The four health questions women often grapple with

It does not take much to notice that women and men's bodies differ, but so can the issues that affect their health.

Taking control of your health with GEMS
At the Government Employees Medical Scheme (GEMS) we encourage our members to take control of their health. With National Women's Day on 9 August 2013 it is worth examining some of the most common health issues women grapple with.

Why should I care about cervical cancer?
Cervical cancer affects more women in South Africa than any other cancer. One in every 35 women in this country will develop cervical cancer in their lifetime and 6 000 women will die from it this year. About 80% of sexually active women will acquire a human papillomavirus (HPV) infection, which can cause cervical cancer, in their lifetime, with the risk of recurring infections increasing with age.

What is cervical cancer?
Cancer of the cervix is a malignant condition that affects the lower part of the uterus (womb). It is caused by an infection from a virus known as HPV, which is usually sexually transmitted.

Can it be prevented?
Cervical cancer is one of the few cancers that can largely be prevented with an HPV vaccination. From next year February government will start administering cervical cancer vaccines in schools.

"The cervical cancer vaccine is recommended for girls and boys ages 11 to 12, although it may be given as early as age nine. It's important for boys and girls to receive the vaccine before they have sexual contact and are exposed to HPV. Once infected with HPV, the vaccine may not be as effective," says the Mayo Clinic.

"If not fully vaccinated at ages 11 to 12, the Centers for Disease Control and Prevention recommends that girls and women through age 26 and boys and men through age 21 receive the vaccine. However, men may receive the HPV vaccine through age 26 if desired," adds the Mayo Clinic.

For the vaccine to be effective, three vaccines need to be administered, the second being one month after the first and the third being six months after the second. Once women become sexually active it is recommended they go for a regular Pap smear and/or HPV testing if they have not been vaccinated.

Will breast cancer affect me?
Although the precise causes of breast cancer are unclear, one in eight women will be affected by it at some point in their lives.

Among the most significant factors are advancing age, ie, women over 50 are more likely to get cancer than younger women, as are those with a family history of breast cancer. Risk also increases for a woman who has certain types of benign breast lumps and previously had cancer of the breast or the ovaries, says WebMD.

"A link between breast cancer and hormones is gradually becoming clearer. Researchers think that the greater a woman's exposure to the hormone estrogen, the more susceptible she is to breast cancer. Estrogen tells cells to divide; the more the cells divide, the more likely they are to be abnormal in some way, possibly becoming cancerous," reveals WebMD.

Is breast cancer a death sentence?
If detected early, there is an excellent chance of recovery.

How can I detect if I have breast cancer?
Women should examine their breasts regularly for any symptoms, such as swelling in the armpit, any change in the size, shape, texture, or temperature of the breast, lumps in the breast or underarm, unusual swellings, discharge etc. Should you have any of these symptoms visit your gynaecologist immediately. If you are over 40, you should visit your gynaecologist annually.

Can I fall pregnant later in life?
When it comes to getting pregnant and having a healthy pregnancy age matters. Once women enter menopause the chances of falling pregnant are zero. However, the good news is that most healthy women are able to fall pregnant after the age 35 and even into their 40s.

What are the risks?
The Mayo Clinic warns of the following:

• It might take longer to get pregnant because women are born with a limited number of eggs. As they reach their early 30s, their eggs might decline in quality - and they might ovulate less frequently, even if they are still having regular periods. "An older woman's eggs also aren't fertilised as easily as a younger woman's eggs. If you're older than 35 and haven't been able to conceive for six months, consider asking your health care provider for advice."
• You're more likely to develop gestational diabetes. This occurs only during pregnancy, and is more common as women get older. "Tight control of blood sugar through diet, physical activity and other lifestyle measures are essential. Sometimes medication is needed as well. Left untreated, gestational diabetes can cause a baby to grow too large - which increases the risk of injuries during delivery."
• You're more likely to develop high blood pressure during pregnancy. To reduce complications you might need to take medication or deliver your baby before its due date.
• You might need a C-section as labour problems are more common in first-time mothers older than 35.
• The risk of your baby being born with chromosome abnormalities such as Down syndrome are higher, as is the risk of miscarriage.

How can I lower my risk for pregnancy problems?

WebMD recommends:

• Visit your doctor regularly if you have a chronic health problem, such as diabetes or high blood pressure. Also visit your dentist for regular exams and cleanings. "Having healthy teeth and gums lessens the chance of preterm birth and of having a baby with a low birth weight."
• Maintain a healthy, well-balanced diet. "Choose plenty of fruits and veggies, whole grains, beans, lean meats, and low-fat dairy products. You should eat and drink at least four servings of dairy and calcium-rich foods every day. That way you'll keep your teeth and bones healthy while your baby develops. Also be sure to include good food sources of folic acid, such as leafy green vegetables, dried beans, liver, and some citrus fruits."
• Gain the recommended amount of weight. Find out from your doctor what this is. "Gaining the appropriate amount of weight lessens the chance of your baby growing slowly and reduces the risk of preterm birth. You also lower your risk for developing pregnancy problems such as gestational diabetes and high blood pressure."
• Exercise regularly. Regular exercise will assist in allowing you to stay at a healthy pregnancy weight and reduce your stress levels.
• Stop smoking and drinking alcohol both increase the risk of your baby developing a wide range of mental and physical defects.

Will I get menopause?
Women enter menopause when they cease menstrual periods for 12 months. Most will have reached this stage when they are 52 years old. "The menopausal transition starts with varying menstrual cycle length and ends with the final menstrual period," says MedicineNet.

Once women enter menopause the function of their ovaries ceases. "Ovaries are the main source of female hormones, which control the development of female body characteristics, such as the breasts, body shape, and body hair. The hormones also regulate the menstrual cycle and pregnancy. Estrogens also protect the bone," reveals MedicineNet.

What are the symptoms?
Symptoms of menopause may include abnormal vaginal bleeding, hot flushes, mood changes, night sweats, sleep difficulties, and irritability. Treatments for menopause may include "hormone replacement therapy, although this is not for every woman. Herbal remedies for menopause may include soy foods and natural supplements. If you have bleeding after menopause, call your doctor as it may indicate a more serious problem," says WebMD.

References
Mayo Clinic: http://www.mayoclinic.com/health/cervical-cancer-vaccine/WO00120
WebMD:  http://www.webmd.com/baby/guide/pregnancy-after-35?
MedicineNet:   http://www.medicinenet.com/menopause/article.htm#what_is_menopause
http://www.webmd.com/menopause/default.htm
http://www.webmd.com/breast-cancer/guide/what-causes-breast-cancer