7 Things A Gynaecologist Wants You To Know

For many women, the idea of a gynaecological appointment makes them squirm. Even though, (see point 7!) it really shouldn't. Being honest, aware and proactive when it comes to all things vagina is the best practice for your sexual and reproductive health. Here, some top women's health experts reveal 7 things they want you to know...

1. Cervical cancer is NOT just a 'young woman's disease'

"Cervical cancer has two peaks – the first is in our 20s and the second is around the age of 50," says gynaecologist Dr Sujata Gupta, from BMI The Alexandra Hospital in Manchester. "We're not entirely sure why but it might be because women who've had pre-cancerous lesions have missed a couple of smear tests and have now developed the disease. These are slow-growing cancers, and if throughout their 40s women have consistently negative test results they begin to feel falsely reassured and start to default from their regular checkups. That's why it's important to attend each and every smear test - any changes can be addressed straight away."

Cervical cancer charity Jo's Trust says that more than one in five women fails to attend their smear test appointment. As part of the NHS's cervical screening programme, women aged 25 to 49 are invited for a smear test every three years and those aged 50 to 64 every five years – so while it's not pleasant, it's hardly a weekly chore. It's an appointment that might just save your life, so get thee to thy GP now…

2. You should change your tampon every SIX hours

"Tampons should be changed every 4-6 hours or when they are saturated with blood," says Dr Vanessa Mackay, spokesperson for the Royal College of Obstetricians and Gynaecologists. "They should not be left in the vagina for longer than this as it can increase the risk of Toxic Shock Syndrome (TSS). TSS is a rare but life-threatening condition caused by bacteria getting into the body and releasing harmful toxins."

Forgetting you're wearing a tampon at the end of your period is more common than you might think, adds Dr Gupta. "The main symptom is foul-smelling discharge and I've removed forgotten tampons a surprising number of times. Of course, this isn't an issue with sanitary towels but what I'd say to women here is that because modern towels are designed to be super-absorbent, they can mask very heavy flow or clotting, neither of which is normal – women don't realise how much blood they're losing, although 'gushing' or flooding is easier to recognise and should also be checked out. There are lots of reasons you might have very heavy periods – often it happens to women over 40 and often the reason is hormonal. So don't suffer in silence - see your GP, who will be able to refer you to a specialist."

3. What your vagina ACTUALLY looks like

"Every woman's vagina is different," says Dr Mackay. "They are different colours, sizes and shapes. Labias are as individual as women themselves and vary in appearance and colour. Women must know that every vagina is unique and that variation in appearance is normal in the vast majority of cases."

"There's a piece of art called the Great Wall of Vagina, created by artist Jamie McCartney, which features 400 plaster casts of vulvas," adds Dr Gupta. "Each looks completely different to the next, demonstrating that when it comes to our vaginas, there is no such thing as normal. I Google this for patients who are concerned about the appearance of their labia. Another reason it's a good idea to get familiar with what your vagina looks like is because you'll be aware of any changes that might occur."

4. That lumps and bumps are probably* nothing to worry about...

Ingrown hairs are hairs that have curled round and grown back into the skin and can result in raised, red spots which can sometimes become infected and turn into painful, pus-filled sores. These can occur along the bikini line and also around the vulva.

"Antibiotics will clear these up but be mindful that this is an area around which clothes create constant friction, which can irritate already delicate skin if you've recently shaved or waxed," says Dr Gupta. "Loose clothing will help if you're prone to ingrown hairs but if it's a recurrent problem, see your GP." It may help to go au natrel for a spell, as there's less chance of hair becoming ingrown when left as nature intended.

5. …but itchiness / smelly discharge should always be investigated

"It's normal and healthy for women to produce a clear or white discharge from their vagina," says Dr Mackay. The amount of vaginal discharge varies throughout a woman's menstrual cycle. Healthy discharge doesn't have a strong smell or colour.

"Any sudden change in discharge may indicate a vaginal infection. Warning signs of infection include - a change in colour or consistency, a sudden bad smell, an unusually large amount of discharge, another symptom alongside the discharge, such as itching outside the vagina or pain in the pelvis or tummy, and unexpected bleeding from the vagina."

"There are many possible causes of abnormal vaginal discharge, but it's usually a sign of infection. The infection is often caused by something that upsets the natural balance of bacteria or yeast in the vagina, such as washing inside the vagina, or it may be a sexually transmitted infection. The most common causes are thrush, bacterial vaginosis, trichomoniasis, gonorrhoea, chlamydia, or genital herpes. It's important to see a GP for a proper diagnosis and advice on how to treat the infection."

6. You CAN get pregnant over 40

According to the most recent figures from the Office of National Statistics, women over 40 now have a higher fertility rate than women under 20. "Women over 40 are able to conceive naturally if their ovaries are still producing eggs," says Dr Mackay. "However, as women grow older, the quantity and quality of their eggs gradually declines until the menopause, when a woman's body stops producing as much of the hormone oestrogen and no longer releases an egg each month. This usually occurs between 45 and 55 years of age."

But before you ditch the contraception, know this: not only can you still get pregnant, the chances of conceiving twins increases, possibly because of increased levels of the follicle-stimulating hormone (FSH). FSH prompts the ovaries into releasing an egg, and extra FSH means they might release two, meaning both could be fertilised. Hello (non-identical) double trouble…

7. They've seen (and heard) it all before

"Don't feel uncomfortable," says Dr Gupta. '"We've seen and heard most things so be as honest as you can. A lot of women are most embarrassed about how frequently (or not) they have sex. Rest assured – however often you have sex, someone has it more or less than you!"

* but get checked anyway!