Thetraveldoctor.com.au

Some Womens’ Health Considerations for Kokoda Trail Trip
Excepts from ‘Travelling Well’ Dr Deborah Mills • Other issues with the contraceptive pill Thrush is a most unpleasant condition to have while travelling! Doxycycline is thecommon anti-malarial medication used for this part of the world and about 9% ofwomen taking doxycycline will develop thrush. Cotton underclothes may help preventit but you need to carry medicines so you can treat thrush promptly if symptomsdevelop.
Cystitis/Urinary Tract Infection
Many women experience cystitis or urinary tract infections when travelling. If you areprone to this type of infection, ensure you drink plenty of fluids, and treat yourselfpromptly if symptoms develop.
Feminine hygiene
Toilet and general washing facilities may be limited. During a menstrual period, ensureyour hands are clean before tampons are used. Wash hands with soap and water, (tapwater is OK), and dry your hands with a clean towel. Products such as Microshield™hand wash can be used where soap and water is not available. The use of tamponapplicators may be convenient. Stopping your periods for the duration of the walk maybe a very good idea – see below.
Stopping periods
Medical research has shown that you do not NEED to have a period every month. Ifyou are on the pill, some contraceptive pills can be taken continuously, thus avoidingperiods altogether. This is safe. It is easier with monophasic (one strength pills) likeMicrogynon, Levlen, or Nordette. You simply skip the sugar pills for that month. Thiswill delay your period 3 weeks. Most women can safely skip three periods in a row.
If you are taking 'multiple dose pills' (e.g. Triquilar, Triphasil, Trifeme), skipping thesugar pills may not work. To delay a period on these pills you need to do this: whenyou reach the end of your active pills for the month - instead of taking the sugar pills,use a spare packet and take the last week of active pills from the spare packet. Thentake the sugar pills. This will delay your period for a week.
Generally it is best to always take a ‘Saturday’ pill on a Saturday or confusion mayoccur. Discuss this with your doctor. If you want to skip periods, it may be easier totemporarily change to a ‘one strength pill’.
Other issues with the Pill
Vomiting .and the Pill
If you are ill, and vomit within five hours of taking the pill, it may not have been
absorbed. You should take another pill to replace the one lost. Use a spare packet; it is
better to use a replacement pill for the correct day of the week, i.e. take a Thursday pill
on a Thursday.
Diarrhoea .and the Pill
It is difficult to predict the effect that diarrhoea will have on pill absorption. The safest
course of action is to continue taking the pill, but use other means of contraception
while you have severe diarrhoea and until 7 active pills after the diarrhoea has ceased.
Antibiotics .and the Pill
This is important if you need to take antibiotics for diarrhoea, or with some of the
antimalarial tablets. Some antibiotics interfere with the effectiveness of the
contraceptive pill. This may lead to spotting in the middle of the month, or even
pregnancy. For most antibiotics, use other means of contraception while taking the
antibiotic and for 7 active contraceptive pills afterwards.
Malaria tablets .and the Pill
Doxycycline, a commonly used antimalarial for this region, may interfere with the 'pill'
leading to irregular bleeding or even pregnancy. Chloroquine, Maloprim, Malarone and
mefloquine (Lariam) do not interfere with the oral contraceptive pill. Use other means
of contraception while on doxycycline and for at least 7 active contraceptive pills after
finishing the malaria pills.
Irregular periods
If you are not on the pill, it is common to have irregular periods while travelling,especially on this sort of trip. Your periods may come early or come late – be prepared.
It is harmless except for the logistics of dealing with sanitary protection, and perhapsthe concern of possible pregnancy if they are very late .
Hair loss during or shortly after travel
This is not a specifically female problem but tends to be more noticeable and causemore concern in women. It is quite common after prolonged or stressful travel to noticean increase in the loss of hair on brushes or on the pillow after sleeping. The hair doesgrow back. Have a checkup when you get home just in case it is something else.
Packing list for women
Thrush medicine – pessaries and creamExtra supplies of tampons/sanitary protectionNoroxin & Ural – in case of urinary tract/bladder infectionExtra supplies of the contraceptive pill if relevant

Source: http://www.thetraveldoctor.com.au/kokodawomen.pdf

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