Womens Health

Health Status of Women

·       Health Issues Relating to Women:

o   Risks associated with pregnancy

§  Child birth concerns

§  Pregnancy journey

§  Miscarriages

§  Postpartum depression

§  Gestational diabetes – specific diabetes related to pregnant women because of glucose levels (drainage and imbalance of nutrients from cravings)

o   Infertility

o   Breast, ovarian and cervical cancer

o   Endometriosis

o   Irregular periods

o   Menopause

o   Interstitial cystitis

·       55% or 1 in 2 Australian females rate their health as excellent or very good

·       Much like how we need to be educated, we still need ways to protect ourselves as women through ways of consent and being presented with information to help our health and safety

Contraception

Contraception or Birth Control – the methods or devices used to prevent pregnancy (prevents the sperm from fertilizing the egg)

·       Mechanical

o   Male and condom – Providing a barrier to male sperm from entering a woman’s uterus

§  Positives: Cheap, no need for pill or surgical operations, 99.9% effective

§  Negatives: Has the possibility of breaking or sperm being released if used incorrectly

·       Chemical

o   Contraceptive pill – Consuming of a pill once or twice a day to stop your period/releasing of eggs

§  Positives: Easy, effective, rid of irregular periods, relives period pain

§  Negatives: Doesn’t stop spread of STI’s, lots of side effects, ineffective for some people, needs a prescription from a doctor

§  In 2013, between 40-45% of women used the Pill

o   Contraceptive implant – put into a woman’s body to stop the eggs from being released

§  Positives: 99.95% effective, thickens cervical uterus to stop sperm entering, last for 3 years

§  Negatives: Doesn’t stop spread of STI’s

·       Surgical

o   Vasectomy – Cutting or typing of male reproductive parts

§  Positives: One time cost, over 99% effective

§  Negatives: General anaesthetic needed (side effects), surgical expenses

o   Female sterilisation – Tying of woman’s fallopian tubes

§  Positives: Can be reversed, one time cost, over 99% effective

§  Negatives: General anaesthetic needed (side effects), surgical expenses, if reversed it is very dangerous

·       Natural

o   Rhythm method – tracking a females ovulation cycle to determine days that will lower the chances of a pregnancy

§  Positives: Safe, completely inexpensive

§  Negatives: Can be inaccurate, one of the least effective, no STI prevention

o   Withdrawal – removing a mans penis before sperm is ejected into a woman’s uterus

§  Positives: Inexpensive

§  Negatives: Doesn’t stop spread of STI’s, doesn’t always work, ineffective

·       Choice of contraception depends of various factors including a person’s age, health status, sexual activity and personal preferences

Sexually Transmitted Infections

STI stands for “sexually transmitted infections” – an infection that is spread through sexual contact, caused by bacteria, viruses or parasites affecting both men and women

·       They can be transmitted through vaginal, anal or oral sex and/or the sharing of needles or other injection equipment – this is why sterilised equipment and condoms are so important

·       Many people with STIs have no symptoms – regular testing is key to detect and treat infections before they cause health problems

·       If let untreated, many STIs can lead to serious complications including:

o   Infertility

o   Cancer

o   Chronic health conditions

·       Very common among young people who are sexually active

Young people are at risk of STI because…

·       Lack of awareness – many young people do not fully understand how STIs are transmitted or to prevent them leaving them vulnerable to contracting an infection

·       Peer pressure – young people, especially in groups where sex is normalised, may feel pressure to engage in sexual activity leading to unprotected sex and risk of an STI

·       Multiple partners – young people may have many sexual partners leaving to an increased risk of contracting an STI

·       Lack of access to healthcare – some young people may not have access to regular healthcare including STI testing and treatment which is hard to manage or prevent STIs

·       Lack of condom use – condoms are one of the most effective ways to prevent the transmission of STIs however many young people do not use them correctly or consistently

·       It's important for young people to understand the risks associated with sexual activity and to take steps to protect themselves from STIs including practicing safe sex, getting regular STI testing, and seeking treatment if an infection is detected

The Most Common STIs

·       Chlamydia

o   Most common STI among young people

o   Caused by the bacteria Chlamydia trachomatis

o   Transmitted through vaginal, anal or oral sex

o   Symptoms: Pain during sex, discharge from the penis or vagina, burning during urination

·       Gonorrhoea

o   Caused by the bacteria Neisseria gonorrhoeae

o   Transmitted through vaginal, anal or oral sex

o   Symptoms: Painful urination, discharge from the penis or vagina, swollen testicles (men)

·       HPV – Human Papillomavirus

o   Viral infection spread through skin to skin contact during sex

o   Some strains of HPV can cause genital warts and others can cause cervical, anus or throat cancer

o   Many people with HPV have no symptoms

·       Herpes

o   Viral infection caused by the herpes simplex virus (HSV)

o   Transmitted through vaginal, anal or oral sex

o   Symptoms: Painful blisters or sores on the genitals, anus or mouth, as well as fevers and body aches

o   Known as the ‘kissing virus’

·       HIV

o   Viral infection that attacks the immune system

o   Transmitted through vaginal, anal or oral sex or the sharing of needles or other injection equipment

o   Symptoms: Fever, fatigue, swollen lymph nodes

o   Many people with HIV have no symptoms for years

Pregnancy and Child Birth

Fertilisation – the process by which a sperm cell and egg cell fuse to form a single cell called a zygote marking the beginning of a new human life

Process of Fertilisation: A new life is created when a woman and a man have sexual intercourse and a sperm from the male joins with an ovum from the female in the process of fertilisation. A baby is conceived and begins to grow and develop in the woman, who is now pregnant.

Steps:

1.      Ovulation

2.      Sperm maturation

3.      Intercourse

4.      Fertilisation

5.      Zygote formation

6.      Cell division

7.      Implantation

Genetic physical features that remain constant between generations include: DNA, facial features, pigmentation, height, etc.

Amniotic Sac - The fluid-filled sac that contains and protects a fetus in the womb

Assisted Reproductive Technology - All fertility treatments where either eggs or embryos are handled

Bonding - Talk/sing to baby, gently touching belly and feeling kicks

Chromosomes - Thread-like structures located inside the nucleus of cells

Dilate – The cervix opening

Episiotomy - A cut or incision made in the tissue between the vaginal opening and anus during childbirth

Genes - Basic physical and functional unit of heredity

Fertilisation - Complex multi-step process that is complete in 24 hours

Implantation - The blastocyst burrows into the uterine wall - process of implanting something

Jaundice - Condition produced when excess amounts of bilirubin circulating in the blood stream dissolve in the subcutaneous fat

Ovulation - Phase of the female menstrual cycle that involves the release of an egg from one of the ovaries

Ovum – A female gamete or egg cell

Placenta - An organ that forms in the womb during pregnancy

Sperm – A sex cell produced by a man or male animal

Trimester – A period of 3 or about 2 months during pregnancy

Umbilical cord - Tube that connects a baby to its month before birth and carries oxygen and food to it

Childbirth

Birthing Options:

·       Vaginal birth – When a person gives birth naturally, through their vagina

·       Caesarean birth – A surgical procedure in which a baby is delivered through a vertical or horizonal incision make in the mother’s abdominal wall and uterus (manually taking out the baby and then sealing up the cut)

Ø  Usually preformed when vaginal delivery would pose risks to the mother, baby or both

o   Positives:

§  No birthing or other pain

§  Easy and quick – takes between 30-45min

§  No complications like tearing

o   Consequences:

§  Scar for the rest of your life

§  Going under anaesthesia can be dangerous

§  Longer recovery time – up to 5 days in the hospital

§  May feel pain in abdomen for sometime after childbirth

§  Possibility of infections and blood clots

·       Epidural birth – An injection given in the back to numb nerves that carry feelings of pain from the birth canal

·       Calm birth – Based on the belief that pregnancy, labour and birth are normal life events which teaches calm breathing and prepares both parents for stages of birth

·       Water birth – Giving birth to your baby under water, often in a bathtub which many women who experienced this have said they had less pain and a greater sense of control

Doula – A non-medical companion who can provide emotional and physical support during labour by helping with pain management and maintaining positivity during the birth

Ø  Allowed generally 1 or 2 support people in a hospital but home births have the freedom for more

Ø  Usually the other parent-to-be

Stages of Labour

·       Labouring is very different for everyone – takes between 4 and 20 hours

·       Beginning recognised by: back ache, water breaking, irregular contractions, discharge

1.      The Latent Phase

It is the longest phase lasting for hours or even days. During this phase, your cervix thins and opens to around 4-6cm while having regular or irregular contractions. Try to rest and relax with gentle stretches, mindfulness, meditation or other calming techniques during this time where you can usually stay at home.

2.      The Active Phase

The second stage starts when the cervix is fully dilated and there will usually be a strong urge to push because of the pressure places on the pelvic are by the baby's head. The baby is moving from the uterus into the vagina in the second stage and can last as little as twenty minutes to three hours.

3.      The Transition Phase

Your cervix will fully dilate to 10 centimetres, with more frequent and intense contractions, which will happen around 2 minutes apart and last 60 to 90 seconds. Indications of stage 3 are feeling significant pressure in your bottom, and the urge to pass a bowel movement. This phase can last from 5 minutes to over an hour.

4.      Delivery of the Placenta

The umbilical cord is cut and the muscles will continue to contract to help push out the placenta. The mother often is given an injection of oxytocin to speed up delivery of the placenta and reduce blood loss.

Oxytocin is a hormone which plays a crucial role during childbirth and breastfeeding, influencing both physiological and emotional processes.

·       As the baby emerges from the birth canal, a surge of oxytocin floods the mother’s system, triggering a cascade of physiological responses – helps to expel the placenta

·       Promotes urine contraction to minimize postpartum bleeding and initiates breastfeeding

·       Fosters the bond between the mother and infant through skin-to-skin contact – reinforces emotional connection

·       Promotes milk ejection reflex (let-down)

·       Stimulates maternal nurturing behaviours

Reproductive Health

Menstrual Cycle – sequence of events occurring each month to prepare the female body for a potential pregnancy

·       4 Phases overall lasting 28-30 days

·       Menstruation – ‘The period’, where the uterine blood and tissue come through the vagina (lasts 3-7 days and the first day of the period marks a new menstrual cycle)

·       Follicular Phase – Longest phase, beginning on the first day of menstruation lasting 14-21 days until ovulation happens

·       Ovulation – Around day 14-16, a mature egg is released from an ovary lasting about 12 to 24 hours

·       Luteal Phase – If fertilisation doesn’t occur, hormone levels drop leading to thickening of the uterine lining preparing for a possible pregnancy, lasting until the start of the next menstruation phase

Endometriosis – a common disease where tissue similar to the lining of the womb grows outside it in other parts of the body

·       More than 830,000 (over 11%) of Australian women and girls suffer from endometriosis at some point in their life

·       You are 8 times more likely to have it id you carry the genes in your DNA

·       Often starts in teenage years

·       Mostly affects the reproductive organs but is frequently found in the bowel, bladder, muscles, joints, lungs and brain

·       Symptoms: Fatigue, sever pain, nausea, bleeding, mental insecurities, infertility (a disease that effects the difficulty and inability to conceive a child)

·       Diagnosis: You will need to discuss your symptoms with doctors, they will do a physical examination or a laparoscopy (minimal invasive surgical procedure) where it can then be diagnosed and treated or in separate surgeries by accident  

Premenstrual Syndrome (PMS) – the physical and emotional symptoms that some women experience in the lead up to menstruation

Fertility – refers the ability to conceive a child

·       A woman’s fertility starts to slowly decline when they are 30 and speed up in decline by their mid-30s

·       Risks associated with conceiving after 35 years of age: miscarriages, birth defects, still births, caesarean birth, chromosomal abnormalities and the risks of mental developmental disorders in the baby

In Vitro Fertilization (IVF) – the method of conceiving a baby through medical procedures to help the process if there is difficulty making a baby associated with things like infertility – the joining of a woman’s egg and a man’s sperm in a laboratory dish

·       People who might want to go through this process are people who:

o   Suffer from infertility and want to conceive a baby with their partner

o   Are over 40 years or older women

o   Are single and want to start a family with or without a partner

Cervical and Ovarian Cancer

Cervical Cancer – the abnormal growth of cells in the lining of the cervix, a narrow, lower part of the uterus connecting to the upper end of the vagina

Ovarian Cancer – the abnormal growth of cells originating in the fallopian tubes or ovaries on each side of the uterus in the pelvis

Human Papillomavirus (HPV) – A common virus that is spread through sexual contact often being serious and causing cancer including cervical, vulva, vagina, penis, anus, head and neck cancers

HPV is responsible for almost all of genital warts and cervical cancers

HPV Vaccine

·       Protects the body and strengthens the immune system against HPV by introducing a tiny or dead organism of that virus into the body so the immune system is able to build antibodies to fight against it in the future

·       Protects women and girls from dysplasia which can lead to cervical cancer

Strategies to Reduce Risk of Cervical and Ovarian Cancer

·       HPV Vaccination

·       Regular cancer screenings

·       Healthy lifestyle choices

Breast Cancer

Breast Cancer – the abnormal growth of the cells lining the breast lobules (glands) or ducts which grow uncontrollably and have the potential to spread to other parts of the body

·       Can develop in both men and women however it is uncommon in men

·       Types: Invasive and non-invasive

·       Breast implants do not impact risk

·       5-10% of cases are inherited

·       30,000 women will die by 2030 if there is not enough put into breast cancer funding and research

Signs and Symptoms

·       Lump in one breast

·       Change in size or shape of breast

·       Nipple changes i.e. size, crusting, discharge, etc.

·       Skin changes

·       Swelling or discomfort in the armpit or collarbone

·       Ongoing pain unrelated to menstrual cycle

·       Most breast changes aren’t cancerous

Treatment Options

·       Breast conserving surgery with radiation or mastectomy

·       Surgery often followed by chemotherapy, radiation, hormone or targeted therapy

1.      Chemotherapy - medicine/drugs called cytotoxic (meaning toxic to cells) that kills or slows the growth of cancer cells

2.      Radiation Therapy – controlled does of radiation is used to kill cancer cells directly to the area being treated

3.      Surgery – operation done to remove tumours of cancer cells specifically called Curative surgery which is once of the main treatments for cancer

4.      Immunotherapy – medicine that works with your immune systems to kill cancer cells taking place over a long period of time

5.      Targeted therapy – drug treatment that targets features of cancer cells mostly used to treat brain, breast or gastrointestinal cancers

6.      Hormone therapy – aims to stop the body’s natural hormones from helping some cancers growth with a 85-90% success rate

7.      Palliative care – helps people with advanced cancer to live as fully and as comfortably as possible, forming supportive care for people whose cancer has spread of is incurable

Statistics

·       About 20,000 new cases are diagnosed annually in Australia

·       Most common cancer in women – 1 in 7 diagnosed in their lifetime

·       More common over aged of 40 as the risk increases with age

Prevention and Early Detection for Young Women

·       Ensuring overall wellbeing (physical, emotional and sexual)

·       Seek a screening mammogram or physical exam if symptoms arise

·       Getting screened every 2 years

·       Checking family history for inherited genes

·       Importance of Early Detection

o   Increases chances of successful treatment and survival

o   Easier to treat when detected early

o   Reduces complications and costs associated with treatment

Lifestyle Factors Increasing Risk

·       Being overweight

·       Lack of physical activity

·       Alcohol and tobacco consumption

Breast Cancer Screening – Mammograms

·       Mammogram – An X-ray of breast tissue that can find changes too small to be felt during a physical examination

·       Each breast is pressed between 2 c-ray plates, which spreads the breast tissue out so that clear pictures can be taken which only takes about 20 seconds

·       Purpose for people:

o   If you are between 50 and 74 without a family history of breast cancer, it should be done every 2 years

o   Women over 55 and older should get one every year

Raising Awareness

·       Walking or running in events to show support in cancer research and awareness

·       Contribute to donations

·       Spreading awareness in schools and communities

·       Vocalising it on social media so young people learn more and are aware

Consent

Consent – an agreement between participants to engage in sexual activity which is a verbal and affirmative expression of the understanding of boundaries and respect

·       It Is about communication and being clear

·       You can stop or change your mind at anytime even if you have originally said “yes”

·       Consenting to one activity does not mean someone gives consent for other activities on the same or different occasion

·       E.g. agreeing to kiss someone doesn’t give that person permission to remove your clothes

·       Discussing boundaries is important prior to engaging in sexual behaviour as it shows mutual respect, honesty and understanding

Enthusiastic consent – while consent is about saying “yes”, an enthusiastic consent focuses on the enthusiasm of the “yes”

Situations where people cannot give consent:

·       When someone is under the influence of drugs or alcohol

·       When someone is unconscious

·       When someone is underage

·       When someone is pressured under intimidation or a threat

·       When there are unequal power dynamics like with an employee or student

Legal age of consent in NSW = 16 years old

Power – the ability to influence the course of events, actions or choices of others e.g.a parent, supervisor, mentor or manager

Powers Impact in Consent – Source of Power:

·       Sexual Experience – a more experienced person might pressure a less experienced person to act in ways they are uncomfortable with to seem “cool”

·       Age Difference – younger individuals may be more vulnerable to manipulation by older, more experienced people who may feel superior

·       Position in Society – people in higher social roles might believe they can exploit those in lower positions, who may feel pressured to comply for job and other opportunities

·       Ability/Disability – some individuals with disabilities may struggle to assert themselves or fully understand consent, making them vulnerable to exploitation

Power in Relationships

Balance of power – the relationship is not one-sided and one person doe not have more control and power than the other

·       Communication is key to a balanced relationship – both parties talking and listening to each-others feelings and thoughts

·       Adopting all of their favourite things, hobbies and lifestyles can make the relationship unbalanced – remembering you have different interests

·       Relationship-building skills are not enough to develop equal and respectful relationships – development of positive relationships through personal positive power

Types of Power Bases

·       Coercive – power through fear e.g. fear of losing a job, deportation or sharing information

·       Reward – power through rewards e.g. prizes or money, complements, winning a race

·       Legitimate – comes from a position of power e.g. being a boss, principal, political status

·       Expert – comes from experience or skills e.g. having a PhD, going to the Olympics, coach

·       Referent – comes from being trusted and respected e.g. a priest, parent, the Pope

Statistics

·       In Australia, one woman dies every week to domestic violence

·       You are 3 times more likely to be attacked if you are an Aboriginal or Torres Strait Islander woman

·       You are 32 times more likely to be hospitalised for your injuries if you are an Aboriginal or Torres Strait Islander woman

Domestic Violence

Avoiding conflicts and resolving them when they do occur is done by: positive communication, cooperation and negotiation skills

·       Unsafe relationships have an abuse of power – one person uses their power to control, hurt and dominate the other person

·       Can occur in many settings including within:

o   Families

o   Intimate relationships

o   While dating

o   As sexual harassment through jokes, comments, internet and physical context

o   Between friends

o   Boss and employee

o   A coach and an athlete

·       Gender Stereotypes

o   Males are more likely to be the abuses with females being abused in most relationships

o   Can be attributed to many factors i.e. impact of gender stereotype in society

o   Males expectation to be strong and tough – expectation making men to believe they must dominate their female significant other

o   Inequalities and dynamics shaped from a young age shown by society and parents can affect their behaviours and views

Early Warning Signs of Abuse and Unsafe Situations

·       Physical, emotional and social indicators

·       Controlling behaviours e.g. cutting of friends and family, financial control, etc.

·       Violence

Advocating for Victims of Domestic Violence

·       Making people aware

·       Sparking the conversation

·       Making other victims less alone and empowered

·       Saving lives

Inequality in LGBTQIA+ Community  

Stereotypes – a widely held but fixed and oversimplified image or idea about a particular type of person, thing or group

Fears for Coming Out as Gay or Lesbian

·       Losing friends

·       Won’t be accepted

·       Social isolation

·       Being treated differently

·       Being bullied

Stereotypes for Members of the LGBTQIA+ Community

·       If someone acts or dresses in a certain way, it means you are gay or lesbian

·       They automatically have a crush on you

·       The way that you dress

·       Lesbian being seen as a ‘butch’

·       Gay men being seen as feminine or girly

Statistics

• Up to 21% of Australian high school students identity as LGBTQIA+ and this number is growing around the world

• 66% of Australian LGBTQIA+ youth experience bullying/harassment based upon their identity