Women's health
Dr Rachel Mackey is a medical doctor who specialises in women’s health. A graduate of the Royal College of Surgeons.
Women's health

Q. I have trouble with a recurring Bartholin’s Cyst. It became so painful and infected at one time I needed an antibiotic, but usually it just flares up for a few weeks and then calms down itself. Is there anything I can do to stop it flaring up or to treat it at home if it does flare up.

Rachel says
Bartholin’s glands lie in the labia, one on each side and they secrete fluid for vaginal lubrication. Women aged 20-29 are most at risk of infection. The gland swells and becomes very painful; they can sometimes become an abscess.

Women's health

Q. I have suffered with gallstones for years and I am having surgery in a few weeks. Once they’re gone what can I do to avoid getting them again?

Rachel says
Only a small percentage of patients develop recurrent gallstones after surgery where your gallbladder is removed. The most effective way to prevent gallstones from recurring is to achieve a normal body weight if you are overweight. This should include a diet with an appropriate number of calories and a regular exercise programme of 30 minutes per day five days a week.

Women's health

Q. Since having my two children who are aged two and five, I have suffered quite badly from bladder weakness. It’s getting me down as I feel nervous about sex and also I feel quite tender ‘down there.’ I am using pads during the day but can you recommend any treatments or self-help therapies I can start to improve my condition?

Rachel says
This type of urinary problem is very common in women after childbirth. It is called stress incontinence and is due to pelvic floor weakness. Typically urine is leaked during exercise, coughing, sneezing and sometimes sex. It is successfully treated with physiotherapy in 70% of women, which strengthens the pelvic floor muscles.

Women's health

Q. Recently I am really struggling with the emotional side of PMS. I don’t have a regular cycle, but I feel I’m at my worst around the time of ovulation and for about three days before I get my period. I’m somewhat tearful on these occasions, but what is really upsetting me is how angry I am. The slightest thing can completely push me over the edge. I am not an aggressive person but the urge to scream when I’m feeling this way is overwhelming! I really don’t like myself when I’m like this. What can I do to stop it?

Rachel says
The emotional symptoms of Premenstrual Syndrome (PMS) can be very difficult to cope with. Anger is a common symptom and it can be scary for you and your loved ones! Firstly you should have a look at your diet and exercise routine around this time. It can help a lot to eat well and frequently to prevent high and low sugar levels from occurring.

Women's health

Q. We have finished our family and at age 43 I cannot decide what the best method of contraception is for me. I fear I’m too old to be on the pill, I suffer from migraines and so I’m terrified to try the Mirena coil or the rod implant and my husband is reluctant to have a vasectomy. I would consider tubal ligation, but the idea of surgery frightens me a little. What other options have I?

Rachel says
There are several excellent contraception options available to you. Firstly, the low dose oral contraceptive pill may suit you, provided your migraines are not of a particular type. Oestrogen- containing low dose pills are unlikely to worsen your migraines and are safe in women who are non-smokers and of a normal weight until the age of 50.

Women's health

Q. My mother and maternal grandmother were both diagnosed with osteoporosis. Do I naturally fall into a high-risk category because of this or are there any preventative measures I can take? I’m 36.

Rachel says
Osteoporosis is a condition that affects older women. The structure of the bone is weakened and the risk of bone fracture is increased. It is more common in older women because the female hormone oestrogen produced by younger women protects bones until the menopause.

Women's health

Q. What are the most important medical screening tests for women and at what age should they have them?

Rachel says
For younger women, cervical smear tests should be done regularly every three years from the age of 25 years onwards and Cervical Check provide this service free of charge at your local doctor. I normally advise my patients to start having annual checks after the age of 40.

Women's health

Q. With all the advances in fertility treatments, how old is too old for a woman to try to get pregnant?

Rachel says
No woman wants to hear that they are too old to have a baby. The truth is, our bodies are designed to give birth at a much younger age than we currently do. This is because of lots of different reasons – advancing your career, having several partners before finally settling down; reliable contraception etc.

ABOUT Dr RACHEL
Dr Rachel Mackey is a medical doctor who specialises in women's health. A graduate of the Royal College of Surgeons.