This is a problem I see very often. It can be exhausting: treatment helps, symptoms settle, and then itching, discomfort, unusual discharge or irritation return again.

Recurrent thrush is not something you simply have to endure. But it is a reason to stop repeatedly treating symptoms on your own and make sure the diagnosis and treatment plan are correct.

Candida is a yeast that can normally be present in the vagina without causing symptoms. Thrush develops when it overgrows and causes inflammation. If symptoms return frequently—typically three or more confirmed episodes within a year—it is important to see a gynaecologist.

Why can symptoms return?

Sometimes the original diagnosis was not confirmed. Itching, burning and discharge are not specific to thrush. Similar symptoms can occur with bacterial vaginosis, sexually transmitted infections, contact dermatitis, vulval skin conditions, vaginal dryness or irritation caused by hygiene products.

For recurrent symptoms, it may be necessary to take a vaginal swab or culture to confirm Candida, identify the species and choose effective treatment. Some species respond less well to standard antifungal medicines and require a different approach.

Certain factors may also increase the likelihood of recurrent thrush, including recent antibiotic use, poorly controlled diabetes, pregnancy, immune-system conditions and some medications. In many women, however, no clear cause is found—and that does not mean that anything is “wrong” with them.

Everyday Care Matters

The vulval area does not need aggressive cleansing. Frequent use of scented gels, antiseptics, douching, intimate wipes or fragranced pads can irritate delicate skin and make discomfort worse.

For everyday hygiene, warm water is usually enough. If you prefer a cleanser, choose one with a simple, fragrance-free formula and use it externally only.

Avoid wearing panty liners every day unless they are necessary. Tight synthetic underwear, very tight clothing and prolonged moisture can also contribute to irritation. Choose breathable underwear and change out of wet clothing promptly.

Lifestyle and Overall Health

Good sleep, stress management, regular meals and balanced nutrition support overall well-being. However, strict “anti-Candida” diets, detoxes and supplements have not been proven to treat recurrent vaginal thrush and should not replace proper diagnosis and medical treatment.

If you have symptoms, there is no need to blame yourself or try to control every food choice. The priority is accurate assessment and a plan that is realistic for your life.

When to Seek Medical Advice

Please arrange a consultation if symptoms keep returning, do not improve after treatment, appear for the first time during pregnancy, or are accompanied by pelvic pain, fever, sores, strong odour or bleeding.

My role is to help identify what is actually causing your symptoms, confirm the diagnosis and create an individual treatment and prevention plan—calmly, carefully and without unnecessary treatment.

This is not about being perfect or undergoing endless “just in case” tests. It is about entering pregnancy with a sense of support: enough energy, a better understanding of your body, stable habits and a calmer mind.

Pregnancy is not experienced by the uterus alone—it is experienced by the whole woman. That is why I look at planning more broadly: thyroid function and metabolism, blood sugar stability, possible nutrient deficiencies, digestive health, sleep quality, stress levels and the ability to recover.

This broader approach often brings the clearest result: less anxiety, more clarity and greater trust in your body.

Good preparation usually does not begin with dramatic decisions. It begins with respecting physiology. The body needs time. For many women, three months of preparation is enough; in some cases, allowing three to six months may be helpful—especially if periods are irregular, there have been previous pregnancy losses, thyroid conditions, significant PMS, suspected insulin resistance, chronic fatigue, digestive concerns or age over 35.

This is not about delaying pregnancy. It is about calmly strengthening the foundation: iron stores, nutritional status, sleep, eating habits, body weight and stress levels. When the body has adequate support, planning and pregnancy often feel more manageable.

I do not believe in “testing everything.” I believe in meaningful assessment.

Some examinations can genuinely help with preparation: identifying significant nutrient deficiencies, assessing thyroid function or carbohydrate metabolism when indicated, and looking for factors that may affect conception or pregnancy.

In gynaecology, it is important to keep cervical screening up to date according to your age and medical history. Assessment of vaginal symptoms, infections or microbiota may be needed when there are complaints, symptoms or individual risk factors. Dental health also matters: treating active dental problems before pregnancy is a sensible preventive step.

Nutrition during preparation is daily support for the body. It is not about strict restrictions, but about a balanced routine that supports energy, metabolism and overall health.

Aim for regular meals with enough protein, vegetables that feel comfortable for your digestion and healthy fats. When eating is chaotic or the diet lacks essential nutrients, the body may respond with fatigue, energy fluctuations, poor sleep, more pronounced PMS or digestive discomfort.

The goal is not a “perfect diet,” but a stable foundation.

Digestive health can also affect how you feel before and during pregnancy. Bloating, unstable bowel movements, pain, food reactions or persistent digestive discomfort are not something you need to simply tolerate. Addressing these concerns before pregnancy can make daily life more comfortable and help ensure that nutrition is well tolerated.

Often, simple steps are helpful: regular meals, adequate fluids, less added sugar, enough sleep and gentle movement. Sometimes a more individual assessment is needed.

Supplements require a careful approach. Some nutrients, especially folic acid or folate, are important before conception. Others should not be taken “just in case.”

I prefer targeted support based on your diet, symptoms, medical history, laboratory results and thyroid or menstrual-cycle health. You should understand what you are taking and why—not try to ease anxiety with a collection of supplements.

Sleep and stress also matter. The nervous system affects appetite, blood sugar regulation, inflammation, libido and overall well-being. If you are constantly tense, sleep poorly and rarely feel rested, the body has fewer resources for recovery.

That is why preparation includes basic forms of support: sleep, a manageable routine, daily walks, gentle breathing or body practices and small restorative rituals. These are not minor details—they are part of preventive care.

Movement is another important part of preparation. Pregnancy places demands on the body, so it is helpful to build gentle strength, mobility and endurance in advance. Walking, swimming, yoga, calm strength training and posture or breathing exercises can all be appropriate options depending on your health and fitness level.

Intimate comfort deserves attention too. If you experience dryness, pain, recurrent inflammation, discomfort after sex or frequent infections, it is best to address this before pregnancy. Comfortable mucous membranes and pain-free intimacy are important for quality of life and emotional well-being.

Preparation is also a shared process for a couple. Sperm quality is influenced by lifestyle factors such as sleep, smoking, alcohol, stress, body weight, overheating and nutrition. When both partners prepare together, it can reduce pressure on the woman and make the process feel more supportive.

Consider a consultation before trying to conceive if:

• Your cycle is irregular or pregnancy has not occurred as expected.
• You have experienced pregnancy loss.
• You have significant PMS, acne, increased facial or body hair, or unexplained weight changes.
• You suspect PCOS.
• You have thyroid disease, diabetes, high blood pressure or autoimmune conditions.
• You take regular medication.
• You have had surgery involving the uterus or ovaries.
• You are 35 or older.
• You simply want a clear, individual plan without anxiety or confusion.

Preparing for pregnancy is not a race or a test of whether you are an “ideal” woman. It is a gentle adjustment of life that helps your body feel more supported.

My role is to help you understand your individual situation, reduce avoidable risks and create a realistic plan—without overload or perfectionism, and with respect for your real life.

Panty liners can seem like a convenient everyday essential: “just in case,” “for freshness,” or “to keep underwear clean.” Many women start wearing them as routinely as underwear. However, daily use can change the conditions around the vulva and mucous membranes, which have their own protective barrier and natural microbiota.

The main issue is warmth and moisture. A panty liner can reduce ventilation and retain moisture, creating a warm, humid environment. This may make the skin more prone to irritation, redness, itching, discomfort or a feeling of dampness. For some women, especially those already prone to irritation or recurrent vaginal symptoms, prolonged use may contribute to discomfort.

Another factor is contact irritation. Panty liners contain different materials, adhesives and sometimes fragrances. Even products labelled “breathable” or “hypoallergenic” can cause irritation when they remain in contact with sensitive skin for many hours. This may lead to burning, dryness, chafing or small skin cracks.

A common cycle can then develop: discomfort leads to more frequent washing, scented gels, wipes or antiseptics, which may further irritate the skin barrier.

Panty liners can also mask changes that deserve attention. If discharge becomes noticeably heavier, changes in colour or smell, or is accompanied by itching, burning or pain, a liner does not address the cause. These symptoms may be related to irritation, hormonal changes, infection or other conditions that should be assessed individually.

What I recommend:

• Avoid wearing panty liners continuously every day when they are not necessary.
• Choose breathable underwear, ideally cotton or with a cotton gusset.
• Avoid very tight synthetic clothing that increases heat and moisture.
• If you need a liner, choose an unscented option and change it regularly.
• Do not use panty liners to manage persistent discharge, itching, burning or unpleasant odour—consult a gynaecologist instead.

Vaginal discharge can change throughout the menstrual cycle, and this is often normal. The most useful comparison is not with someone else, but with what is usual for you. The goal is not “sterility,” but noticing when something has changed and responding to it with care.

Intimate hygiene products that claim to have an “acidic pH” are one of the most persistent marketing myths in personal care.

The idea sounds logical: since the environment inside the vagina is acidic (pH 3.8–4.5) and this is important for protection against infections, then the same acidity should be maintained externally. However, there is an important anatomical distinction.

The acidic environment is formed and maintained strictly inside the vagina. It is supported by lactobacilli that live on the mucous membrane and produce lactic acid.

During washing, we do not apply gel inside the vagina. Externally—the skin of the vulva, perineum, and labia—the environment is different. The skin in this area has its own protective barrier and differs from vaginal mucosa in both structure and function.

Therefore, the promise to “maintain an acidic environment” in products intended for external use is largely a marketing claim. Even if a gel has a pH of 4.0 in the bottle, it is rinsed away with water within seconds. It cannot meaningfully change the vaginal microbiota or maintain acidity inside the vagina.

What matters more is how the product affects the skin barrier. Some cleansing products, especially those containing harsh surfactants, fragrances, antiseptics or unnecessary acids, may cause dryness, irritation or discomfort. This can be particularly relevant for women prone to recurrent vulvovaginal irritation, painful intercourse, dryness or urinary discomfort.

In some cases, frequent use of strongly fragranced or aggressive products may worsen symptoms by disrupting the skin’s natural protective barrier. Antiseptics should not be used routinely unless specifically recommended by a doctor, as they may irritate delicate tissues and are not necessary for everyday hygiene.

In practice, warm water is enough for external intimate hygiene for most women. If an additional cleanser is preferred, choose a product with a simple formula and a mild cleansing base, without fragrances or antiseptics.

Remember: no external gel can improve the microbiota or acidity inside the vagina. Vaginal health depends on many factors, including hormonal status, overall health, medication use and individual medical conditions.

If you experience itching, burning, unusual discharge, pain or persistent dryness, do not try to solve the issue by changing hygiene products alone—consult a gynaecologist.

One of the most common questions from women after the age of 40–45 is: “Which tests should I take to find out whether menopause is approaching?”

Testing FSH, AMH, inhibin B or estradiol may seem logical if you want to look ahead and prepare. However, from the perspective of evidence-based medicine, these tests cannot reliably predict when menopause will begin.

No single test can determine the exact timing of menopause. AMH (anti-Müllerian hormone) does reflect ovarian reserve, but it cannot answer the question of “when.” FSH levels may rise several years before the final menstrual period, but they fluctuate greatly and a single result is not informative.

Even if we knew the exact date, we could not substantially change it. The age at which menopause begins is influenced largely by genetics. No “supportive” regimen, supplement or diet can significantly delay it.

However, genetics are not a verdict. While we cannot change the date written in our DNA, lifestyle factors—including nutrition, stress, physical activity, smoking and chronic health conditions—can affect how perimenopause is experienced and how pronounced its symptoms may be.

The goal is not to predict the exact date, but to help your body go through this transition with the best possible quality of life.

Chasing Numbers Can Increase Anxiety

A low AMH result can be alarming, even when it is completely expected for a woman’s age and has no direct effect on her current well-being.

Trying to identify the exact timing of menopause can create unnecessary stress. Chronic stress itself may worsen sleep, mood and the perception of symptoms during perimenopause.

Instead of focusing on a “day X,” it is more helpful to focus on the things you can influence now.

What Can Support a More Comfortable Transition

• Regular gynaecological check-ups and timely treatment of health concerns.
• A balanced diet with enough protein, fibre, vitamins and minerals.
• Correction of confirmed deficiencies, such as iron or vitamin D deficiency, together with a doctor.
• Regular physical activity to support bone, muscle, cardiovascular and mental health.
• Maintaining a healthy weight.
• Good sleep and stress-management habits.
• Attention to emotional well-being and access to psychological support when needed.

Support for sexual and emotional health also matters. Past experiences, body image, relationship dynamics, stress and anxiety can all influence how a woman feels during this stage of life. Working with a qualified psychologist, psychotherapist or sexologist can be helpful if these concerns affect well-being.

When blood vessels, bone tissue, the nervous system and mucous membranes receive appropriate care long before ovarian function declines, the transition may be easier to manage.

The most useful strategy is not “take tests and find out the date.” It is supporting your health now—both physically and emotionally—so that your quality of life remains high, whether menopause begins at 48 or at 55.

Childbirth marks the end of a major physiological process. Afterwards, the body does not simply return to its previous state—it adapts to a new stage of life. This process needs comprehensive support.

Recovery is not limited to one diet or one exercise. It involves four key areas: nutrition, sleep, physical activity and emotional well-being.

Nutrition

Nutrition provides the resources needed for tissue repair and hormonal balance. During the postpartum period, the body restores muscles, ligaments, skin and blood vessels.

Protein is especially important because it provides amino acids—the building blocks of tissues. Include a source of protein in each main meal and discuss your individual protein needs with a doctor or nutrition specialist, particularly if you are breastfeeding, have kidney disease or follow a restrictive diet.

Vegetables and greens provide fibre, vitamins and antioxidants that support digestion and overall health. Whole grains provide energy, which is particularly important while caring for a baby and adapting to a new routine. Healthy fats—such as vegetable oils, nuts, avocado and oily fish—support hormone production and nervous-system function.

A simple balanced-plate approach can be helpful: half the plate with vegetables, one quarter with a protein source and one quarter with complex carbohydrates, with healthy fats added as appropriate. Regular, nourishing meals are often more helpful than relying on quick snacks alone.

Sleep

Sleep is a key factor in recovery and hormonal regulation. During sleep, the body carries out many important repair processes, including tissue recovery and protein synthesis.

Lack of sleep can affect physical recovery, emotional well-being, appetite and stress levels. Chronic sleep deprivation may increase cortisol, a stress hormone that can affect mood, metabolism and overall health.

Sleep is understandably disrupted after childbirth. The goal is not perfection, but reducing the impact where possible: rest when support is available, share night-time responsibilities when you can and create the best possible sleep environment during the hours that are accessible to you.

Physical Activity

Returning to physical activity after childbirth should be gradual and based on how your body is recovering.

The first 6–8 weeks after a vaginal birth—and often longer after a caesarean section—are a period of healing. During this time, gentle walking, breathing practices and light everyday activity may be appropriate if you feel well and your doctor has not advised otherwise.

Before returning to more intensive exercise, it is important to assess your recovery with a healthcare professional. This is especially relevant for the pelvic floor.

Pelvic floor muscles may be weakened, but they can also be overly tense. In cases of increased muscle tension, unsupervised Kegel exercises may worsen discomfort or pain. An individual assessment by a gynaecologist, pelvic-floor physiotherapist or other qualified specialist can help determine whether the priority is strengthening, relaxation or both.

Once your body is ready, activity can be introduced step by step. Priorities usually include restoring diaphragmatic breathing, reconnecting with the deep core muscles and then gradually returning to general exercise.

Emotional Well-Being

Emotional recovery is just as important as physical recovery.

Hormonal changes after childbirth affect not only the reproductive system but also the nervous system. Changes in estrogen, progesterone, oxytocin and prolactin levels can influence mood, anxiety and the ability to adapt.

Sleep deprivation, fatigue, changes in social roles and physical limitations can place additional pressure on mental health. This may appear as irritability, tearfulness, anxiety, low mood or emotional numbness.

Supporting emotional well-being is part of postpartum recovery. Regular meals, adequate rest, gentle physical activity when appropriate and practical support from loved ones can all help.

If low mood, anxiety, hopelessness or loss of interest lasts longer than two weeks, interferes with daily life or includes thoughts of harming yourself or your baby, seek help from a perinatal psychologist, psychotherapist or doctor as soon as possible. Postpartum depression is a medical condition, not something a woman should simply “rest through.”

Complete postpartum recovery is a system: nutrition provides the resources, sleep supports repair, physical activity is introduced when the body is ready and emotional well-being receives the support needed for adaptation. None of these areas works in isolation.

Questions about collagen are among the most common. Some people say it is not absorbed and is a waste of money. Others take it every day and expect miracles. So where is the truth?

What Is Collagen From a Physiological Perspective?

Collagen is a protein. Like any protein you eat—chicken, fish or eggs—it is broken down in the gastrointestinal tract into amino acids and short peptides.

The body does not simply send collagen directly to the skin or joints. It uses the amino acids and peptides according to its current needs.

What makes collagen different is its amino acid profile. It contains high levels of glycine, proline and hydroxyproline, which are important components of connective tissues: skin, joints, ligaments, bones and blood vessels. Regular dietary proteins contain these amino acids in different proportions.

Is Collagen Absorbed?

Yes. Hydrolysed collagen is collagen that has already been broken down into smaller peptides. These peptides can be absorbed in the intestine and enter the bloodstream.

The Important Detail

The body is not a storage system—it has priorities.

It will not say, “Collagen has arrived, let’s send it straight to the skin.” Amino acids are distributed according to the body’s most important current needs.

If your overall diet does not provide enough protein, the body may use available amino acids first for essential functions: supporting the immune system, producing enzymes, maintaining muscle mass and other vital processes.

In this situation, collagen supplements cannot replace a balanced diet with enough protein.

Collagen supplements may be most useful as an addition to an already adequate diet—not as a substitute for it.

What About Joints?

There is a lot of confusion around this topic.

Myth: collagen amino acids travel directly into a joint and rebuild damaged cartilage.

This is not how it works. Cartilage does not have its own direct blood supply and receives nutrients through diffusion from the synovial fluid. You cannot simply “add” collagen to a joint by taking a supplement.

The reality is more complex.

Studies suggest that hydrolysed collagen may help reduce joint pain and improve joint function in some people, including those with osteoarthritis. However, it does not rebuild severely damaged cartilage or make it grow back.

There are several possible mechanisms behind its effect.

Stimulation of the Body’s Own Cells

Collagen peptides that enter the bloodstream may act as signalling molecules. They can potentially stimulate fibroblasts and chondrocytes—cells involved in connective tissue and cartilage—to produce their own collagen and proteoglycans.

In other words, collagen does not replace the tissue directly. It may support the body’s own repair processes.

Support of Inflammatory Balance

Collagen contains glycine and proline, amino acids that may be involved in anti-inflammatory processes. Since low-grade chronic inflammation can contribute to joint discomfort and degeneration, reducing it may help improve symptoms in some people.

Collagen is not a miracle treatment. It cannot restore cartilage that has already been destroyed. But it may be a useful part of comprehensive joint support when combined with medical care, movement, adequate nutrition and treatment of the underlying condition.

My Recommendations

1. Start with your diet.

Make sure you consume enough protein every day: meat, fish, eggs, dairy products, legumes or other suitable protein sources.

1. Assess your overall health when needed.

If you have symptoms of nutritional deficiency, unexplained fatigue, weight loss, digestive problems or a restrictive diet, discuss this with your doctor. Laboratory tests, including total protein and albumin, may be useful in certain situations—but they should be interpreted together with your overall health and diet.

1. Consider collagen as additional support.

If your diet is balanced and you have no contraindications, collagen may be used as targeted support for connective tissues, especially after the age of 30–35, during active exercise or when there are joint concerns.

Collagen is a supplement, not a replacement for proper nutrition. It works best when the foundation is already in place.

Laser procedures are now offered for many areas: the face, neck and intimate area. They promise firmer tissue, collagen renewal and a lifting effect. This is true: laser treatment can stimulate fibroblasts and initiate new collagen formation.

However, there is one important detail that is rarely discussed openly.

What is usually recommended before and after the procedure? At most, a woman may be advised to take collagen for one month before and two months after treatment. Sometimes hyaluronic acid and vitamin C are added. And that is where the preparation ends.

No one suggests checking total blood protein. No one assesses whether the body has the resources needed to produce the new collagen that the laser procedure is expected to stimulate.

Why Is This Important?

Laser treatment creates controlled thermal damage. It causes microscopic injuries in the skin or mucous membranes. The body recognises this as a signal that repair is needed.

Fibroblasts move to the treated area and begin producing new collagen and elastin. However, collagen synthesis is a complex biochemical process. It requires:

• Amino acids, including glycine, proline, lysine and hydroxyproline — the building blocks of collagen.
• Vitamin C — an essential cofactor in collagen formation.
• Zinc, copper and silicon — cofactors for enzymatic processes.
• Energy in the form of ATP.

The main resource is protein. New collagen is formed from amino acids, which come from dietary protein and the body’s protein reserves.

What Happens If There Is Not Enough Protein?

Low total protein or albumin levels may indicate that the body does not have sufficient nutritional resources. In this situation, the body prioritises essential functions such as immunity, enzyme production and liver function.

Laser treatment creates an additional demand. The body receives a signal to produce collagen in the treated area, but there may not be enough building material available.

As a result, the effect of the procedure may be limited or absent. Fibroblasts receive the stimulation signal, but the tissue may not have enough resources for effective regeneration.

In some cases, particularly when treating delicate mucous membranes such as the intimate area, careful assessment is especially important. Temporary swelling after treatment can create a short-term feeling of firmness. However, the quality of tissue recovery depends on many factors, including overall health, hormonal status and adequate nutrition.

Stimulating tissue without supporting its recovery is like asking builders to work without delivering the necessary materials.

Why Collagen Supplements Alone May Not Be Enough

Collagen supplements can be part of an overall approach, but they do not replace adequate nutrition.

If a woman has an underlying protein deficiency or other nutritional deficiencies, the amino acids from collagen supplements may be used first to support the body’s essential needs rather than tissue recovery after a cosmetic procedure.

The body always prioritises vital functions over skin appearance or tissue firmness.

How to Prepare Properly

Preparation for laser procedures should begin with an individual medical assessment, not simply with purchasing collagen supplements.

Step 1. Assess Protein Status

A doctor may recommend checking total protein and albumin levels when indicated. If there are signs of nutritional deficiency, it is important to address them before planning procedures that rely on tissue regeneration.

Step 2. Assess Nutritional Status

Depending on your medical history and symptoms, your doctor may assess vitamin D, iron, ferritin, zinc and B vitamins. Deficiencies can affect the body’s ability to recover.

Step 3. Support a Balanced Diet

Adequate protein intake should be part of every meal. Sources of complete protein include meat, fish, eggs and poultry. The appropriate amount of protein depends on your individual health status, diet and medical conditions.

Step 4. Consider Targeted Supplement Support

Collagen, vitamin C and other supplements may be considered after the nutritional foundation has been addressed and only when appropriate for you.

Beauty Does Start From Within

Laser treatment is a powerful tool, but it does not replace the body’s own resources. It provides stimulation, while tissue recovery depends on your overall health, nutrition and individual medical factors.

Before any laser procedure, discuss preparation and possible contraindications with your doctor. When the body has the right conditions for recovery, treatment can be safer and more effective.

Painful Periods

Many women believe that pain during menstruation is simply something they have to endure. This is a dangerous misconception.

What Is Normal

Mild discomfort in the lower abdomen on the first day of the cycle can be normal. It should not affect your ability to work or go about your usual activities. You should not need to cancel plans or spend the day in bed.

Pain relief medication is either not needed or taken only once. Your wellbeing should return to normal within one or two days.

Normal means that period pain does not interfere with your life.

When Pain Is Not Normal

Pain requires medical assessment if:

• It is severe enough to make you miss work or school, cancel plans or stay in bed.
• It lasts throughout your period, rather than only during the first one or two days.
• It is not relieved by standard doses of pain medication or requires increasing the dose.
• It is accompanied by nausea, vomiting, dizziness, fainting or diarrhea.
• It appears for the first time.
• It becomes worse with each cycle or is more intense than it used to be.

Any of these signs is a reason for diagnosis, not for enduring the pain.

Chronic pain does not build resilience. It exhausts the nervous system. Over time, the brain may become more sensitive to pain signals, even in the absence of an immediate threat. The longer pain is ignored, the more difficult it can be to manage.

Enduring pain can also mask a progressing condition. You do not need to tolerate it—and it can be harmful to do so.

What May Be Causing the Pain

• Endometriosis — one of the most common causes of painful periods.
• Adenomyosis — endometriosis affecting the muscular wall of the uterus.
• Uterine fibroids, especially those that distort the uterine cavity.
• Chronic inflammatory conditions of the pelvic organs.
• Pelvic adhesions.
• Congenital abnormalities of the reproductive organs.

Pain is not without a cause. It may indicate an underlying condition that needs to be diagnosed.

When a patient says, “I have lost my desire,” there is almost never just one cause. The approach, however, is clear: first, we rule out physical causes; then we address psychological and emotional factors.

Psychotherapy will not eliminate pain caused by endometriosis. A sexologist cannot restore estrogen levels. And hormones will not resolve the effects of birth trauma or chronic stress.

What can cause low libido?

Hormonal changes

Low estrogen levels can cause vaginal dryness, thinning of the vaginal tissues and pain during intimacy. Lower testosterone levels may reduce sexual initiative and sensitivity.

Elevated prolactin levels can suppress sexual desire. Thyroid disorders—both hypothyroidism and hyperthyroidism—can also affect sexual function.

Postpartum changes

After childbirth, estrogen and progesterone levels drop sharply. Breastfeeding-related amenorrhea is associated with naturally lower estrogen levels.

Perineal injuries, scarring, diastasis recti and pelvic floor prolapse can affect comfort during intimacy. Changes in tissue sensitivity, nerve function and blood supply may also contribute to reduced desire.

Inflammation and vaginal microbiome imbalance

Chronic infections, recurrent candidiasis, bacterial vaginosis and sexually transmitted infections can all affect sexual wellbeing.

Even inflammation without obvious symptoms may create an association between intimacy and pain. In response, the brain may begin to suppress arousal.

General health conditions

Diabetes can affect nerve function, blood circulation and vaginal moisture. Autoimmune conditions, such as Sjögren’s syndrome, and neurological disorders may also play a role.

Medication

Some medications can affect libido and vaginal lubrication, including SSRIs, antihistamines, blood pressure medications and hormonal contraceptives.

Do not stop or change prescribed medication without discussing it with your doctor.

Psychological and emotional factors

Chronic stress raises cortisol levels and may affect the production of sex hormones. Anxiety, depression, low self-esteem and fear of pain can all reduce sexual desire.

Internal restrictions, shame around sexual fantasies and negative sexual experiences may also create a persistent inhibition of libido.

Relationship and social context

Conflict, a lack of emotional closeness, household responsibilities and fatigue can all affect desire.

Unrealistic expectations, pressure from social media and myths about the “right” frequency of sex can make the situation more difficult.

What to do

The first step is a consultation with a gynecologist. This may include an examination, ultrasound and, when indicated, assessment of hormonal status.

It is important to rule out infections, pain-related conditions and anatomical changes. Once physical causes have been assessed and treated where necessary, working with a sexologist or psychotherapist can be the next step.

Vaccination against human papillomavirus (HPV) is not simply “another vaccine.” It is an effective way to protect your health and the health of your loved ones for years to come.

HPV is a very common virus, most often transmitted through intimate skin-to-skin and sexual contact. Some high-risk types can persist in the body for years and may contribute to the development of cervical, vaginal, vulvar, anal, penile and oropharyngeal cancers. HPV can also cause genital warts.

Why is HPV vaccination important?

Persistent infection with high-risk HPV types is the main cause of cervical cancer. Vaccination is one of the most effective ways to prevent HPV-related disease before infection occurs.

The vaccine is relevant for both women and men. Boys and men can carry HPV and may also develop HPV-related cancers or genital warts. Vaccinating all eligible people helps reduce the spread of the virus.

Modern HPV vaccines have been used internationally for many years and have a well-established safety profile. They are highly effective at preventing infections and precancerous conditions associated with the HPV types covered by the vaccine, especially when vaccination is completed before exposure to the virus.

The best time for vaccination is before sexual activity begins, when the body has not yet encountered HPV.

Who should be vaccinated?

Children and adolescents

Vaccination is generally recommended for girls and boys from the age of 9. The optimal age is usually 9–14 years, as the immune response is strongest and the likelihood of previous exposure to HPV is minimal.

For most children who begin vaccination before the age of 15, the course consists of two doses given 6–12 months apart.

Catch-up vaccination

Vaccination may also be recommended for adolescents and adults who have not previously completed the course.

For people who begin vaccination at the age of 15 or older, a three-dose schedule is commonly used. The exact schedule depends on the vaccine and individual medical circumstances.

Adults aged 27–45 may also benefit from vaccination in some cases. This should be discussed individually with a doctor, taking into account medical history, previous vaccination and personal risk factors.

Which vaccines are available?

The specific vaccine available may vary depending on the country and clinic. Different vaccines protect against different HPV types, including the high-risk types most commonly associated with cervical cancer.

Your doctor will help you choose the appropriate vaccine and schedule.

Is revaccination necessary?

According to current evidence, protection after a complete HPV vaccination course is long-lasting. Booster doses are not routinely recommended at this time.

However, vaccination recommendations may be updated as new data becomes available, so it is always worth confirming the current guidance with your doctor.

Important information before vaccination

• HPV vaccination does not replace regular cervical screening, including Pap tests and HPV tests.
• Vaccination and screening work together: vaccination helps prevent infection, while screening can detect changes at an early and treatable stage.
• If one HPV type has already been detected, vaccination may still protect against other types covered by the vaccine.
• Routine HPV testing is not usually required before vaccination.
• HPV vaccination prevents new infections but does not treat an existing HPV infection or HPV-related disease.

How is HPV transmitted?

Sexual and intimate contact

This is the main route of transmission. HPV can be passed through vaginal, anal or oral sex, as well as through close skin-to-skin contact in the genital area. Transmission is possible even without penetration.

Condoms reduce the risk of HPV transmission but do not provide complete protection, as the virus may be present on skin not covered by a condom.

Mother-to-child transmission

In rare cases, HPV can be transmitted from mother to child during childbirth. This may lead to recurrent respiratory papillomatosis, a condition in which papillomas develop in the airways.

Key facts about HPV

• HPV is very common. Most sexually active people encounter it at some point in their lives.
• The infection often causes no symptoms, so a person may not know they carry the virus.
• HPV is mainly transmitted through intimate skin-to-skin or mucosal contact.
• HPV is not spread through blood or airborne droplets.

My recommendation as a doctor

If you have children, especially teenagers, do not miss the opportunity to discuss HPV vaccination before sexual activity begins.

If you are an adult and would like to understand whether vaccination may still be beneficial for you, book a consultation. Together, we can discuss your individual situation and choose the most appropriate approach to prevention.