Women's Health & Reproduction

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Taking good care of your reproductive health is important because problems with this system can make it difficult or impossible for you to become pregnant. Beyond this, reproductive health problems also can be harmful to your overall health and emotional wellbeing and can affect your ability to enjoy a sexual relationship.

This section provides details about reproductive health, which includes information about the reproductive system and ways to care for your reproductive health. There is also an overview of conditions that can affect fertility, such as ovulation disorders and physical problems.

Because endometriosis and polycystic ovary syndrome are two of the most common disorders that can affect a woman’s ability to become pregnant, the following pages also contain more information on these conditions. 

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About the female reproductive system

The female reproductive system is the set of body parts that contribute to the reproductive process, which includes the menstrual cycle, conception, pregnancy and childbirth. This system plays an important role in maintaining balance in the whole body through hormone production and interaction. A woman has reproductive organs both inside and outside her body. The female reproductive system consists of the ovaries, fallopian tubes, uterus, cervix and vagina.

About reproductive health

According to the Centers for Disease Control and Prevention , your reproductive system is one of the most fragile systems of your body. This is because it can easily get infected or injured. Taking good care of your reproductive health is important because problems with this system can make it difficult or impossible for you to become pregnant. Beyond this, reproductive health problems also can be harmful to your overall health and emotional wellbeing and can affect your ability to enjoy a sexual relationship. Fortunately, many reproductive health problems can be prevented or corrected if you take good care of your body and see your doctor for regular checkups and screenings.

Caring for your reproductive health involves:

  • Learning how your reproductive system works and what is normal for you. Being in touch will help inform you if you need to see a doctor.
  • Taking simple steps to protect yourself from sexually transmitted infections (STIs), which are very common and easily spread. STIs can damage reproductive organs, cause problems with pregnancy, and affect long-term health.
  • Avoiding substances and chemicals that can harm your reproductive health and ability to produce healthy children.
  • Incorporating family planning, which means having control over if and when you become pregnant by being aware of your contraceptive options.
  • Seeing your doctor for routine check-ups and screenings. This way, problems can be found early, so they can be treated or kept from getting worse.
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Most conditions that affect fertility are caused by hormone imbalances and problems with ovulation. Without ovulation, there are no eggs to be fertilised. Signs that a woman is not ovulating normally include irregular or absent menstrual periods. Causes of female infertility include:

  • Ovulation disorders: These hinder or prevent the ovaries from releasing eggs. An example is polycystic ovary syndrome (PCOS), a hormone imbalance problem which is often characterised by irregular menstrual periods. According to the Office on Women’s Health , PCOS is the most common cause of female infertility. Another example of ovulation disorders is hyperprolactinemia. This condition occurs when you have too much prolactin, the hormone that stimulates breast milk production. Other underlying causes of ovulation disorders may include excessive exercise, eating disorders, injury or tumors.
  • Primary ovarian insufficiency (POI): POI occurs when a woman's ovaries stop working normally and menstruation ends before age 40.
  • Blocked or damaged fallopian tubes: This can be due to pelvic inflammatory disease, endometriosis, sexually transmitted infections or surgery for an ectopic pregnancy.
  • Physical problems with the uterus or cervix: This can include problems with the opening of the cervix or cervical mucus, or abnormalities in the shape or cavity of the uterus.
  • Uterine fibroids: These are non-cancerous clumps of tissue and muscle on the walls of the uterus. Fibroids may distort the uterine cavity interfering with implantation of the fertilised egg.
  • Endometriosis: Endometriosis occurs when endometrial tissue implants and grows outside of the uterus. This often affects the function of the ovaries, uterus and fallopian tubes.
  • Pelvic adhesions: These are bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery.
  • Thyroid disorders: Either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism) can interrupt the menstrual cycle or cause infertility.
  • Cancer and cancer treatment: Specific cancers, particularly female reproductive cancers, can severely impair female fertility. Cancer treatments, such as radiation and chemotherapy, may also affect a woman's ability to reproduce.
  • Other conditions: Other medical conditions associated with delayed puberty or the absence of menstruation may also cause infertility. Examples include celiac disease, Cushing's disease, sickle cell disease, kidney disease or diabetes.
  • Certain medications: The use of certain medications may cause temporary infertility. In most cases, however, fertility is restored when the medication is stopped.
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What is endometriosis?

Endometriosis is a common, and often painful, health problem in women. It occurs when tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, bowel or the tissue lining your pelvis.

What are the symptoms of endometriosis?

Some women with endometriosis don’t experience any symptoms. However in those that do, symptoms may include:

  • Chronic pain in the lower back and pelvis
  • Very painful menstrual cramps
  • Painful bowel movements or painful urination during menstrual periods
  • Pain during or after sex
  • Intestinal pain
  • Infertility
  • Spotting or bleeding between menstrual periods
  • Fatigue
  • Diarrhea, constipation, bloating, or nausea, especially during menstrual periods

Does endometriosis affect fertility?

If you have endometriosis, it may be more difficult for you to become pregnant. According to the American Society of Reproductive Medicine , up to 30% to 50% of women with endometriosis may experience infertility. Endometriosis can affect fertility in several ways, such as through distorted anatomy of the pelvis, adhesions, scarred fallopian tubes, or inflammation of the pelvic structures.

How is endometriosis diagnosed?

The only sure way to diagnose endometriosis is by a minor surgery called laparoscopy. A laporoscopy is an operation performed under general anaesthetic, where a small telescope is inserted into the abdomen through a cut in the belly button, to look for endometriosis tissue. Sometimes doctors can diagnose endometriosis just by seeing the growths. Other times, they need to take a small sample of tissue and study it under a microscope.

How is endometriosis treated?

There is no cure for endometriosis, but there are many treatments for the pain and infertility that it causes. Talk with your doctor about what option is best for you. Treatment will depend on the severity of the condition, the symptoms occurring and whether pregnancy is desired. Treatments can include surgery, hormone therapy and natural therapies, as well as medication for pain relief. 

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What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women of reproductive age. According to the Royal Australian College of General Practitioners , PCOS affects 12–21% of women of reproductive age, but the vast majority remain undiagnosed. Women with PCOS typically have high levels of androgens (sometimes called male hormones), missed or irregular periods, and many small cysts in their ovaries.

What are the symptoms of polycystic ovary syndrome?

Symptoms of PCOS can vary between women, and may include any of the following things:

  • Irregular menstrual periods – menstrual bleeding may be absent, heavy, unpredictable or only spotting 
  • Severe acne, or acne that occurs after adolescence and does not respond to usual treatments
  • Obesity or unexplained weight gain
  • Infertility
  • High cholesterol
  • Excess hair growth in places such as the face, chest, stomach and back
  • Abdominal pain
  • Skin pigmentation
  • Thinning hair 

Does it affect fertility?

PCOS can affect fertility, yet many women with this condition do become pregnant naturally. Some women with PCOS may also experience reduced fertility or sub fertility, where it may take longer to conceive. The good news is that there are many things you can do to improve your fertility and treatments are available if you do have difficulty conceiving.

How is polycystic ovary syndrome treated?

While there is no cure for PCOS, a variety of treatments are available to address the problems associated with this condition. Treatment is tailored to each person according to symptoms, other health problems, and whether she wants to become pregnant. Treatment can range from lifestyle changes centred on a healthy diet and regular exercise, medications such as oral contraceptive pills, to surgery.

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