The Unique Spectrum of Women’s Health
The typical female body goes through many changes throughout life. For some, not understanding and managing these changes can be distressing or challenging, especially when education on these topics is not universal. Join us in covering common women’s health topics, because women’s health is directly linked with mental health and well-being. If you feel overwhelmed, confused, or stressed regarding the following topics, you are not alone. We hope this overview provides some answers, and normalizes the many physical and emotional changes you may encounter.
What changes should a teenager be aware of during puberty?
Many changes occur during puberty, which is the time between 8-15 years old when the body goes through new maturation phases. This includes breast changes, pubic and axillary (armpit) hair growth, growth spurts, starting the menstrual cycle, and mood changes secondarily to bodily changes.
What is a menstrual cycle?
Menstruation is also referred to as a monthly “period.” Each month, the female body prepares for the possibility of carrying a pregnancy. So each month when there is no pregnancy achieved, the uterus sheds its lining which presents as a few days of lower abdominal cramps and bleeding.
What should a regular period be like?
An average period can vary from 3 to 7 days of bleeding, with the entire cycle lasting 21-35 days. When you experience polymenorrhea (too many periods in a year) or oligomenorrhea (too few periods in a year), this is a sign to talk to your doctor about your health. Typically, a period should be predictable and occur at a regular time each month.
What do I do if my period is heavy?
It is important to define what a heavy period is for you personally, because it varies from person to person. An average amount of blood loss per month during menstruation involves changing a pad or tampon every few hours. If you constantly need to change your supplies every hour or you are bleeding through your clothes, this is a sign to talk to your doctor to see how your symptoms can be better managed. The most common causes of heavy bleeding are fibroids (extra smooth muscle and tissue in the uterus) or endometriosis (extra uterine tissue outside the uterus). This warrants an appointment with your doctor who can potentially perform further workup, such as a transvaginal ultrasound or blood work, to assess potential causes.
What does it mean if my period is light?
Some people’s periods are simply lighter than others. Additionally, women approaching menopause also often notice that their periods get lighter. If you notice your period is lighter than your normal, it could be caused by life changes – such as appetite change, weight loss, or stress – or other physical changes – such as thyroid abnormalities or Polycystic Ovarian Syndrome (PCOS) – and you should see your doctor to discuss.
What are the different types of birth control?
Choosing the best birth control for you is a personal decision. Since it is a decision that can cause many people a great deal of stress, self-doubt, and confusion, we’ve decided to outline the currently available options at a high level here:
Permanent - Sterilization aka “tube tying” (99% effective): This is a surgical procedure to prevent sperm from reaching an egg.
Hormonal implant (99% effective): An implant is placed into the arm and releases hormones that prevent pregnancy for 3 years.
Intrauterine device (IUD) (99% effective): IUDs change the lining of the uterus to prevent implantation. Hormonal options can last from 3-8 years. The copper IUD can last for 10 years.
Injection (94% effective): A hormonal shot is given every 3 months.
Hormonal pills (91% effective): These must be taken at the same time everyday. They work by preventing ovulation (release of an egg from the ovary).
Hormonal rings (91% effective): A ring is inserted into the vagina and releases hormones that prevent pregnancy. It must be replaced once a month.
Hormonal patches (91% effective): A patch is placed on the skin and releases hormones that prevent pregnancy. It must be replaced once a week.
Barrier methods (75-82% effective): These include both male and female condoms, sponges, and cervical caps. These must be replaced each time you have sex. Only condoms protect against sexually transmitted infections.
What does fertility preservation mean?
Advanced maternal age is currently technically and medically defined as 35 years old. Of course, women can still have children after 35, but the odds of having a normal pregnancy decrease. To combat this, there are a few options available to augment future fertility, including egg and sperm freezing. Egg freezing is when someone stores their eggs long-term in a facility. (More specifically, storage occurs after a stimulation cycle with a fertility specialist.) This allows the eggs to stay healthy and at a preserved age until the woman decides to try to have children. Once retrieved, the eggs can also be made into embryos using sperm, and the embryos could be frozen. The process of fertility preservation and family planning can be discussed with your Ob/Gyn who may refer you to a reproductive endocrinologist and infertility specialist.
What changes occur during pregnancy?
Pregnancy can cause mental health changes due to social stressors and changes in hormone levels. Depression and anxiety are most common, especially in women who stop psychiatric medication due to pregnancy. Social support, as well as participating in activities that improve your mental health (e.g. walking, talking to a therapist), are very important during pregnancy. Speak with your doctor about severe symptoms and treatment options as certain antidepressants and other interventions may be helpful.
What is postpartum depression?
Postpartum depression (PPD) is when a new mother experiences symptoms of major depressive disorder that last more than two weeks after the delivery of the baby. These symptoms can include trouble with sleep, lack of interest in usual activities, feelings of guilt, change in energy, problems with concentration, changes in appetite, psychomotor slowing, and any suicidal ideation. During this time, it is important to be vigilant of changes in behavior or attitude towards others or the baby. The best first step for PPD treatment is making an appointment with your Ob/Gyn to discuss your options. PPD can be treated with medication, including starting a trial of selective serotonin reuptake inhibitors (SSRIs). This class of medication increases the amount of serotonin in the body which helps to regulate mood. Alternatively, there are non-pharmaceutical options including talk therapy, yoga, massage therapy, and ecotherapy.
What is menopause?
Menopause is a normal process that occurs at an average age of 51. It is the process of ovarian follicles “shutting down”. This results in a decrease in estrogen levels, which is the cause of most menopausal symptoms.
What symptoms occur with menopause?
The most common symptoms are hot flashes, night sweats, migraines, and changes in menstrual cycles. Before the periods stop altogether, women often notice they get lighter or more irregular. Other common symptoms are vaginal dryness, burning, itching, or irritation. Many women also notice changes in mood such as increased irritability, anxiety, depression, or loss of concentration. Speak with your doctor about the best symptomatic treatment for you.
How is menopause diagnosed?
Menopause is a clinical diagnosis based on the combination of symptoms listed above. Menopause is officially defined as when it has been 12 months since your last menstrual period. If your doctor wants to do bloodwork for a confirmatory diagnosis, the Follicle Stimulating Hormone (FSH) will be elevated.
What does an Ob/Gyn want you to know if you are hesitant to see a doctor?
“Let your doctor know if this is your first Ob/Gyn appointment and ask plenty of questions. We want our patients to feel safe and comfortable, so don’t be afraid to advocate for yourself!”
- Micaela Motzko, Ob/Gyn Resident Physician
Where can I go for help with women's health care?
Your primary care physician (these are typically doctors specializing in Family Medicine or Internal Medicine)
Your Ob/Gyn (this is a doctor specializing in Womens’ Health)
A psychiatrist (a doctor specializing in Psychiatry/Mental Health)
A psychologist (a mental health provider with a PhD or PsyD degree), therapist, or counselor (note that these providers cannot prescribe medications but can provide valuable interventions such as therapy)
Where can I learn more?
Nemours Kids Health, “All About Puberty”
Office on Women’s Health, Menstrual Fact Sheets
Office on Women’s Health, Infertility Fact Sheets
The National Institute on Aging, Menopause
Disclaimer: The information above is intended to provide education regarding women’s health. It is not medical advice and should not be used for medical diagnosis. For questions regarding diagnosis, treatment, and more regarding any women’s health conditions, contact a physician or other medical professional.
Published: September 2, 2024. Updated: October 10, 2024.
Written by: Tillie Schumann (Medical Student) & Natalie Sipes (Medical Student). Edited by: Alexandra Lawlor (Medical Student).
References:
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