Being a woman is a privilege, a matter of pride, but also, a complicated thing. Women, no matter who they are or where in the world they live, have an elaborate reproductive system. This is why women have specific health needs related to sexual and reproductive function, that too, throughout our lives. Studies show that a woman’s reproductive system is vulnerable to dysfunction and diseases, even before it becomes active by reaching menarche (the age at which menstruation starts), and continues to be equally vulnerable even after menopause (the age at which menstruation stops).
What every woman needs to know…
Since every woman’s genetic constitution, hormonal environment, and lifestyle behaviours are different, each one of us is vulnerable in a different way. What’s more, diseases or dysfunction in other systems of the body can also affect the reproductive system. These are just some of the reasons why each and every woman needs to take their sexual and reproductive health (SRH) very seriously, and that too throughout life.
A study published in BMC Women’s Health in 2020, titled Services for Women’s Sexual and Reproductive Health in India, explains that women’s health policy in India has had a longstanding focus on maternal health and family planning. This, however, leaves other aspects of women’s reproductive health issues underserved. Given this, the need to address and beware of SRH issues is even more urgent for Indian women.
Now, if you’re wondering which SRH problems most commonly plague women’s sexual and reproductive systems, read on.
Polycystic Ovary Syndrome
Recent studies suggest that one in every five Indian women tend to suffer from polycystic ovary syndrome (PCOS), making it one of the most common SRH issues in the country. This problem emerges when a woman’s ovaries or adrenal glands produce more male hormones than normal, leading to symptoms ranging from excess hair growth on the face, chest, and stomach, as well as acne, oily skin and dandruff, pelvic pain, irregular periods, and infertility.
As a result of PCOS, fluid-filled sacs, also known as cysts, develop on the ovaries. Women with obesity are not only at risk of infertility, but may also develop other issues like diabetes and heart disease. Though obese women are commonly assumed to be at risk of developing PCOS, those who are thin, have high blood sugar or thyroid dysfunction, are also at risk. While there is no cure for PCOS, it can be treated with medications and by adopting better lifestyle habits.
Endometriosis
The Endometriosis Society of India reveals that around 25 million women in India suffer the pain of endometriosis in silence. Awareness about this SRH issue is still low, which clearly exacerbates the situation. If you have endometriosis, it means that the tissue that normally lines your uterus is growing somewhere else—on the ovaries, behind the uterus, on the bowels, or on the bladder. This misplaced tissue growth can cause excruciating pain, very heavy bleeding during periods, and infertility.
While many women get diagnosed with endometriosis after experiencing extreme pain in their abdomen, lower back or pelvis, many get diagnosed after many tests and ultrasounds. Some women may never get a symptom of this disorder, but may get diagnosed due to the infertility it results in. While the exact causes of endometriosis are not known, the problem is usually treated with hormonal medications, lifestyle changes, and surgery in extreme cases.
Uterine Fibroids
Studies suggest that uterine fibroids are the most common types of non-cancerous tumours among women of childbearing age. In fact, they are so common that one in five women may have them without ever realising it. Fibroids are made of muscle and other tissue cells around the wall of the uterus, and can cause heavy, painful periods, bleeding between periods, a feeling of fullness in the lower abdomen, frequent urination, pain during sex, lower back pain, and infertility.
The exact causes of fibroids are not known, but many believe obesity/overweight and a family history may cause it. Many women who have fibroids don’t present with any symptoms, which is why it’s important for women of childbearing age to consult a gynaecologist regularly for exams. Fibroids are usually treated with hormone-regulating medications and lifestyle changes, but if the fibroids grow too large, then removal by surgery becomes crucial.
Sexually Transmitted Infections
Sexually transmitted infections (STIs) have been around for centuries, and have played havoc with women’s lives throughout that time. There are more than 20 types of STIs which are caused by a wide range of bacteria, parasites, and viruses, and include chlamydia, gonorrhoea, genital herpes, bacterial vaginosis, HPV (human papillomavirus), and HIV/AIDS. While the effects of an STI are harsh for both men and women, the results can be more devastating for women, especially if they are pregnant (as most STIs can be passed on to the unborn child).
This is the reason why safe sex practices and maintaining sexual/reproductive hygiene are as important as getting regularly screened for STIs—and getting the HPV vaccine too. Treating STIs depends on its causes. If bacterial in origin, the disease can be treated with a course of antibiotics. There is no cure for viral STIs like HIV and HPV, but the symptoms can be managed with medications.
Primary Ovarian Insufficiency
Early menopause is an emerging concern among Indian women, and primary ovarian insufficiency (POI) is the official diagnosis that is given to women who suffer from it. POI basically refers to the depletion or dysfunction of ovarian follicles due to the cessation of menstruation before the age of 40 years. This disease is highly sensitive, which is why delays in diagnosing it can cause not only SRH issues but heart and mental health ones too, because the disease affects everything from fertility to sexual and reproductive functions.
This is the primary reason why women diagnosed with POI should be provided with counselling and support to deal with not only the comorbidities of the condition, but also with the emotional distress and social anxiety it can cause. Doctors even recommend annual evaluations, including psychological evaluation, of women with POI, so that the repercussions can be dealt with appropriately. Hormonal therapy is as important for these women, as is regular consultations with endocrinologists and fertility specialists.
Interstitial Cystitis
Interstitial cystitis (IC) can affect both men and women, but studies suggest it’s more common among women. IC is a chronic bladder condition caused by an inflamed or irritated bladder, which causes chronic or recurring discomfort or pain in the bladder and the surrounding pelvic region. The common symptoms of IC include pelvic or abdominal discomfort, frequent urination, and a sensation of abdominal or pelvic pressure, tenderness, intense, and recurring pain in the pelvis, and intensified pain when the bladder fills or empties out. Medications, physiotherapy, and other forms of treatment are usually recommended for IC.
Gynaecological Cancers
There are many kinds of cancers that start in or primarily affect a woman’s reproductive organs. In fact, the gynaecological cancers are named after the specific area of a woman’s pelvis which is affected. None of these cancers can be cured, but there are many treatments that can help manage the symptoms or control the spread of these cancers, including chemotherapy and surgery. The following are the types of gynaecological cancers women are most at risk of:
• Cervical cancer, which begins in the cervix.
• Ovarian cancer, which begins in the ovaries.
• Uterine cancer, which begins in the uterus.
• Vaginal cancer, which begins in the vagina.
• Vulvar cancer, which begins in the vulva.