Gynecological and Reproductive Disorders

Gynecological disorders affect the internal and external organs in a woman’s pelvic and abdominal areas and may affect a woman’s fertility. These disorders include vulvodynia—unexplained chronic discomfort or pain of the vulva—and chronic pelvic pain—a consistent and severe pain occurring mostly in the lower abdomen for at least 6 months. While the causes of vulvodynia are unknown, recent evidence suggests that it may occur in up to 16 percent of women, usually beginning before age 25, and that Hispanic women are at greater risk for this disorder.1 Chronic pelvic pain may be symptomatic of an infection or indicate a problem with one of the organs in the pelvic area.2

Reproductive disorders may affect a woman’s ability to get pregnant. Examples of these disorders include polycystic ovary syndrome (PCOS), endometriosis, and uterine fibroids. PCOS occurs when immature follicles in the ovaries form together to create a large cyst, preventing mature eggs from being released. In most cases, the failure of the follicles to release the eggs results in a woman’s inability to become pregnant. An estimated 1 in 10 women in the United States are affected by PCOS.ibid Endometriosis occurs when tissue resembling that of the uterine lining grows outside of the uterus. Uterine fibroids are non-cancerous tumors that grow underneath the lining, between the muscles, or on the outside of the uterus.

In 2005–2006, 9.3 percent of women aged 20–54 years had endometriosis and 12.6 percent had uterine fibroids, but the prevalence of both disorders varied with age. Of women aged 20–54 years, endometriosis was most common among 35- to 44-year-olds (13.4 percent), while uterine fibroids were most common among 45- to 54-year-olds (25.6 percent). Women aged 20–34 years were least likely to have either disorder (4.2 and 3.4 percent, respectively).

A hysterectomy—abdominal surgery to remove the uterus—is one option to treat certain conditions including chronic pelvic pain, uterine fibroids, and endometriosis when symptoms are severe.ibid In 2005–2006, nearly 40 percent of women aged 45–54 reported having had a hysterectomy, though it is not clear how many of these hysterectomies were to treat gynecological or reproductive disorders (data not shown).

Endometriosis and Uterine Fibroids Among Women Aged 20-54, by Age, 2005-2006 [D]

1 Harlow et al. A Population-Based Assessment of Chronic Unexplained Vulvar Pain: Have we underestimated the prevalence of vulvodynia? JAMWA. 2003; 58: 82-88.
2 U.S. Department of Health and Human Services, Office on Women’s Health, National Women’s Health Information Resource Center. Health Topics: Pregnancy and Reproductive Health., accessed 04/01/08

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