WOMEN’S HEALTH

 

 

The Telegraph in 2017 had reported that women needed to visit their G.P at least 10 times before being diagnosed with common gynaecological complaints. It also indicated that the All Party Parliamentary Group on Women’s Health (WHAAPG) found doctors often telling their patients that their symptoms are all in their head.’

Almost a majority of women are effected by gynaecological condition or infection at some stage during their life. We can consider the following:

  • A study conducted by Ding T, Baio G, Hardiman PJ, et al (2014), conducted a study to estimate the incidence and prevalence of Poly Cystic Ovarian Syndrome in U.K primary care. In their conclusion, compared to rates estimated in community samples, the incidence and prevalence of women presenting in primary care with PCOS diagnoses and features are low, indicating that PCOS is an under-recognised condition. This is quite concerning considering that 1 in 10 women in the U.K are diagnosed or at risk of having a form PCOS (March WA et al, 2010).
  • A systematic review (Siobhan D H, Oona M R Campbell, 2004) on menstrual disorders in developing countries had reported that abnormal uterine bleeding appears to affect 5-15% of women of reproductive age and a higher percent group in mature age groups. In Europe and North America it is a major cause of gynaecological morbidity, affecting up to one in five women at some point during their reproductive life. 9 – 14% of women have had a blood lost of more than 80mL, which has traditionally been the critical level of blood loss, however Janssen et al (1998) argued that anaemia is not being observed in women in the U.K until a 120mL blood loss is reached. The review eventually summarised that menstrual conditions amongst women constitute an important unmet area of reproductive health service of women in developing countries and that more consideration is significantly required to the diagnosis and concerns of menstrual issues within reproductive health programs.

References:

Ding T, Baio G, Hardiman PJ, et al

Diagnosis and management of polycystic ovary syndrome in the UK (2004–2014): a retrospective cohort study. BMJ Open 2016;6:e012461. doi: 10.1136/bmjopen-2016-012461

Janssen CA, Scholten PC, Heintz AP. Reconsidering menorrhagia in gynecological practice. Is a 30-year-old definition still valid? Eur J Obstet Gynecol Reprod Biol 1998;78:69 – 72.

March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. (2010) The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod. 25(2):544-51.

Sarah Knapton, Women with painful gynaecological problems told by GPs: ‘It’s all in your head’ , 27th March 2017, The Telegraph.

http://www.telegraph.co.uk/science/2017/03/26/women-painful-gynaecological-problems-told-gps-head/

Siobhan D H, Oona M R Campbell

Epidemology of menstrual disorders in developing countries: a systematic review. BJOG: an international journal of obstetrics and gynaecology. January 2004, Vol. 111 pp. 6 -16.

Back to Basics:

The endocrine system involves glands that produce different hormones which regulate metabolism, growth, development, sexual function, sleep, emotions and reproduction. It includes the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas, ovaries in women and testicles in men. It also receives assistance from organs including the kidney, liver, heart and gonads, which also secrete hormones. A combination of factors including stress, infection, electrolyte balance, diet, prescribed drugs, substance misuse, inherited conditions can all impact the body failing to respond to hormones as required.

Energy production in women is highly dependent on female hormones as they control blood sugar levels. Therefore, female hormones not only influence energy production and reproduction but also how we manage stress and rejuvenate ourselves or for our cells to repair itself. What are the main female hormone you ask? Let me outline them here:

  • Estrogen: It is produced by the ovaries, adrenal glands and fat cells. It Increases during the first half of your menstrual cycle to help build the lining of the uterus. A well as this it stimulate breast tissue, builds the bones supporting the cardiovascular system, offers optimal energy, good sleep and sharp concentration and memory. During menopause one of the compounds (estriol) prevents hot flashes and night sweats.
  • Progesterone is produced and increases in the second half of the menstrual cycle to prepare the uterine lining for egg implantation if fertilised. A wide variety of factors (stress, trauma, prescribed drug), can disturb progesterone levels and disrupt the pituitary-ovarian communication. This period of the menstrual cycle is where Pre-Menstrual Stress is commonly experienced. The disruption can interfere with the supply of progesterone, leading to a potential decrease.
  • Testosterone is a hormone not only produced by men but also by women from their ovaries. It is responsible for stimulating sexual desire, creating energy and muscle mass.

10 years prior to entering menopause, the ovaries will gradually decrease the production of hormone estrogen and progesterone. This will then require the adrenal glands to then compensate for the hormones which the ovaries no longer can. However, in most women the adrenal glands are depleted and therefore struggle to produce enough of the hormones to support the system. This often results in the adrenal glands producing too much of the stress hormone cortisol to try and manage the stress. However, the overwhelming pressure on the adrenal glands to manage the stress, is then left depleted and  unable to produce enough of the hormones which are required.

During this period it is common for women to also put on weight but this tends to be because fat is able to produce and store estrogen in fat cells.

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