A productive approach to reproductive health

Today, as more women delay childbearing to pursue education and establish a career, that age has increased to an all-time high of 25, according to the Centers for Disease Control and Prevention.

While more women may delay motherhood, they shouldn’t delay appropriate medical care to preserve their fertility.

A good relationship to have
Long before a woman’s biological clock begins to tick, she should seek professional care for her reproductive system, which includes the ovaries, fallopian tubes, uterus, cervix and vagina.

By the time she turns 18 or becomes sexually active, she should establish a relationship with a gynecologist or primary care physician, according to Dr. Linda Smirz, MBA, managing partner of Women’s Health Alliance and chief medical officer for Clarian North Medical Center.

Dr. Frederick Stehman, chair of the department of obstetrics and gynecology for the Indiana University School of Medicine, recommends that a woman’s reproductive care begin even earlier — “probably the day she’s born.”

“The biggest threats to people’s lives and health and, ultimately, reproductive health are cigarette smoking, not wearing seatbelts, diets, exercise [and] weight control,” he explained.

Stehman specifically urges young women to anticipate and prepare for coitarche, or coital debut — terms used to describe the first sexual experience.

“Young people — and young people’s parents — need to have the maturity and the insight to anticipate this,” he said, adding that they then should discuss the importance of partner selection, pregnancy prevention and disease prevention. “That is when your sexual health begins. Pre-coitarche or pre-coital debut patients need to take personal responsibility for their sexual health, their reproductive health.”

No studying required
Routine care of the reproductive tract generally involves an annual visit with a gynecologist or primary care physician. The visit may include a physical examination and Pap smear, a procedure in which cells are collected from the cervix and analyzed for any abnormalities that could indicate infection, inflammation or cervical cancer. The American Cancer Society recommends women begin getting Pap smears at age 18 and repeat them every one to three years.

If a Pap test returns an abnormal result, there are several possible next steps.

“For some of the results, we just repeat the Pap smear in six months,” Smirz said.

“Others we have to move on to a procedure where we look at the cervix under magnification to determine whether or not there is an abnormality that absolutely needs to be treated with a different procedure.”

But the Pap smear is just one part of good reproductive care.

“I think the most important thing is a gonorrhea and a Chlamydia culture,” Smirz said.

“A lot of young women still assume that if they are on the birth-control pill they don’t need to use condoms — even with all the information out there. Using a condom is absolutely the most important thing a woman can do.”

According to Smirz, both gonorrhea and Chlamydia are “simple to treat, but when neglected or undetected can cause serious repercussions on the ability to get pregnant in the future.”

Other sexually transmitted infections — including syphilis, HIV, genital warts, genital herpes and trichomoniasis — can inhibit reproduction and should be treated promptly.

Women between ages 9 and 26 may want to ask their physician about Gardasil, a vaccine recently approved by the Food and Drug Administration.

“[Gardasil] is a three-dose series that we think is going to be protective for life from the human papillomavirus, which is the virus that causes warts,” Smirz said. “While being positive for HPV will not affect your fertility, if the wart virus causes a lesion on the cervix or an abnormality in the cervix and that has to be treated, that can affect your fertility.”

HPV infection also is the cause of cervical cancer.

Weighty issues
Beyond seeking regular professional care, women should strive to mitigate the primary threats to reproductive health.

“If a woman really wants to look at her fertility, she needs to maintain a normal body weight — not too much, not too little,” Smirz said.

As Stehman explained, a woman’s weight impacts her body’s production of estrogen. Very thin women may have low estrogen levels and not ovulate, while very heavy women may have high estrogen production and likewise not ovulate. In both cases, ovulation often returns when a normal weight is reached.

As with all bodily systems, cigarette smoking is harmful to reproductive health.

“There are a lot of individuals who believe that smoking does have an adverse effect on cervical mucus,” Smirz said. “Smoking is just bad for you all around.”

source:www.indystar.com