By Professor Lesley Regan, RCOG President
While we hear so much about gender equality in the UK and worldwide, there are many issues affecting the health of women and girls which still remain “off-limits”. This stigma often causes women to ignore concerns about their health, while the fear of embarrassment can leave them suffering in silence. We must do more to address this and break down taboos surrounding gynaecological health.
As a group of doctors, we care for 51 per cent of the population and have unique access to women across their life course. Many of those interactions are not about ill health but helping them to do normal things like have safe sex, prevent pregnancy, become pregnant and have a healthy menopause and post-menopausal life.
To make the most impact, we must move away from being a disease intervention service and instead promote the importance of preventative measures to improve the health of all women at every age and stage of their lives.
One in four women don't take up their screening invitation
It is disheartening to see that gynaecological health remains a taboo subject among the public, despite more than 21,000 women being diagnosed with one of the five forms of gynaecological cancer each year in the UK. Cervical cancer, which leads to the death of two women a day, is a largely preventable disease, yet screening rates are at their lowest level in two decades*.
Evidence shows that routine screening – which can detect pre-cancer abnormalities – prevents up to 75 per cent of cervical cancers, however, one in four women don’t take up their screening invitation. Early detection is vital to increasing survival rates so we must continue to raise awareness about the disease, its symptoms and ways to prevent it.
Later maternal age and weight can increase risk of miscarriage
The 21st century has brought with it the largest ever group of adolescents in history and we urgently need to ensure that they can take control of their own fertility. To do this successfully, we need to place women and their families at the centre of their care, educating them and empowering them to make informed choices about their health.
Currently, around 15 per cent of couples experience infertility; that’s around 3.5 million people in the UK. Unfortunately, by the time a woman decides to have a baby or is already pregnant, she may not realise the impact maternal age and weight can have on her ability to conceive or have a healthy pregnancy. We know that female fertility starts to decline gradually from the late 20s and more rapidly from the mid-30s onwards.
As well as potentially taking longer to get pregnant, later maternity and being overweight can involve a greater risk of miscarriage, a more complicated labour, and higher rates of medical intervention at the birth. As healthcare professionals, our role is to advise both men and women about the implications that maternal age and weight can have for fertility, pregnancy and birth, to enable couples to make informed decisions about when to plan a family.
* Latest figures by NHS Digital for the NHS Cervical Screening Programme 2016-17 show that there has been a decrease in attendance rates from 75.7 per cent in 2011 to 72 per cent in 2017 for women aged 25-64 in England.
This blog post was originally published as a foreword in Media Planet's Reproductive & Gynaecological Health supplement