PROBLEMS ASSOCIATED WITH FEMALES’ REPRODUCTIVE HEALTH

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Gender Issues In Psychology (PSY - 512)

Lecture 39

PROBLEMS ASSOCIATED WITH FEMALES' REPRODUCTIVE HEALTH

Problems Associated With Females' Reproductive Health

As said earlier, more females than males go for medical advice and help. Their frequent consultation with the

physician is besides their visits for pregnancy related advice and care. One probable reason for this behavior is

that women are endowed with a complex reproductive system. The structure and the functions of female

reproductive system are complex and vulnerable to a variety of conditions. In our discussion of this subject we

will focus upon a few of such problems that may affect a women's physical or psychological well-being.

We will be discussing the following problems:

a) Dysmenorrhea

b) Pre-menstrual syndrome

c) Menopause

The main objectives of our discussion of these problems are:

To create an awareness about the very existence of these problems

ii.

Besides, we want to make the point that it is not necessary that all women experience these problems.

Many women never experience any of these symptoms.

iii.

Although there are certain stereotypes associated with females' reproductive health, one must realize

that part of these problems are physical and part psychological.

iv.

Most importantly, these problems are manageable.

Dysmenorrhoea

Dysmenorrhoea is pain along with cramping of the uterine musculature accompanying the menstrual period. In

some females the pain can be very severe and debilitating. Whereas many women do not experience such a

condition. There are two types of Dysmenorrhoea:

Primary

ii.

Secondary

Primary Dysmenorrhoea

This type occurs without any causal disease. It usually begins in the teens and disappears after child birth.

Secondary Dysmenorrhoea

This type is caused by some primary disease process. The symptoms of Dysmenorrhoea are related to the

primary condition e.g. endometriosis.

Etiology/Causes

Physical cause: Prostaglandins

Biologically active ad naturally occurring unsaturated fatty acids, prostaglandins, have been found to be related

with Dysmenorrhoea. Prostaglandins have potent actions on blood cells, smooth muscles, fat cells and nerve

tissues.

Psychological causes

Heightened stress level, especially negative stress has been found to be associated with Dysmenorrhoea.

Treatment

Physical treatment:

Prostaglandin Inhibitors e.g. ibuprofen, naproxen sodium and others. Regular exercise, especially aerobic

exercise has been found to be very helpful in symptom relief as well as symptom control.

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Psychological interventions:

Relaxation exercises have been known to help. If positive imagery is added, the treatment becomes more

effective.

Premenstrual Syndrome (PMS)

Commonly known as PMS, refers to the symptoms experienced by many females prior to the monthly period.

The symptoms usually occur around 10 days prior to the beginning of the period. The common symptoms

include depression, irritability, water retention, fatigue, and/or lethargy.

Etiology:

Physiological Explanation:

A number of physiological explanations are available about PMS. However most researchers, and medical

professionals believe in the effect of insufficient progesterone, or insufficient progesterone relative to estrogen,

or a high estrogen-progesterone ratio.

Psychological Explanation:

Psychological theories primarily focus upon a state of arousal along with an appraisal of one's inner state as

negative or positive. Some theories extend the same approach even further.

These theories propose that the cultural stereotypes of the premenstrual women as being depressed and

irritable, affect which environmental or physiological cues are attended to when attaching a label to increased

arousal (Koeske, 1980).

The treatment of PMS

A number of treatments have been found to be effective in relieving the symptoms of PMS. The treatments

include medical and psychological treatments as well as lifestyle changes.

Medical Treatment

Physicians, who strongly believe that PMS is caused by low levels of progesterone, recommend progesterone

therapy (Dalton, 1964). Diuretics are also recommended in many cases (Appleby, 1960). Bromocriptine, that

inhibits prolactin release, has also been found effective (Steiner et al., 1984). Medicines increasing the level of

Serotonin have been recommended by some (Harrison et al., 1984). Some have found prostaglandin inhibitors

to be effective (Jakubowicz et al., 1984). The use of evening primrose oil is also helpful (Horrobin, and Phil,

1983).

Psychological Treatment

The following interventions have been found to be effective:

_ Relaxation exercises with imagery

_ Cognitive therapy for changing appraisal of situation

_ Role modeling through, video recordings of symptom free females

Lifestyle changes

_ Regular Exercise, especially aerobic exercise, has been found to be effective.

_ Healthy dietary habits are recommended e.g. reduced dairy intake.

_ The PMS sufferers are advised to stop or restrict the use of refined sugar. They are recommended to

acquire the sugar required by the body through complex carbohydrates, cereals etc.

_ Multivitamins are also helpful.

Menopause

Menopause is a condition, or change that every women beyond the age of 45-55 years experiences. Menopause

refers to the cessation of menstruation. In turn it means the end of fertility. At menopause ovulation stops

permanently. The average age of menopause is about 51 years; in 4 out of 5 women menopause takes place

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between 45 and 55 years (Avis, 1999; Messill, and Verbrugge, 1999). Some women may have this experience as

early as in their thirties, whereas some as late as in their sixties.

Symptoms of Menopause

Besides being a major life change with reference to fertility, menopause is considered a significant period

because of the accompanying symptoms. Little or no physical discomfort is experienced by most women

during perimenopausal phase (NIA, 1993).

Perimenopausal or climacteric, or "change in life", refers to the period during which the changes that lead to

menopause are experienced. This period may be stretched over many years, beginning usually in the 30s. The

commonly known symptoms include:

_ Hot flashes or hot flushes

_ Increased body weight

_ Headaches

_ Profuse sweating

_ Sleep problems/insomnia

_ Depression

_ Dizziness

_ Sensation of cold in hands and feet

_ Irritability, and arthrosclerosis, among many others

_ Osteoporosis (brittle bones)

The most common symptoms are hot flashes i.e., sudden sensations of heat that flash through the body due to

expansion and contraction of blood vessels. Many women do not experience these at all, and many have these

continually (Avis, 1999). There are many diverse views about these symptoms. Some viewpoints see these

symptoms as purely psychological in nature, resulting from the menopausal women's perception of her

changed physical ability.

Others regard these symptoms as clearly physical in nature, resulting from hormonal changes. A third view

point considers these symptoms as resulting form both psychological and physical factors.

However what needs to be kept in mind is the fact that not all women experience these symptoms, and not all

women experience the same intensity and frequency of these symptoms if they experience any. The supporters

of the psychological viewpoint use this fact as their main supporting argument. They propose that had the

menopausal symptoms been purely physical in nature, then all women would have experienced the same

symptoms.

The Sociopsychological approach

According to this approach, two factors determine the experience of menopause:

a) The woman's perception of a major life change, and the end to fertility

b) The societal stereotypes about menopause. This includes especially the attitudes, awareness, and

behavior of the husband and near relatives.

If the research on menopause is scrutinized, it will show that "so-called menopausal syndrome may be related

more to personal characteristics or past experiences than to menopause per se" (Avis, 1999, P. 129).

At the same time cultural and societal factors play a very important role. The typical menopausal symptoms are

experienced more, and felt more seriously, in societies (e.g. western societies) where a women feels she is

important primarily because of her body. Few problems are associated with menopause in societies and

cultures where social, religious, or political power is acquired by older women after menopause (Avis, 1999;

Treatment of Menopausal Symptoms

A number of treatments have been found effective in alleviating, controlling, and managing symptoms of

menopause. Some of the more commonly used ones are mentioned here:

1. Hormone Replacement Therapy:

Estrogen alone, or in combination with progesterone is used.

2. Evening Primrose Oil:

Of the herbal remedies, evening primrose oil is claimed to have very positive effects.

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3. Exercise:

Regular aerobic exercise helps prevent, control and alleviate the symptoms.

4. Cognitive Therapy:

Cognitive therapy for menopausal woman focuses upon the wrong perceptions about the end of fertility.

The menopausal women are made to realize that this is an age of more freedom when they are free of

children's responsibilities, have more money, more leisure time, and more time for using their creative or

intellectual potentials.

What Needs To Be Done???

· Health education for females

· Changes and additions in school curriculum pertaining to reproductive health.

· Encouraging girls to express their health concerns with mothers, teachers, or with health professionals.

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