WOMEN'S HEALTH

Much of the improved quality of life in the past few decades has resulted not only from the improved medical management of diseases, but also from their prevention. Studies have shown morbidity and mortality can be decreased by preventative measures such as lowering cholesterol, blood pressure control, tight management of diabetes, good prenatal care, and smoking cessation. Each individual has different risk factors for developing diseases, thus medical care should be individualized in order to prevent or delay potential health problems.

PREVENTATIVE CARE

HEALTH MAINTAINENCE
       Cigarette Smoking
          Exercise
          Nutrition
          Stress management

REPRODUCTIVE HEALTH
       Contraception
       Pregnancy

CONCLUSION

        Preventative care includes good health habits and regular health care screenings. It is important that all individuals obtain appropriate cancer screenings, yearly physical exams, and prenatal care. Screening is an important part of preventative care to identify persons susceptible to developing diseases and to discover conditions before clinical evidence appears so that there is a better chance for treatment to be effective. Below is a table containing the recommended screening exams, evaluations, immunizations, and risk factor assessments for women of each age range. 
 

Cigarette Smoking

    Cigarette smoking is the single greatest cause of preventable health problems for American women. It is a contributing factor in 55% of cardiovascular deaths in women younger than age 65. It not only increases the risk of lung cancer, but also that of oral cancer, laryngeal cancer, bladder cancer, pancreatic cancer, and cervical cancer. In addition, it causes chronic lung diseases such as asthma and chronic obstructive pulmonary disease (COPD) which can significantly decrease one’s quality of life. It increases the risk of heart attacks and strokes in women greater than 35, especially if contraceptive pills are used concomitantly. There are also cosmetic sequelae of smoking such as yellowing of the teeth and wrinkling of the skin.

Smoking can be particularly harmful for women of childbearing age. It not only decreases fertility, but in pregnancy it increases the rate of miscarriages, placental abruption, and premature rupture of membranes. The baby can suffer from the increased rate of preterm delivery and decreased birth weight. After the childbearing years, smoking can have such deleterious effects as early menopause and increased risk of osteoporosis.

Your doctor or health care clinic should have smoking cessation information and programs. The American Cancer Society suggests a 5-step program. Quitting smoking especially for a long time smoker can be extremely difficult. Some people try quitting cold turkey, which can be difficult if one has nicotine withdrawal symptoms. One helpful method is to supplement the nicotine through nicotine gum or nicotine skin patches so that this addictive chemical can be slowly weaned while cigarette use is discontinued. For those with particular difficulty, a medication called Bupropion (Wellbutrin) can often be helpful. In addition, support groups can be a crucial part of smoking cessation and maintenance. 

                     Exercise can have many beneficial effects including cardiovascular health as well as physical and mental well being. It can improve cardiovascular health by improving conditioning and the lipid profile. Regular exercise increases HDL and reduces LDL, a pattern that lowers the risk of heart attacks and strokes. Cardiovascular exercise improves conditioning which is the improvement in exercise capacity, giving one more energy and physical endurance. In addition, exercise is an important part of any program to lose or maintain weight. Exercise also increases muscle strength, flexibility, and coordination. Weight bearing exercises such as walking or biking increase bone density and help to prevent osteoporosis.

In order to have a safe and effective cardiovascular workout, one should achieve a target heart rate range using the following formula: (220-age) x 60%-80% = target range. A physician should be consulted prior to beginning an exercise program to make certain it is safe. Each workout should start with a warm up period of at least 5 minutes, then proceed to an aerobic exercise to elevate the heart rate into the target range for at least 20 minutes. This should be followed by a cool-down period to prevent dizziness, nausea, and fainting by allowing peripheral blood to slowly return to the central vascular system. 

              Evidence proves that diet significantly affects the risk of developing illnesses ranging from heart disease to cancer. A diet high in saturated fat increases serum cholesterol level, atherosclerotic heart disease and cancers of the gastrointestinal tract. Diets high in grains, fruits, and vegetables are associated with a decrease in heart disease as well as lung, colon, esophageal, and stomach cancers. If one uses any over-the-counter vitamins, herbal medicines, or special diets a physician should be consulted in order to be counseled regarding missing nutrients or overdosing of certain vitamins. 

    Alcohol consumption should be in moderation, and limited to less than 1 oz per day (2 cans of beer, 2 glasses of wine, or 2 cocktails). Moderate use of alcohol, 1 drink per day, has been shown to increase HDL and decrease the risk of coronary artery disease and stroke. On the other hand, alcohol abuse can cause serious health problems such as liver cirrhosis, head and neck cancers, pancreatitis, gastritis, dementia and memory loss.

                       Stress can have significant ill effects on a person’s physical and mental health. While we all have stress throughout our daily lives, we can learn to cope with them in more healthy and productive ways. Some relaxation techniques include the following: 
                1. Progressive muscle relaxatio
                2. Stretching
                3. Guided visual imagery
                4. Self-hypnosis
                5. Meditation or prayer
                6. Yoga
                7. Biofeedback
                8. Massage
                9. Music
              10. Self-help groups

      Good lifestyle habits improve overall health and also help to better cope with stress. Healthy diet, regular sleep, regular exercise, cessation of smoking and drug use, and moderation of alcohol consumption are crucial in improving one’s ability to handling stress. It is also extremely important to have a supportive social network to discuss problems with work or family. Often the clergy, health professionals, counselors, or social workers fill such roles. 

 
 

Contraception

Some people find birth control a difficult subject to discuss with their healthcare provider. If not actively planning to have a baby, it is important to choose a reliable form of contraception that is right for each individual. The chart below lists the various contraceptive methods available, what their use involves, and the risk of failure with each method.
 

                 Whenever possible, a physician should be consulted when planning a pregnancy. This way, a couple can find an obstetrician and receive pre-conception counseling to discuss any genetic risk factors and start on the recommended vitamin supplements such as iron and folate. In addition, any necessary laboratory or x-ray studies can be done prior to pregnancy. For example if a patient has a positive skin test for tuberculosis, a chest x-ray can be obtained prior to the start of pregnancy. 

    The first sign of pregnancy is often a late or missed period. To determine whether one may be pregnant, an over-the-counter urine pregnancy test can be helpful. This can be confirmed by making an appointment with your primary care physician or obstetrician for a pregnancy test, exam, and any other necessary studies. Initial screening tests obtained for every pregnancy include: complete personal and family medical history, full physical exam including pelvic exam with pap smear, blood count, urinalysis, blood typing, rubella titer, tuberculosis screening, hepatitis screening, cervical cultures, and HIV testing for those at risk. The first prenatal visit is important to establish accurate dating for the pregnancy. Further visits are important to screen for potential pregnancy related complications by the use of physical, laboratory and ultrasound examination. Visits become more frequent toward the end of pregnancy to detect for signs of early labor, poor fetal growth, or pregnancy induced hypertension. 

 

       Women’s health care has significantly improved in the past decades due largely in part to improved knowledge of good health maintenance and improved disease screening. During physician’s visits, one should discuss any relevant issues such as smoking cessation, weight control, or hormone replacement therapy. In addition, each individual should discuss all the relevant screening studies recommended for each age and at-risk group. Just as important as physical health is maintaining good mental health with attention to stress coping techniques, and evaluation for possible depression or domestic violence. Proper contraception and good prenatal care throughout pregnancy are also critical to good women’s health care.

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