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Being women and the importance of health

Being women and the importance of health

Girls and women face a gamut of health issues unique to them. Moreover, gender disparities, poverty, domestic violence and sexual abuse put them at a further disadvantage while accessing healthcare facilities

What comes to mind when we talk about women’s health? A female enjoying complete physical, mental and social well-being and not merely the absence of disease or infirmity, as defined by the World Health Organization (WHO). The same logic applies to men too.

According to the United Nations (UN), there were an estimated 3,970 million males in the world (50.42 per cent of the overall population) and 3,905 million females (49.58 per cent of the world population) in 2021.

Ignoring women’s health also means ignoring the well-being of their families, communities and, in the larger context, their nations
Photo by Anantha Subramanyam K / Happiest Health

Surely, the importance of women’s health can’t be stressed enough. Further, as the popular saying goes, “Healthy women, healthy world.”

Ignoring women’s health also means ignoring the well-being of their families, communities and, in the larger context, their nations — because all these aspects are interconnected.

Dr Malavika Dikshit Chaturvedi, an obstetrician and gynecologist from Lucknow, Uttar Pradesh, told Happiest Health that a woman is the backbone of her family (at least in the Indian context), the smallest unit of society. “If the woman of the house is ill or indisposed then the whole family is often at odds,” she said. “Even if others are there to help, nobody can replace a woman/mother, as she often seamlessly manages her house. She is the one who keeps all the limbs united and working together in the house.

“Most importantly, as a species or race we will cease to exist if there are ill, fewer or no women around. God has chosen women to bear children and advance the human species.”

Tussle between women’s health and work

No discussion on the health of the female population can be complete without discussing the root causes of the problems that they face on a day-to-day basis. All these factors have a direct impact on their health and treatment. There is no denying that women’s health is not a priority area, say health experts and women rights activists.

Chennai-based gynaecologist and obstetrician Dr Akhila Sangeetha Bhat U told Happiest Health that women’s health has been neglected in India and across the world for a long time. “No matter how much we say we are a free society and we respect women, somewhere the ‘weaker section’ has been troubled,” she said. “No matter how much women are educated, they have to take care of their families, children (being mothers); they have to work outside (if they have a job) and still they are expected to do everything at home. It is really difficult, and it takes a mental and physical toll on women.”

When Happiest Health asked about the role of government bodies in facilitating a conducive environment to help women focus on their health, Dr Bhat, who is a senior consultant at AK Meds, Kilpauk, Chennai, said it’s not their responsibility. “It has to happen at a personal level,” she said. “It will take time but slowly things are changing.”

Myriad and unique women’s health issues

Women and girls not only face a gamut of health issues unique to them, but gender disparities, poverty, malnutrition, illiteracy, domestic violence and sexual abuse also put them at a disadvantage compared with their male counterparts while accessing healthcare facilities.

The WHO says sociocultural factors like unequal power relationships between men and women, lack of access to education and employment opportunities, focus on women’s reproductive roles and physical, sexual and emotional violence prevent women and girls from benefiting from quality health services and attaining the best possible level of health.

Surprisingly, poverty is an equalizer because of which both men and women face health issues arising primarily because of malnutrition and lack of a hygienic environment and sanitation facilities. Simultaneously, they have no financial means to access available healthcare facilities.

Same, yet different

Men and women are different anatomically: the symptoms and treatments of many diseases and conditions in them are different because of biological and genetic reasons. Experts say the presence of several hormones and chemicals – especially, androgens and estrogens — in different quantity makes all the difference in males and females.

While female bodies produce greater amounts of estrogens, male bodies produce greater amounts of androgens. However, both these hormones are present in males and females.

Estrogens help in the sexual and reproductive development of females. They also define the menstrual cycle of women during their childbearing years.

Androgens, the group sex hormones, controls menstruation, helps in conception and pregnancy, reduces chances of osteoporosis or bone loss and determines pubic and underarm hair growth in females.

Beyond sexual and reproductive health

While the sexual and reproductive health of women does get discussed and addressed to an extent, conditions such as cardiovascular diseases are not easily associated with women.

“Cardiovascular diseases like heart disease and stroke in women remain understudied, under-recognized, underdiagnosed and undertreated,” according to ‘The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030’, a report published in 2021.

According to the 2019 Global Burden of Disease study, there are approximately 275 million women around the world with cardiovascular diseases, with global age-standardized prevalence estimated at 6,402 cases per 100,000. Ischemic heart disease (47 per cent of cardiovascular diseases deaths) and stroke (36 per cent of cardiovascular diseases deaths) are the leading causes of death in women across the globe.

“As far as cardiovascular diseases go, estrogen hormone protects women from cardiovascular diseases to a large extent in their reproductive age (15-45 years),” says Dr Chaturvedi, who runs her own clinic at Aliganj, Lucknow. “After menopause, the protective effect of estrogen generally wears off and that is when women start getting high blood pressure and other cardiovascular diseases. Once the cardioprotective effects of estrogen wear off, then women are as susceptible to cardiovascular diseases as men are.”

Likewise, 40 per cent of pregnant women are anaemic, around 810 women die every day from preventable causes related to pregnancy and childbirth, 2,95,000 women died of maternal and reproductive related causes in 2017 and 3,11,000 women died in 2018 from cervical cancer (more than 85 per cent of these occurring in low-and middle-income countries).

Common women’s health issues

The US-based research organization Eunice Kennedy Shriver National Institute of Child Health and Human Development has identified the following women-related health issues and conditions:

  • Gynaecological health and issues like menstruation and irregular menstrual cycle, urinary tract health, bacterial vaginosis, vaginitis, uterine fibroids and vulvodynia
  • Pregnancy-related subjects like pre-pregnancy care and prenatal care, miscarriage, stillbirth, birth defects and breastfeeding
  • Infertility-related issues like uterine fibroids, polycystic ovary syndrome, endometriosis and primary ovarian insufficiency
  • Turner syndrome, Rett syndrome and breast, ovarian and cervical cancers are health problems exclusive to women only
  • Violence against women is as much a health issue as it is a law-and-order problem. So are the issues faced by women with disabilities. Osteoporosis, bone health and menopause are problems that concern women in a big way

Dr Flavia Bustreo, advocate for health of women, children and elderly and former assistant director-general, family, women’s and children’s health, WHO, lists the top ten issues related to women’s health:

  • Cancer (breast and cervical cancer since they are the most common ones among women)
  • Reproductive and sexual health, including access to contraception services
  • Maternal health (from pregnancy to childbirth)
  • HIV (many women are still at risk of sexually transmitted diseases because of lack of access to contraception, taboo surrounding sex, lack of sex education right from homes to schools)
  • Sexually transmitted infections like gonorrhoea, chlamydia and syphilis
  • Violence against women
  • Mental health (depression, OSD, suicide and anxiety)
  • Non-communicable diseases like obesity, accidents and tobacco, alcohol and drug abuse
  • Issues of adolescents, like sexual and reproductive issues and teen pregnancy
  • Health issues like menopause and the emotional well-being of older women

In 2021, the WHO, unhappy over global statistics on women and health, called for six steps to be taken to address the problem:

  • Address gender inequality in the COVID-19 response and recovery
  • Elevate the position of women in the health and care workforce
  • Prevent and respond to violence against women
  • Ensure quality sexual and reproductive health for all
  • Reduce non-communicable diseases among women
  • Increase women’s participation and leadership in science and public health

How to gift good health to women

The 2016 study ‘Women’s health: a new global agenda’, published by BMJ Global Health, an online journal on global health and research, said “the global agenda for the health of women needs to be redefined and broadened.”

“Yes, it is the need of the hour,” said Dr Archana Verma, vice-president of the Federation of Obstetric and Gynaecological Societies of India (FOGSI). “First, we need to understand women’s physical and mental health. We need to create awareness among the general public about the needs and gaps in achieving good health for women. It is a vast topic and needs time. We need research specific to women’s health. We need data to understand and analyse every specific health issue faced by women. Then we can have governmental policies to address, treat and minimize health risks faced by women.”

The FOGSI is a professional organization representing practitioners of obstetrics and gynaecology in the country.

Misinformation galore

Doctors say ignorance and misinformation are big hindrances in providing accurate and necessary healthcare facilities to women. “The amount of misinformation is enormous, even among urban teenagers and women,” said Dr Chaturvedi, who has practised medicine for about three decades. “Basically, they lack knowledge. People would go to the chemist shops and ask for medicines. People don’t even ask about the side effects of the medicines. Unfortunately, they do not even respect their own body.”

Dr Chaturvedi said once women cross the reproductive age, they generally stop paying attention to their health. “I am talking about urban women who are educated and well-versed in worldly affairs,” she said. “Why can’t they take charge of their own health? We can’t depend on anyone to take care of our health.”

Dr Chaturvedi said she had noticed disproportionate attention been given to women’s cosmetic issues rather than other health concerns. “Concern for cometic issues is far more than cardiovascular diseases, neurological diseases or bone health,” she said. “Women are concerned about their age spots rather than the pain all over their body and creaking joints. The priority often seemed to be skewed among urban women.

“Once a woman crosses her reproductive age, her bone health goes downhill very rapidly. I advise every woman above 35-40 years to take calcium supplementation on a regular basis and vitamin D supplementation as indicated after blood test and a doctor’s visit.”

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