Popularization of female health knowledge
I. Women's Health
1. Adolescent health
The period from menarche to the maturation of the reproductive organs is also called adolescence; it is a transitional period from child development to adulthood. The World Health Organization sets adolescence at 10-19 years.
(1) Physiological characteristics of adolescence
The increase in height and weight is the second peak after childhood. The sudden increase in height is an important sign of puberty. The height increase during this period is about 5 to 7 cm per year. It weighs about 5 to 6 kilograms per year. 2. Development of the reproductive system
It shows that the external genitalia changes from naive to adult type, such as the bulge of the genitals, the enlargement of the labia majora, the pigmentation of the labia minora, the wrinkles of the vagina, the length and width increase. The uterus is enlarged, and the uterine body is particularly significant. The ratio of the uterine body to the cervix has changed from 1: 2 in early childhood to 2: 1 in adulthood. The fallopian tubes are thickened, and the ovaries show follicles of varying degrees of development.
The first menstrual period is called menarche. Menarche is one of the important indicators of the onset of puberty. The menarche age is mostly between 13 and 15, and there are individual differences due to environmental, health and other factors. If menarche occurs before the age of 9 years, it is necessary to consider whether it is "precocious puberty" and there is no menstruation after the age of 18, which may be the primary amenorrhea, and you should seek medical examination as soon as possible. Because the ovarian function is not yet perfect, the menstrual cycle after menarche is often irregular, and it must be gradually adjusted to be close to normal.
The first day of bleeding is the beginning of the menstrual cycle, and the interval between the first days of two periods is one menstrual cycle, usually 28-30 days. The duration of menstruation is 2 to 7 days, and most of them are 3 to 5 days. The amount of bleeding per menstruation is menstrual volume, about 50 ml. Menstrual blood is generally dark red, the main feature is non-coagulation, and occasionally small clots, which is normal.
Menstrual periods generally have no special symptoms. Some women may experience symptoms of lower abdomen and lumbosacral fall, mild headache, insomnia, diarrhea, or constipation, which generally do not affect daily life and work.
4. Second sexual characteristics appear
Second sexual characteristics are those unique to men and women outside the genitals. Women's second signs of pregnancy are first manifested by breast development, followed by pubic hair and axillary hair, the pelvis gradually widens, subcutaneous fat on the chest, shoulders, and buttocks increases, and female-specific physiques appear.
5. Systemic development throughout the body
(1) The circulatory system: the heart enlarges and the heart muscle thickens. The blood pressure and stroke volume increased, and the pulse gradually slowed down, close to the adult standard.
(2) Respiratory system: The development of lungs reaches the peak period, respiratory function increases, and vital capacity increases.
(3) Nervous system: The brain development does not change much in weight and capacity, but the neural structure of the brain gradually develops closer to an adult. It is characterized by active thinking, improved ability to respond to things, more accurate coordination of fine movements, and enhanced analysis and reasoning ability and memory.
1.性意识的萌发 (II) Adolescent Psychological Behavior 1. Germination of Sexual Consciousness
After adolescence is physiologically mature, it has a special effect on the mind and is the germination of sexual consciousness. It begins to realize its gender, the relationship between the sexes, and attitudes and behavioral norms towards the sexes.
2. Increased self-awareness
After entering adolescence, self-awareness develops rapidly, prominently manifested by strong self-esteem, and a strong sense of "adulthood" and seeking "independence." At this stage, young people often show contradictions between ideal and reality, independence and dependence.
3. Curiosity is better than imitation
In this state of mind, it is easy to be influenced by others. When the ability to recognize and judge is not mature, it is easy to become infected with bad habits and go astray.
4. Lack of Psychology
While adolescents have a sense of adulthood, adolescence-specific lock-in psychology begins to appear, that is, a sense of secrecy begins to form. It manifests itself as an understanding of the problem, and is tightly closed to the outside world, parents, and teachers. The psychological characteristics of adolescence have both a locked side and a desire to be understood. Teachers and parents should fully understand and master this psychological characteristic, pay attention to the way, grasp the time, and help and guide in time.
1.营养指导 (C) adolescent health guidance 1. Nutrition guidance
(1) Adolescence develops rapidly and nutritional needs increase greatly. First, more calories are needed than adults. The source of calories is mainly the sugar in the staple food. Therefore, the amount of meals needs to increase, and the rapid polymerization of hormones, antibodies, enzymes, etc. increases. These are mainly dependent on protein. , Fish and grains.
(2) Vitamin A, vitamin B, and vitamin D are all essential for growth and development. Calcium and phosphorus are the main raw materials for bone formation and teeth. Iron is an important component of red blood cells. It should be added during adolescence. Excessive dieting or weight loss can affect the development of the endocrine system and the body.
2. Psychological guidance
Before and after puberty, with sexual maturity, psychological changes are great, especially sexual awakening. In this period, the girls showed shyness, anxiety, personality changes, and love for the opposite sex. The formation of self-awareness, independence intention and sense of adulthood often has contradictions between independence and dependence. Therefore, we should strengthen the education of sexual knowledge and moral concepts. According to the psychological characteristics of adolescents, parents, teachers and their adults should be concerned about their friendships and properly guide them.
3. Menstrual health guidance
(1) Choose sanitary products with soft texture and strong water absorption, keep the vulva clean, and do not take a bath.
(2) Avoid cold stimulation and excessive physical labor.
(3) Eat less spicy food and do not smoke or drink.
(4) Find abnormal menstruation or acne in the front of the menstrual area. Do not crowd or abuse drugs. Seek medical treatment in time.
It is to carry out health consultation and health check for the men and women who are about to get married, and to publicize the necessary knowledge on marriage and childbirth, so as to lay a good foundation for harmonious life, happiness and the birth of a healthy next generation.
1.性保健指导 (I) Premarital health guidance 1. Sexual health guidance
Including the basics of sexual physiology, sexual psychology and sexual health.
2. Reproductive health guidance
(1) Preparations before planning pregnancy: including the choice of pregnancy timing, preparation of health conditions, and avoiding interference from adverse factors.
(2) According to the schedule calculation algorithm, basal body temperature measurement method, and cervical mucus observation method to help determine the "pregnancy-prone stage" and "non-pregnancy-prone stage", and arrange for pregnancy in the pregnancies.
3. Guidance for Newlyweds
Newlyweds should consider the physiological characteristics of the newly-married stage when choosing a contraceptive method. The method should be simple and should not affect fertility and the health of the offspring after stopping use.
(1) Require short-term contraception after marriage: general contraceptives are suitable. For example, the male condom method is simple and easy to master. Applying some contraceptive ointment on it can increase lubrication, reduce foreign body sensation, and improve contraceptive effect. Although the natural contraceptive method has the advantages of simplicity, economy, safety, and harmlessness, as the emotional excitement and physical exertion during the wedding period will affect the ovulation rule, it should be used with extreme caution to prevent failure.
(2) Long-term (more than 1 year) contraception is required after marriage. In addition to the use of external contraceptives, if there is no contraindication to steroid hormones, oral contraceptives can be used, and short-acting is appropriate. Discontinued in the first half of pregnancy.
(3) Those who require long-term contraception after marriage or do not plan to have children after remarriage: they should first use long-acting, safe, convenient, and economically stable contraceptive methods, such as intrauterine contraceptive devices, long-acting contraceptive needles, and subcutaneous implantation. .
(4) For those who are not suitable for life: In principle, the affected party should adopt sterilization or long-acting contraception. 医学 意见 (2) Medical opinions on marriage and childbirth
1. Suspension of marriage (1) During the onset of mental illness: such patients lose their ability to control themselves during the onset of illness; multiple factors affect the rehabilitation of the patient after marriage; if a female patient becomes pregnant after marriage, a large number of antipsychotic drugs can cause teratogenesis, Stunting, intrauterine death and other effects. (2) The designated infectious disease is in the infectious period: the health hazards of marriage at this time: ① infectious spouse; ② affect the rehabilitation of the disease; ③ if pregnancy can be transmitted to the fetus, resulting in adverse outcomes.
(3) Important organ diseases with insufficiency.
(4) Reproductive organ development disorder: It may affect sexual life after marriage and should be corrected before getting married.
2. It is not suitable to have severe genetic diseases, and the patient has lost all or part of his or her ability to live independently; no effective treatment is available; the offspring is at high risk of recurrence; 3. Perinatal health care Perinatal health care refers to a series of health care measures for the health of a pregnant mother and fetus during a pregnancy from pre-pregnancy, pregnancy, childbirth, puerperium (lactation), and newborn. 孕前期保健是为了选择最佳的受孕时机。 (A) Pre-pregnancy health Pre-pregnancy health is to choose the best time to conceive. The issues that should be paid attention to during preconception health care are as follows: ①. Choosing an appropriate reproductive age is conducive to reproductive health. Females <18 or> 35 years of age are risk factors for pregnancy, which can easily cause dystocia and other obstetric complications. Women over 35 years of age have an increased rate of fetal chromosomal abnormalities (trisomy 21). Research data show that the maternal mortality rate and the reincarnation mortality rate are the lowest between the ages of 25 and 29, followed by those between 20 and 24 and between 30 and 34.
②. Have a healthy physical and social environment before pregnancy. Have suffered a great mental blow, too much work and study tension, difficult living conditions, family disagreement, etc., are not suitable for pregnancy.
③. Actively treat diseases If you have diseases that affect pregnancy, such as viral hepatitis, tuberculosis, diabetes, hyperthyroidism, heart disease, hypertension, etc., you should actively treat them, and you should be pregnant again when you are pregnant.
④. Quit smoking and drinking If you have a bad smoking habit, you should quit before pregnancy and do not drink too much.
⑤. Select the appropriate contraceptive method Drug contraception needs to be changed to tool contraception for a period of time Oral contraceptives for a longer period of time, should stop using drugs and use tools for contraception and then conceive after 6 months.
⑥. Avoid contact with poisons and radiations. If necessary, you should switch jobs to avoid affecting the fetal development and even teratogenicity.
重视. Pay attention to the history of previous pregnancy and birth If you have a history of adverse pregnancy and birth before, you should consult your doctor this time to make preparations to reduce the risk of high-risk pregnancy and high-risk fetuses.
二）早孕期保健 ( B) Health care during early pregnancy
Early pregnancy is the intervention of embryo, fetal differentiation and development stage, various biological, physical, chemical and other factors, which can easily lead to fetal teratogenesis or abortion. Attention should be paid to preventing disease and teratogenicity. The main contents of early pregnancy health care are: ① confirming the diagnosis of early pregnancy; ② determining the basic blood pressure and weight; ③ conducting a high-risk pregnancy screening, ④ asking family members for a genetic medical history; ⑤ keeping indoor air fresh, avoiding contact with air pollution, and avoiding Viral infection, quit smoking and alcohol; ⑥ follow the doctor's advice to prevent teratogenic drugs; ⑦ know whether you have been exposed to harmful chemicals and long-term radiation exposure history; 避孕 contraceptive mental stimulation during early pregnancy, maintain a comfortable mood, pay attention to nutrition, Provide enough calories, protein, and eat more fruits and vegetables; ⑨ regular living, avoid overwork, ensure sleep time, and have appropriate activities daily. 孕中期是胎儿生长发育较快的阶段。 (3) Health care during the second trimester The second trimester is a period of rapid fetal growth and development. Health care in the second trimester should pay attention to strengthening nutrition, appropriate supplementation of iron and calcium, and monitoring of various indicators of fetal growth and development (such as palace height, abdominal circumference, weight, double parietal diameter, etc.). Prevent pregnancy complications such as pregnancy-induced hypertension, prevent and treat reproductive tract infections, and do a good job of screening for high-risk pregnancy.
(IV) Health care during late pregnancy The fetus grows and develops fastest in the third trimester, and the fetal weight increases significantly. At this time, nutritional supplementation and fetal growth monitoring are extremely important. When adding nutrition, you should pay attention to the aspects of calories, protein, vitamins, trace elements, minerals, etc., which must be increased and balanced. In the third trimester, special attention should be paid to monitoring the placenta function, early detection and timely correction of intrauterine hypoxia; make psychological preparations before delivery, and prepare breasts to facilitate postpartum breastfeeding.
(5) Health during delivery
Maternity health care refers to health care during childbirth. Although this time is the moment of childbirth, it is the key to the safety of the entire pregnancy. Advocate hospitalized delivery. High-risk pregnant women should be admitted in advance. The main points of health during delivery are summarized as "five preventions and one strengthening". "Five preventions" means: ① preventing infection ② preventing delayed labor ③ preventing labor injuries ④ preventing bleeding ⑤ preventing suffocation. "One strengthening" refers to strengthening the perinatal monitoring and treatment of high-risk pregnancy.
产褥期保健通常在初级保健单位进行，产后访视时访视者应认真观察产妇子宫复旧情况、手术伤口情况、有无乳腺感染及生殖道感染等。 (6) Nursing during puerperium Nursing during puerperium is usually carried out in primary health care units. Visitors should carefully observe maternal uterine rehabilitation, surgical wounds, breast infections and reproductive tract infections during postpartum visits. Patients with prenatal complications try to cure during puerperium. Pay attention to mental and psychological care, care about the pregnant woman's recuperation environment, enter a nutritious diet, pay attention to the cleanness of the vulva, and the parturient woman needs to feed her baby.
Lactation refers to the period during which the postpartum mother feeds her baby with her own milk, usually 10 months. The central task of lactation health care is to increase the exclusive breastfeeding rate. The benefits of breastfeeding are: ① breastmilk is an essential and ideal nutritional food for babies, rich in nutrients, suitable for babies 'digestion and absorption; breastfeeding is a unique way to provide ideal food for babies' healthy growth and development. Breeding babies with breast milk saves time and effort It is economical and convenient; ② Breast milk contains a variety of immune substances, which can increase the baby's disease resistance and prevent disease; ③ Through breastfeeding, frequent contact between mother and infant skin can enhance mother-child relationship.
Fourth, perimenopausal and postmenopausal women's health
(I) Perimenopausal Health
The main contents of perimenopausal women's health are:
① Make reasonable arrangements for life, pay attention to the intake of protein, vitamins and trace elements, maintain a comfortable mood, and pay attention to exercise.
② Prevention and treatment of premenopausal menstrual disorders, pay attention to the reproduction of vaginal bleeding after menopause.
③ This period is the age at which gynecological tumors occur, and a general survey focusing on cancer prevention should be performed every year.
④ Fertility decline, but contraception should be continued until menstruation ceases for more than 12 months. The IUD has been placed. If there is no discomfort, you can continue to use it, and you can also use barrier contraception. ⑤ In order to prevent the occurrence of perimenopausal syndrome, osteoporosis and cardiovascular diseases, the application of hormone replacement therapy has been effective in recent years, which has significantly improved the quality of life, and at the same time, it has the effects of preventing blood lipid disorders and bone loss during menopause.
⑥ Calcium supplements to prevent osteoporosis.
支持 The supporting tissues and ligaments in the body are loose, prone to uterine prolapse and tension urinary incontinence. Exercises of the levator anus should be performed, that is, the action of contracting the anal sphincter should be used 3 times a day for 15 minutes each time.
绝经后至进入老年期仍有10多年时间，此时期体内雌激素水平进一步下降，出现相应的临床症状，故应做好此期保健工作。 (2) Post-menopausal women's health There is still more than 10 years after menopause to enter the senile period. During this period, the level of estrogen in the body further decreases, and corresponding clinical symptoms appear. Therefore, health care should be done well in this period.
1. Common clinical manifestations in postmenopausal women
Common clinical manifestations are: ① atrophy of genitourinary organs, vaginal dryness, susceptibility to infection, frequent urination, urgency, or urinary incontinence; ② thinning of the skin, decreased elasticity, prone to wrinkles, reduced secretion of sebaceous glands, and thinning hair; Body shape changes, the abdomen and hips increase; ④ osteoporosis, prone to fracture; ⑤ the incidence of coronary atherosclerotic heart disease increased.
2. Postmenopausal health
The main contents are: ① regular daily life, reasonable diet, maintain a comfortable mood, strengthen physical exercise; ② keep the vulva clean and prevent atrophic genital infection; ③ pay attention to vaginal bleeding after menopause, once the vaginal bleeding is reproduced, you should go to the hospital promptly Examination; ④ As the level of estrogen in the body decreases, the supporting tissues and ligaments relax, prone to uterine prolapse and tension urinary incontinence, levator ani muscle exercises should be performed (strengthen the contraction of the anus) to strengthen the support of pelvic floor tissues ⑤ This period is the age at which gynecological tumors occur, and gynaecological examinations and systemic examinations should be performed regularly; ⑥ Increase the calcium dose to prevent postmenopausal osteoporosis; ⑦ continue to undergo hormone replacement therapy; 取出 remove the intrauterine one year after menopause IUD.
(Three) hormone replacement therapy Hormone replacement therapy requires supplementation of female hormones from the causes of perimenopausal clinical symptoms, but patients have not yet reached menopause, and the levels of estrogen in the body fluctuate. The dose and time of estrogen varies from person to person. The best time to supplement estrogen should be when the body begins to reduce estrogen, such as when menstruation begins to be scarce, or when perimenopausal symptoms appear. Due to fluctuations in estrogen levels during menopause, it is difficult to accurately grasp the supplementary dose, and it is necessary to synchronize with their menstruation. Therefore, most people advocate using it after menopause has been determined (that is, 1 year after menopause). Hormone replacement therapy must be selectively applied under the guidance of gynecologists to ensure rationality and safety. Particular emphasis is placed on the individualization of hormone replacement therapy.
Source: Maternal and Child Health Hospital of Pingyang County