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[A recent survey](https://thebms.org.uk/2021/08/the-british-menopause-society-response-to-the-department-of-health-and-social-cares-call-for-evidence-to-help-inform-the-development-of-the-governments-womens-health-strateg/) found that 45% of women felt that menopausal symptoms had a negative impact on their work. But thanks to an increased focus from campaigning groups, charities and the media, more people than ever are starting to talk openly about the menopause.

[Menopause](https://www.livi.co.uk/medical-advice/endocrine-system/menopause/) doesn’t just affect people who identify as women. It can also affect some transgender men, non-binary people and intersex people.

## What are the stages of menopause?
‘Menopause is the natural ageing process of a woman’s ovaries, affecting their production of oestrogen and progesterone, and eventually causing periods and ovulation to stop,’ explains Dr Rosén. In the UK, the [average age](https://www.livi.co.uk/your-health/what-age-will-i-reach-menopause-a-doctors-guide/) for a woman to reach the menopause is 51.

Perimenopause is the transition towards menopause which can take several years. The first sign is usually a change to your [menstrual cycle](https://www.livi.co.uk/your-health/your-menstrual-cycle-explained/) where it starts to become shorter and more irregular, and then becomes heavier with longer bleeds.

Your oestrogen production will continue to decrease for a few years after you reach menopause. Around 5 years after your last period marks the end of menopause and the beginning of post-menopause.

## What are the most common menopause symptoms?
‘Although it can be a slow and gradual process, women may experience a range of mild to severe symptoms’, says Dr Rosén.

‘The decrease in hormone levels will affect the body in many different ways, and be different for every person.’

There are 3 key types of [symptoms caused by menopause](https://www.livi.co.uk/your-health/7-signs-of-perimenopause-a-doctors-guide/) – changes to your periods, your mental health and your physical health.

Some of the most common [mental health symptoms](https://www.livi.co.uk/your-health/lets-talk-about-menopause-and-mental-health/) include low mood, [anxiety](https://www.livi.co.uk/medical-advice/mental-health/anxiety/), [depression](https://www.livi.co.uk/medical-advice/mental-health/depression/), brain fog and problems with concentration.

Other physical symptoms include hot flushes, problems sleeping, heart palpitations, low libido, vaginal dryness, joint pain and migraines.

## How can menopause affect you at work?
Menopause can have a significant impact on your working life. Sometimes the symptoms of menopause or your working conditions while going through the menopause can affect your concentration, attention to detail or ability to carry out your role properly.

‘Lots of women find managing their menopause symptoms in the workplace challenging – partly because of how difficult it can be to talk openly about menopause at work,’ says Dr Elisabeth Rosén.

The good news is that workplaces are getting better at supporting menopausal women who are the fast-growing demographic at work in the UK.

## How to manage menopause symptoms at work
Opening up about your health to someone at work can feel uncomfortable or awkward. Especially if you don’t feel comfortable talking about personal matters to colleagues.

But the first step to getting help is to speak to your line manager, HR team or occupational health service. The more we talk, the easier the conversations will become.

__1. Keep communicating__
Regular conversations can help to discuss things like flexible working hours, working from home and your work environment (easy access to fresh air, bathroom facilities, cold water etc.) It can be helpful to take notes of your menopausal symptoms as well as how they are affecting you. 

__2. Share your experience__ 
It can be helpful to let others know you’re going through the menopause – either with colleagues you can trust or with external support groups. This can help reduce the stigma and widen your support network. You may also want to prepare for conversations at work by talking it through with a friend or family member. 

__3. Ask about adjustments__ 
There are lots of practical changes that can make a big difference, and you’re entitled to ask for these. For hot flushes, ask about a desk fan or to sit near a window. Ahead of any meetings to discuss your symptoms, have a think about some of these solutions so that your employer knows you’re taking your health and work seriously.

__4. Build in breaks to your day__ 
Give yourself enough rest and quiet time to recharge throughout the day, and make this a priority. Meditation, mindfulness and other relaxation techniques during your break may help to reduce your symptoms too. It’s also important to stick to a regular sleep routine, so that you can properly rest after each working day.

__5. Make the most of technology__ 
You may already do so, but it can help to set yourself digital reminders for important meetings and tasks, or get into the habit of using digital note-taking tools. This technology is a great way to overcome the stress caused by brain fog and other memory-related symptoms. 

__6. Ask about other support__ 
Find out if your employer has a menopause policy or health insurance which can guide you through the support available. For example, can your workstation be more comfortable? In some areas you can access local menopause cafes or online groups to speak to people going through a similar experience.

__7. Take the time you need__ 
If you’re struggling to manage your symptoms, speak to your employer about whether you need to take some time off. Outside of work, as well as treatment like [HRT](https://www.livi.co.uk/your-health/what-is-hrt/), you should consider making some simple lifestyle changes such as more regular exercise and eating a healthy balanced diet. 

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Livi.co.uk > Your health > 7 tips for managing menopause symptoms at work

Woman with fan managing menopausal symptoms at work

Managing menopause symptoms at work

Menopause has lots of mental and physical symptoms that can be challenging to manage at work. We speak to our women’s health expert for her specialist advice.

7 tips for managing menopause symptoms at work

livi.co.uk > Medical Reviewer

Dr Bryony Henderson

Lead GP at Livi

Women Health

Women's Health

There are many different causes of hair loss in women, and your hair loss can be temporary or permanent, gradual or sudden. Though hair loss is more likely to happen as you age, it can happen earlier on too. 

If you’re experiencing hair loss, try not to panic. It’s helpful to determine the type of hair loss you’re experiencing first – yours may be happening over time in the form of ‘thinning,’ or you may be seeing patches of baldness. 

## What causes female hair loss?
The most common type of hair loss in women is called female pattern baldness, known medically as alopecia. In the UK, around [40% of women aged 70 years](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322157/) or over experience this type of hair loss, and its main cause is thought to be hereditary. 

But there are lots of other different reasons for thinning or balding hair, and so it’s a good idea to investigate the core cause in order to find the best treatment or management. The key potential causes include:

- High levels of [stress](https://www.livi.co.uk/medical-advice/mental-health/stress/)
- [Iron deficiency](https://www.livi.co.uk/your-health/a-doctors-guide-to-iron-deficiency-symptoms-causes/)
- Medical conditions such as [thyroid disorders](https://www.livi.co.uk/your-health/thyroid-symptoms-overactive-underactive/), anaemia, [psoriasis](https://www.livi.co.uk/medical-advice/skin-conditions/psoriasis/) and some autoimmune diseases
- Chemotherapy
- [Having a baby](https://www.livi.co.uk/your-health/10-post-baby-body-changes-advice-from-a-womans-health-specialist/) – it’s common for women to experience postpartum hair loss for up to 3 months after birth 
- Weight loss

## Why is my hair falling out?
The life cycle of hair growth happens in 3 stages. Each hair follicle on your scalp goes through this cycle and this helps us to understand how hair loss occurs biologically.

- __Anagen__ – the active growing phase where the hair becomes longer and thicker, which can last between 2-7 years

- __Catagen__ – the hair follicle then moves into a short transitional phase where the hair fibre stops growing, which lasts around 3 months

- __Telogen__ – your old hair is gradually pushed up towards the skin’s surface before it’s then shed naturally and replaced with new hair at the start of the cycle

You won’t be aware of this cycle happening, as each hair follicle is at a different stage, at different times. But the cycle will continue throughout our lifetime until there’s an imbalance or sensitivity to changing hormones. 

Apart from age or a genetic predisposition, most causes for losing your hair are known as reactive hair loss.

## How much hair loss is normal?
It's completely normal for women and men to lose varying amounts of hair each day and you’ll notice an increase as you get older. On average, we lose between 50 and 100 hairs a day. This is called [hair shedding](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336434/) and it’s part of the normal hair cycle. Usually we don’t notice this amount of hair loss and it’s nothing to worry about.

## What’s the difference between female and male hair loss?
For women, hair loss or hair thinning usually happens when the growing phase slows down. It then takes longer for new hair to begin growing. As hair follicles shrink, the hair that does grow back becomes finer, and this can lead to weaker hair that easily breaks.

Women with alopecia also tend to shed more hairs each day than the average person, and the pattern of baldness often starts at your parting line, or in patches across your head. Women are less likely than men to lose all of their hair.

In men, hair loss usually starts at the front of the head and gradually recedes to the back. Lots of men with male pattern baldness will experience complete hair loss and become bald.

## Who’s more likely to lose their hair?
Hair loss is more common than you might realise. [Research shows](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684510/) that fewer than 45% of women go through life with a full head of hair – so most will experience hair loss or reduced hair volume at some point. The good news is that there are treatment and management options.

As well as hereditary and genetic causes, age and hormones play a part too. Hair loss in women is more common after [menopause](https://www.livi.co.uk/your-health/what-age-will-i-reach-menopause-a-doctors-guide/), when levels of oestrogen and progesterone reduce. These hormones help hair grow and stay healthy for longer periods of time. 

A decrease in these hormones can also trigger an increase in the production of male hormones (androgens). Androgens can cause hair follicles to shrink and lead to greater hair loss or cause hair to grow on the face. This is why some women – during or after menopause – develop small sprouts of hair on the chin.

## Can I prevent hair loss?
Though it’s tough to hear, hair loss in women and men can’t usually be prevented. But there are lots of lifestyle choices you can make to keep your hair healthy and protect it from breakage.

- __Eat iron-rich foods__ – as part of a balanced diet, make sure you get enough iron from foods like green leafy vegetables, beans, and fortified cereals.
- __Be kind to your hair__ – avoid treatments that can damage your hair like bleach, perms or straightening products. If you do sometimes use them, add a strengthening product or heat protective spray to your routine.
- __Check your medication__ – speak to a healthcare professional to see if any of the medications you take contribute to hair loss and whether you can switch.
- __Make healthier choices__ – limit or quit smoking as this can damage hair follicles and speed up hair loss.
- __Stay out of the sun__ – too much [sun exposure](https://www.livi.co.uk/your-health/how-to-enjoy-the-sun-safely-and-what-to-do-about-sunburn/) can also damage your hair, so it’s always best to wear a hat or seek out the shade when you’re outdoors.

## What’s the best hair loss treatment?
Most hair loss in women doesn’t need treatment and is either temporary (your hair will grow back) or it’s a natural part of getting older. 

Hair loss caused by a medical condition or high levels of stress usually stops and grows back once you’ve recovered.

If you’re worried about hair loss or female pattern baldness, there are treatments available and it’s best to discuss this with a doctor. 

There are other things you can try if your hair loss is causing you distress, such as:
- Synthetic wigs
- Real-hair wigs
- Steroid injections and creams
- Immunotherapy	
- Light treatment	
- Tattooing	
- Hair transplant		

Like the treatments mentioned above, some of these options won’t be suitable for everyone or available on the NHS.

Your hair is an important part of your identity. As losing your hair can be upsetting for women and men, it can be helpful to get some emotional support too. Talking therapy may be helpful.

## How to cope with hair loss
It’s really important to talk about the psychological impact of losing your hair. If you’ve experienced hair loss, even temporarily, there are many things you can do to help you cope and feel more confident. Here are 5 self-help tips:

### 1. Join a support group
You can find online forums and local groups where you can meet and socialise with other people with alopecia. 

### 2. Practice self-love
Making a list of all your good qualities and focusing on this positive energy can help you come to terms with hair loss.

### 3. Talk openly and honestly
Let your friends, family and loved ones know how you feel, and what kind of support you need. [Talking therapy](https://www.livi.co.uk/online-therapy/book-an-appointment/) or counselling can help too.

### 4. Cover up creatively
There are plenty of creative ways to help you feel more confident and conceal baldness (if you want to), with wigs, hair extensions, scarves and make up. 

### 5. Be aware of marketing
It’s easy to be tempted by online products and supplements, but there are no miracle cures. A doctor can advise whether [dietary supplements](https://www.livi.co.uk/your-health/what-vitamins-should-i-take/) are necessary.

## When should I speak to a doctor about hair loss?
If your hair loss is affecting your wellbeing, speak to a healthcare professional about the support and treatment available. 

It’s also a good idea to speak to a doctor if you have new symptoms of hair loss, like if you’re: 
- Developing bald patches
- Losing hair in clumps
- Experiencing itches and burns

__This article has been medically reviewed by Livi GP Dr Roshaan Saloojee.__

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Hair loss in women

Understand the medical causes and key symptoms of hair loss in women, plus learn how to cope with different types of hair loss.

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What causes hair loss in women? | Livi UK

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Dr Roshaan Salojee

Livi GP

What causes hair loss in women?

Expecting a baby and wondering if you can continue, or even start, exercising? For most women, exercise is good for you and your baby. It helps you stay in shape and prepares your body for childbirth. 

Despite this, [research](https://pubmed.ncbi.nlm.nih.gov/28613571/#:~:text=Traditionally%20women%20were%20advised%20to,women%20who%20exercised%20during%20pregnancy.) suggests that only 40% of women continue to exercise during pregnancy. 

The good news is that [regular exercise is safe](https://www.britishjournalofmidwifery.com/content/midwife-blog/exercise-during-pregnancy/) when you’re pregnant. What’s important is that you choose the right types of activity that will work for you over the next 9 months as your body changes. 

## What are the benefits of exercising during pregnancy? 
Pregnancy may feel like the ideal time to sit down, relax and put your feet up, but unless you’re experiencing complications, there’s [evidence](https://pubmed.ncbi.nlm.nih.gov/28613571/#:~:text=Traditionally%20women%20were%20advised%20to,women%20who%20exercised%20during%20pregnancy.) to suggest that physical activity is beneficial for both you and your baby. 

As well as help you adapt to your changing body shape and maintain a healthy weight, regular exercise during pregnancy can:
- Lower your risk of gestational diabetes
- Reduce [blood pressure ](https://www.britishjournalofmidwifery.com/content/midwife-blog/exercise-during-pregnancy/)
- Prepare your body for labour and delivery 

[Research](https://www.ncbi.nlm.nih.gov/books/NBK430821/) also shows that exercising can make your pregnancy easier – it can improve your sleep, [ease back pain](https://www.livi.co.uk/your-health/what-can-help-my-lower-back-pain-a-doctors-tips/), reduce your risk of [constipation](https://www.livi.co.uk/medical-advice/digestive-problems/constipation/) and boost your mood. 

[One study](https://pubmed.ncbi.nlm.nih.gov/22904295/) found that women who exercised mid-pregnancy had a lower risk of lower back pain, pelvic girdle pain and [depression](https://www.livi.co.uk/medical-advice/mental-health/depression/) in late pregnancy. 

What’s more, there’s also [evidence](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075987/) to suggest that exercising during pregnancy can reduce your baby’s risk of developing diabetes, obesity and cardiovascular disease later in life.   

## How to keep fit during pregnancy 
It’s natural to feel cautious about exercising during pregnancy. Here are some ways you can keep fit in your first, second and third trimester. 

### 1. Keep active on a daily basis 
Ideally, you should aim for [150 minutes](https://www.ncbi.nlm.nih.gov/books/NBK430821/) of moderate-intensity activity every week. This can be broken down into smaller periods of time – for instance, 30 minutes of brisk walking per day for five days each week. You should be able to hold a conversation whilst exercising. If you can't, you’re probably pushing yourself too much. 

Or if you’re new to exercising, you can start small and begin with sessions of 5 minutes and build up to 10 minutes, 20 minutes, and so on, until you’re exercising for longer durations. 

Remember, every minute of activity counts, so this includes walking, housework, gardening and shopping. 

### 2. Aim to continue with your normal activities or exercise 
If you were physically active before pregnancy, you should be able to continue with your normal activities for as long as you’re comfortable. 

If you decide to join an exercise class, let the instructor know you’re pregnant. Depending on what class you go to, they may give you modifications depending on your trimester. Also look out for prenatal classes.

### 3. Start gradually  
If you weren’t active before pregnancy, start gradually. Exercise doesn’t have to be demanding to benefit you and your baby. 

Walking is a brilliant exercise for beginners. It’s a low impact exercise with minimal stress on your joints. [Research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6742678/) suggests a brisk walk has the potential to lower the risk of complications, including preeclampsia, gestational diabetes and excessive weight gain. It may also reduce the risk of premature birth. 

### 4. Combine strengthening and aerobic exercises 
Doing a combination of aerobic and strengthening exercises is beneficial during pregnancy.  

__Aerobic exercise__ – like brisk walking, dancing, swimming, gardening and housework – strengthens your heart and lungs, tones your muscles and improves your overall fitness. 

__Strengthening exercises__ – like weight training, walking upstairs or carrying shopping – strengthen your muscles and joints. This will help you carry your growing bump as well as prepare you for labour and when your baby is born. 

[Research](https://pubmed.ncbi.nlm.nih.gov/26984583/) shows that strengthening exercises during pregnancy can boost your energy and improve feelings of fatigue too. Aim to do muscle strengthening activities twice a week.  

### 5. Add pelvic floor exercises into your routine 
Pregnancy puts a lot of strain on your [pelvic floor](https://www.livi.co.uk/your-health/how-to-exercise-weak-pelvic-floor-muscles/). This is a group of muscles that lie across the base of your pelvis, stretching from the pubic bone at the front to your tailbone at the bottom of the spine. 

If these muscles are weak, there’s a greater chance of you experiencing stress or urinary incontinence. This is where you leak pee when you cough, sneeze, laugh, jump, walk, run or exercise. 

Exercising your pelvic floor muscles during pregnancy and after childbirth helps you to reduce or avoid stress incontinence. So, if there was ever a better time to start these exercises, it’s now. 

[One study](https://pubmed.ncbi.nlm.nih.gov/32506232/) found that doing pelvic floor exercises during pregnancy may even be effective in shortening and reducing the risks of perineal tears during childbirth. 

### 6. Be mindful about what you do 
Although it’s important to stay active, there are some moves and exercises that you should avoid when expecting.  

__Avoid exercising while lying on your back__
After 16 weeks, [avoid exercises that involve lying on your back](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309362/) for long periods. This is because the weight of your bump presses on your main blood vessel, reducing blood flow to your baby, as well as potentially making you feel dizzy or faint. 

__Avoid contact sports__
These include rugby, hockey, football, squash and martial arts, because there’s a risk your bump could be hit. 

__Avoid exercises where you could fall__
Horse riding, gymnastics or skiing all come with a higher risk of falling and injuring yourself. It may also be more difficult to maintain your balance because your growing baby bump changes your centre of gravity. 

__Avoid scuba diving and exercising at high altitudes__
Scuba diving isn’t safe during pregnancy and exercising at high altitudes (over 2,500 metres) reduces oxygen to you and your baby. 

### 7. Listen to your body 
Always [listen to your body](https://www.livi.co.uk/your-health/body-literacy/). Exercise doesn’t have to be demanding to be beneficial, so avoid pushing yourself too hard. If you feel uncomfortable, stop. 

A good way to know whether you’re working at a suitable intensity is if you’re able to hold a conversation as you exercise. If you’re breathless, ease off a bit – you may be exercising too strenuously. 

What’s more, it’s especially important to stay hydrated by drinking plenty of fluids when you’re exercising and avoid exercising in very hot weather. 
Always make sure you warm up and cool down as this can help prevent muscular injury. 

## How do I know if I’m pushing it too far?
Stop exercising and seek medical help from a doctor, midwife or obstetrician if you develop the following symptoms: 

- Dizziness or feeling faint
- Shortness of breath before you start exercising 
- Chest pains or palpitations 
- A headache 
- Calf pain or swelling 
- Pelvic girdle pain
- Extreme tiredness or fatigue
- Abdominal pain 
- Muscle weakness

## When should I speak to a doctor?
If you have any complications during your pregnancy or have any concerns, speak to a doctor before you start exercising. 

Always seek medical attention if you have: 
- Vaginal bleeding or spotting 
- A change in your baby’s movement 
- Severe headaches
- Leg pain and a swollen calf
- Chest pain or breathlessness 
- Stomach pain

__This article has been medically reviewed by Dr Bryony Henderson.__


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Exercising during pregnancy

From listening to your body to what you should avoid, discover everything you need to know about exercising during pregnancy.

Meta information > Your Health > Exercise and pregnancy

How to exercise throughout pregnancy | Livi UK

How to exercise throughout pregnancy 

There are lots of reasons why women of all ages might experience abdominal pain. It’s extremely common and generally easy to manage if you know the cause.

‘Most lower abdominal pain in females isn’t a sign of a serious condition, but occasionally there can be something that needs investigating. If you do experience this type of pain, it’s helpful to familiarise yourself with the area of the tummy that hurts and how to manage the different types of pain,’ says Dr Rhianna McClymont, Lead GP at Livi.

The lower abdomen refers to the part of your tummy below the belly button. Pain in that area might also be referred to as pelvic pain.

## What causes central lower abdominal pain?

A woman’s lower abdomen has two main organs including the uterus (womb) and part of the bowel. Here are some of the potential causes of pain in this area.

### Period pain

Period pain is usually a crampy, dull or tight pain in the middle of the lower abdomen, sometimes spreading further into the lower back. It can be very uncomfortable, but many people find they can manage it with a hot water bottle and painkillers like paracetamol and ibuprofen.

### Urinary tract infection (UTI)

A UTI or [water infection](https://www.livi.co.uk/your-health/utis-your-questions-answered/) can also cause lower abdominal pain in women, as well as urinary symptoms like burning when you pee, or needing to go to the toilet very frequently or urgently.

Mild urinary tract infections like cystitis often clear up on their own if you drink plenty of fluids, but more persistent UTIs might need a short course of antibiotics, which a GP can prescribe. More severe UTIs can affect the kidneys, and might cause lower back pain on either or both sides, and make you feel generally unwell, sometimes with flu-like symptoms. 

It’s important to speak to a doctor as soon as possible if your symptoms are more severe or if you have recurring UTI symptoms.

### Pelvic inflammatory disease

Infections in the reproductive system can affect the uterus, fallopian tubes and ovaries. An untreated infection in the reproductive tract can become very serious and lead to long-term problems, so needs to be treated by a doctor. 

These kinds of infections are often caused by an underlying sexually transmitted infection (STI), so if you’re sexually active, make sure you have regular sexual health screening.

[Pain during sex](https://www.livi.co.uk/your-health/what-causes-painful-sex-and-pain-after-sex/), [spotting](https://www.livi.co.uk/your-health/whats-causing-my-spotting-in-between-periods/) or [discoloured](https://www.livi.co.uk/your-health/is-my-vaginal-discharge-healthy-a-doctors-guide/), smelly discharge can be other symptoms of an STI, or infection of the reproductive system. 

## What causes pain in the lower left abdomen?

‘Any of the causes of one-sided abdominal pain listed above, can just affect the left side, but there are some reasons that the pain might be only on the left – particularly because the bowel is closer to the end of the digestive system,’ says Dr Rhianna McClymont.

### Gas (flatulence)

A common cause for pain on your left side is [trapped or excessive wind and bloating](https://www.livi.co.uk/your-health/whats-causing-your-gas-and-flatulence/). Gas builds up in the digestive tract by swallowing air or as a by-product of gut bacteria breaking down foods. Having some gas is perfectly normal, but having a lot of wind could be a sign of an underlying health issue.

### Polyps or diverticular disease

Diverticular disease can affect the lower left side too, or can cause more generalised pain. Polyps are small wart-like lumps in the bowel, and diverticular disease is a condition where the bowel forms tiny pockets that become inflamed and painful. 

Diverticulitis and polyps can both cause diarrhoea and sometimes bleeding in the bowel. If you notice [[blood in your poo](https://www.livi.co.uk/your-health/10-things-your-poo-can-tell-you-about-your-health/), or if your poo looks black and tarry](https://www.livi.co.uk/your-health/10-things-your-poo-can-tell-you-about-your-health/), it’s important to speak to a doctor straight away.

## What causes pain in the lower right abdomen?

### Appendicitis 

The right lower abdomen contains the part of the bowel where the small intestine meets the large intestine. The appendix is a small part of the bowel which is found where the intestines join, and this can sometimes get inflamed, swollen, and infected. Appendicitis is a painful intestinal disorder that causes intense lower right abdominal pain – although the pain might also spread across the lower abdomen.

## Causes of general lower abdominal pain

### Muscular pain

Muscular pain can account for some cases of lower abdominal pain. A strained muscle from exercise or an injury can be very painful, affect one or both sides, or be more generalised across the lower abdomen. 

Sometimes it’s possible to work out how or when muscular pain started, and this makes it more manageable with regular painkillers and lots of rest.

### Pregnancy

Pregnancy causes major changes in a female’s body shape and places a huge amount of strain on the organs and muscles of the lower abdomen. As well as general discomfort in this area, women often experience pain from Braxton Hicks contractions during the later stages of pregnancy, as the muscles prepare for childbirth. 

You can always speak to a midwife or your local prenatal team for advice if you have any concerns about your health during pregnancy. There are some less common causes of lower abdominal pain in pregnancy that can be more serious. If you experience any severe, sudden or unexplained pain, or pain alongside unusual vaginal discharge or bleeding, go to your nearest A&E for urgent medical advice.

### Ectopic pregnancy

[Ectopic pregnancies](https://www.nhs.uk/conditions/ectopic-pregnancy/) affect around 11,000 people in the UK every year. Women affected can have problems with one ovary or fallopian tube that leads to lower abdominal pain either in one or both sides. This complication can also cause general or central lower abdominal pain, which is usually very severe. 

## When to see a doctor

‘Occasional lower abdominal pain isn’t unusual for women, and period pain is a particularly common cause. Most of the time, this type of pain can be easily managed at home with pain relief, hot water bottles, rest or gentle exercise depending on the cause,’ reassures Dr Rhianna McClymont, Lead GP at Livi.

‘Very severe, unexplained or unmanageable pain, with other concerning symptoms, should be checked by a doctor urgently.’ 
It isn’t always easy to identify the cause yourself, but if you do experience regular pain during your menstrual cycle or notice urinary or bowel problems, make a note of this if you do want to discuss your lower abdominal pain with a GP.


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Livi.co.uk > Your health > What causes lower abdominal pain in women?

What causes lower abdominal pain in females? 

Female abdominal pain can be caused by several different conditions, ranging from small infections to intestinal disorders. Discover the causes of abdominal pain in women, broken down by each area of the tummy

Livi.co.uk > Your health > What causes lower abdominal pain in females? 

What causes lower abdominal pain in females? | Livi

Reviewer > Dr Rhianna

IMG 20200730 224911 865[33] (1)

Dr Rhianna McClymont

What causes lower abdominal pain in women?

How often do you check your breasts? If it’s rarely or never, then you might be inadvertently putting your health at risk. Breast cancer is the most common cancer in women worldwide, representing 25.4% of all cancers in women. It’s also one of the most treatable and the earlier it's picked up, the better the outcome.

‘The earlier breast cancer is detected and treated, the better the prognosis,’ says Dr Elisabeth Rosen, medical doctor and women's health specialist at Livi. ‘That’s why it’s important to get into the habit of checking your breasts for lumps regularly.’

## When is the best time to check your breasts?

‘Knowing how your breasts should look and feel normally can help to alert you to any unusual changes that may be a symptom of breast cancer,’ says Dr Rosen. ‘Ideally, you should check your breasts once a month on the same day, a few days after your period.’ 

Like the rest of your body, your breasts react to hormonal changes during your menstrual cycle. Many women, for example, find their breasts naturally become swollen, tender and even lumpy in the week or so leading up to their period, so that’s not an optimal time to check them. 

If you’re postmenopausal, you should be checking your breasts for lumps on the same day every month.

## Am I eligible for breast screening?

The risk of breast cancer increases with age and most breast cancers are diagnosed after age 50. It’s important to have regular breast screening, called a mammogram, when you’re invited. The aim of mammograms is to detect breast cancers early, when they’re too small to see or feel. 

In the UK, women aged from 50 to 71 are invited for breast screening every 3 years. Anyone who has symptoms or a family history of breast cancer is also eligible to have a mammogram.

## How can I know what’s normal for me?

‘Look out for anything that’s different in how your breasts, armpits and nipples look and feel,’ says Dr Rosen. By checking regularly, you’ll become familiar with what’s normal for you regarding: 
- skin colour
- skin texture
- feel and shape of your breasts
- look, feel or shape of the nipples

## Most breast lumps aren’t cancer, right?

‘If you find a lump in your breast, you should always have it checked by a GP,’ says Dr Rosen. But a new symptom doesn’t automatically mean you have breast cancer. Around 9 in 10 breast lumps are benign. 

‘It could be that you’ve simply got a cyst, or a fibroadenoma, which is a non-cancerous, solid growth of fibrous or glandular tissue,’ says Dr Rosen.

Most cysts go away by themselves and are nothing to worry about. But if a cyst is large or causing discomfort, the fluid can be drawn off. Fibroadenomas may also disappear over time. In some cases, surgery (an excision biopsy) might be needed to remove it.

## What changes am I looking for?

Always consult a doctor if you notice any of the following changes:
- A new lump, bumpy area, swelling or thickening in one breast or armpit that’s different to the same area on the other side
- A change in the size, outline or shape of your breast
- A change in the look or feel of your skin, such as puckering or dimpling
- Nipple discharge (not milky, for example, if you’re breast-feeding)
- Bleeding from your nipple
- A rash or redness on or around the nipple area or a sore that doesn’t heal
- Any change in the position of the nipple – eg: becomes inverted, or is pointing differently
- Any new discomfort or pain in the breast (although pain is a rare symptom of breast cancer)

‘Checking your breasts for lumps monthly will help you to become aware of how they look and feel,’ says Dr Rosen. ‘It’s perfectly normal, for example, to have one breast that’s slightly bigger than the other. Most women have slightly asymmetrical breasts. What you’re looking for is anything that’s not normal for you. This means any changes and symptoms that weren’t there before.’  

## How to do a breast self-examination – a checklist

When you check your breasts, stand in front of the mirror with your shoulders straight and your arms on your hips. Observe the following:
- Are your breasts the same size and shape as usual?  
- Are there any visible distortions or swellings?
- Are there any changes in colour or texture to your breasts, armpits or nipples? For example, are there any areas that look red, inflamed, crusty, puckered or dimpled? Is there any soreness, rash or swelling? 
- Do you notice any indentations? This may be caused by a lump or tumour that’s pulling the skin inwards
- Has your nipple changed position; drawn inwards instead of protruding outwards?
- Check whether there’s any fluid or discharge coming out of your nipples eg: watery, yellow or bloody

Now raise your arms above your head. Notice how your breasts move while you do so. Are they moving in the same way as always? Breast cancer can make breasts less mobile. Keeping your hands above your head, look for any of the changes above.

Now check your breasts for how they feel. Standing or sitting, use your right hand to feel your left breast, and your left hand to feel your right breast. If you're less mobile, you can also lie down. Now:

- Keeping your index and middle fingers flat and together, using circular motions, feel your breast – from side to side, from the collarbone to the top of your abdomen and from your armpit to your cleavage. Begin at the nipple, moving towards the outer edge of the breast. Make sure you cover the whole breast. Next do the same of your armpit area.
- Do you feel any lumps, bumps or swellings? 
- Does skin feel different than usual?

## When to get help for a breast lump

‘If you find a breast lump or notice any other signs, always see your doctor as soon as possible,’ says Dr Rosen. ‘Try not to panic, as the vast majority of lumps are benign and there may be other reasons for them. Also, lumps that hurt are usually not cancerous but hormonal. Your GP will examine you and refer you to a breast cancer unit or clinic for further tests.’

## How will I be tested for breast cancer?

If you have symptoms, you may be referred for a mammogram. You may also need an ultrasound scan, which uses high frequency waves to create an image of part of the body.

If breast cancer is suspected, you will have a biopsy, which examines cells taken from your breast to see whether they are cancerous. A needle biopsy (where a sample of tissue is taken from a lump) is the most common type of biopsy. A biopsy can also be done by needle aspiration, where a sample of breast cells is removed using a small needle. 

If a diagnosis of breast cancer is confirmed, tests will be needed to confirm the stage and grade of the cancer, and the best method of treatment.

## What about gene testing for breast cancer?

Certain types of breast cancer may be genetic. For example, if you have BRCA1 or BRCA1 genes, this may raise your risk of developing breast cancer, and ovarian cancer.

If you’re concerned, for example, if breast cancer runs in your family, and you’re worried you may also develop it, talk to your GP about genetic testing. 

Not everyone is eligible and you would usually have to have good reasons to have this done. For example, if a relative has already been tested and shown to carry the BRCA1 or BRCA2. Testing is often inconclusive. You may also need to consider whether you really want to know, as a positive result may cause ongoing anxiety. 

Start with a discussion with your GP about your family history and they will help you decide on next steps.

__This article has been approved by women’s health specialist Dr Elisabeth Rosen.__


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Livi.co.uk > Your health > Are you checking your breasts correctly? A doctor’s guide

Are you checking your breasts correctly? A doctor’s guide

Most breast lumps are harmless. But if they’re cancerous, then the earlier they are treated the better — so, make sure you’re checking your breasts regularly

How to Check your Breasts for Lumps - A Doctor's Guide

Whether you’ve just been called up or you’re looking ahead to your next cervical screening (cervical smear) appointment, it’s more important than ever not to miss this routine test.

There were an estimated [33,000 cases of cervical cancer in Europe in 2018](https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30122-5/fulltext),  with 15,000 people dying from the disease. The average age at diagnosis globally is 53, yet it’s the [third most common type of cancer affecting people under the age of 45](https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30482-6/fulltext).  

‘Each year in the UK alone, around 4,500 lives are saved by cervical screening – which shows the importance of having regular tests,’ says Dr McClymont.

## When do I need to go for a cervical screening?

‘Any person with a cervix is invited for screening automatically when they reach the age of 25, and if the results are normal they’ll receive further invites every 3 years until the age of 49,’ Dr McClymont explains. 

‘Between the ages of 50 and 64, you’ll be invited every 5 years.’

You won’t usually need to have cervical screening if you’re pregnant – until at least 12 weeks after you’ve given birth. This is because pregnancy can make it harder to get clear results.

## What if I’m embarrassed by the thought of a 'smear test'?

Despite the evidence that regular screening is so effective in detecting abnormal cell growth and the virus that causes cervical cell changes, human papillomavirus (HPV), many people avoid the tests due to embarrassment or anxiety. 

‘People who avoid cervical screening often say awkwardness is the biggest reason for doing so,’ says Dr McClymont. ‘But it’s a short procedure, and your doctor or nurse has seen it all before – they’re just interested in testing your cervix. This is a simple test that could save your life, and there’s really no reason to be embarrassed.’ 

## What does the cervical screening test for?

‘The test looks for abnormalities in the cells of the cervix, as well as for HPV, which, if present, can cause abnormal cell growth,’ says Dr McClymont.

## Has the cervical screening process changed as a result of the pandemic? 

As a result of lockdowns, reallocation of staff and the prioritisation of other urgent care, [the pandemic has caused significant disruption to cervical smear screening programmes](https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(21)00078-8/fulltext)  throughout Europe. So, it’s more important than ever to attend your cervical screening when you’re called.

The test itself hasn’t changed as a result of the pandemic, says Dr McClymont, but you might find that processes at your local GP surgery have changed. ‘The nurse will wear a mask, and there may be fewer appointment slots available as it takes longer to thoroughly clean a clinical room between patients.’

## How can I prepare for a cervical screening if I’m anxious or nervous?

It’s not unusual to be anxious before a cervical screening. Some people find that asking for a female nurse or doctor helps them feel more at ease, and relaxation breathing can help too. You can also ask the person performing the test to start with the smallest speculum. 

‘If you’re nervous about undressing, wearing a loose skirt is a good idea as you won’t need to fully remove it for the procedure,’ says Dr McClymont.

## What should I expect during the test itself? 

The nurse performing the cervical screening will explain to you exactly what will happen when you arrive and answer any questions you have before the test. 

- You’ll be invited to lay on an examination couch behind a screen and remove clothing from your lower half
- There will be a sheet or piece of clinical roll for you to cover your groin with, and you’re entitled to have a chaperone in the room with you if you’d prefer
- You should lie on your back with your feet together and knees apart
- The nurse will insert a lubricated plastic speculum into your vagina to enable good visualisation of your cervix
- A small 'brush' is then used to remove some cells from the cervix, which are deposited in a small pot and sent to the laboratory for analysis

The examination itself usually only takes a few minutes.

## Can it ever be painful or uncomfortable?

‘A cervical screening is usually not a painful procedure, although some people report mild discomfort,’ says Dr McClymont, adding that it’s usually worse if you’re tense or anxious, as your pelvic floor muscles are more likely to tighten, making the procedure more difficult. 

‘If you’re very anxious, take some deep breaths and try to relax as much as possible.’

## Is it normal to bleed after the screening? 

‘A small amount of spotting after the procedure is quite common, but it should resolve very quickly,’ says Dr McClymont. ‘Wearing a pantyliner for a few hours is normally all that’s required.’

## What happens after the screening? 

After the test, the specimen is sent to a laboratory for analysis. It usually takes around 2 weeks for the results to come back.

‘If your results are normal, no further action is required, and you’ll be invited for another routine smear 3 or 5 years later, depending on your age,’ says Dr McClymont. ‘If abnormalities are found, however, you’ll usually be invited for a procedure called a colposcopy, to look at your cells in more detail.’

A colposcopy, Dr McClymont explains, is a procedure similar to a cervical smear, but it’s performed in hospital using a microscope and special dye to stain the cervix cells and make abnormalities easier to identify. ‘Having abnormalities in your cells usually doesn’t mean that you have cancer, but further tests or treatment are recommended to prevent cancer developing in future.’

## Do you need to have a cervical screening if you’re not sexually active?

People who have never been sexually active have a very low risk of cervical cell abnormalities – but not a zero risk. That’s why attending a screening is always advisable, regardless of your sexual history. ‘If you’ve never had sex, this may understandably make you nervous,’ says Dr McClymont. ‘It’s best to chat to a doctor or nurse about your individual circumstances.’


livi.co.uk >  article page >   CTA

Talk to a GP about your smear test

Livi.co.uk > Your health > What happens during a cervical screening? How to prepare and what to expect

What happens during a cervical smear test? How to prepare and what to expect

Regular cervical smear tests save lives. Lead Livi GP Dr Rhianna McClymont explains what you can expect from your cervical smear test

Livi.co.uk > Your health > What happens during a cervical smear test? How to prepare and what to expect

What happens in a cervical smear test? How to prepare | Livi UK

livi.co.uk > medical reviewer

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What happens during a cervical screening? How to prepare and what to expect

Endometriosis and polycystic ovary syndrome (PCOS) are two conditions that affect millions of people around the world. PCOS affects around 8% to 13%  of women and people with uteruses globally, and endometriosis affects around 10%.  While they both can cause irregular bleeding and problems getting pregnant, there are some key symptom differences to be aware of.

Here, Dr Elisabeth Rosen, a medical doctor at Livi who specialises in gynaecology and obstetrics, gives her advice on how to tell if severe period pain and other symptoms are caused by PCOS or endometriosis, and when to talk to a doctor.

## What is PCOS and what are the key symptoms?

‘PCOS is a complex disorder that causes elevated levels of sex hormones,’ says Dr Rosen. ‘Polycystic ovaries contain fluid-filled cysts known as follicles, in which eggs develop but usually never mature enough to ovulate. This affects the menstrual cycle, leading to [irregular bleeding](https://www.livi.co.uk/your-health/what-causes-heavy-or-irregular-periods-a-doctors-guide/) and problems ovulating.

‘In the long term, living with PCOS can lead to a higher risk of type 2 diabetes, cardiovascular diseases and uterine cancer.’

The most common PCOS symptoms include:

- Irregular periods, long gaps between periods, or no periods
- Excessive hair growth on the face, chest and abdomen
- Weight gain
- [Acne](https://www.livi.co.uk/your-health/acne-types-and-their-treatments-help-to-clear-your-skin/)

## What is endometriosis and what are the key symptoms?

Endometriosis is an inflammatory condition in which cells similar to the ones in the lining of the womb are found elsewhere in the body, explains Dr Rosen. When these start to grow, they cause local inflammation and scarring. Endometriosis is most commonly found in the pelvis, but can be found in other parts of the body.

Not everyone who has endometriosis gets symptoms, and they can vary over time and between different people.

The most common endometriosis symptoms include:

- Severe period pain
- Heavy or irregular periods
- Pelvic or lower back pain, outside of menstruation
- Urinary tract problems, like blood in the urine or pain when emptying your bladder
- Pain during sex
- Pain while pooing
- Fatigue and lack of energy

## What’s the link between endometriosis, PCOS and infertility?

Both endometriosis and PCOS are linked to an increased risk of infertility. ‘As PCOS is a condition that causes problems with the release of eggs from the ovaries, it can make getting pregnant more difficult,’ says Dr Rosen.

More research is needed to determine why endometriosis affects fertility, but this may be caused by inflammation, scarring or deformation in the pelvic area.  People who have minimal or mild endometriosis usually have a better chance of becoming pregnant than those with more severe cases.

## How is PCOS diagnosed?

There’s no single definitive test to diagnose PCOS, which can make it harder to identify. A doctor will ask questions about your symptoms and experiences, explains Dr Rosen. They will refer you for a blood test to test your hormone levels and do an ultrasound to check for signs that your ovaries are polycystic.

## How is endometriosis diagnosed?

Endometriosis can take 6 to 7 years on average to diagnose.  Like PCOS, it’s usually a multi-stage process. Dr Rosen advises that a doctor will first ask about your symptoms, before referring you for further testing such as an ultrasound or laparoscopy – a form of keyhole surgery – to check for the presence of endometriosis lesions.

## Can you have both PCOS and endometriosis at the same time?

There are people who have been diagnosed with both conditions,  but Dr Rosen explains that while it’s possible, it’s not very common.

## When should I see a doctor about severe period pain?

Severe period pain is more closely linked to endometriosis than PCOS. ‘If you can manage the pain with paracetamol or ibuprofen a couple of days per month and it decreases over a couple of years (after your periods have just begun), there’s usually nothing to worry about.’

Dr Rosen emphasises that if you’re concerned, it’s better to speak to a doctor, especially if your menstrual pain affects your ability to go to work or school.

## How can I prepare to see a doctor about severe period pain – and increase my chance of a faster diagnosis?

Dr Rosen advises keeping track of your symptoms and menstrual cycle to help you spot patterns. You can use a cycle tracker app or a physical diary.

According to Dr Rosen, the more information you can give, the better. ‘Write any symptoms down that you feel may be associated with either your irregular bleeding (for suspected PCOS) or your severe period pain (for suspected endometriosis), including how long they last and when they occur,’ she says.

This also applies to painkillers. ‘Rather than just saying: “I take paracetamol,” it’s good to know how much, how often and for how many days,’ adds Dr Rosen.

## What can I do if I feel my pain isn’t being taken seriously?

Unfortunately, many women encounter difficulties getting diagnosed with endometriosis and PCOS, but being aware of this can help. 

If you don’t get a diagnosis immediately, you should keep pushing for answers, says Dr Rosen. ‘Even if it isn’t endometriosis or PCOS, a doctor will be able to carry out the necessary investigations to understand what’s causing your pain, irregular bleeding or other related symptoms.’

If you’re ever concerned about your period or period-related symptoms, book a meeting to discuss it with a doctor.

__This article has been medically approved by Dr Elisabeth Rosen, a medical doctor at Livi who specialises in gynaecology and obstetrics.__


livi.co.uk > Your health > Severe period pain, endometriosis or PCOS – how can you tell the difference?

Severe period pain, endometriosis or PCOS – how can you tell the difference?

Wondering whether your heavy periods or extreme period pain could be the sign of an underlying issue? Here’s what you need to know about two common, but often misunderstood, conditions

livi.co.uk > Your health >Severe period pain, endometriosis or PCOS – how can you tell the difference?

Differences between period pain, endometriosis & PCOS | Livi UK

## Quick facts

- Pelvic pain is widespread, and chronic pain affects 1 in 6 women
- Women are less likely to report chest pain and more likely to dismiss heart disease symptoms than men
- Ovarian cancer is often diagnosed at a late stage, despite being one of the most common gynaecological cancers

If you’ve ever found yourself dismissing or brushing off a health symptom, you’re not alone. Lots of women feel embarrassed, anxious or scared of being judged when it comes to speaking up about certain health issues.

Many female conditions can also be harder to identify – like endometriosis, a debilitating condition that affects 10 percent of women in the reproductive age group worldwide  and takes an average of 7.5 years from the onset of symptoms to get a diagnosis. 

This likely stems from the historic gender inequality within the world of healthcare. ‘For years, women’s health has been under-prioritised, meaning it may take longer to get a diagnosis, and until recently clinical trials were mainly conducted on men,’ says Dr Elisabeth Rosen, a medical doctor at Livi who specialises in gynaecology and obstetrics.

‘It’s important to always put your health first as you only have one body and it’s supposed to last for a very long time. You should always speak to a doctor if you have an issue with anything that you don’t feel familiar with or are worried about.’

Here are some key women’s health symptoms that you shouldn’t ignore.

## 1.	Breast changes

Regularly examining your breasts is an important way to detect breast cancer. It’s now the world’s most commonly diagnosed cancer. 

‘It’s very important to check for changes in your breasts,’ says Dr Rosen. ‘Every woman should examine their breasts once a month at the same point in their menstrual cycle. It’s the most important life insurance a woman can give herself.’ 

A breast lump is the most recognisable  (and common ) [sign of breast cancer](https://www.livi.co.uk/your-health/are-you-checking-your-breasts-correctly-a-doctors-guide/). Reassuringly, most breast lumps are not cancerous.  Other breast changes to look out for include:

- The shape and size of your breasts
- A lump or swelling in your armpit
- Discharge from your nipples
- Thickening or dimpling of the skin
- An inverted nipple
- Red areas
- A rash

‘If you notice any changes, it’s worth getting them checked out by a doctor,’ advises Dr Rosen.

## 2.	Discomfort or pain in your chest

If you experience discomfort or pain in your chest, this may be an indicator of something more serious. If it suddenly occurs and doesn’t go away, it may even be a sign of a heart attack. 

‘The most common heart attack symptoms for women include chest pain or discomfort, shortness of breath, lethargy, and pain radiating in the arms, back, jaw and neck. You could also suffer from a sensation of heaviness and pressure on your chest,’ says Dr Rosen. ‘Get emergency help straight away if you feel any strange sensations in your chest.’

Despite coronary heart disease (CHD) being the single biggest killer of women worldwide,  women are less likely to report chest pain and more likely to dismiss symptoms. They’re also 50 percent more likely than men to be initially misdiagnosed when it comes to heart attacks. 

Dr Rosen points out that chest pain could also indicate a lung embolism, which affects more women than men and requires urgent medical assistance, as it can be life-threatening.

## 3.	Heavy or irregular bleeding

There are many factors that affect your menstrual cycle, including stress, weight loss and doing too much exercise.  But if your periods are heavier than normal and you have irregular bleeding, it’s a good idea to discuss this with a doctor.

‘With abnormal bleeding, it’s important to get it checked as there could be an underlying condition that needs to be treated. Apart from being an inconvenience, heavy bleeding can cause anaemia and can also be a sign of fibroids, polyps, or womb or cervical cancer,’ says Dr Rosen.

‘Irregular bleeding is usually related to your menstrual cycle not working properly. Polycystic ovary syndrome, sexually transmitted infections (STI), ovarian cysts, benign growths in the womb or the lining of the cervix, or cervical or womb cancer can all cause irregular bleeding.’

She also recommends seeing a GP straight away if you have postmenopausal bleeding, as this is abnormal.

## 4.	Bloating

Feeling bloated occasionally isn’t necessarily something to worry about, but it’s important to know that increased abdominal size is one of the main signs of ovarian cancer.  Unfortunately, ovarian cancer is often diagnosed at a late stage and there’s generally a low awareness of the risk factors and symptoms,  even though it’s one of the most common gynaecological cancers. 

‘Ovarian cancer is a harder condition to identify,’ says Dr Rosen. Other associated symptoms of ovarian cancer to look out for include:

- Lower abdominal pain
- Irregular bleeding
- Increased urinary urgency
- Lower back pain
- Loss of appetite
- Feeling full when eating
- Weight loss
- Changes in your bowel habits

Other common causes of bloating include irritable bowel syndrome (IBS), food intolerance and constipation. 

## 5.	A persistent low mood

[Depression](https://www.livi.co.uk/your-health/help-for-depression-7-daily-tools-to-improve-your-mood/) appears to be more prevalent in women.  The signs and symptoms to be aware of include a persistent low mood, irritability, low energy and difficulty concentrating and sleeping. 

‘Depression is a condition that needs to be treated, so it’s important to discuss it with a doctor. [Postnatal depression](https://www.livi.co.uk/your-health/help-for-postnatal-depression/) is an underdiagnosed condition and many women feel ashamed about getting help because the expectations placed on a new mother can be high,’ says Dr Rosen.

## 6.	Abnormal discharge

Vaginal discharge is something that most women experience, and it’s needed to keep the vagina moist and protect against infections.  According to Dr Rosen, healthy discharge doesn’t have a smell and is either clear or white. It’s also common to see changes in the amount and consistency throughout your menstrual cycle. 

‘If you’re experiencing discharge that is unusual for you, speak to a GP,’ says Dr Rosen. ‘Abnormal discharge could be a sign of an infection.’ Common infections like thrush can often be treated with over-the-counter medicine.  But abnormal discharge can also be a symptom of an STI, like gonorrhoea or chlamydia. If these STIs are left untreated, they can cause pelvic inflammatory disease (PID), which can lead to damage to the reproductive organs  and sometimes infertility. 

‘It’s important not to ignore symptoms because if infections are ruled out, abnormal discharge could be a sign of cervical cancer,’ says Dr Rosen.

## 7.	Pelvic pain

Pelvic pain is widespread and chronic pain affects 1 in 6 women.  ‘Common causes of pelvic pain include ovulation, endometriosis, [a urinary tract infection (UTI)](https://www.livi.co.uk/your-health/utis-your-questions-answered/) or PID. If you’re pregnant, pelvic pain can be caused by an ectopic miscarriage, miscarriage or premature labour. Other causes include ovarian cysts, IBS, constipation, appendicitis, inflammatory bowel diseases and ovarian cancer,’ says Dr Rosen. ‘If you have sudden, severe and long-term pelvic pain, seek an appointment with a GP.’

Learn more about what causes [abdominal pain in women](https://www.livi.co.uk/your-health/what-causes-lower-abdominal-pain-in-women/). 

## 8.	Pain during intercourse

Nearly 3 out of 4 women experience painful sex at some point in their lives.  ‘Pain during intercourse isn’t normal, but many women suffer from it from an early age and often don’t seek help due to embarrassment,’ says Dr Rosen. 

There are a variety of reasons why sex may be painful, including:

- Endometriosis
- Vaginal dryness
- Atrophic vaginitis (thinning and drying of the vaginal walls, which occurs most often after menopause)
- PID
- Ovarian cysts
- Fibroids
- Infections
- Vulvodynia (vulval pain)
- Vaginismus

‘Discuss it with a doctor and they’ll help determine the cause of your pain,’ advises Dr Rosen.

## 9.	An intense headache

The leading symptom of a migraine is an intense headache on one side of the head.  Women experience migraines 3 times as often as men.  According to Dr Rosen, it’s partly due to oestrogen levels changing, so many women will experience it at the same time in their menstrual cycle each month or during [perimenopause](https://www.livi.co.uk/your-health/7-signs-of-perimenopause-a-doctors-guide/). 

‘Additional symptoms of a migraine include nausea, visual disturbances and increased sensitivity to light. Sometimes you may also experience sweating, diarrhoea and poor concentration. In very severe cases, your nervous system can be affected – you may have problems speaking properly or you may become dizzy and lose consciousness. It’s important to seek help to rule out other conditions like a tumour,’ says Dr Rosen.

Discover what other [types of headaches](https://www.livi.co.uk/your-health/9-types-of-headache-and-what-you-can-do/) might mean.

## 10.	Ongoing fatigue

While it’s very common for people to feel tired, if you’re experiencing ongoing fatigue, your body may be trying to tell you something is wrong. Dr Rosen suggests that there could be many different reasons for your fatigue, including:

- Iron deficiency
- Lack of vitamin D
- Depression
- Heart disease
- Lack of quality sleep

‘[Fatigue ](https://www.livi.co.uk/your-health/whats-causing-your-tiredness/)is one of the main symptoms of an underactive thyroid (hypothyroidism), an autoimmune disease that mainly affects women. The condition has symptoms of tiredness, feeling cold, lack of concentration, depression, dry skin, brittle hair and nails, constipation, weight gain, a low heart rate and muscle pain and weakness. Speak to a GP if you’re experiencing these symptoms.’

Book a meeting to discuss any symptoms or issues that you’re worried about with a doctor.

__This article has been medically approved by Dr Elisabeth Rosen, a medical doctor at Livi who specialises in gynaecology and obstetrics.__


Livi.co.uk > Your health > 10 women’s health symptoms you should always talk to a doctor about

10 women’s health symptoms you should always talk to a doctor about

It may be tempting to dismiss health symptoms that seem minor, but there are some issues you shouldn’t ignore. Dr Elisabeth Rosen, a Livi doctor who specialises in gynaecology and obstetrics, shares her advice on the women’s health issues to be aware of

livi.co.uk > Women’s health > Articles

Women’s health

Livi UK

Livi is Europe’s leading digital healthcare provider. We combine digital technology with clinical expertise to help NHS services and health insurers solve the biggest challenges in healthcare.