stay with you before and after surgery. Hospital visitor policies for overnight stays vary from region to region due to the Covid-19 pandemic.

Does my procedure require an anesthetic?

Laparoscopic robotic surgery requires general anesthesia meaning patients will be temporarily put to sleep. The surgeon may also inject a local anesthetic into the incisions to decrease postoperative pain.

What’s the procedure when I check-in?

Most surgeries will involve a preoperative visit with your surgeon to go over the procedure’s risks and benefits in detail. Your surgeon answers questions regarding your upcoming surgery. The surgical consent form is reviewed, signed, or updated with any changes.

Because robotic hysterectomies will eliminate the possibility of child-bearing, your doctor will ask questions to make sure you are confident you will not want children in the future.

In most settings, patients will receive a preoperative phone call by a nurse or medical assistant one to two days before surgery. If any blood work or preoperative testing is required, it will be scheduled and confirmed.

After arrival at the hospital or Ambulatory Surgery Center, the staff will guide you to the preoperative holding area to change into a surgical gown and store your valuables. You will meet the nursing team who will provide care during your stay. An IV will be placed at this time.

The anesthesia team will come to interview you and answer questions. Typically your surgeon will also come and review any last-minute questions.

What happens in the operating room?

After the preoperative evaluation, the team will guide you to the operating or procedure room. You will move from the mobile bed to the operating table. Once you are positioned comfortably and safely, the anesthesiologist will give you medication through your IV to help you go to sleep.

The OR nursing team will cover your body with sterile drapes and prep the abdomen for surgical sterility. The team then performs a “surgical time-out.” A surgical safety checklist is read aloud, requiring all surgical team members to be present and attentive.

The gynecologic surgeon will insert a speculum into the vagina to allow visualization of the cervix, the opening of your uterus located at the back of the vagina.

Once the speculum is in place and the cervix visualized, the surgeon inserts a device called a uterine manipulator into the cavity of the uterus. This step facilitates the surgeon’s ability to safely operate and avoid injury to surrounding tissue such as the bladder, rectum, intestines, and ureter.

The surgeon will mark the surgical sites with a small marking pin. A small camera is inserted through an incision into the belly button. Air inflates and distends the abdomen to allow visualization of the pelvis. Three or four secondary ports are placed to allow the robotic arms to function. 

The robot is then positioned over the body and attached to the ports. The laparoscopic camera is positioned to show the pelvic anatomy. Small instruments are passed through the additional ports. Scissors are attached to one robotic arm and a grasping device in the other. This allows the surgeon to operate with both hands. 

The surgeon then moves away from the patient to the surgical consult to control the robot. 

As the surgeon takes her seat, she adjusts the camera and robotic arms’ position to begin the surgery.

Many surgeons recommend complete removal of the fallopian tubes (bilateral salpingectomy) at the time of surgery as this technique reduces the risk of ovarian cancer.

The fallopian tubes are located and grasped with one instrument. Using the other hand, the surgeon clamps and cuts the tubes from the adjacent anatomy.

The surgeon travels down the sides of the uterus freeing it from the connecting tissues. The round ligament and utero-ovarian ligaments are clamped, cauterized and then cut. At each step, the surgeon will take precautions to control and avoid bleeding. 

Towards to lower end of the uterus lies important anatomy. The surgeon will separate the bladder from the lower uterine segment to allow visualization of the cervix. 

The surgeon will focus attention on the uterine arteries. These two blood vessels are the main blood supply to the uterus and travel over the ureters, which are the tubes connecting the kidney to the bladder. 

Once the uterine arteries are controlled, the surgeon can safely separate the uterus from the vagina. 

The surgeon makes a circular incision just below the cervix freeing the uterus. The uterus is delivered through the vagina and sent to the pathologist to analyze the tissue. 

The surgeon then sews the edges of the vagina closed to form the vaginal cuff. 

The surgeon examines all of the surgical sites for bleeding. When safe, the Obgyn removes the operative ports and sews the surgical incisions closed. 

Once the procedure is complete, the surgical team completes a post-procedure review. All instruments and equipment are counted and verified. When finished, the anesthesiologist will begin to wake the patient up for transfer to the recovery room.

How long will I be in the operating room?

Once the patient enters the operating room, a series of safety steps must occur. This process takes about 20 minutes.

The operative time for robotic hysterectomy varies. The surgeon’s experience, surgical technique, patient body type, uterine size, and patient’s previous surgeries are all factors.

In general, patient should expect 1–2 hours of total operative time.

When can I go home?

Postoperative recovery time will vary from person to person. Some surgeons will recommend an outpatient procedure while others prefer an overnight stay. The patients underlying health status, surgical complexity and physician preference are all factors. 

To be able to go home, each patient must meet specific discharge criteria. The patient’s vital signs must be stable. The patient must be alert, oriented, and able to walk with assistance. Postoperative nausea, vomiting, and pain must be controlled as well as confirmation of no postoperative bleeding.

The nursing team will go over discharge instructions, and the plan for postoperative pain management options will be confirmed.

What is the usual recovery time

Most women should be able to return to normal daily activities within a few weeks of surgery. The nursing team will help patients walk and move around a few hours after surgery to reduce blood clots’ risk, improve lung function, and expedite bowel function return.

Most patients will require pain medication like NSAIDs and narcotics for a time. Many experience discomfort in the right shoulder due to air irritating the nerves of the diaphragm.

Light bleeding, spotting, and brown or black discharge is common and expected. Sanitary napkins are safe to use.

What aftercare is required?

You should speak with your physician regarding the resumption of exercise and sexual activity. Most can return to basic activities in one to two weeks. Sexual activity is typically restricted for 6–8 weeks to allow the vaginal cuff to heal.

Your doctor will schedule a postoperative examination 1–2 weeks after the procedure to evaluate the incisions.

Danger Signals to look out for after the procedure

You should call your doctor if you experience heavy vaginal bleeding, fevers, severe nausea or vomiting, worsening abdominal pain, or the inability to pass gas.

If you experience heavy bleeding, abdominal or pelvic pain, a fever, or pain that increases over 24 hours, call your physician. After any surgery, contact your physician if you meet any of the following criteria:

• Pain not controlled with prescribed medication
• Fever > 101
• Nausea and vomiting
• Calf or leg pain
• Shortness of breath
• Heavy vaginal bleeding
• Foul-smelling vaginal discharge
• Abdominal pain not controlled by pain medication
• Inability to pass gas

What preparations should I make for aftercare at home?

Robotic procedures require very little postoperative care. Keep the incisions clean and dry. Sexual activity should be avoided until cleared by your doctor. One may resume a normal diet the day of surgery and begin light exercise the day after the procedure or when you feel ready.

What information should I provide to my doctors and nurses?

It is very important to provide your doctor with an updated list of all medications, vitamins, and dietary supplements prior to surgery. All medication and food allergies should be reviewed. Share any lab work, radiologic procedures, or other medical tests done by other healthcare providers with your surgeon prior to your procedure.

Still have questions?

Read through any existing comments in the section below and if you still need information on this procedure please do leave your questions in the comments section.

The post Preparing for: Robotic Hysterectomy appeared first on Medika Life.

So what causes the “not so fresh” feeling? 

Sweat, food intake, medications, and hormonal changes all alter vaginal scent, but the most common cause of an unpleasant vaginal odor is an overgrowth of normal vaginal bacteria called bacterial vaginosis. 

Bacterial vaginosis is easy to treat with antibiotics, but the crucial step is to confirm the diagnosis with a medical provider. Self-diagnosing often leads to errors. The malodorous situation “down there” will not improve if we are not treating the right thing.

While most women will get bacterial vaginosis at some point in their life, everyone wants to know why BV happens and how to get rid of it.

What is bacterial vaginosis (BV)?

Bacterial vaginosis (BV) is not an infection in the traditional sense, but rather a condition caused by an overgrowth of anaerobic bacteria living in the vagina. 

Vaginal bacteria are supposed to be present. Bacteria live on our skin, mouths, and gastrointestinal tracts all the time. These healthy bacteria help keep our body systems running smoothly. The vagina always contains small amounts of healthy, protective bacteria.

Vaginal bacteria and yeast live in perfect harmony, maintaining the vaginal ecosystem. Bacteria and yeast work to keep the vaginal chemistry pH balanced in the healthy range between 3.5–5.5. 

Periodically, something disruptive happens to break the chemical balance allowing bacteria to flourish. When bacteria outgrows the counterbalancing yeast, women develop bacterial vaginosis.

When vaginal bacteria overpower and suppress yeast, women will notice a gray or yellow, fishy smelling discharge. 

Who is at risk for bacterial vaginosis?

BV is the most common vaginal condition, and any woman can get it. BV is more common in sexually active women, but it is not a sexually transmitted infection. 

BV is most common in ages 15 to 44, but it can happen at any age and in women who do not have sex. 

The risk of bacterial vaginosis increases with: 

• New sexual partners
• Multiple sex partners
• Inconsistent sexual activity or a change in a sexual routine
• Vaginal Douching. Douching disrupts the vaginal ecosystem by altering the vaginal acidity allowing bacteria to grow.
• Sex without condoms. Semen raises the vaginal pH allowing creating a hospitable bacterial environment. 
• Pregnancy. 25% of pregnant women develop episodic bacterial vaginosis due to hormonal changes in the vaginal chemistry. 
• African-American race
• Irregular vaginal bleeding or frequently spotting. Blood raises the vaginal pH allowing bacteria to thrive. Infections, polyps, and fibroids are common causes of abnormal uterine bleeding. 

What are the symptoms of BV?

BV symptoms vary from person to person. While some may have no symptoms, others will notice a fishy vaginal odor, vulvar irritation, or discomfort with urination. Some experience a watery or foamy white, yellow, or gray vaginal discharge. 

These symptoms are often confused with STIs and vaginal yeast infections. Seeing your doctor or practitioner is the only way to determine if you have a BV and not a more severe problem.

The signs and symptoms of a BV are similar to other more serious infections. Trichomoniasis is a common STI that also causes itching and vaginal odor.

If left untreated, STIs and BV raise your risk of getting other STIs, including HIV. Untreated gonorrhea and chlamydia can lead to problems getting pregnant. BV can also lead to problems during pregnancy, such as preterm labor and premature delivery.

How is bacterial vaginosis diagnosed?

A doctor will do a pelvic exam to look for the characteristic discharge. The doctor may also use a cotton swab to take a sample of the discharge from the vagina. 

A test can be done to see if the pH is elevated. The providers may add a chemical called KOH to perform a Whiff test. (Yes, this involves smelling the discharge). Finally, the provider may look at the sample under a microscope to evaluate for a particular finding called clue cells. 

Nucleic acid amplification microbial testing is a widely available rapid test technology to help distinguish between yeast, bacterial vaginosis, and trichomoniasis. 

How is bacterial vaginosis treated?

BV is treated with prescription antibiotics. Metronidazole pills or vaginal gel are the most common. Clindamycin is a common acceptable alternative. 

Sex partners do not need to be treated.

Patients suffering from recurrent bacterial vaginosis may qualify for more robust treatment protocols.

Many times BV will resolve on its own. Vaginas are very effective at self-correcting. Untreated BV increases the risk of getting HIV, genital herpes, gonorrhea, chlamydia, and pelvic inflammatory disease. Women with HIV who get BV are also more likely to pass HIV to a male sexual partner.

Is it safe to treat pregnant women who have BV?

The medicine used to treat BV is safe for pregnant women at any stage of pregnancy. All pregnant women with symptoms of BV should be tested and treated. Some evidence indicates a link between BV and preterm birth. 

How can I lower my risk of BV?

Researchers do not know exactly what causes BV, but we know ways to help the vagina maintain a normal pH and reduce the risk of BV. Steps include:

• Keeping your vaginal bacteria balanced. Use warm water to clean the outside of your vagina. Always wipe front to back from your vagina to your anus. Keep the area cool by wearing cotton or cotton-lined underpants.
• Fix irregular bleeding. Blood in the vagina raises the pH. A gynecologist can help find a solution to abnormal uterine bleeding and spotting. Fixing the blood exposure often eliminates recurrent bacterial vaginosis. 
• Avoid douching. Douching wipes out the balance of good and harmful bacteria in your vagina. 
• Not having sex. Abstaining from sex is not a popular option for some, and you can get BV without having sex. But BV is more common in women who have sex.
• Pull out. Semen raises the vaginal pH. Women with recurrent BV may want to have their male partner withdraw the penis prior to ejaculating inside the vagina.
• Limiting your number of sex partners. Research indicates an increased BV risk with multiple partners.

The post Bacterial Vaginosis; What to Do When Your Vagina Smells Bad appeared first on Medika Life.

Ovulation Calculator

About the Ovulation Calculator

Knowing the days you are most likely to be fertile can increase your chance of getting pregnant. The typical menstrual cycle is 28 days long, but each woman is different. There are about 6 days during each menstrual cycle when you can get pregnant. This is called your fertile window. Use the calculator to see which days you are most likely to be fertile. The sections below explains the rhythm of the menstrual process in more detail.

What is ovulation?

Ovulation is when the ovary releases an egg so it can be fertilized by a sperm in order to make a baby. A woman is most likely to get pregnant if she has sex without birth control in the three days before and up to the day of ovulation (since the sperm are already in place and ready to fertilize the egg as soon as it is released). A man’s sperm can live for 3 to 5 days in a woman’s reproductive organs, but a woman’s egg lives for just 12 to 24 hours after ovulation.

Days 1 through 5

Day 1 starts with the first day of your period. The blood and tissue lining the uterus (womb) break down and leave the body. This is your period. For many women, bleeding lasts from 4 to 8 days. Hormone levels are low. Low levels of the hormone estrogen can make you feel depressed or irritable.

During Days 1 through 5 of your cycle, fluid-filled pockets called follicles develop on the ovaries. Each follicle contains an egg

Days 5 through 8

Between Days 5 and 7, just one follicle continues growing while the others stop growing and are absorbed back into the ovary. Levels of the hormone estrogen from the ovaries continue rising. By Day 8 the follicle puts out increasing levels of estrogen and grows larger. Usually by Day 8, period bleeding has stopped. Higher estrogen levels from the follicle make the lining of the uterus grow and thicken. The uterine lining is rich in blood and nutrients and will help nourish the embryo if a pregnancy happens. Estrogen helps boost endorphins, which are the “feel good” brain chemicals that are also released during physical activity. You may have more energy and feel relaxed or calm.

Day 14

A few days before Day 14, your estrogen levels peak and cause a sharp rise in the level of luteinizing hormone (LH). LH causes the mature follicle to burst and release an egg from the ovary, called ovulation, on Day 14. A woman is most likely to get pregnant if she has sex on the day of ovulation or during the three days before ovulation (since the sperm are already in place and ready to fertilize the egg once it is released). A man’s sperm can live for three to five days in a woman’s reproductive organs, and a woman’s egg lives for 12 to 24 hours. In the few days before ovulation, your estrogen levels are at their highest. You may feel best around this time, emotionally and physically.

Days 15 through 24

Over the next week (Days 15 to 24), the fallopian tubes help the newly released egg travel away from the ovary toward the uterus. The ruptured follicle on the ovary makes more of the hormone progesterone, which also helps the uterine lining thicken even more. If a sperm joins with the egg in the fallopian tube (this is called fertilization), the fertilized egg will continue down the fallopian tube and attach to the lining of the uterus (womb). Pregnancy begins once a fertilized egg attaches to the womb.

Day 24 through 28

If the egg is not fertilized, it breaks apart. Around Day 24, your estrogen and progesterone levels drop if you are not pregnant. This rapid change in levels of estrogen and progesterone can cause your moods to change. Some women are more sensitive to these changing hormone levels than others. Some women feel irritable, anxious, or depressed during the premenstrual week but others do not.

In the final step of the menstrual cycle, the unfertilized egg leaves the body along with the uterine lining, beginning on Day 1 of your next period and menstrual cycle.

If you would like to understand your menstrual cycle in more detail or still have questions, Medika recommends reading the following article The Menstrual Cycle explained, for more information.

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