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The Yale Guide to Women’s Reproductive Health

The Yale Guide to Women’s Reproductive Health: From Menarche to Menopause

Mary Jane Minkin
Carol V. Wright
Copyright Date: 2003
Published by: Yale University Press
Pages: 464
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  • Book Info
    The Yale Guide to Women’s Reproductive Health
    Book Description:

    This book is for every woman who has wished for an unhurried, personal conversation with a sympathetic doctor who will answer her questions about reproductive health. Dr. Mary Jane Minkin, a gynecologist practicing for more than 25 years, presents a complete and up-to-date guide to a healthy reproductive system for women in their teens through middle age.With warmth and understanding, Dr. Minkin and coauthor Carol V. Wright respond to questions about the gynecological issues that concern women today, including sexual activity, contraception, and family planning. Readers ofThe Yale Guide to Women's Reproductive Healthwill learn how the female body works, what problems may arise, and what solutions are available-in short, they will become better prepared to participate in their own health care and to make healthy decisions.

    eISBN: 978-0-300-13521-3
    Subjects: Health Sciences, Public Health

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
    (pp. vii-x)
    (pp. xi-xvi)
  5. 1 Your Reproductive System and How It Works
    (pp. 1-11)

    THIS chapter describes the basics of your reproductive anatomy, tells you how it works, and explains how to keep your body in good working order throughout your life.

    The external female genital organs, collectively called the vulva, include the mons pubis, labia majora, labia minora, clitoris, urethral opening, hymen, vaginal opening, and perineum.

    The mons pubis, or mons, is a fatty pad that covers the pubic bone. The labia are two pairs of skin folds, one inside the other, that cover and protect the vagina. The outer ones, the labia majora (large lips), are derived from the same embryological tissues...

  6. 2 You and Your Gynecologist
    (pp. 12-29)

    GYNECOLOGISTS are specialists in women’s reproductive health, but internists or family practitioners, trained nurse-practitioners, and physician’s assistants are all trained in routine gynecological care. These professionals can do physical exams and tests, write prescriptions (under the supervision of a physician), treat common problems, and answer most of your questions. Gynecologists, unlike these other professionals, are trained in surgery. Throughout this book I speak from my own point of view as a gynecologist, but remember that your family doctor or your nurse-practitioner can also help you.

    You may start seeing a gynecologist because you have a problem—perhaps painful, heavy, or...

  7. 3 Menstruation: Problems and Possible Solutions
    (pp. 30-59)

    MENSTRUATION is your body’s monthly response to not being pregnant. The menstrual cycle starts every month with preparation for the release of an egg from the ovary and continues with the buildup of the uterine lining to nourish that egg if it is fertilized. If fertilization does not take place, the lining sloughs off as the menstrual flow.

    Although women differ from one another in their personal patterns of menstruation as much as they differ in other areas, there is nonetheless something called a normal menstrual cycle. While the average cycle (counting from the day bleeding begins one month to...

  8. 4 Premenstrual Syndrome
    (pp. 60-70)

    THE term “premenstrual syndrome” (PMS) describes a disease that is not entirely understood by the medical profession in general, by psychiatrists, even by women who have it. All sorts of symptoms and disorders can be lumped together under that name. The symptoms can be emotional—irritability, tearfulness, or mood swings—or physical—headaches, pelvic pain, breast tenderness, or bloating.

    Any of these symptoms can be caused by other conditions or can appear in milder form in women who do not have PMS. Many women experience sore, tender breasts. Many women get headaches from tension, hormone swings, or other causes. Many...

  9. 5 Contraceptive Choices and Responsibilities
    (pp. 71-138)

    SAFE, legal contraception has given women control over their lives as never before. If you have grown up since the 1960s, in an era when contraception has been largely a matter of personal choice, you may not realize that this freedom is relatively new and was won only after years of struggle.

    Margaret Sanger, an obstetrical nurse, saddened by the physical and social consequences of unwanted pregnancies, botched illegal abortions, and widespread sexually transmitted disease, started her crusade for birth control in the early 1900s. Defying existing laws against distributing information about birth control, she was reviled for her work,...

  10. 6 Vaginitis and Urinary Tract Infections
    (pp. 139-153)

    VAGINITIS simply means “inflammation of the vagina,” just as appendicitis simply means “inflammation of the appendix.” (Vulvovaginitis means that the vulva—the external genitals—are involved, as well as the vagina.) Vaginitis can be very uncomfortable, but it is rarely serious and can usually be treated easily and effectively.

    The three major kinds of vaginitis can be categorized by the microorganisms causing them. Yeast infections are caused by overgrowth of a microscopic fungus. Bacterial vaginosis (BV) seems to be caused by bacteria that thrive in the absence of oxygen. Trichomoniasis, discussed in Chapter 7, is caused by a single-celled amoeba-like...

  11. 7 Sexually Transmitted Diseases
    (pp. 154-193)

    SEXUALLY transmitted diseases (STDs) are almost as common as the common cold. Every year an estimated 15 million Americans contract a disease that is transmitted by intercourse or other sexual activity. Worldwide, 340 million people annually contract curable sexually transmitted infections; in addition, an estimated 5 million new cases of HIV arise each year.

    Although we like to think of STDs as happening to other people, they can appear in anyone who is sexually active, since the viruses and bacteria that cause them are blind to social and cultural distinctions. They do not discriminate according to education or economic status;...

  12. 8 Fibroids and Endometriosis
    (pp. 194-222)

    BOTH fibroids and endometriosis are fairly common conditions. It is estimated that between 20 and 30 percent of women of childbearing age have fibroids and between 10 and 20 percent have endometriosis. Some women with fibroids have no symptoms; others are made miserable. Likewise, some women with endometriosis do not know they have it, while others suffer severe pelvic pain. Although both conditions can be treated with some degree of success, neither can be prevented.

    Fibroids, lumps of fiber-like tissue that grow from the wall of the uterus, are seldom dangerous; they will not harm you. Yet they can be...

  13. 9 Cervical, Ovarian, and Endometrial Cancer
    (pp. 223-248)

    CANCER, especially breast cancer, is the disease women fear above all others. One reason I became a gynecologist is that I have a reasonable chance to heal many people. Most gynecological cancers can be detected early and have high cure rates. The most common cancers that afflict the female reproductive system, in order of frequency, are breast cancer, endometrial (uterine) cancer, cervical cancer, and ovarian cancer. Cancer of the fallopian tube does exist, but it is very rare.

    Cervical cancer, which most often afflicts women in their 30s and 40s, is a relatively rare form of cancer that...

  14. 10 Breast Health
    (pp. 249-278)
    Kristin Zarfos

    BREAST cancer is probably the disease women in the United States fear most. Although coronary artery disease is the leading killer of American women, affecting about 2.5 million and killing about 500,000 every year, breast cancer has a more fearful image. Excluding skin cancers, it is the most widespread form of cancer among women in this country and the second most lethal (after lung cancer). According to the American Cancer Society, an estimated 192,000 American women are diagnosed with breast cancer every year and 40,200 die of it. Even when it is not lethal, the consequences of this disease—the...

  15. 11 Planning for Pregnancy
    (pp. 279-297)

    DECIDING to have a baby is one of the most important decisions you will ever make. If you are like most women, you will cherish parenthood and your children will bring joy to your life, but there is no denying that having and raising children will require major adjustments from you and your partner. Ideally, pregnancy should be something you choose, not something that happens to you, for your life will change irrevocably from the moment your pregnancy test is positive.

    Kara, a medical resident at the hospital where I teach, is intelligent, competent, energetic, and highly professional. As she...

  16. 12 Fertility and Infertility
    (pp. 298-327)

    MEDICALLY speaking, infertility is the inability to conceive a child after a year of unprotected intercourse.Primary infertilityis the inability to conceive any children at all.Secondary infertilityrefers to infertility in someone who has at least one child.

    Infertility can be a significant crisis in the marriage of any couple who have assumed, individually or together, that they would be parents. Despite the astounding biological complexity of the process of conception, somehow it seems that it should be simple to achieve, because so many couples do have children (some even when they would rather not). The failure to...

  17. 13 Abortion, Miscarriage, and Ectopic Pregnancy
    (pp. 328-360)

    AS we have seen, no contraceptive is perfectly reliable even if used correctly every single time, though in theory some are more than 99 percent safe. In real life, contraception can fail because you don’t use it, or you don’t use it correctly, or the method lets you down. Unintended pregnancies, whether they come about through carelessness or method failure, can be devastating because they will alter the course of your future. Pregnancies that come about through sexual assault or incest can be unbearably painful.

    Before 1973, whenRoev.Wademade abortion legal in the United States, there were...

  18. 14 Sex and Society
    (pp. 361-377)

    A gynecologist’s practice overlaps social issues in a way that an ophthalmologist’s or a dentist’s does not. Women’s eyes and teeth do not carry the heavy symbolic moral or social meaning that their reproductive systems do. And so some of the issues that gynecologists deal with are not strictly medical. Because our society is ambivalent about sex, some of these issues are nebulous and difficult.

    This chapter covers an assortment of topics where social and sexual issues converge. I have tried to outline the main concerns of each and to suggest reasonable courses of action or offer further resources. I...

  19. 15 Lifestyle Issues
    (pp. 378-390)

    IN these times of information overload, it is easy to find out what you should do to take care of your general health and well-being. As a reminder, here are some absolutely basic, bottom-line recommendations, which you can refer to when you are tempted to become a chocoholic couch potato. Two of the most important things you can do for yourself are eat a healthy diet and get enough exercise.

    The science of nutrition is complicated, uncertain, and controversial, yet every day you must make decisions about what you are going to eat and what you are going to avoid....

  20. Afterword
    (pp. 391-394)
    M.J.M. and C.V.W

    MANY women compare their relationships with their mothers to their relationships with their daughters. We must always take care of ourselves for our own primary health, but we must also understand that we are role models for our daughters as our mothers were for us.

    Although my mother was a wonderful role model intellectually and professionally, she was hardly a healthy role model. I grew up assuming that all women wore size 18 dresses (after all, when we shopped at Loehmann’s, that was where we looked for hers), smoked a pack of Chesterfields a day, and never exercised. And even...

    (pp. 395-411)
    (pp. 412-432)
  23. INDEX
    (pp. 433-448)