Last week I looked at the function of the endocrine system and hormones for both the female and male reproductive systems and this week an overview of some of the health issues that women can face during their lifetime.
An overview of health issues – The fertile years 10 – 50 years old.
In this third part of the series on the female reproductive system a look at some of the health issues that might occur in the 40 years that it is active. Every woman is unique and I can only give you averages when talking about events during a monthly cycle.
From the age of ten a girl is maturing towards becoming fertile. Puberty marks the start of an average of 40 years of one of the most miraculous, but also often inconvenient monthly cycles. Beneath our skin a complex series of actions are taking place to ensure the smooth running of this female process. Although the actual period only lasts an average of 7 to 10 days but can be shorter or longer, the process is ongoing for the full 28 to 32 days. The cycle can be different depending on a number of factors and will change as a woman matures.
There are a number of hormones, other than oestrogen and progesterone, involved in the menstrual cycle and the process is normally very precise and runs like clockwork to afford the very best chance of fertilisation of the egg.
There are three distinct stages that are orchestrated by the hormones, in sequence, and the whole cycle will take between 28 and 32 days to complete.
Stage one – Follicular phase day 1 – 13
During this phase the pituitary gland releases a hormone called FSH (follicle stimulating hormone) which will stimulate the egg containing follicles in the ovaries. In turn the follicles will release oestrogen which produces changes in the consistency of the mucus in the cervix resulting in a clear discharge mid cycle. This change help prepare the mucus to receive and nourish the sperm from the man.
Stage two – Ovulatory phase – approximately day 14
At this stage the level of luteinising hormone (LH) released from the anterior pituitary gland, dramatically increases or surges. LH forces the follicles to break open and release its egg into the fallopian tube. This is ovulation and takes approximately 24 hours.
Stage three – Luteal phase – day 15 to 28
After the follicle has released its egg it changes function and becomes a gland called the corpus luteum. This gland now releases the progesterone that will stimulate the growth of the thick and blood rich lining of the womb that might be needed if the egg is fertilised.
If the egg is not fertilised it dries up and dies and the lining of the womb is expelled through the cervix and out of the body as a period.
The health of the reproductive system.
Forty years is a very long time in body terms and it is hardly surprising that a system as complex as the reproductive function is not going to suffer from problems. These are either due to disruptions to the hormones in charge, or the organs themselves.
I know that you expect long posts from me but even I draw the line in covering all the health issues we might face over the years. Here are the headlines!
Conditions associated with the reproductive system
Many young girls and women suffer from PMS (Pre-menstrual syndrome) and in some cases this continues right up to menopause. This can be helped by changes in diet and exercise levels as well as some supplementation of specific nutrients and herbs.
Infertility is a problem that may not be discovered until a woman is in her late 20’s and 30’s and is actively trying to get pregnant but there are certain lifestyle and dietary issues as well as possible physical or hormonal reasons for difficulties in becoming pregnant. I will cover the basics under that heading.
PMS symptoms tend to occur at specific phases of the menstrual cycle, which are modulated by the changing levels in the female sex hormones oestrogen and progesterone. It is logical then to assume that any adverse symptoms are caused by some disruption to the balance between these two hormones.
PMS always occurs during the luteal phase of the menstrual cycle when the luteinising hormone (LH) increases the production of progesterone and oestrogen in the ovaries. This phase in the cycle is specifically to encourage secretions in the fallopian tubes and womb to ensure the proper nourishment and implantation of a fertilised egg.
There are a number of theories that have been put forward to try and explain the various reasons why individual women suffer differing symptoms at this time from water retention to depression. Some studies suggest that it is a lack of progesterone that causes the problems with some women responding favourably to progesterone therapy and other studies finding that it makes matters worse. The common factor appears to be an imbalance of one or other of the two female hormones oestrogen and progesterone. I think the key lies in a number of factors one of which is that we are all individual and this includes our hormonal makeup.
I have worked with many teenagers and older women who were suffering from PMS and I found the best way to start was with diet and exercise with particular attention to any other influences such as Candida Albicans or stress. Many women respond very favourably to being treated for Candida Albicans, as some of the symptoms for this are lower back pain, depression and water retention. Candida takes over the intestines and healthy and friendly bacteria are in short supply. Bacteria in our gut is responsible for the manufacture of certain nutrients such as Vitamin K that plays a role in regulating our menstrual flow so it is logical that Candida could also contribute to PMS problems.
I have written a number of posts on the subject of Candida that you might find useful.
There are a number of nutrients that are also implicated in PMS and in my experience usually the cause is a lack of variety in the diet, particularly vitamin B6. This tends to be the result of dropping a major food group such as wholegrains and animal protein from the diet..
Foods that contain B6 – wholegrain carbohydrates like brown rice, porridge oats, walnuts and sunflower seeds, bananas, avocados, salmon and tuna, dried fruit such as prunes and raisins, eggs, wheatgerm, poultry and meats/ such as lamb.
Some doctors prefer to put women on the contraceptive pill to help regulate periods and minimise PMS but I am still not happy about taking additional hormones without first trying the natural approach for at least two cycles. Talk to your doctor about making lifestyle changes first including reducing the amount of sugar in your diet. The recommended amount of sugar is 7 teaspoons per day.. It is easy with breakfast cereals, flavoured yoghurt etc to consume 14 teaspoons for breakfast. Blood sugar levels are erratic and hormones are affected.
Infertility can be devastating to a young couple who have dreamt of having a large family and assumed that it was going to be as simple as stopping taking the pill or any other form of contraceptive. Unfortunately, for some women, there are physical reasons why they are unable to either produce an egg in the first place or carry the fertilised embryo to full term.
Usually there are a number of factors involved that cause or add to the reasons behind a woman’s infertility. Since these are also the more common health issues with the reproductive system in general it is worth focusing on them in this post.
- Hormone levels are not sufficient to stimulate the release of an egg from the ovary or for it to successfully implant into the lining of the womb.
- A woman is more than 30% over her ideal weight or severely underweight and this effects ovulation. There is a link between eating disorders such as anorexia where body weight is reduced for extended periods of time. The body switches off non-life sustaining body functions. If you cannot nourish yourself then you would not be able to nourish a foetus.
- Fibroids of the womb.
- Endometriosis where the normal tissue that lines the womb is found outside in other areas of the pelvis.
- Production of antibodies that attack a partner’s sperm and kills them before they can fertilise her eggs.
- Infections throughout the pelvis caused by Chlamydia or by appendicitis leading to damage and scarring of the reproductive organs.
Abnormal ovulation results in irregular or absent periods. This is usually caused by a lack of co-ordination between the hypothalamus and the pituitary gland, as these regulate the release of the hormones into the bloodstream.
If insufficient LH (luteinising hormone) or FSH (follicle stimulating hormone) is secreted then the levels of oestrogen and progesterone will not be high enough to begin the process of ovulation. This may require hormonal treatment but the first step is to ensure that diet and lifestyle factors are not playing a role in the imbalance.
Extreme weight fluctuation can also cause periods to cease as this is linked to hormonal imbalances associated with diet. Being overweight puts incredible stress on all the operating systems in the body including the reproductive system. Most women who have been overweight since childhood are likely to suffer from irregular or no menstrual cycle at all. Even being slightly overweight can affect hormone levels and it is recommended that a women get down as close to her ideal weight as possible before trying to conceive. There is additional wisdom in this as a woman who is already over three stone overweight is going to add another three at least during her pregnancy which can add significantly to risks of complications such as Gestational diabetes, very high blood pressure and the need for a Caesarean delivery.
In nature, in times of drought or famine, certain animals will not only cease to ovulate but they will also stop the gestation of their young until such time as conditions improve. One of the long-term issues with eating disorders such as Anorexia is infertility, as there is insufficient nutrients being made available to manufacture the necessary hormones. Before trying to conceive anyone who is dramatically underweight should take a close look at their diet and seek professional help in building up nutrition, calories and body mass.
One of the staggering statistics is that one in four women will enter the menopause because of medical treatment, the leading one being a hysterectomy (removal of the womb and ovaries). The biggest single reason is fibroids, which are benign tumours inside and outside the womb. There are three general locations for fibroids.
- Subserosal –on the outside surface of the uterus
- Intramural – within the muscular wall of the uterus
- Submucous – bulging in to the uterine cavity.
The submucous location is rarer than the other two but is the one associated with failure to conceive and early miscarriage. If the other two types of fibroid grow too large however they too can have an effect on the reproductive system.
No one is entirely sure what causes fibroids to form. There are a number of factors and hormone imbalance is probably involved. However, our diet may also be partly to blame as many foods that we consume contain substances that mimic the way oestrogen affects the body – and these include growth hormones in milk, beef and chicken, pesticides on our food and even the plastics we use in our kitchens for storage. This leads to oestrogen dominance in a woman, which can then lead to a number of reproductive problems including the growth of these benign tumours.
There is also a genetic link and if your female relatives have tended to get fibroids then you are at risk of developing them too. The light at the end of the tunnel is that they nearly always shrink when you reach menopause but if they cause heavy and painful bleeding and are making your life a misery you should deal with them as soon as possible.
Endometriosis develops when tissue resembling the endometrium inside the womb begins growing out in the pelvic cavity. The most common symptoms of this are painful sexual intercourse, period pains and infertility.
The endometrium is made up of blood, endometrial skin cells, glands and pieces of blood vessels and connective tissues. Although the endometrium is usually discarded and broken into pieces to be excreted in menstrual blood through the vagina, it can sometimes find its way through the upper openings of the womb that lead to the fallopian tubes. The ends of the fallopian tubes are open to the pelvic cavity and the pieces of endometrium can then attach themselves to any surface within the cavity and reform using all the components to grow and develop.
If the fallopian tubes are blocked and the ovaries are now coated with growing endometriosis there is little chance of an egg being produced and fertilised by a sperm – leading to infertility.
The usual treatment is to remove the lesions surgically or prescribe drugs that suppress the endometrium in the womb to keep it thin. This, in effect, creates a false menopause as it also suppresses the ovaries and the production of oestrogen. If you are hoping to have children it might have a long term effect on your ability to conceive.
When the body is not ovulating, cervical mucous has a role in killing any harmful bacteria trying to get into the body via the vagina. However, during ovulation a chemical change occurs which is designed to ensure the survival of the sperm on its way into the system. Some women react to their partner’s sperm, by developing antibodies instead, and killing the sperm as it fights its way towards the cervix.
One of the more common causes of infertility today is an infection that has damaged part of the reproduction system. For example, Chlamydia is a bacterial infection transmitted sexually and is the most common of the STDs contracted by adolescents and young adults today. The biggest problem is that you may not discover that you have been infected until you are trying to have a baby because 75% of women and 50% of men have no overt symptoms and it is therefore known as a silent disease.
Left untreated, Chlamydia can spread and cause pelvic inflammatory disease (PID) which rises through the vagina and the cervix before infecting the womb, fallopian tubes and the ovaries. The resulting scarring to the fallopian tubes can cause infertility and increase the risk of ectopic pregnancies (inside the fallopian tube).
In the rare cases where symptoms are present they can mimic other pre-menstrual symptoms and be ignored such as lower back pain, bleeding between periods, nausea and fever. However, if these are also accompanied by frequent urinary tract infections, chronic pelvic pain and vomiting it is necessary to consider that it is Chlamydia and seek medical attention.
Fertility levels decrease with age in women. Although there have been some reports of women becoming pregnant during the change of life it is rare. Women are at their most fertile up to 24 years old but today many women are putting off having children, preferring to wait for career or economic reasons. It is estimated that one third of women over 35 will experience some problems getting pregnant and at least half will have severe difficulties.
Declining hormone production, lack of viable eggs and an accumulation of the other factors I have covered in this article will combine to cause fertility problems. If a woman has also smoked, drunk too much alcohol and not eaten a healthy diet she will add to the difficulties.
Our body has very specific needs and this includes essential nutrients that can be processed and distributed around the body to where they are needed. As always a varied diet with lots of fresh vegetables, lean protein, fruits and wholegrains is a great place to start… And need I say.. Cooked from Scratch without any industrialised sugary additives.
For those of you who would like to know more about the nutrients we need here is a shopping list by nutrient with the foods that supply it in adequate amounts: Weekly shopping list by nutrient.
Thank you for reading and please feel free to comment or share. best wishes Sally
©Sally Cronin Just Food for Health 1998 – 2021
I am a qualified nutritional therapist with twenty-three years experience working with clients in Ireland and the UK as well as being a health consultant on radio in Spain. Although I write a lot of fiction, I actually wrote my first two books on health, the first one, Size Matters, a weight loss programme 20 years ago, based on my own weight loss of 154lbs. My first clinic was in Ireland, the Cronin Diet Advisory Centre and my second book, Just Food for Health was written as my client’s workbook. Since then I have written a men’s health manual, and anti-aging programme, articles for magazines, radio programmes and posts here on Smorgasbord.
If you would like to browse my health books and fiction you can find them here::Sally’s books and reviews
Thanks for visiting and I am always delighted to receive your feedback.. stay safe Sally.