People’s Health

You’ve just finished making love, and you’re in that pleasant dream-like state when you go to the bathroom and discover that you are bleeding. Nothing can bring you back to reality faster than vaginal bleeding after sex. Post-coital bleeding can occur for a number of reasons, and is nothing to take lightly. Here’s a look at the top 10 causes of vaginal bleeding after sex:

1. Cervical dysplasia: Cervical dysplasia is precancerous changes of the epithelial cells that line the cervix. Risk increases with multiple sexual partners, sex before age 18, childbirth before age 16, or a past history of STDs. Treatment is usually cryosurgery or conisation.

2. Chlamydia: A bacterial infection that is usually transmitted through sexual activity or contact with semen, vaginal fluid, or blood.

3. Gonorrhea: A usually sexually transmitted disease caused by a bacteria. Several pharmaceutical treatments are available.

4. Vaginitis or Cervicitis: Inflammation or swelling and infection of the vagina or cervix. Treatment depends on the cause.

5. Cervical polyps: Cervical polyps are smooth, red or purple, finger-like growths that grow out of the mucus layer of the cervix or the cervical canal. Cervical polyps are extremely fragile, extending out of the cervix, and easily and painlessly removed.

6. Trichomoniasis: A usually sexually transmitted disease caused by protozoan. Can also be passed to newborns during vaginal birth by infected mothers. Although rare, transmission is also possible in tap water, hot tubs, urine, on toilet seats, and in swimming pools. May cause vaginitis.

7. Vaginal Yeast Infection: An overgrowth of the normal fungi that inhabits the vaginal area. Common symptoms include itching, burning, and an odorless, white, cheese-like discharge.

8. Endometritis or adenomyosis: Endometritis is defined by Dorland’s Medical Dictionary, 27th Edition as an inflammation of the endometrium (the innermost layer of the uterus). Both conditions are associated with endometriosis. Adenomysis is when endometrial tissue attaches itself to the uterus, or another organ such as the ovaries, and grows outside of the uterus.

9. Uterine polyps: Uterine polyps occur when the endometrium overgrows causing these protrusions into the uterus. It is extremely rare for these growths to grow in a way that is either benign or malignant. Women with uterine polyps frequently experience bleeding between periods (metrorrhagia), other symptoms includes vaginal bleeding after sex, spotting, menorrhagia, bleeding after menopause, and breakthrough bleeding during hormone therapy. Hysteroscopic-guided curettage is the preferred treatment, since the normal D&C is basically an unguided procedure that may miss many of the uterine polyps.

10. Fibroid tumors: Uterine fibroid tumors are usually benign tumors. They are solid masses made of fibrous tissue. Fibroid tumors are rarely malignant. Symptoms of fibroid tumors vary among women, with some women never experiencing any symptoms at all. Women who can wait until menopause will see their fibroids shrink and disappear once their bodies stop producing estrogen. It’s important that women with fibroids make sure they never take estrogen, in any form including birth control pills, since estrogen increases fibroid growth. Several treatments are currently available for uterine fibroid tumors from myomectomy and uterine artery embolization to the traditional hysterectomy.

Diagnosing vaginal bleeding after sex is usually a matter of exclusion. Anytime you experience post-coital bleeding or vaginal bleeding after sex see your physician.

Gaza hospitals have shortages of medicine and specialist equipment

A convoy bringing medical aid to Gaza is stranded at the border with Egypt, after most of the activists and volunteers with it were denied entry.

Only 16 of the group of 130 Europeans were permitted to enter, leaving trucks laden with wheelchairs, medicines and a dialysis machine stuck at the border.

UN agencies say the Gaza blockade appeared to have been tightened in recent months.

Separately, a desert marathon runner was also denied access to the Strip.

The Hope for Gaza convoy, organised by a range of small, Europe-based humanitarian organisations and other groups, had travelled from Milan over the past month.

Its UK-based coordinator, Rami Abdu, claimed the Egyptian authorities had said they would be allowed access and had even stamped the whole group’s passports to allow them to exit Egypt.

But they were told "high instructions had… suddenly" been received and only 16 of the convoy participants would be allowed to enter, he said.

It is the latest of several attempts by activists and NGOs to break the blockade. Previously groups have brought ships into Gaza by sea.

Mr Abdu said the aid deliveries were co-ordinated with hospitals and rehabilitation centres in Gaza, some of which were private, some run by the Hamas administration.

‘Tightened restrictions’

Under Israel and Egypt’s joint blockade of the strip, little more than humanitarian basics are allowed in.

International organisations say the Israeli authorities have tightened restrictions, after the flow of aid increased in the wake of Israel’s military operation in January.

"These restrictions have again become severe and excessive," said Tony Laurance, acting Head of World Health Organization in the West Bank and Gaza Strip.

Although medicines and medical equipment do enter Gaza, the process of getting permission for many items is "slow and cumbersome", he said.

The WHO said that, as of mid-May, stocks were short of 82 different drugs, with less than a month’s supply left.

Mr Laurance said there had been problems ensuring that medical donations matched needs, and inappropriate or out-of-date medicines having to be destroyed.

At the weekend, the UN relief agency Unrwa said the blockade was intensifying the deteriorating health situation in Gaza.

Unrwa said the number of different "essential" items allowed into Gaza had gone down from 4,000 before the Israeli military operation in January to about 40.

‘Run for Love’

A spokesman for the Israeli Defence Ministry disputed the claim and said the policy had not changed.

 

Critics say Israel’s list of banned items now includes marathon runners

He said there was no list of banned items, but "luxury items" and items which could be used for military purposes were still restricted.

The blockade was tightened after Hamas seized control of Gaza in June 2007 and in response to rocket fire into Israel.

The spokesman said militants were still firing rockets into Israel and there had been no movement on the release of the captured Israeli soldier Gilad Shalit.

Separately, Italian marathon runner Max Calderan, was denied access from Israel into Gaza.

He had been planning a Run for Love covering 335 miles (540km) from Ramallah in the West Bank to Jerusalem, through Gaza to the summit of Egypt’s Mount Sinai.

Unrwa, which had been due to provide security for the Gaza leg, said the Israeli authorities had told him they would let him in.

The Defence Ministry spokesman said he was unaware of Mr Calderan’s request for permission until he arrived at the crossing.