Female Troubles: Gynecological Health

The more complicated the machinery, the greater the expertise necessary to fix anything that goes wrong with it. That’s true for exotic cars as well as for some of the more exotic parts of the human anatomy. And so we have a branch of medicine known as gynecology, which specializes in treating the uniquely female parts of the human anatomy—the vulva, vagina, uterus, fallopian tubes, and ovaries.

Any female of any age can have a gynecological problem, but as women get a bit older, some gynecological problems are more prevalent than others.


Vaginitis, an infection or inflammation of the vagina, is probably one of the most common conditions a woman can have. It’s known by many names and is perhaps most often referred to as a “yeast infection.” But many organisms can cause a vaginal inflammation, with yeast or C. albicans, being but one. Bacteria, parasites, and viruses can also trigger vaginitis, as can an allergic reaction or a hormonal change.

Normally the vagina is an area of the body where there is a balance of bacteria and yeast. But if you have a medical condition such as diabetes, or if you are taking medication such as antibiotics, then the balance of vaginal flora is altered; either the yeast or the bacteria becomes overgrown, and a vaginal infection occurs.

The symptoms of vaginitis include burning, itching, abnormal vaginal discharge, painful sexual intercourse, and painful urination. Most women with vaginal infections do not have any symptoms, however. By doing a physical examination, a doctor can diagnose vaginitis, which can then easily be treated with topical or oral medications.

Menstruation Problems

Troubles related to menstruation are another source of common gynecological problems. One of these is dysmenorrhea, a painful menstruation that’s usually due to a cramping of the uterus when bleeding occurs during the menstrual cycle. This can be seen as early as the teen years when a young girl begins to have her menstrual cycle, but for many women it only develops over time. It can last just a few hours or as long as several days.

Other symptoms associated with dysmenorrhea include headaches, pelvic tenderness, back pain, diarrhea, and nausea, all of which can be attributed to the contractions of the uterus that occur during menstruation. For many women, the most effective treatments are simple pain relievers or sedatives. In severe cases, medication to decrease the amount of a biochemical called prostaglandins, which are produced during menstruation, relieves the pain.

PMS, or premenstrual syndrome, is a cluster of behavioral symptoms resulting from the hormonal changes that occur about two weeks before menstruation. The symptoms themselves appear right before or during menstruation. Up to 40 percent of women may be affected by PMS, though only 5 to 10 percent have a severe form that requires treatment.

The behavioral symptoms involved range from depression, aggression, irritability, and anxiety to mood swings, nervous tension, and food cravings. And for many women PMS also includes headaches and fatigue. Because the problem is difficult to identify, treatment is problematic.

Dietary and other lifestyle changes can have a direct affect on PMS. Women who exercise regularly report having fewer PMS symptoms. Reducing salt in the diet can help minimize bloating and swelling, while reducing caffeine and alcohol can minimize irritability and mood swings.

Yoga, meditation, and other relaxation techniques can help reduce the physical discomfort of PMS and lower stress. Calcium and moderate doses of magnesium and vitamin E may also be helpful in decreasing many PMS symptoms. Other treatments for PMS include anti-inflammatory drugs, such as ibuprofen to reduce PMS-associated pain, and diuretics, which may help reduce fluid buildup and decrease bloating.


Another common gynecological condition, endometriosis, affects about 20 percent of American women of childbearing age. The condition gets its name because it involves the endometrium, which is the tissue that lines the uterus. The tissue plays a major role in getting pregnant and is shed during menstruation.

In endometriosis, cells from the endometrium migrate and become embedded outside the uterus or in the major muscle of the uterus. During menstruations, these out-of-place cells react the same way as the bleeding endometrium within the uterus; when these cells outside the uterus start bleeding, they can create excessive menstrual cramps and incredible pain.

And if those cells are numerous, the bleeding can pocket and eventually form fibrous bands of scarlike tissue, which may create terrible pain during intercourse and block the fallopian tubes, causing infertility.

A gynecologist can diagnose endometriosis after reviewing a patient’s history and performing a physical examination or, if necessary, doing a laparoscopy. In this procedure, a small visual scope is inserted through a tiny puncture hole in the abdomen, providing a good view of the internal anatomy of the pelvis and any endometriotic sites that may be present. These sites can either be surgically removed or burned off. If the coverage is significant, other treatments like hormone therapy are recommended to try to disintegrate these tissues and encourage their reabsorption.

A patient whose endometriosis is very severe may end up needing a hysterectomy, which is the surgical removal of the uterus and surrounding tissues.


A uterine fibroid is a tumor in the female pelvis. These are nodules of smooth muscle and connective tissue that grow within the wall of the uterus. They range in size from microscopic to ten inches and are more commonly seen in African American women than in white women. Although fibroids are very rarely associated with cancer, they can degenerate into cancerous lesions. Obesity has been linked to the development of fibroids, but the association is not a strong one.

Women who have fibroids, especially small ones, may not have any symptoms. If the fibroids are a little bit larger, women may complain of pressure, painful menstruation, back pain, excessive or heavy menstrual periods, frequent urination because of the pressure on the bladder, or painful intercourse.

Depending on the size and location of the fibroid and the age of the patient, treatment can range from nothing more than observation to a myomectomy, the surgical removal of fibroids, or a hysterectomy. There are new noninvasive procedures that women should consider, such as embolization, which involves blocking the vessels that feed the fibroid in an effort to shrink it, as well as cryosurgery, which is the freezing of fibroids.

Early Menopause

Some medical therapies, such as radiation treatments and chemotherapy, can lead to premature menopause. So can a total hysterectomy, which is the surgical removal of both the uterus and the ovaries. One percent of women are affected by premature ovarian failure (POV); this is usually seen in women younger than 40 years of age and is due to genetic factors or an autoimmune disease. POV has puzzled researchers for decades, and there is at present no safe and effective treatment for restoring the normal function of the ovaries.

Click here to check out Dr. Manny's book The Check List (Harper Collins, 2007), from which this article was excerpted.

Dr. Manny Alvarez is the managing editor of health news at FOXNews.com, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit AskDrManny.com.