“A normal looking vulva is neat and tidy”

“If I don't eat enough fruit and veg, a multivitamin will make up for it”

“Low libido is usual following menopause”

"Girls don't get endometriosis in their teens"

“Bleeding for more than 7 days is normal”

“Women in traditional cultures have better mental health”

Complementary medicines should be prescribed by a trained professional who can properly educate you about appropriate use, potential side effects and interactions. Tell your GP and other health professionals about any medications you are taking, including complementary medicines.

For otherwise healthy women, taking hormone replacement therapy (HRT) for two to five years to relieve menopausal symptoms causes little if any increase in breast cancer risk.

If you're not taking HRT during menopause, you have a 3 in 1000 chance of developing breast cancer in a given year. If you take HRT for five years, that chance goes up slightly to just under 4 in 1000. Weigh this small risk against the benefits of HRT: It can significantly improve women's quality of life and reduce risks of osteoporosis, diabetes and colon cancer.
Take the lowest effective dose of HRT, for only as long as required by your symptoms, and regularly review your reasons to continue (or not) with your health practitioner. HRT can be stopped at any time, after which any increase in breast cancer risk lessens over time and is lost within five years.

Our mothers taught us this one! Your bladder is meant to be a reservoir; it isn't supposed to be emptied out every time it contains a small amount. It's normal to go to the toilet every few hours, to store a cupful or more and to be able to hold on if we need to. Get out of the habit of going "just in case" - only go when your bladder tells you to. If you think you may have bladder problems, visit your GP.

Incontinence

Small steps can make a big difference. You don’t have to live on lettuce leaves or hire a personal trainer.

Make sustainable changes to your physical activity and eating behaviours. Schedule a walk on most days, or another activity that you will enjoy enough to keep doing. Swap less nutritious foods such as soft drinks, snack foods and convenience foods for more nutritious options such as fresh fruit, vegetables, wholegrain foods, low fat dairy and lean meats.

Women who are overweight are at 14 times more risk of type 2 diabetes than women who maintain a healthy weight.

1 in 3 Australian women will experience an anxiety disorder at some point in their lifetime.

Depression and Anxiety

All women under 70 should have a Pap test every two years, even if they’ve had the HPV (Gardasil) vaccine. The vaccine only protects against 70% of cervical cancers so you could still develop cervical cancer in the future, even if you were not sexually active before the vaccine. Pap tests are quick, painless and potentially life-saving; book in with your GP or a women’s sexual health centre today.

4 out of 5 women will be exposed to HPV (human papilloma virus) at some point in their lifetime. This virus can cause cervical cancer or genital warts.

Many people do empty their bowels once every day, but if this is not your routine, that's fine. It is normal to empty your bowels anywhere from three times per week to three times per day.

You should get a good message when it's time to go. Don't sit and force it if it's not ready, but when the message comes it's good to empty as soon as is practical.
Bowel actions should be like soft 'sausages' and easy to pass without straining or having to sit for too long. Once finished, you should feel satisfied that it's all out. There should be no pain or bleeding. If there is, see your GP.

Incontinence; Your guide to Bowel Health

There are no demonstrated health benefits to shaving off pubic hair. It is a personal choice. Some prefer short or no pubic hair if they are wearing bikinis or light coloured clothes, others feel cleaner and notice less odour. 

Shaving only removes hair down to just below the surface of the skin. Shaving may also cut the skin, increasing the risk of folliculitis or spread of viral warts to other places if the same shaver is used.

Menopause is a time of transition – while some women have negative feelings about the end of their reproductive years, others look forward to the next stage of their life. Who you are, what your life experiences have been and how you feel about your life will all influence the way you experience menopause. 

The attitude that you have toward this time of your life can influence your coping abilities, your emotional wellbeing and your risk of mood disorders. It is helpful to understand how you feel about the different areas of your life, along with the physical changes of menopause.

20% of women experience no symptoms during menopause, and another 60% have only mild symptoms.

About Menopause; Life Begins at Menopause [video webcast]

Women tend to gain weight in their middle years, particularly around the stomach, whether they take HRT or not – Your base metabolic rate tends to decline with age, so if your energy intake from food and beverages is more than the energy you use in daily activities and exercise, your weight will increase.

Most studies do not show a link between weight gain and HRT use. In fact in several studies women who used HRT had less weight gain than those who did not. Weight gain may occur temporarily when starting HRT, but it is usually due to fluid retention and the body readjusting to new hormone levels.

Women gain and average of 5-7 kg per decade as they age, whether they take HRT or not.

If it was as simple as following a particular diet for a short time, no-one would have an ongoing weight problem! Diets can lead to short term weight loss, but fail in the long term – repeated dieting may even lead to weight gain.

Body weight is determined by more than willpower and a plan. The body balances lifestyle, genetics and many other factors to keep weight stable over time. It will usually return to the same balance after dieting, or may even add a few extra kilos 'just in case'.
Aim to prevent weight gain and then, if needed, try to achieve 5-10% weight loss over time by making healthy lifestyle changes.

95% of people who go on weight loss diets regain everything they have lost (and more) within two years.

“Period pain is normal”

Period pain that does not respond to simple treatment is not normal. You do not have to endure period pain “because that’s what being a woman means” - It is not. 

Period pain can be a symptom of endometriosis, but the only sure way to diagnose endometriosis is by a keyhole surgery called laparoscopy. Some experts offer medical treatment without a definite diagnosis of endometriosis , if they have ruled out a ‘pelvic mass’ and the woman is not actively trying to have a baby.
Even if you do have a laparoscopy, and endometriosis is found, there is no guarantee this is the cause of the pain. Likewise, there is no guarantee that treating the endometriosis (e.g. by burning or cutting out the misplaced endometrial tissue) will relieve your symptoms - and surgery does have complications.

Endometriosis affects around 1 in 10 women at some stage during their reproductive years.

Period Questions and Answers; Symptoms of Endometriosis

Weight is complex: Hormonal factors around menopause or with polycystic ovary syndrome (PCOS) can put someone at more risk of weight gain if they aren’t careful with their health and lifestyle. On their own, though, hormones are not the cause.

Body weight still reflects overall lifestyle and energy balance. Pay attention to preventing weight gain, particularly at those times of life when gain is more likely.

On average, Australian women are gaining about 7kg per decade more than they would have in the past.

The amount of extra food energy you need during pregnancy is equivalent to an apple and a small glass of milk per day, so you don’t have to eat for two.

What you do need is good quality food that will give you a lot of extra vitamins and minerals but not many extra kilojoules. Eating healthily, maintaining usual exercise and keeping weight gain within normal pregnancy recommendations right from conception will help prevent gestational diabetes later in the pregnancy.

Normal weight gain over the course of a pregnancy, for a woman who was a healthy weight before conception, is around 10–13kg.

Any leakage of urine, faeces or wind is incontinence, no matter how small.

In most cases, incontinence will not go away and tends to worsen over time. The earlier you seek help from your GP, the easier it is to cure. Your GP sees many people who have incontinence and is used to discussing it, so don't be embarrassed to mention it when asked "and is there anything else?" in your regular check-up.

To reduce your risk of incontinence, drink 6-8 glasses or cups of fluid each day (mostly water), reduce your intake of caffeine and alcohol and exercise regularly (including pelvic floor exercises). Try to maintain a healthy body weight, include plenty of fibre in your diet, avoid smoking and treat the causes of chronic coughing or sneezing. Also avoid repetitive heavy lifting, which can weaken your pelvic floor muscles.

About 20% of all Australians are affected by incontinence. It is most common in women and older people.

Incontinence

Many cases of dyspareunia (pain before, during or after vaginal intercourse) are treatable, but a lot of women are reluctant to seek help because they find it difficult to discuss. Apart from the physical impact on their bodies, painful sex can also affect mental and emotional health, and relationships.

Pain can be caused by insufficient lubrication, infections, inflammation, spasms of vaginal wall muscles (vaginismus), gynaecological and bowel disorders, surgical scars and/or emotional factors.

If you suffer from painful sex, see your GP. Many people find discussing sex difficult or embarrassing, so it may help to prepare for the appointment by writing down your symptoms and when/how often they occur. Other useful information to have with you is your medical history, including any other medical conditions and medications.

Dyspareunia (pain before, during or after vaginal intercourse) affects over 14% of premenopausal women, with the highest rate found in women aged 16-39.

Painful Sex – When Love Hurts

A Pap test can be embarrassing, but is only slightly uncomfortable. If you are comfortable with the health practitioner performing the test, then you are more likely to relax, which then makes the test less painful.

The Pap test is a quick and simple test, in which an instrument called a speculum is inserted into the vagina. Cells are taken with a cervical brush or spatula from the cervix, which is at the top of the vagina. These are then sent away to be looked at under a microscope.

4 out of 5 women will be exposed to HPV (human papilloma virus) at some point in their lifetime. This virus can cause cervical cancer or genital warts.

Each woman's vulva is unique in size and appearance including differences between the right and left labia. There is also variation in the size, shape and length between individual women. These differences and variations are normal.

Many women worry that their vulva looks unattractive. Often this anxiety is caused by what they see in the media or social pressures to have a 'childlike' vulva. It's unhelpful to compare yourself to (often digitally altered) images in the media or pornography.

Whilst cosmetic surgery (labiaplasty) is an option, you should remember that surgical procedures have risks including infection, bleeding and scarring – and there's no guarantee that you will be happy with the result. Talk to your health professional, a counsellor and your partner (if you have one) before considering cosmetic surgery.

‘Labia minora hypertrophy’ is defined as having labia minora (inner lips) measuring more than 5cm from midline to edge. Symptoms may include discomfort, infection and emotional distress. Management involves counselling that size is a normal variant and teaching general personal hygiene. If symptoms persist, surgery can be offered but may lead to scarring or chronic (ongoing) pain.

Sexual interest (libido) depends on many factors – not just hormone levels. Stresses of daily life, poor physical health, medications, relationship conflict or psychological problems can affect sexual wellbeing. Most studies on sexuality in menopausal women indicate wide variations and the underlying causes need to be addressed.

Lower oestrogen levels can result in vaginal dryness and discomfort during intercourse, but this problem can be treated with appropriate lubrication or oestrogen therapy. Many women think that this is a normal part of menopause and will not mention it to their doctor.

Testosterone levels, which are often associated with libido, start decreasing in the mid-30s but do not fall any further during menopause. 

20% of women experience no symptoms during menopause, and another 60% have only mild symptoms.

“Bleeding for more than 7 days is normal”

“Changing a pad/tampon every hour is normal”

Bleeding more than 80ml (1/3 cup) per period is abnormal, and bleeding for more than 7 days is abnormal. Both can cause iron deficiency, fatigue, lethargy and interfere with life.

Irregular or heavy periods may be a sign of pathology (e g. polyps, fibroids, hyperplasia, cancer) or an indication of entering perimenopause with anovulation.

Heavy uterine bleeding (menorrhagia)

Supplements are just that – a supplement to the recommended amounts of nutrients you should be having. Fruits and vegetables provide a lot more nutrients than a multivitamin – such as fibre, antioxidants and other phytochemicals.

Some children are fussy eaters, but they are rarely malnourished, so they don't need multivitamins. If you are worried about your child's nutrition or growth, see your GP.

Endometriosis can start at any time during a woman's reproductive years, i.e. between menarche (when periods start) to menopause (when they stop permanently).

Average time to diagnosis is about seven years, but when endometriosis occurs in adolescence it can take even longer to diagnose. Some girls are told (or just believe) that severe period pain is just part of being a woman, and don't seek help. If diagnosis is delayed, the disease may carry on and can affect fertility.

Greater awareness of endometriosis in adolescent girls needed

What is endometriosis?

Pregnant women and new mothers in poorer parts of the world are more likely than women living in wealthier, Western countries to suffer poor mental health.

Traditional cultural practices in some poorer countries do not protect expectant and new mothers from anxiety and post-natal depression. Factors found to increase a woman's risk of poor mental health during pregnancy or in the first year of her baby's life are poverty and having a partner who is unsupportive, uninvolved, critical or physically abusive.