Women health

• Women's health


  A branch of medicine that focuses on the diagnosis and treatment of diseases and conditions that affect a woman's physical and emotional well-being
• Women's unique problems


  • Birth control, sexually transmitted infections (STIs)
  • Breast cancer, ovarian cancer, and other female cancers
  • Menopause and hormone therapy
  • Osteoporosis
  • Pregnancy and childbirth
  • Sexual health
  • Pelvic floor disorders and Polycystic ovary syndrome
  • Benign conditions affecting the function of the female reproductive organ
• Mental health issues are common but underdiagnosed and underreported
• Gender differences occur particularly in the rates of common mental disorders - depression, anxiety and somatic complaints
• These disorders, in which women predominate, affect approximately 1 in 3 people in the community and constitute a serious public health problem
• Mental health issues that affect women more than men

  • Unipolar depression
  • Depressive disorders
  • Depression
  • Anxiety
  • Psychological distress
  • Sexual violence
  • Domestic violence
  • Substance use
• Vitamin D deficiency


  Serum 25-hydroxyvitamin D level of less than 20 ng per mL (50 nmol per L)
• Vitamin D insufficiency


  Serum 25-hydroxyvitamin D level of 20 to 30 ng per mL (50 to 75 nmol per L)
• A 25-hydroxyvitamin D level should be obtained in patients with suspected vitamin D deficiency
• Vitamin D deficiency affects all ages
• Vitamin D deficiency is more common in females (37.3%) than males (5.1%)
• Causes of vitamin D deficiency

  • Malnutrition
  • Obesity
  • Anorexia/bulimia
• Common manifestations of vitamin D deficiency

  • Low back pain
  • Proximal muscle weakness
  • Muscle aches
  • Throbbing bone pain elicited with pressure over the sternum or tibia
• Goal of vitamin D deficiency treatment

  To normalize vitamin D levels to relieve symptoms and decrease the risk of fractures, falls, and other adverse health outcomes
• Vitamin D deficiency treatment

  1. Oral ergocalciferol (vitamin D2) at 50,000 IU per week for eight weeks

  2. After vitamin D levels normalize, cholecalciferol (vitamin D3) at 800 to 1,000 IU per day from dietary and supplemental sources
• The American Academy of Pediatrics recommends that infants and children receive at least 400 IU per day from diet and supplements
• Evidence shows that vitamin D supplementation of at least 700 to 800 IU per day reduces fracture and fall rates in adults
• Obesity rates are higher in Jordanian females (53.1%) compared to males (28.1%)
• Breast cancer is the most lethal cancer for women ages 20-59 throughout the world
• Breast cancer is increasing among women in developing countries where it is often diagnosed at too late a stage to receive effective medical treatment

  
• Breast cancer survival rates vary greatly worldwide, ranging from 80% or over in North America, Sweden and Japan to around 60% in middle-income countries and below 40% in low-income countries

  
• Cervical cancer


  A cancer arising from the cervix due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body

  
• Nearly all cases of cervical cancer can be attributable to certain types of HPV infection

  
• Two HPV types (16 and 18) cause 70% of cervical cancers and precancerous cervical lesions

  
• HPV is mainly transmitted through sexual contact and most people are infected with HPV shortly after the onset of sexual activity
• It takes 15 to 20 years for cervical cancer to develop in women with normal immune systems, and only 5 to 10 years in women with weakened immune systems, such as those with untreated HIV infection

  
• In developed countries, programmes are in place which enable women to get screened, making most pre-cancerous lesions identifiable at stages when they can easily be treated, preventing up to 80% of cervical cancers

  
• In developing countries, limited access to effective screening means that the disease is often not identified until it is further advanced and symptoms develop, resulting in a higher rate of death from cervical cancer

  
• Symptoms of cervical cancer

  • Irregular, intermenstrual (between periods) or abnormal vaginal bleeding after sexual intercourse
  • Back, leg or pelvic pain
  • Fatigue, weight loss, loss of appetite
  • Vaginal discomfort or odorous discharge

  
• Screening for cervical cancer

  • Cervical cytology alone every 3 years
  • High-risk HPV testing every 5 years
  • Co-testing with cervical cytology and high-risk HPV testing every 5 years

  
• Maternal mortality


  Deaths due to complications from pregnancy or childbirth
• From 2000 to 2017, the global maternal mortality ratio declined by 38 per cent – from 342 deaths to 211 deaths per 100,000 live births
• Ninety-nine percent of these deaths occur in the developing world
• Maternal mortality is higher in women living in rural areas and among poorer communities
• Young adolescents face a higher risk of complications and death as a result of pregnancy than other women
• Maternal mortality in Jordan decreased from 110/100,000 in 1990 to 58/100,000 in 2015
• Between 2000 and 2017, South Asia achieved the greatest overall percentage reduction in maternal mortality ratio, with a reduction of 59 per cent (from 395 to 163 maternal deaths per 100,000 live births)
• Sub-Saharan Africa achieved a substantial reduction of 39 per cent of maternal mortality during this period
• Causes of maternal death

  • Hemorrhage (27%)
  • Hypertension (14%)
  • Sepsis (11%)
  • Abortion (8%)
  • Embolism (3%)
  • Infection, anaemia, HIV/AIDS, and cardiovascular disease
• Polycystic ovary syndrome (PCOS)

  Consists of the clinical findings of ovulatory dysfunction, hyperandrogenism, and polycystic ovaries