2007 > Women's Health > Reproductive Health: Keeping Problems “Private” Can Hide Serious Health Issues

Reproductive Health: Keeping Problems “Private” Can Hide Serious Health Issues


Virtually every woman knows when her period is coming, through signs like bloating and breast tenderness. But many women still feel uncomfortable talking about this and other awkward health issues, even with their doctor. The first step to feeling more comfortable is to learn more about the topic. Here is a look at reproductive health issues every woman should know about.


Obstetricians and gynecologists are commonly referred to as OB/GYN specialists. These doctors focus on reproductive and sexual health issues including:


A regular, healthy menstrual cycle means different things to different women. In a recent interview with Better Health, Dr. Saowanee Karnplumjid, an OB/GYN specialist, described menstruation as typically lasting for 1 to 7 days with a 20-day gap between cycles. But once a woman reaches menopause, changes in her ovarian hormone levels can lead to irregular bleeding patterns.

Pre-menstrual syndrome (PMS) affects almost all women during the week before menstruation. High progesterone levels are responsible for the pain felt during menstruation, as well as other PMS symptoms like tiredness, mood swings and insomnia. It’s common to experience some pain and discomfort during menstruation, but when these symptoms become severe, your body may be telling you something is wrong and needs medical attention.

The onset of female menopause typically occurs between t he ages of 40 and 45. Most women experience a variety of painful, uncomfortable conditions, including hot flashes, vaginal dryness, diminished libido, and in severe cases, osteoporosis. Hormone replacement therapy (HRT) has been the treatment-of- choice for most patients, but new research has uncovered a possible link between HRT and breast cancer.

“HRT should be kept to a maximum of 1 to 3 years,” noted Dr. Saowanee. “There are alternatives such as calcium supplements to stave off osteoporosis, vaginal creams for dryness, and soymilk, which contains natural estrogen.”

Women who don’t get much physical activity are more likely to feel heavier menopausal symptoms, so regular exercise can make a major positive difference. And keeping a menstrual diary is useful in identifying clues that may pinpoint health problems.

“A woman’s menstrual cycle is a good indicator of her overall health status, and nobody knows her body better than the patient herself,” said Dr Saowanee.

If you feel your cycle is outside what’s considered ‘normal,’ share your concerns and questions with your doctor.


Many women assume that pain is just a normal occurrence and choose not to mention the subject to their doctor. In actual fact, some of the pains they feel can be specifically diagnosed and treated.

Research shows that about 15% of women aged 18 to 50 suffer from chronic pelvic pain. Diagnosing the exact cause can prove difficult, and it’s not uncommon for women to continue to experience pain even after diagnostic tests find no specific problem.

Pelvic pain is considered chronic when it’s been present for at least six months and affects a woman’s daily routine. Some studies have found that diets high in sugar and salt can cause inflammation, which can lead to pelvic pain. Many women test positive for allergies to foods like wheat, corn and yeast, and it’s believed these foods can contribute to pelvic pain. Making healthy changes to your diet or exercise routine can help lower the risk of developing pelvic pain.

“Some women think that cleaning the home or going shopping is adequate exercise, but it’s not,” said Dr. Saowanee. “A good workout typically lasts for 20-30 minutes and raises your heart rate by 20 percent. Exercise helps reduce stress, aids relaxation and offers effective menstrual pain relief.”


Many women suffer from endometriosis during their childbearing years, when their estrogen levels are high. The condition occurs when the tissue that lines the uterus begins to grow elsewhere, such as outside the uterus, in the intestines or on the ovaries or fallopian tubes. While there’s no proven cause for the extra tissue growth, research has shown that when a woman reaches menopause, her estrogen levels drop and endometriosis symptoms usually disappear.

Endometriosis sufferers may feel pain wherever the tissue growth occurs; they also can experience heavy periods, painful intercourse, bleeding after sex, or blood in the urine or stool. The condition makes getting pregnant more difficult for some women.

Doctors have a variety of tools to help diagnose endometriosis. “Ultrasound, MRI and CT scans, Pap smears and pelvic exams are useful in diagnosis, and additional tests for anaemia, blood sugar, kidney function, and cholesterol may also be recommended,”

Dr. Saowanee explained. “We also ask about a patient’s family history, as this condition sometimes runs in families.” While there is no cure for endometriosis, medication can help reduce bleeding and pain, while birth control pills also appear effective in controlling pain and shrinking tissue growth.

For women planning to become pregnant in the future, surgery is often recommended, with laparoscopic surgery (the insertion of a thin lighted tube through a small incision in the belly) considered the most effective way to remove cysts or scar tissue.

For some women, endometriosis can cause severe pain and debilitating symptoms. In these serious cases, some women opt to have a hysterectomy the removal of the uterus and ovaries. But this decision should be carefully considered, as the surgery not only prevents future childbearing, but also leads to early menopause.


Infections of the vagina are extremely common, and most can be easily treated with medication.

It’s normal for some women to have a non-odorous discharge from the vagina during menstruation. But if you notice an abnormal discharge with an unpleasant odor, itching on the o utside of the vagina, pain during or after intercourse, or a burning sensation while urinating, you probably have a vaginal infection that requires medical attention.

The most common vaginal infections include candida (“yeast” infection), bacterial vaginosis, and viral vaginitis. These and other vaginal conditions can result from an infection or a change in the vagina’s normal bacterial balance. Improper hygiene, tight-fitting clothing, soaps and laundry detergents, and sexual transmission are just some of the possible causes. Medication is usually sufficient to treat a vaginal infection.

Different vaginal infections share many of the same symptoms, but each requires a different treatment. It’s important for women who experience any of these symptoms to consult a doctor for an examination and to rule out a more serious problem. And while most vaginal infections are not serious, some infections pose a risk to pregnant women and their unborn child, so they need to be especially vigilant about seeing their doctor as soon as they experience any infection symptoms.


Becoming pregnant can be difficult for many women even those in their prime childbearing years with no apparent health problems. It’s estimated that 1 in 10 couples experience infertility, defined as the inability to conceive after at least one year of trying. There are many possible causes for infertility, and a man’s fertility is as often the cause as a woman’s.

OB/GYN specialists have a number of diagnostic tools for both men and women to help trace the source of a couple’s infertility. Doctors also look at a couple’s family histories, as many fertility-related problems tend to run in families.

If you’re having trouble becoming pregnant, the best first step is for you and your partner to see your OB/GYN specialist. He or she is best able to evaluate your current situation and recommend the best treatment option.


Dr. Saowanee pointed out that it’s not uncommon for women to miss one or two periods a year or notice their periods becoming heavier over time. “But missing more than two periods in a row may mean a serious problem,” she cautioned. “It often indicates an ovulation problem and is of special concern for women planning a future pregnancy.”

That’s one more reason that all women should make it a habit to receive regular annual check-ups with their OB/GYN, to help catch any potential problems earlier, when treatment is most effective. And be sure to follow the screening schedule recommended by your doctor.

Healthy at Any Age Regular Screenings Help Protect Women Against Illness

Mammograms – To guard against breast cancer, women should have a mammogram every 1 to 2 years, beginning at age 40. 
Pap Smear – This cervical cancer screening test should be performed every 1 to 3 years for sexually active women and those aged 21 or older. 
Obesity – Have your body mass index(BMI) checked to screen for obesity. BMI is a measure of body fat based on height and weight.
Cholesterol – Have an annual cholesterol test starting at age 45. For women under 45, ask your doctor about earlier colesterol testing, especially if you smoke, have diabetes or have a family history of heart disease. 
Blood Pressure – Have your blood pressure monitored at least every 2 years (more frequently for older women). Some racial and ethnic groups have higher risks; your doctor can recommend a testing schedule that’s right for you. 
Colorectal Cancer ScreeningRegular screening for colorectal cancer should begin around age 50. How often you need to be tested will depend on which test you have. 
Diabetes – Have a diabetes screening test if you have high blood pressure or high cholesterol. 
Osteoporosis – Have a bone density test at age 65 to screen for osteoporosis, a serious condition involving thinning of the bones. For women younger than 65 and those weighing less than 70 kg., ask your doctor about earlier osteoporosis testing.

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