Gynecology

Gynecology (alternately, gynaecology) is the branch of medicine that deals with the female reproductive organs. It is closely related to the field of obstetrics, which is involved with the care of women and fetuses during pregnancy. OB/GYN is a common medical specialty. Gynecological problems are rare in preadolescence except in cases of birth defects or conditions precipitated by sexual abuse. The onset of menstruation, which generally occurs around the age of 12, marks the beginning of puberty. Even in cases where physical abnormalities are present, they may not surface before puberty. Dysmenorrhea (painful menstruation), for instance, may be either primary or secondary to pelvic disease. Around 50 percent of all women of childbearing age experience dysmenorrhea to some extent, but it is severe in only one in 10. Incidences of the disorder tend to decline after the age of 24 and may disappear earlier in women who become pregnant. In some women, amenorrhea, the absence of menstruation, is experienced without a clear physical cause. In most cases, it is associated with autoimmune or infectious diseases or cancer treatments. It may also occur in female athletes and in females with eating disorders.

It is estimated that 95 percent of all premenopausal women experience Premenstrual Syndrome (PMS), occurring seven to 10 days before the beginning of the menstrual cycle. Symptoms tend to disappear once bleeding starts. Experiences with PMS vary greatly. Common symptoms include facial acne, breast swelling and tenderness, fatigue, insomnia, gastrointestinal problems, bloating, constipation, diarrhea, headache, backache, appetite variations, joint or muscle pain, and concentration and memory difficulties. Caused by fluctuating hormone levels, the classic symptom of PMS is wide mood swings involving tension, irritability, crying jags, anxiety, or depression. While there is no specific treatment for PMS, pain medication, vitamin B6, oil of evening primrose, and serotonin inhibitors offer relief to some women.

In some cultures and religions, the most pressing gynecological problem is female genital mutilation (FGM), also known as female circumcision. The purported purposes of altering a girl's external sexual organs are to prolong virginity and enhance marriageability. Performed in Africa, the Middle East, and in Muslim areas of Indonesia and Malaysia without anesthesia, FGM poses major health risks for females. Because the procedure is also performed among immigrant populations in Western countries, many nations have passed laws to make the practice illegal. [Page 765]However, physicians are encouraged to show compassion in dealing with women who have undergone FGM. In 1995, the landmark Beijing Conference on women's rights condemned the practice as a violation of human rights.

Throughout the world, sexually transmitted diseases (STDs) continue to present major difficulties for the medical community, society, and governments. Health clinics are established to screen for STDs and to provide treatment and follow-up. Once diagnosed, all sexual partners of infected persons must be notified in order to prevent individual health problems and the spreading of the disease. Even women who have had sex with only one partner may be vulnerable to infection if that partner has practiced unsafe sex or had sex with multiple partners. The human papillomavirus (HPV) is the most prevalent of all STDs, and around 70 strains of the virus have so far been identified. In many developing nations, HIV/AIDS has become the most pressing gynecological problem for both women and for the children they deliver because of the risk of mother-to-child transmissions during the birthing process.

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