My post today glosses over certain health issues that affect women. I just put together an overview of each issue but detailed information on each condition is readily available online. The second part of this post will be next friday.
Urinary incontinence is classified as the involuntary loss of urine. It has been estimated that it affects as many as 13 million Americans and that 10 to 30% of all US women aged 15 to 64 and 50% of all female nursing home patients are affected with the condition.
Around the globe, urinary incontinence is widespread. In Asian nations, between 4% (China) and 17% (Singapore) of all women are affected. Between 15 and 34% of all European women experience some form of urinary incontinence. The overall average worldwide rate of urinary incontinence for men and women is greater than 25% and is approximately 15% for all women world wide. The prevalence of urinary incontinence tends to be higher in women than in men due to anatomical differences as well as the fact that women experience pelvic trauma during childbirth. The number of women with urinary incontinence of any type increases with age. Younger age group cohorts tend to reflect a lower percentage while post menopausal women tend to yield a higher percentage.
In order to understand urinary incontinence, one must understand the anatomy and physiology of the urogenital system. Normal bladder control is maintained by the bladder and urinary sphincter as they work together as a valve. The urethra and urinary sphincter muscle relax and open, the bladder opens, and urine passes. The bladder neck and urethra are under muscular control with the lower portion of the sphincter tightening to maintain continence. When surrounding tissue is compromised or weakened, there is lack of bladder neck support and incontinence is the result.
The primary causes of urinary incontinence are:
Bladder related: caused by the bladder's failure to store, failure to empty, or both; reduced capacity, involuntary contractions, poor bladder compliance.
Sphincter related: poor positioning of the bladder neck in women, uncoordinated bladder sphincter action, sphincter damage or weakness, outlet obstruction.
There are three major types of incontinence which are based on the characteristics of the disorder:
Stress: caused by weak external sphincter and pelvic floor muscles and an unsupported bladder neck.
Urge: causes may be neurological in origin; bladder is overly sensitive and may contract unexpectedly.
Overflow: continual leakage from an overly full bladder that never empties completely.
Pharmacologic therapy is generally used in the treatment of urge incontinence due to the fact that the underlying causes of urge incontinence are primarily related to neuromuscular dysfunction. These drugs, while effective, produce a variety of untoward side effects of varying degrees. Stress incontinence is typically treated surgically, however anticholinergics found in common decongestants seem to be effective in patients with poor muscle tone and poorly functioning sphincters.
As many as 50% of women in the United States have asked their physicians about breast pain, also known as mastalgia or fibrocystic breast disease. Women often find they have symptoms of swelling, breast pain, tenderness and lumps that increase in their breasts immediately prior and during their menses. This clustering of symptoms is called cyclical mastalgia. Symptoms can last up to seven days or more but frequently last one to four days.
For about 15% of the women who do experience breast pain, the pain warrants the women take prescription medication for their pain. Most women who do consult their physician regarding breast pain do not have breast cancer. If you are concerned about breast pain, it is very important to consult your physician about the symptoms you are experiencing. Mastalgia can impair a woman’s ability to work, participate in her daily activities, embrace a child or have an intimate relationship with her partner. In addition, mastalgia frequently causes increased anxiety and stress in a woman’s life as a result of dealing with pain each month. Additional psychological stress is often caused by the mammograms, ultrasound scans and breast biopsies, utilized by physicians to rule out other diseases of the breast.
Current treatments for mastalgia include one FDA approved prescription medication for mastalgia which typically causes unwanted side effects like facial hair growth, weight gain and acne; dietary changes and vitamin supplements; and purchasing a properly fitting brassiere.
Dysmenorrhea is the term used to describe the pain and cramping associated with menstruation. It is estimated that dysmenorrhea is the most common gynecological condition affecting women and can occur in the absence or presence of other conditions (like endometriosis).
Primary dysmenorrhea is menstrual pain that is not related to any other condition. Dysmenorrhea can start shortly after a woman’s first menstrual period and last through menopause. Estimates indicate 50% of all women worldwide experience primary dysmenorrhea and some prevalence rates indicate that as many as 90% of all women experience dysmenorrhea at some time in their lives.
In the United States, it has been estimated that 100 million work hours are lost per year due to dysmenorrhea which could translate into $2 billion in lost work productivity. More than half of all women who experience primary dysmenorrhea indicate that their pain is moderate to severe in nature. Multiple treatments have been used throughout recent history to ameliorate dysmenorrhea including herbal supplements, aspirin, non-steroidal anti-inflammatory agents, prescription pain medications and oral contraceptives.