Healthcare for women includes the entire spectrum of a woman'slife, not just pregnancy and childbirth. Besides developing conditions such as diabetes, heart disease, and cancer, women have special health issues that revolve around hormonal changes in their bodies and their reproductive organs. Also, medical problems canaffect women and men differently.
Women's health issues include breast conditions, menstruation, infections, menopause, heart conditions, mental health, osteoporosis, and sexual health.
This monograph focuses on hormonal changes in the female body and the relationship these hormonal changes have on the overall health of a woman. Other women's health issues, such as osteoporosis, heart disease, breast cancer, and ovarian cancer, are covered in separate condition monographs.
Hormonal changes in women can cause health imbalances to arise, including menopause, pre-menstrual syndrome (PMS) and related conditions (such as dysmenorrhea, menorrhagia, amenorrhea, and polycystic ovary syndrome), and infections of the vagina.
For women, hormone imbalance is the term that describes the incorrect relationship between the two primary hormones, progesterone and estrogen, in the body.
For a woman to have regular menstrual cycles, the reproductive organs, including the ovaries and uterus, should all be functioning normally. The hypothalamus stimulates the pituitary gland to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The hypothalamus is a part of the brain that links the nervous system with hormone release. FSH and LH cause the ovaries to produce the hormones estrogen and progesterone. Estrogen and progesterone are responsible for the cyclical changes in the endometrium (uterine lining), including menstruation. In addition, a woman's genital tract should be free of any abnormalities to allow the passage of menstrual blood.
Normally, in the first 10-12 days of the menstrual cycle, only estrogen is produced in the female body. If ovulation occurs, then progesterone is produced by the ovaries. On or about day 28, levels of both hormones drop, resulting in menstruation. However, if ovulation does not occur, women can still have the menstrual period, but the estrogen is never "balanced" by progesterone, which needed ovulation to trigger its production. This results in symptoms of hormone imbalance;- estrogen is present but progesterone production drops to very low levels.
Variations in the estrogen/progesterone balance can have a dramatic effect on health. Hormonal imbalances are also thought to play a major role in PMS, or premenstrual syndrome.
Hormonal imbalances in women may be a result of aging, stress levels, a lack of exercise, poor nutrition, alcohol intake, poor sleep, synthetic hormone replacement therapy (HRT), and environmental toxins, called xenoestrogens, such as the pesticides DDT and dioxin.
Symptoms of hormone imbalance in women tend to increase as a woman ages and continue until menopause. Hormone imbalance symptoms can include: allergy symptoms, such as sneezing and runny nose; depression, fatigue and anxiety; endometriosis, a condition in which the tissue that lines the uterus is found to be growing outside the uterus, on or in other areas of the body; fibrocystic breasts or lumps in the breasts; hirsutism or hair loss and facial hair growth; headaches, dizziness and foggy thinking; low sex drive; osteoporosis or the gradual loss of bone; PMS or premenstrual syndrome; urinary tract infections and incontinence; uterine fibroids; weight gain, water retention and bloating; and wrinkly skin.
Abnormal menstrual bleeding, Alzheimer's disease, amenorrhea, anti-androgen, anti-estrogen, atrophic vaginitis, bacterial vaginosis, breast cancer-related hot flashes, calcium, Candida, cervicitis, cervix, chronic pelvic pain, contraceptive, corpus luteum deficiency, cramps, cytokines, dysmenorrheal, ectopic pregnancy, emmenagogue, endometriosis, estrogen, fibrocystic breast disease, follicle-stimulating hormone, FSH, GABA, gardnerella, gonorrhea, gynecologist, hirsutism, hormonal disorders, hormone replacement therapy, hormone-related vaginitis, hot flashes, HRT, hypermenorrhea, hypothalamus, hypothyroidism, hysterectomy, hysteroscopy, incontinence, interleukins, irregular menstrual cycles, irritant vaginitis, laparoscopy, leukorrhea, LH, luteal phase deficiency, luteinizing hormone, menopausal disorders, menopausal hot flashes, menopausal symptoms, menopause, menorrhagia, menses, menstrual, menstrual pain, menstruation, neurochemicals, oophrectomy, osteoporosis, ovaries, ovariotomy, ovulation, PCOS, peri-menopause, pituitary gland, PMDD, PMS, polycystic ovary syndrome, postmenopause, premenstrual dysphoric disorder, premenstrual syndrome, premenstrual tension, progesterone, progestin, serotonin, uterine fibroids, uterus, vaginal dryness, vaginal inflammation, vaginal yeast infection, vaginitis, vitamin D, vulvovaginitis, xenoestrogens, yeast infection, yeast vaginitis.
female conditions related to hormonal imbalances
Menopause, also known as "the change," is when a woman's menstrual periods stop altogether. It signals the end of the ovaries releasing eggs for fertilization. A woman is said to have gone through menopause when her menses have stopped for an entire year. Menopause generally occurs between the ages of 45-55, although it can occur as early as the 30s or as late as the 60s. It can also result from the surgical removal of both ovaries. A woman may still get pregnant during menopause until she has gone at least 12 months without menstruating (a period).
Changes and symptoms include: a change in menstruation (periods) - periods may be shorter or longer, lighter or heavier, with more or less time in between; hot flashes and/or night sweats; trouble sleeping; vaginal dryness; mood swings; trouble focusing; and hair loss on the head but increased hair on the face. About 85% of women experiencing menopause will have hot flashes.
All women will experience menopause. Menopause is not considered a disorder and most women do not need treatment for it. However, if symptoms are severe, medications may be used to help alleviate symptoms.
Researchers have estimated that more than 1.3 million women in the United States and 25 million women worldwide experienced menopause. There are about 470 million postmenopausal women worldwide, a number that is expected to increase to 1.2 billion by the year 2030.
Perimenopause: During perimenopause, the woman may begin to experience menopausal physical and emotional signs and symptoms, such as hot flashes and depression, even though they still menstruate. The average length of perimenopause is four years, but for some women this stage may last only a few months or continue for 10 years. Perimenopause ends the first year after menopause, when a woman has gone 12 months without having her period. Periods (menstruation) tend to be irregular during this time and may be shorter or longer or even absent.
Despite a decline in fertility during the perimenopause stage, individuals can still become pregnant. If the individual does not want to become pregnant, they may continue to use some form of birth control until menopause is reached.
Postmenopause is a time when most of the distress of the menopausal changes have faded. Hot flashes may seem milder or less frequent and energy, emotional, and hormonal levels may seem to have stabilized. During postmenopause, women are at a higher risk for developing osteoporosis (bone loss) and heart disease, due to the decrease in circulating estrogen. The postmenopausal phase begins when 12 full months have passed since the last menstrual period. After menopause (postmenopause), women are more vulnerable to osteoporosis (bone loss) and heart disease, in part due to estrogen imbalance.
Women may become pregnant during menopause.
Premenstrual syndrome (PMS)
Menstruation, commonly referred to as a period or menses, is the periodic discharge of blood and mucosal tissues from the uterus in non-pregnant women, usually occurring at four week intervals. Every month, a woman's body prepares for pregnancy. If no pregnancy (fertilization of the egg) occurs, the uterus sheds its lining. The menstrual blood is partly blood and partly tissue from inside the uterus, or womb. The blood passes out of the body through the vagina. Periods usually start around age 12 and continue until menopause (generally between the ages of 45-55). Most periods last from three to seven days.
Premenstrual syndrome, or PMS, is a group of symptoms that start one to two weeks before the period (called the luteal or secretory phase). Four out of 10 menstruating women suffer from PMS. There have been as many as 150 symptoms associated with PMS. Most women have at least some symptoms of PMS, and the symptoms go away after their periods start. The most common symptoms are: irritability, anxiety, depression, headache, bloating, fatigue or excessive tiredness, feelings of hostility and anger, and food cravings, especially for chocolate or sweet and salty foods. Breast tenderness is also common in women during PMS.
The exact causes for PMS are not known. One theory points to low levels of the hormone progesterone. Others link it to nutritional deficiencies, such as calcium and magnesium. To be classified as PMS, symptoms must occur between ovulation and menstruation - that is, anytime within two weeks before the menstrual period and disappear shortly after the period begins.
For some women, symptoms of PMS are minor and may last only a few days before menstruation. For others, they can be severe and last the whole two weeks before every period.
While not all women have PMS, it's estimated that 70-90% of women who menstruate experience premenstrual symptoms. And another 30-40% of individuals suffering from PMS have symptoms severe enough to disrupt their lives. Severe PMS is seen in 3-8% of women.
Other conditions due to hormonal imbalances
Premenstrual dysphoric disorder (PMDD): Premenstrual dysphoric disorder
(PMDD) is a condition where women suffer from many of the physical symptoms of PMS, often more severely than other women. In addition, they experience debilitating emotional symptoms such as feelings of hopelessness, isolation, and extreme mood swings. Women with family members (a mother or sister) who have PMDD may be genetically predisposed to experiencing PMDD.
Dysmenorrhea: Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation. Dysmenorrhea may be classified as primary or secondary. Primary dysmenorrheal is severe and frequent menstrual cramping caused by severe and abnormal uterine contractions in women. Painful menstrual periods may be caused by another medical condition present in the body, such as pelvic inflammatory disease (PID) or endometriosis. Pelvic inflammatory disease (PID) is a general term that refers to infection of the uterus (womb), fallopian tubes (tubes that carry eggs from the ovaries to the uterus), and other reproductive organs. It is a common and serious complication of some sexually transmitted diseases (STDs), especially chlamydia and gonorrhea. Endometriosis is when the tissue that lines the uterus is found to be growing outside the uterus, usually due to hormonal fluctuations. Secondary dysmenorrhea is caused caused by another medical condition, such as endometriosis (abnormalities in the lining of the uterus), adenomyosis (nonmalignant growth of the endometrium into the muscular layer of the uterus), pelvic inflammatory disease, uterine fibroids, cervical narrowing, uterine malposition, pelvic tumors, or an IUD (intra-uterine device). This condition usually occurs in older women.
Amenorrhea: Amenorrhea is a menstrual condition characterized by absent menstrual periods for more than three monthly menstrual cycles. Amenorrhea may be classified as primary or secondary. Primary amenorrhea is the absence of menstrual bleeding and secondary sexual characteristics (for example, breast development and pubic hair) in women during puberty or the absence of menstrual bleeding with normal development of secondary sexual characteristics in a girl by age 16 years. Secondary amenorrhea is the absence of menstrual bleeding in a woman who had been menstruating but later stops menstruating for three or more months in the absence of pregnancy, lactation (the ability to breastfeed), cycle suppression with systemic hormonal contraceptive (birth control) pills, or menopause.
Menorrhagia: Menorrhagia, also known as hypermenorrhea, is the medical term for excessive or prolonged menstrual bleeding and for periods that are both heavy and prolonged. Normal menstrual flow produces a total blood loss of 30-40 milliliters (about two to three tablespoonfuls). An individual's period may be regular or irregular, light or heavy, painful or pain-free, long or short and still be considered normal. Menorrhagia refers to losing 80 milliliteres or more of blood during the menstrual cycle.
Osteoporosis: Osteoporosis is a disease associated with a gradual thinning and weakening of the bones. It occurs most frequently in women who have gone through menopause. Declining estrogen levels during the first postmenopausal decadelead to rapid bone loss. Increased fracture risk maybe reversed by estrogen replacement therapy. The bone-protectiveeffects of estrogen may involve suppression of inflammatorychemicals called cytokines. Cytokines, such as interleukin-1 (IL-1) and tissue necrosis factor-alpha (TNF-α), promote bone loss and bone resorption. Without estrogen, such as in postmenopause, bones may become weak. As bones become thinner and weaker, they also become increasingly susceptible to fractures. Over the course of time, tiny bone fractures in the spine can lead to stooped posture and loss of height. If left untreated, postmenopausal osteoporosis can lead to constant back pain, disabling fractures, an increase in hip and leg fractures, and lost mobility.
Polycystic ovary syndrome: Polycystic ovary syndrome (PCOS) is a common condition characterized by irregular menstrual periods, excess hair growth, and obesity, though it can affect women in a variety of ways. A cyst is a closed sac- or bladder-like structure that is not a normal part of the tissue where it is found. Polycystic ovary syndrome affects about one in 10 women in the United States and is the leading cause of infertility in women. Early diagnosis and treatment of polycystic ovary syndrome can help reduce the risk of long-term complications, which include diabetes and heart disease.
Vaginitis (yeast infection): Vaginitis, or yeast infection, is irritation and/or inflammation of the vagina. Vaginitis is a very common disease affecting millions of women each year. The three most common vaginal infections are bacterial vaginosis (caused by the bacterium Gardnerella), Candida vaginitis (caused by yeast infection or Candida albicans), and Trichomonas vaginitis (caused by the protozoan Trichomonas vaginalis). Hormonal vaginitis is usually found in postmenopausal or postpartum (after childbirth) women. In these women, the estrogen support of the vagina is poor. Irritant vaginitis can be caused by allergies to condoms, spermicides, soaps, perfumes, douches, lubricants, and semen. Irritant vaginitis can also be caused by hot tubs, abrasion, tissue, tampons, or topical medications.
Yeast infections are also common in women during menstruation.