Objective To investigate the relationship between common gynecological symptoms, reproductive tract infections and psychosocial factors such as violence and depression.
Gynecological complaints are common and disabling health problems for women in India. The commonest gynecological complaint is abnormal vaginal discharge. Although some women's complaints may be caused by Reproductive Tract Infections (RTI), studies have shown that the majority of women with this complaint do not have an RTI. There is a large body of information showing that depressive and anxiety disorders are very common in women and that they are an important cause of medically unexplained physical complaints. This primary research objective of this study was to describe the relationship between common gynecological complaints, in particular of abnormal vaginal discharge with psychosocial factors, related to common mental disorders and gender disadvantage. the study also aimed to investigate the risk factors of common mental disorders in women.
|Poster presentation at 4th Asia
Pacific Conference on reproductive
and Sexual Health and Rights
- Reproductive Tract Infections (RTIs) and dysmenorrhea are amongst the commonest health problems affecting women aged 18 to 50 years; sexually transmitted infections (STI) affect about 4% of women.
- Depressive Disorder affects about 1 in 20 women.
- Social disadvantage, particularly spousal sexual violence and economic difficulties, are important determinants of both biomedical diagnoses and women's reported complaints.
- There are strong linkages between mental health and common physical health complaints experienced by women. Medical assumptions about causes of symptoms (that the symptom of abnormal vaginal discharge is most commonly caused by RTIs; or that fatigue is most commonly caused by anaemia) are not valid in community settings. Poor mental health is an important determinant of such symptoms.
- Depressive Disorder is a major cause of disability, health service use, and health care costs and, as a consequence, may impoverish women.
- Over a period of 12 months, about I in 100 women will attempt suicide. Attempted suicide is caused by acute economic difficulties; spousal violence; and Depressive Disorder.
Implications for Public Health Policy
- To increase the coverage of effective diagnosis and treatment for Depressive Disorders through integration of mental health care in all health programs targeted to women, especially Primary Health Care, Reproductive &Child Health, and Maternal &Child Health.
- To strengthen the Reproductive & Child Health program to increase the coverage of RTI management through simple lab diagnosis of common RTIs (such as bacterial vaginosis) and the development of central lab facilities for diagnoses of other RTIs (including STIs); and to addressing menstrual health complaints.
- To modify the syndromic management guidelines for the control of RTIs in women with an approach aimed at identifying and treating the causes of abnormal vaginal discharge (in particular, RTI and mental health problems).
- To implement community strategies to reduce the burden of domestic violence, particularly sexual violence, in married women.
- To improve access for reproductive and mental health services for socially disadvantaged groups in the population