What’s this bad odour coming from my vagina?

Hello Dr Flo, I have recently noticed a bad odour from my vagina, which comes when my monthly periods are about to start. What could be the problem? Please help. 
Amina
 

Dear Amina,
The vagina has a normal musty smell, which changes due to hormonal changes at different times of the monthly cycle, or due to pregnancy, menopause, or use of hormonal medications, among others. The odour may also be different after intercourse due to mixing with semen and/or a lubricant. 
Some women experience a metallic smell during their periods due to the iron in the blood. A change in the odour can also happen due to sweating a lot, or due to taking foods or drinks that have strong smells like garlic, onion, caffeine and some fruits. These changes do not require treatment.
If, in addition to the odour, you have itching, an abnormal discharge, or low abdominal pain, then most likely you have an infection, and it would be advisable to see a doctor so that you can have tests done to get an accurate diagnosis. You will then be put on the appropriate treatment by your doctor.
Dear Dr Flo,
I suffered from Bell’s palsy last year and since then, my right eye is noticeably smaller than the left one. Are my nerves okay? What could be the cause? 
Herman

Dear Herman,

Bell’s palsy is a paralysis that occurs suddenly, causing temporary weakness of the muscles on one side of the face. It can occur following a viral infection or due to inflammation of the main nerve that serves the face. 

It makes your face look like it is drooping on one side, with a one-sided smile and an eye that has difficulty closing. You may also experience drooling, pain in the jaw or behind the ear on the affected side, headache, sound sensitivity, decrease in ability to taste and changes in the amount of saliva produced.
In most people, the symptoms go away in six months, but in a few people the symptoms can persist. The damage to the nerve may not reverse completely and the affected eye is not able to close well. In this case, the eye may have excessive dryness and is easily scratched which can damage vision. 
Initially, you may also have had changes in the eyelids and brow, and later, contracting of the facial muscles, which can make your eye look smaller. Other long term complications include tearing when chewing, abnormal facial muscle movement and even facial disfigurement.
It would be advisable to be reviewed by a nerve specialist (neurologist) and also continue with the physical exercises you were doing during treatment.

Dear Nation Doctor,
When the weather is cold, and especially in the morning I cannot walk fast or carry something that will keep rubbing against any part of my body. I cannot wear hard clothes like jeans because I start feeling itchy. I either have to stop walking or the itchiness spreads to every part of the body. This becomes unbearable since I have to find something to help me scratch my body, resulting in swelling. 
The condition is becoming more frequent. Please advise on the condition and if there is medication that can help me.
Mutiso

Dear Mutiso,
This may be pressure or vibratory urticaria, where exposing the skin to friction, repetitive stretching, pressure or vibration results in itching, swelling, burning sensation and pain. It is a rare allergy disorder and there’s a high likelihood of getting it if at least one of your parents has it. In some people, there is no known cause.
You would benefit from a dermatologist review and possibly allergy testing. Medications that may help relieve the itching include antihistamines and steroids. Meanwhile, avoid scratching yourself as much as possible. You can place a cool cloth or ice over the area that is itching the most for a few minutes to relieve the itch. 
Use sunscreen when you are going out into the sun. Use mild soap and warm water to bathe, not hot water. Use moisturising cream after taking a shower. Avoid clothes and beddings made from material that can trigger itching like wool and jeans. Instead, go for soft cotton clothing. You may also benefit from reducing movement, limiting carrying weights or use wide straps when carrying something heavy.

Dear doctor,
I have been having pain in my anal region for quite some time. I have been given medication called ‘anusol’ to insert and a cream to apply, but the problem keeps recurring. What can I do to treat this problem once and for all? Kindly advice.
Monica

Dear Monica,
Pain in the anus can be caused by: 

• anal fissure – a tear in the lining of the anus caused by passing large or hard faeces
• haemorrhoids – bulging veins in the lower part of the rectum and anus
• anal fistula – a small tunnel that develops from the inner lining of the anus to the skin, usually caused by an infection leading to accumulation of pus (abscess)
• muscle spasms
• trauma
• inflammation of the lining of the anus and rectum
• infection
• diarrhoea or constipation
• ulcer in the lining of the rectum
• cancer (rare).

Since the problem is recurring, it would be good to see a surgeon so that a proper examination of the lower part of the gastrointestinal tract can be done. Treatment depends on the cause.
Medication like anusol has a pain reliever that helps with the symptoms. 
In addition, prevent constipation by taking a lot of fluids and high fibre diet every day, exercise, schedule time each day for a bowel movement, and take your time. Use baby wipes instead of toilet paper and, you can also take a sitz bath – sit in warm water for about 20 minutes twice a day to help soothe the injured tissue. There are fibre supplements that you can take to help with passing soft stool.