Sorry for the late blog. It took a bit of time for this blog. We all are seeing the deadly impact of the second wave of COVID 19, on all aspects of our lives and now we are also worried about vaccination and the third wave. But among all this one thing is true that approach towards personal fitness has changed a lot.
We are now more concerned to keep ourselves fit and healthy. But it is not a one-day job, It has to be earned over a period of time. So I thought to put some focus on the long-term planning of health. We generally pay attention to illness in the acute phase and then forget about it once better.
Women are endowed with natural tendency to’’ BE THE NURTURER”.
To stand strong, against any difficult situation is a natural instinct of a woman. In the womb also when conditions are not favorable it is always, the female embryo that battles strongly against the male embryo. It is the women who carry the strong foundation across the generations, But when things come to pay attention to their own health, all women generally have a tendency to put themselves last.
So, to build healthy generations ahead nurture should have both a healthy body and mind. The sustainable long-term effects come over a period of time and with timely intervention. Be it any organization, project, or health.
Adopting a” LIFE COURSE APPROACH “ provides an insight into the impact of various biological, behavioral, psychological, and social determinants on health and well-being.
Not only do events occurring at each stage of an individual woman’s life have an impact on the quality of the next stage, but there is clear evidence of a strong intergenerational transmission of both good and bad health behaviors and outcomes.
What is the Life-course approach? In simpler and more practical terms it focuses on early intervention to reduce disease risk and severity in later life. At the most general level, for example, it includes stopping smoking to reduce the risk of cardiovascular disease and cancer.
However, the life course approach outlined here goes beyond general health promotion to those aspects of sexual and reproductive health (SRH) that have particular implications for women’s future health and, through pregnancy, the health of the next generation. In contrast to sporadic disease episodes, women have reproductive and sexual health needs that unfold across their life courses.
There are three key stages in a woman’s life course:
Adolescents and young adults( puberty to 25 years)
This is a very important stage in the female life course with the onset of menstruation, sexual activity, and fertility. Nowadays we are seeing an increase in smoking, alcohol, and drug abuse in teenage girls. Losing virginity at an early age and multiple sexual partners make them at high risk for developing sexually transmitted infections and cervical cancer. High-quality relationship and sex education (RSE) delivered at
school and supported by parents about what to expect, how to deal with problems that may develop
and how they can be resolved is the key.
Middle and reproductive years (25-50 years)
In addition to the ongoing need for contraception and promoting healthy lifestyle advice, many women
will require specific help to manage menstrual disorders such as heavy bleeding and pelvic pain and
Later years( 51+ years)
Historically, this stage of a woman’s life course has received little attention and many women find themselves without support from health care services until they present with an acute episode or medical problem.
Now let's see what exactly we can do to avoid future complications. Screening and immunization are classic examples of health interventions that fit the life-course model. More specifically, screening for cervical dysplasia and genital chlamydia infection both illustrate a life-course approach to women’s health aimed at preventing cervical cancer and pelvic inflammatory disease (leading to ectopic pregnancy and infertility) respectively.
HPV vaccination for adolescent girls before they become sexually active prevents most cases of cervical cancer. It is given between 9-11 yrs age group and consists of 2 doses six months apart. If given after 15 yrs needs three doses. Even after receiving a vaccine pap smear screening is essential for the early detection of cervical cancer.
Every woman after the age of 25 years is advised pap smear screening. It has to be repeated every 3 years or before depending on previous reports.
The examples above of protecting sexual health across the life-course to prevent
cancer, ectopic pregnancy, and infertility are relevant to all sexually active women regardless of whether or not they go through pregnancy.
A growing number of older women are now seeking assisted conception as their fertility declines with age. Interventions around the time of conception that target the baby’s health have long been recommended, with folic acid supplementation to prevent neural tube defects being one of the best-known examples. Some women will require specialist advice for medical disorders that may be exacerbated by pregnancy.
Preconception counseling offers the opportunity to discuss preconception health interventions such as diet, physical activity, contraception, healthy sexual relationships, folic acid intake, avoiding smoking, sexually transmitted infections (STIs), excess alcohol, and obesity. These are all fundamentals of good pre-conception care but are all too often missed until a woman presents in pregnancy.
‘Life-course interventions’ in the antenatal period can target the future health of the mother, or the child, or both. For example, women who develop diabetes in pregnancy (gestational diabetes) have a much higher risk of developing type 2 diabetes in the years following their pregnancy even if their blood sugar returns to normal just after delivery; two out of every five women with gestational diabetes will have type 2 diabetes within 5 years. Furthermore, babies born to mothers with gestational diabetes have significantly higher birth weight, which is associated with an increased risk of childhood obesity and diabetes. Gestational diabetes has been called a disease of two generations. Here is an important role of annual check up after delivery to detect type 2 diabetes mellitus at the earliest. Early treatment and lifestyle modification can prevent future cardiovascular and renal complications. A similar situation pertains to women found to have raised blood pressure in pregnancy or pre-eclampsia: these women are at much higher risk of hypertension and heart disease in later life. It is crucial for all women to undergo a health check following pregnancy to ensure that future pregnancy complications and preventable health problems in later life are avoided.
The next stage of middle and late adulthood requires a reconsideration of biological, behavioral, and psychosocial factors. Because there is a change in every aspect including body and hormonal status. Managing the transition from perimenopause to menopause including treatment of symptoms where appropriate, provides further opportunities to promote healthy lifestyles and decrease the likelihood of the early onset of chronic diseases such as osteoporosis, cardiovascular disease, frailty, and dementia. Symptoms such as hot flashes, vaginal dryness, adverse mood can be very bothersome for some ladies. Pap smear screening and mammography will give us the opportunity to intervene early in the course of cervical and breast cancer.
In conclusion, these few examples illustrate the impact of interventions designed to improve women’s health across the life course. Interventions may differ according to the target population.
Here are TOP FIVE interventions
HPV vaccination- all girls aged 11-12 years.
Preconception counseling - all women preparing for pregnancy. Such interventions may be intended to benefit women’s future health, their child’s, or both.
Screening and early treatment - high-risk subgroups of pregnant women. Those who are at risk of developing diseases such as diabetes, hypertension, and related complications in later life.
Diagnosis and management – perimenopausal and menopausal symptoms including mental health.
screening for cervical and breast cancer. Pap smear in all women after age 25 to detect cervical cancer and mammography after age 40 for breast cancer.
During every woman’s life, there are opportunities to help her improve her physical and mental health and wellbeing. We need to learn, grab these opportunities, and utilize them to the fullest.
“’I HAVE GATHERED STRENGTH BEHIND MY YEARS, I OWNED THEM, I HAVE EARNED THEM, I HAVE DESERVED THEM, I HAVE A RIGHT TO HAVE THEM” - SALLY FIELD
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Stay Safe Stay Healthy.