Women’s Health Issues:

A Program for Women and Men

Topics of concern for the general health of women and men:

• Nutrition
• Exercise
• Sleep
• Social behaviors
• Sexual Health
• STD screening
• Breast cancer
• Osteoporosis
• Testicular cancer
  

General Healthy: Nutrition, Exercise, Sleep, Social Behaviors:

• Diet: balanced meals, regular small meals, low in saturated fats, low in simple carbohydrates, high in fibers, fruits/vegetables, 8 glasses/fluids day
• Exercise: 30 minutes of aerobic exercise 3 times a week; weight lifting. Several benefits: maintain or/and lose body weight; decrease blood pressure; improve cholesterol levels; improve mood; stress reliever; prevent bone loss
• Sleep: 6-8 hours of uninterrupted sleep a night
• Blood screening: cholesterol panel, fasting blood sugar at 22 y.o.
• Self skin exams: monthly exams for new moles, changes in pre-existing moles (color, size, shape, and texture). Use of SPFs, avoid prolonged sun exposure.
• Stress reduction activities: exercise, meditation, yoga, reading, performing a hobby, spending time with friends and family
• Smoking cessation
• Moderate alcohol intake: less than 6 alcohol drink/week

 Sexual  Health:

• Females

• History of menarche onset, menstrual history, frequency of menses, duration, amount, associates symptoms
• History of papsmears:  last exam, results
• History of STDs
• Type of birth control method
• Number of partners
• Safety in Relationship
• Breast masses, nipple inversion or discharge
• Information about papsmears, HPV testing, breast exams:

A) Papsmears:

• Cervical cancer screening
• Annual testing
• Start at 18 y.o. or when becomes sexually active
• Results ranging from negative for malignancy, atypical cells of unknown significance, cervical dysplasia

B) HPV testing

• Cervical screening in females for high risk Human Papilloma Virus (HPV)
• Done together with or separate from papsmears
• Reflex done when papsmears are abnormal, starting with ASCUS to dysplasia
• Done as a screening at 30 y.o. and then every 3 years
• 70% of sexually active individuals will be exposed to HPV and 50% will acquire HPV, a very common infection
• HPV low risk, usually type 6 and 11 causes genital warts
• HPV high risk, usually type 16 and 18 causes cervical cancer
• Most HPV will be undetectable in 2 years
• Can cause Vaccine developed for HPV high risk 16 and 18 and low risk 6 and 11
• HPV vaccine recommended for:
  • Routine vaccination of girls 11-12 y.o. with 3 doses
  • Can start as early as 9 y.o.
  • Catch up vaccination of adolescent and young women 13 to 26 y.o. who have not been previously vaccinated
  • Cost of over $ 100.00 per vaccine

Self Breast exams:

• checking for breast masses, nipple inversion or discharge, skin changes
• teach about self breast exams, usually done 1-2 weeks before menses
  
  
• Males

• History of genital development: circumcision or non circumcision, descended testicles
• History of initial sexual activity
• History of number of sexual partners
• History of use of protection, condoms during sexual activity
• History of sexually transmitted diseases

History of Sexually Transmitted Diseases:

• Chlamydia/Gonorrhea
  • sexual transmission
  • cervical infection in females, characterized by friable, purulent
  • tender cervix, occasional vaginal itching, abnormal discharge, pain and bleeding with vaginal intercourse
  • urethral infection in males, characterized by urethral discharge, itching, discomfort
  • cervical or urethral cultures
  • cervical or urine amplified screening
  • treatment with antibiotics
  • sexually reported disease to the health care department
  • sexual partners need to be treated
  • recommended doing test of cure
  • if untreated can lead to pelvic inflammatory disease, sterility in both male and female

• Human Papilloma Virus

• genital lesions on both males and females, caused by low risk HPV, usually 6 or 11
• tan, fleshy growth in the genital area  
• acquired by skin to skin contact
• may be transmitted when person does not have symptoms
• External genital lesions can be treated with Aldara creams, liquid nitrogen
• Cervical lesion caused by high risk HPV
• HPV testing on cervix together with papsmears or separate, female testing only
• Biopsy lesions from males

• Genital Herpes

• genital  lesions on both males and females
• feeling of tingling, followed by appearance of painful blisters which rupture to ulcer with erythmatous border
• females may complain of recurrent yeast infections
• acquired by skin to skin contact
• may be transmitted with person does not have symptoms
• treated with antiviral for acute episodes, or place person on prophylaxis for recurrent episodes
• diagnosis by viral culture from fluid filled blister
• diagnosis by serology, IgG and IgM antibodies, PCR method
  
  
• Trichomona Infection:

• transmitted sexually, but can also be transmitted from public restrooms
• females complain of abnormal vaginal discharge, odors, pelvic pain, urinary problems
• males usually not symptomatic
• diagnosed by doing a vaginal wet mount in clinic
• treated with Flagyl oral
• both partners need to be treated

• HIV

• transmitted sexually, IV drug use, occupational exposures, rarely by blood transfusions
• person usually develops fly like symptoms 1-3 days after exposure
• have a 6 month window period for conversion
• suspicion arises when patients are immunossupressed
• screening by ELISA
• confirmatory testing by Westernblot

• Syphilis

• sexually transmitted
• genital ulcer: 1st stage
• screening by doing RPR serology
• treated with antibiotics
• 3 stages of disease

Breast Cancer

• Incidence
• Risk Factors
• Signs and Symptoms
• Screening
• Self Breast Exams

Osteoporosis

• Incidence
• Risk Factors
• Signs and Symptoms
• Screening
• Dietary Supplements
• Physical Activity
• Social Avoidance

 Testicular Cancer 

• Incidence
• Signs and Symptoms
• Treatment