Tuesday, July 5, 2011

My Body Myself---Maybe?

I am continually amazed at the myths, untruths and misunderstandings that women have about their own bodies and how they work.  I do a LOT of educating in my day-to-day office sessions, and I always feel good when people leave understanding much more than they did when they came.  I'm not really sure where these ideas come from,other than information incorrectly gleaned from the Internet, or from family and friends, or from TV shows and other media.  One of the least well-understood concepts is that of the menstrual cycle.  My typical "menstrual cycle 101" explanation goes something like this:
The reproductive cycle is sort of a closed loop, involving the brain, the ovaries and the uterus.  The brain signals the ovaries to produce Estrogen.  The ovaries make Estrogen, whose job it is to make a thick blood-filled lining form inside the uterus.  Once it gets nice and thick (ready for something to implant) the brain again signals the ovary. This signal occurs about 12 days after the first day of the last period.  This signal is to OVULATE, or release an egg.  Once the egg is released, it takes a trip in search of a sperm to join with (into the fallopian tube).  What is then "left over" in the ovary after that ovulation, makes Progesterone, another hormone.  Progesterone helps stabilize that lining that has been building up in the uterus.  IF that egg is not fertilized, the levels of Estrogen and Progesterone drop very low, and the uterus, realizing that there is nothing coming to be implanted in the uterine lining, sheds that lining, hence---the next period.  This is quite a delicate balance of signals and hormones (estrogen and progesterone) and organs.  If ANY part of this cycle is not functioning correctly, it will result in either irregular periods, missing periods, and/or possible difficulty getting pregnant.  Once women understand this concept, they have a MUCH better understanding of their own cycle, and will understand the various ways that I can help them manage the problems they may be having with it.  There are explanations like this for so many other bodily functions, and I believe understanding these concepts is important for women to take control of their own health care.  In the "olden days" of Gynecology, when women were not so autonomous, and "The Doctor Always Knew Best", (and that doctor was usually a man), it was not unusual to hear things like, "You're finished having babies, why not just take your uterus out?" at the hint of any problem with the menstrual cycle.  These days,  women should hear about and understand all of their options when it comes to reproductive care.  It is important, and one of the things I love best about my doctor-patient relationships.

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