WOMEN’S HEALTH –
- Dr.Gulrukh Hashmi
Focus on women beyond reproductive years
Modes of interventions
CHANGING DEFINITIONS OF WOMEN
Women’s health typically connotes reproductive
Increased focus on public programs providing pregnancy
related and/or family planning services.
Women’s health focus shifted to beyond reproductive
years in 1960s and 70s
Health is a state of complete
physical, mental and social well
being and not merely the absence
of disease or infirmity. Women’s
health involves their emotional ,
social and physical well being and
is determined by the social
political and economic context of
their lives as well as by biology.
WHY FOCUS ON WOMEN’S
HEALTH BEYOND REPRODUCTIVE
Global population of age 60 yrs.
Currently - 580 million
INDIA - 90 million
48.2% - Female in India
55% - Widows
70% - dependent on others
50% - Postmenopausal women
Source:Report on the Status of Elderly in Select States of India, 2011
Life expectancy for women is 67.57 years as against
65.46 years for men.
Proportion of elderly women is 71/1000 in rural areas as
compared to men 70/1000
In urban areas proportion of elderly women and men is
71/1000 and 62/1000 respectively.
Sex ratio is favourable to women only in age group of 65
years and above
TOTAL FERTILITY (AVERAGE NUMBER OF CHILDREN PER
WOMAN)BY MAJOR REGION, 1970–2005
Health events in post reproductive life
Ageing involves slowing down of the system
The key event that occurs in women is
Marks the end of women’s reproductive life
Occurs between the 45-55years
Nearly 1/3rd of the women’s life is spent after
•Muscle And Joint Pain
•Dryness Of Skin
Short term problems
LONG TERM PROBLEMS
• Problems of Hearing, vision
Osteoporosis is common problem
Prevalence is 52% in urban areas
and 76% in rural areas.
Falls account for 87% of all fractures for
About one-fifth of hip fracture patients require
long-term nursing home care
10% remain functionally dependent for daily
Stroke is the most common cause of death leading to
Ischemic heart diseases leads to 19.8% deaths.
No protective action of estrogen
The chance of having a stroke more than doubles for
each decade of a woman's life after age of 55.
Decreased heart capacity, decreased pumping capacity
An estimated 20% suffer depression
at some point during the menopause.
Mood swings, irritability, tearfulness, anxiety,
and feelings of despair in the years leading to
These symptoms occur in conjunction with
vasomotor instability as a result of declining
INCIDENCE OF MOST COMMON CANCERS
Occurs before the age of 60 years but most of the deaths
(68%) occur at older ages.
Breast cancer is a hormonally influenced disease
Age at menarche, age at first and last pregnancy, and age
at menopause and family history of breast cancer are
associated with an increased risk.
Breast cancer accounts for 572,100 cases of breast
cancer each year in the world, of which 40 percent occur
in developing countries.
Out of the 572,100 new cases each year worldwide, it
accounts for between 1 and 3 percent of all deaths in
developing countries and 3 to 5 percent in developed
Cancer of the cervix accounts for 500,000 new cancer
cases each year worldwide.
About 80 percent of these occur in the developing
countries, accounting for 200,000 deaths annually
Develops slowly and readily detectable
OTHER HEALTH PROBLEMS
Prevalence is 3.8% in rural areas and 11.8% in urban areas
affects 31.5% of women.
46.8% of women affected
19% women have difficulty in hearing
Increasing awareness of health issues
Smoking and alcohol cessation
HORMONE REPLACEMENT THERAPY
The use of estrogens can relieve the menopausal
Hot flashes , sweats and other complaints disappear or
improve within a few days of starting estrogens therapy.
The administration of estrogen without progestogen
increases the risk of endometrial cancer and breast cancer.
Cyclical therapy with 10 days progestogen per month ,
can reduces the incidence of cancer.
oVaccination to prevent cervical cancer
3 dose schedule
Given to women and girls age 11-26 years
o Influenza – every year age 65-80
(optional age 50-64)
Pneumonia – once at age 65
Tetanus toxoid – every 10 years
Zoster (Shingles) – once at age 60
EARLY DIAGNOSIS AND TREATMENT
Early detection usually means a better
outcome and less invasive treatment
Regular check-ups should include dental, vision and
Self breast examination
Examination by physician
Pap smear tests
Bone mineral density
DISABILITY LIMITATION AND
Most common disabilities are locomotor and vision.
46.8% women suffer from poor vision
Free operation facilities for cataract surgeries
Nearly 19% women had difficulty in hearing but only
3.6% of women use hearing aids.
LIFE CYCLE APPROACH TO WOMEN’S
Anticipates and meets women’s health needs
from infancy through old age
Emphasizes health-seeking behavior and
appropriate services to meet women’s health
needs throughout their lives
HEALTH AND NUTRITIONAL PROBLEMS
•Women and girls have
special health needs
throughout their lives.
•Health systems should
recognize and address
women’s health problems
throughout the life cycle
For post-reproductive age women:
Encourage women to continue seeking health care
throughout their menopausal and post-menopausal
Provide screening and accessible treatment for breast
and gynecological cancers.
Health and social status of women beyond reproductive
years highlight greater emphasis on involvement of
health care activities
Awareness generation regarding healthy lifestyle should
Information on common health problems and facilities
available should be provided.
Policies need to be more gender sensitive and should
focus on women’s needs.
Geriatric medicine should be given more focus and
Encourage more research regarding the health and social
issues in relation to women beyond reproductive age
Health strategies has to be country specific as there are
variations in diseases.
Park’s text book of “preventive & social medicine” 22nd
WHO AFMC textbook of community medicine. 2nd Edition
Sunder Lal Textbook of community medicine 3rd edition
Flavia Bustreo, Felicia Marie,Knaul Afsan Bhadelia.
Women’s health beyond reproduction: meeting the
challenges. Bulletin of the World Health
Organization 2012;90:478-478A. doi:
Barfield WD, Warner L. Preventing chronic disease in women
of reproductive age:opportunities for health promotion and
preventive services. Prev Chronic Dis
Gender, health and ageing. Department of
gender and women’s health.WHO
Dr. Indira Jai Prakash. Health Concerns of older
Women in India
Carol S. Weisman. Changing definitions of
women’s health: implications for health Care and
Policy.. Maternal and child health journal, Vol 1,
No 3, 1997.183-189
Susan U Raymond,Henry M Greenberg, Stephen R
Leeder. Beyond reproduction: Women’s health in
today’s developing world. International Journal of
Experts suggest ways of coping with menopausal
effects. Times of India available on
Mary Eming Young. Health Problems and
Policies for Older Women: An Emerging Issue in
Developing Countries. HRO Working Papers
World Bank, May 1994
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