Introduction Description: Anxiety is a common acute or chronic emotion that is associated with physical symptoms. It is two to three times more common in women. Subtypes of anxiety include situational anxiety, adjustment disorders, panic disorders, phobias, and post-traumatic stress disorder. Moreover, obsessive–compulsive disorders are often classified in this group. Prevalence: 18% of women; 40 million Americans. Predominant Age: 20–45 years. Genetics: Increased risk of panic…

Introduction Description: An anorectal fistula involves communication between the anal or rectal canal and the perineum. Prevalence: Common. For women, 5.6/100,000 population. The male-to-female ratio is 1.8:1. Predominant Age: Any. The average age is late 30s to early 40s. Genetics: No genetic pattern. Etiology And Pathogenesis Causes: Anorectal fistulae may spontaneously arise or result from the drainage of a perirectal abscess, most commonly an infected anal…

Introduction Description: Anemia is the reduction (ie, below normal) in the oxygen-carrying capacity of the blood as reflected by the hemoglobin or hematocrit values. Women are at a higher risk because of menstrual blood loss and the iron demands of pregnancy and delivery. Prevalence: Approximately 20%–30% of women; 50%–60% of pregnant women. (The prevalence of anemia in pregnancy in non-Hispanic Black women [35.38/1000] is 2-fold higher…

Introduction Description: Anal incontinence is the recurrent involuntary passage of solid or liquid fecal material or flatus. Anal incontinence may be further divided into urge incontinence (incontinence occurs despite efforts to retain stool) and passive (the lack of awareness before the incontinent episode). Anal incontinence can result from damage or dysfunction of the anal sphincters, abnormal rectal compliance, decreased rectal sensation, altered stool consistency, or a…

Introduction Description: Alzheimer disease is a degenerative organic mental syndrome that is characterized by progressive intellectual deterioration and dementia. It is the most common form of dementia (60%–70%). Prevalence: More than 55 million people live with dementia worldwide; roughly 47 million of whom have Alzheimer symptoms or findings. This figure is projected to rise to 13.8 million in the United States and >130 million worldwide by…

Introduction Description: Alcohol abuse and other substance use disorders are significant, underdiagnosed health problems for women and carry high costs for individuals and society. Compared with men, alcohol abuse by women has a disproportionate effect on their health and lives, including reproductive function and pregnancy outcomes. The National Institute on Alcohol Abuse and Alcoholism defines at-risk alcohol use for healthy women as more than three drinks…

Introduction Description: Acne is an inflammatory disorder of the sebaceous glands that results in comedones, papules, inflammatory pustules, and scarring. The significance of acne often exceeds that dictated by medical considerations. For a woman, it is often a reason to either choose or discontinue the use of oral contraceptives. Acne, or the fear of it, is a major factor in poor compliance with oral contraceptives. Prevalence:…

Introduction Description: Abuse is a pattern of physical or emotional trauma that occurs in a continuing relationship (see Chapter 35 , Domestic Violence [Intimate Partner Violence]). Although the definition of abuse requires only one episode of abuse, a pattern of escalating violence is more typical. (In at least one-fourth of cases, there have been three or more episodes of violence in the 6 months preceding the…

Important Considerations (Physiologic Changes) This age group is notable for maturity, leisure, and age-related health changes. Healthcare is still directed toward prevention; however, it becomes more and more occupied by the management of general medical and age-related illness. While reproductive health issues no longer are the focus of well-women visits, the women’s healthcare provider is often still the patient’s primary entry point for healthcare. Leading Causes…

Important Considerations (Physiologic Changes) This age group is notable for transitions from reproductive function to maturity, from rhythmic menstrual function to menopause, and from robust health to the emergence of age-related changes. Leading Causes of Death Breast, lung, colorectal, and ovarian cancer Coronary artery disease Accidents/unintentional injury Diabetes mellitus and its complications Cerebrovascular disease Obstructive pulmonary disease Leading Causes of Morbidity Nose, throat, and upper respiratory…

The Challenge The challenge is to assist couples in identifying and using the most appropriate method of controlling fertility. Changing patterns of sexual expression, new technologies, increased consumerism, and heightened cost pressures all affect the choices made in the search for fertility control. The very nature of the topic gives contraception personal, religious, and political overtones that often lead to conflict, emotionality, and confusion. Scope Of…

Important Considerations (Physiologic Changes) This age group is notable for more established menstrual function, punctuated for many individuals by one or more pregnancies. Sexuality and sexual expression patterns have generally become well established and comfortable. Healthcare is directed toward prevention and health promotion because these patients generally have good health during these years. Leading Causes of Death Motor vehicle accidents/unintentional injuries Malignant neoplasms Suicide Homicide Cardiovascular…

The Challenge Description Sexuality includes an individual’s sexual feelings, thoughts, attractions, and behaviors toward others. One can find other people physically, sexually, or emotionally attractive—all of which are a part of sexuality. Sexuality, sexual behaviors, and sexual relationships are an important and necessary part of human development. Responsible sexual behavior, including delaying initiation of sexual activity, choosing caring and respectful partners, the use of safe sexual…

Important Considerations (Physiologic Changes) This age group is notable for the development and consolidation of reproductive capacity, sexual identity, and expressiveness. Changing life roles and self-awareness present both challenges and opportunities for the development of good health practices. The first visit to the obstetrician-gynecologist for screening and the provision of preventive healthcare services and guidance often occurs between the ages of 13 and 15 years; however,…

The Challenge The onset of puberty in adolescents is a time of great emotional and physical change. By understanding the normal sequence of events and being sensitive to the presence of abnormalities, the caregiver may be able to make the most of opportunities to improve health and well-being. Scope of the Problem The variety of decisions, concerns, and changes confronting an adolescent are formidable, not the…

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