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Health information, articles, news and advice for NHS patients.

kry.co.uk > Your health > Metainfo

Your health | KRY

## Quick facts 

-  The average adult breaks wind 12-25 times a day
-  Sweeteners ending with ‘-tol’ are hard-to-digest sugar alcohols which can cause flatulence
-  Wind problems might be down to an underlying condition

It’s normal to pass wind every now and then, but when it happens frequently it can undermine your confidence. And while it varies between individuals, on average we emit gas from our mouth or bottom between 12 and 25 times a day.

## Why wind happens

Gas builds up in the digestive tract in two ways: by swallowing air or as a by-product of gut bacteria breaking down foods. Having some gas is inevitable and perfectly normal, but having a lot of wind problems could be a sign of an underlying health issue.

During digestion, chemicals called enzymes break down foods so they can be absorbed in the small intestine. During this process, some undigested sugars, starches and fibres reach the large intestine. There, they ferment as bacteria in the gut try to break them down. This produces gases, including carbon dioxide and hydrogen sulphide, which are released as flatulence.

## Can trapped wind be painful?

Yes, trapped wind can cause pain and discomfort. If you do experience painful trapped wind, you‘ll likely feel it in your stomach and lower abdomen. 

## What are the symptoms of trapped wind?

Common symptoms of trapped wind include a bloated stomach or abdomen, flatulence or burping, stomach cramps, a rumbling or gurgling sound, nausea, and pain when you bend or exercise.

## Causes of trapped wind, excess wind and flatulence

Everyone passes wind and many factors, from your genes to an underlying condition, can lead to increased gas and flatulence. But you can reduce unwanted wind problems — the first step is to identify the source of the problem. Here are some of the likely reasons:

__Eating or drinking too quickly__ makes us swallow air, which is then released as burps and belches. Swallowing air, or aerophagia as doctors call it, can also be caused by chewing gum, smoking, having a blocked nose and wearing dentures that don’t fit properly. It‘s common to experience trapped wind after eating.

__Foods that cause trapped wind and flatulence__ include cabbage, cauliflower, Brussels sprouts, broccoli, dried fruit and beans because they tend to contain a lot of hard-to-digest fibres and sugars. But these are incredibly important in the diet, particularly for detoxification of the liver.

If you suspect these foods, before you cut them out, keep a diary of your trapped wind after eating different foods. It could be that only particular vegetables or bean types cause problems. Raw vegetables such as cabbage might be problematic for you, but lightly steamed may not — so note down how you react in relation to the cooking method of the food you’re consuming too.

__Sweeteners__ such as xylitol and sorbitol — which are commonly used in reduced-calorie drinks, chewing gums, sweets, cakes and biscuits — cause flatulence because we lack the enzymes needed to digest them. Any sweetener ending with ‘-tol’ can cause problems.

__Fructose__ is a fruit sugar found in table sugar, sweeteners and syrups, dried fruits, juices and other processed foods and drinks. Our bodies can’t digest too much fructose at one time, and it can add up quickly in our bodies. An apple, or a 200ml glass of orange juice, both have around 6g of fructose and some carbonated drinks have up to 50g for a single can or bottle. For many of us, undigested fructose reaches the large intestine — where it ferments and produces gas.

__Gut bacteria__ play a key role in digestion. Around 500 different bacteria species are found in the large intestine and everyone’s microbiome — as this mix of bacteria is known — is unique.

As bacteria interact with undigested carbohydrates in the gut, they produce a range of different gases and these can lead to excessive wind and flatulence.

Our microbiome is influenced by our diet, lifestyle and use of antibiotics can lead to significant changes in the gases we produce. That’s why antibiotics can sometimes cause flatulence, and why probiotics — which contain so-called friendly bacteria — can improve the balance of beneficial bacteria and reduce flatulence and other gastric symptoms. Probiotic drinks and yogurts are readily available, and fermented foods such as sauerkraut and kimchi also provide probiotics.

__Medicines__ including ibuprofen, statins and antifungals can sometimes cause flatulence. Speak to your doctor if you suspect a medicine you take regularly is causing wind problems.

__[Irritable bowel syndrome (IBS)](/medical-advice/digestive-problems/irritable-bowel-syndrome-ibs/)__ affects as many as 1 in 5 people and can arise from food passing through the gut too quickly or slowly, overly sensitive nerves in the gut, food intolerances and stress. It can also cause stomach cramps, bloating, diarrhoea and constipation. These tend to come and go over time, and episodes can last for days, weeks or months. Talk to your doctor, who can suggest a management plan. This may include adherence to an eating plan known as the FODMAPs diet, which has been clinically shown to help with IBS symptoms, however it must be followed with the supervision of a dietitian.

__Lactose intolerance__ occurs when we don’t make enough lactase, the enzyme needed to break down and digest milk sugars. Warning signs include excessive flatulence as well as diarrhoea, bloating, stomach pain or feeling sick after consuming lactose-containing dairy foods such as milk and cheese. Talk to your doctor if you suspect you might have it.

__Coeliac disease__ occurs when your immune system reacts to gluten found in many foods. It can cause symptoms such as flatulence, bloating, constipation, diarrhoea, weight loss and skin problems. It affects around 1 in 100 people and often runs in the family. A doctor can diagnose coeliac disease with a simple blood test.

## 6 simple steps to help reduce excessive wind and flatulence

1. __Keep a food diary__ to identify foods that cause wind — and avoid them.
2. __Eat smaller meals, more often__ — and chew food slowly. This gives the amylase in saliva more time to start breaking down carbohydrates which can help prevent excess wind.
3. __Drink plenty of water__ — this reduces the risk of constipation and keeps things moving.
4. __Drink peppermint tea__ — it contains essential oils which have been shown to reduce flatulence and bloating.
5. __Exercise to improve digestion__ — studies confirm light exercise, such as walking or a gentle bike ride, will reduce symptoms. It’s believed exercise helps matter move through the intestine so it may aid constipation too.
6. __Check your fibre intake__ — most of us don’t eat enough fibre. Around 30g a day is recommended. Fruits, vegetables and wholegrains such as wholemeal bread, oats and quinoa are good sources.

Speak to a doctor if you have other symptoms such as bloating, pain, diarrhoea, [constipation](/medical-advice/digestive-problems/constipation/), chronic belching or there’s [blood in your poo](/your-health/10-things-your-poo-can-tell-you-about-your-health/) – these could be a sign of something more serious.

__This article has been medically approved by Dr Rhianna McClymont, Lead GP__


Kry.co.uk > Your health > What’s causing your gas and flatulence?

See a GP for trapped wind and flatulence

sew41

Trapped wind can be embarrassing and painful. It can also have many causes — from food to underlying conditions. Here’s a guide to dealing with flatulence.

What’s causing your gas & flatulence? What causes trapped wind?

General health

General health and seasonal

What’s causing your gas and flatulence? 

There’s no medical guidance to define a normal amount of sweating, but if you’re worried that you’re sweating a lot more than you should, and it’s started to interfere with your daily life, it’s a good idea to speak to a GP.

In the meantime, here are some key questions answered. 

## Am I sweating too much?

It's completely normal for us to sweat if we feel particularly hot or are doing strenuous exercise. If you notice yourself sweating a lot even when your body doesn’t need to cool down, this could be a sign that you’re sweating too much. 

‘Excessive sweating usually happens to help our body cool down, but it can also happen for no apparent reason. It could be linked to a medication you’re taking or a medical condition called hyperhidrosis,’ says Dr Rhianna McClymont.  

## What is hyperhidrosis?

[Hyperhidrosis](https://hyperhidrosisuk.org/what-is-hyperhidrosis/) is the medical term for excessive sweating – and because everyone’s level of sweating is different, it can often be hard to diagnose. Primary hyperhidrosis is more difficult to spot as there is no specific cause, whereas secondary hyperhidrosis has several different triggers – usually an underlying medical condition or side effect of medication.

According to the charity Hyperhidrosis UK, the condition affects around [2 in every 100 people in the UK](https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/hyperhidrosis), which means hundreds of thousands of people are having to deal with the discomfort and stress it can cause. 
Hyperhidrosis usually develops during childhood (or soon after puberty), but can come on at any age.

If you think you have hyperhidrosis, here are some of the daily challenges you might find difficult, or even avoid:

- Making physical contact like shaking hands, because you feel embarrassed about having sweaty palms
- Attending social gatherings that might make you feel even more self-conscious about sweating a lot
- Taking part in activities like group exercise or dancing, as you’re worried it will make your excessive sweating more noticeable
- Doing normal day-to-day activities like driving or using public transport
- Carrying out tasks for work – from typing on a keyboard to holding tools or products
- Spending lots of time trying to manage and cope with excessive sweating, by regularly showering, using deodorant and changing clothes

## What actually causes excessive sweating?

For primary hyperhidrosis, there’s often no particular cause other than the nervous system, which controls how much we sweat. People with this type of excessive sweating usually don’t sweat in their sleep.

Secondary hyperhidrosis has a number of causes which are much easier to spot and manage. Some of the most common triggers include:

- certain medications
- [anxiety](/medical-advice/mental-health/anxiety/)
- low blood sugar (hypoglycaemia)
- overactive thyroid (hyperthyroidism)
- pregnancy
- [menopause](/your-health/10-womens-health-symptoms-you-should-always-talk-to-a-doctor-about/)
- infections

‘If excessive sweating is affecting you on a daily basis, it’s definitely worth talking to a doctor to help you manage. Sometimes there’s no cause found for hyperhidrosis, but there are some medical treatments you could try which may help,’ explains Dr Rhianna McClymont, Lead GP at Kry.

A GP can help you understand the causes of hyperhidrosis, and after discussing your symptoms, they should be able to advise whether any treatment will help.

## Is there a treatment for hyperhidrosis?

Depending on the level of your excessive sweating, it’s not always the easiest to treat quickly. But there are several options that may be effective in helping you sweat less.

‘The most simple, and least invasive option, is to try a strong commercial antiperspirant. Patients may also find that avoiding tight clothing and man-made fabrics is best, and wearing white or black clothing can minimise the signs of sweating,’ says Dr McClymont. 

‘Topical aluminium salt preparations can also be applied to the skin to reduce excessive sweating. These preparations can be bought over-the-counter without the need for a prescription, and a pharmacist could direct you to the best choice.’ 

There are also lots of simple lifestyle changes that can make a big difference. You could try wearing much lighter clothing, and avoiding spicy foods or alcohol as these can be common triggers. 

If these simple measures are not helpful and your symptoms are adversely affecting your life, a GP may suggest a referral to a dermatologist for specialist advice. [Treatment options](https://hyperhidrosisuk.org/treatment-options/iontophoresis/) a dermatologist may consider include iontophoresis, which involves an electric current targeting the affected area, and other treatments involve botox injections or local surgery for more serious cases.

## When should I speak to a GP?

Asking a GP for advice about excessive sweating can feel daunting. One of the great things about speaking to a Kry GP is that you can do so from the comfort of your own home which lots of patients find more reassuring.

The GP may ask about your family history of hyperhidrosis. They may also refer you for further tests or treatment if they think another medical condition may be causing your sweating.

But knowing when to ask for help can be the hardest part. So if you’ve answered yes to one or more of the below questions, book a GP appointment to find out more.

1.	Have your symptoms lasted longer than 6 months?
2.	Are you sweating a lot – at least once a week?
3.	Do you experience regular night sweats?
4.	Have you found that lifestyle changes don’t seem to be helping?
5.	Does sweating a lot make your day-to-day activities difficult?
6.	Have you started a new medication since you’ve been sweating a lot?


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See a GP about excessive sweating

Kry.co.uk > Your health > What causes excessive sweating? Doctor’s guide to hyperhidrosis 

What causes excessive sweating? Doctor’s guide to hyperhidrosis 

Guidance from Lead GP at Kry about managing excessive sweating

Why do I sweat so much? How to deal with excessive sweating | Kry UK

For many parents, having ‘the talk’ with their children can seem like an awkward and uncomfortable moment. But the conversation should be about more than just sex – it’s a chance to talk about bodies, relationships and consent. Having these chats early helps parents empower their children with the knowledge and confidence to make healthy life choices. 

## Why do we need to have these conversations? 

Children are naturally curious about relationships and their bodies. Surveys suggest children as young as 11 might experiment with kissing,  while teenagers may have access to pornography and begin experimenting with sex.  

But according to a US study, 37% of teen boys and 56% of teen girls have never spoken to their parents about contraception.  

There’s no doubt it can feel daunting, but research shows that parent-child communication about sex is vital. In one study, open, supportive conversations were found to reduce the chance of children engaging in sexual behaviours.  Studies have also shown that children whose parents spoke to them about sex and consent were more likely to use safer sex practices, including contraception. 

‘While many young people find these conversations embarrassing, most of them do report that they’re helpful,’ says Beatrice Lindéh, a Kry psychologist specialising in sex. 

## When is the right time to talk to children about sex and consent?

‘By starting these conversations early, you can help to promote that sense of integrity and your child’s respect for themselves as well as others,’ says Lindéh. 

Here’s some advice for approaching each age group:

### 1. Very small children
‘You can start talking about relationships as early as when children are just starting to talk,’ says Lindéh. ‘Listen when they say “no” or “stop” to certain actions – and avoid forcing intimacy like hugs if they show signs of not wanting to.’ 

### 2. Preschool and primary school years
‘Help your child understand social rules and expectations, like if you hit someone, they won’t want to be your friend,’ says Lindéh. ‘This age is also about teaching them to talk to a trusted adult when something feels wrong. You could explain that if they’re asked to keep secrets they have a bad feeling about, they should tell an adult.’ 

### 3. Pre-teens and teenagers
When it comes to pre-teens and teenagers, open communication is key. ‘Building a good foundation for having these conversations is important, as sexual health becomes more important for teenagers,’ says Lindéh.

‘Having the ability to talk openly and honestly about sex makes it easier for them to ask for help if something feels wrong or somebody is crossing boundaries.

## So, what should I say?

‘You might find it challenging, but as a parent or guardian, it’s your responsibility to have these conversations,’ says Lindéh. Here are a few suggestions for getting the conversation started:

### 1. Use everyday situations
With smaller children, use real-life examples to teach them about consent and boundaries. ‘When you see your child behave in an undesirable way towards a sibling or friend, flag it right away. You can ask, “What happened there?” and explain what’s OK and what’s not,’ says Lindéh. 

‘As your child gets older, you can say, “I heard that your friend was upset over something that happened at the party. Can we talk about that?” 

‘When they start having sex education at school, chat about it: “I heard you spoke about this at school today. What are your thoughts?”’

### 2. Respect their boundaries
Show them you’re paying attention to their feelings. ‘If a child is hiding when their aunt wants a hug, say, “I can tell you don’t want to hug right now, and that’s OK – do you want to wave instead?”’ suggests Lindéh.

### 3. Ask if they feel safe
‘Once children are old enough to go on a date or start a relationship, ask if they feel safe with that person,’ says Lindéh. ‘Check if they feel able to say “yes” or “no” when it comes to sex and intimacy.’

### 4. Make conversations positive
‘Conversations about boundaries, consent and learning to say “no” can sometimes tend towards the negative, but it’s good to highlight the positive aspects of sex and relationships too,” says Lindéh. 

‘Having open and supportive conversations has the most positive impact. Avoid stern lectures, as they tend to have the opposite effect. It’s best not to try to fit everything into one big chat but to have smaller, regular conversations. That way, it will also be more natural for the child to raise questions.’

## How can I help with peer pressure?

‘You can talk to your child about learning to listen to their inner compass. If something feels wrong, it usually is,’ says Lindéh.

But be conscious not to blame and shame your child, even if they do fall for peer pressure. ‘Peer pressure is all about wanting to belong, which is only human. Talk to them about what’s happened from their perspective,’ Lindéh advises.

## When and how should I talk to my children about contraception?

‘Most schools don’t cover the subjects of safe sex and sexually transmitted infections until nearer the end of secondary school. If your child is curious, it’s a good idea to broach the subject sooner – possibly as early as when they start asking questions about how children are made.

‘You could always open up the conversation by buying a packet of condoms and letting your teenager know they’re there if they need them,’ Lindéh suggests. 

## How do I deal with the issue of porn?

Most children come across porn at some point during secondary school and, for many, it can be the only source of information about sex they have. However, it can be reassuring to know that most young people understand that it’s exaggerated and unrealistic. 

‘Make your child feel that it’s OK to ask questions,’ says Lindéh. ‘Try to explain that porn may feel frightening, exciting and arousing all at once, and ask how your child feels about that.’

‘Try to emphasise to your child that you should only ever do what feels good for you.’

## Should I talk to my child about self-pleasure and masturbation?

‘A lot of children masturbate – many of them from an early age – and it’s something that isn’t talked about enough,’ says Lindéh. 

Children can feel shame around pleasure if that’s what they’re taught. ‘It’s important to point out that pleasure is good and healthy, based on your child’s level of maturity. Explain that masturbation can feel good. Some children touch themselves in a soothing way, for instance at bedtime, and you can validate their experience by pointing out that they can do this if they want to when you’ve said goodnight and they’re alone.’

‘All forms of sex are about pleasure, whether it’s self-sex or sex with someone else, so try to get this across when you’re talking about sex and consent.’

__This article has been medically reviewed by Beatrice Lindéh, a Kry psychologist specialising in sex.__


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Speak to a GP about children’s health

Kry.co.uk > Your health > How to talk to young people about sex and consent – a therapist’s tips

How to talk to young people about sex and consent – a therapist’s tips

When and how should we talk to children and teenagers about sex? Get expert advice from Beatrice Lindéh, a Kry psychologist specialising in sex.

How to talk to young people about sex and consent | Kry UK

If you’re trying for a baby, what defines healthy sperm is probably high on your list of concerns. 

In fact, the quality and quantity of the sperm people produce can vary considerably as a result of all sorts of external factors. 

Here, we outline everything you need to know about sperm health and its impact on fertility.

## What constitutes healthy sperm?

There are 4 main factors that doctors look for when checking the quality of a person’s sperm:

### Sperm count
On average, there are between 40 and 50 million sperm in a millilitre of semen, and anything below 15 million per millilitre is classed as a low sperm count, according to the NHS. Having a low sperm count reduces the chance of conception but, as long as some sperm are present, it doesn’t rule it out – only one is needed to fertilise the egg. 

### Sperm motility
This is measured by looking at the semen sample under a microscope to see how many sperm are moving, how well they can swim, and how many are swimming in a straight line or going around in circles. It also takes into account whether sperm are clumped together or moving freely.

### Sperm morphology
This refers to how healthy the sperm look and is assessed by looking at the shape of the sperm to see if there are any obvious defects to the head, body, or tail of each gamete. 

### Volume of semen
This relates to the amount of fluid that is ejaculated, which might be a factor in how many sperm are released, and also provides a guide to how well glands within the testicles are working. 

## Are sperm problems common?
Sperm problems are a factor for 1 in 3 couples who are struggling to conceive, and in another third of cases the cause may not be known. Dr McClymont advises, ‘If you’ve been trying for a baby for a year, and your partner has not become pregnant, then it’s best to see your doctor to discuss further tests such as semen analysis.’

This routine test involves providing a fresh sample of semen so a laboratory can check several measures of sperm health. 

## Does abstaining from sex make your sperm more effective?
It’s not clear whether long periods without sex may increase the risk of some damaged sperm.

‘Aiming for sex every day during a person’s most fertile days will give you the best chance of conceiving,’ Dr McClymont advises. ‘But if that seems a little too much, then every 2 or 3 days will still give you an excellent chance.’

## Is there such a thing as healthy sperm colour?
Most semen is white-greyish. ‘Some men may notice a variation in colour from time to time,’ Dr McClymont says. But if you notice a persistent change – particularly if you also experience pain when passing urine or in your testicles, or there is blood in your semen – it should be investigated.’

Infections including chlamydia, gonorrhoea, and prostatitis can all impact male fertility. So can a structural problem like damage to the tubes that carry sperm, having undescended testicles as an infant, or previous surgery to the testicles or for a hernia.

## 6 lifestyle factors that affect sperm quality
Sperm health can be affected by a number of lifestyle factors. But if you’re trying to start a family, the good news is that it takes just 70-90 days for sperm to develop and mature. That means improvements to your diet and lifestyle should show benefits within 2-3 months.

### 1. Being overweight or obese 
This is associated with lower sperm counts. If you’re trying for a baby, and are overweight or obese, talk to a doctor about the treatment and options available for healthy weight loss.

### 2. Alcohol
Drinking any alcohol impairs semen volume and sperm morphology to some degree, according to an analysis of studies involving more than 16,000 men. The research found that drinking daily was the most damaging.

‘If you’ve started trying for a baby, or are thinking of doing so, then drinking alcohol at below the recommended limit of 14 units per week is recommended’, says Dr McClymont. ‘Drinking excessively can reduce sperm production, as well as adversely affecting the shape, size and swimming ability of sperm. For couples who are already experiencing fertility issues, men may wish to consider abstaining from alcohol completely.’

### 3. Temperature
Working in a hot environment reduces the quality and quantity of sperm. That’s why it can be helpful to avoid using a laptop on your lap or having saunas  if you’re trying to start a family. 

Wearing boxers, rather than close-fitting briefs can also help keep the testicles cooler and improve sperm concentrations and counts.

### 4. Diet
A healthy diet provides the fuel needed to produce healthy sperm. A recent Danish study found that men who ate plenty of fruit and vegetables, high-fibre foods, and fish, but minimised their intakes of red and processed meat, and sugar also had better sperm. Fat intakes did not seem to make any difference. 

### 5. Smoking
The harm smoking can do is well known, so it probably comes as no surprise that it’s bad news for sperm health too. Studies show smoking reduces sperm counts, motility, and morphology. This is probably due to increased oxidative stress, with one study describing the impact on sperm as ‘devastating’. 

### 6. Anabolic steroids
Illegal use of these muscle-building drugs is a growing problem in the UK, Sweden, and other European nations. Research shows that anabolic steroids can not only render men infertile, but it can also cause organ damage and violent outbursts.

See a GP about sperm health

Kry.co.uk > Your health > Is my sperm healthy? 6 things that can affect sperm quality

Is my sperm healthy?

How can you tell if your sperm is healthy? Dr Rhianna McClymont, Kry Lead GP, has a guide to healthy sperm, including the lifestyle changes that may help

Is my sperm healthy? 6 things that can affect sperm quality

6 things that can affect sperm health and quality | Kry UK

kry.co.uk > medical reviewer

IMG 20200730 224911 865-33- 1 .jpg

Dr Rhianna McClymont

Lead GP at Kry

Men Health

Men's Health

Sex can be one of life’s great pleasures but occasionally, it can be painful and cause worry for both partners. While painful sex is more common in women, with an estimated 3 out of 4 affected at some point in their lives, around 5% of men are also thought to experience it. 

‘Pain during or after sex is known as dyspareunia and there’s a variety of reasons why both men and women may experience it, including infections, illness, a physical or a psychological problem,’ says Dr Rhianna McClymont, Kry Lead GP. 

‘Don’t be embarrassed to discuss it with a doctor. Medical professionals are used to dealing with things like this and your symptoms might be your body’s way of telling you it needs attention,’ she says.

Here, Dr McClymont shares some of the main reasons why you might experience painful sex.

## 1. An infection down there
There are two types of non-STI infections that may cause painful sex:

### Thrush
This is an infection caused by the fungus candida albicans. Both men and women can suffer from it but thrush is more common in women, with around 75% experiencing it at some point in their lives.

‘Symptoms of thrush in women include itching and soreness, particularly around the entrance to the vagina, [vaginal discharge](/your-health/is-my-vaginal-discharge-healthy-a-doctors-guide/) which is often thick and creamy in appearance, and sometimes discomfort during sex,’ says Dr McClymont. ‘In men, it can present as irritation and redness in the skin of the penis.’

Thrush can be treated with over-the-counter antifungal pessaries or cream but if symptoms persist after treatment, you should see a GP. 

You may be able to prevent further attacks of thrush by avoiding soap and shower gels on the genital area, wearing cotton underwear and avoiding tight jeans. It’s also wise to avoid sex while you have thrush to prevent passing it to a partner (although it’s not classed as an STI).

### Cystitis
Up to 60% of women will experience a [urinary tract infection (UTI)](/your-health/utis-your-questions-answered/) like cystitis at some point. In men, it’s less common and so men should seek medical help if they believe they are suffering from one of the symptoms, says Dr McClymont. 

Symptoms in both sexes include a burning sensation when trying to urinate, feeling like you need to go to the toilet more often, cloudy or smelly urine and sometimes painful sex. Most mild cases in women will clear up on their own or with over-the-counter products from a pharmacy. But if you suffer from recurring bouts, or you have a temperature over 38C and pain in your lower back or side, see a GP as it may be a sign of a kidney infection. 

### An STI
Sexually transmitted infections like chlamydia or gonorrhoea can cause symptoms of painful sex, bleeding after sex (chlamydia), vaginal or penile discharge, pain when passing urine or for women, bleeding between periods (gonorrhoea). ‘But sometimes there are no symptoms at all. If you suspect you have an STI, it is important to see a GP or attend a sexual health clinic for tests and treatment.’

## 2. The effects of menopause
Painful sex is one of the most commonly reported problems in post-menopausal women. ‘During menopause, falling oestrogen levels lead to reduced vaginal secretions, which can cause dryness in the vagina, making sex uncomfortable or even painful,’ says Dr McClymont. You may also experience these symptoms in the years leading up to menopause, [known as perimenopause](/your-health/7-signs-of-perimenopause-a-doctors-guide/). 

‘Lubricants can help improve this dryness and can be bought from a pharmacy. But if symptoms persist, despite lubricants, you may wish to discuss other treatments with your GP such as topical hormone replacement therapy (HRT).’

## 3. Not being aroused enough
One of the key causes of painful sex may simply be down to lack of arousal. When a woman is aroused she produces more vaginal secretions, and this lubrication makes penetrative sex easier.

‘If you’re not aroused, you may not have produced enough natural lubrication to make sex comfortable. You can buy vaginal lubricants from a pharmacy to help with this, but it’s also important to explore and discuss any sexual problems or lack of arousal with your partner to see if there are things that you can do together to improve this. If there are other stressors in your life or problems that are affecting your libido, it’s important to address these or talk to a GP or counsellor.’

Read more about the [causes of a low libido](/your-health/8-causes-of-low-libido-a-doctors-guide/) and what you can do to help.

## 4. Irritated or inflamed skin
‘Skin may become inflamed due to allergies or irritants like latex condoms, soaps or certain spermicides,’ says Dr McClymont. ‘If you have a skin condition such as [eczema](/medical-advice/skin-conditions/eczema/) or dermatitis, and it’s present around the opening to the vagina or over the penis, it may cause dry, cracked and fissured genital skin that can lead to painful sex.’

Silicone-based lubricants can help in the short term, but it's important to get the underlying skin condition treated by a GP.

## 5. An underlying medical cause
Here are some of the medical conditions that can cause painful sex and why it’s important to get symptoms checked by a doctor. 

### Vaginismus
This is the automatic tightening and contracting of the muscles of the vagina at the point of intercourse, making sex either impossible or painful. It’s thought to be one of the most common female psychosexual conditions, although figures vary as to how many women suffer from it.

‘Vaginismus is an uncontrolled reaction and often happens due to fear of penetration,’ says Dr McClymont. ‘Treatment usually focuses on psychological help, relaxation techniques and exercises to help you become accustomed to penetration.’ 

### Pelvic inflammatory disease (PID)
Although it’s not known exactly how many women suffer from PID, it usually affects women under 24. ‘Pelvic inflammatory disease is inflammation in the pelvis, normally caused by an infection,’ says Dr McClymont. ‘It may cause pain during sex, [pelvic or abdominal pain](/your-health/what-causes-lower-abdominal-pain-in-women/), a temperature, vaginal discharge or vaginal bleeding. Pelvic inflammatory disease needs assessment and treatment by a GP, usually with antibiotics.’ 

### Endometriosis
Around 1 in 10 women — an estimated 176 million worldwide — suffer with [endometriosis](/medical-advice/womens-health/endometriosis/). ‘It’s a condition where cells resembling those in the uterus grow in other places in the body, for example around the ovaries, and can cause painful sex in some women,’ says Dr McClymont. ‘It may also cause painful periods and abdominal pain’.

While there’s no known cure, there are different methods of treatment to manage the symptoms, including surgery, hormone treatment and pain relief.

### Fibroids
‘These are benign growths in the womb which may cause no symptoms,’ says Dr McClymont. ‘But in some women they can cause painful sex, particularly if the fibroids are large and located close to the cervix.

Fibroids may also cause [heavy menstrual periods](/your-health/what-causes-heavy-or-irregular-periods-a-doctors-guide/), [lower back pain](/your-health/what-can-help-my-lower-back-pain-a-doctors-tips/) and frequent urination.’ Treatment usually involves medicine from a GP but if your symptoms are particularly severe, surgery may be an option.

### Phimosis
‘This is a condition where the foreskin is tight so cannot retract around the tip of the penis,’ says Dr McClymont. Although rare, occurring in about 1% of boys, phimosis can cause pain during sex if it continues into adulthood and is left untreated. ‘Discomfort may be improved by using condoms or lubricant, but if it continues to cause problems it’s best to speak to a GP.’

Inflammation of the prostate gland – ‘This is known as prostatitis and can cause pain around the penis, testicles, anus and lower back,’ says Dr McClymont. It can occur at any age and up to 10%-15% of the population may suffer with it at some point. ‘It also often causes pain when passing urine, or [urinary frequency or urgency](/your-health/urinary-frequency-constant-need-to-pee/). Treatment with antibiotics is needed for acute prostatitis.’ 


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See a GP about painful sex

Kry.co.uk > Your health > What causes painful sex? — A doctor’s guide

Painful sex pain after sex

If you’re feeling pain when you have sex, don’t be embarrassed to talk to a doctor. Here are the most common reasons for painful sex and what to do.

What causes painful sex and pain after sex? | Kry UK

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What causes painful sex? — A doctor’s guide

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If you’re [planning to have a baby](/your-health/10-health-tips-for-planning-a-pregnancy-a-doctors-advice/), are pregnant or about to give birth, it’s natural to feel a certain degree of anxiety. Studies suggest that around 80% of pregnant women experience worries and fears in relation to childbirth.

‘This can range from moderate anxiety to severe distress and common reasons include fear of pain, loss of control or that something may happen to the baby,’ says Dr Elisabeth Rosen, medical doctor at Kry who specialises in gynaecology and obstetrics. 

‘But at the more extreme end of the spectrum is tokophobia, a pathological fear of childbirth that causes severe anxiety. For many women, restrictions imposed by the pandemic have added to their fears. If you’re anxious, it’s important to know what help is available so that you can give birth in the best possible way.’

## What is tokophobia?
Tokophobia is a severe fear, or phobia, of childbirth, and for many women this also extends to pregnancy. It’s currently estimated that tokophobia could affect as many as 14% of women worldwide.  

‘Tokophobia causes severe anxiety at the thought of childbirth that usually also impacts a woman’s feelings about pregnancy,’ says Dr Rosen. 

There are two types of tokophobia. Primary tokophobia occurs in women who have never given birth before. Secondary tokophobia occurs in women who have previously had a traumatic experience of childbirth.

## What are the main signs of tokophobia?
Typical symptoms of a fear of childbirth may include:

- Excessive anxiety when thinking about or imagining childbirth
- Intense feelings of dread about childbirth
- [Panic attacks](/medical-advice/mental-health/panic-disorder/) – these can include shortness of breath, a dry mouth, sweating, shaking, trembling, nausea, numbness, feeling dizzy, light-headed or faint, chest pains, and disassociation
- Flashbacks to a past traumatic experience of childbirth (in women with secondary tokophobia). This type of tokophobia is a risk factor for [post-traumatic stress disorder (PTSD)](/medical-advice/mental-health/postnatal-depression/) in some women. 

## Is pregnancy anxiety different to tokophobia?
‘Most women will experience some type of anxiety while they’re pregnant,’ says Dr Rosen. ‘Typical worries may include anxiety about something happening to the baby. For example, is the baby developing as it should? What if it suffers damage or some other injury during childbirth? Will the baby be healthy? You may also feel anxious about experiencing difficulties with pregnancy or labour and worry that you might not get the right support and assistance. 

‘There may be other factors causing you to feel anxious, like how are you going to cope – financially, emotionally or practically. If it’s your first baby, there’s a sense of going into the unknown that can feel scary. For single mothers, there may be the added anxiety of having to cope with everything on your own.’

## What triggers tokophobia? 
Here are some of the causes that may trigger a severe fear of pregnancy and childbirth:

- Fear of pain
- A history of anxiety, [depression](/medical-advice/mental-health/depression/) and other mood disorders, including PTSD
- A previous traumatic experience during childbirth
- A previous traumatic medical experience
- Previous traumatic events like sexual assault, rape, or a history of child abuse
- Hearing stories, reading about or witnessing negative experiences of childbirth
- A need to be in control
- A lack of support during pregnancy and birth, and lack of information

## What help is available if I’m not pregnant yet?
‘If you’re feeling excessively anxious and feel that anxiety is affecting you significantly, either physically or mentally, seek help from a psychologist or counsellor,’ says Dr Rihanna McClymont, Lead GP at Kry.  ‘Your doctor can refer you to the appropriate psychological service. If you suffer from tokophobia, it’s especially important to access the right help.’

## What are the best solutions for tokophobia? 
Treatment for tokophobia may involve a combination of therapy, medication, social support and lifestyle changes. Like other phobias, with the right help, tokophobia can be successfully treated and cured. ‘Having therapy before you get pregnant can help you work through your fears and teach you strategies to help you cope,’ Dr Rosen says. 

‘Cognitive behavioural therapy (CBT) can be helpful for tokophobia and pregnancy anxiety, as it can help you to identify, and learn how to change, the thought patterns contributing to your fears. CBT will also provide you with psychological techniques to reduce and manage your anxiety.’ 

## I’m already pregnant and scared of childbirth, what can I do?
‘If you’re pregnant and feeling fearful, it’s important to talk to your doctor, consultant obstetrician, or midwife as early as possible,’ says Dr Rosen. 

‘Your obstetric team should be aware of any specific fears and talk to you about the best treatment options and services and also discuss a birth plan for you.  

‘A clear birth plan will help you know what to expect and what plans are in place,’ says Dr Rosen. ‘For example, what happens if you go into early labour? What happens if there are any complications? What are the alternatives if you’re scared of needles? What are your options for having a caesarean section?  

‘But this is a major operation, and many women ask for it through fear. Yet often, after talking with their midwife or obstetrician, they change their mind and opt for a natural birth. But with tokophobia, it’s important to know that this option is available. Most women with secondary tokophobia will be offered an elective caesarean. You should always be referred for additional psychological and medical support if you have tokophobia.’

‘Feeling isolated can make anxiety or low mood symptoms worse, so it’s important to stay connected to family and friends as much as possible. If you feel you need additional support, always talk to your doctor. Also, seek help if you experience feelings of [sadness or depression after giving birth](/medical-advice/mental-health/postnatal-depression/).’ 

## Can anxiety affect childbirth?
‘Feeling fearful or anxious is not good for a pregnant woman,’ Dr Rosen says. ‘It activates the sympathetic nervous system and your body goes into fight or flight mode, which is not conducive to having a good birth. When you’re anxious and stressed, your muscles tense up and oxytocin levels decrease, making childbirth more difficult.’  

‘There’s no need to put yourself through this, as with the right support, it’s possible to transform your pregnancy and childbirth into a much happier experience,’ Dr Rosen advises.

## Can a partner do anything to help?
‘It’s important to let your partner know how you feel,’ says Dr Rosen. ‘That way, they can better support you for example, by attending consultations with you, so they’re fully informed. Sometimes, a partner may be feeling anxious too, in which case they may benefit from a course of therapy themselves.’

__This article has been medically approved by Dr Elisabeth Rosen, medical doctor at Kry who specialises in gynaecology and obstetrics and Dr Rhianna McClymont, Kry Lead GP.__


See a GP about tokophobia

Kry.co.uk > Your health > Fear of childbirth and pregnancy (tokophobia) and how to cope

Pregnancy anxiety tokophobia 

Tokophobia is a fear of childbirth that can extend to a fear of pregnancy. Learn about tokophobia from a Kry women’s health specialist, including what help is available

Understanding the fear of childbirth and pregnancy | Kry UK

Fertility and pregnancy

Tokophobia – how to cope with a fear of childbirth and pregnancy

## Quick facts 

- Ticks are most common in grassy, shady areas
- Wearing long-sleeved shorts and long trousers tucked into your boots can help prevent tick bites
- Quick spotting and removal of ticks can help protect you and your family from tick-borne illnesses such as Lyme disease

As the autumn approaches and leaves start to change colour, there’s nothing better than exploring the great outdoors. But if you're going hiking through dense forest or grassy areas — or anywhere else where it’s shady — be sure to keep an eye out for ticks.

## What are ticks?

These small parasites are members of the spider family that attach to skin, causing bites that can lead to tick-borne illnesses such as Lyme disease (see below). Not all ticks cause this bacterial infection – it’s carried by around 12% of ticks. 

As tick bites are usually painless, you may not even notice you’ve been bitten (which is why regularly checking for them is important – see below).

Ticks are found throughout the year, but they're most active in spring and autumn. They’re common in woodland and forests, but ticks can be found anywhere that it’s damp and shady. They can’t jump or fly, but it’s easy to pick one up if you are walking through long grass or greenery. They can be tiny — as small as 0.5mm, which is around the size of a poppy seed — and grow no bigger than 1.5cm (though their bodies balloon out when they feed).

## Symptoms of Lyme disease

If you get bitten by a tick, you may get symptoms of Lyme disease. These symptoms appear after 1-4 weeks (or anywhere from 3 days to 3 months), often in the form of a redness or rash around the bite (see below).  Lyme disease may cause flu-like symptoms such as:

- Fever
- Headache
- Fatigue
- Joint or muscle pain

If left untreated, Lyme disease can progress to more serious symptoms including persistent fatigue, neurological symptoms and inflammatory arthritis.

## What to do if you get bitten by a tick

If you get bitten by a tick, or see a tick bite on your skin, you should remove it. You can do this with a pair of tweezers. Follow these steps:

- Pinch the tick as close as you can to the surface of your skin
- Grab the tick and pull it straight up away from the skin
- Check the bite site to see if any parts of the tick are still there – like the head or mouth parts. Remove them if so
- Use soap and water to clean the bite site

Once removed, you can see a GP to talk about your risks and any complications to look out for.

## What does a tick bite rash look like?

In Europe, around three out of five people who are bitten by a tick will develop a rash.

The most common type of tick rash occurs at the bite site. It's quite distinctive, and looks like a bull’s-eye, with a red circle around the immediate area, then a circle of clear skin, and then another ring of redness. These changing stages can appear gradually. However, sometimes this all merges into one large rash with a darker central circle. The edges of the rash might feel slightly raised.

The rash probably won’t be itchy but might feel warm to the touch. Most rashes will appear within the first four weeks but can emerge any time between three days and three months after being bitten.

## Symptoms to look out for after a tick bite

Wondering what happens when a tick bites you? Thankfully, most people won't see any symptoms after being bitten by a tick. But you may be allergic to tick bites, and in that case, you should look out for pain and swelling where the bite is, a burning sensation, blisters, a rash and difficulty breathing.

## What can I do to prevent tick bites?

The simplest way to avoid being bitten when you’re in tick-infested habitats — such as forest, woodland, or long grass — is to wear long-sleeved shirts and long trousers, tucked into your socks.

Other preventative steps include:

- Using an insect-repellent for ticks which contains 20-30% DEET or 20% Picaridin
- Applying this repellant to any exposed skin and reapplying it regularly as you would with a sunscreen
- Treating boots, clothing and camping gear with 0.5% permethrin (an insecticide) spray or solution (you can get wash-in formulas effective through several washes)
- Keeping to the centre of paths and trails and trying not to brush up against greenery
- Carrying tweezers in your first-aid kit to remove ticks as quickly as possible (see below)

## Where and when should I check for ticks?

Check for ticks regularly if you are in a high-risk area. The sooner they are removed, the lower the risk of developing tick-borne diseases such as Lyme disease. Generally, in order for you to become infected, it’s required that the tick be stuck to the skin for at least 24 hours.

Adults are most likely to be bitten on the lower legs. With children, the most commonly bitten areas are the head, neck and around the armpits. 

## How can I remove a tick safely?

 The safest way to remove ticks from the bite site is to:

- Use tweezers or a specially designed tick-removal tool
- Grasp the tick as closely as possible to the skin
- Pull upwards, with a steady even pressure
- Never twist or jerk the tick as this can risk leaving the mouthparts behind
- Clean the bite with antiseptic or soapy water

## Should I see a doctor?

If you develop any symptoms of Lyme disease, speak to your doctor straight away and let them know if you have been bitten, or think you might have been. Do this even if the symptoms disappear as this doesn’t necessarily mean the disease has gone away too.

You will probably be given a two-to-three-week course of antibiotics if you have suspected or confirmed Lyme disease to kill the bacteria which transmit the disease. And remember, it’s important to finish the course, even if your symptoms subside.


See a GP about a tick bite

kry.co.uk > Your health > Tick bites – what you need to know

Tick bites – what you need to know

As the summer approaches, so does tick season. Although they are very rare, tick-borne illnesses can be serious. But there is plenty you can do to prevent tick bites or deal with them quickly if they occur


Tick bites – Symptoms, What to do, Treatment & more

Hemal Shah, Lead GP, Kry

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Hemal Shah

Lead GP

To meet the demand for blood donations, the UK needs 5,000 people to give blood every day. 

There are lots of reasons why someone might need a blood transfusion, and one of these is blood cancer. Blood cancer is the fifth most common cancer in the UK, with over 40,000 people being diagnosed in the UK every year. It’s also the most common childhood cancer, with over 500 children (under 15) diagnosed with blood cancer every year. The most common blood cancers are leukaemia and lymphoma.

‘As September is National Blood Cancer Awareness Month, we want to help raise awareness of how important it is to give blood if you can,’ says Dr Rhianna McClymont, Lead GP at Kry.

‘We’ve tried to list everything you need to know about giving blood if you’re perhaps considering it for the first time.’
In the UK, there’s currently a greater need for male donors to give blood (and men can actually donate more often than women), black donors and O negative donors.

## Why might I need a blood donation?
Blood donations are crucial to treat patients who have suffered a significant loss of blood – either from having a serious accident, surgery, childbirth or if they have a medical condition like anaemia, cancer or blood disorders such as haemophilia.

O negative is the blood type used most in emergencies and across hospitals in the UK. Because it can be given to anyone, it’s seen as the most 'prized' blood type. Other blood types have to be a much closer match – so someone with blood type A positive would need to be given to an A positive type recipient. 

There’s also a higher demand for blood donations from black donors to treat black patients with sickle cell disease. It’s crucial for their treatment to have blood transfusions from black donors as a closest match to their blood.

## Can I give blood?
‘Most people are able to give blood, but it’s worth speaking to a GP or checking the restrictions online if you’re not sure. These cover any issues with your health, medication you take, and whether you've been abroad recently,’ says Dr McClymont.

To find out if you’re eligible to give blood, you can visit the UK’s blood donation website and search the Health and Eligibility sections.

It will take you through some interactive questions – based on the most common reasons people are unable to give blood, and advise you on whether you can give blood in the future.   

## What is my blood type?
There are 8 main blood types, with some more common than others. These percentages give you an idea of which blood types are the most common, and which are the most rare (UK data collected in 2018).
O positive: 35%
A positive: 30%
O negative: 13%
A negative: 8%
B positive: 8%
B negative: 2%
AB positive: 2%
AB negative: 1%

If you’re not sure of your blood type, you’ll find out after your first blood donation.

You can find out more about different blood types, and why some are more in demand than others.

## Which blood types are in demand?
Sometimes there will be a shortage of certain blood types – this is why regular donors will be contacted about giving blood if they have the particular blood type.

Certain blood types can also be more widely used which creates a much higher demand. Even though 8% of people in the UK have type O negative blood, this type of blood makes up 13% of blood donation requests from hospitals because anyone in need of a blood transfusion can receive the red cells from O negative donors. 

If a person’s blood type is unknown in an emergency, O negative red cells will be used.

## How do I give blood?
Thousands of people are already signed up to give blood – and you can too. To join the growing community of blood donors, you firstly need to register your details on the blood donation database. 

Once you’ve answered a few questions to check whether you’re eligible, you’ll be asked to fill in some personal details and set up an account. The process is super quick and easy. 

Through your account you can then find out where you can give blood, book an appointment, change any future appointments, update your details and view your blood donation history over the last 5 years. 

Don’t worry if you can’t book an appointment straight away, as some centres get busier than others!

## Are there side effects after you give blood?
Most people don’t feel any different after giving blood. It’s possible you may have some mild bruising on your arm (around the needle site). Some people can feel a bit tired or lightheaded afterwards.

‘Light bruising is completely normal and will disappear very quickly. To make sure you don’t feel dizzy after giving blood, you’ll be encouraged to have at least two drinks and a snack afterwards, and rest for at least 15 minutes before you leave,’ advises Dr Rhianna McClymont. ‘If you feel unwell, stay sitting down and let a member of staff know as soon as you can.’

Once you’re home, if you start to feel poorly in the following 2 weeks (other than a cold or cold sore) or if you believe there’s a reason your blood should not be given to a patient, call the donor helpline on 0300 123 23 23.

## How to feel less anxious about giving blood
It’s completely normal to feel anxious about giving blood, especially if it’s your first time. There will be lots of helpful staff around to put you at ease as soon as you arrive at the blood donation centre – and it’s a good idea to let them know you’re feeling a bit nervous so they can offer reassurance.

One of the best ways to help your anxiety is to distract yourself. Some people bring music to listen to or a book to read. 

During your blood donation, you’ll also be asked to do a simple technique called ‘applied muscle tension’. This helps to regulate your blood pressure and stop you feeling faint or unwell. It’s also another great way to distract you during your blood donation. The technique involves tensing and relaxing your muscles during the giving blood process – including clenching and unclenching your buttock muscles.

More information will be available at the blood donation centre. Ask a member of staff if you have any questions.

## What to eat and drink when you give blood
Eating regularly before giving blood will help to keep your blood sugar levels stable. This is important so that you don’t feel lightheaded or dizzy afterwards. 

‘It’s a good idea to have a snack before you give blood and try to eat foods rich in iron afterwards, like red meat, fish, leafy vegetables, nuts and seeds. This will help to keep you feeling fit and well during and after giving blood,’ Dr McClymont explains.

Almost half of the blood you will donate is made up of water, and so any fluids you lose during the process can lead to your blood pressure falling. To prevent this and stop you feeling faint, it’s recommended you drink lots of fluids in the days leading up to your blood donation, as well as 500ml of water right before you give blood. 

Drinking lots of water after you give blood is just as important – try and bring a refillable bottle if you can to help cut down plastic waste!

Make sure you avoid any alcohol before and after the blood donation. Drinking after giving blood may affect your hydration levels and delay your blood volume returning to normal.

## What to do after giving blood
Dr McClymont has shared a few things you can do to make sure you feel well immediately after giving blood, as well as for the rest of the day. They include:

- Sit down for 15 minutes after you give blood and rest as much as you can – don’t drive if you feel faint or lightheaded

- Keep the pressure dressing on your arm for at least half an hour after you’ve given blood, and the plaster on for at least 6 hours

- Stay hydrated – make sure you have at least 2 drinks straight after giving blood, and avoid drinking alcohol as this can dehydrate you more

- Eat regularly – make sure you eat a snack afterwards and eat your regular meals throughout the day to prevent you feeling dizzy

- Avoid strenuous exercise or using the arm you gave blood from to carry anything heavy, for the rest of the day

For more advice, or if you notice any unusual side effects from your blood donation, call the helpline on 0300 123 23 23.

## Can you exercise after giving blood?
‘Try to avoid exercising or lifting anything heavy on the day you give blood, especially afterwards,’ says Dr McClymont.

‘Resting your body means that you have a chance to properly recover and build up fluids that are lost during your blood donor session. It’s fine to do some light exercise like walking, as long as you stay hydrated throughout the day.’

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Kry.co.uk > Your health > Everything you need to know about giving blood

Blood donations: everything you need to know when you give blood

All you need to know about giving blood and why blood donations are so important. Expert advice from a Kry Lead GP. 

Everything you need to know when you give blood | Kry UK

Everything you need to know about giving blood

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