Of near miss events, obstetrical fistulae (OF), including vesicovaginal and rectovaginal fistulae, remain one of the most serious and tragic. Although corrective surgery is possible it is often not available and OF is considered completely preventable. If repaired, subsequent pregnancies will require cesarian section.[53] While unusual in developed countries, it is estimated that up to 100,000 cases occur every year in the world, and that about 2 million women are currently living with this condition, with the highest incidence occurring in Africa and parts of Asia.[39][53][54] OF results from prolonged obstructed labor without intervention, when continued pressure from the fetus in the birth canal restricts blood supply to the surrounding tissues, with eventual fetal death, necrosis and expulsion. The damaged pelvic organs then develop a connection (fistula) allowing urine or feces, or both, to be discharged through the vagina with associated urinary and fecal incontinence, vaginal stenosis, nerve damage and infertility. Severe social and mental consequences are also likely to follow, with shunning of the women. Aprt from lack of access to care, causes include young age, and malnourishment.[11][55][53] The UNFPA has made prevention of OF a priority and is the lead agency in the Campaign to End Fistula, which issues annual reports[56] and the United Nations observes May 23 as the International Day to End Obstetric Fistula every year.[57] Prevention includes discouraging teenage pregnancy and child marriage, adeaquate nutrition, and access to skilled care, including caesarian section.[11]
Dairy. Women should get 3 cups of dairy each day, but most women get only half that amount.6 If you can’t drink milk, try to eat low-fat plain yogurt or low-fat cheese. Dairy products are among the best food sources of the mineral calcium, but some vegetables such as kale and broccoli also have calcium, as do some fortified foods such as fortified soymilk, fortified cereals, and many fruit juices. Most girls ages 9 to 18 and women older than 50 need more calcium for good bone health.
SOURCES: Elaine Turner, PhD, RD, associate professor, department of Food Science and Human Nutrition, University of Florida, Gainesville. Sharon B. Spalding, MEd, CSCS, professor, physical education and health; and associate director, Virginia Women's Institute for Leadership, Mary Baldwin College Staunton, Va. American Dietetic Association web site. Institute of Medicine at the National Academies web site.
All of the identified studies focused on LNSs for pregnant and lactating women through antenatal care–based and –affiliated delivery platforms (97–101). These studies relied on antenatal care to recruit mothers but delivered the intervention through home visits. There was no evidence evaluating use of LNSs for women who were not pregnant or lactating. The majority of studies evaluating LNS interventions involved children with severe or moderate acute malnutrition. Although LNS supplementation could be an intervention to provide essential nutrients to women and girls, it is expensive. Filling energy gaps using local foods or other commodities can often be done at a lower cost (97). LNS supplementation should be limited to contexts in which cheaper, more sustainable solutions are not available.
Social protection programs typically target the most marginalized members of communities and typically families with children (5, 196). Cash transfers are often targeted to women in these households because they more often invest the transfers in household and food expenditures than men do (192, 202, 204, 205). Cash transfer programs were also targeted to older adults through government-coordinated programs (196, 198, 206). The delivery of transfers involved community centers (town halls, post offices) and banks, as well as locations associated with other services, e.g., schools or health centers (192, 206, 207). These latter platforms were relevant not only for the distribution of social protection programs (i.e., the receipt of transfers), but also for enrollment in and “conditions” of those programs. Conditional transfers required that recipients had access to certain delivery platforms (e.g., schools and health centers) in order to meet the “conditions” of their transfer, and this was a limitation in very rural areas. Although social protection programs are intended for the most vulnerable populations, their delivery platforms can serve as barriers to individuals’ receipt of services, particularly if they require engagement with health care, school, or work-related systems.

Nutrition education interventions were often implemented in conjunction with other programs, and it was difficult to identify the effects of nutrition education alone. In addition, many studies reported on one-on-one counseling and group education, and it was not possible to differentiate the impact. The effects of nutrition education were often greater when combined with other resource-based interventions, such as micronutrient supplementation (31, 32), home gardening (28), food supplementation (33), and water provision (22). For nutrition education programs targeting mothers, those who were more educated or of higher socioeconomic status more often translated the intervention to nutritional outcomes (33). This suggests that the effectiveness of nutrition education might relate to individuals’ ability to access resources and implement information received.
  Schools (“condition” and delivery platform)  ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets  ↑ knowledge about health and nutrition, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control HH resources  ↑ knowledge about health and nutrition, ↑ HH food security, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control over resources  ↑ knowledge about health, NC hypertension, ↓ missed meals, ↑ health care utilization 
Women's menstrual cycles, the approximately monthly cycle of changes in the reproductive system, can pose significant challenges for women in their reproductive years (the early teens to about 50 years of age). These include the physiological changes that can effect physical and mental health, symptoms of ovulation and the regular shedding of the inner lining of the uterus (endometrium) accompanied by vaginal bleeding (menses or menstruation). The onset of menstruation (menarche) may be alarming to unprepared girls and mistaken for illness. Menstruation can place undue burdens on women in terms of their ability to participate in activities, and access to menstrual aids such as tampons and "sanitary pads". This is particularly acute amongst poorer socioeconomic groups where they may represent a financial burden and in developing countries where menstruation can be an impediment to a girl's education.[113]
Most vegetarians eat milk products and eggs, and as a group, these lacto-ovo-vegetarians enjoy good health. A healthful vegetarian diet falls within the food pyramid guidelines offered by the USDA. However, meat, fish and poultry are major sources of iron, zinc and B vitamins, so pay special attention to these nutrients. Vegans (those who eat only plant-based food) should consult a health care professional about adding vitamin and mineral supplements; make sure you consume sufficient quantities of protein, vitamin B12, vitamin D and calcium.
As the table above shows, some of the best sources of calcium are dairy products. However, dairy products such as whole milk, cheese, and yogurt also tend to contain high levels of saturated fat. The USDA recommends limiting your saturated fat intake to no more than 10% of your daily calories, meaning you can enjoy whole milk dairy in moderation and opt for no- or low-fat dairy products when possible. Just be aware that reduced fat dairy products often contain lots of added sugar, which can have negative effects on both your health and waistline.

Women have traditionally been disadvantaged in terms of economic and social status and power, which in turn reduces their access to the necessities of life including health care. Despite recent improvements in western nations, women remain disadvantaged with respect to men.[6] The gender gap in health is even more acute in developing countries where women are relatively more disadvantaged. In addition to gender inequity, there remain specific disease processes uniquely associated with being a woman which create specific challenges in both prevention and health care.[18]
In 2013 about 289,000 women (800 per day) in the world died due to pregnancy-related causes, with large differences between developed and developing countries.[11][37] Maternal mortality in western nations had been steadily falling, and forms the subject of annual reports and reviews.[38] Yet, between 1987 and 2011, maternal mortality in the United States rose from 7.2 to 17.8 deaths per 100,000 live births, this is reflected in the Maternal Mortality Ratio (MMR).[38] By contrast rates as high as 1,000 per birth are reported in the rest of the world,[11] with the highest rates in Sub-Saharan Africa and South Asia, which account for 86% of such deaths.[39][37] These deaths are rarely investigated, yet the World Health Organization considers that 99% of these deaths, the majority of which occur within 24 hours of childbirth, are preventable if the appropriate infrastructure, training, and facilities were in place.[40][37] In these resource-poor countries, maternal health is further eroded by poverty and adverse economic factors which impact the roads, health care facilities, equipment and supplies in addition to limited skilled personnel. Other problems include cultural attitudes towards sexuality, contraception, child marriage, home birth and the ability to recognise medical emergencies. The direct causes of these maternal deaths are hemorrhage, eclampsia, obstructed labor, sepsis and unskilled abortion. In addition malaria and AIDS complicate pregnancy. In the period 2003–2009 hemorrhage was the leading cause of death, accounting for 27% of deaths in developing countries and 16% in developed countries.[41][42]
Just like trying to find a guy who meets certain exact standards, trying to reach an exact weight is a lofty—and often unattainable—goal. Having a range, such as losing five to 10 pounds, may lead to a more successful outcome than if you aim to lose precisely 8 pounds in four weeks, according to a study published in the Journal of Consumer Research. Flexible goals seem more feasible, which in turn boosts your sense of accomplishment, encouraging you to stay driven, the study authors say.
Income-generation interventions largely target adult women (women of reproductive age, women with young children, and older women). Many microfinance and loan programs are targeted to women because of their likelihood to pay back the loans, although women with lower education levels and smaller businesses do not benefit to the same degree as women who are educated or who have bigger businesses (165). There was limited evidence of such interventions targeting adolescent girls (169). In order to understand the potential impact of income-generating activities on adolescents, more information is needed about the pathways by which adolescents contribute to their own food security, the degree to which they rely on their caregivers to meet their nutritional needs, and how those dynamics change with the age of adolescents (169). Training, workshops, and extension activities were often delivered through community centers, community groups, and financial institutions (165). Other affiliated interventions, such as agricultural extension and nutrition education, were provided at the community level and at home visits (160, 173). These delivery platforms were effective at reaching women, including low-income women, particularly when they engaged with existing community groups (e.g., self-help, farmers’, and women's groups) (160, 161, 167, 169, 172, 173).
Although there is evidence that interventions can address widespread malnutrition among women, there is a lack of operational research and programs to tackle the issue. There is an imperative for the nutrition community to look beyond maternal nutrition and to address women's nutrition across their lives (3). How we reach women matters, and different delivery platforms are more appropriate for some women than others. Delivery platforms for reaching young mothers are different from those for adolescents and postmenopausal women. There is a need to intentionally consider strategies that appropriately target and deliver interventions to all women. This means that nutrition researchers and practitioners need to further adapt existing strategies and modes of delivery to adequately engage women who might not be in clinic settings (78). This also requires that researchers and practitioners explore how to deliver nutrition interventions to women and at different stages of life in order to reduce inequities in the delivery of nutrition services and to reach women missed by programs focusing on maternal nutrition alone.
When layering for an outdoor activity this winter, consider a compression fabric for your base layers. “These fabrics are fantastic at wicking moisture from the body, which allows you to sweat and breath while keeping you warm,” says Chiplin, who notes they can also reduce fatigue and muscle soreness so you’re ready to head out again tomorrow. Consider throwing them in the dryer for a minute before dressing to further chase away the morning chill. 

  Community centers (including banks, town halls, post offices)    ↑ knowledge about health and nutrition, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ intake of MN (except for heme-Fe), ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ weight gain (greater among high BMI), ↑ participation in social networks, ↑ self-confidence, ↑ control over resources  ↑ knowledge about health and nutrition, ↑ HH food security, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control over resources, ↑ ANC coverage  ↑ knowledge about health, NC hypertension, ↓/NC missed meals, NC food sufficiency, ↑ health care utilization 
Something else to remember: an estimated 90 to 95 percent of dieters who lose weight regain all or part of it within five years, and the consequences can be even worse than simply being overweight. Those who exercise regularly as part of a weight loss diet and maintenance program are more likely to keep the weight off. Also note that an overly restrictive diet can lead to more overeating, a natural reaction to food deprivation.
The U.S. Department of Agriculture's (USDA) food pyramid system (www.mypyramid.gov) provides a good start by recommending that the bulk of your diet come from the grain group—this includes bread, cereal, rice and pasta— the vegetable group; and the fruit group. Select smaller amounts of foods from the milk group and the meat and beans group. Eat few—if any—foods that are high in fat and sugars and low in nutrients. The amount of food you should consume depends on your sex, age and level of activity.

According to researchers who recently reviewed the risks associated with coronary heart disease (CHD) in women, a poor diet was linked to 20 percent of all cases of heart disease. Factor in diet’s effect on other chronic diseases like diabetes and osteoporosis, and it’s obvious that good nutrition has huge women's health benefits. One way to immediately turn your health situation around is through the foods you choose to eat. Here are nine foods that you'll want to make part of your daily diet.
It sounds counterintuitive, but fatty fish are actually good for you because they deliver omega-3 polyunsaturated fatty acids (PUFAs), fats with cardiovascular and anti-inflammatory benefits. While fish oil capsules will help you meet your PUFA needs, studies have found that fish itself offers even more nutritional benefits, including vitamin D, selenium, and antioxidants. Among the best choices are salmon, albacore tuna, herring, and trout. Recommendations are for 1 gram of PUFAs daily for people with coronary heart disease and at least 250 to 500 mg daily for those who want to prevent it.

Women with ovaries but no uterus may be able to use a gestational carrier. This may also be an option for women who shouldn't become pregnant because of a serious health problem. In this case, a woman uses her own egg. It is fertilized by the man's sperm and the embryo is placed inside the carrier's uterus. The carrier will not be related to the baby and gives him or her to the parents at birth.

Breast cancer is the second most common cancer in the world and the most common among women. It is also among the ten most common chronic diseases of women, and a substantial contributor to loss of quality of life (Gronowski and Schindler, Table IV).[6] Globally, it accounts for 25% of all cancers. In 2016, breast cancer is the most common cancer diagnosed among women in both developed and developing countries, accounting for nearly 30% of all cases, and worldwide accounts for one and a half million cases and over half a million deaths, being the fifth most common cause of cancer death overall and the second in developed regions. Geographic variation in incidence is the opposite of that of cervical cancer, being highest in Northern America and lowest in Eastern and Middle Africa, but mortality rates are relatively constant, resulting in a wide variance in case mortality, ranging from 25% in developed regions to 37% in developing regions, and with 62% of deaths occurring in developing countries.[17][122]
It sounds counterintuitive, but fatty fish are actually good for you because they deliver omega-3 polyunsaturated fatty acids (PUFAs), fats with cardiovascular and anti-inflammatory benefits. While fish oil capsules will help you meet your PUFA needs, studies have found that fish itself offers even more nutritional benefits, including vitamin D, selenium, and antioxidants. Among the best choices are salmon, albacore tuna, herring, and trout. Recommendations are for 1 gram of PUFAs daily for people with coronary heart disease and at least 250 to 500 mg daily for those who want to prevent it.
Anaemia is a major global health problem for women.[132] Women are affected more than men, in which up to 30% of women being found to be anaemic and 42% of pregnant women. Anaemia is linked to a number of adverse health outcomes including a poor pregnancy outcome and impaired cognitive function (decreased concentration and attention).[133] The main cause of anaemia is iron deficiency. In United States women iron deficiency anaemia (IDA) affects 37% of pregnant women, but globally the prevalence is as high as 80%. IDA starts in adolescence, from excess menstrual blood loss, compounded by the increased demand for iron in growth and suboptimal dietary intake. In the adult woman, pregnancy leads to further iron depletion.[6]
Vitamin D: Over the past decade, dozens of studies have revealed many important roles for vitamin D, the nutrient that skin cells produce when they are exposed to sunlight. The recommended daily intake of Vitamin D is 600 IU per day, although recommended levels are under review. If you avoid the sun or live in the northern half of the U.S., ask your doctor whether your vitamin D level should be tested.
Although there is evidence that interventions can address widespread malnutrition among women, there is a lack of operational research and programs to tackle the issue. There is an imperative for the nutrition community to look beyond maternal nutrition and to address women's nutrition across their lives (3). How we reach women matters, and different delivery platforms are more appropriate for some women than others. Delivery platforms for reaching young mothers are different from those for adolescents and postmenopausal women. There is a need to intentionally consider strategies that appropriately target and deliver interventions to all women. This means that nutrition researchers and practitioners need to further adapt existing strategies and modes of delivery to adequately engage women who might not be in clinic settings (78). This also requires that researchers and practitioners explore how to deliver nutrition interventions to women and at different stages of life in order to reduce inequities in the delivery of nutrition services and to reach women missed by programs focusing on maternal nutrition alone.
UN Women believe that violence against women "is rooted in gender-based discrimination and social norms and gender stereotypes that perpetuate such violence", and advocate moving from supporting victims to prevention, through addressing root and structural causes. They recommend programmes that start early in life and are directed towards both genders to promote respect and equality, an area often overlooked in public policy. This strategy, which involves broad educational and cultural change, also involves implementing the recommendations of the 57th session of the UN Commission on the Status of Women[146] (2013).[147][148][149] To that end the 2014 UN International Day of the Girl Child was dedicated to ending the cycle of violence.[112] In 2016, the World Health Assembly also adopted a plan of action to combat violence against women, globally.[150]
In vitro fertilization (IVF) means fertilization outside of the body. IVF is the most effective ART. It is often used when a woman's fallopian tubes are blocked or when a man produces too few sperm. Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs. Once mature, the eggs are removed from the woman. They are put in a dish in the lab along with the man's sperm for fertilization. After 3 to 5 days, healthy embryos are implanted in the woman's uterus.

Calcium: “Getting enough calcium is important for all ages, but it's particularly important during adolescence and early adulthood, when bones are absorbing calcium,” says Heather Schwartz, MS, RD, a medical nutrition therapist at Stanford University Hospital and Clinics. Calcium and vitamin D are often paired in fortified foods such as milk. The reason: The body needs D in order to absorb calcium.
For some simple suggestions about eating a healthy, balanced diet, check out the "New American Plate Concept" from the American Institute for Cancer Research. This concept suggests you fill your plate with two-thirds or more of vegetables, fruits, whole grains or beans and only one-third or less of animal protein. This simple principle can guide you toward healthier eating. For more details, visit http://www.aicr.org/site/PageServer?pagename=reduce_diet_new_american_plate.

Osteoporosis ranks sixth amongst chronic diseases of women in the United States, with an overall prevalence of 18%, and a much higher rate involving the femur, neck or lumbar spine amongst women (16%) than men (4%), over the age of 50 (Gronowski and Schindler, Table IV).[6][7][128] Osteoporosis is a risk factor for bone fracture and about 20% of senior citizens who sustain a hip fracture die within a year.[6] [129] The gender gap is largely the result of the reduction of estrogen levels in women following the menopause. Hormone Replacement Therapy (HRT) has been shown to reduce this risk by 25–30%,[130] and was a common reason for prescribing it during the 1980s and 1990s. However the Women's Health Initiative (WHI) study that demonstrated that the risks of HRT outweighed the benefits[131] has since led to a decline in HRT usage.
The U.S. Public Health Service recommends that all women of childbearing age consume 400 mcg of folic acid (a B vitamin) daily to reduce their risk of having a pregnancy affected with spina bifida or other neural-tube defects. Women who are actively trying to get pregnant should consume 600 mcg, and lactating women should consumer 500 mcg. Women of childbearing age should also take care to meet the daily requirements for calcium, fiber, iron, protein and vitamin D. Discuss supplements with a health care professional, however. Iron and vitamin D in particular can be dangerous in high amounts.
Our findings identified gaps and limitations in the evaluation, scope, targeting, and delivery platforms of nutrition interventions in low- and middle-income countries. First, the monitoring and evaluation of nutrition programs that reported on women's nutrition outcomes was generally inadequate. Many of the studies we identified included small-scale efficacy trials. Although there were many large-scale programs that targeted women and adolescent girls with nutrition-specific and nutrition-sensitive approaches, they lacked rigorous evaluation. Whether the evidence about women's outcomes was limited because they are not systematically measured or because they are not well reported is not clear. Negative results are often not published, and many evaluations of nutrition interventions that are conducted by the same groups responsible for implementing them are typically presented positively. This may have also skewed our findings. More intentional research-quality program evaluation, including of large-scale programs, would provide a stronger evidence base. Of the studies identified in this review, many reported on short-term findings such as changes in knowledge, dietary behaviors, and program coverage. They were limited in their ability to report clinical and anthropometric outcomes for women, the duration of those outcomes, and the feasibility of scaling up programs. There is also a need for systematic, long-term evaluations of interventions whose effects on nutrition outcomes are more distal (e.g., nutrition education compared with micronutrient supplementation). The effects of multisectoral interventions are even more complex to measure. However, frameworks exist to evaluate complex interventions (102) and could be utilized to evaluate the impact of interventions across the life course.

Grains, vegetables and fruits are essential to getting the vitamins, minerals, complex carbohydrates (starch and dietary fiber) and other nutrients you need to sustain good health. Some of these nutrients may even reduce your risk of certain kinds of cancer. But experts say we rarely eat enough of these foods. To make matters worse, we also eat too much of unhealthy types of food, including fat (and cholesterol), sugar and salt.
Educational interventions most often targeted school-age children and adolescent girls, and there were few examples of programs targeting women of reproductive age (174). The majority of education interventions were delivered in formal school-based settings (174). However, this is a “selective” delivery platform given that not all adolescents attend schools (193). School fees and distance to school are major barriers to school enrollment (174, 194). Educational interventions need to be sensitive to the reasons why girls are not in school, e.g., work, and to the hours and locations that might make education interventions more accessible (193). Nonformal education, alternative education, mobile schools, and literacy programs can target women and girls not in school, although these approaches were less common and not as well evaluated (174). Interventions that target girls who are no longer in school provide valuable examples about how such interventions could be delivered to hard-to-reach groups (182).
The U.S. Public Health Service recommends that all women of childbearing age consume 400 mcg of folic acid (a B vitamin) daily to reduce their risk of having a pregnancy affected with spina bifida or other neural-tube defects. Women who are actively trying to get pregnant should consume 600 mcg, and lactating women should consumer 500 mcg. Women of childbearing age should also take care to meet the daily requirements for calcium, fiber, iron, protein and vitamin D. Discuss supplements with a health care professional, however. Iron and vitamin D in particular can be dangerous in high amounts.
Women and men differ in their chromosomal makeup, protein gene products, genomic imprinting, gene expression, signaling pathways, and hormonal environment. All of these necessitate caution in extrapolating information derived from biomarkers from one sex to the other.[6] Women are particularly vulnerable at the two extremes of life. Young women and adolescents are at risk from STIs, pregnancy and unsafe abortion, while older women often have few resources and are disadvantaged with respect to men, and also are at risk of dementia and abuse, and generally poor health.[17]
Fourth and finally, there was a general lack of focus on the relevant delivery platforms for nutrition interventions. Many studies were not explicit about how and where interventions were delivered, and we had to cross-reference multiple sources to identify the delivery platform for many interventions. Delivery platforms are important and relevant information in terms of replicability, but also for identifying who is effectively reached and missed. Information about delivery platforms is also instrumental in understanding gaps in implementation. A greater emphasis on delivery platforms could enhance the reach of nutrition interventions and could also strengthen the capacity to mobilize resources more effectively. For instance, organizing and grouping interventions by delivery platform (e.g., antenatal care, community centers, schools, clinics) or by the relevant stakeholders required for delivery (e.g., ministries, health care providers, teachers, administrators, transporters, etc.) could have the potential to more efficiently deliver nutrition interventions.

Packing your two-piece away for winter means you won't think about how you'll look in it until about April. Avoid any potential “how did my butt get this big?!” panics come spring by keeping your swimsuit handy and putting it on every so often to make sure you like what you see, says Tanya Becker, co-founder of the Physique 57 barre program. You can also toss it on when you're tempted to overindulge, she adds. “There’s no better way to keep yourself from having that after-dinner cookie or slice of cake."

A 55-year-old woman who gets less than 30 minutes of daily physical activity should eat five ounces of grains; two cups of vegetables; one and a half cups of fruit; three cups of milk; five ounces of meat and beans; five teaspoons of oils, and no more than 130 calories of additional fat and sugar. If she got 30 to 60 minutes of daily exercise, she could increase her intake to six ounces of grains; two and a half cups of vegetables; and up to 265 additional calories of fat and sugar.
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