Student Health 101 General Health
A Reference Guide to Student Health
Women’s Health
Breast Cancer
Pap Smears and Pelvic Exams
Pelvic Pain
Pregnancy
Premenstrual Syndrome (PMS)
Uterine Bleeding
Vaginal Infections (Vaginitis)
Breast Cancer
Breast cancer is the second leading cause of cancer deaths among women. Risk factors for breast cancer include:
- Advanced age
- Family history
- Obesity
- High-fat diet
- Excessive alcohol consumption
Early detection of breast cancer is vitally important. Perform monthly breast self-examinations as an easy method of early detection. Regardless of your age or family history of breast cancer, contact your physician if you suspect you have a new lump or an existing lump has changed in size or texture. In most cases, your physician will perform a breast examination and order imaging studies, such as mammography.
A mammogram is a breast X-ray that can reveal tumors that may be too small to be recognized by a breast exam. Mammography screening should generally start at the age of 40 and be repeated every one to two years until the age of 50. After 50, annual mammography screening is recommended. If you have a family history of breast cancer, talk to your physician about when to begin mammography screening.
Pap Smears and Pelvic Exams
Regular Pap smears and pelvic examinations are critical to women’s health. These examinations can give you early insight into any abnormalities with your reproductive organs. Early detection is important to increasing the probability of effective treatment. Women who are sexually active or have reached 18 years of age should have both annual Pap smears and pelvic examinations (manual palpation of the uterus and ovaries).
The Pap smear is a screening test for cancer of the cervix. To perform the test, your physician will gather samples of cells from the cervix and analyze them in a laboratory. If you have had three consecutive normal Pap smears and are at low risk for developing cervical cancer, your physician may suggest having Pap tests less frequently.
An abnormal Pap smear result does not mean that you have cervical cancer. It simply means that more testing is necessary to determine appropriate care and follow up. If recommended, it is important to return to the office for frequent Pap smears or treatment of the cervix. If left untreated, abnormal Pap smears could progress to cancer of the cervix over a period of several years.
Pelvic examinations are manual exams of the pelvic organs. During the examination, your physician will insert two fingers into your vagina and press on your lower abdomen with her other hand to feel for any abnormalities in the shape and size of your ovaries and uterus.
Pelvic Pain
Many different conditions can cause pain that originates in the pelvic area. Sometimes, it is a sign of something serious, while at other times it is perfectly normal. Severe pain that starts suddenly may indicate a harmful process, such as a pelvic infection, an ectopic pregnancy (a pregnancy growing in the fallopian tube), ovarian cysts, or appendicitis. All of these conditions need prompt evaluation by a physician.
Chronic pelvic pain has many possible causes as well, including:
- Endometriosis (abnormal growth of the uterine lining outside the uterus)
- Dysmenorrhea (painful periods)
- Scar tissue from previous surgeries or pelvic infections
- Fibroid tumors on the uterus
- Ovulation
- Muscle disorders
Seek medical attention for evaluation of sudden-onset or chronic pelvic pain. Your physician will conduct a thorough physical exam and tests to find a diagnosis. Treatment plans may encompass pain medications, hormonal medications, muscle relaxants, biofeedback, or surgical intervention.
Pregnancy
When a woman ovulates, she releases an egg, which can be fertilized any time during a 12 to 24 hour period. For a woman with a 28-day menstrual cycle, this occurs approximately 14 days after the first day of her period.
Semen is the fluid that carries sperm, which travel up through the cervix to fertilize the egg in the fallopian tube. The fertilized egg then migrates to the uterus, where it attaches and begins to grow. It is at this point that pregnancy is achieved.
Bleeding during Pregnancy
Bleeding during pregnancy is very common. Often, it is normal and does not indicate a problem; however, it can be a sign of a dangerous abnormality. Call your physician to report any bleeding you experience during pregnancy.
During the first trimester, many women experience spotting or light bleeding, especially after a pelvic exam or intercourse. If you experience these symptoms, see your physician to have an exam or ultrasound to help diagnose a possible miscarriage (loss of the fetus), ectopic pregnancy (fetus growing outside of the uterus), or molar pregnancy (abnormal growth of placental tissue). If all of these conditions are ruled out, then the bleeding is not a threat to the fetus.
See your physician as soon as possible for any bleeding in the second trimester. It can be a sign of such serious conditions as early labor, placental abruption (when the placenta separates from the uterine wall), or placenta previa (when the placenta has implanted over the cervix).
During the last month, any spotting or light bleeding you experience may be bloody show, which happens when the cervix starts opening and softening for the upcoming labor. However, it is still important to see your physician to evaluate the cause of the bleeding.
Diet
It is best to reach a healthy weight prior to pregnancy. For a woman of average weight, 20 to 30 pounds is the ideal gain for the entire pregnancy. If you are already overweight or underweight, your physician may recommend more or less weight gain. Most women in this country gain too much during pregnancy, which may adversely affect the delivery process and the baby.
A pregnant woman needs an extra 300 calories a day above the approximately 2,200-calorie requirement for non-pregnant women. It is especially important during pregnancy to eat a healthy diet that is low in fat and high in fiber. Pregnant women should also take an important vitamin called folic acid, which can help prevent defects of the fetal spine. It is best to start taking 0.4 milligrams of folic acid daily before conception and continue throughout pregnancy.
Exercise
Daily exercise has many health benefits and should be continued in most pregnancies. However, some pregnant women have medical conditions or complications that prevent them from exercising. Ask your physician what is best for you. Avoid activities such as hockey, soccer, basketball, skiing, horseback riding, and scuba diving. Safe exercises include walking, swimming, water aerobics, and stationarybike riding.
Genetic Counseling and Testing
Approximately 3% of all babies in the U.S. are born with a birth defect. Some are minor, allowing the baby to live a normal life. Other times, the baby may have multiple defects that may cause death. Most birth defects have no known cause, while others are the result of inherited disease, prenatal infection, or prenatal drug or alcohol use.
During an obstetrical visit, your physician analyzes your family history to advise you of any increased birth-defect risk. Pregnant women over the age of 35 are at increased risk of having infants with chromosome defects such as Down syndrome, and therefore should seek genetic counseling and testing.
Physicians can’t detect all birth defects prior to delivery, but testing can identify some of the most common defects. The most common test is an amniocentesis, which is performed around 16 to 18 weeks. Guided by an ultrasound, the physician inserts a needle into the uterus and withdraws a small sample of amniotic fluid. Results of the test are available within two weeks. There are a few risks involved with the procedure, which you should discuss with your physician.
Travel
Travel is safe throughout most of your pregnancy. When traveling by car, bus, or train, limit travel time to no more than six hours a day. Stretch or move your legs at least every two hours, and wear a lap-shoulder seatbelt at all times. Most physicians and airlines agree that plane travel is acceptable until the last month of pregnancy. The altitude and metal detectors are not dangerous to you or your fetus. Consult your physician about any travel plans if your pregnancy is high risk.
Medications
Many women worry about the effects of medications during pregnancy, but many over-the-counter medications are safe. The following table provides appropriate medications to take for specific health conditions during pregnancy.
Condition
Cold, fever, headache
Medication
Acetaminophen
Condition
Constipation
Medication
Docusate sodium, methylcellulose, psyllium
Condition
Cough
Medication
Guaifenesin
Condition
Heartburn
Medication
All antacids
Condition
Hemorrhoids
Medication
Witch-hazel pads, hydrocortisone cream (talk to your healthcare provider first)
Condition
Nausea
Medication
Phosphorated carbohydrates, doxylamine, dimenhydrinate
Condition
Sore throat
Medication
Cough drops or lozenges, Chloroseptic® spray
Condition
Vaginal yeast infection
Medication
Miconazole, clotrimazole
Visits to Your Obstetrician
Your physician dates your pregnancy from the first day of your last menstrual period and refers to your progress based on the number of weeks you have completed. Most full term pregnancies last 40 weeks.
The following timetable lists common prenatal care procedures for a normal, low risk pregnancy:
Stage
Approximately 8 weeks
Procedures
First prenatal visit: Full medical history, physical exam, ultrasound to detect fetal heartbeat, blood and urine tests. Follow up visits generally occur monthly after this visit.
Stage
15 to 20 weeks
Procedures
A triple screen blood test that detects your risk for having a fetus with a birth defect is offered.
Stage
20 weeks
Procedures
An ultrasound, which evaluates the anatomy of the fetus, including the gender, is usually offered.
Stage
24 to 26 weeks
Procedures
A blood test to detect gestational diabetes is performed. Most expectant parents begin taking Lamaze or other birthing technique classes.
Stage
30 weeks
Procedures
More frequent visits to your physician begin
Stage
36 weeks
Procedures
An exam that checks for a certain bacteria in the vagina and rectum usually performed
Stage
36 weeks to birth
Procedures
Weekly visits to your physician begin. (In high risk pregnancies, your physician sees you more often to follow your condition closely.)
Premenstrual syndrome (PMS)
Premenstrual syndrome affects many women in their reproductive years. Its cause is unknown. Some sufferers have severe symptoms and seek treatment, while others’ symptoms are mild. PMS begins near the middle of the cycle, around ovulation, and continues until the menstrual period begins.
PMS complaints can include both emotional symptoms and physical symptoms. Common emotional symptoms are:
- Mood swings
- Depression
- Forgetfulness
- Irritability
Common physical complaints include:
- Bloating
- Acne
- Food cravings
- Breast soreness
- Water retention
Lifestyle changes, including regular exercise, stress reduction, and avoidance of alcohol and caffeine, often alleviate symptoms. Sometimes, medical therapy is also necessary. Visit your physician to obtain the correct diagnosis and appropriate treatment.
Uterine Bleeding
Menstruation is the regular cycle of monthly bleeding that females experience from puberty through menopause. Regular periods are consistent with regard to cycle length, duration of flow, and amount of bleeding.
Dysfunctional uterine bleeding is characterized by cycles that are longer than 42 days or shorter than 21 days, with bleeding that lasts longer than seven days. This is typically characterized as a heavy flow that soaks a sanitary napkin in one hour and is accompanied by the passage of large clots. If you experience this type of bleeding, seek medical attention. Your physician may want to obtain blood tests, including a pregnancy test, as well as an ultrasound of the reproductive organs. The goal of treatment, whether observation, medications, or surgery, is to help minimize symptoms associated with heavy bleeding, including anemia, and to improve your quality of life.
Vaginal Infections (Vaginitis)
Most women experience a vaginal infection at some point, and some have recurrent problems for many years. The different types of vaginitis share some symptoms. Therefore, to ensure successful treatment, visit your physician for an exam, a slide test, and an accurate diagnosis.
A healthy vagina produces a clear or cloudy/whitish discharge daily. Certain factors change this discharge, allowing bacteria to overgrow and cause vaginitis. These factors include:
- Douching
- Antibiotics
- Menstrual blood
- Semen
- Spermicides
- Changes in hormonal levels
- Sexually transmitted diseases
Some of the most common types of vaginitis are atrophic vaginitis, bacterial vaginosis, trichomonas vaginitis and yeast infection.
Atrophic Vaginitis
A lack of estrogen, which occurs in menopause and during breastfeeding, causes this inflammation of the vagina. Symptoms include vaginal burning and dryness. Treatment usually involves an estrogen cream or water-soluble lubricant.
Bacterial Vaginosis
A thin, gray discharge and a strong fishy odor are symptoms of this infection. Treatment includes antibiotic pills or cream. It is not a sexually transmitted disease.
Trichomonas Vaginitis
This is a less common sexually transmitted vaginitis. Symptoms include a foul-smelling green discharge and burning sensation in the vagina. You and your partner will both require antibiotic treatment.
Yeast Infection
This is the most common type of vaginitis. Symptoms include itching, burning, and a thick, white, odorless discharge. Treatment comes in the form of either a pill or cream. This is not a sexually transmitted disease, so your partner does not need treatment.