We’re answering frequently asked questions about common women’s health concerns: symptoms you should look out for, how to prevent them and the treatments we can provide to support you when you need them.

Urinary tract infections (UTIs)

What is a UTI?
Urinary tract infections are one of the most common conditions affecting women, with around half of all women in the UK estimated to have at least one UTI during their lifetime(1). By age 24, nearly 1 in 3 women will have already experienced one (2).

Why do women get UTIs more than men?
Women are thought to be more prone to UTIs than men because they have a shorter urethra — the tube that you pee from. It’s closer to the rectum and vagina, which makes it easier for bacteria to enter the urinary tract. Older women are also more susceptible to UTIs due to a weaker flow of urine. This means the bladder doesn’t empty fully, which can lead to a build-up of bacteria.
What causes UTIs?
Around 80–90% of UTIs are caused by E. coli bacteria (3).This and other types of bacteria naturally live in your gastrointestinal tract and can enter the urinary tract through:

• Poor toilet hygiene — Wiping from back to front can allow E. coli to transfer from the rectum to the urethra. 
• Sexual intercourse — This can introduce bacteria from the vagina into the urinary tract.

• Medical conditions — Diabetes and weakened immune system from chemotherapy/HIV can increase your risk of UTIs
• Medical procedures, such as urinary catheterisation 

What are the symptoms of UTIs? 

• Burning sensation when you pee

• Increased frequency and urgency of urination
• Pain or discomfort in the pelvis, lower abdomen, or lower back
• Cloudy, bloody, or foul-smelling urine

How can you treat UTIs?
Antibiotics such as nitrofurantoin are commonly used to treat UTIs. They work by stopping the bacteria that causes infection from reproducing. Paracetamol can also help relieve pain.

How can you prevent UTIs in the future?
Once you get a UTI, there’s around a 20–30% chance you’ll get another one. Here are some tips to prevent future flare-ups:

• Stay hydrated and pee when needed
• Pee before and after sex
• Wipe front to back after using the toilet
• Avoid irritants like deodorants, sprays, and douches around your genitals

Bacterial vaginosis (BV)

What is BV?

BV is a common vaginal infection caused by an overgrowth of bacteria naturally found in the vagina. It’s the most common cause of abnormal vaginal discharge in women of childbearing age, affecting approximately 15–30% of women aged 15–49 (4).

What causes BV?When something disrupts the vaginal bacteria balance, the pH becomes less acidic. This allows harmful bacteria to rapidly multiply and take over, causing the symptoms of bacterial vaginosis.

Things that can disrupt the balance of vaginal bacteria include: 

• Multiple or new sexual partners
• Douching
• Using intrauterine devices
• Natural hormonal changes, e.g. menstrual cycle
  
  

What are the symptoms of BV?Approximately 50% of women with BV are asymptomatic. Those with symptoms commonly experience:  

• Thin, grey/white vaginal discharge with an unusual odour
• Burning when peeing
• Itching around the outside of the vagina

How can you treat BV?Bacterial vaginosis is commonly treated with antibiotics that can be either applied locally in the vagina or taken orally. They work by suppressing the growth of bacteria causing the infection. The first line antibiotic treatment we use in the UK is metronidazole, which can be taken as an oral tablet, or applied as a gel directly to the vagina. Clindamycin antibiotic gel works in a similar way. 

How can you prevent BV in the future?It’s common to get BV again after treating the first infection, with roughly 15–30% of women experiencing a recurrence of symptoms. Here are some tips to help you prevent BV: 

• Avoid douching
• Use condoms correctly every time you have sex
• Avoid using irritants like perfumed soaps, sprays, tampons
• Wear cotton underwear and avoid tight clothes
• Stop smoking

Chlamydia

What is chlamydia?
Chlamydia is a common sexually transmitted infection (STI) caused by bacteria found in infected semen and vaginal fluids. In the UK, there’s been a 24% increase in the number of people reporting chlamydia since 2021(5). While the infection is easy to treat with antibiotics, many people don’t have symptoms, which can leave the infection undiagnosed and cause serious health complications. 

What causes chlamydia?
Chlamydia infection occurs when bacteria is transmitted from an infected sexual partner to another through sexual contact. Some of the risk factors for chlamydia include: 

• Having unprotected vaginal, anal, or oral sex
• Having multiple sexual partners
• Having a new sexual partner
• Having a sexual partner who has an STI

What are the symptoms of chlamydia?
Many people with chlamydia don’t have any symptoms, which is why it often goes undiagnosed. It’s estimated that around 70% of women and up to 50% of men with chlamydia have no symptoms (6).

When symptoms do occur, they often appear 1-3 weeks after exposure. In women, these include:

• Increased vaginal discharge
• Burning/pain when you pee
• Bleeding between periods
• Pain during sex
• Lower abdominal pain

How can you treat chlamydia?A simple urine sample and/or vaginal swab can be used to diagnose chlamydia. Once diagnosed, the first line treatment is an oral antibiotic called doxycycline. It works by inhibiting bacterial protein synthesis, which prevents the bacteria from reproducing and surviving.

How can you prevent chlamydia? 

• Use condoms correctly every time you have sex

• Limit the number of sexual partners you have
• Get regular STI screenings if you’re sexually active
• Complete your full prescribed antibiotic course if you’re diagnosed with chlamydia. 

Emergency contraception

What is emergency contraception? 

Emergency contraception, also known as the morning after pill, can prevent pregnancy after unprotected sex or contraceptive failure.

How does emergency contraception work?

Emergency contraception delays or prevents ovulation. It does not cause abortion.

What situations are emergency contraception used in?

You may decide to take emergency contraception if:

• You’ve had sex without using contraception
• You’re worried a condom broke or leaked
• You missed your regular contraceptive pill
• You’ve been sick or had diarrhoea after taking an oral contraceptive

What types of emergency contraception are there?

MedExpress offers two types of oral emergency contraception: levonorgestrel and ulipristal.Levonorgestrel is a synthetic progestin hormone that prevents or delays ovulation and can be taken 72 hours after unprotected sex. It’s considered: 

• 95% effective if you take it within 24 hours (1 day) of unprotected sex 
• 85% effective if you take it within 25–48 hours (2 days) of unprotected sex 
• 58% effective if you take it within 49–72 hours (3 days) of unprotected sex
  
  

Ulipristal is an anti-progesterone medication that blocks the action of progesterone in your body and delays ovulation. It can be taken up to 120 hours (five days) after having unprotected sex, and is 98% effective.

You can also have a copper intrauterine device (IUD) inserted after unprotected sex. This is the most effective form of emergency contraception, preventing 99% of pregnancies, and it can be used alongside oral treatments. To find out more, speak to your GP or local sexual health clinic. 

Does emergency contraception have any side effects? 

Like all medications, emergency contraception can cause side effects. These may include headaches, breast tenderness, fatigue, dizziness, diarrhoea, nausea and vomiting. If you vomit within 3 hours of taking emergency contraception, you should take a repeat dose. 

You might also experience some spotting before your next period. 

Period delay

What are period delay tablets? 

Period delay tablets contain a hormone called norethisterone. It acts like progesterone, which is a natural hormone in your body. The norethisterone stops your uterus lining from shedding when your next period is due. This delays your period for a maximum of 17 days.

What are the common reasons women take period delay tablets?

• Going on holiday 
• Getting married
• Big life events, such as moving house or changing jobs
• Exams 

How long can I take period delay tablets for? It’s recommended that you take norethisterone to delay your period for a maximum of 17 days. After you stop taking the tablets, your period is likely to start after two to three days, but this can vary. Prolonged use may cause side effects and affect your natural hormone balance. Can I still get pregnant on period delay tablets? Yes. Norethisterone doesn’t act as a contraceptive, so you could still get pregnant.

What are some of the side effects of Norethisterone?

Norethisterone may cause some side effects, including: bleeding and spotting between periods, unusual discharge, breast pain and tenderness, headaches, dizziness and tiredness. 

With MedExpress, you can access any of these treatments when you need them, with no GP or pharmacy visits required. Our dedicated clinicians can issue a fast, private prescription and have your order delivered to your home quickly and discreetly.

Experiencing symptoms? Start a free online consultation now.

References:

References:

(1). Brown L. Utis: What are the burning issues? [Internet]. 2023 [cited 2023 Oct 4]. Available from: https://bsac.org.uk/utis-what-are-the-burning-issues/

(2). CKS is only available in the UK [Internet]. [cited 2023 Oct 4]. Available from: https://cks.nice.org.uk/topics/urinary-tract-infection-lower-women/

(3). K; E. Bacterial characteristics of importance for recurrent urinary tract infections caused by escherichia coli [Internet]. U.S. National Library of Medicine; [cited 2023 Oct 4]. Available from: https://pubmed.ncbi.nlm.nih.gov/21466767/

(4). 23 June 2023  By Joseph Heskin & Suki Leung. Bacterial vaginosis: Diagnosis and management [Internet]. 2023 [cited 2023 Oct 4]. Available from: https://pharmaceutical-journal.com/article/ld/bacterial-vaginosis-diagnosis-and-management

(5). STI prevalence [Internet]. [cited 2023 Oct 4]. Available from: https://www.tht.org.uk/news/new-sti-data-shows-24-increase-rates-england

(5). 23 June 2023  By Joseph Heskin & Suki Leung. Bacterial vaginosis: Diagnosis and management [Internet]. 2023 [cited 2023 Oct 4]. Available from: https://pharmaceutical-journal.com/article/ld/bacterial-vaginosis-diagnosis-and-management

(7). NHS Chlamydia [Internet]. NHS; [cited 2023 Oct 4]. Available from: https://www.nhs.uk/conditions/chlamydia/symptoms/