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Reproductive Health Concerns in Females |
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See
Glossary |
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MENSTRUAL PROBLEMS |
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What
is a painful menstrual period?
Painful menstrual periods are marked by
crampy lower abdominal pain. A woman may
feel sharp pain that comes and goes, or
have dull, aching pain. Painful menstrual
periods may also cause back pain. The pain
may begin several days before or just at
the start of your period. It generally
subsides as menstrual bleeding tapers off.
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How
can painful menstrual periods be managed
at home?
The following steps may allow you to avoid
prescription medications: (i) Apply a
heating pad to your lower abdomen (below
the umbilicus). Be careful NOT to fall
asleep with it on. (ii) Take warm showers
or baths. (iii) Drink warm beverages. (iv)
Do light circular massage with your
fingertips around your lower abdomen. (v)
Walk or exercise regularly, including
pelvic rocking exercises. (vi) Follow a
diet rich in complex carbohydrates such
as whole grains, fruits, and vegetables,
but low in salt, sugar, alcohol, and
caffeine. (vii) Eat light but frequent
meals. (viii) Practice relaxation
techniques like meditation or yoga. (ix)
Keep your legs elevated while lying down.
Or lie on your side with knees bent.
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When
should a doctor be consulted for painful
menstrual periods?
A doctor may be consulted if self care
measures have not relieved the pain for 3
consecutive months or if there is a
history of passage of large blood clots.
Also occurrence of pain more than 5 days
prior to the period and continuation after
the period gets over warrants a doctor’s
consultation.
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What
is pre-menstrual syndrome?
Premenstrual syndrome (PMS) involves
symptoms that occur in relation to the
menstrual cycle. The symptoms usually
begin 5 to 11 days before the start of
menstruation. Symptoms usually stop when
menstruation begins, or shortly
thereafter. These symptoms may include
headache, swelling of the feet, backache,
abdominal cramps, breast tenderness,
bloating sensation etc.
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What
are the causes of PMS?
An exact cause of PMS has not been
identified. It occurs more often in women
between their late 20s and early 40s,
those with at least one child, those with
a family history of depression, or women
with a past medical history of depression
after delivery of first child.
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How
can pre menstrual syndrome be managed at
home?
Self-care methods for managing PMS
include: (i) Regular Exercise – at least
twenty minutes to half an hour everyday,
which may include brisk walking or
cycling.(ii) Dietary measures: Increased
whole grains, vegetables, fruit, and
decreased or no salt, sugar and coffee may
prove beneficial. (iii) Maintain a daily
diary or log to record the type, severity,
and duration of symptoms. A "symptom
diary" should be kept for a minimum of 3
months. The diary will greatly assist the
doctor not only in the accurate diagnosis
of PMS, but also with the proposed
treatment methods. (iv) It is important to
get adequate rest.
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When
is a heavy menstrual period said to be
occurring?
If there is soakage through a sanitary pad
every hour for 6 consecutive hours, this
is considered a very heavy period.
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What
are the common causes of heavy menstrual
periods?
The common causes of heavy menstrual
periods include: (i)Growths on the uterine
lining (ii) Unexplained- referred to as
dysfunctional uterine bleeding (iii)
Thyroid gland problems (iii) Blood
clotting disorders. (iv)Intra uterine
device. (v) Stress.
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What
is a prolonged menstrual period?
A prolonged period is one that lasts
longer than 7 days.
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What
are the common causes of prolonged
menstrual periods?
Prolonged menstrual periods may result
from (i) Ovarian cysts (ii) Sometimes the
cause may not be found-referred to as
dysfunctional uterine bleeding. (iii)Bleeding
disorders and intake of anti clotting
medications. (iv) Stress
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What
is an irregular menstrual period?
An irregular menstrual period is one in
which the duration can vary excessively
from cycle to cycle, with the periods
occurring too frequently or being
separated by an unusually long duration.
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Is
it normal to have irregular periods during
the first few teenage years?
Yes. At first, the menstrual periods
typically are irregular. The girl may have
2 months between periods, or may have two
periods in 1 month. Over time, they become
more regular.
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What
are the causes of irregular menses?
Menstrual periods that are abnormally
frequent can be caused by (i)
Endometriosis is a condition of unknown
cause that can lead to pelvic pain and
frequent bleeding. (iii) Sometimes, the
cause of unclear, in which case the woman
is said to have dysfunctional uterine
bleeding. (iii)Ovarian cysts (iv) Stress.
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Is
there a cause for worry if bleeding during
menses lasts for only 2-4 days instead of
the usual 5 days?
No, there is no need to worry. Periods
change over time and from cycle to cycle
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What
needs to be done in case of Heavy,
Prolonged or Irregular Menstrual Periods?
(i) Keep a record of your menstrual
cycles, including when menstruation begins
and ends, how much flow you have (count
numbers of pads used, noting whether they
are soaked), and any other symptoms you
experience. (ii) Consult a doctor if the
problem persists beyond 3 months.
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What
is absent menstruation?
Absent menstruation refers to appearance
of no menstruation by age 16. The Causes
may include: (i) Birth defects of the
female reproductive system (ii) Lack of an
opening in the membrane at the entrance of
the vagina (hymen) (iii) Problem with
glands in the brain |
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ABNORMAL VAGINAL DISCHARGE |
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What
is vaginal discharge and when is it said
to be abnormal?
Vaginal discharge is composed of mucous
secretion produced by the cervix. Disease
may be indicated if vaginal discharge is
abnormal in color, odour, or consistency,
or significantly increased in amount.
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Which
are the conditions that lead to an
increase in the normal vaginal secretion?
The amount of normal vaginal discharge
may be increased in conditions such as
sexual excitement, emotional stress and
ovulation (when you produce and release an
egg from your ovary in the middle of your
menstrual cycle)
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What
are the causes of abnormal vaginal
discharge?
These conditions can lead to abnormal
vaginal discharge: (i) Sexually
transmitted infections. (ii) Fungal/yeast
infection of the vagina common in
diabetics and those with weak immune
system.
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How
can abnormal vaginal discharge be
prevented?
To help prevent vaginal discharge: (i)
Genital area must be kept clean and dry.
(ii) Douching (splashing water into the
genital area) should be avoided. While
many women feel cleaner if they douche
after menstruation or intercourse, it may
actually worsen vaginal discharge because
it removes healthy bacteria lining the
vagina that are there to protect you from
infection. (iii) Stress should be avoided.
(iv) Condoms must be used to avoid
catching or spreading sexually transmitted
diseases. (v) Blood sugars should be kept
under good control in case there is
presence of diabetes.
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Should
a doctor be consulted for an abnormal
vaginal discharge?
Yes, a doctor should be
consulted promptly. Your doctor will take
a brief history about your symptoms,
conduct a pelvic examination and prescribe
a treatment accordingly. |
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OVARIAN CYSTS |
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What are ovarian cysts?
An ovarian cyst is a growth or
swelling on, or inside, the ovary. It may be
solid, or filled with fluid.
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Are ovarian cysts cancerous?
The vast majority of ovarian
growths are not cancerous.
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What are the symptoms of ovarian cysts?
Ovarian cysts may produce the
following symptoms: (i) Many women experience
no symptoms when they have an ovarian cyst,
particularly if it's small. (ii) Certain cysts
grow large and may cause the abdomen to swell.
(iii) Depending on where the cyst is and its
size, it may put pressure on the bladder or
bowels, making you need to go to the toilet
more often. (iv) You may also notice abdominal
discomfort and sex may be uncomfortable or
painful. (v) Your periods may be affected;
they may become irregular or the bleeding may
be heavier or lighter than usual. (vi)
Appearance of excess facial and body hair
(vii) Deepening of voice.
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What
is the treatment for ovarian cysts?
While some cysts may disappear on their own,
other cysts may need surgery. Your doctor will
discuss with you the pros and cons of surgery.
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What
is Polycystic Ovary Syndrome (PCOS)?
Polycystic simply means 'many cysts' and
describes the appearance of the ovary on
ultrasound scan.
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What
are the symptoms of PCOS?
The symptoms of PCOS include: (i) Irregular or
absent periods (ii) Infertility (iii) Unwanted
body hair (iv) Acne (v) Weight gain (vi)
Abdominal discomfort.
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What
is the treatment for PCOS?
PCOS can be treated by hormonal medicines or
surgery. The discretion for treatment lies
with the doctor.
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PROLAPSE |
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What
is prolapse?
Prolapse refers to descent of a pelvic organ
like uterus, bladder, urethra or rectum into
the vagina.
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What
are the causes of prolapse?
Prolapse occurs as a result of weakening of
the pelvic muscles due to (i) repeated
childbirth (ii) old age (iii) lumps in the
uterus due to fibroid (iv) obesity (v) Spinal
injuries.
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What
are the common symptoms of prolapse?
Symptoms that may be occur with all types of
prolapse: (i) Feeling a lump or heavy
sensation in the vagina (ii) Lower back pain
that eases when you lie down (iii) lower
abdominal pain or pressure (iv) Pain or lack
of sensation during sex (v) inability to
control urination and leaking urine.
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What
treatment options are available for prolapse?
Mild degrees of prolapse can be treated by (i)
Pelvic exercises (ii) Inserting vaginal
pessary to hold the prolapsed organ in place.
Severe degrees of prolapse need to be
corrected by different kinds of surgery.
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VULVAL PAIN AND DISCOMFORT |
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What
can cause vulval pain and itching?
Pain, itching, burning and irritation of the
vulval area can be the result of a vaginal
infection , or the result of a non-infectious
skin problem such as dermatitis, eczema.
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What
are the causes of non infectious skin diseases
which can cause vulval pain and discomfort?
A woman's vulva can also be affected by skin
problems that are not infectious and cannot be
passed on to sexual partners. Soap,
disinfectants and detergents used for washing
underwear can easily irritate vulval skin.
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How
can vulva skin problems be treated?
Treatment often includes using a steroid cream
and emollients which are bland creams and
ointments free of skin irritants. They can be
used to soothe and hydrate sore and cracked
skin and as a soap substitute to clean the
vulva. They are available as creams and
lotions and are available from chemists
without a prescription.
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How
can a woman care for her vulval skin?
If you have, or are prone to, vulval problems,
avoid wearing tights or tight fitting
trousers. Avoid synthetic underwear and try
cotton underwears that are not too tight. Use
mild soap for washing the vulval skin.
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What
is the commonest cause of swelling in the
vulva?
The commonest cause for swelling in the vulva
is known as “Bartholin’s cysts”. Bartholins
glands are two tiny glands present on both
sides of the vaginal opening. There are tiny
ducts in the gland and if those get 'clogged'
up by skin cells or secretions, it can form a
cyst - (a fluid filled sac). The cyst can grow
from the size of a pea to larger than a golf
ball.
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How
is Bartholin’s cyst treated?
The treatment really depends on several
things; the size of the cyst, how painful it
is, if it is infected and how your
gynecologist chooses to treat them. Some cysts
are just treated with oral antibiotics.
Sometimes your gynecologist might decide to
put a 'drain' into the cyst, The drain (like a
thick string) stays in place for about 2 to 4
weeks. This allows the fluid to drain and
causes a small opening to form inside the lip
of your vagina. The drain is removed after
that 2 - 4 week period.
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OBSTETRIC FISTULA |
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What
is an obstetric fistula?
A fistula is a hole between a woman's birth
passage and one or more of her internal
organs. This hole develops over many days of
obstructed labor, when the pressure of the
baby's head against the mother's pelvis cuts
off blood supply to delicate tissues in the
region. The dead tissue falls away and the
woman is left with a hole between her vagina
and her bladder and sometimes between her
vagina and rectum. This hole results in
permanent leaking of urine and/or feces.
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What
are the causes of obstetric fistula?
A fistula results from an obstructed labor
that is left unrelieved and untreated. There
are three delays that contribute to the
development of a fistula: delay in seeking
medical attention during labour; delay in
reaching a medical facility; and delay in
receiving medical care once arriving at a
health care facility.
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Can
a fistula be cured?
Yes. An obstetric fistula can be closed with
intravaginal surgery. If her surgery is
performed by a skilled surgeon, a fistula
patient has a good chance of returning to a
normal life with full control of her bodily
functions. The operation has a 93%
success/cure rate.
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ECTOPIC PREGNANCY |
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What
is ectopic pregnancy?
Ectopic pregnancy is one in which the
fertilized ovum (egg) is implanted and
develops outside the uterus. The most common
site is tube. Normally fertilization occurs in
the tube and the fertilized ovum moves into
the uterus. But in tubal pregnancy the ovum
remains in the tube.
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What
are the main symptoms of an ectopic pregnancy?
The four important symptoms are-
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What
is to be done on suspicion of an ectopic
pregnancy?
A. The women should be urgently rushed to a
hospital. The principle in the management of
acute ectopic is resuscitation and surgery
done at the same time. Blood transfusion is
done if required. A quick surgery stops the
bleeding and improves the patients condition.
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CANCERS OF THE REPRODUCTIVE
TRACT |
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What
is cancer?
Cancer affects body's basic unit, the cell.
Cancer occurs when cells become abnormal and
divide without control. This mass of extra
tissue, called a growth or tumor, can be
benign or malignant.
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What
is a benign tumour?
Benign tumors are not cancerous. They can
usually be removed and, in most cases, they do
not come back. The most important thing is
that cells from benign tumors do not spread to
other parts of the body.
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What
is a malignant tumour?
Malignant tumors are cancer. Cancer cells can
invade and damage tissues and organs near the
tumor. Cancer cells also can break away from a
malignant tumor and enter the bloodstream and
spread throughout the body.
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CERVICAL CANCER |
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Who
are the women who are at risk of getting
cervical cancer?
Women who are at risk of getting cervical
cancer are those who (i) have Multiple sexual
partners (ii) started sexual intercourse early
in life –during teens or early twenties (iii)
women with history of genital warts or
chronic sexually transmitted infections.
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What
are symptoms of cervical cancer?
In the initial stages, cervical cancer does
not produce symptoms, Symptoms are produced
when the cancer cells start invading nearby
tissues. The most common symptom is abnormal
bleeding. Bleeding may start and stop between
regular menstrual periods, or it may occur
after sexual intercourse. Menstrual bleeding
may last longer and be heavier than usual.
Increased vaginal discharge is another symptom
of cervical cancer. These symptoms may be
caused by cancer or by other health problems.
Only a doctor can tell for sure. It is
important for a woman to see her doctor if she
is having any of these symptoms.
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Can
cervical cancer be prevented?
Yes, cervical cancer can be prevented by
early detection of changes in the cervix by
means of getting a regular cervical smear or
Pap smear test done.
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What
is a Cervical smear or Pap smear test?
A smear test is a simple examination to check
the health of a woman’s cervix. It is called
a smear test (or Pap smear) because
the doctor or nurse takes a small sample of
cervical cells and smears them onto a glass
slide to be analysed under a microscope.
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Who
should have a smear test?
All sexually active women should get a
cervical smear test done every 3 to 5 years.
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Is
there any need for a non sexually active woman
to get her smear test done?
Cervical cancer is extremely rare in women who
have never been sexually active, therefore
most recommendations suggest women don’t need
to have smears until they’ve had sex.
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How
is a Pap smear done?
A warmed speculum is passed into the vagina to
separate the walls so the doctor can see your
cervix. A wooden spatula (thinner than a
tongue depressor) is wiped across the cervix,
and the smear is transferred to a glass slide.
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When
is the best time to get a smear done?
The best time to get a smear done is between
the middle of your menstrual cycle – about
half way between one period and the next. It’s
easiest to get a good cell sample from your
cervix at this time.
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Is
any vaccine available for protection against
cervical cancer?
Yes, a vaccine (HPV Vaccine) is now available
which protects against a virus known as Human
Papilloma virus which is responsible for
causing 70 % of cervical cancers
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Who
should receive the HPV vaccine?
The vaccine is for girls and women ages 9 to
26. It works when given before one has any
contact with virus.
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How
is HPV Vaccine administered?
The vaccine is administered as 3 injections
given over a span of 3 months.
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What
are its side effects?
It can cause pain, swelling, itching, and
redness at the injection site, fever, nausea,
and dizziness.
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Does
the vaccine protect everyone who is vaccinated
against cervical cancer?
The vaccine may not fully protect everyone and
does not prevent all types of cervical cancer,
so it is important to continue regular
cervical cancer screenings.
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OVARIAN CANCER |
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Who
are the women who are at risk of getting
ovarian cancer?
The exact causes of ovarian cancer are not
known. However, studies show that the
following factors may increase the chance of
developing this disease : (i) Family history.
First-degree relatives (mother, daughter,
sister) of a woman who has had ovarian cancer
are at increased risk of developing this type
of cancer themselves (ii) Age. The likelihood
of developing ovarian cancer increases as a
woman gets older. Most ovarian cancers occur
in women over the age of 50, with the highest
risk in women over 60. (iii) Women who have
never had children are more likely to develop
ovarian cancer
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What
are the symptoms of ovarian cancer?
The symptoms of ovarian cancer are almost
similar to those of benign ovarian conditions
such as menstrual disturbances, abdominal
discomfort. At times, the symptoms may be
vague such as loose motions, weight loss etc.
Thus, you should see your doctor promptly
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What
are the treatment options for ovarian cancer?
Treatment options and outcomes for patients
who have ovarian cancer depend on the exact
classification of the cancer and how far it
has spread before it is diagnosed
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Is
there any screening test for preventing
ovarian cancer?
No screening test has yet been developed for
early diagnosis of ovarian cancer.
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