Women s Health Issues - Merck Manuals Consumer Version

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Biology of the Female Reproductive System

The female reproductive system consists of the external genital organs and internal genital organs. Other parts of the body also affect the development and functioning of the reproductive system. They include the following:
Symptoms of Gynecologic Disorders

Genital itching may involve the vagina or the genital area (vulva), which contains the external genital organs. Itching is an unpleasant sensation that seems to require scratching for relief.
Diagnosis of Gynecologic Disorders

Preventive health care includes having regular gynecologic examinations, even when no symptoms are present, and screening tests. Screening tests are done before people have any symptoms to check for disorders that can be prevented or treated effectively if recognized early. Recommendations for screening sometimes change as new evidence becomes available.
Breast Disorders

Breast disorders may be noncancerous (benign) or cancerous (malignant). Most are noncancerous and not life threatening. Often, they do not require treatment. In contrast, breast cancer can mean loss of a breast or of life. Thus, for many women, breast cancer is their worst fear. However, potential problems can often be detected early when women do the following:
Cancers of the Female Reproductive System

Cancers can occur in any part of the female reproductive system—the vulva, vagina, cervix, uterus, fallopian tubes, or ovaries. These cancers are called gynecologic cancers.
Endometriosis

In endometriosis, patches of endometrial tissue—normally occurring only in the lining of the uterus (endometrium)—appear outside the uterus.
- Endometriosis
Family Planning

Contraception is prevention of fertilization of an egg by a sperm (conception) or prevention of attachment of the fertilized egg to the lining of the uterus ( implantation).
Fibroids

A fibroid is a noncancerous tumor of the uterus that is composed of muscle and fibrous tissue.
- Uterine Fibroids
- Cervical Fibroids
Infertility

Infertility is usually defined as the inability to achieve a pregnancy after 1 year of regular sexual intercourse without birth control.
Menopause

Menopause is the permanent end of menstrual periods and thus of fertility.
- Menopause
Menstrual Disorders and Abnormal Vaginal Bleeding

Complex interactions among hormones control the start of menstruation during puberty, the rhythms and duration of menstrual cycles during the reproductive years, and the end of menstruation at menopause (which is usually defined as beginning 12 months after a woman's last period).
Miscellaneous Gynecologic Abnormalities

Noncancerous (benign) gynecologic growths include cysts, polyps, and fibroids ( leiomyomas). Noncancerous growths can develop on the vulva or in the vagina, uterus, or ovaries. The vulva consists of the labia and other tissues around the opening of the vagina.
Pelvic Organ Prolapse (POP)

Pelvic organ prolapse involves relaxation or weakening of the ligaments, connective tissue, and muscles of the pelvis, causing the bladder, urethra, small intestine, rectum, or uterus to bulge into the vagina.
- Pelvic Organ Prolapse (POP)
Sexual Dysfunction in Women

Sexual dysfunction includes pain during intercourse, involuntary painful contraction (spasm) of the muscles around the vagina, and lack of interest in (desire for) sex and problems with arousal or orgasm. For a sexual dysfunction disorder to be diagnosed, these problems must cause distress to the woman.
Vaginitis, Cervicitis, and Pelvic Inflammatory Disease

Vaginal infections are one of the most common reasons women see their doctor, accounting for millions of visits each year.
Domestic Violence and Sexual Assault

Domestic violence is physical, sexual, or psychologic abuse between people who live together. It includes intimate partner violence, which refers to physical, sexual, or psychologic abuse by a current or former sex partner or spouse.
- Domestic Violence
- Sexual Assault and Rape
Symptoms During Pregnancy

Symptoms that occur during pregnancy may be normal or may indicate a problem. A problem may be related to the pregnancy (an obstetric problem) or to another disorder, and evaluation by a doctor may be required.
Complications of Labor and Delivery

Usually, labor and delivery occur without any problems. Serious problems are relatively rare, and most can be anticipated and treated effectively. However, problems sometimes develop suddenly and unexpectedly. Regular visits to a doctor or certified nurse midwife during pregnancy make anticipation of problems possible and improve the chances of having a healthy baby and safe delivery.
Complications of Pregnancy

Ectopic pregnancy is attachment (implantation) of a fertilized egg in an abnormal location, such as the fallopian tubes.
Detection of Genetic Disorders Before and During Pregnancy

Genetic disorders are disorders caused by abnormalities in one or more genes or chromosomes. Some genetic disorders are hereditary and others are spontaneous.
Drug Use During Pregnancy

More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy, and use of drugs during pregnancy is increasing. In general, drugs should not be used during pregnancy unless necessary because many can harm the fetus. Less than 2 to 3% of all birth defects result from drugs that are taken to treat a disorder or symptom.
- Drug Use During Pregnancy
- Drug Use During Breastfeeding
High-Risk Pregnancy

There is no formal or universally accepted definition of a high-risk pregnancy. Generally, however, a high-risk pregnancy involves at least one of the following:
Normal Labor and Delivery

Although each labor and delivery is different, most follow a general pattern. Therefore, an expectant mother can have a general idea of what changes will occur in her body to enable her to deliver the baby and what procedures will be followed to help her. She also has several choices to make, such as whether to have a support person (such as the baby’s father or another partner) present and where to have the baby.
Normal Pregnancy

Pregnancy begins when an egg is fertilized by a sperm. For about 9 months, a pregnant woman’s body provides a protective, nourishing environment in which the fertilized egg can develop into a fetus. Pregnancy ends at delivery, when a baby is born.
Postpartum Care

The 6 weeks after pregnancy and delivery of a baby is called the postpartum period, when the mother’s body returns to its prepregnancy state.
Pregnancy Complicated by Disease

During pregnancy, having a disorder can increase the risk of problems. The disorder may be one that

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