2. By the end of the session, the learner will be able to: 1.Define the women health 2.Identify the needs for gender-special care 3. Discuss the diseases unique for women 4.Discuss why diseases affect women in different way 5.Identify different specialties involved in women health care 6.Identify preventive care activities involved in women health 7.Identify curative care activates involved in women health care

3. Women's health-A case

4. Haya is a 67-year-old female who recently moved to the city. She has chosen you as her primary care physician and presents to your office for the first time. During the visit she inquires about health prevention and screening. Throughout the years she has remained relatively healthy. Her medications consist of 25 mcg of levothyroxine for treatment of hypothyroidism, and a multivitamin. Her only surgeries consist of nonmalignant mole removals. She is150 cm and weighs 70 kg. Her BP is 120/70. Heart, lung, breast, and abdominal exam are all within normal limits How will you approach this patient? Case 1

5. Women's health Definition Women’s health refers to the branch of medicine that focuses on the treatment and diagnosis of diseases and conditions that affect a woman’s physical and emotional well-being.

6. Women's Health Highlights: Recent Findings: Program Brief. September 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/factsheets/women/womenh/index.html Some Facts in Women Health:  Longer life expectancy than men,  They do not necessarily live those extra years in good physical and mental health.  Women experience 3.1 years of reduced physical functioning at the end of life,  2010, 13.5 percent of women aged 18 and older who were surveyed said they were in fair or poor health.

7.  Health issues or conditions affect women differently than men  Symptoms may be similar, the effects of the condition and the care necessary can differ significantly for women.  Conditions might affect women primarily or more severely than men.  For example, almost 12% of women are at risk for developing breast cancer during their lifetime.  Male breast cancer accounts for less than 1% of existing breast cancer cases.

8. Women's Health Highlights: Recent Findings: Program Brief. September 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/factsheets/women/womenh/index.html RESEARCH IN WOMEN HEALTH The Agency for Healthcare Research and Quality (AHRQ) supports research on all aspects of health care provided to women, including:  Enhancing the response of the health system to women's needs.  Understanding differences between the health care needs of women and men.  Understanding and eliminating disparities in health care.  Empowering women to make well informed health care decisions

9. What health issues or conditions affect women differently than men?

10.  Heart disease.  Mental health.  Osteoarthritis.  Sexually transmitted diseases (STDs/STIs).  Stress.  Stroke.  Urinary tract health  Violence against women,  Osteoporosis and bone health What health issues or conditions affect women differently than men?

11.  Heart disease. Heart disease is the leading cause of death for women  Mental health. Women are more likely to show signs of depression and anxiety than men are.  Osteoarthritis. The condition affects more women than men. What health issues or conditions affect women differently than men?

12.  Sexually transmitted diseases (STDs/STIs).  The effect on women can be more serious than on men.  Stress:  Women are more likely to report stress,  50% of all women in a survey, (39% men).  Stress might reduce a woman’s chance of becoming pregnant. What health issues or conditions affect women differently than men?

13.  Stroke. More than men.  Some risk factors are unique to women: Birth control pills Being pregnant Hormone replacement therapy. Frequent migraine headaches Thick waist (larger than 102 cm), particularly if post-menopausal, High triglyceride levels What health issues or conditions affect women differently than men?

14.  Urinary tract health. Women > men are to experience urinary tract problems; urinary incontinence What health issues or conditions affect women differently than men?

15. Unique health issues and conditions:  Pregnancy and menopause  Gynecological conditions, such as uterine fibroids and pelvic floor disorders. Others:  Violence against women,  women with disabilities  osteoporosis and bone health http://www.nichd.nih.gov/health/topics/womenshealth/conditioninfo/pages/whatconditions.aspx

16. Women’s health Problems are long list : Birth control, sexually transmitted infections, and gynecology Breast cancer, ovarian cancer, and other female cancers Mammography Menopause and hormone replacement therapy Osteoporosis Pregnancy and childbirth Sexual health Women and heart disease Benign conditions affecting the function of the female reproductive organs, eg……

17. Women's health

18. Regular gynecological checkups, including a pelvic exam and breast exam Pap smear Bone density testing Breast cancer screening Colon cancer screening Age-appropriate immunizations Healthy lifestyle risk assessment Hormonal testing for menopause PREVENTATIVE CARE AND SCREENINGS

19. BREAST CARE SERVICES The diagnostic services of breast:  Mammography  Breast biopsy  Breast MRI scan  Breast ultrasound  Genetic testing and counseling for women with a family or personal history of breast cancer

20. BREAST CARE SERVICES Therapeutic Services:  Hormonal therapy, radiation therapy, and chemotherapy  Mastectomy and breast reconstruction  The breast care services team may also diagnose and treat noncancerous conditions of the breast, including:  Benign breast lumps  Lymphedema, a condition in which excess fluid collects in tissue and causes swelling

21. SEXUAL HEALTH SERVICES Sexual health is an important part of your overall well-being. Women’s sexual health services may include:  Birth control (contraceptives)  Prevention, diagnosis, and treatment of sexually transmitted illnesses  Therapies to help with problems with sexual function

22. GYNECOLOGY AND REPRODUCTIVE HEALTH SERVICES Gynecology and reproductive health services may include the diagnosis and treatment of various conditions and diseases, including: Abnormal Pap smears Abnormal vaginal bleeding Bacterial vaginosis Endometriosis Heavy menstrual cycles Irregular menstrual cycles Ovarian cysts Pelvic inflammatory disease Pelvic pain Polycystic ovary syndrome (PCOS) Uterine fibroids Uterine and vaginal prolapse Vaginal yeast infection Various conditions affecting the vulva and vagina Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD)

23. BLADDER CARE SERVICES Diagnose & Treatment:.  Bladder emptying disorders  Urinary incontinence and overactive bladder  Interstitial cystitis  Prolapse of the bladder

24. OTHER WOMEN’S HEALTH SERVICES Cosmetic surgery and skin care, including skin cancer Diet and nutrition services Psychological care and counseling for women dealing with abuse or sexual assault Sleep disorders services Smoking cessation

25. SPECIAL TREATMENTS AND PROCEDURES  Cesarean section (c-section)  Endometrial ablation  Endometrial biopsy  D&C  Hysterectomy  Hysteroscopy  Mastectomy and breast reconstruction  Pelvic laparoscopy  Procedures to treat precancerous changes of the cervix (LEEP, Cone biopsy)  Procedures to treat urinary incontinence  Tubal ligation and reversal of tubal sterilization  Uterine artery embolization

26. The women's health services team includes :  Obstetrician/gynecologist (ob/gyn)  General surgeons specializing in breast care  Perinatologist: An ob/gyn specializes in the care of high-risk pregnancies  Radiologist  Physician assistant (PA)  Primary care doctor  Nurse practitioner (NP)  Nurse midwives

27. PREGNANCY AND CHILDBIRTH SERVICES  Planning and preparing for pregnancy, including information about proper diet and prenatal vitamins  Prenatal care, delivery, and postpartum care  High-risk pregnancy care (maternal-fetal medicine)  Breastfeeding and nursing INFERTILITY SERVICES  Testing to determine the cause of infertility  Blood and imaging tests to monitor ovulation  Fertility treatments, including:  Medications to stimulate ovulation  Intrauterine insemination  In vitro fertilization (IVF)  Intracytoplasmic sperm injection (ICSI)  Counseling for couples who are dealing with infertility or loss of a baby

28. Women's health

32. Haya is a 67-year-old female who recently moved to the city. She has chosen you as her primary care physician and presents to your office for the first time. During the visit she inquires about health prevention and screening. Throughout the years she has remained relatively healthy. Her medications consist of 25 mcg of levothyroxine for treatment of hypothyroidism, and a multivitamin. Her only surgeries consist of nonmalignant mole removals. She is150 cm and weighs 70 kg. Her BP is 120/70. Heart, lung, breast, and abdominal exam are all within normal limits How will you approach this patient? Case 1

33. FINALLY: لماذا لم يرضى الله للنساء الحزن ؟ ( ان تقر اعينهن ولا يحزن ) ( فناداها من تحتها الا تحزني ) ( ولا تخافي ولا تحزني ) ( كي تقر عينها ولا تحزن ) وضحت الايات ان حزن المرأة عميق ، والم شديد لا يتحمله قلبها @ رفقا بالقوارير @ تشبيه بليغ من معلم البشرية رسولنا محمد صلى الله عليه وسلم.

34. Thanks