Generally, women seem to have more health issues than men.
Yet, they live longer.
According to the 2015 World Health Organization (WHO) data, life expectancy in Malaysia is 72.7 years for males and 77.3 for females, which gives us a World Life Expectancy ranking of 66.
At every phase in a woman’s life, niggling problems may crop up, and if not addressed immediately, they may become a medical complication.
These can start during the adolescent stage, from ages 10 to 19.
The WHO estimates that 20% to 35% of all adolescents have a chronic disease or condition.
These conditions cause many problems, including missed school days, high out-of-pocket expenses for families and substantial time spent by parents attending to their adolescents’ needs.
The teenage years bring many changes, not only physically, but also mentally, emotionally and socially.
Somehow, adolescent girls are more affected by these changes.
“When you go through puberty, there is a lot of ‘demand’ on the body. This is a period of physical change and the greatest growth spurt. These girls could be the same age, but have different bodies. In terms of psychosocial changes, different girls go through different stages of maturity at different times. A lot of girls also start risk-taking behaviour,” says Dr Lim Ser Chin, consultant paediatrician and paediatric rheumatologist.
Two common autoimmune diseases during this period are juvenile idiopathic arthritis (JIA) and systemic lupus erythematosus (SLE). These conditions are more common in girls compared to boys.
The incidence of these diseases are rising globally in adolescents, with 3% (girls and boys) of the population afflicted.
JIA is normally seen in children below the age of 17, and symptoms include persistent joint pain, swelling and stiffness. Some children may experience symptoms for only a few months, while others have symptoms for the rest of their lives.
This disease causes the body’s immune system to attack its own cells and tissues. It’s unknown why this happens, but both heredity and environmental factors are thought to play a role.
Dr Lim says, “Statistics show JIA affects more girls, but with proper treatment, 70% of the disease can be controlled within two years. Patients have to be taught to handle it.”
The doctor was speaking at a roundtable session highlighting little known health conditions and issues that are specific to women. Organised by the International Medical University in conjunction with International Women’s Day on March 8, the session last week featured three speakers.
Dr Lim, who presented her topic, “Autoimmune Disease In The Female Adolescent – I Am Too Young To Be This Sick”, says JIA could potentially be life-threatening.
SLE can affect joints, skin, brain, lungs, kidneys, and blood vessels. Children and teens with SLE may have fatigue, pain or swelling in joints, skin rashes, fever, hair loss and mouth sores.
“SLE is aggressive in children and adolescents. Medications have proven to be effective although they come with a cost as they could impair growth and cause damage to other organs,” she says.
Fatigue is a problem that can affect the healthiest of individuals, but the underlying cause is difficult to determine.
It’s twice as common in women than in men.
Speaking on “Fibromyalgia vs Chronic Fatigue Syndrome: Am I Imagining My Sickness”, family medicine specialist Dr Verna Lee says these two conditions are often under-diagnosed.
Fibromyalgia and chronic fatigue syndrome (also called systemic exertion intolerance disease or SEID) are considered separate, but related disorders.
Affecting older women, they share a common symptom – severe fatigue that greatly interferes with everyday living. With fibromyalgia, there is widespread muscle pain and excessive tenderness when the muscle is touched.
“There is also fatigue, sleep disturbances, headaches, depression and anxiety. The cause is unknown, though the triggers could be infection, physical or emotional trauma. There is no diagnostic test so it can take a while before fibromyalgia is diagnosed,” says Dr Lee.
She cites the case of a 50-year-old patient who had all the symptoms, consulted various specialists who conducted many tests and invasive procedures, was wrongly diagnosed with stroke and spinal stenosis, was started on spinal injections and given tons of medication; yet, her problem was not alleviated.
For two years, the woman suffered in agony until she was finally diagnosed with fibromyalgia.
Dr Lee says, “With correct medication, the patient’s quality of life improved tremendously and she can now sleep interrupted for at least four hours.
“With chronic fatigue syndrome, it causes one to stop more than half of her usual activities over a six-month period. Despite no exertion, fatigue is there, and it cannot be arrested with rest.
“Sleep does nothing to refresh them and they have poor memory and concentration. But unlike fibromyalgia, there is no pain and it affects mainly young and middle age women.
“The important thing to remember is that these are not life-threatening disorders and do not lead to another serious disease. Patients have to take charge and learn to cope with the symptoms.”
Another female-only problem, especially among post-natal women, is urinary incontinence.
“One in five Malaysian women suffer from it but they don’t reveal it unless the doctor asks. They’re either too shy or embarrassed,” says consultant obstetrician and gynaecologist Dr Sharifah Suhaila Syed Aznal in her presentation, “Incontinence In Women: Is It My Age?”
Common factors include a difficult vaginal birth, pelvic organ prolapse, obesity and high parity. The likelihood also increases with age.
The three types of incontinence are urge (nocturia, frequency and urgency), stress (loss of urine when laughing, coughing and straining) and overflow (dribbling of urine without the sensation to urinate).
“Our bladder can take up to 500ml of liquid, so you can actually drink three to four mugs of water and won’t have to rush to the toilet immediately. If you do, then something is not right.
“Depending on the kind of incontinence, it can be treated with surgery, medication, exercise or behavioural therapy,” says Dr Sharifah. There are a number of methods that can be used for prevention, such as leading a healthy lifestyle, preventing diabetes, avoiding diuretic drugs and reducing high-caffeinated beverages and alcohol.
She says, “We all want to have a normal delivery, but if the baby is big, try to prevent a difficult birth vaginally and consider having a caesarean section. Medicine has advanced so much that the surgery is safe and the risks are minimal. Women also have to be educated on the normal function of the bladder and treat infections promptly.
“One of the best ways to improve bladder function is by performing pelvic floor or Kegel exercises. By that, I don’t mean just doing one or two, but at least 1,000 a day to see results.
“You can do it anytime, anywhere, and no one has to know. Hold for 10 seconds before you let go. Another way is to practise Kegel exercises is during sex – it’s cheap maintenance!”