1. Women’s health Dr aljohara almeneessier 2013

2. By the end of the session, the learner will be able to: 1.Define the women health 2.Understand the needs for gender-special care 3.Understand the disease unique for women 4.Understand why diseases affect women in different way 5.Identify different specialties involved in women health care 6.Identify preventive care activities involved in women health care 7.Identify curative care activates involved in women health care 8.Understand the practice guidelines of women health care

3. Women's health Definition Women’s health refers to the branch of medicine that focuses on the treatment and diagnosis of diseases and conditions that affect a woman’s physical and emotional well-being.

4. Women's Health Highlights: Recent Findings: Program Brief. September 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/factsheets/women/womenh/index.html Women have a longer life expectancy than men, but they do not necessarily live those extra years in good physical and mental health. On average, women experience 3.1 years of reduced physical functioning at the end of life, and in 2010, 13.5 percent of women aged 18 and older who were surveyed said they were in fair or poor health. The Agency for Healthcare Research and Quality (AHRQ) supports research on all aspects of health care provided to women, including: Enhancing the response of the health system to women's needs. Understanding differences between the health care needs of women and men. Understanding and eliminating disparities in health care. Empowering women to make well informed health care decisions

5. Some health issues that are common to both men and women affect women differently. Although the symptoms may be similar, the effects of the condition and the care necessary can differ significantly for women. In addition, some of these conditions might affect women primarily or more severely than men. For example, almost 12% of women in the United States are at risk for developing breast cancer during their lifetime. Male breast cancer accounts for less than 1% of existing breast cancer cases.

6. Heart disease. Heart disease is the leading cause of death for women in the United States. Mental health. Women are more likely to show signs of depression and anxiety than men are. Osteoarthritis. The condition affects almost 27 million people, and affects more women than men. Sexually transmitted diseases/sexually transmitted infections (STDs/STIs). The effect of STDs/STIs on women can be more serious than on men. Stress. According to a recent survey, stress is on the rise for women. Women are more likely to report having stress, and almost 50% of all women in the survey, compared to 39% of the men. stress might reduce a woman’s chance of becoming pregnant. What health issues or conditions affect women differently than men?

7. Stroke. More women than men suffer a stroke each year., some risk factors are unique to women. These include: Taking birth control pills Being pregnant Using hormone replacement therapy. Having frequent migraine headaches Having a thick waist (larger than 102 cm), particularly if post-menopausal, and has high triglyceride levels Urinary tract health. Women are more likely than men to experience urinary tract problems. For example, urinary incontinence What health issues or conditions affect women differently than men? http://www.nichd.nih.gov/health/topics/womenshealth/conditioninfo/pages/whatconditions.aspx

8. What health issues or conditions are specific to women only? Women experience unique health issues and conditions, from pregnancy and menopause to gynecological conditions, such as uterine fibroids and pelvic floor disorders. Issues related to women’s overall health and wellness include violence against women, women with disabilities and their unique challenges, osteoporosis and bone health http://www.nichd.nih.gov/health/topics/womenshealth/conditioninfo/pages/whatconditions.aspx

9. Women’s health includes : Birth control, sexually transmitted infections, and gynecology Breast cancer, ovarian cancer, and other female cancers Mammography Menopause and hormone replacement therapy Osteoporosis Pregnancy and childbirth Sexual health Women and heart disease Benign conditions affecting the function of the female reproductive organs, eg……

10. Preventative care for women includes the following services: Regular gynecological checkups, including a pelvic exam and breast exam Pap smear Bone density testing Breast cancer screening Discussions about colon cancer screening Age-appropriate immunizations Healthy lifestyle risk assessment Hormonal testing for menopause PREVENTATIVE CARE AND SCREENINGS

11. BREAST CARE SERVICES Breast care services include the diagnosis and treatment of breast cancer, which may involve: Breast biopsy Breast MRI scan Breast ultrasound Genetic testing and counseling for women with a family or personal history of breast cancer Hormonal therapy, radiation therapy, and chemotherapy Mammography Mastectomy and breast reconstruction The breast care services team may also diagnose and treat noncancerous conditions of the breast, including: Benign breast lumps Lymphedema, a condition in which excess fluid collects in tissue and causes swelling

12. SEXUAL HEALTH SERVICES Women’s sexual health services may include: Birth control (contraceptives) Prevention, diagnosis, and treatment of sexually transmitted illnesses Therapies to help with problems with sexual function

13. GYNECOLOGY AND REPRODUCTIVE HEALTH SERVICES Gynecology and reproductive health services may include the diagnosis and treatment of various conditions and diseases, including: Abnormal Pap smears Abnormal vaginal bleeding Bacterial vaginosis Endometriosis Heavy menstrual cycles Irregular menstrual cycles Ovarian cysts Pelvic inflammatory disease Pelvic pain Polycystic ovary syndrome (PCOS) Uterine fibroids Uterine and vaginal prolapse Vaginal yeast infection Various conditions affecting the vulva and vagina Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD)

14. BLADDER CARE SERVICES The women’s health team can diagnose and treat bladder-related conditions. Bladder emptying disorders Urinary incontinence and overactive bladder Interstitial cystitis Prolapse of the bladder OTHER WOMEN’S HEALTH SERVICES Cosmetic surgery and skin care, including skin cancer Diet and nutrition services Psychological care and counseling for women dealing with abuse or sexual assault Sleep disorders services Smoking cessation

15. TREATMENTS AND PROCEDURES Cesarean section (c-section) Endometrial ablation Endometrial biopsy D&C Hysterectomy Hysteroscopy Mastectomy and breast reconstruction Pelvic laparoscopy Procedures to treat precancerous changes of the cervix (LEEP, Cone biopsy) Procedures to treat urinary incontinence Tubal ligation and reversal of tubal sterilization Uterine artery embolization

16. The women's health services team includes : Obstetrician/gynecologist (ob/gyn) General surgeons specializing in breast care Perinatologist: An ob/gyn specializes in the care of high-risk pregnancies Radiologist Physician assistant (PA) Primary care doctor Nurse practitioner (NP) Nurse midwives

17. PREGNANCY AND CHILDBIRTH SERVICES Planning and preparing for pregnancy, including information about proper diet and prenatal vitamins Prenatal care, delivery, and postpartum care High-risk pregnancy care (maternal-fetal medicine) Breastfeeding and nursing INFERTILITY SERVICES Testing to determine the cause of infertility Blood and imaging tests to monitor ovulation Fertility treatments, including: Medications to stimulate ovulation Intrauterine insemination In vitro fertilization (IVF) Intracytoplasmic sperm injection (ICSI) Counseling for couples who are dealing with infertility or loss of a baby

21. Haya is a 67-year-old female who recently moved to the city. She has chosen you as her primary care physician and presents to your office for the first time. During the visit she inquires about health prevention and screening. Throughout the years she has remained relatively healthy. Her medications consist of 0.15 mg of levothyroxine for treatment of hypothyroidism, and a multivitamin. Her only surgeries consist of nonmalignant mole removals. She is a thin,153 cm and weighs 52 kg. Her BP is 120/70. Heart, lung, breast, and abdominal exam are all within normal limits Case 1

22. What preventive measures are applied to this patient? How will you approach this patient?

23. http://www.kaiseredu.org/tutorials-and-presentations/global-womens-health.aspx

24. Thanks