WOMEN'S HEALTH
AMENORRHEA
Amenorrhea is the abnormal absence of menstrual periods. Generally speaking, there are three categories of women who have experienced amenorrhea:
- Women who have never had a menstrual period by age sixteen.
- Women who have not had a period for two to three months or more.
- Women who have irregular periods that may vary from 35 to 90 days.
Determining why a woman over 16 years of age has never had a menstrual period is essential for proper treatment; identifying a reason may involve several blood hormone tests, and possibly referral to an endocrinologist. Missing periods after regular periods have begun is much more common, especially among college students. Changes in environment, diet, stress, as well as medical problems can cause variability in menstrual cycles.
If you menstruate fewer than four times per year or if you miss three consecutive periods, you need to see a health care provider. If you are sexually active, you should see a provider for a pregnancy test after one missed or late period. You should also see a provider if you notice breast/nipple discharge, or if you notice unusual facial hair or other body hair growth. Some of the factors associated with cessation of periods are:
- stress
- calorie-restricted diet
- eating disorders
- strenuous exercise
- hormone imbalance
- organic disease (e.g.. thyroid disease)
- travel
The general treatment for patients with amenorrhea is as follows:
- Rule out the possibility of pregnancy.
- Examine the patient and perform hormone or other tests as indicated.
- Prescribe a drug that stimulates a menstrual period, if appropriate.
- Consider options for long-term treatment of absent periods such as taking oral contraceptives or taking periodic courses of a progesterone medication.
OSTEOPOROSIS
Osteoporosis, which means "porous bones," is a condition of the skeleton in which the amount of calcium present in the bones slowly decreases to the point where the bones become less dense and more prone to fracture. Contrary to popular belief, it is not just a disorder of elderly woman. It can occur in the college-aged population. People with eating disorders, high performance athletes, or patients on certain medications may be at the greatest risk. Even if you have no present high risk factors, building strong bones today may prevent osteoporosis from occurring in the future.
From childhood to adulthood, bone is made faster than it is broken down and bones become larger and denser. Peak bone mass occurs by the mid 20's. The remodeling process, in which bone is broken down faster than it is made, begins to reverse as early as age 35 and results in precipitous bone loss after menopause. It is crucial that young adults "bank" enough calcium in their bones to draw on later in life to prevent osteoporosis. A person who has exceptionally dense bones to begin with will probably never lose enough calcium to reach the point where osteoporosis occurs. However, a person who has low bone density could easily develop osteoporosis despite losing only a relatively small amount of calcium.
Many factors affect the remodeling process. A deficiency of the hormone estrogen appears to increase bone loss. Intense exercise such as marathon running affects hormonal levels and may lead to osteoporosis. Severe underweight and under nutrition problems that occur in patients with eating disorders can lead to hormonal deficiencies which cause amenorrhea (absence of menstrual periods) and severe osteoporosis.
Early osteoporosis may have no symptoms. Symptoms occurring LATE in the disease include:
- Fractures of the vertebrae, wrists or hips following very minor trauma
- Low back pain
- Neck pain
- Bone pain or tenderness
- Loss of height over time (may be as much as 6 inches)
- Stooped posture ("dowager's hump")
What factors increase your risk of developing osteoporosis? For women:
- Being female (80% of osteoporosis occurs in women)
- Increasing age: after 65 about 30% of women have osteoporosis
- Being postmenopausal, either due to natural or surgical menopause (decreased estrogen)
- Estrogen deficiency due to abnormal absence of menstruation. This can occur in persons with eating disorders or high performance athletes. In fact, over half of anorexics have osteoporosis with bones resembling those of women in their 70s or 80s.
- Ethnic heritage - Caucasian and Asian women are at highest risk. Risk is lower for African American and Latino women.
- Thin, slight body frame
- Lifestyles that increase the risk of osteoporosis include cigarette smoking, excessive alcohol consumption, high caffeine use, lack of exercise and low intake of calcium and vitamin D.
- Certain medications may increase risk including steroids, excessive thyroid medications, anticoagulants, antiepileptic drugs and immunosuppressants.
- Certain metabolic diseases can cause secondary osteoporosis.
Treatment cannot eliminate osteoporosis, but medicines may be able to slow down the loss of bone. Most of the medicines available today are primarily aimed at treating osteoporosis in the postmenopausal woman. Increasing calcium intake to 1500 mg per day, increasing vitamin D to 800 IU per day and maintaining normal weight and exercise patterns to restore hormonal balance may be helpful in preventing further bone loss.
GYN EXAMS
GYN exams are an integral part of a woman's comprehensive health care. GYN exams are not only for sexually active women and are not only for heterosexual women. ALL women, regardless of their sexual orientation or their level of sexual activity, should have regular GYN exams. GYN exams allow women to maintain an up-to-date knowledge of their reproductive health, to become familiar with what is normal for their body and, in turn, to be able to identify future health problems.
Having regular GYN exams can help you:
- Prevent illness
- Detect cancers such as cervical, uterine and breast cancer at an early and potentially more treatable stage
- Detect Sexually Transmitted Diseases before they cause infertility or other damage
- Provide health care before, during, and after pregnancy
You also want to visit your medical provider for a GYN exam if you are experiencing:
- Unusual or severe abdominal, vaginal or pelvic pain
- Abnormal vaginal bleeding or discharge
- Pain or swelling or the vulva and/or vagina
- Sores, lumps or itching of the vulva and/or vagina
- Thickening, dimpling, puckering or other changes in the breasts
- Retracted nipple(s) or abnormal discharge from the nipple(s)
- Unusual or severe menstrual pain
When should I have my first GYN exam?
A woman should have her first GYN exam as soon as she becomes sexually active or when she reaches the age of 21 - whichever happens first.
How often do I need to have GYN exams?
A woman should have a GYN exam every year if she is sexually active, or over the age of 21. Hence, women often refer to it as their "annual."
Do I have to be tested for STIs?
You don't HAVE to do anything, but if you have been sexually active, your medical provider most likely will recommend that you have at least a Chlamydia STI screening. Screening should begin soon after initiation of sexual intercourse, and repeated annually. Anyone seeking STI evaluation and treatment should be screened for HIV infection. Screening should be routine, but it is voluntary, and patients should be allowed to opt-out of HIV screening.
CAN I REQUEST A FEMALE MEDICAL PROVIDER?
Yes, of course. If you are more comfortable having a female medical provider, you can make that request when you call to schedule your appointment. If there is a particular medical provider you feel the most comfortable with, you can also request that person. It is important to note that if you choose to have a male provider, you may request a female chaperone to be present during the exam, as well.
PAP SMEARS
Cervical screening for cancer with a Pap Smear should be started approximately three years after the initiation of sexual intercourse, but not later than the age of 21. Pap Smears should be repeated annually.
HUMAN PAPILLOMA VIRUS (HPV)
Human Papillomavirus is the name of a group of viruses that infect the skin. There are over 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of men and women, including the skin of the penis, vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum. Most people who become infected with HPV will not have any symptoms and will clear the infection on their own.
Some of these viruses are called "high-risk" types, and may cause abnormal Pap tests. They may also lead to cancer of the cervix, vulva, vagina, anus, or penis. Others are called "low-risk" types, and they may cause mild Pap test abnormalities or genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped.
Most women are diagnosed with HPV on the basis of abnormal Pap tests. A Pap test is the primary cancer-screening tool for cervical cancer or pre-cancerous changes in the cervix, many of which are related to HPV. No HPV tests are available for men.
There is no "cure" for HPV infection, although in most women the infection goes away on its own. The treatments provided are directed to the changes in the skin or mucous membrane caused by HPV infection, such as warts and pre-cancerous changes in the cervix. For more information, visit the HPV section of Wellness A-Z.
HUMAN PAPILLOMA VIRUS (HPV) VACCINATION
The HPV vaccine protects against four major types of HPV that can lead to precancers of the cervix, vulva and vagina, and genital warts. It is recommended for 11-12 year-old girls, as well as 13-26 year-old girls/women, who have not yet received or completed the vaccine series. Ideally, females should get the vaccine before they are sexually active. This is because the vaccine is most effective in girls/women who have not yet acquired any of the four HPV types covered by the vaccine.
Student Health Service provides the Human Papillomavirus (HPV) vaccination, GARDASIL, to Marquette students. The vaccination is delivered in three doses. Students can receive all three doses at Student Health Service, or any of the three individual doses (if they have already received a dose, or will receive future ones, from another health care provider).
To receive the HPV vaccination, call Student Health Service at (414) 288-7184 to schedule an appointment. If you have questions about your eligibility, you can call Student Health Service and ask to speak to a nurse about the vaccination, or email immunizations@marquette.edu.
Additional information about HPV/HPV vaccination:
OUTREACH PROGRAMS AND AWARENESS EVENTS
The Center for Health Education and Promotion staff (Peer Health Educators and Professional Health Education staff) offer a variety of educational and interactive
outreach programs that can be scheduled at your convenience. The outreach programs linked to this health issue are
- The Truth About Women, Inside and Out
- PMS: It's Not Your Imagination
- Breast Cancer Awareness Week (Events Calendar)
Also available is programming for body art, credit card debt, gambling awareness, and other topics. If there is something that you have an interest in but do not see it listed, please contact us and we will work together to determine what will best meet your needs.
CAMPUS SERVICES
RESOURCES
Our resource area contains brochures, articles, bulletin board packets, books, videos, and handouts on a wide variety of health related topics. If we don't have it, we will help you find it!
ONLINE RESOURCES
DOWNLOADABLE RESOURCES
