The pharmacy team is perfectly placed to help female customers tackle some of the gender-specific problems that women are susceptible to

Bacterial vaginosis

Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge in women of reproductive age. Symptoms include a greyish or greyish-white discharge, which is frequently accompanied by a noticeable fishy smell. Unlike many other common causes of vaginal discharge, BV does not cause soreness, irritation or itching.

BV occurs when there is an overgrowth of harmful bacteria over good bacteria, causing the vagina to lose its normal slight acidity. It is a difficult condition to identify because symptoms are often mild and many women are symptomless. However, an OTC test has recently been launched to help women identify the condition. All women are at some risk of developing BV, but it is identified more frequently in those who are sexually active.

Over-the-counter products which restore the acid-alkali balance of the vagina can be recommended. Sometimes BV may clear without treatment and other cases may need to be treated with an antibiotic. Pregnant women should be referred to the pharmacist because they may be at a slightly increased risk of pregnancy complications.

Vaginal thrush

At least three out of four women will experience thrush at some point in their lives. Thrush is a yeast infection caused by an overgrowth of the fungus Candida albicans. Symptoms include severe vaginal itching and a cottage cheese-like discharge and it can make the vagina and vulva red and sore. It is the second most common reason for vaginal discharge.

Thrush is often triggered by taking antibiotics, which kill the friendly bacteria that naturally suppress Candida albicans. It can also be caused by a weak immune system, the contraceptive pill, pregnancy, diabetes, and wearing tight synthetic clothing. Thrush can be passed on to men by sexual contact.

OTC antifungal creams, tablets or pessaries can be recommended. If this is the first time the customer has had thrush, they may benefit from a visit to a GP or nurse to confirm the diagnosis. Some people will experience recurrent bouts of thrush and may also need to see a GP.

Cystitis

Cystitis is an inflammation of the bladder, usually caused by bacteria entering the urethra from outside and infecting the bladder. Symptoms include a burning sensation during urination, frequent urination, cloudy and foul smelling urine and pain directly above the pubic bone.

Mild cases will often get better by themselves within a few days. Some people experience frequent episodes of cystitis and may need regular or long-term treatment. Cystitis can sometimes lead to a more serious kidney infection, so customers whose symptoms don’t improve should be advised to see a GP.

Pharmacy teams can also offer the following self care advice:

• Take painkillers to relieve any pain
• Drink plenty of water
• Hold a hot water bottle on the tummy or between the thighs
• Avoid having sex
• Observe toilet hygiene by always wiping front to back to avoid transferring bacteria from the bowel to the urethra.

OTC cystitis treatment products may also help.

Period pain

Many women experience period pain lasting 48-72 hours at some point in their lives. For the majority, it will be mild although uncomfortable pain that they can treat themselves at home with OTC painkillers. A hot water bottle or heat therapy product applied to the abdomen or gentle exercise may also help.

Period pain is caused by muscle cramps in the lower tummy, which can sometimes spread to the back and thighs. Sometimes the pain comes in intense spasms, while at other times the pain may be dull but more constant. Occasionally, period pain can be caused by an underlying medical condition, such as endometriosis or pelvic inflammatory disease.

If the customer reports pain that becomes more severe and is interfering with their usual activities, they should be advised to see a doctor. The intrauterine system (IUS) and progesterone contraceptive pill can reduce the amount of pain and bleeding during periods.

Bladder weakness

It is estimated that approximately one-third of women in the UK experience bladder weakness or stress urinary incontinence, but embarrassment stops many from seeking help. It is caused when urine leaks out at times when the bladder is under pressure – for example, when someone coughs or laughs, sneezes or lifts something.

Anyone can develop symptoms at any age, but a weak bladder usually occurs when the muscles in the pelvic floor or sphincter have been damaged or weakened. In women, these muscles can be weakened during pregnancy and after the menopause.

Pharmacy teams can advise on lifestyle changes, such as losing weight and cutting down on caffeine and alcohol, which may help. They can also direct customers to the range of bladder weakness protection products sold in pharmacy.

Menopause

The menopause occurs when a woman stops having periods and is unable to get pregnant naturally. Most women will go through the menopause between the ages of 45 and 55. Symptoms include hot flushes, night sweats, difficulty sleeping, low mood or anxiety and reduced sex drive.

If symptoms are troubling, a woman should be advised to see a GP, who may prescribe hormone replacement therapy (HRT). Pharmacy teams can recommend lubricants for vaginal dryness that can be bought in the pharmacy. Advice can also be given on eating a healthy, balanced diet and taking plenty of exercise, which may also help to relieve symptoms.