Blog # 8 - Menopause

Explore how menopause is viewed from a different cultural perspective. Write about this and be sure to cite your source/s.

Menopause is the end of menstrual cycle and childbearing capability. Menopause in a natural event in all women’s lives, it is the last menstrual cycle. Right before and during menopause women experience physical changes due to drop in hormone production. Menopause depicts end of woman’s reproductive life usually occurring between ages 45 and 55. Menopause is accompanied by various symptoms like hot flashes, night sweats and various psychic symptoms, of which hot flashes is known to occur in about 75% of the women and may continue for as long as 40 years. Image shows list of the symptoms women reports during menopause. (http://www.google.com/imgres?imgurl=http://www.jos-health-network.150m.com/menopause1.jpg&imgrefurl=http://www.jos-health-network.150m.com/menopause.html&usg=__xftJ__n5SutLg1PgwvItJYZ-KV4=&h=544&w=500&sz=128&hl=en&start=1&zoom=1&um=1&itbs=1&tbnid=GREXXR0zChQYaM:&tbnh=133&tbnw=122&prev=/images%3Fq%3Dmenopause%26um%3D1%26hl%3Den%26sa%3DN%26tbs%3Disch:1)

Menopause also differs in different areas of the world. Hot flashes in the West, shoulder pain in Japan and loss of vision in India, are the hallmarks of menopause. Even the median age of menopause differs from country to country. The median age at menopause reported from the West (50.3 years) is higher as compared to the range of 45–47 years in developing countries.

 In some societies youthfulness is valued and menopause is viewed as negative stage in a women lives. It is considered a difficult time in a women life because during menopause women experience uncontrollable moodiness, irritability and depression whereas, some women appreciate the freedom from menstrual periods. Western women are tired of the chorus of U’s associated with menopause: unattractive, useless, ugly, undesirable, unhappy and so on. I wanted to share the following image with everyone to show you how some people view menopause in our society. (http://ihatemenopause.com/)

 In Asian countries women gain respect when they enters into their middle age. They are thought to be wiser and more experienced. In countries such as New Zealand and India menopausal women are community leaders and hold a place of honor in their communities. It is a belief held by many cultures, that life after menopause is a time of strength, courage and wisdom.

In my opinion a women should not be afraid of getting old, and menopause should be a sign of wisdom and maturity. Women should enjoy every stage of their life so we can live up to our full potential.

Reference:

Alexander, L.L., LaRosa, J.H., Badar, H., Garfield, S., Alexander, W.J., (2010). New dimensions in women’s health (5^th ed.). Boston: Jones &Bartlett

Hunt, G. Menopause Across Cultures. RagMag. Retrieved October 18, 2010, from http://ragmag.net/2009/05/menopause-across-cultures

Blog # 7 - The Silent Partner HIV in Marriage

The Silent Partner - HIV in Marriage video shows that we live in a male dominating world. Yes, this world is changing and bringing rights to women but at what cost. Male domination is not only practiced in Kenya but throughout the world. The video shows that it’s okay for men to do anything he pleases and women should obey his every decision. Women cannot even have a say in usage of contraceptive which can save her from getting infected. Just because men are providing, doesn’t mean women cannot have a say in anything. Customs and tradition has added to women pain and suffering, custom such as dowry gets men to thinking that they own women. Women are owned by their father and then when they get married there husband buys them in the name of dowry which means they are taking complete ownership of that woman. It brings me to a documentary that I saw about Female Infanticide in India. In India and most of South East Asia dowry is where bride’s father pay’s groom family as compare to dowry in Africa where groom pays bride’s family. In this documentary daughters are killed the day that they are born and, the reason is that parents cannot afford to raise the daughter and needs to pay dowry required by groom’s family. http://www.youtube.com/watch?v=mnmtKLQRh6g. These documentaries show that women are not in power. They cannot make decision about their life and their life is been constantly handling by male. It all comes down to illiteracy among people.  Educations about usage of contraceptive early on can save lives. In sub-Saharan Africa, home to two-thirds of the world’s people living with HIV, women make up 60 percent of those infected. Places like Africa and Kenya needs special attention from their government and NGO’s they should organize a program which not only teaches women but also men about the benefit of contraceptive. Most men transmit STI’s to women and then die from it. Condoms play a key role in preventing HIV infection if these men are given proper knowledge infection rate will go down. I hope that social and economic inequalities between men and women can come to an end.

Blog # 6 - Prenatal Care

In your opinion, why should prenatal testing be routine for all pregnant women?

Prenatal care is recommended for all women who are pregnant and who are thinking of becoming pregnant. Prenatal care ensures healthy pregnancy and a healthy baby. When a woman is thinking about becoming pregnant she should consult with a doctor so she can start by having right type of vitamin, she might need some immunization and some other test. We all should adopt a healthy behavior but when you are thinking about becoming pregnant or are already pregnant you should take special care of yourself. Healthy behavior includes proper diet, physical activity and proper weight gain. Pregnant women should go for a routine checkup every month or as health care provider advice, regular prenatal checkups let you know how your baby is doing and can identity problems before hand. It’s always best to educate yourself about all the prenatal test and checkups so you know what to expect.

Prenatal care is very important it can help identify any problems that a pregnancy might have. I will give you my example; when I was pregnant I was diagnose with gestational diabetes. I was able to control my diabetes very well and the reason was I had prenatal care. Imagine if I didn’t seek prenatal care than there was no way of knowing about my gestational diabetes and I wouldn’t have any care of my diet and it would result in risking my health and my baby’s health. Due to my routine checkups and required test that is a part of prenatal care a problem can be identify and be solved within time before any major health risk.

Prenatal care can identify several different things for example health problem in mother that can affect the baby’s health, growth of baby every month such as heart rate, size, sex and, position in the uterus. It can also identify the chance that baby has certain congenital, genetic or chromosomal problems. There are several tests that are performed during each trimester. First trimester includes ultrasound test for fetal nuchal translucency and two maternal serum blood tests which can identify risk for chromosomes abnormalities.  

First trimester screening image. (http://www.chop.edu/export/system/galleries/images/hospital/conditions/first-trimester-screening-161393.gif)

Second trimester tests includes Alpha-fetoprotein screening (AFP). If the blood test is abnormal AFP can detect spina bifida, Down syndrome and other chromosomal disease.  Other test includes amniocenteses, chronic villus sampling, fetal monitoring and, glucose tolerance test.

Chorionic villus sampling (CVS) is a prenatal test that involves taking a sample of some of the placental tissue. This tissue contains the same genetic material as the fetus and can be tested for chromosomal abnormalities and some other genetic problems. Third trimester test includes Group B Streptococcus (GBS) and, abdominal and transvaginal ultrasound.

GBS is caused by the bacteria Streptococcus agalactiae. Not all babies who are exposed to the bacteria will become infected. Above Image displays Vaginal Bacteria Spreading to Fetus. For more detail information about these test visit http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/pregnant/tests.html.

Blog # 5 - Contraception

In what ways could someone’s culture, beliefs and practices influence contraceptive decision making?  Provide thorough examples based on some of your readings and your own personal experiences. What were the beliefs about birth control/contraception within your own home and family?

I am from Pakistan and usage of contraception is low as compare to western and even other Muslim countries. Women in Pakistan have four children only 22% of the married women use modern method of family planning (http://ipsnews.net/news.asp?idnews=51270). Pakistan has the sixth largest population, high birth rate and high infant mortality rate. It is vital that the women of Pakistan reduce the number of children they have so they can improve their health.  Many women in Pakistan lack access to contraception. Many of the rural area do not provide reproductive health care and one out of every three pregnancy is unplanned.  It used to be even worse since Pakistan is a male dominant society use of contraceptive was minimal and was not promoted among young married couples. Contraceptive practice was only taught to female but they didn’t have the decision making power due to societal structure.  Within past few decade government of Pakistan has initiated a national family program to reduce fertility rate. Government is also promoting limiting family size, use of contraceptives, and spousal communication on family planning. Government funded programs such as The Lady Health Worker Program has increased the access to contraceptive services. A network of community-based female workers providing family planning services to women in their homes. Also these programs are brining awareness to men so they can initiate in using contraceptives. Above all, education is the long-term solution. Educating men and women on contraceptive should be implemented.  Some of the program are running ad on prime time television to promote contraception. I am attaching a video link of one of the ad. Ad is also featuring a man to promote men to be more involved in family planning decision.

http://www.youtube.com/watch?v=0Tugu_04z_w

I am not sure but I think my parents did use contraceptive. The reason I am not sure is because in my family we never talked about it and the reason I think they used it because I have two brothers. So, compare to other families in Pakistan our family size is smaller. I wished that my mother talked to me about contraceptives but the culture she is from doesn’t make her comfortable. Now more and more families are talking about it since, Pakistani government is promoting contraception through advertisement more families are gaining knowledge.

Blog # 4 - Menarche

Describe a woman's experience of going through menarche (first menstrual cycle). Was it a positive experience that was celebrated by her or her family?    Or was it a negative experience (shame, embarrassment, fear, etc)? You may provide pseudo names to protect their identity.

The first period is seen as a milestone in almost every culture.  Some culture celebrates menarche while other doesn’t much care about it. Reshma was born and raised in small country part of South East Asia. When she was 12 year old she had her first period. In her culture menarche is a celebrated but just among women. Periods are not to be discussed with any men in the house. For Reshma there was no party, gifts or any rituals. Within her family she became a woman. For her it was not a negative experience, she felt grownup. Her mother gave her all the information she needed. Her mother also told her never to discuss about her period with her brothers, father or any other male figure. It is consider embarrassing for a girl to discuss about her periods with her brothers or father.  After she began having regular period cycle she felt a little closer to her mother, because she was able to discuss and ask question about her periods. After she became more comfortable she was able to discuss about her periods with her female friends. She came to know within her culture other families persuade menarche differently. One of her friend told her that when she had her first period she was ‘congratulated’ among her close female family members. Another friend told her that when she had her first period she was told not to touch any cooking utensils because she was thought to be ‘unclean’.

In my opinion girls should have more positive menarcheal and menstrual experience.  Most of the girls are not very knowledgeable about the menstruation. There should be proper menstrual education that should help girls in preparation, expectations and positive experience. In North America it was considered ‘cursed’ when girls had their first period, but that was very long time ago. Now, menarche is celebrated, some celebrate it by throwing a ‘Red Party’ while others have ‘Crossing Over’ ceremony.  There are several different which helps you celebrate “Girlhood to Womanhood”. I think these parties or ceremonies helps girl, it makes the time easier for the girl and for her parents.  

Visit the following website for more menarche party information:

http://celebratepuberty.org/menarche.html

One of many games played at menarche party.

Blog # 3 Self-Assessment

Read the self-assessment on pg 57.  How would you rate your "preventive practices?"  What are some ways in which you can improve your health?  What preventative practices do you already implement?

If I took the test on page 57 of the book one year ago, some of the answer would be “no”. I started to take better care of my self during my pregnancy after I found out I have gestational diabetes.  Having gestational diabetes during pregnancy can increase the risk of having diabetes later in life. Uncontrolled gestational diabetes can be harmful to babies, babies can be born very large, they can have low blood sugar after birth and breathing problems can occur (http://diabetes.niddk.nih.gov/dm/pubs/gestational/).  After knowing the effect of gestational diabetes I started to take better care of myself.  First, I had to educate myself for what is a healthy diet and, what physical activity will be best for me. Then, I had to implement all my knowledge on keeping a low blood sugar level. I increased my intake of vegetables and fruits.  I switched to whole grain, nonfat milk, olive oil and low fat/no sugar/low calorie products. Now, I am taking good care of myself by proper nutrition, regular physical activity and avoiding everything that is harmful to my body. 

Many women with gestational diabetes develop diabetes within 5 - 10 years after delivery. My mother had gestational diabetes and now she is diabetic. She has to maintain a balance diet to maintain normal blood sugar level and, maintaining that balance require great deal of work. She has to take diabetic medications which help the body process sugar. She has to watch what she eats all the time. Her diet  has fit in a category of no sugar, no carb and no fat. She has to monitor her sugar level three times a day (by poking her fingers). I certainly don’t want all of this for myself so I am disciplining myself now to live a healthier lifestyle.

Preventive care can also be influence by different factors. Being a Muslim we are forbidden to use alcohol and drugs, it impairs the judgment of the person consuming it. So, being a true follower, never in my life I have used drugs or alcohol. Islam teaches it follower discipline and self-restraint. Muslims once a year, irrespective of the weather, fast during the holy month of Ramadan. Fasting teaches self-discipline and restraint, and is also good for one’s physical health. In order to fast one has to be healthy. World Health Organization (WHO) give definition of health; “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".  People who are sick are not allowed to fast. This year for the first time I truly realized the physical and mental benefits of fasting. The heat and thirst did made me realized that I am blessed with the a lot, and made me realize the suffering and pain people are going through in this world due to disease, hunger, flood and other disasters. So, some of the preventive care question listed in the book can be answered “yes” because of the teaching of Islam.

Few years ago I didn’t take care of my health. I was eating lots of junk food, barely ate fruits and vegetables and, exercised few times a month. Due to that habit I had to suffer the consequences and had to learn the hard way about healthier lifestyle. After some challenges and other factors influencing my life I am living a healthier life and I would rate my preventive care 10 out of 10.

Preventive care can be implemented but one has to discipline themselves. To begin a better healthier life we need to control our eating habits, do regular physical activity and avoid alcohol, drugs, tobacco and stress.  Unhealthy food can be very tempting but know this when you give in to your temptations you will be responsible for the outcome. Beginning a healthy lifestyle can be challenging and, requires small changes in taking positive action on your health, diet, relationship and exercise.

Blog # 2 - Health Care in America

About 47 million Americans have no health coverage. In order for anyone to receive health care we need insurance and that is the biggest problem. Insurance companies are making tons of money from people like us. The reason that the large numbers of American don’t have Health Care is because they cannot afford it. Health Care has high premiums, and if someone got sick they won’t be able to pay for care that they received. People cannot afford high cost of treatment, and some of them are facing serious illnesses because they don’t seek medical health.

Most families have health insurance through their employer. If someone loses their job they lose health coverage with it. Last year 2.6 million American lost their job. When you don’t have a job health care is impossible to afford. I know this because I have lived through it. I was in school while my husband was working and I was covered through his insurance. We got pregnant October 2009 and my husband lost his job March 2010, he was laid off. We had no insurance, and I had to see a doctor every month, which can be very costly. We thought about getting Cobra but, we knew we will be paying very high premiums. Having no other option we had to choose Cobra, we spend all of our saving paying premiums. Finally, we had our baby and everything worked out fine. When we thought we are done paying bills we were wrong. After the delivery we got bills from the hospital which our insurance didn’t cover. We got three to five bills every week, which we are still paying. I feel that Health Coverage today is a big FAIL because it’s not working for anyone.

Health Care passed by current administration “The Health Reform Plan” has promised to make health care more affordable, all American will be covered and many more things. So, why majority of American still have no insurance?