gynaecological problems in working women. presented to tata steel
TRANSCRIPT
GYNAECOLOGICAL PROBLEMS WITH WORKING WOMEN
By
Dr. Ranjit ChakrabortiDirector, Gynaecology & Obstetrics
Woodlands Hospital Bhagirathi Neotia Hospital
Parkland Chambers
Steel Women Aspirational Team Initiative
Thank You for Inviting
From the standpoint of a practicing Obstetrician – Gynaecologist , certain
gynaecological problems are of interest as affecting the women work force and
mostly stem out of these Lifestyle diseases
THE REALITY AMONG WORKING WOMEN
• 68% Indian working women suffer lifestyle diseases
• While two-third of working women suffer from lifestyle diseases, 53 per cent of them skip meals and go for junk food due to work pressure and deadlines
• According to a survey conducted by the Associated Chamber of Commerce and Industry (Assocham), 68 per cent of working women in the age bracket of 21-52 years were found to be afflicted with lifestyle ailments such as obesity, depression, chronic backache, diabetes and hypertension
The report further said that as 27 per cent of females in urban India were employed, their health issues are a major concern both for society and business
INTRODUCTION
Most quantitative assessments of women’s health status are still based on maternal health measures:Indicators such as the Maternal Mortality Ratio (MMR), the proportion of births attended by a skilled attendant and the percent of women who attend an antenatal check up.
WOMEN HEALTH INDICATORS
Exposure to industrial pollutants Environmental toxins Poor quality of sleep Lack of exercise Less sunlight exposure, Poor nutrition, Excessive intake of alcohol and drug abuse Long working hours and deadlines Anxiety & insecurity
FACTORS WHICH MOSTLY AFFECT
Breast CancerInfertility
Menstrual DisordersSTD’s
High risk pregnancy
THE TOP 5 PROBLEMS WOMEN SHOULD BE CAREFUL ABOUT ARE:
PREVENTION OF GYNAECOLOGICAL DISORDERS
• Proper Pre-Employment Check up• Preventive Health Check ups
• Regular Check up with Corporate Medical Officer• Health Awareness Programmes
• Breast Examination (Self Breast Examination)• Examination of Pelvis (By USG,internal examination)
• Mammography/Sono-Mammography• Vaginal Examination
• Menstrual Disorders• Vaginal Discharge• Pelvic Pain
• Polycystic Ovarian Disease• Uterine Fibroid
• High Risk Pregnancy
COMMON GYNAE DISORDERS
Another disease that women have to be knowing about and have to be careful about is the breast cancer. After the menopause, most of the hormones in the women's body stop secreting.
As ever, the women, try not to give much importance to their personal health. They stop exercising. Now a days many women, just like men have started smoking, chewing pan etc which have changed the entire life style which in turn have increased the vulnerability of women to breast cancer.
After 30 years, every women should go for a mammogram to check whether they have breast cancer. But all at the same time, it will be better for women to keep themselves abstained from smoking and pan.
BREAST CANCER
Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children..
INFERTILITY
• Age• Causes of failure to ovulate• Premature menopause
• Scarred ovaries• PID
• Poorly functional fallopian tubes
CAUSES THAT PLAY A MAJOR ROLE IN INFERTILITY
ENDOMETRIOSIS AND INFERTILITYStudies indicate that women with endometriosis take longer to conceive and are less
likely to conceive than women in general.
Many women with endometriosis have children without difficulty and
many others become pregnant eventually it may take time and
may require the help of surgery or assisted reproductive technologies
or both.
CAUSE & TREATMENT OF ENDOMETRIOSIS
• Ovaries and Fallopian Tubes in abnormal places due to adhesion
• Newly released egg cannot find a way to Fallopian Tubes• No evidence of Endometriosis causing repeated miscarriages
Treatment
• Hormonal & Surgical Management• Hormonal treatment effective for Mild Cases• Moderate to Severe Cases requires Laparoscopic Surgery
Conception is a complicated process that depends upon many factors:
On the production of healthy sperm by the man and healthy eggs by the woman;
unblocked fallopian tubes that allow the sperm to reach the egg;
the sperm's ability to fertilize the egg when they meet;
the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and sufficient embryo quality.
Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman's hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result
CONCEPTION
Menstrual Disorders include • Amenorrhea• Menorrhagia
• Irregular bleeding• Dysmenorrhe
MENSTRUAL DISORDER
• Stress• Hormonal imbalance,
• Diet • Birth control pills
• Uterine polyps or fibroids• Endometriosis
• PCOS.
CAUSES
• Amenorrhea is the absence of menstrual periods.
• There are two types of amenorrhea, – Primary amenorrhea – Secondary amenorrhea.
AMENORRHEA
Heavy Periods• Passage of more than 80 ml of blood each period (it is seldom realistic or practical. However to actually measure
the blood loss and doctors rely on the women’s description of her period)
CAUSE : • Temporary Imbalance in Young, eventually cured with Age• Hormonal Imbalance• Symptom of any underlying disease to be excluded
MENORRHAGIA
Dysmenorrhea is the name for painful menstrual cramps.
There are two types of dysmenorrhea,◦ primary dysmenorrheal and ◦ secondary dysmenorrheal.
Primary dysmenorrhea is the most common with cramping pain in the lower abdomen occurring at the onset of menstruation in the absence of identifiable pelvic disease. It must be distinguished from secondary dysmenorrhea, which refers to painful menses resulting from pelvic pathology such as endometriosis.
DYSMENORRHEA
PCODPCOD
Patients suffering from polycystic ovarian disease (PCOD) have multiple small cysts in their ovaries (the word poly
means many). These cysts occur when the regular changes of a normal menstrual cycle are disrupted. The ovary is
enlarged; and produces excessive amounts of androgen and estrogenic hormones. This excess, along with the absence of ovulation, may cause infertility. Other names for PCOD are Polycystic Ovarian Syndrome (PCOS) or the Stein-Leventhal
syndrome.
A schematic, comparing a polycystic ovary with a normal ovary
We don't really understand what causes PCOD, though we do know that it has a significant hereditary component, and is often transmitted from mother to daughter . We also know that the characteristic polycystic ovary emerges when a state of anovulation persists for a
length of time. Patients with PCO have persistently elevated levels of androgens and estrogens, which set up a vicious cycle. Obesity can aggravate PCOD because fatty tissues are hormonally active and they produce estrogen which disrupts ovulation . Overactive adrenal glands can also produce excess androgens, and these may also contribute to PCOD. These
women also have insulin resistance ( high levels of insulin in their blood, because their cells do not respond normally to insulin) of androgens and estrogens in PCOD
WHAT IS THE CAUSE OF PCOD ?
Fig 2. The self-perpetuating vicious cycle of elevated levels of androgens and estrogens in PCOD
HOW IS PCOD TREATED ?
TreatmentTreatment of PCOD for the infertile patient will usually focus on inducing
ovulation to help them conceive.
Weight loss:
• It is an effective tool• Long term Weight Loss Plan• Regular monitoring by dietician or weight Loss Clinic• Increasing Physical Activity• Walking, Jogging, Swimming • Avoid Junk foods• Do this in groups of 2-3 ladies for better results
WHAT ARE FIBROIDS?
Non-Cancerous tumors growing around womb Varies in Size
Made up of muscle and fibrous tissue Also referred as uterine myomas or fibromyomas.
A TYPICAL PICTURE OF A FIBROID
HOW ARE FIBROIDS TREATED?
Fibroids do not cause symptom and treatment is not required.Overtime it will often shrink and disappear without any treatment.Around 1 in 3 working women experience symptom from fibroids.Such as pain or heavy bleeding. In such cases medication may bePrescribed. If this doesn’t work, other techniques, including surgery
WHO IS AFFECTED?
Fibroids are common with around 40% of women developing them at some stage in their life. They most occur in women who are from 30-50 years old.it is also thought that they occur more often in heavier women as a result of higher oestrogen levels.
• Exact cause is unknown• Mainly Hormonal Cause
• Female Hormone Oestrogen• Usually occurs in Reproductive
Age (16-50 yrs)
CAUSES FOR FIBROIDS
• Pelvic inflammatory disease (or PID) is an infection that occurs in some part of the female reproductive organs. One of the symptoms of PID is a foul-smelling discharge from the vagina
• It may also be accompanied by irregular menstrual periods or pain during sex. The most common cause for PID is by coming into contact with a sexually transmitted disease. PID is a serious illness that may damage the fallopian tubes and prevent future pregnancies.
PID
• A high risk pregnancy is one in which some condition puts the mother, the developing foetus or both at higher than normal risk for complications during or after the pregnancy and birth.
• CAUSE : A pregnancy can be considered a high risk pregnancy for a variety of reasons. Factors can be divided into maternal and fetal. more than in high risk pregnancy can happen bleeding during the third trimester, abnormalities of reproductive tract, urine fibroids hypertension, RH incompatibility. Gestational Diabetes,fever,cancer,tuberculosis,mumps,syphlis,folic acid smoking are the causes of high risk pregnancy.
WHAT IS HIGH RISK PREGNANCY?
HIGH RISK PREGNANCY
Puts the mother and developing foetus for complications before or after delivery
Reasons can both be maternal or Foetal
Bleeding in 3rd trimester of Pregnancy
Hypertension, Uterine Fibroid
Anomalies of Reproductive Tract
Rh-incompatibity
Diabetes,Chicken-Pox,Fever,Mumps,Syphillis
Smoking or Drinking
• Working Women nowadays are ambitious and career oriented• Late Marriage • Planning to conceive late because of career• Fast & Stressful Lifestyle• Long Hours of Work in IT/BPO Sector/Shifting Duty • Junk Food Habits• Smoking & Drinking• Stress related hypertension and Diabetes• Ideal age for conceiving is 26-30 yrs• Conceiving after 35 yrs leads to complications
HIGH RISK PREGNANCY RELATED TO WORKING WOMEN
TREATMENT : Treatment varies widely with the type of disease, the effect that pregnancy has on the disease additional tests may help determine the need for changes in medication or additional treatment.
PREVENTION : A pregnant women need regular heath check up and close monitoring. – Her medication should also be taken care off– Avoiding Stress
HIGH RISK PREGNANCY
MENOPAUSE & TREATMENT OF.....
Menopause is the permanent end of menstruation in that case menstruation is less frequent and eventually stop altogether.
Treatment of Hormonal Disorders
– Medication– Hormone Replacement Therapy
– Birth Control Bills– Overdose of Cosmetics & Non-Organic Animal
Products– Medical Causes– Genetic Causes– Obesity– Sedentary Life-Style– Pregnancy
CAUSE:There are multiple causes for hormone imbalance. Common causes include birth control pills, stress, overuse of cosmetics, and non organic animal products. Other medical causes include genetics, obesity and tumors. Other causes include lack of exercise, pregnancy, and sedentary lifestyle.
CAUSES OF HORMONAL IMBALANCE
Fatigue Skin Problems Mood Swing Overweight or Loosing Weight Diminished Sex Drive Loss of Memory Arthritis Anxiety Attacks
SYMPTOMS: Some of the most commonly shared symptoms includes fatigui,skin problem,mood swings,weight problem,diminished sex drive and no memory.The disorder include Arthritis,chronic fatigue syndrome,fibromyalgia and anxiety attacks.
MENOPAUSE : Menopause is the permanent end of menstruation fertility in that case menstruation is less frequent and eventually stop altogether.
TREATMENT : There are two types of therapy for its treatment like prescription therapy and HRT combination therapy.
SYMPTOMS OF HORMONAL IMBALANCE
If the problems are severe, bleeding may be regulated by medications
Hormonal treatment include the contraceptive pills and danazols
Non hormonal treatment include tranexamic acid
Hysterectomy-the removal of the uterus is commonly performed for heavy periods
If diagnosis of an underlying condition is made then the treatment will be tailored towards that condition
If the women is anaemic iron or folic supplements may be needed
TREATMENT
Cause
The exact cause is usually unknown. The risk of developing ovarian cancer appears to be affected by several factors. The more children a woman has, the lower her risk of ovarian cancer. Early age at first pregnancy, older age of final pregnancy and the use of low dose hormonal contraception have also been shown to have a protective effect.
OVARIAN CANCER…..THE SILENT KILLER
Following factors form the risk in ovarian cancer:
(i) family history of cancer (ii) personal history of cancer (iii) age over 55 years(iv) never pregnant
RISK FACTORS
Highlighting the fact that women play vital and multiple roles, especially those who are employed, a correct work –life balance has become absolutely necessary
TO WISH TO BE WELL IS PART OF BECOMING WELL
To insure good health: Eat
lightly, breathe deeply, live moderately, cultivate cheerfulness, and maintain an interest in life.
TO CONCLUDE
What a wonderful world!!
Stay Healthy and Enjoy It