SAMPLE QUESTIONS AND ANSWERS

Q.    I am a 52 year old woman. I have a dragging feeling in my groin that has been getting worse for six months. I also keep wetting myself whenever I cough or laugh. My doctor says it is a prolapse. What is a female prolapse and how can it be cured?

A.    A prolapse is a protrusion of an organ into an abnormal place.

    The vagina leads from the outside up to the uterus. During childbirth, it becomes very stretched, and it does not always return to its original size. The muscles around the vagina may become weakened and the ligaments supporting the uterus may also become stretched and sag. After some years, this may lead to the uterus slowly moving down the vagina to a point where it completely fills it. Occasionally it may even protrude through to the outside. This is a uterine prolapse.

    In other women, part of the bladder which is in front of the vagina, may push back into the vagina causing a bladder prolapse and difficulty with passing urine. The large gut which is behind the vagina may also push forward into the vagina as a rectal prolapse, this time causing bowel problems. Often there is a combination of these three types of prolapse.

    Treatment is usually successful by means of an operation. In some older women, a ring inserted into the vagina may be used to hold everything in the correct place. Younger women can help prevent the problem by undertaking special pelvic floor exercises under the guidance of a physiotherapist both before and after the delivery of their baby.

Q.    I am trying to get pregnant, but so far haven't had any luck. Can you tell me just when is a woman fertile during the month?

A.    The day a woman starts bleeding with her period is day one. A woman ovulates 14 days before her next period. If she has a 28 day cycle, she will ovulate on day 14, but if the cycle is 35 days, she will ovulate on day 21, and with a 24 day cycle, ovulation is on day 10.  

    If the cycle is regular, it is easy to work out the day of ovulation, but if the cycle is irregular, it can be much harder.

    Other clues to ovulation are are rise in the basic temperature and a change in the vaginal mucus.

    A woman is fertile from two days before ovulation (the sperm can survive this long in her body after sex) to 4 days after ovulation. With a regular 28 day cycle she is fertile from days 12 to 18. If you wish to avoid pregnancy, sex should be avoided for an additional two days either side of this fertile time.

    If pregnancy is desirable, sex on the day of ovulation and for the two days afterwards is best.

Q.    What symptoms does a person with stress develop? How can you tell if those symptoms are due to stress or something else?

A.    Everyone experiences stress in their lives, but some people cope with it far better than others, and some experience far more due to their individual circumstances.

    Stress can cause a very wide range of physical illnesses. Chronic headaches and peptic ulcers are probably the best known diseases due to stress, but depression, heart disease, migraines , diarrhoea, shortness of breath, sweating, passing excess urine, rashes, vomiting and a host of other symptoms may be an outward manifestation of inward emotional turmoil.

    There is often no easy way to tell if the symptoms are due to stress or some other underlying disease, and doctors may perform numerous blood and other tests to exclude any other possible diagnosis.