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Women’s Health

Menstrual cup revolution – The Hindu BusinessLine

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* Access to menstrual hygiene is critically related to gender equality. The lack of toilets or sanitary napkins is the main reason for girls to drop out of school.

* I bought two for ₹ 500 (it was available at a discount) and it’s meant to last one person for five years. That equates to about 8 per period.

* Alappuzha Community was the first civic institution in India to distribute 5,000 menstrual cups free of charge as part of an environmentally friendly hygiene campaign.

****

“You feel almost Protestant,” said my friend via text message. This is exactly how I felt with the menstrual cup after my first non-napkin period.

Menstrual hygiene has a long, twisted history in India. Access to menstrual hygiene is critically related to gender equality; The lack of bathrooms or sanitary napkins is one of the main reasons girls drop out of school. Whenever a disaster strikes, sanitary napkins are in demand along with calls for food and clothing. Still, we were taxed by the government for our autonomy (at 18 percent GST) until the year-long campaign led to some relief on GST compensation.

India has the lowest use of sanitary napkins in the world. According to reports from top companies in this segment (P&G, Johnson and Johnson), sanitary napkins are 15 to 20 percent of the population in India, although the government’s national family household survey shows a higher prevalence (national average of around 48 percent in rural, 58 percent in urban areas). Product prices are still high: an average period of 5-7 days costs an average of 88 yen, a significant portion of the daily minimum wage rate of 180 yen.

Step into the menstrual cup. I bought two cups at a discounted price of ₹ 500 (for both). A cup should last five years. That equates to about 8 per period. Several brands have hit the market, and a cup costs anywhere from 500 to 1,000 yen. Not to mention the huge environmental benefit of using the cup: a sanitary napkin can take around 500-800 years to decompose. Data from the Department of Drinking Water and Sanitation shows that 28 percent of the pads are thrown into mixed trash and end up in the landfill, 28 percent are thrown outdoors, while 33 percent are disposed of by burying and 15 percent are incinerated. although the Solid Waste Management Rules 2016 clearly stipulate that waste separation must be practiced at the source. The regulations also require waste producers to work with local government and set up waste management systems for sanitary waste. Companies also have to take packaging waste into account.

The local truth couldn’t be further from this reality. Sanitary towels and tampons also carry the risk of toxic shock syndrome, a rare but serious disease caused by bacteria.

Reusable cotton pads are seen as a viable alternative to sanitary napkins, and there are many voluntary organizations advocating reusable napkins. However, these come with some problems – they take time to dry out, especially during the rainy season and winter.

The menstrual cup that is celebrated by users and environmentalists is not new. The first commercially used menstrual cup was invented and patented by Leona Chalmers in the USA in the 1930s. I ordered a silicone menstrual cup. I later learned that there are different sizes for girls and women between the ages of 18-44 and women who have given birth vaginally. It looked like a medical grade silicone egg cup with a thin snout designed to insert the product into. One was as pink as the women’s reserved bus signs on the Delhi metro, but the other was a beautiful black goblet that was soft to the touch, about a finger high and half a finger wide.

The instruction manual said you had to fold it into a C-fold (the rim of the mug would go in) for better access. As soon as the cup was in place it burst and the holes in the rim created a suction. Pretty simple science.

My friend, an organic chemistry postdoctoral fellow and Cup advocate, trained me all the way from California. The C-fold doesn’t work for everyone, try the punch-down fold, she said, and sent me a diagram and video to demonstrate the different folds. I was pleased about this timely advice.

A common question many women have about the mug is, what if it is leaking? I had that question too. Apparently it is much denser than sanitary napkins and can last up to 12 hours. It has markings inside (10-30ml) and a woman will bleed around 80ml during her entire period. It will only leak when the cup is full. Alternatively, if you don’t insert it properly, it can leak (the fold opens as soon as you push it in and it “pops!”). Fortunately, these scenarios did not play out for me.

Menstrual cups are said to have a steep learning curve. Although I’m new to the Cup, I have to admit that it was easier for me than I expected. My friend’s words encouraged me: “The only problem I have with the cup,” she said, “is that I forget that I’m on my period. I just plug it in when my app tells me it’s time and it’s a one-way trip. ”

Cleaning the cup is not the German expressionist horror film as we (or just me?) Imagine it to be. It does not have to be sterilized every time it is changed – a quick rinse under running water is sufficient. For this operation it is essential to ensure that your hands are washed and sterile. The moment of truth for me was when I used it overnight and slept in any position I felt and slept well. “Don’t freak out when it starts up, just walk a little and it’ll come down on its own,” was my friend’s advice before I tried it.

Menstrual cups can be the key to liberation and access to all sorts of wonderful things – education and livelihood, for example – by relieving women in developing countries from being tied to their homes during their periods. The Alappuzha community in Kerala was the first citizen’s organization in India to distribute 5,000 menstrual cups free of charge in 2019 as part of an environmentally friendly hygiene campaign. The Liberation of Women? In any case! You can tell that a woman invented the menstrual cup. I won’t miss any more swimming lessons or beach days!

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Women’s Health

Contraception in SA: What you need to know

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Although the majority of South African women of childbearing age use contraception, research shows that access to information about contraceptive methods of their choice is still limited – especially for women in rural communities. This restricted access to information has resulted in an alarming increase in young women looking for emergency options like the morning-after pill.

Health-e News takes a look at the current situation and explores the opportunities for young women.

#AskLwanda

Without much access to information, women turn to social media in hopes of finding answers to their many questions about contraception.

A pharmacist and health advisor from the Eastern Cape, Lwanda, Mkhatshane, used his experience as a retail pharmacist to set up a service where everyone can access health and health information online in real time. The hashtag #AskLwanda was featured on social media platforms such as Facebook, Twitter, Instagram. For those who are not in the mood for social media, calls via Skype and messages via Whatsapp are available.

Its website states: “This pre-existing technology enables you to speak to the customer, confidentially and privately, with the pharmacist. The pharmacist is ready to speak to you and provide information on acute or chronic treatments, drug side effects, contraindications and other information. This convenient service costs only R20 per consultation.

Mkhatshane, known as “pharmacist on call,” said it was shocking how many women are looking for the pill and stressed the importance of people choosing contraception as a choice rather than an emergency option.

He shared some of the most common questions people ask him:

  • Is there any other way to have safe sex without using a condom mara?
  • Is the morning-after pill a contraceptive method?
  • How does the contraceptive ring work?
  • Why is Implanon so expensive?

Here is the thread on contraception.

I focused on the brand 🇿🇦, the price and for whom the method.

1. Enter-use device (IUD)
2. Implant
3rd injection
4. Skin patches
5. vaginal ring
6. Pills

There is no silver bullet. ❌
The choice depends on the patient. pic.twitter.com/DPzG3frVRg

– Online recipes (@AskLwanda) September 5, 2021

Access to SA and contraception

The prevalence rate of contraceptives among all South African women of childbearing age (15–49 years) using modern contraception is 64.6%, according to a study published by BMC in 2019.

Although this percentage is relatively high, it overshadows the problem of quality contraception services, equal access and the ability of women to correctly and consistently use contraceptive methods of their choice. This is especially true for young black women who live in working-class communities and rural areas, according to the study.

The aim of the study was to understand the needs and behaviors of women of childbearing age in South Africa in relation to family planning and contraception. This was achieved through research into women’s biomedical knowledge of the reproductive system and contraception, including the physical and sensory experiences of contraception and how they influence contraception decision-making.

Body mapping explained

In order to examine the physical and sensory experiences of women with contraception methods, body mapping and group discussions were carried out on 57 women of childbearing age during the study.

Body mapping, which can be defined as “the process of creating body maps using drawing, painting, or other art-based techniques to visually represent aspects of people’s lives, their bodies and the world in which they live” – stressed the need to address communication and knowledge gaps related to the female reproductive system.

An example of body mapping and a contraception timeline. (Photo: Reproductive Health Journal)

AYFS – youth and youth-friendly offers

The South African government has developed and implemented various programs through the National Ministry of Health over the years, such as the National Adolescent Friendly Clinic Initiative or NAFCI (2000-2005), the Youth Friendly Services (2006-2011) and the current revised model for youth and youth friendly services (2013-2017).

While there have been remarkable positive results in reducing the prevalence of HIV among young people, this age group continues to face numerous health problems stemming from the lack of widespread systemic change; Lack of in-depth analysis of AYFS programming and implementation; and poor use of health services by adolescents and young people.

As a result, in April 2017, the government and the Ministry of Health, in collaboration with UNICEF and UNFPA, commissioned a Rapid Assessment of Youth and Youth Friendly Services (AYFS) in all nine provinces of the country, with peer educators in some provinces of primary health care facilities in clinics to help young people.

Another BMC research study found the following: The institutions had the essential components for general service delivery, but there were no youth-specific service offers. AYFS is a government priority, but additional facility support is required to meet agreed standards. The fulfillment of these standards could make an important contribution to safeguarding the health of adolescents, in particular to the prevention of unwanted pregnancies and HIV as well as to the improvement of psychosocial management. “

Communication and knowledge gaps

The study concluded that there is an urgent need to address the gaps in communication and knowledge related to female reproductive anatomy, different methods of contraception, and how contraceptives work to prevent pregnancy, thanks to the influence of wider social networks and local language is underlined.

“Overall, women have limited biomedical knowledge of female reproductive anatomy, conception, fertility, and how contraceptives work, which appeared to be exacerbated by a lack of contraceptive advice and support from health care providers. Body map images put existing local perceptions and reproductive health knowledge in the foreground. Most women were where the baby was developing, outside of the womb, in the abdomen, and often relied on the local vernacular when naming the reproductive organs with words like “mouse” and “cake” for the vagina, “so the BMC research.

“Women, including younger women, have identified gaps in their own knowledge of sexual and reproductive health and identified these gaps as important factors that have influenced the acceptance and effective use of contraception. These gaps in knowledge were mainly due to poor or lack of communication and advice from the health services. “

Types of contraception available in SA

There are six different hormonal contraceptive methods available to women in South Africa. All of these forms of contraception are available free of charge in public hospitals, but shortages remain a problem.

Health-e News reported on the contraceptive shortage that hit parts of South Africa, particularly Limpopo, in July. The ongoing COVID-19 pandemic devastated pharmacies and clinics in particular, which were unable to meet the demand for the Depo-Provera contraceptive injection.

Contraception methods available in South Africa:

  • Oral contraceptives
  • Spirals
  • Implants
  • Injections
  • Patch
  • Rings

Oral contraceptives

The pill is a tablet that you take once a day – there are different types of pill. The combined pill contains estrogen and progestin, which prevent the ovaries from releasing eggs. It also thickens the cervical mucus, which prevents the sperm from getting to the egg. The so-called minipill contains only 1 hormone, a progestogen that offers an alternative to those affected by the hormone estrogen.

You should swallow the pill at the same time each day whether you are having sex or not. Ask your doctor whether the combination pill is an appropriate method of contraception for you based on your medical history, and if so, which one is best for you.

Popular options are Yazmin, Levora, Camila, and Jolivette.

Spirals

An intrauterine device, commonly known as an IUD, is a sling device that releases progestin to prevent fertilization for five years. It can be obtained with a prescription and inserted into the uterus by a doctor to help prevent pregnancy. It is an option for women who have never been pregnant and offers immediate protection.

Any hormonal contraception carries a risk of side effects – albeit rare. With IUDs, side effects can include vaginitis (inflammation, discharge), headache, back pain, mood swings, and depression.

Implants and injections

The contraceptive implant is a small rod-shaped plastic object that is placed under the skin on the upper arm. It is available free of charge, accessible in public clinics, and lasts for three years. Mkhatshane said it should be implanted during the first five days of menstruation and it works immediately. Enlarged breasts, weight gain, and an irregular period are some of the side effects that can occur.

Depo-Provera and Nuristerate injections are available in both private and public health settings. Depo affects glucose intolerance and can be associated with grimacing. While Nuristerate is considered the milder of the two injectable contraceptives available. Depo-Provera slowly diffuses over a period of three months after injection. It offers instant protection when injected within the first week of menstruation and can be used by all women, including those with epilepsy and those unable to take estrogen. It can prevent pregnancy for nine to 18 months after a single injection. The side effects are similar to those of the implant.

Mkhatshane noted that women with the nuristerate injection would still get their periods but would not experience spotting or prolonged bleeding. This is the preferred injection for women with diabetes, but Mkhatshane warned that women with hyperpigmentation (chloasma) should avoid the injection as it could make their condition worse.

Patches and Rings

The skin patch releases hormones through the skin and into the blood and works to prevent ovulation, thicken vaginal fluid to prevent sperm survival, and alter the lining of the uterus to make it harder for a fertilized egg to attach. Mkhatshane suggested that women with a history of active breast cancer, liver disease, and diabetes with high blood pressure should avoid this method.

The vaginal ring is a small plastic ring that is inserted into the vagina. It releases a steady dose of hormones into the bloodstream to prevent pregnancy. According to Mkhatshane, the vaginal ring is just as effective as contraceptive pills but should not be used by women who smoke and are older than 35 years. Side effects include nausea, vaginal discharge, and decreased sexual appetite.

What do SA women prefer?

Injectable birth control was by far the most common method, used by 25% of women, according to a 2017 study by the South African Medical Journal (SAMJ). Other methods were less common and only a negligible proportion used an IUD (1.6%), while 8.6% used a birth control pill. – Health-e news

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Women’s Health

Coming second in the game of life – Kate Pickett

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“We don’t want to behead the big poppies,” said Boris Johnson in July. But for Kate Pickett, his “leveling” ambitions will require a flattening of the entire social divide.

The not entirely social winners? – a wedding reception on the Thames (Ian Luck / shutterstock.com)

There was enough athletic competition in the summer to remind us how hard it can be not to be quite the winner. In England there was great excitement when the national soccer team reached the final of the European Championship, only to lose there on penalties to Italy. There was almost immediately a backlash of racism and hatred towards the players who missed those crucial final shots on goal.

At the US Open tennis tournament, the women’s final was played by two talented teenagers who had both done spectacularly to get this far – but the disappointment of runner-up Leylah Fernandez was hard to see. And at the Tokyo Olympics, one competitor after another said to the cameras, ‘I’m not here for second place; I’m not here for silver. ‘

But in life, unlike in sport, is the second one surely good enough? We can’t all be winners, but if we have a good education, a good job, and all of our material needs, is that enough for our health and wellbeing?

In some ways it is true: nobody needs excessive income or wealth to be healthy, and too large an income gap between rich and poor is detrimental to the health of the population and the good functioning of society. But it is also true that, like in sports, being the winner is not that important.

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Social slopes

Almost all major causes of death and illness show social inequalities. They are not only more common among the poor and the lower classes of society, while they are rare among the rest of the population. Instead, there is a steady gradient in the incidence of various diseases and causes of death between each level of the social ladder. So while morbidity and mortality are certainly highest among the worst-off, if you are not entirely at the top of the income bracket, not entirely in the top social class, or not well educated, there is a risk of poor health. Illness and death are still a little higher than those directly above you.

This is an almost ubiquitous pattern around the world. We see it in life expectancy and infant mortality, in health behaviors like smoking and obesity, chronic diseases, heart attacks, infections, and most cancers. There are one or two exceptions, particularly breast and prostate cancer, but otherwise there are social health gaps everywhere.

In the graph below, the bars show life expectancy for men and women in England, with the population divided into ten groups, from those most deprived on the left to those least deprived on the right. When we look at such charts, we usually notice the differences between the top and the bottom – here a life expectancy of 9.5 years between the most deprived and least deprived men and 7.7 years between the most deprived and least deprived Men least disadvantaged women.

Life expectancy at birth by decile and gender, England 2018

social gradient

But with every step from prosperity to misery, from right to left, both men and women, on average, lose a little bit of life expectancy. Men in the least disadvantaged group live an average of about 82 years, about a year and a half less than men in the least disadvantaged group of all. Women in the second best group live just over 85 years, but women in the top group live about a year longer.

These are surprising penalties for being among the least disadvantaged instead of making it into the top 10 percent. No one in the top 20 percent is denied any material necessity, and no one is likely to lack the knowledge to make healthy decisions. Nevertheless, people in the second decile still die younger and suffer from almost all acute or chronic diseases more often than in the first.

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Status matters

What these social gradients tell us is how important the social environment is – it’s status itself that matters. If you have a little less status than the one at the top, you are not doing as well as if you are the highest status. If we are to address health inequalities, we need to level the entire gap, not just try to tackle health problems from the bottom up.

While social gradients are almost ubiquitous in the health sector, the steepness of the gradient varies from place to place. Societies with lower economic inequalities have a widespread tendency to have smaller absolute differences in health. Reducing inequalities in income, wealth, education and social class will help society as a whole – not just the poorest or those in dire need. We would all be winners if the playing field was leveled.

Covid-19 of course also has a social gradient. It was never an “equality disease,” as some claimed early on. It’s too late for the pandemic we are in, but some serious social and economic leveling would help us cope with whatever might come next.

This is a joint publication by Social Europe and IPS-Journal

social gradient

Kate Pickett is Professor of Epidemiology, Associate Director of the Center for Future Health, and Associate Director of the Leverhulme Center for Anthropocene Biodiversity, all at the University of York. She is co-author with Richard Wilkinson on The Spirit Level (2009) and The Inner Level (2018).

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Women’s Health

Mon Health Stonewall Jackson Memorial Hospital physician honored by WVSOM

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WESTON, W.Va. – Mon Health Stonewall Jackson Memorial Hospital Obstetrician / Gynecologist Robert Harris, MD, was born on Friday 17th), in Lewisburg.

The Outstanding Preceptor Awards are given to physicians who show professionalism and demonstrate their service to students, including a commitment to teaching, mentoring, and the educational process. They also serve as positive role models, reflecting their commitment to the osteopathic teachings or the Hippocratic Oath and commitment to patient care. Preceptors support and advise the medical students of the WVSOM in their clinical rotations in the third and fourth years.

Students in each region nominate and vote on the preceptors for the awards. The Central East region encompasses the central portion of WV, including Elkins, Buckhannon, Weston, Bridgeport, and Morgantown.

Dr. Harris earned his bachelor’s degree from Quinnipiac College, Connecticut, before earning his medical degree from St. Georges University in the West Indies. He completed his residency at Staten Island University Hospital in New York. He is certified by the American Board of Obstetrics and Gynecology and a Fellow of the American Congress of Obstetricians and Gynecologists.

“DR. Harris is an excellent teacher. He challenges you as a student to see your potential. He allows us to perform procedures and has very hands-on experience in obstetrics / gynecology. I’m in with little interest in obstetrics / gynecology gone the rotation but after working with Dr. Harris I appreciate the field a lot more, ”wrote one student.

Other nominators wrote: “Dr. Harris goes way beyond that for his students. He’s a great teacher and really helps students prepare for the post-test rotation and boards. ”Others wrote that Dr. Harris was one of the finest teachers they had worked with and that his ability to teach and work with patients was “paramount”.

In an interview a few years ago, Dr. Harris carefully considered why he made women’s health his specialty.

“I chose Women’s Health because I enjoy short-term and long-term care options. For example, an emergency room cannot maintain a long-term relationship with the patient. This field gives me the opportunity to have both surgical and medical treatments, ”he explained. “But perhaps one of the most important aspects of my practice is the opportunity to be present at the birth. Having a baby is a unique and extraordinary experience. It is more moving than any other experience in the medical field. “

Other doctors at Mon Health Stonewall Jackson Memoria Hospital who have received the award in the past include Dr. Robert Snuffer and Dr. Brian Hornsby.

Approximately 50 hospitals, clinics, and medical centers across West Virginia participate in WVSOM’s statewide campus program. Outstanding Primary Care and Specialty Preceptor Awards were given to physicians in each campus region, including the central (split), eastern, northern, southern, central, southeastern, and southwestern regions.

To learn more about Mon Health Obstetrics and Gynecology, visit MonHealth.com/OBGYN or call 304-269-3108 in Weston.

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