Vaginal seeding after Caesarean 'risky', warn doctors

New mothers should not embrace the trend of "seeding" their babies with vaginal bacteria, say doctors.

It exposes children born by Caesarean section to bacteria that could have coated their bodies if they had been born vaginally.
The idea is bacteria help train the immune system and lower the risk of allergies and asthma.
But doctors in Denmark and the UK said there was too little evidence and it may be doing more harm than good.
Being born by Caesarean section is linked to a higher risk of some immune-based diseases.
And there is growing medical interest in the role of the microbiome - the microorganisms that call our bodies home - in preventing disease.
Swabs
Seeding involves taking a swab of vaginal fluid and rubbing it into the newborn's face, skin and eyes.
A report, published in BJOG: An International Journal of Obstetrics and Gynaecology, said more than 90% of Danish obstetricians (pregnancy and birth doctors) had said they had been asked about vaginal seeding.
It said there was no evidence of any benefit to seeding as there was only one proper study of the technique and it involved just four babies.

• Parkinson's disease 'may start in gut'

• Which foods can improve your gut bacteria?

However, it warned of clear risks to the baby, including infections such as group-B streptococcus, E. coli and a range of sexually transmitted infections.
Dr Tine Clausen, the report author and a consultant at Nordsjaellands Hospital in Denmark, said: "We know that women and their partners are increasingly speaking to their doctors about vaginal seeding."
She told the BBC News website: "I really understand, it's a fascinating thought that you're able to mimic nature by doing the seeding, but it's based on some theoretical thoughts and we don't have evidence to support it."
Dr Clausen said a swab may not contain the same bacteria as those transferred during a vaginal birth and any bacteria were more diluted because of blood and amniotic fluid in the vaginal tract during labour.
Her advice to women is to "avoid unnecessary [Caesarean] sections, aim for breast feeding for at least half a year and to have early skin-to-skin contact".
Each of which does have a beneficial impact on a child's microbiome.
In the UK, about a quarter of babies are born via Caesarean section
Dr Patrick O'Brien, from the Royal College of Obstetricians and Gynaecologists, said: "There is no robust evidence to suggest that vaginal seeding has any associated benefits.
"We would therefore not recommend it until more definitive research shows that it is not harmful and can in fact improve a child's digestive and/or immune system."

HIV and Pregnancy

Hiv-superb women who are thinking about getting pregnant -- or already are pregnant -- have alternatives which can help them stay healthful and guard their toddlers from turning into hiv-inflamed.

Because the mid-Nineties, hiv trying out and preventive measures have ended in greater than a ninety% decline within the range of youngsters within the u.S. Inflamed with hiv in the womb. And after three many years of research, medical doctors now recognize how to craft a detailed plan to preserve infants of hiv-superb girls from getting the virus.

Medicinal drugs are key

Hiv is exceeded from one character to another thru blood, semen, genital fluids, and breast milk. Being pregnant, hard work and delivery, and breastfeeding all pose a risk of passing hiv alongside to the baby.

Seble g. Kassaye, md, an assistant professor of medicine at georgetown university, says prevention starts offevolved with antiretroviral capsules. These medications were first authorised within the Nineties, and researchers soon learned that combining three of them -- known as an antiretroviral (art) regimen -- added as much as quite a few safety for a toddler in the womb.

“with interventions that we've -- which consist of starting women on nicely-tolerated antiretroviral medicines as early as possible -- transmission danger may be decreased to much less than 2%,” says kassaye.

The medicine decrease the quantity of virus in the body, which lowers the risk of mom-to-toddler hiv transmission. A few anti-hiv medicinal drugs additionally bypass from the pregnant mom to her infant via the placenta. This enables defend the toddler from hiv.

No overlooked doses

For all of this to paintings, the mom need to commit to taking her artwork routine, that may every now and then be a mission all through being pregnant.

“the important thing to maintaining the virus suppressed inside your frame and your child’s frame is taking your medicines every day,” says dominika seidman, md. She's an obstetrician-gynecologist at san francisco wellknown sanatorium with area of expertise training in hiv. “if the aspect effects are bothering you or you could’t preserve the drug treatments down due to morning sickness, see your medical doctor proper away. He or she permit you to find a manner to live on them.”

Two tablets to avoid

Most effective  antiretroviral capsules have been proven to pose a risk to babies within the womb whilst taken within the early months of being pregnant. They're sustiva and atripla (which includes sustiva).

About 25% of infants whose hiv-nice mothers don’t cross on artwork will settlement hiv, says kassaye.

The first-rate plan, seidman says, is for hiv-wonderful girls to talk thru all of their options with their physician early on.

Installation a plan early

“the first-rate-case situation is for the woman to start speaking to her health practitioner or medical doctors approximately prenatal care even earlier than she becomes pregnant,” seidman says. “we want people to be on a good regimen previous to pregnancy, so we are able to talk about which tablets are safe to get on, and establish care as early as possible.”

Barring that, all pregnant ladies inflamed with hiv need to be taking anti-hiv medicines by using the second one trimester. Girls diagnosed with hiv later in pregnancy ought to start taking anti-hiv medications as quickly as viable.

Who Drinks More -- Couples or Singles?

Those who are married or live together drink much less than single humans, in line with a brand new examine.

The findings display that "when you're in a dedicated relationship, your drinking frequency declines permanently, while quantity goes returned up if you exit that dating," said lead creator diana dinescu, a doctoral candidate in clinical psychology at the university of virginia.

The researchers checked out greater than 2,four hundred twin pairs (approximately 1,600 woman pairs and greater than 800 male pairs). They located that people who had been married drank much less alcohol and drank less frequently than folks that had been single or divorced.

This is not the first observe to reveal that married adults drink less than their peers without companions. But through specializing in twins, the authors said genetic predispositions and differences in upbringing could be less likely to affect the outcomes.

"it appears that evidently intimate relationships may also offer a actual gain in phrases of consuming behavior, perhaps via mechanisms which includes a monitoring effect that partners have on every other," dinescu stated in a university information launch.

The researchers determined that twins who lived with a accomplice drank greater often than married twins, but ate up lower quantities of alcohol than folks that were unmarried, divorced or widowed.

While men in common-regulation relationships drank much less according to occasion than married men, girls in not unusual-law relationships drank approximately the identical quantity per event as those who had been married, consistent with the look at.

The effects have been published lately inside the journal of own family psychology.

4 Soothing Moves for the Menopause Blues

Those sporting activities from mary beth janssen, author of rejuvenation: spa secrets for menopause, will help you loosen up—and may even help hold hot flashes at bay.

1. The bridge

Lie down on a mat with your knees bent and your ft flat, placed hip-width aside and near your butt. Your hands have to be by using your sides. Loosen up and awareness for your respiratory. As you let your frame sink into the mat, experience your returned lengthen and release. Firm your butt and draw your tailbone closer to your heels to guard your lower returned. Pressing your feet into the mat, slowly raise your backbone upward as you inhale, raising your pelvis as excessive as is relaxed. Hold respiration smoothly. You can stay in this pose for some breaths or longer, if desired. While you sense geared up, exhale and slowly roll go into reverse.

2. Downward-dealing with dog

Kneel on all fours. Knees ought to be beneath hip­bones, and fingers, with palms unfold, should be one-hand’s distance ahead of shoulders. On an exhale, elevate your butt towards the ceiling, pressing into the floor thru your palms. (it’s adequate in case your heels don’t reach the ground.) allow your head cling between your fingers. Breathe smoothly and naturally for several breaths. Launch your frame backtrack to all fours. Take a seat back to your heels, whilst lowering your torso and head to the ground. Rest in this function for numerous breaths.

3. Recuperation breath

Take a seat in a cozy function. Retaining your shoulders down, inhale through nostrils into lowest part of lungs, and watch your stomach moving outward. Exhale absolutely before the subsequent inhale. Repeat 10 instances

4. Upward-dealing with canine

Lie face down with toes hip-width aside and the tops of your feet urgent into the mat. Place arms, with palms spread, on both aspect of your chest, maintaining elbows near your body. Draw tailbone towards heels to protect lower again. Inhale and lift torso and hips off the ground, straightening hands. Maintain shoulders drawn down and lower back. Appearance forward, keeping neck long and cozy. Press down thru your arms as you maintain your body lifting away from the floor. Breathe. On an exhalation, decrease your body to the ground. Place your hands with the aid of your sides and turn your head to the right for a couple of breaths; repeat with your head became left.

Is it possible for a pregnant woman to be allergic to the placenta?

Even though many of us are well-educated about the diverse dangers and rewards of pregnancy, few have any idea that the placenta, grown inside a mother's own womb, can clearly turn on a dime and purpose allergy through a rare, painful autoimmune sickness.

This ailment, acknowledged in scientific circles as pemphigoid gestationis (pg), is characterised by way of painful, itchy, large blisters or welts on various frame elements. In maximum cases, the rash starts in the abdominal location, progressing to the limbs and buttocks over the years. Large, irritated blisters usually seem after the patient reports numerous weeks' really worth of lesions and papules (swelling that resembles a pimple) [source: Huilaja et al.]. Happily, the genitals, face, mouth and scalp are normally spared the rash in all its blister-y glory [source: EADV]. Thank heaven for small favors, right?

But before you swear off being pregnant altogether, undergo in thoughts that only a tiny percentage of pregnant women get pg. Internationally, the sickness is anticipated to affect one in each 2 million pregnancies, with a higher prevalence within the u.S. Of about one in 50,000 to 60, 000 pregnancies. Obviously, it influences most effective women of childbearing age, despite the fact that caucasian women are more likely to be identified with it than african-people. At the beginning referred to as herpes gestationis (the call changed into changed because it became out to have 0 relation to the herpes virus), current medicine nevertheless isn't sure why pg happens, however placental involvement is a famous theory. The prevailing concept is that normally innocent placental tissue enters the mom's bloodstream, handiest to be attacked by way of a stressed immune device, as is the case with different types of autoimmune diseases. Lady hormones, especially estrogen, may also aggravate the response, which can explain why the disease takes place for the duration of later being pregnant as estrogen stages upward push [sources: Freiman, EADV]. The offensive measures taken by means of the immune machine in error can eventually wreak havoc at the body, in this case resulting within the allergy rash. Not cool, immune machine. No longer cool.

Gestational Diabetes (Diabetes and Pregnancy)

Diabetes is a sickness wherein your blood glucose, or blood sugar, levels are too excessive. When you are pregnant, high blood sugar stages are not right in your infant.

About seven out of each 100 pregnant women in the america get gestational diabetes. Gestational diabetes is diabetes that occurs for the primary time while a female is pregnant. Maximum of the time, it is going away after you've got your infant. However it does boom your chance for growing kind 2 diabetes afterward. Your infant is likewise at threat for weight problems and type 2 diabetes.

Most women get a check to check for diabetes at some point of their second trimester of pregnancy. Women at higher hazard may get a take a look at in advance.

If you already have diabetes, the exceptional time to control your blood sugar is before you get pregnant. Excessive blood sugar degrees may be harmful to your baby at some stage in the primary weeks of being pregnant - even earlier than you understand you're pregnant. To keep you and your toddler healthful, it's miles essential to preserve your blood sugar as near ordinary as possible before and at some point of being pregnant.

Either kind of diabetes at some stage in pregnancy will increase the possibilities of troubles for you and your child. To help decrease the possibilities communicate on your fitness care group about

• A meal plan for your being pregnant
• A secure workout plan
• How regularly to test your blood sugar
• Taking your medication as prescribed. Your remedy plan may also want to trade all through being pregnant.

Treatment for ovarian cancer

Remedy for ovarian cancer

Treatment for ovarian most cancers includes surgery, chemotherapy, a mixture of surgical procedure with chemotherapy, and, once in a while, radiotherapy.

The form of remedy depends on many factors, which include the kind of ovarian cancer, its level and grade, as well as the overall health of the patient.
Surgery

A surgical elimination of the most cancers is finished in the considerable majority of ovarian most cancers cases, and is regularly the primary treatment the affected person will undergo.

Unless the ovarian most cancers is very low grade, the patient will require an in depth operation that includes the removal of each ovaries, the fallopian tubes, the uterus, nearby lymph nodes, and the omentum (a fold of fatty tissue within the abdomen).

This operation, now and again known as a complete hysterectomy and bilateral salpingo-oophorectomy, will suggest that the girl will start her menopause right now.

If the cancer is constrained to just one of the ovaries, the medical professional may also simply do away with the affected ovary and the adjoining fallopian tube. The female will have a chance of being capable of conceive. If both ovaries are removed, it'll not be feasible to conceive.

This sort of surgery calls for a live in hospital of 3-7 days, plus a recovery length of at the least four-6 weeks whilst the patient receives domestic.
Chemotherapy

Chemotherapy is using chemical compounds (remedy) to smash most cancers cells. Cytotoxic medicine (tablets which are toxic to cells) prevents most cancers cells from dividing and developing. Chemotherapy for ovarian most cancers, as well as maximum other cancers, is used to target cancer cells that surgical treatment can not or did no longer put off.

Treatment normally involves three-6 chemotherapy periods (known as cycles) that allows you to take delivery of three-four weeks aside, giving the frame time to recover. If the cancer returns or starts offevolved to develop returned again, chemotherapy can be given again to decrease it.
Centered remedy

More moderen medicines are being evolved that focus on precise pathways (or vital capabilities) in most cancers cells directly. These medicines consist of bevacizumab (avastin) and olaparib (lynparza). Their benefit over traditional chemotherapy is that they restrict damage to regular cells, therefore lowering commonplace aspect effects.
Hormone therapy

Hormone remedy can be delivered to the treatment plan with a purpose to prevent estrogen from reaching the cancer cells. Slicing off its supply of estrogen slows cancer mobile's boom.
Tracking response to chemotherapy

Exams will be executed to decide how properly the chemotherapy is running. This will encompass blood assessments and imaging scans to look if the tumors have shriveled. From time to time the health practitioner may also need to have another look inside.

If all checks are clear of cancer, it's far called "in remission" - the cancer is underneath manipulate.

If cancer continues to be gift after chemotherapy treatment, medical doctors will switch to other treatments.
Side outcomes of chemotherapy

Chemotherapy objectives hastily dividing cells. Unfortunately, healthy hastily dividing cells, inclusive of crimson and white blood cells, and hair follicles can also be affected.

The severity and kind of side effects rely on the sort of medication, quantity of remedies, and a few components of the affected person and their widespread fitness. Aspect effects can include:

    nausea, vomiting
    diarrhea
    hair loss
    lack of appetite
    mouth sores
    anemia
    infections because the white blood mobile be counted is low (leucopenia)

Inside the extensive majority of cases, the damaged healthful cells repair themselves hastily after treatment is over and the aspect-outcomes quickly disappear.

Tumor DNA fragments help predict ovarian cancer outcomes

Latest take a look at investigated the levels of unique dna fragments within the blood of ovarian cancer patients. The findings should finally cause a blood test which can make accurate predictions approximately tumor length and disease progression.
 Ovarian cancer impacts around 20,000 women within the u.S. Each 12 months. It's miles the ninth maximum not unusual cancer in the u.S., but the fifth leading reason of cancer dying.

The earlier ovarian cancer is caught, the more likely remedy is to achieve success.

High-grade serous ovarian most cancers (hgsoc) is the maximum malignant shape of ovarian most cancers, accounting for 70 percentage of instances.

Currently, as with maximum other cancers, assessing how properly a remedy is performing is difficult. In an ideal international, if medical doctors had complete visibility of the way a tumor turned into responding to a certain medicinal drug, they might be able to manage the drug type and agenda with extra self belief.

Remedy and progression of hgsoc are gauged via measuring stages of a protein referred to as ca-one hundred twenty five. However, after one or  remedy cycles, the stages do now not exchange quick sufficient. This makes results hard to interpret. Additionally, ca-one hundred twenty five can be expressed with the aid of ordinary tissue, making false readings a further subject.

Locating an ovarian most cancers biomarker

Researchers from cancer studies uk's cambridge institute currently set out to research some other molecule that could act as a greater responsive marker. A group of scientists, led by means of nitzan rosenfeld and james brenton, published their findings this week in plos medicinal drug.

The molecule in question is circulating tumor dna (ctdna). Those brief sections of genetic code are launched from tumor cells as they die. They input circulation and may be picked up within the bloodstream.

Ctdna has been studied for more than twenty years, however utilising it as a diagnostic device has now not been easy - tiny quantities of ctdna should be identified inside a sea of regular circulating dna fragments.

Way to current advances in the sensitivity of assaying technology, ctdna has become a potentially beneficial tool for assessing most cancers development. But, whilst there were a number of interesting research suggesting ctdna's potential use in tracking cancer, research continues to be in its infancy.

To analyze these fragments further, rosenfeld and brenton focused in particular on tiers of ctdna that carried mutations inside the gene tp53. These mutations can be discovered in ninety nine percent of patients with hgsoc.

The crew took 318 blood samples from 40 hgsoc sufferers before, for the duration of, and after remedy. Along these analyses, computerized tomography (ct) scans of tumors and facts on the development of the most cancers had been also noted.

The group found that stages of mutated tp53 in ctdna (tp53maf) correlated with the volume of the tumor (whilst compared with the ct test), and also the affected person's time to development.

While in comparison with the diagnostic abilties of ca-125, tp53maf fared much better. Ca-125 took 84 days to mirror adjustments following chemotherapy. Tp53maf, alternatively, took simply 37 days.
Tp53maf outcome prediction

In sufferers being treated for a relapse, a decrease of 60 percent or less in tp53maf was associated with a weaker response to chemotherapy and a time to progression of underneath 6 months. A decrease in degrees of more than 60 percent was related to a longer time to progression.

In easy terms, a greater drop in the amount of tumor dna located in the blood correlates with stepped forward affected person results.

Menopause and Hormone Replacement Therapy (HRT)

The menopause can cause various symptoms such as hot flushes and changes to your vagina and genital skin. Hormone replacement therapy (HRT) may ease your symptoms. If you are considering taking HRT, you should discuss the risks and benefits fully with your doctor. The lowest effective dose of HRT should be taken. You should have regular follow-up to decide whether you still need HRT. For most women who use HRT in the short term for the treatment of their menopausal symptoms, the benefits of treatment outweigh the risks.

What is the menopause?

Strictly speaking, the menopause is your last menstrual period. However, most women think of the menopause as the time of life leading up to, and after, their last period. In reality, your periods don't just stop. First they tend to become less frequent. It can take several years for a woman to go through the menopause completely. Women are said to have gone through the menopause (be postmenopausal) when they have not had a period at all for one year.

What causes the menopause?

A natural menopause occurs because as you age your ovaries stop producing eggs and make less oestrogen (the main female hormone). The average age of the menopause in the UK is 51. Your menopause is said to be early if it occurs before the age of 45 and it is called Premature Ovarian Insufficiency if it occurs before the age of 40 years.

There are certain things that may cause an early menopause - for example:

•     If you have surgery to remove your ovaries for some reason, you are likely to develop menopausal symptoms straightaway.
•     If you have radiotherapy to your pelvic area as a treatment for cancer.
•     Some chemotherapy drugs that treat cancer may lead to an early menopause.
•     If you have had your womb (uterus) removed (hysterectomy) before your menopause. Your ovaries will still make oestrogen. However, it is likely that the level of oestrogen will fall at an earlier age than average. As you do not have periods after a hysterectomy, it may not be clear when you are in 'the menopause'. However, you may develop some typical symptoms (see below) when your level of oestrogen falls.

•     An early menopause can run in some families.
•     In many women who have an early menopause, no cause can be found.

Early menopause and premature menopause are not discussed in detail in this leaflet.

What are the possible symptoms and problems of the menopause?

The menopause is a natural event. Every woman will go through it at some point. You may have no problems. However, it is common to develop one or more symptoms which are due to the low level of oestrogen. About 8 out of 10 women will develop menopausal symptoms at some point. Around a quarter of women have very severe symptoms.

Symptoms of the menopause can last much longer than most women realise. More than half of women actually have symptoms for more than seven years.

Short-term symptoms

These short-term symptoms only last for a few months in some women. However, for others they can continue for a few years after their last period:

•     Hot flushes occur in about 3 in 4 women. A typical hot flush lasts a few minutes and causes flushing of your face, neck and chest. You may also sweat (perspire) during a hot flush. Some women become giddy, weak, or feel sick during a hot flush. Some women also develop a 'thumping heart' sensation (palpitations) and feelings of anxiety during the episode. The number of hot flushes can vary from every now and then, to fifteen or more a day. Hot flushes tend to start just before the menopause and can persist for several years.
•     Sweats commonly occur when in bed at night. In some cases they are so severe that sleep is disturbed and you need to change your bedding and nightclothes.
•     Other symptoms may develop, such as headaches, tiredness, being irritable, difficulty sleeping, depression, anxiety, aches and pains, loss of sex drive (libido), and feelings of not coping as well as before.
•     Changes to your periods. The time between periods may shorten in some women around the menopause; in others, periods may become further apart, perhaps many months apart. It can also be common for your periods to become a little heavier around the time of the menopause.

Longer-term changes and problems

•     Skin and hair. You tend to lose some skin protein (collagen) after the menopause. This can make your skin drier, thinner and more likely to itch.
•     Genital area. Lack of oestrogen tends to cause the tissues in and around your vagina to become thinner and drier. These changes can take months or years to develop:

1.         Your vagina may shrink a little and expand less easily during sex. You may experience some pain  when you have sex.
2.         Your vulva (the skin next to your vagina) may become thin, dry and itchy.
3.         You may notice that you need to pass urine more frequently.
4.         Some women develop problems with recurrent urine infections.

•     'Thinning' of the bones (osteoporosis). As you become older, you gradually lose bone tissue. Your bones become less dense and less strong. The amount of bone loss can vary. If you have a lot of bone loss then you may develop osteoporosis. If you have osteoporosis, you have bones that will break (fracture) more easily than normal, especially if you have an injury such as a fall. Women lose bone tissue more rapidly than men lose it, especially after the menopause when the level of oestrogen falls. Oestrogen helps to protect against bone loss.
•     Cardiovascular disease. Your risk of cardiovascular disease (disease of the heart and blood vessels), including heart disease and stroke, increases after the menopause. Again, this is because the protective effect of oestrogen is lost. Oestrogen is thought to help protect your blood vessels against atheroma. In atheroma, small fatty lumps develop within the inside lining of blood vessels. Atheroma is involved in the development of heart disease and stroke.

Do I need any tests to see if I am going through the menopause?

Your doctor can usually diagnose the menopause by your typical symptoms. Hormone blood tests are not usually needed to confirm that you are going through the menopause. However, they may be helpful in some cases - for example, in women aged under 45 years.

Other blood tests or scans may be undertaken in some women, especially if they do not have symptoms which are typical of the menopause.

It is important that you keep up to date with the national cervical screening programme and breast cancer screening programme, if appropriate.

Do I need treatment for the menopause?

Without treatment, the short-term symptoms discussed above last for several years in most women. HRT is available to ease the symptoms of the menopause. It has benefits and risks, which are discussed below.

There are treatments other than HRT for menopausal symptoms. As a rule, they are not as effective as HRT but may help relieve some symptoms. See separate leaflet called Menopause - Alternatives to HRT for more details.

What is vaginal dryness (atrophic vaginitis) and what causes it?

Many women notice changes in their vagina and genital area after the menopause. These changes may include dryness and discomfort during sex. There may also be bladder symptoms. These can all usually be improved with treatment. Treatment options include hormone replacement therapy (HRT), oestrogen cream, vaginal tablets and lubricating gels.Before the menopause (often called the change of life) the skin and tissues around your vagina are kept supple and moist by fluids and mucus. These are made by glands at the neck of your womb. The female hormone, oestrogen, affects these glands. Oestrogen also affects your tissues in and around your vagina, causing the lining of your vagina to be thicker and more elastic. Oestrogen also stimulates the cells that line your vagina to produce glycogen. Glycogen is a compound which encourages the presence of helpful germs (bacteria) which protect your vagina from infections.

After the menopause your ovaries make less oestrogen. The lack of oestrogen leads to thinning of the tissues around your vagina and a reduction in the number of glands that make mucus. You may also lose some fat tissue from around the genital area. This may make the area also look slightly different to how it was before the menopause.

In summary, the hormonal changes that occur during the menopause make your vagina shorter, less elastic and drier. These changes usually take months or years to develop after the menopause and vary from woman to woman. Atrophic vaginitis is the medical term for the condition when these changes produce troublesome symptoms.How common is vaginal dryness (atrophic vaginitis)?

After the menopause at least half of women have some symptoms related to vaginal dryness. You are also more likely to experience symptoms as more years pass after your menopause. It is probably even more common than that, as many women are embarrassed and feel they do not want to trouble their doctor with these symptoms.What symptoms can occur?

The changes described above can occur without causing any symptoms or discomfort. However, some of the following symptoms may develop in some women. Vaginal dryness is a common (and usually treatable) cause of the following problems. However, these problems can also be caused by other medical conditions.

•     Pain when you have sex. This may occur because your vagina is smaller, drier and less likely to become lubricated during sex compared with how it was before the menopause. Also, the skin around your vagina is more fragile and this can make the problem worse.
•     Discomfort - if your vulva or vagina is sore and red.
•     Vaginal discharge. There may be a white or yellow discharge. Sometimes this is due to an infection. Infection is more likely if the discharge is smelly and unpleasant.
•     Itch. The skin around your vagina is more sensitive and more likely to itch. This can make you prone to scratching, which then makes your skin more likely to itch, and so on. This is called an itch/scratch cycle which can become difficult to break and can be distressing.
•     Urinary problems. Vaginal dryness may contribute to various urinary problems. This is because of thinning and weakening of the tissues around the neck of your bladder, or around the opening for urine to pass (the urethra). For example, urinary symptoms that may occur include an urgency to get to the toilet and recurring urinary infections.

What are the treatments for vaginal dryness (atrophic vaginitis)?

Not all women have all of the above symptoms. Treatment usually depends on which symptoms are the most troublesome. Because the problem is mainly due to a lack of oestrogen, it can often be helped by replacing the oestrogen in your tissues.

Oestrogen creams and other topical preparations

A cream, vaginal tablet or ring containing oestrogen is often prescribed. A vaginal tablet is a very small tablet that you insert into your vagina with a small applicator. The ring is a soft, flexible ring with a centre that contains the oestrogen hormone. This ring releases a steady, low dose of oestrogen each day and it lasts for three months.

These preparations work to restore oestrogen to your vagina and surrounding tissues without giving oestrogen to the whole body. Usually the treatment is used every day for about two weeks, and then twice a week for a further three months. After this the effect of the treatment is usually assessed by your doctor. This treatment usually works well but the symptoms may recur some time after stopping the treatment. Repeated courses of treatment are often necessary or many women simply use this treatment for a much longer period of time. These preparations should not be used as additional lubrication during sex; lubricating gels should be used instead.

Note: the oestrogen creams may damage latex condoms and diaphragms; if you are using these types of contraception then it would be preferable either to use vaginal tablets or the vaginal ring.

Hormone replacement therapy (HRT)

This means taking oestrogen in the form of a tablet, gel or patches. This is often the best treatment for relieving your symptoms, especially if you are experiencing other symptoms of the menopause. There are advantages and disadvantages of using HRT. See separate leaflet called Menopause and Hormone Replacement Therapy (HRT) for more details.

Lubricating gels

If vaginal dryness is the only problem, or hormone creams are not recommended because of other medical problems, lubricating gels or moisturisers may help. There are different lubricants which can work really well to improve the dryness during sexual intercourse. These include Sylk® and Yes®. You can buy these from the pharmacy and your pharmacist should be able to advise you.

Vaginal moisturises such as Replens MD® and Hyalofemme® can work really well to improve the moisture in your vagina. These need to be used regularly.

Note: Vaseline® can break down the latex in condoms, so is not recommended for women whose partners are using condoms.

Your symptoms should improve after about three weeks of treatment. You should see your doctor if your symptoms do not improve, as sometimes these symptoms can be due to other conditions. It is also very important to see your doctor if you have any bleeding from your vagina if you are receiving hormone treatment.

Brown Vaginal Discharge

Most brown vaginal discharges are harmless or a natural process for the female body. Light brown discharges usually go away on their own within a few days. Dark drown discharges can be more serious and should be checked out.

Vaginal discharge is a normal, even healthy, occurrence. A vaginal discharge is the excess mucus and fluid that is produced by the vaginal walls and cervix. A vaginal discharge is the body's way of cleaning the vaginal area and keeps the vaginal environment healthy. The discharge removes dead skin cells and bacteria from the vaginal area. This sort of self-cleaning method is necessary for preventing infections. 

The interaction between the hormones called estrogen and progesterone is largely responsible for the female's bodily changes during the different stages of the female menstrual cycle. It is common for the color, texture, and the amount of discharge to vary, depending on the stage of the cycle. For example, during the ovulation stage you may notice an increase in the discharge. In addition, light spotting is not usually a reason for concern. If you experience other symptoms with the spotting, consult your gynecologist.

Causes of Light Brown Vaginal Discharge

There are a few reasons why a woman's vaginal discharge may be brown in color. The most common two are pregnancy and Perimenopause.

•     Pregnancy. A pinkish brown colored discharge is an early sign of pregnancy.

•     Perimenopause. Perimenopause can cause a light brown discharge, pink, or a yellow discharge. In some women, the discharge may be heavy and uncomfortable.
•     Implantation Bleeding. This is another early sign of pregnancy. The discharge can be light brown, pink or red. This type of discharge is normal and usually occurs 10 -14 days after conception. The discharge is caused by the egg implanting itself to the uterine wall. It usually appears as a single smear of discharge not a spotting or flowing type.
•     Old Endometrial Tissues. A light brown discharge is common in young girls before they start their menstrual cycle. In women, the discharge is the body's way of releasing any old endometrial tissue that was not shed during the menstrual cycle.
•     Atrophic Vaginitis. Atrophic vaginitis can cause a brown discharge, bleeding, pain or itching in the vaginal area. A woman may also experience painful intercourse, burning sensation, dryness; the discharge may be yellow in color and have a foul smell.
•     Uterine Polyps. Uterine polyps are also called endometrial polyps. The Polyps can cause a discharge as well as bleeding after intercourse, heavy menstrual bleeding, and abnormal vaginal bleeding.
•     STDs. A light brown discharge can be an early symptom of a sexually transmitted disease (STD). The most common STDs that cause a discharge include chlamydia, trichomoniasis, gonorrhea, and genital warts.

Causes of Dark Brown Vaginal Discharge

There are seven common reasons a woman may experience a dark brown vaginal discharge. Most of the reasons are not serious however; a few are so it is important to set up an appointment with your gynecologist if you have other symptoms of a serious condition or for peace of mind.

•     Pregnancy. A dark brown discharge usually is implantation bleeding. The color can range from pink, red to light or dark brown. The discharge may last as long as three to four days.
•     Ovulation. During the process of the egg being released it is not uncommon to experience a dark brown discharge or spotting. It will usually only last a few days.
•     Menopause. Many women who are close to menopause will experience a dark brown discharge in place of a normal menstrual flow.
•     Endometrial Bleeding. Endometrial bleeding occurs when some of the uterine wall was not discharged during the menstrual cycle. It may occur just after the cycle ends or just before the next cycle begins. Because the blood is old, it becomes dark brown in color.
•     Pelvic Inflammatory Disease. Pelvic Inflammatory disease is a more serious condition and requires a visit to the gynecologist. This disease happens when there is an infection in the uterus lining, fallopian tubes, ovaries, cervix and/or the vagina. It is painful and can lead to pain during intercourse, abdominal pain, and infertility if left untreated.
•     Cervical Cancer. Cervical cancer is by far the most serious disease that is associated with a dark brown discharge. Cervical cancer is spread through the HPV virus (human papilloma virus.)Other symptoms of cervical cancer can include loss of appetite, weight loss, leg pain, pelvic pain, and fatigue.

Complications of Brown Vaginal Discharge

•     Often the discharge will have a foul odor
•     Itching
•     Burning sensation
•     Pain in the vaginal area
•     Swelling in the vaginal area
•     Painful intercourse

Diagnosing the cause of light brown or dark brown vaginal discharge is as easy as visiting the gynecologist. They will be able to determine the cause based on the answers you provide to their questions, a pelvic exam, and possibly some other tests if your pelvic exam does not show a cause for the discharge.

Treatments and Preventions of Brown Vaginal Discharge

Some conditions that cause a light brown discharge such as pregnancy and implantation bleeding cannot be treated, as they are a natural process the body goes through.

If you have other symptoms or your discharge lasts longer than a few days, it is always a good idea to see your gynecologist. Treating a brown discharge depends on why you are experiencing the discharge.
Treatments for Brown Vaginal Discharge

•     STDs. Sexually transmitted diseases require antibiotics.
•     Menopause. The discharge cannot be treated it has to run its course but other related symptoms can be treated.
•     Uterine Polyps. Hormonal medications can help shrink the polyps and reduce some of the other symptoms. A procedure called curettage may be performed. This procedure will allow the doctor to scrape the polyps off of the uterus walls. The polyps will then be sent to lab for examination. Polyps are usually not cancerous. The last option is a hysterectomy, this will remove all of the polyps and again these will be sent to lab to be examined. In the event they are found to be cancerous, your doctor will discuss future treatment options with you.

•     Cervical Cancer. The treatments for cervical cancer include surgery to remove the cancer, chemo and radiation.

Preventions of Brown Vaginal Discharge

The best prevention for brown virginal discharges depends on the cause of the discharge. You cannot prevent certain discharges such as the following.

•     Pregnancy
•     Ovulation
•     Menopause
•     Endometrial bleeding

The following causes of discharges can be prevented by receiving medical attention. This may require medications or surgical intervention.

•     STDs
•     Pelvic Inflammatory Disease
•     Uterine polyps
•     Cervical cancer

In addition, to the above listed preventive measures , you can

•     Wear cotton underwear.
•     Wear lose fitting undergarments.
•     Change your tampon or sanitary napkin frequently during your menstrual cycle.
•     Avoid douching as it can increase your risk of developing an infection by throwing off your body's natural pH level