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WOMEN HEALTH ISSUESDr Maryam Alam Khan
• Breast cancer• Cervical cancer• Anal fissure and hemorrhoids• Reproductive Health• Nutrition• Psychiatric problems and drugs• Osteoporosis• Diabetes, heart disease and HTN
Statistics
• Global burden rises to 14.1 million new cases and 8.2 million cancer deaths in 2012!
• 34.6% of female cancers in Pakistan!• 1 in 9 women!
Risks for Breast Cancer• Family history of malignancies• Early Menarche Late menopause• Nulli parity• Having children in later age• Estrogen therapy/ OCP/HRT• Lack of breast feeding• Genetics• Obesity and lack of exercise• Smoking and alcohol• Radiation history• Xenoestrogens!• Sleep!
Sleep…and breast cancer risk• Hormone of sleep--melatonin• Immune booster, decreases circulating sex hormones
(estrogen, progesterone, and testosterone)• Breast cancer is less common in women who sleep > 9
Hrs / night than in women who sleep less.• Women who consistently sleep more than 9 hours/night
have less than 1/3rd the risk of developing a breast tumor than women who sleep 7 or 8 hours per night• Women who work shifts have a 50% increase in breast
cancer (same with men and prostate cancer and shiftwork)
(Cancer Research, October 15, 2005)
MYTH BUSTERS!!• Abortion• Under wire Bras• Deodorants• Fertility treatments• Folic acid (folate)• Viruses
SELF BREAST EXAMINATION
CERVICAL CANCER
RISK FACTORS• cervical cancer is the fourth most
common cancer affecting women worldwide (after breast, colorectal, and lung cancers)
• HPV 16 and HPV 18
Screening: the PAP smear
Age group (years) Frequency of screening
25 First invitation25 - 49 3 yearly50 - 64 5 yearly
65+
Only screen those who have not been screened since age 50 or have had recent abnormal tests
ANAL FISSURE AND HEMORRHOIDS
CAUSES
• Constipation!!!!!!!• Low fiber diet!• Prolonged straining!• Meat!• Pickles and spices!• Pulses!
PREVENTION AND TREATMENT• Lifestyle modification• Medications• Surgery
REPRODUCTIVE HEALTH
EARLY MARRIAGES!
• Psychological issues• STDs and cervical cancer• Pregnancy and nutritional
problems• Childbirth : VVF• Incompetent mothers
LATE MARRIAGE• Down’s syndrome!• Weak bones• Co morbidities• Mother hood potentials
FAMILY PLANNING• Reduce health burden• Decreased abortions• Reduce financial burden• Focus one child at a time• Population control
METHODS
PREGNANCY• Regular check ups!• Proper diet• Multi vitamins• Back ache and relation to spinal anesthesia!!!!
INFERTILITY• Male vs female infertility
Causes of Female Infertility• Ovulation problems• Poly cystic ovaries• Endometriosis• Tubal problems(PID)• Fibroids
Methods to Conceive • Medical• Surgical• Male partner• IVF (in vitro fertilization)• GIFT (Gamete intra fallopian transfer)• ICSI (intra cytoplasmic sperm injection)
• Choosing Sex= Male child!?
SEXUALLY TRANSMITTED DISEASE
• Chlymadia• Gonorrhea • Syphillis• Hepatitis B/C• Scabies• Trichomoniasis• Herpes• HPV• HIV/AIDS• Honeymoon cystitis
PSYCHIATRIC PROBLEMS AND DRUGS
• Depression !• Pre Menstrual Syndrome• Obsessive Compulsive Syndrome
Treatments for PMS & PMDD• Lifestyle changes and psychosocial interventions
(no controlled trials)• Dietary modifications (reduce refined sugars, caffeine,
salt, alcohol), Exercise, ,Stress management, Cognitive Psychotherapy, Relaxation training, Group therapy, Charting symptoms
• Vitamins and nutritional supplements• Calcium, Linoleic acid (Evening primrose oil),
Pyridoxine (Vit. B6)-limited evidence, mixed results• Bright light, Sleep deprivation
Parry et al (1987, 1989, 1993, 1995)
ANOREXIA NERVOSA
An eating disorder causing people to obsess about weight and what they eat.
BULLIMIA NERVOSA
• A serious eating disorder marked by binging, followed by methods to avoid weight gain• potentially life-
threatening eating disorder.• Treatments include
counseling, medications, and nutrition education
CHRONIC DISEASES!• OSTEOPOROSIS• ARTHRITIS• DIABETES• HYPERTENSION• HEART DISEASE
CONTACT INFORMATION
• Surgical E Ward, Khyber Teaching Hospital• Thursday and Saturday OPD• 10:30am -1:00pm
