5 Reproductive Health Issues We Should Be Talking About


Welcome to In Her Words, a twice-weekly column the place girls rule the headlines. Sign up right here to get it delivered as a publication to your inbox. Let me know what you suppose at dearmaya@nytimes.com.

If somebody speaks to you about your physique with something however kindness and concern, it’s he who has an issue.”
— Dr. Jen Gunter, an obstetrician-gynecologist

Premenstrual dysphoria. Pelvic ground issues. Endometriosis.

These could be severe well being circumstances for girls, but many people are reluctant to debate them, even with our docs. In truth, the majority of my data on these and plenty of different points that have an effect on girls’s reproductive well being have been handed alongside to me by means of phrase of mouth like some form of lore.

How extensively girls are uninformed, to the purpose that some battle to articulate potential signs, hit dwelling with me just lately, after I wrote a column on menopause. (Specifically, it was about how girls who had been seeking to discover any data or camaraderie past the medical had been usually out of luck. You can learn that article right here.)

As a part of the column, I requested readers if there have been another well being points we wanted to start out speaking about extra brazenly — and I obtained an onslaught of emails.

Did you realize, for instance, that about 50 p.c of girls will develop some type of pelvic organ prolapse of their lifetimes? More on that under.

Here are 5 circumstances, which have an effect on tens of millions of girls, defined by Dr. Jen Gunter, an obstetrician-gynecologist within the San Francisco Bay-area who writes The Cycle, a Times column on women’s reproductive health.

[Read more from Jen Gunter: “Your Vagina Is Terrific and Everyone Else’s Opinions Still Are Not”]

Premenstrual Dysphoric Disorder

What is it? It’s a severe form of PMS, but PMDD generally includes severe depression, irritability and tension. Like PMS, it starts a week or two before your period, and ends abruptly when your period ends.

What to know: For about two weeks of the month, PMDD should be gone. Keep a symptom diary to gauge how long you’re experiencing these symptoms and, as always, consult your doctor.

Endometriosis

What is it? It is when tissue that normally lines the uterus grows outside of the uterus, in the pelvic cavity. While this tissue doesn’t shed blood as it would inside the uterus, it does undergo inflammatory changes that it would during one’s period.

What to know: It affects 6 to 10 percent of women. For some, it can cause infertility. For some, a few specks of the disease can cause severe pain. For other women, it takes a massive amount of disease to cause pain. And other women have no symptoms at all. Treatments include hormones or excision surgery.

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Pelvic floor disorders

What is it? Pelvic floor disorders primarily fall into two categories: the floor being too weak or too tense. (The floor consists of a group of muscles located at the base of the pelvis.) Either condition can result in symptoms that are hard to describe and therefore hard to diagnose, such as incontinence or pelvic organ prolapse, as well as pain, particularly during sex.

What to know: A common feeling with a weak pelvic floor is that there’s something stuck in the vagina. Childbirth can exacerbate or cause a weak floor, since tissue that stretches is more vulnerable to age and injury. There is also a big genetic component, and smoking can weaken the floor.

A tense floor is more complex, in that women can have it from birth or develop it at an early age. A floor can also tighten or spasm after sexual trauma or an event that caused pain, including a yeast infection.

Pelvic organ prolapse

What is it? It’s the sagging of one’s cervix and vaginal wall toward the vaginal opening.

What to know: It occurs normally with age since pelvic tissue, stretchy by nature, is more vulnerable to gravity and aging. Fifty percent of women will develop some form of it over time, and most women don’t get symptoms until it has progressed.

The most common symptom is the feeling that something is falling out. But it’s important to note that a pelvic floor spasm, which in many ways is an opposite condition, can cause the same sensation.

Incontinence

What is it? There are two main types: stress incontinence, when urine leaks when pressure is exerting on the bladder by coughing, sneezing, laughing, exercising or lifting something. And there’s overactive bladder, or having to urinate even though there’s only a small amount of liquid in the bladder. It’s possible to have both conditions at the same time.

What to know: A lot of women are not screened for incontinence, and ignoring it can lead to a lot of issues. If it gets severe, it can lead to social isolation. There are effective treatments, including medication, physical therapy or bladder retraining. It can also be controlled with an incontinence ring called a pessary. Injecting Botox into the bladder, a treatment for overactive bladder, is extremely effective by preventing muscles in the bladder from spasming from low volume of urine.

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6 months

That’s the length of state paid parental leave California’s new governor, Gavin Newsom, is expected to propose this week. It would be the most generous state policy in the nation.

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