Empowering Women's Health: Insights from a Gynecologist
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– Ovulation is a part of the female menstrual cycle where an egg is released from an ovary and moves towards the uterus.
– Ovulation usually occurs once each month, about two weeks before the next period and can last from 16 to 32 hours.
– Ovulation does not occur if a woman is on the contraceptive pill, pregnant, or postmenopausal.
– It is possible to get pregnant in the five days before ovulation and on the day of ovulation, but the three days leading up to and including ovulation are the most likely for pregnancy.
– Signs of ovulation include slick and slippery vaginal discharge or mucus, abdominal pain on one side of the tummy, and premenstrual symptoms.
– Ovulation predictor kits can be used to predict fertile days by measuring the level of luteinising hormone (LH) in urine.
– Ovulation calculators or calendars can help determine fertile days and estimate due dates.
– Some women do not ovulate regularly, particularly in the first two to three years after periods start and during the lead-up to menopause.
– Conditions such as polycystic ovary syndrome (PCOS), amenorrhoea, and certain hormone conditions can cause irregular ovulation or no ovulation at all.
– Medical tests, such as blood tests for progesterone, can be conducted to check if a woman is ovulating.
– Tablets and injections can be used to increase hormones that control ovulation for women who do not ovulate regularly.
– There are various ways to improve chances of ovulation.
– Pelvic inflammatory disease (PID) is an infection of a woman’s reproductive organs
– PID is often caused by STDs like chlamydia and gonorrhea
– Other non-sexually transmitted infections can also cause PID
– Factors that increase the risk of PID include having an untreated STD, having multiple sex partners, having a partner with other sex partners, a history of PID, being sexually active and under the age of 25, douching, and using an intrauterine device for birth control
– To reduce the risk of getting PID, it is recommended to practice abstinence or have sex in a long-term mutually monogamous relationship and use condoms correctly
– There are no specific tests for PID, and diagnosis is based on medical history, physical examination, and other test results
– Symptoms of PID can include lower abdominal pain, fever, unusual discharge with a bad odor from the vagina, pain or bleeding during sex, burning sensation during urination, and bleeding between periods
– It is important to see a doctor if these symptoms occur, if there is a suspicion of an STD, or if there are any genital symptoms
– PID can be cured with early diagnosis and treatment, but damage to the reproductive system cannot be reversed
– It is crucial to complete the full course of antibiotics and inform recent sex partners for testing and treatment
– PID can be transmitted to a sexual partner, so it is important for both partners to receive treatment
– If PID is not treated early, it can lead to complications such as scar tissue formation in the fallopian tubes, which can cause blockages
– Other complications include ectopic pregnancy (pregnancy outside the womb), infertility, and long-term pelvic or abdominal pain
– Ways to reduce the risk of getting PID include abstaining from vaginal, anal, or oral sex, being in a long-term mutually monogamous relationship with a partner who has tested negative for STDs, and using latex condoms correctly
– Diagnosis of PID is usually based on medical history, physical examination, and other test results
– It is important to see a doctor if any symptoms of PID occur or if there is a suspicion of STD exposure
– PID can be cured if diagnosed early, but treatment cannot reverse damage already done to the reproductive system
– Partners should also be informed to get tested and treated for STDs
– Having had PID before increases the chances of getting it again
– Early treatment of PID can prevent complications such as the formation of scar tissue outside and inside the fallopian tubes, which can lead to tubal blockage
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– The main function of progesterone is to prepare the endometrium for a fertilized egg to implant and grow.
– Progesterone thickens the uterine lining and creates a good environment for a fertilized egg to implant.
– If no pregnancy occurs, progesterone levels decrease, causing the uterine lining to thin and break down, leading to menstruation.
– Progesterone helps support the early stages of pregnancy by thickening the uterine lining and preventing ovulation.
– Progesterone also suppresses uterine contractions and helps prepare the breasts for breastfeeding.
– Progesterone levels increase each trimester during pregnancy, reaching their highest level in the third trimester.
– Progesterone levels decline leading up to menopause, when ovulation stops.
– Low progesterone levels may make it difficult to conceive and increase the risk of miscarriage.
– Symptoms of an ectopic pregnancy usually develop between the 4th and 12th weeks of pregnancy
– Main symptoms include missed period, positive pregnancy test, and other signs of pregnancy
– Vaginal bleeding during ectopic pregnancy may be watery and dark brown in color
– Tummy pain, typically low down on one side, can develop suddenly or gradually
– Shoulder tip pain, felt where the shoulder ends and the arm begins, can be a sign of internal bleeding in ectopic pregnancy
– Discomfort when going to the toilet, including pain or pressure in the bottom, pain when going for a pee, and diarrhea, may occur
– These symptoms may also be caused by urinary tract infections and stomach bugs, but medical advice should be sought if pregnant and experiencing these symptoms
– An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus.
– It most often occurs in a fallopian tube, but can also occur in other areas of the body such as the ovary, abdominal cavity, or the lower part of the uterus (cervix).
– If left untreated, it can cause life-threatening bleeding.
– Chlamydia is a common STD that can cause infection among both men and women.
– Chlamydia can cause permanent damage to a woman’s reproductive system and potentially fatal ectopic pregnancy.
– Chlamydia can be spread through vaginal, anal, or oral sex, even without ejaculation.
– The only way to completely avoid STDs is to not have sex, but using condoms and being in a long-term mutually monogamous relationship can lower the risk.
– Sexually active people, especially young individuals and gay/bisexual men, are at a higher risk of getting chlamydia.
– Pregnant people with chlamydia can pass the infection to their babies during childbirth, which can lead to eye infection or pneumonia.
– Chlamydia often has no symptoms, but it can cause serious health problems such as abnormal vaginal discharge and burning sensation when urinating in women, and discharge from the penis and burning sensation when urinating in men.
– Testing and treatment are essential to prevent health problems associated with chlamydia.
– Chlamydia can cause pain and swelling in testicles, pain and bleeding in rectum.
– Symptoms in women include unusual sore, smelly discharge, burning when peeing, bleeding between periods.
– Chlamydia can be diagnosed through laboratory tests using urine or vaginal samples.
– Chlamydia can be cured with proper treatment, but it won’t undo any permanent damage.
– Repeat infection with chlamydia is common, so testing should be done again after treatment.
– It is advised to wait until completion of treatment before having sex again (7 days for single dose, complete all doses for 7-day treatment).
– Untreated chlamydia in women can lead to pelvic inflammatory disease, scarring of fallopian tubes, ectopic pregnancy, infertility, long-term pelvic/abdominal pain.
– Men rarely have health problems from chlamydia, but it can cause fever and pain in testicle tubes, leading to infertility in rare cases.
– Untreated chlamydia increases the chances of HIV transmission.
– Endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus.
– It can cause severe pelvic pain and make it harder to get pregnant.
– The cause of endometriosis is unknown, and there is no known way to prevent it.
– There is no cure for endometriosis, but its symptoms can be treated with medicines or surgery.
– It causes a chronic inflammatory reaction and can result in the formation of scar tissue.
– Different types of endometriosis lesions have been described, including superficial, cystic ovarian, and deep endometriosis.
– Symptoms of endometriosis include severe pelvic pain, pain during sex or when using the bathroom, trouble getting pregnant, heavy bleeding, bloating, fatigue, depression, and anxiety.
– Retrograde menstruation, cellular metaplasia, and stem cells are thought to contribute to the development of endometriosis.
– Estrogen is known to be involved in endometriosis, but the relationship is complex.
– Endometriosis has significant social, public health, and economic implications.
– It can decrease quality of life due to severe pain, fatigue, depression, anxiety, and infertility.
– Pain can prevent individuals from going to work or school.
– Painful sex due to endometriosis can impact sexual health.
– There is currently no known way to prevent endometriosis.
– Early diagnosis and management can slow or halt the progression of the disease.
– Several screening tools and tests have been proposed but none are validated to accurately identify the disease.
– Ultrasonography or MRI can be used to detect certain forms of endometriosis.
– Histologic verification through surgical/laparoscopic visualization can help confirm diagnosis.
– Treatments for endometriosis vary based on symptom severity and desire for pregnancy.
– No treatments cure the disease.
– Non-steroidal anti-inflammatory drugs (NSAIDs) and painkillers like ibuprofen can be used to treat pain.
– Hormonal medicines and contraceptive methods can help control pain.
– Fertility medicines and procedures may be used for those having difficulty getting pregnant.
– Surgery is sometimes used to remove endometriosis lesions and scar tissue.
– Treatment options depend on individual preferences, effectiveness, side effects, safety, cost, and availability.
– Raising awareness can lead to early diagnosis and treatment.
– Hormonal management can have adverse side effects and may not be suitable for individuals with endometriosis who want to get pregnant.
– Success in reducing pain symptoms and increasing pregnancy rates through surgery depends on the severity of the disease.
– Lesions may recur even after successful treatment, and pelvic floor muscle abnormalities can contribute to chronic pelvic pain.
– Physiotherapy and complementary treatments may benefit patients with secondary changes in the pelvis and central sensitization.
– Treatment options for infertility caused by endometriosis include surgical removal, ovarian stimulation with intrauterine insemination, and in vitro fertilization.
– Lack of awareness among the general public and healthcare providers can lead to a delay in diagnosis.
– Limited awareness of endometriosis among primary healthcare providers can result in a lack of medical treatment for symptomatic management.
– Access to specialized surgery is sub-optimal in many countries, particularly low and middle-income countries.
– Screening and accurate prediction tools for endometriosis are lacking.
– Non-invasive diagnostic methods and medical treatments that do not prevent pregnancy are needed.
– WHO recognizes the impact of endometriosis on sexual and reproductive health and aims to stimulate effective policies and interventions globally.
– WHO partners with various stakeholders, including research institutions and patient support groups, to address endometriosis.
– WHO collaborates with stakeholders to collect and analyze endometriosis prevalence data for decision-making.