How itching ‘down there’ could be a sign of rare cancer – and other signs to watch for

IN Menopause Awareness Month, it’s great to see more celebrities talk about their experiences.

It reminds women they are not alone if, and when, symptoms occur.

Olivia West

Sun columnist Dr Zoe advises readers on their health[/caption]

The best way to prepare for perimenopause, when hormone levels start to decline in the lead-up to menopause, is to get informed.

Familiarise yourself with symptoms that might strike – they can be unexpected or different to how you imagined.

Most of us are aware of hot flushes, but what about brain fog, anxiety, weight gain, low libido or discomfort during sex due to vaginal dryness?

It’s important men talk with their partners about menopause, too.

It can test relationships but requires patience and understanding.

After all, women can feel low in self-esteem.

But it’s not all doom and gloom – many women report feeling fabulous in mid-life, with more confidence and understanding of themselves.

Here’s a selection of what readers have asked me this week…

PERSISTENT ITCHING IN INTIMATE AREA

Q) I HAVE had itching in the vaginal area since April.

During this time I have used cream for thrush, had antibiotics for UTIs and lots of creams for other things but it just won’t go away.

I have been referred to the hospital but they have only just started to see referrals from August last year.

The doctors have told me that they can’t do anything else.

A) I’d be really interested to know your age, as that would help me share what other potential causes of your symptoms could be.

At any age, skin diseases such as eczema and psoriasis can affect vulval (external) skin.

Itching of the vagina (internal) can be caused by infections including thrush (which can be resistant to some antifungals), or bacterial vaginosis (BV) which is an overgrowth of a type of bacteria that lives in the vagina.

BV can be brought on by douching (pushing water into the vagina) as this can wash away the microbes of the vagina that help keep bacteria that cause BV in check.

Vaginal swabs can test for both thrush and BV.

Sexually transmitted infections should also be considered.

Vaginal itching can also be a symptom of perimeno-pause and menopause.

As oestrogen levels decline, some women experience the genitourinary syndrome of menopause which can include symptoms of vulval and/or vaginal itch/pain/dryness, altered sexual function, urinary symptoms and recurrent UTIs.

There is also an inflammatory skin condition called lichen sclerosus, which mostly affects the vulval skin and the skin around the anus and is most common after menopause.

It can cause itching and white or pale patches to appear, and the tissue can be more delicate and prone to splitting.

It’s important to have it diagnosed because in a small number of people it may develop into vulval cancer.

It can’t be cured, but it can be controlled with potent steroid ointments such as clobetasol.

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The reader has had abdominal pain for two years[/caption]

Q) I HAVE had abdominal pain for two years.

As a 17-year-old female, I have been told it is probably due to stress, PMS or IBS but I have had no definite diagnosis.

My condition has fluctuated but is now getting worse.

I went from having a persistent stomach ache to bloating, indigestion, heartburn, excess wind, extreme fatigue and severe anal pain when defecating.

The pain is annoying me and I cannot focus at school. I get agitated quickly and so tired. Is this normal?

I finally got an endoscopy, which did not find anything abnormal, but I know deep down that some-thing is not right.

A) I’M so sorry to hear that you are struggling with such awful symptoms and that you have not yet received a diagnosis or explanation for what is causing them.

Firstly, you are absolutely right to persist in trying to find answers and it may be that you need input from multiple specialist teams.

We know that certain conditions commonly have a very delayed diagnosis.

Endometriosis, for example, affects one in ten women and those assigned female at birth in the UK.

A recent study shows that diagnosis of endometriosis – when tissue similar to the lining of the uterus grows outside of the uterus – takes an average of eight years and ten months which is shocking.

It’s partly due to the fact that the gold standard test for diagnosis requires keyhole surgery, but progress is being made towards making a “clinical diagnosis” based on the patient’s symptoms and ever-improving imaging techniques.

Has endometriosis been considered in your case?

Do your symptoms tend to get worse at the time of your period?

If so this would certainly be something to seriously consider.

Some other examples of conditions that can prove hard to diagnose include coeliac disease, thyroid abnormalities, and fibromyalgia.

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THROAT-CLEARING ISSUES A MYSTERY

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Dr Zoe helps a reader who has been unable to clear her throat[/caption]

Q) MY wife has been unable to clear her throat, especially at night when she has to get up to the bathroom, and is sometimes sick.

She was sent to an ENT clinic where they could not find anything untoward, but weeks later she was bringing up a yellow liquid, we now know to be bile.

The doctor sent her for X-rays and it was found she had gallstones, but because they were small, they were reluctant to remove the gallbladder.

What can she do to relieve her suffering?

A) IF she is continuing to vomit bile and doctors suspect it’s not due to the gallstones, then she will require further investigations to find out the cause of her symptoms.

An ENT camera assessment (nasendoscopy) examines the inside of the nose, throat and voice box.

For the oesophagus (gullet), stomach and intestines to be fully assessed she would need to have additional investigations, most likely a camera test that a gastroenterology specialist would conduct.

Throat-clearing can be a symptom that is linked to issues within the stomach.

For example, if acid is refluxing into the oesophagus or throat it can cause irritation, swelling or excess mucus production which can all cause the urge to want to clear the throat clear.

I’m assuming that she has already had blood tests?

These should include liver function, full blood count, kidney function, and amylase.

Does she have any other symptoms such as change in energy levels, appetite or weight, abdominal pain or bloating, change in bowel habits or symptoms related to swallowing?

If so it’s important to share these with the doctor too.