Conditions of the reproductive system, in function and dysfunction and disease play a central role in affecting the internal and external organs in women’s health. Below are a list of common reproductive health problems affecting women.
Endometriosis is one of the more common conditions impacting the functionality of a woman’s reproductive system. At least one in 10 women of reproductive age have the condition, where the uterine lining, known as the endometrium, grows outside of the uterus.
The endometrium normally responds to the sex hormones oestrogen and progesterone. In women with endometriosis, these endometrium-like cells growing outside the uterus also respond to these hormones.
During menstruation, bleeding occurs not only inside the uterus, but wherever the endometrium has landed – on the ovaries, behind the uterus, on the bowels, or on the bladder. Inflammation from the dysfunctional growth of endometrium can damage the sperm, egg or interfere with movement through the fallopian tubes and uterus. Fibrous scar tissue can form on the lining inside the abdomen (the peritoneum), causing the uterus, ovaries, fallopian tubes and bowel to stick to each other.
The two main symptoms are:
- Pain: Chronic pelvic pain before and during periods, pain with sex, pain in the lower back and thighs, pain during bowel movements and urination, very heavy periods, nausea and lethargy
- Reduced fertility
Many women think painful periods are normal. Seek a health professional if you experience bad period pain.
The only way to diagnose endometriosis is through a laparoscopic exam, an invasive procedure.
As long as you have functioning ovaries you can still be affected by endometriosis. Once you go through menopause then endometriosis will not be able to grow any more. There is currently no cure, however, there are treatments and procedures available to help alleviate pain.
Polycystic ovarian syndrome (PCOS)
Polycystic ovarian syndrome (PCOS) happens when a woman’s ovaries or adrenal glands produce more male sex hormones than normal. PCOS affects 8-13% of reproductive age women, with around 21% of Indigenous women affected. One result is that cysts (fluid-filled sacs) develop on the ovaries. Obesity itself is strongly associated with PCOS; the heavier you are the worse your symptoms are likely to be, but conversely symptoms and diabetic risk can be greatly reduced with even a modest weight loss.
Symptoms may include:
- Pelvic pain
- Irregular periods due to few or no ovulations
- 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
- Increased risk of developing diabetes and cardiovascular disease
- Increased risk of psychological and emotional problems such as depression, anxiety, poor self-esteem, eating disorders and sexual dysfunction.
Up to 70% of women with PCOS go about their lives experiencing these symptoms, but remain undiagnosed and without answers so it is important to see a health professional if you identify some of these symptoms. It is a complex condition and guidelines to make the process of diagnosis clearer are currently being developed in Australia.
There is no one-size-fits-all treatment for PCOS but weight management is crucial to controlling the condition that even modest weight reduction can greatly alleviate symptoms and may be enough for a woman to ovulate regularly again. This is particularly important for women with PCOS-induced fertility.
The oral contraceptive pill can also be helpful to regulate periods and improve acne and excess body hair.
Fibroids (also called myomas) are noncancerous tumours which develop in smooth muscle. Uterine fibroids are the commonest harmless tumours found in women of reproductive age. Up to 80% of black women, 70% of white women and a smaller proportion of Asian women will develop at least one fibroid between the age of 15 and 50 years. Seventy to 80% of women over the age of 50 will have fibroids.
Symptoms may include:
- Heavy, long and painful periods
- Spotting between periods
- Feeling “full” in the lower abdomen (back, bowel and bladder)
- Lump or swelling in the lower abdomen
- Urinating often
- Pain with sex
- Reproductive problems, such as infertility, multiple miscarriages, or premature labour
Only 20-30% of women will have symptoms from fibroids as most fibroid occurrences do not cause any problems, so it is important to seek a health professional if possible association with infertility, miscarriage and premature labour.
Gynaecological cancer refers to the cancers that start in a woman’s reproductive organs. Gynaecological cancers begin in different places within a woman’s pelvis, which is the area below the stomach and in between the hip bones.
- Cervical cancerbegins in the cervix, which is the lower, narrow end of the uterus. Its upper margin is connected to the uterus, while its lower margin is connected to the vagina. Almost all cervical cancers are caused by the human papillomavirus (HPV), which can be prevented through immunisation.
- Ovarian cancerbegins in the ovaries, a pair of solid, oval-shaped organs producing hormones and eggs (ova) located on each side of the uterus.
- Uterine cancerbegins in the uterus, the upside-down pear-shaped organ in a woman’s pelvis where the baby grows when a woman is pregnant.
- Endometrial cancer is cancer that arises from the lining of the uterus (called the endometrium). It is the most common type of cancer of the uterus, and the most common gynaecological cancer diagnosed in Australian women.
- Vaginal cancerbegins in the vagina, which is the hollow, tube-like channel between the bottom of the uterus and the external part of the female sex organs (vulva). It is rare in Australia.
- Vulval cancerbegins in the vulva, the outer part of the female genital organs. It is rare in Australia.
Some women are affected by gynaecological cancers before menopause. Menopause does not cause cancer, but the risk of developing cancer does increase as you get older.
Interstitial cystitis (IC) is a chronic bladder condition resulting in recurring discomfort or pain in the bladder or surrounding pelvic region. People with IC usually have inflamed or irritated bladder walls that can cause scarring and stiffening of the bladder. IC can affect anyone, however, 90% of the affected people are women, most commonly in their 40s to 60s.
Some people have some or none of the following symptoms:
- Abdominal or pelvic mild discomfort
- Frequent urination
- A feeling of urgency to urinate
- Feeling of abdominal or pelvic pressure
- Intense pain in the bladder or pelvic region
- Severe lower abdominal pain that intensifies as the urinary bladder fills or empties
Symptoms may begin gradually or suddenly and with no apparent reason. In mild forms or early stages of IC, symptoms may occur as “flares” which may be mistaken for urinary tract infections. Therefore, it is important to have a urine culture to help distinguish these IC symptoms from a bacterial urine infection.
There is no cure for IC but many treatment options available depending on severity and type of symptoms, as well as your preferences.