Woman’s Health Defined

Woman’s health is so much more than fertility, pregnancy and the PAP test... Woman’s health is the cornerstone of community health... The foundation of a healthy society. I see my role as a gynaecologist as an extraordinary privileged and a wonderful opportunity not only to positively influence the health of the woman consulting me, but also that of her home and her family. Each of us has a mother and owe our lives to her pains and sacrifice. In most cases our mother is the primary influence in our lives, nurturing & preparing us for all that follows. This even holds true for foster mothers and care-givers. Women in general are the nurturers with the exception simply proving the rule.

All health has three facets, mind, body and spirit. They are not mutually exclusive. Childhood brings its special challenges, but more so if you are born female. Nurturing is as much learned as it is hormonal and genetic. There is as much to be said about the nutritional and immune benefits of breastfeeding as there is about the psychological and emotional development of both mother and child. Abuse of the female child, both emotional and sexual is rampant in our society, and a safe environment with a mother or grandmother close at hand cannot be rivalled.If you have to work, providing a safe environment for your child has to take priority in the position you accept.

The onset of menstruation, the advent of hormones and the attention or the lack thereof from the opposite gender are confusing, often terrifying and depressing stages of a woman’s life. It takes patience, time and a good knowledge and control of self to guide a youngster through this early minefield. It is here that sexual health is established, opinions are formed, and habits are cultivated. Did you know a vaccine is now available that can protect your child completely from the embarrassment of genital warts and reduce the scourge of cervix cancer (the reason for the PAP smear) by an astounding 85%? It is here that a decision often has to be made about hormonal regulation for severe menstrual pain, acne or debilitating moods. It is at this stage that we must take responsibility for protecting our teens from unplanned pregnancy and sexually transmitted disease.

The decision to exercise one’s ability to reproduce or not is the defining moment of woman’s health. It is our desire for our children that this always are their decision to make and our actions and my interaction will always reflect this desire. Our spirit is endowed with free will and a woman has the freedom to express herself by making an autonomous decision to exercise her fertility.... Or not. What a wonderful privilege... And indeed, my privilege to assist in realising such a decision.

There are many ways of fertility control. An understanding of your physiology and personal control of fertile periods is undoubtedly the best option, though the self control and discipline required are considerable. Hormonal manipulation is gradually becoming much more physiologic and far safer. There is now a 5 year reversible contraceptive method without exposure to estrogens and no known carcinogenic effect that is as effective as sterilisation... And has benefits for cycle control and menopause to boot! There is even a weekly hormone patch which offers every benefit of the pill, but is safer and avoids the vagaries of the bowel.

The desperation of infertility need never ruin a relationship. ART or Assisted Reproductive Techniques are readily available and affordable in committed adults. There is a remedy for virtually every scenario and what cannot be dealt with locally will be referred to excellent regional units. Focusing on general health, diet, lifestyle and emotional wellbeing are important in attaining one’s fertility goals. Having babies is now far safer than ever before. Nature pre – determines a poor outcome in up to 25% of all pregnancies... We are down to less than 2% with the advent of antenatal care, imaging and assisted delivery.

a premium on this aspect of feminine health. It is the woman that makes a house a home and her fulfilment and happiness often determines the emotional health of the entire family. It is worth considerable effort and time defining this parameter and determining how this environment can improve. It may be a cyclic problem associated with...well, lunar cycles, or an underlying unfulfilled desire or need...a question of low self esteem, weight or emotional or verbal abuse... By a spouse, parent or child. There may even be underlying depression, particularly in the years following childbirth. It is my place to assist women in acknowledging such possibilities and empowering them with choice to change their circumstances.

Sexual health is often taboo, but it is and will always remain, a critical aspect of feminine health and always deserves attention. A surprisingly high number of women have pain with intercourse and simply don't enjoy what should by the ultimate expression of intimacy with their partners. Often the cause is obvious and can be rectified, such as thrush, endometriosis or a womb tilted backwards. At times the cause is a much deeper psychological injury, perhaps even stemming back to childhood abuse. Even this can be addressed and cured.

Menopause and the empty nest are the next challenges faced by woman. They can be approached stoically; however there are options to make the transition easier and knowledge is power. It is my privileged to discuss these options, to provide a range of alternatives that empower a woman through these difficult times.

As the body ages, so the incidence of chronic disease and malignancy increases. Preventative healthcare is aimed throughout life to ameliorate and delay this transition, to ensure there is more life to than living. Bone health, breast, cardiovascular and digestive health can all be screened with relatively cheap and available screening tests when appropriate. This is then the focus of my consultation in later years.

There are many reasons why surgery may make up one of the options required to deal with problems as diverse as pelvic pain, excessive bleeding, uterine fibroids, prolapsed and urinary incontinence. Surgery is becoming far less invasive and much more enduring. There are innovative and far safer and simpler options than hysterectomy and major abdominal surgery for gynaecological pathology. I work extensively with senior colleagues to ensure the benefits of progress are passed on to my patients.

I am a firm believer in the statement ‘we are what we eat’ and rarely will a consultation pass where we do not discuss optimal nutrition and supplementation. It is, after all again the woman and mother who by -and -large attends to the nutrition of the household. Getting this aspect of health right has great spin-offs for the family. Woman's health is not just about woman. It is about all of us. It remains my privilege to be involved.

Dr Douglas Seton, Obestetrician & Gynaecologist Knysna © 2021

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