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]

Many women and teenage girls don't get enough calcium. Calcium-rich foods are critical to healthy bones and can help you avoid osteoporosis, a bone-weakening disease. Additionally, recent studies suggest that consuming calcium-rich foods as part of a healthy diet may aid weight loss in obese women while minimizing bone turnover. The National Institute of Medicine recommends the following calcium intake, for different ages:
A healthy vegetarian diet falls within the 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) may want to consider vitamin and mineral supplements; make sure you consume sufficient quantities of protein, vitamin B12, vitamin D and calcium. You can obtain what you need from non-animal sources. For instance:
If you are over the age of 50 (heck - even 40 and possibly 30) then this is not the magazine for you. Show me real female athletes of all ages and include more serious articles on women's issues. The final straw was seeing a Kardashian on the cover. No thanks. I felt like this was Cosmopolitan magazine and Entertainment Tonight wrapped in spandex. Going back to Runner's World and Prevention.
All youth need calcium to build peak (maximum) bone mass during their early years of life. Low calcium intake is one important factor in the development of osteoporosis, a disease in which bone density decreases and leads to weak bones and future fractures. Women have a greater risk than men of developing osteoporosis. During adolescence and early adulthood, women should include good food sources of calcium in their diets This is when bone growth is occurring and calcium is being deposited into the bone. This occurs in women until they are 30 to 35 years of age. Women 25 to 50 years of age should have 1,000 mg of calcium each day, while women near or past menopause should have 1,200 mg of calcium daily if they are taking estrogen replacement therapy; otherwise, 1,500 mg per day is recommended. Women older than 65 years of age should have 1,500 mg per day.
It takes a lot of discipline to turn down a cupcake or roll out of your warm bed for a cold morning run. To make staying on track easier, it's important to make a real connection with your motivation, says Tara Gidus, R.D., co-host of Emotional Mojo. So think less about fitting into your skinny jeans or spring break bikini and more about emotional ties to the people you love. “Your relationships will grow stronger when you are physically healthy and taking care of yourself,” she says.

Before and during pregnancy. You need more of certain nutrients than usual to support your health and your baby’s development. These nutrients include protein, calcium, iron, and folic acid. Many doctors recommend prenatal vitamins or a folic acid supplement during this time. Many health insurance plans also cover folic acid supplements prescribed by your doctor during pregnancy. You also need to avoid some foods, such as certain kinds of fish. Learn more about healthy eating during pregnancy in our Pregnancy section.

For healthy bones and teeth, women need to eat a variety of calcium-rich foods every day. Calcium keeps bones strong and helps to reduce the risk for osteoporosis, a bone disease in which the bones become weak and break easily. Some calcium-rich foods include low-fat or fat-free milk, yogurt and cheese, sardines, tofu (if made with calcium sulfate) and calcium-fortified foods including juices and cereals. Adequate amounts of vitamin D also are important, and the need for both calcium and vitamin D increases as women get older. Good sources of vitamin D include fatty fish, such as salmon, eggs and fortified foods and beverages, such as some yogurts and juices.


If you lose weight suddenly or for unknown reasons, talk to your health care professional immediately. Unexplained weight loss may indicate a serious health condition. And even if it doesn't, simply being underweight is linked to menstrual irregularity, menstrual cessation (and sometimes, as a result, dental problems, such as erosion of the enamel and osteoporosis) and a higher risk of early death.
Health care experts haven't reached a consensus on the issue of vitamin and mineral supplements. Many say that if you are healthy and eat a well-balanced diet, you don't need any. But not all of us eat a well-balanced diet. And sometimes, you may follow a nutritious diet and still be deficient. Many women fail to get the adequate amount of vitamins and minerals. Stress increases your need for vitamins and minerals, especially C, B-complex and zinc.
No matter how busy you are, eat lunch before 3 p.m., a Spanish study suggests. Researchers placed a group of women on a diet for 20 weeks; half ate lunch before 3 and half consumed their midday meal after 3. Although both groups’ daily caloric intake, time spent exercising and sleeping, and appetite hormone levels were the same, those who lunched late lost about 25 percent less weight than earlier eaters. Being European, lunch was the biggest meal of the day for these women, constituting 40 percent of their calories for the day, so consider slimming down dinner in addition to watching the clock.
Pregnancy Unintended pregnancy Gravidity and parity Obstetrics Antenatal care Adolescent pregnancy Complications of pregnancy Hyperemesis gravidarum Ectopic pregnancy Miscarriage Obstetrical bleeding Gestational diabetes Hypertension Preeclampsia Eclampsia Childbirth Midwifery Preterm birth Multiple births Oxytocin Obstructed labor Cesarian section Retained placenta Obstetrical fistulae Vesicovaginal fistula Rectovaginal fistula Episiotomy husband stitch Postpartum care Maternal deaths Perinatal mortality Stillbirths Abortion Mother-to-child transmission Sterilization Compulsory sterilization
Research findings can take some time before becoming routinely implemented into clinical practice. Clinical medicine needs to incorporate the information already available from research studies as to the different ways in which diseases affect women and men. Many "normal" laboratory values have not been properly established for the female population separately, and similarly the "normal" criteria for growth and development. Drug dosing needs to take gender differences in drug metabolism into account.[6]

We live in a modern world with amazing advancements in technology, yet our soil lacks minerals that it once contained causing whatever grows out of it (i.e. fruits, vegetables, and whole foods) to be significantly lower in minerals than it once was. Not only is our soil different, but our food takes a long time to get to us! Unless we’re growing our own whole food in our gardens, picking it out with our bare hands, and washing it off before eating, most likely our produce has been picked weeks before it reaches your grocery store and is purchased by you. This entire process can take weeks and cause nutrients to be depleted from the whole food (2).
After menopause. Lower levels of estrogen  after menopause raise your risk for chronic diseases such as heart disease, stroke, and diabetes, and osteoporosis, a condition that causes your bones to become weak and break easily. What you eat also affects these chronic diseases. Talk to your doctor about healthy eating plans and whether you need more calcium and vitamin D to protect your bones. Read more about how very low estrogen levels affect your health in our Menopause section. Most women also need fewer calories as they age, because of less muscle and less physical activity. Find out how many calories you need based on your level of activity.
To help you learn how to eat healthfully, start with the U.S. Department of Agriculture's (USDA) dietary guidelines system, which you can find at http://www.mypyramid.gov. The MyPyramid system, which looks somewhat like the familiar food pyramid of old, offers guidance based on individual needs and replaces "serving" recommendations with actual amounts of food. It also emphasizes the importance of balancing nutritious (and tasty!) food choices from all food groups every day with daily physical activity.
Food fortification is one of the most cost-effective strategies to improve micronutrient status through a variety of food vehicles, including staples, condiments, and processed foods (63, 64). Common fortifiable micronutrients include iron, folic acid, vitamin A, vitamin D, vitamin E, and iodine, although B vitamins and vitamin C are also used as fortificants (33, 64). Food fortification reduced anemia and iron deficiency anemia, and improved vitamin A, folate, niacin, thiamin, vitamin B-6, vitamin B-12, zinc, and iodine status of women of reproductive age and adolescents (13, 46, 61, 63–74). Vitamin D and calcium fortification were found to reduce the risk of osteoporosis among older women, especially for those exposed to inadequate sunlight (63, 64). Biofortification efforts, including those that involved breeding or genetic modification of plants to improve micronutrient content, have also shown improvements in the vitamin A and iron status of women (64, 75). Similar to micronutrient supplementation, women and girls with low micronutrient status were most likely to benefit.
Our women’s fitness programs are designed for women from the ground up. We teach from the female anatomy and physiology, the feminine psyche and include all the subtle bodies – the emotional, mental and spiritual that have an impact on the physical. We understand the different needs of the woman as she exercises through pregnancy, postnatal, menopause and the later years of her life and how these changes affect her women’s fitness needs and goals.

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.
Popular belief says if you really want to make a big change, focus on one new healthy habit at a time. But Stanford University School of Medicine researchers say working on your diet and fitness simultaneously may put the odds of reaching both goals more in your favor. They followed four groups of people: The first zoned in on their diets before adding exercise months later, the second did the opposite, the third focused on both at once, and the last made no changes. Those who doubled up were most likely to work out 150 minutes a week and get up to nine servings of fruits and veggies daily while keeping their calories from saturated fat at 10 percent or less of their total intake. 

Changes in the way research ethics was visualised in the wake of the Nuremberg Trials (1946), led to an atmosphere of protectionism of groups deemed to be vulnerable that was often legislated or regulated. This resulted in the relative underrepresentation of women in clinical trials. The position of women in research was further compromised in 1977, when in response to the tragedies resulting from thalidomide and diethylstilbestrol (DES), the United States Food and Drug Administration (FDA) prohibited women of child-bearing years from participation in early stage clinical trials. In practice this ban was often applied very widely to exclude all women.[151][152] Women, at least those in the child-bearing years, were also deemed unsuitable research subjects due to their fluctuating hormonal levels during the menstrual cycle. However, research has demonstrated significant biological differences between the sexes in rates of susceptibility, symptoms and response to treatment in many major areas of health, including heart disease and some cancers. These exclusions pose a threat to the application of evidence-based medicine to women, and compromise to care offered to both women and men.[6][153]
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