Gynaecology & Women’s Health

If you are changing protection every hour or two, passing large clots, flooding through to clothes or bedding, or feeling tired and breathless, that is worth investigating. Heavy bleeding is common but it is not something you simply have to accept.

Mild cramping is. Pain that stops you working, studying or sleeping, or that is not helped by ordinary painkillers, is not — and can point to endometriosis or fibroids, both of which are treatable.

An annual review is a reasonable habit from the start of sexual activity or around 21, with cervical screening at the interval recommended for your age. Anything unusual should be seen when it happens, not at the next annual visit.

No. Many cause no symptoms and can simply be watched. Treatment is considered when they cause heavy bleeding, pain, pressure, or difficulty conceiving — and there are medical as well as surgical options.

For most women starting near menopause, the benefits for symptoms and bone health outweigh the risks, but it depends on your own history. It is a personal calculation, made with you, not a blanket yes or no.

Bleeding between periods, after sex or after menopause, and any discharge with odour, itching or pain, should be checked. Most causes are simple and easily treated — but they should be identified rather than assumed.