You may have received an email similar to the one above. It’s one of those chain mail messages we women send to one another to illicit a laugh, show solidarity and put our busy lives into perspective. At face value, the words might sound a little silly, but at the heart of the message is the desire to show a friend, coworker or loved one that we are thinking of her and that we care about her health and happiness.
Of course, we added the last line about having a women’s health provider for all stages of life. We think it’s a sentiment that fi ts well in any list that offers pointers about a life well-lived.
What follows are brief vignettes that discuss the more important women’s health considerations for each of the four major stages of a woman’s life: adolescence, the childbearing years, midlife and seniors. Every stage of a woman’s life brings exciting possibilities and diffi cult challenges—both emotionally and physically—so it stands to reason she should forge a strong relationship with a women’s health provider along the way.
The transition from child to young woman Young girls transition into young women during their teenage years in ways not hard to notice. Growth spurts, new hair growth, widening hips and breast development signal that puberty is in progress.
Once menstruation begins, young women are faced with the prospect of transitioning from their pediatrician to a women’s health professional.
WellSpan adolescent and pediatric gynecologist Helen Deitch, M.D., says her new teenaged patients initially come to her to discuss heavy, irregular and painful periods, or to seek counseling on contraception.
“Most of my patients are rather nervous and worried about the idea of a pelvic exam, but in most cases an internal exam is not necassary,” she explains. “Instead, I use that fi rst appointment as an information gathering session and an opportunity to educate my patients about what is happening to their bodies. “We spend time discussing normal development and menstrual cycles for her age. She might think she has periods that are abnormally heavy, when in reality she’s perfectly normal.
Sometimes her only frame of reference may be her mother, who is in a different life stage and therefore not a good standard for comparison.”
Dr. Deitch has a special interest in polycystic ovarian syndrome (PCOS), a hormonal imbalance that may mimic many of the regular signs of puberty. Symptoms include infrequent periods, acne, excessive weight gain and abnormal hair growth.
Deitch enjoys developing relationships with her adolescent patients. “Many of these young women are not comfortable discussing their periods or physical development, neither with me nor with their mothers, who often accompany their daughters to their fi rst appointment,” she explains.
“I always give my patients the opportunity to discuss their problems with me confi dentially without mom in the room. By the end of the appointment the patient should understand that my primary relationship is with her, not her mother—that she and I are partners in her health.”
Women preparing for baby
The focus on high school proms and then college life shifts to more adult concerns—career, marriage and children—for women in their 20s and 30s. For those ready to start a family, the importance of regular gynecologic check-ups is understandably heightened.
According to Jan Bollinger, a certified nurse midwife with WellSpan’s York Women’s Health Center, women at this stage of their lives need to take proactive measures to ensure they are making healthy decisions to prepare for future pregnancies.
“I love those initial visits,” she explains. “More women are becoming aware of the importance of pre-conception counseling and early prenatal care. This is great because the best gift you can give your baby is a healthy mommy.”
The goal during the early preconception visits is to assess the woman’s health and create a plan to bring her to the optimal level of health by the time she does indeed become pregnant.
“By the end of the appointment,” Bollinger adds, “we’ve covered all the bases, including family medical history, weight goals, prenatal vitamins and folic acid, updating immunizations, smoking and drinking habits, and identifying potentially harmful chemicals at home and work.”
Once a woman becomes pregnant, regular prenatal visits to her obstetrician or certifi ed midwife begin. “When you see a patient on a regular basis, the more opportunity you have to a catch a problem when it’s small,” she adds. “When a pregnancy deviates from what we consider is normal, I have the immediate attention of another provider in my practice or within the WellSpan network.
That’s the beauty of our system.” Midlife is adolescence in reverse Once a women’s childbearing years are in the rearview mirror, her body enters into a period of signifi cant change both on the outside and inside.
“Midlife is a time of tremendous change in a woman’s life. There are so many emotional and physical changes a woman goes through during this stage. In fact, it’s like adolescence in reverse in terms of hormonal changes,” points out Laurie Hitchcock, a certified nurse practitioner, York Women’s Health Center.
With the average age of onset at 51.5 years, menopause—the changes in a woman’s body that end menstruation and the possibility of pregnancy is probably the most disruptive. “Some women never notice the symptoms of menopause,” says
Hitchcock. “But many experience symptoms like irritability, hot flashes, night sweats, vaginal dryness and lack of interest in sex especially the first two or three years post menopause. From this perspective, midlife is a time of symptoms management.
“We also discuss the silent symptoms, such as bone loss and cardiovascular issues, both which need to be monitored closely during this period of change,” she says. “And there’s also urinary incontinence that can be a result of childbirth and age.”
Luckily, there have been many advances in medical science in recent years that can provide women with the help they need to address these problems.
Minimally invasive procedures such as laparoscopies can provide the needed care but with easier, faster recovery times and therefore less disruption to woman’s regular routine. (See article about robotic surgery).
“Midlife health issues for a woman can be a bit of challenge, especially from an emotional standpoint,” admits Hitchcock. “But if she partners with her health care provider to take the challenge head-on, she can make it through the more disruptive parts with grace and good humor.”
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WellSpan experts quoted in this article:
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Helen Deitch, M.D.,
OB/GYN, York Women’s Health Center
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Jan Bollinger, Certified-nurse midwife,
York Women’s Health Center
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Laurie Hitchcock, Certified nurse practitioner,
York Women’s Health Center
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Marian Damewood, M.D.,
Vice president of WellSpan’s Women & Children Services
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The golden years
Conditions often associated with advanced age, such as arthritis, heart disease, osteoporosis, Alzheimer’s disease and cancer, become greater concerns for many women age 65 and older. Though some of these conditions may be genetically inherited, they often can be lessened by exercise and healthy eating, as well as working with a women’s health provider to explore medication and elective surgery solutions.
“Though our patients come to our women’s health providers for gynecological and obstetrical care, we evaluate their health in total,” explains Marian Damewood, M.D., vice president of WellSpan’s Women & Children Services. “It’s not uncommon for our providers to be the first to identify issues, such as heart disease or joint problems, that require a referral to other specialists.”
Declining bone mass, which accelerates after menopause due to lower estrogen levels, is a problem widely experienced by older women. “A fall that would only bruise a younger woman might very well result in a broken bone for a woman in her 70s or 80s,” she notes.
Wear and tear on joints is also a problem for many women in this age group. Osteoarthritis and rheumatoid arthritis are up to three times more prevalent in women than in men. (See expanded article on arthritis treatment).
“Women’s health doesn’t stop at annual pelvic exams or helping women have healthy pregnancies and safe deliveries,” Damewood concludes. “Our providers concern themselves with a comprehensive evaluation of each and every patient they examine.”
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WellSpan Medical Group Directory of Women’s Health Providers
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York County
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Adams County
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WellSpan Health Physician
Referral & Information Service
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York County Adams County
York Women’s Health Center
1399 S. Queen St.
York, PA 17403
(717) 812-2316
York Women’s Health Center
4222 Lincoln Highway
York, PA 17406
(717) 812-7800
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York Women’s Health Center
WellSpan Stonebridge
Health Center
13515 Wolfe Rd.
New Freedom, PA 17349
(717) 812-2540
York Women’s Health Center
3130 Grandview Rd.
Hanover, PA 17331
(717) 633-1433
Adams County Women’s Health
450 S. Washington St.,
Suite B
Gettysburg, PA 17325
(717) 337-4487
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York Women’s Health Center
3130 Grandview Rd.
Hanover, PA 17331
(717) 633-1433
Adams County Women’s Health
450 S. Washington St.,
Suite B
Gettysburg, PA 17325
(717) 337-4487
WellSpan Certified-Nurse Midwives
455 S. Washington St.,
Suite 25
Gettysburg, PA 17325
(717) 337-4290
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You may also call
(800) 840-5905 or
(717) 851-3500
to receive a referral to any provider associated with the medical staffs of York Hospital or Gettysburg Hospital.
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