Laparoscopy (lap-uh-ROS-kuh-pee): A minor surgery to see inside the abdomen. The doctor does this with a small tool with a light called a laparoscope (LAP-uh-roh-skohp). She or he makes a small cut in the lower abdomen and inserts the laparoscope. With the laparoscope, the doctor can check the ovaries, fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.
Three related targets of MDG5 were adolescent birth rate, contraceptive prevalence and unmet need for family planning (where prevalence+unmet need = total need), which were monitored by the Population Division of the UN Department of Economic and Social Affairs. Contraceptive use was part of Goal 5B (universal access to reproductive health), as Indicator 5.3. The evaluation of MDG5 in 2015 showed that amongst couples usage had increased worldwide from 55% to 64%. with one of the largest increases in Subsaharan Africa (13 to 28%). The corollary, unmet need, declined slightly worldwide (15 to 12%). In 2015 these targets became part of SDG5 (gender equality and empowerment) under Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights, where Indicator 5.6.1 is the proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care (p. 31).
Some fat is an important part of your diet; fat is part of every cell. It maintains skin and hair; stores and transports fat-soluble vitamins A, D, E and K; keeps you warm; and protects your internal organs. It even helps your mental processes—not surprising given that fat comprises about 60 percent of your brain. But many women consume too much fat. The American Heart Association (AHA) recommends that you keep your total fat intake between 25 and 35 percent of your total calories.
Instinct may tell you to slow down when running in wintery conditions, but the secret to not slipping is actually to speed up and shorten your stride. Aim to have each foot strike the ground 90 times per minute, says Terry Chiplin, owner of Active at Altitude, a Colorado-based facility for endurance athletes. This high cadence helps ensure that each foot lands beneath the center of your weight rather than ahead of it, which can throw off your balance on slick terrain.
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 (2013). To that end the 2014 UN International Day of the Girl Child was dedicated to ending the cycle of violence. In 2016, the World Health Assembly also adopted a plan of action to combat violence against women, globally.
What you eat is even more important as you enter your 40s. Women need protein (meat, fish, dairy, beans, and nuts), carbohydrates (whole grains), fats (healthy oils), vitamins, minerals, and water. These foods have been linked to some disease prevention, such as osteoporosis, high blood pressure, heart disease, diabetes, and certain cancers. The American Academy of Family Physicians supports the development of healthy food supply chains in supplemental nutrition programs so as to broaden the availability of healthy food.
Many nutrition-sensitive approaches were delivered in broader community-based settings and more equitably reached women across the life course. Non-facilities-based settings more equitably delivered nutrition interventions to women who were not pregnant or lactating, and who were less engaged with health clinics and schools. For instance, food fortification, which was often delivered through markets, home visits, and community centers, seemed to be more effective at reaching women of reproductive age than health center–based delivery platforms. Community-level interventions are often reported as more equitable than platforms that require access to “fixed and well-equipped health facilities” (212). This aligns with our findings, where we found that community-based platforms such as home visits, community centers, homes of community leaders, work, mass media, mobile phones, and commercial settings were effective at reaching women across the life course (Table 1). Other delivery platforms such as marketplaces, water points, tailoring shops, and agricultural points for seeds or inputs were also effective. These locations need to be context-specific in order to capture where women spend their time. For instance, in countries where many adolescent girls do not attend school, school-based delivery platforms might be less effective. Delivery platforms also need to be sensitive to the sociodemographic differences that influence where women spend their time, such as differences for women in rural and urban areas, and of different socioeconomic statuses. Additional research needs to identify and report where women and adolescent girls are, and how best to reach them.
Third, of the interventions that were evaluated, many interventions targeted women who were pregnant, lactating, or with young children <5 y of age. We do not refute the important focus on mothers and their children as a group deserving of special attention, given women's increased nutrient needs during pregnancy and lactation and the intergenerational consequences during this period. However, even the interventions that focused on maternal nutrition often only reported on birth and nutrition outcomes of the child, and not those of the mother. In addition, although there were interventions that targeted adolescent girls and women of reproductive age, they were fewer and less well evaluated than interventions that targeted women as mothers. This aligns with findings from other research which illustrated a higher proportion of programs targeting pregnant and lactating women and women with young children (209). We also found major gaps in the targeting of interventions for older women. With growing rates of overweight, obesity, and noncommunicable diseases, in addition to undernutrition and micronutrient deficiencies, it is essential to think outside of the maternal-focused paradigm to reach women at all life stages.
Animal products, such as meat, fish and poultry are good and important sources of iron. Iron from plant sources are found in peas and beans, spinach and other green leafy vegetables, potatoes, and whole-grain and iron-fortified cereal products. The addition of even relatively small amounts of meat or foods containing vitamin C substantially increases the total amount of iron absorbed from the entire meal.
While defended by those cultures in which it constitutes a tradition, FGC is opposed by many medical and cultural organizations on the grounds that it is unnecessary and harmful. Short term health effects may include hemorrhage, infection, sepsis, and even result in death, while long term effects include dyspareunia, dysmenorrhea, vaginitis and cystitis. In addition FGC leads to complications with pregnancy, labor and delivery. Reversal (defibulation) by skilled personnel may be required to open the scarred tissue. Amongst those opposing the practice are local grassroots groups, and national and international organisations including WHO, UNICEF, UNFPA and Amnesty International. Legislative efforts to ban FGC have rarely been successful and the preferred approach is education and empowerment and the provision of information about the adverse health effects as well the human rights aspects.
Johnson, Paula A.; Therese Fitzgerald, Therese; Salganicoff, Alina; Wood, Susan F.; Goldstein, Jill M. (3 March 2014). Sex-Specific Medical Research Why Women's Health Can't Wait: A Report of the Mary Horrigan Connors Center for Women's Health & Gender Biology at Brigham and Women's Hospital (PDF). Boston MA: Mary Horrigan Connors Center for Women's Health & Gender Biology.
Community centers ↑ MN provision, ↑ health care utilization, ↑ knowledge about FP, ↑/NC use of FP ↑ MN provision, ↑ health care utilization, ↑ knowledge about FP, ↑/NC use of FP ↑ knowledge about nutritional needs, ↑ MN provision, ↓/NC maternal mortality, ↓ parasitemia, ↑ health care utilization, ↑ hospital deliveries, ↑ knowledge about FP, ↑/NC use of FP, ↑ STI testing
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.
Our review found that protein-energy supplementation was largely targeted to pregnant and lactating women (19, 86–88, 90, 91); however, there were some studies that evaluated the delivery of protein-energy supplementation to households (92, 93) and adolescents (46). The only studies we found that evaluated the impact of protein-energy supplementation in older, healthy women were hospital-based studies in high-income countries (96). Delivery platforms varied depending on the target audience. The majority of studies targeted pregnant women through antenatal care or through antenatal care–associated community-based programs. National programs targeting low-income families had broader reach, although they targeted households and not women specifically (92). Additional research is needed for how women might best be reached (94). For programs that provided provisions for women to take home, there was also limited information about how much was shared with other members of the household. School-based programs targeting adolescents could be an important venue to target interventions to adolescents in the future. However, children and adolescents not in school would be missed. Despite limited evidence of impacts of energy and protein supplementation on the health of women, supplementation might be an important complement to other interventions (e.g., nutrition education and counseling) to ensure that women have the resources needed to implement other interventions successfully. Indeed, many large-scale programs for protein-energy supplementation are often complemented with nutrition education and counseling (33).
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.
Not everyone who is underweight suffers from an eating disorder, but anorexia and bulimia are serious health problems in this country; an estimated 500,000 women suffer from anorexia, and 1 to 2 million women struggle with bulimia. Women with anorexia nervosa starve themselves and/or exercise excessively, losing anywhere from 15 percent to 60 percent of their normal body weight. Some die. Women with bulimia nervosa binge on large quantities of food—up to 20,000 calories at one time—and then try to get rid of the excess calories. Some purge by inducing vomiting, abusing laxatives and diuretics or by taking enemas. Others fast or exercise to extremes.
To optimise women's control over pregnancy, it is essential that culturally appropriate contraceptive advice and means are widely, easily, and affordably available to anyone that is sexually active, including adolescents. In many parts of the world access to contraception and family planning services is very difficult or non existent and even in developed counties cultural and religious traditions can create barriers to access. Reported usage of adequate contraception by women has risen only slightly between 1990 and 2014, with considerable regional variability. Although global usage is around 55%, it may be as low as 25% in Africa. Worldwide 222 million women have no or limited access to contraception. Some caution is needed in interpreting available data, since contraceptive prevalence is often defined as "the percentage of women currently using any method of contraception among all women of reproductive age (i.e., those aged 15 to 49 years, unless otherwise stated) who are married or in a union. The “in-union” group includes women living with their partner in the same household and who are not married according to the marriage laws or customs of a country." This definition is more suited to the more restrictive concept of family planning, but omits the contraceptive needs of all other women and girls who are or are likely to be sexually active, are at risk of pregnancy and are not married or "in-union".
Call it a vegetable or a fruit, the tomato is in a food class by itself. Interestingly, cooked tomato products, like tomato paste, puree, stewed tomatoes, and even ketchup, deliver more of its well-known antioxidant lycopene, a cancer fighter, and potassium than when eaten raw. Tomatoes also have vitamins A and C and phytochemicals that make it an nutrition essential for women’s health.
B12: Like folic acid, B12 is essential for healthy nervous system development and function. Pregnant women who are vegans or vegetarians may fall short on B12, since it is present in animal protein and to a lesser extent in dairy. Teenage and adult women need 2.4 mcg. Recommended levels rise to 2.6 mcg for pregnant women and 2.8 mcg for lactating women.
Evaluations of protein-energy supplementation were limited to specific situations and contexts, and few studies evaluated national-scale programs (14, 33). National-level protein-energy supplementation programs for women and adolescent girls are expensive and challenging to implement compared with other efficacious interventions (33). Procuring, preparing, and distributing food and appropriately targeting women most in need (e.g., women below the poverty line, women who have or are at high risk of malnutrition, etc.) present challenges to protein-energy supplementation interventions (33).
Consult your health care professional. Women of childbearing age may want to consider taking folic acid supplements to reduce the risk of having a pregnancy affected with neural tube defects. Many women and teenage girls don't get enough calcium or vitamin D, both of which are critical to healthy bones and avoiding osteoporosis. Some people with diabetes appear to benefit from chromium. Vegetarians, especially vegans, may want to consider supplements to obtain nutrients they aren't getting from animal products.
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.
Abortion is the intentional termination of pregnancy, as compared to spontaneous termination (miscarriage). Abortion is closely allied to contraception in terms of women's control and regulation of their reproduction, and is often subject to similar cultural, religious, legislative and economic constraints. Where access to contraception is limited, women turn to abortion. Consequently, abortion rates may be used to estimate unmet needs for contraception. However the available procedures have carried great risk for women throughout most of history, and still do in the developing world, or where legal restrictions force women to seek clandestine facilities. Access to safe legal abortion places undue burdens on lower socioeconomic groups and in jurisdictions that create significant barriers. These issues have frequently been the subject of political and feminist campaigns where differing viewpoints pit health against moral values.
Interventions resulting in public infrastructure changes were found to be less effective than household-based interventions; however, both are important aspects of improved health outcomes for women (128, 130). Public water infrastructure requires regular maintenance and periodic replacement and water from these sources is often contaminated (130). However, even public water points that provide good-quality water have had minimal impacts on health outcomes (136). One review estimated that water-source interventions were associated with a 27% reduction in diarrhea risk at all ages, whereas household-based interventions were associated with a 43% reduction (128). This could be associated with bias and confounding, as measuring WASH outcomes is not a blinded process (128). The differential impact could also be related to practice. As compared with public water sources, home water connections were associated with greater odds of handwashing and fecal waste disposal (136). As a significant portion of diarrheal disease is a result of person-to-person transmission and poor hygiene, interventions that improve domestic hygiene behaviors can have a significant impact (136). Behavior change communication and resource provision, e.g., soap and point-of-use water treatment resources, were also important and sustainable aspects of WASH interventions (131, 137).
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.
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. Maternal mortality in western nations had been steadily falling, and forms the subject of annual reports and reviews. 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). By contrast rates as high as 1,000 per birth are reported in the rest of the world, with the highest rates in Sub-Saharan Africa and South Asia, which account for 86% of such deaths. 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. 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.
Child marriage (including union or cohabitation) is defined as marriage under the age of eighteen and is an ancient custom. In 2010 it was estimated that 67 million women, then, in their twenties had been married before they turned eighteen, and that 150 million would be in the next decade, equivalent to 15 million per year. This number had increased to 70 million by 2012. In developing countries one third of girls are married under age, and 1:9 before 15. The practice is commonest in South Asia (48% of women), Africa (42%) and Latin America and the Caribbean (29%). The highest prevalence is in Western and Sub-Saharan Africa. The percentage of girls married before the age of eighteen is as high as 75% in countries such as Niger (Nour, Table I). Most child marriage involves girls. For instance in Mali the ratio of girls to boys is 72:1, while in countries such as the United States the ratio is 8:1. Marriage may occur as early as birth, with the girl being sent to her husbands home as early as age seven.
Cardiovascular disease is the leading cause of death (30%) amongst women in the United States, and the leading cause of chronic disease amongst them, affecting nearly 40% (Gronowski and Schindler, Tables I and IV). The onset occurs at a later age in women than in men. For instance the incidence of stroke in women under the age of 80 is less than that in men, but higher in those aged over 80. Overall the lifetime risk of stroke in women exceeds that in men. The risk of cardiovascular disease amongst those with diabetes and amongst smokers is also higher in women than in men. Many aspects of cardiovascular disease vary between women and men, including risk factors, prevalence, physiology, symptoms, response to intervention and outcome.
The prevalence of Alzheimer's Disease in the United States is estimated at 5.1 million, and of these two thirds are women. Furthermore, women are far more likely to be the primary caregivers of adult family members with depression, so that they bear both the risks and burdens of this disease. The lifetime risk for a woman of developing Alzeimer's is twice that of men. Part of this difference may be due to life expectancy, but changing hormonal status over their lifetime may also play a par as may differences in gene expression. Deaths due to dementia are higher in women than men (4.5% of deaths vs. 2.0%).
There remain significant barriers to accessing contraception for many women in both developing and developed regions. These include legislative, administrative, cultural, religious and economic barriers in addition to those dealing with access to and quality of health services. Much of the attention has been focussd on preventing adolescent pregnancy. The Overseas Development Institute (ODI) has identified a number of key barriers, on both the supply and demand side, including internalising socio-cultural values, pressure from family members, and cognitive barriers (lack of knowledge), which need addressing. Even in developed regions many women, particularly those who are disadvantaged, may face substantial difficulties in access that may be financial and geographic but may also face religious and political discrimination. Women have also mounted campaigns against potentially dangerous forms of contraception such as defective intrauterine devices (IUD)s, particularly the Dalkon Shield.
In 2000, the United Nations created Millennium Development Goal (MDG) 5 to improve maternal health. Target 5A sought to reduce maternal mortality by three quarters from 1990 to 2015, using two indicators, 5.1 the MMR and 5.2 the proportion of deliveries attended by skilled health personnel (physician, nurse or midwife). Early reports indicated MDG 5 had made the least progress of all MDGs. By the target date of 2015 the MMR had only declined by 45%, from 380 to 210, most of which occurred after 2000. However this improvement occurred across all regions, but the highest MMRs were still in Africa and Asia, although South Asia witnessed the largest fall, from 530 to 190 (64%). The smallest decline was seen in the developed countries, from 26 to 16 (37%). In terms of assisted births, this proportion had risen globally from 59 to 71%. Although the numbers were similar for both developed and developing regions, there were wide variations in the latter from 52% in South Asia to 100% in East Asia. The risks of dying in pregnancy in developing countries remains fourteen times higher than in developed countries, but in Sub-Saharan Africa, where the MMR is highest, the risk is 175 times higher. In setting the MDG targets, skilled assisted birth was considered a key strategy, but also an indicator of access to care and closely reflect mortality rates. There are also marked differences within regions with a 31% lower rate in rural areas of developing countries (56 vs. 87%), yet there is no difference in East Asia but a 52% difference in Central Africa (32 vs. 84%). With the completion of the MDG campaign in 2015, new targets are being set for 2030 under the Sustainable Development Goals campaign. Maternal health is placed under Goal 3, Health, with the target being to reduce the global maternal mortality ratio to less than 70. Amongst tools being developed to meet these targets is the WHO Safe Childbirth Checklist.
“Whole grains help with digestion and are excellent for your heart, regularity [because of the fiber content], and maintaining a steady level of blood sugar,” says Hincman. “They are also a great source of energy to power you throughout the day.” Whole grains, such as oats, also help improve cholesterol levels. While food manufacturers are adding fiber to all sorts of products, whole grains, like whole wheat, rye, and bran, need to be the first ingredient on the food label of packaged foods, she stresses. Watch your serving sizes, however. Current guidelines are for six one-ounce equivalent servings per day (five if you’re over 50). One ounce of whole-wheat pasta (weighed before cooking) is only one-half cup cooked.