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Common Reproductive Health Concern (Female)

Endometriosis is a common health problem affecting a woman’s uterus—the place where a baby grows when a woman is pregnant. Endometriosis is when the kind of tissue that normally lines the uterus (called the endometrium) grows somewhere else. It can grow on the ovaries, behind the uterus, on the bowels, or on the bladder. Rarely, it grows in other parts of the body.


The most common symptom of endometriosis is pain. Women with endometriosis may have many different kinds of pain, which include:

– Very painful menstrual cramps. The pain may get worse over time.

– Chronic (long-term) pain in the lower back and pelvis

– Pain during or after sex. This is usually described as a “deep” pain and is different from pain felt at the entrance to the vagina when penetration begins.

– Intestinal pain

– Painful bowel movements or pain when urinating during menstrual periods. In rare cases, you may also find blood in your stool or urine.

– Spotting or bleeding in between periods. If you are bleeding or spotting between menstrual periods, this can be caused by something other than endometriosis. However, if it happens often, you should see your doctor.

– Stomach (digestive) problems. These include diarrhea, constipation, bloating, or nausea, especially during menstrual periods.

– Infertility, or not being able to get pregnant.


There is no cure for endometriosis, but treatments are available for the symptoms and problems it causes. Talk to your doctor about your treatment options. If you are not trying to get pregnant, hormonal birth control is generally the first step in treatment. This may include:

-Birth control that reduce or eliminate periods. Hormonal birth control such as oral contraceptive pills, the contraceptive injectable, and the contraceptive implant can help reduce pain and menstruation. Hormonal treatment is best for women who do not have severe pain or symptoms.

If you are trying to get pregnant, your doctor may prescribe a gonadotropin-releasing hormone (GnRH) agonist. This medicine stops the body from making the hormones responsible for ovulation, the menstrual cycle, and the growth of endometriosis. This treatment causes a temporary menopause, but it also helps control the growth of endometriosis. Once you stop taking the medicine, your menstrual cycle returns, and you may have a better chance of getting pregnant.

Surgery is also an option for women with server endometriosis– when hormones are not providing relief or if you are having fertility problems. During the operation, the surgeon can locate any areas of endometriosis and may remove the endometriosis patches. After surgery, hormone treatment is often restarted unless you are trying to get pregnant.

Uterine fibroids are the most common noncancerous tumors in women of childbearing age. Fibroids are made of muscle cells and other tissues that grow in and around the wall of the uterus, or womb. Fibroids can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a grapefruit. In unusual cases they can become very large. The cause of fibroids is unknown. Being overweight or obese is a risk factor for uterine fibroids.

About 20-80% of women develop fibroids by the time they reach age 50. Fibroids are most common in women in their 40s and early 50s. Most fibroids do not cause any symptoms, but some women with fibroids can have:

-Heavy bleeding (which can be heavy enough to cause anemia) or painful periods

-Feeling of fullness in the pelvic area (lower stomach area)

-Enlargement of the lower abdomen

-Frequent urination

-Pain during sex

-Lower back pain

-Complications during pregnancy and labor, including a six-time greater risk of cesarean section

-Reproductive problems, such as infertility, which is very rare.



If you have fibroids but do not have any symptoms, you may not need treatment. Your doctor will check during your regular exams to see if they have grown. If you have fibroids and have mild symptoms, your doctor may suggest taking over-the-counter medication used to manage mild pain. Several drugs commonly used for birth control can also be prescribed to help control symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding. If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. Your doctor will speak to you about options that are bested suited for you.

PCOS happens when a woman’s ovaries or adrenal glands produce more male hormones than normal. One result is that cysts (fluid-filled sacs) develop on the ovaries. Women who are obese are more likely to have polycystic ovary syndrome.


• Infertility

• Pelvic pain

• Excess hair growth on the face, chest, stomach, thumbs, or toes

• Baldness or thinning hair

• Acne, oily skin, or dandruff

• Patches of thickened dark brown or black skin

Women with PCOS are at higher risk of diabetes, metabolic syndrome, heart disease, and high blood pressure. Medicines can help control the symptoms. Birth control pills help women have normal periods, reduce male hormone levels, and clear acne. Other medicines can reduce hair growth and control blood pressure and cholesterol. However, there is no cure. If you think you may have POCS, speak to your health provider about your options.

If you are concerned about urinary tract infections (UTIs), you’re not alone. Many women — 1 out of 5 — will experience a urinary tract infection at least once in their lives. A UTI is an infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract include:

Kidneys — collect waste from blood to make urine

Ureters — carry the urine from the kidneys to the bladder

Bladder — stores urine until it is full

Urethra— a short tube that carries urine from the bladder out of your body when you pass urine

UTIs are caused by bacteria getting into your urinary tract. This can happen in many ways:

-Wiping from back to front after going to the bathroom. Germs can get into your urethra, which has its opening in front of the vagina.

-Having sexual intercourse. Germs in the vagina can be pushed into the urethra.

-Waiting too long to pass urine. When urine stays in the bladder for a long time, more germs are made, and the worse a UTI can become.

-Anything that makes it hard to completely empty your bladder, like a kidney stone.

-Having diabetes, which makes it harder for your body to fight other health problems.

-Loss of estrogen and changes in the vagina after menopause. Menopause is when you stop getting your period.


If you have an infection, you may have some or all of these signs:

-Pain or stinging when you pass urine.

-An urge to pass urine a lot, but not much comes out when you go.

-Pressure in your lower belly.

-Urine that smells bad or looks milky, cloudy, or reddish in color. If you see blood in your urine, tell a doctor right away.

-Feeling tired or shaky or having a fever.


UTIs are treated with antibiotics, medicines that kill the bacteria that cause the infection. Your doctor will tell you how long you need to take the medicine. Make sure you take all of your medicine, even if you feel better! Many women feel better in one or two days. As you are taking antibiotics, make sure to also hydrate with plenty of water.


Try these simple tips to prevent getting a urinary tract infection:

-Drink when you are thirsty.

-Urinate as soon as you feel the urge. Don’t hold it.

-Keep your vulva clean and dry.

-Urinate immediately before and after sex.

-Avoid positions during sex that seem to trigger UTIs.

-Use latex or female condoms during vaginal intercourse.

If you are susceptible to frequent UTIs, you may want to talk to your health care provider to see if there are any other reasons for the infections. Your provider may be able to provide antibiotics to help prevent a recurring infection.


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