Women dedicate their entire life in playing several roles trying to balance both professional and household lives. They tend to concentrate less on their health which could lead to several issues. A comprehensive and quality gynecological and obstetric support and care must be provided to every woman regardless of age. Younger women must be educated about menstrual health, personal care and hygiene.
In order to educate more on women’s health issues, Plush conducted a Women Health and Hygiene Awareness Session on July, 29th, 2022, in association with JournoMed at iSprout, Chennai. The speaker, Dr Meenakshi Balasubramanian, an eminent Gynaecologist and Obstetrician, discussed common gynaecological issues. She spoke about the importance of vaginal hygiene, menstrual health, contraceptives, unplanned pregnancies, estrogen and progesterone hormones, the process of ovulation, breast, uterine, ovarian and cervical cancers, the necessary medical examination and the importance of human papillomavirus (HPV) vaccination.
The vagina is a long muscular canal, elastic with a soft flexible lining that provides lubrication and sensation. The vulva and labia form the vaginal entrance. The uterus protrudes into the vagina from the interior end via the cervix. Each vagina has its characteristics and releases a specific odour. This odour can be due to discharge, pre-menstrual, post-menstrual or ovulatory. It is important to remember many experience continuous white discharge all throughout their menstrual cycle.
Vaginal discharge refers to the mucus or fluid that is secreted by vaginal glands that flushes out the dead cells and unwanted bacteria. Hence, the vagina is a self-cleaning organ. These fluids help in maintaining the vaginal environment and is a key healthy part of vaginal health.
Vaginal secretions come out as white/clear-ish discharge which can help to determine hormone profile and vaginal health. The uterus, cervix and vagina remain lubricated due to the continuous flow of fluids which enables rapid movement of the cells. White discharge accompanied by foul smell and a burning sensation/itching indicates vaginal infections, either yeast or bacterial.
Key points to remember about the vagina:
- One need not wash the vagina as it could lead to several problems.
- The vagina contains a lot of good bacteria, cleanses itself and maintains its ideal slightly acidic pH balance.
- The hair present in the pubic area need not be trimmed or shaved as it traps foreign bodies and germs and protects the vagina. But most women find it pubic hair uncomfortable and gets it shaved. Avoid using harsh chemicals and hair-removing creams to remove the pubic hair.
- Continuous shaving causes ingrown hair which may increase the chances of infection in the pubic area.
- Use mild or non scented soaps to clean the vulva
- Avoid the use of feminine wash or sprays as these products are unnecessary and harmful and can irritate the vulva and vagina.
- Vaginal odour varies from from coppery to sweet and it depends on the diet and the menstrual cycle of the person.
- If the smell of the vagina is pungent and unpleasant along with any itching or burning sensation, please do visit a certified specialist.
Menstruation is a biological process which happens every month in a woman after attaining puberty. In many countries, menstruation is considered taboo and women are excluded from daily chore activities. Menstrual health and hygiene are essential for well-being and women empowerment especially for adolescent girls. To manage menstrual health, women require access to proper sanitation, affordable menstrual hygiene products and a supportive environment.
We should normalise having discussions around menstruation in order to get rid of the stigma surrounding it and to help women better understand their body. Irregular periods are often a sign of impaired menstrual health and consulting a gynaecologist help in resolving this issue. As far as menstruation is concerned, it is one’s personal choice to use either pad, menstrual cups or tampons.
A Sanitary pad is a rectangle-shaped absorbent material which is attached inside the underwear to catch menstrual blood. It is also called a menstrual cloth/sanitary napkin. Sanitary pads need to be changed every 4 hours.
A tampon is made of compressed absorbent material in the form of a small pellet which is inserted into the vagina to absorb menstrual blood. Tampons are available in different sizes for heavier and lighter periods. Tampons and sanitary pads are not safe for 12-hour usage.
A menstrual cup is a non-absorbent bell-shaped device or receptacle that is inserted into the vagina to collect menstrual flow. It is made up of medical-grade silicone or thermoplastic elastomer. They are available in different sizes and shapes. The smaller size cups are usually recommended for women younger than 30 years old. After each menstrual cycle, the cup must be sterilized in hot water for 5-10 minutes. Menstrual cups are a little messy and not every woman prefers them. However, they are extremely helpful in reducing menstrual waste generation and is thus, an extremely eco-friendly option.
Estrogen, Progesterone and Ovulation
During the menstrual cycle, every month, the ovary releases an egg along with critical hormones, estrogen and progesterone. Estrogen, progesterone, follicle-stimulating hormone and luteinizing hormone govern the menstrual cycle. Estrogen and progesterone are primary sex hormones and drivers of reproduction and pregnancy. These two hormones are crucial for uterine/endometrial health, breast health, and cardiovascular health. Ovulation and egg release is determined by the overall hormonal environment of the ovary.
Ovulation is a monthly process where the ovaries release an egg. The egg travels all along the fallopian tube and after sexual intercourse, the sperm cells that are released into the vagina, traverse through the uterus and reach the fallopian tubes. These sperm cells may or may not fertilise with the egg. If the sperm cell does not fuse with the egg, the egg eventually disintegrates and it is released along with the the uterine lining. This shedding occurs during the first five days of the menstrual cycle and is termed as “period”.
Most women have no clue about their menstruation and ovulation dates and many mistakenly believe that ovulation always happens exactly 14 days after their last period. But the timing of ovulation varies for each woman and depends on the length of her menstrual cycle. If a woman typically has 28 days in the menstrual cycle, she ovulates between days 13 to 15. One can calculate their ovulation date with the start day of the period and by knowing the average length of the menstrual cycle. This provides an estimate of the fertile window which can help in avoiding unwanted pregnancies or help in getting pregnant.
The use of contraceptives among women to avoid unintended pregnancies are high in number. Almost 50% of unintended pregnancies end in abortions. It is an individual’s perspective on giving birth and raising a child and there is nothing wrong with choosing contraceptives or abortion. Do seek the help of a gynaecologist on both fronts. Any women who want to become pregnant or want contraception need to get of breast, cervix, ovaries and vaginal tests done.
Necessary Medical Examinations a Woman Needs
Breast examination: Breast examination is performed 4-5 days after the menstrual flow. Breast examination also helps in the early detection of breast cancer. Women can also perform breast self-examination 7-10 days after their menstrual period.
Pelvic examination: In a pelvic examination, the doctors examine the reproductive organs i.e. ovaries and uterus. Doctors usually recommend pelvic examination if there is any unusual vaginal discharge. It helps to recognize ovarian cysts, uterine fibroids or other early-stage cancers. Pelvic examination is not recommended during menstruation.
Cervix examination: A cervix is a canal from the vagina to the uterus. Most practitioners perform cervix examination to obtain pap smear for detecting precancerous lesions.
A majority of cervical cancers (80%) are caused by the human papillomavirus (HPV). This virus spreads through sexual contact with a person who possesses it. Some HPV viruses causes genetic warts while others cause infections. HPV vaccines protect against the HPV virus which prevents genetic warts formation and eradicates cervical, anal, oropharyngeal, vulvar and vaginal cancers. The HPV vaccines are very expensive and are recommended both for children and adults. Like other immunizations which guard against infections, HPV vaccines stimulate the production of antibodies. These vaccines don’t prevent other sexually transmitted diseases but they reduce HPV-related infections.
Understanding vaginal hygiene and its maintenance and taking care of menstrual health is crucial for any woman as it avoids the risk of vaginal infections and cancers related to the breast, ovary, vagina and cervix. Following good menstrual hygiene and safe sex protocols can avoid the occurrence of STDs. Most gynecologists recommend special examinations which help in detecting cancers or other infections. An insight into women’s healthcare and awareness not only educates the current generation, it can also transform the healthcare scenario for the upcoming generations.