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Ligne titre Doctors' advice.

Gynaecology and Women's Health Counseling

Our doctors answer your questions

You might have a quiery about your health? A doubt about your body? An issue that concerns you? Our doctors are here to answer your questions and give you the right advice. To facilitate navigation, topics are grouped according to your age group.

14-18 years

1

My breasts aren’t the same size – is this normal?


A difference in the size of your breasts is a frequent occurrence and is completely normal during adolescence. It happens as your breasts grow, during puberty. But don’t worry, this difference will balance itself out over time until it completely disappears.

The difference in size is caused by different responses to hormonal signals in glandular tissue growth. If asymmetry persists after 18 years old, correction with lipostructure is possible.

Do not hesitate to contact us if in doubt.

2

My periods don’t come at the same time each month and sometimes I don’t have any bleeding at all. What’s wrong?


Irregular cycles are very frequent throughout adolescence and are no cause for concern. Cycles can be highly varied and may be longer or shorter than 28 days.

The absence of menstrual bleeding is most frequently linked to cases of psychological or physical stress on the body. It can also be associated with polycystic ovary syndrome.

Once your cycles become more regular, if you experience more than 3 months without menstrual bleeding, it would be wise to come in for a consultation in order to carry out a hormonal assessment and an ultrasound of the genital organs in order to identify a diagnosis.

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18-26 years

1

What are the different types of contraception that I can use?


Generally speaking, there exist two main methods of contraception: the “barrier” method, such as condoms or IUDs (intrauterine device), and hormonal methods, such as the contraceptive pill. Before deciding which form to use it is advisable to discuss the options with your gynaecologist.

Here are the most common methods:

Condom: the advantage of a condom (male and female) is that it will also protect you from the HIV virus and the majority of other sexually transmitted diseases.

IUD: this intrauterine device was originally reserved uniquely for women who had already given birth due to concerns regarding the possibility of infection or difficulties in fitting the device. More recently, mini IUDs have been introduced to the market and have been met with great success and no increase in infection rates. Two types of IUD are generally favoured – one in copper and one using hormones (Mirena ®, Jaydess ® , Kyleena ®) – with a preference for the hormonal IUD in case of a risk of blood clots.

This is a reliable method of contraception. What’s more, with the IUD you no longer have to remember to take a pill every day. The device can keep working for between 3 and 10 years, depending on the model.

Contraceptive pill: there exist several generations of contraceptive pill with varying hormonal compositions. It is important to consult your gynaecologist to find the pill which is best suited for you.

Contraceptive patch: the patch, which you stick on your skin by yourself, contains two types of hormone: oestrogen and progestogen. It must be changed every week for three weeks, with the fourth week being the week of menstruation.

Implant in the arm: a cylindrical rod, 4cm long and 2mm wide, is inserted into your arm under local anaesthetic. The insertion takes just a few minutes and the implant works for three years. This method, in which only progesterone is released, may be used in cases where there is a risk of blood clots.

Contraception injection: progesterone is injected intramuscularly every 10 weeks. This method is often prescribed for women who frequently forget to take their contraceptive pill. However, it may worsen existing skin problems such as acne.

NuvaRing ® vaginal contraceptive ring: you insert this flexible ring into your vagina yourself. It provides oestroprogestative contraception for three weeks. During the fourth week, the week of menstruation, the ring is removed.

Other methods of contraception also exist, such as the diaphragm and spermicidal gel, but these two methods are less effective and more complicated to use.

2

Which is the most reliable method of contraception?


The reliability of different contraceptive methods is measured according to the Pearl-Index. According to this index, the most effective reversible contraceptive methods are the IUD and the implant.

The contraceptive pill is also an effective method provided that you remember to take it at the right time and that you use a condom when taking antibiotics.

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26-35 years

1

I have very strong pains before and during my periods. Could it be a sign of endometriosis?


Yes. Endometriosis is a gynaecological condition in which the tissue that is usually found inside the uterus is found outside of it, around the organs in the pelvis (ovaries, Fallopian tubes, ligaments, intestines or bladder). This is one of the most frequent causes of infertility.

An estimated 20% of women of child bearing age suffer from endometriosis. The development of endometriosis after the menopause is however very rare.

The most common clinical symptoms are extremely strong pains before and during menstruation, as well as during sexual relations, bowel movements and urination. Other symptoms include weakness, bloating and fertility problems.

If you are experiencing the symptoms mentioned above, endometriosis may be considered a potential cause, but a definitive diagnosis will only be pronounced after endoscopic imaging (ultrasound or MRI scan) or investigation.

Treatment depends on the type of pain experienced, the impact on your quality of life and the desire for fertility. It is also entirely dependent on the stage and extent of the condition.

The first step of treatment is to begin taking a contraceptive pill, followed by additional, more targeted progesterone-only pills. The next step involves blocking certain hormones through injections of GrNH analogues.

In certain cases, an assessment must be carried out via an endoscopic intervention in order to establish a clearer view of the extent of the condition. During this surgery, which is generally practiced as an outpatient intervention with minimal incisions (minimally invasive surgery, coelioscopy, laparoscopy), lesions are treated either by cauterisation or excision. At the same time, adherences which may have been causing discomfort are freed.

2

I have a lump-like feeling in my vagina. What should I do?


A vaginal lump can point to several things. It may be due to an inflammation of the Bartholin gland, which is located at the entrance to the vagina and which can sometimes cause discomfort when touched, or pelvic organ descent or prolapse, which may occur around the bladder, rectum or vagina.

In any case, the best option is to consult with your gynaecologist. Only an examination can provide an accurate diagnosis and enable you to create a treatment plan, either through anti-inflammatories or minimally invasive surgery.

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35-45 years

1

My family has a history of cancer. Am I more at risk of developing the disease?


Generally speaking, you are effectively more likely to develop cancerous cells than someone who comes from a family with no history of cancer. But your family’s past in no way indicates that you yourself will definitely develop cancer.

The level of risk is evaluated during a consultation, through a detailed questionnaire regarding the cases of cancer present in your family. The questionnaire notably aims to detect whether or not a close relative has had cancer in one of the following organs: breast, uterus, ovaries, and to a lesser extent, colon.

During the consultation, a detailed examination of your different organs will be carried out, depending on the degree of risk and any symptoms you may be experiencing. Additional examinations, such as a blood test, an ultrasound of the breast or genital organs and a screening mammogram will also be prescribed.

We also offer you the possibility of fixing an appointment with a geneticist.

2

Why do I lose my hair when brushing?


One of the most frequent causes of hair loss is an iron deficiency, particularly if you are also experiencing heavy periods or menstrual pain.

A blood test will enable the evaluation of your iron levels and will look for possible vitamin deficiencies.

Hair loss may also be a result of androgenic alopecia, which is caused by a hormonal imbalance. This possibility can be ruled out with a blood test.

It is wise to be attentive to the texture and quality of your skin, particularly if you have spots or acne.

Occasionally, it not possible to identify the exact reason for hair loss. In any case, the treatments available involve taking dietary supplements and correcting vitamin and iron-related disorders, as well as local treatments to the scalp.

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45-55 years

1

I am experiencing hot flushes. Why is this?


Hot flushes are a very common symptom of the menopause and affect around 75% of women. Although they may feel dramatic, they are generally harmless.

They occur because of a hormonal disruption: the secretion of oestrogen is reduced, leading to a hormonal imbalance which unsettles the internal mechanism for regulating body temperature.

On average, hot flushes appear for around 3 to 5 years, and can arrive sporadically several times per day, often in the middle of the night.

In order to evaluate them, a series of examinations is necessary, such as a hormonal assessment of the blood with the calculation of sexual and thyroid hormones.

To calm hot flushes, a personalised treatment will be prescribed, taking into account the risks and the advantages. There are several possible approaches: a substitutive hormonal treatment, phytotherapy or dietary supplements.

2

Why has my sex drive decreased?


A drop or absence of sexual desire can be caused by many factors. For example, your libido may drop in the case of a hormonal disorder, as well as during difficult or stressful periods. It may also be related to a disease, medicine you are taking or your psychological state.

In order to obtain an accurate diagnosis, to discover the cause of the problem and to seek help, it is important to consult with your gynaecologist and to complete a few examinations, including a hormone assessment.

A variety of treatments may be offered, ranging from psychological coaching to the introduction of certain hormones, or phytotherapy.

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55 years and over

1

What is osteoporosis?


Osteoporosis is a skeletal disease. Its signs are characterised by a reduction in bone mass and modifications in bone structure. Bones become porous, weakened, and fracture more easily.

Osteoporosis can be encouraged by the onset of menopause. At this time, the production of oestrogen, a hormone which preserves bone mass, dramatically decreases.

Although osteoporosis does not bear any obvious outward symptoms, certain clinical signs may suggest its presence, such as fractures, back or lower back pain, vertebral compression fractures, hyperkyphosis (hunching in the back), and reduction in height.

Additionally, deficiencies in calcium, proteins and vitamin D, as well as sedentariness and a premature deficit in sexual hormones (premature menopause) can lead to its onset.

Osteoporosis-based examinations include a targeted consultation and additional examinations such as a blood test and a bone density test. Treatment is then adapted depending on the signs, symptoms and severity of the disease.

2

Why do I have constant itching around the vagina?


Dryness of the vaginal mucus is frequent following the reduction in the rate of hormones. The mucus is effectively unable to retain water in the way it could before menopause. This leads to dryness, which is very often confused with fungal infections and thus wrongly treated.

A detailed local examination will allow for a diagnosis.

If there is no contraindication, a local prescription of oestrogen – and sometimes corticoids – should be sufficient to resolve the problem. These treatments should be applied two to three times per week. Symptoms will start to improve in one or two months.

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Pregnancy

1

What are the important steps to follow to prepare for pregnancy?


In the majority of cases, a healthy lifestyle with a balanced diet of fibre, protein and carbohydrates will suffice. It is also important to make sure you have a sufficient intake of folic acid. Folic acid is recommended as a dietary supplement at the design conception.

A medical consultation is not necessary, but your doctor can certainly prescribe the examinations necessary for ruling out problems or conditions which may affect the pregnancy, such as diabetes or issues relating to blood pressure.

2

What is folic acid and why should I take it if I want to have a baby?


Whether it is during the periconception period or during the pregnancy itself, taking folic acid plays an important role in your baby’s development as it reduces the risk of a neural tube defect – a type of malformation of the nervous system.

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