Gynecological Health Concerns

There are several conditions that can interfere with gynecological health. We will discuss some of the most prevalent, including endometriosis, toxic shock syndrome, uterine fibroids, vulvodynia, polycystic ovarian syndrome, and vagi­nal infections.

Endometriosis occurs when endometrial cells begin to migrate to places other than the uterus. They may implant on any of the reproductive organs or other abdominal organs and then engorge and atrophy every month with the menstrual cycle, just like the en­dometrium does in the uterus. The disease ranges from mild to severe, and women may experience a range of symptoms or none at all.

Endometriosis is most common in women between 25 and 40 years of age who have never had children; it has been called the “career woman’s disease” because it is more common in professional women (Simsir et al., 2001). Women who have not had chil­dren and those who experience short and heavy menstrual cycles have also been found to be more at risk for endometriosis (Vigano et al., 2004). Among women of childbear­ing age, the estimated prevalence of endometriosis is as high as 10%; and among infer­tile women, between 20 and 40% (Vigano et al., 2004; Frackiewicz, 2000). If you or someone you know has had symptoms of endometriosis, it is important that complaints are taken seriously.

The cause of endometriosis is still unknown, though some have suggested that it is due to retrograde menstrual flow (a process in which parts of the uterine lining are car­ried backward during the menstrual period into the Fallopian tubes and abdomen; Frackiewicz, 2000; Leyendecker et al., 2004). The symptoms of endometriosis depend on where the endometrial tissue has invaded but commonly include painful menstrual periods, pelvic or lower back pain, and pain during in­tercourse; some women also experience pain on defecation (Prentice, 2001). Symptoms of­ten wax and wane with the menstrual cycle, starting a day or two before menstruation, be­coming worse during the period, and gradually decreasing for a day or two afterward. The pain is often sharp and can be mistaken for menstrual cramping. Many women discover their endometriosis when they have trouble becoming pregnant. The endometrial cells can affect fertility by infiltrating the ovaries or Fallopian tubes and interfering with ovulation or ovum transport through the Fallopian tube.

Endometriosis is diagnosed through biopsy or the use of a laparoscope. Treatment consists of hormone therapy, surgery, or laser therapy to try to remove endometrial patches from the organs. Endometriosis declines during preg­nancy and disappears after menopause.