Gynaecological Problems

Antibiotic use, synthetic underwear, sweating and contraceptive pills can lead to fungal vaginal infections, especially when travelling in hot climates. Thrush (yeast infection or vaginal candidiasis) is characterised by a rash, itching and discharge. Nystatin, mico-nazole or clotrimazole pessaries or vaginal cream are the usual treatment. Maintaining good personal hygiene and wearing loose-fitting clothes and cotton underwear may help prevent these infections.
STIs are a major cause of vaginal problems. Symptoms include a smelly discharge, painful intercourse and sometimes a burning sensation when urinating. Medical at-tention should be sought and male sexual partners must also be treated. For more de-tails see p311. Besides abstinence, the best thing is to practise safe sex using condoms.

Pregnancy

Most miscarriages occur during the first three months of pregnancy. Miscarriage is common and can occasionally lead to severe bleeding. The last three months should also be spent within reasonable distance of good medical care. A baby born as early as 24 weeks stands a chance of survival, but only ; in a good modern hospital. Pregnant women j should avoid all unnecessary medication, al- | though vaccinations and malarial prophylactics should still be taken where needed ' Additional care should be taken to prevent ' illness and particular attention should be I paid to diet and nutrition. Alcohol and nico-'tine, for example, should be avoided.