Female Travellers

There are special considerations for the female traveller. To avoid unnecessary complications or issues arising during your trip the following information may be useful.

Personal security

Female travellers tend to receive more uninvited attention and harassment than males whilst travelling through some countries. Dress in a culturally sensitive manner. You wouldn't wear a bikini to church, so don't wear that skimpy top into the Thai temple. Dressing immodestly in some countries may be an invitation to sexual harassment. A useful tip is to wear a wedding ring, even if you are not married, as you may receive less unwanted male attention. Travelling with a companion will reduce the risk of insecurity, as can avoiding areas that provoke danger such as alleys and poorly lit streets. Avoid walking alone, particularly at night. Avoid being intoxicated or under the influence of any recreational drug if there is nobody around to watch over you. Use a taxi. Don't accept food or drink offerings; they may contain sedatives and allow you to be robbed or assaulted.Only drink beverages you have opened and poured yourself. Keep relatives, friends or your embassy informed of your itinerary.Leave expensive watches,rings,handbags,etc at home..

Well women

It is advisable to be up to date with Pap smears (recommended every two years), and breast self-examination should be performed regularly once a month after your period.

Menstruation

Bring an adequate supply of your preferred tampons or sanitary protection, and be generous with your estimates. Disposal should be done thoughtfully e.g. burying or burning. For convenience there is the option of taking the pill continuously, avoiding a period altogether. This can be particularly convenient when hygiene facilities are poor or inaccessible - e.g. trekking through Nepal. Antiseptic gel (e.g. Dermasoft) and personal wipes are handy to clean yourself. Bring adequate pain relief for menstrual cramps, such as Ibuprofen.

Contraception

The oral contraceptive pill is the most common form of contraception and providing you have no medical contraindications to using it, has the added advantage of regulating periods, minimising menstrual cramps and bleeding. However, high altitude and the pill can independently predispose towards the development of blood clots in the brain, lungs or legs, and taking the pill at altitude for prolonged periods can more than double the chance of this often fatal outcome. Smoking increases the risk. If you have concerns, discuss this with your doctor, who may suggest coming off the pill and using alternative methods of contraception. Time zones can cause problems with the pill. Try taking your pill at your usual home time if travelling across time zones, then adjust it by four hours earlier or later each day until you readjust to a suitable local time.

Remember vomiting, diarrhoea and some antibiotics will all interfere with the pill. It is safest to continue taking the pill but in addition use other forms of contraception until 7 days after the vomiting, diarrhoea or antibiotics has ceased. be used during this time.

The progesterone only pill, diaphragm, IUD's and long acting depot injection or implants may be suitable alternatives for contraception. Condoms will reduce the risk of pregnancy and STDs. Emergency contraception can be organised, either with the morning after pill or an emergency IUD. The morning after pill is now available from your chemist.

Sexually Transmitted Diseases (STDs)

STDs are a major cause of vaginal problems such as discharge, pain on intercourse or pain while urinating. Many women however, have no symptoms. People are meant to be having fun on holidays, and the steamy encounter can always be made safe. Bring protection, or else don't have sex! Condoms help protect against sexually transmitted diseases including chlamydia and AIDS. Many countries have much higher rates of AIDS and other STDs. Remember that even one casual sexual encounter can cause disease, so it is advisable to use condoms. If you put yourself at risk or have symptoms seek medical attention.

Irregular bleeding

A degree of irregular bleeding is unfortunately common amongst women travellers. This is due to hormonal changes occurring as a result of disrupted routine and time zone changes but will often settle down. However, this could be a sign of pregnancy and if there is a chance of this, it should be confirmed as soon as possible. Those who choose not to allow the pregnancy to continue are advised to be very careful. A termination of pregnancy performed under unhygienic conditions can cause life-threatening complications and can have implications for the mother's future health and fertility. Termination can be safely left as late as 12 weeks. If you decide to continue with the pregnancy, you should make sure you have access to adequate medical care, and attend regular antenatal visits.

Candida infections (Thrush)

Hot, humid, tropical conditions often result in thrush, an overgrowth of a yeast which is normally present in the vagina. Antibiotics and the oral contraceptive pill also increase the likelihood of experiencing candida overgrowth. Symptoms of thrush include vulval or vaginal itch and irritation, along with a cottage cheese-like vaginal discharge. This can be easily treated with anti-fungal preparations such as Clotrimazole, in the form of cream or as a vaginal tablet.

To avoid recurrences:

  • Keep the genitals clean and dry.
  • Wear cotton underwear.
  • Avoid nylon, including stockings.
  • Remember after urinating or having a bowel motion, to wipe from front to back to avoid spreading bacteria from the bowel to the vagina.
  • Have showers rather than baths.
  • Change out of bathers/swimsuits after swimming.
  • Avoid tight pants, jeans, lycra pants, etc.

Cystitis or Urinary Tract Infection (UTI)

This annoying condition is characterised by the urge to pass frequent small amounts of urine, accompanied by stinging and burning - most inconvenient during a trek.... Ideally urine should be sampled and cultured before antibiotics are prescribed. If medical care is not easily accessible, drink plenty of water and if symptoms persist beyond 24 hours, take an antibiotic e.g. Cotrimoxazole or Norfloxacin. Be sure to take the full course.

If you are concerned about any of these issues please see your doctor prior to travel.

© 2014, Travel Medicine Centre Perth