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[Smoking and female reproductive health].

Epidemiological data shows that 9 millions of Poles are in smokers group, 43% of them are women. Smoking has significant negative impact on different fields of female sexual and reproductive life, like menstrual cycle, fertility, gynecological cancers and early menopause. Smoking during pregnancy is an important cause of ill health for both mother and foetus-it increases risk of placental complications, pregnancy induced hypertension, reduced fetal growth and perinatal death. Many of adverse effects of smoking is at least partially reversible after stopping smoking, so large public information campaigns can be useful for increasing women awareness of smoking hazards. Gynecologist, as a first contact specialist, has a responsibility to provide accurate information on the risks smoking poses both to the health of the smoker and to give clear, firm advice to stop smoking and offer suitable support.

Female↗

The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey.

This paper examines the association between traditional practices of female genital cutting (FGC) and adult women's reproductive morbidity in rural Gambia. In 1999, we conducted a cross-sectional community survey of 1348 women aged 15-54 years, to estimate the prevalence of reproductive morbidity on the basis of women's reports, a gynaecological examination and laboratory analysis of specimens. Descriptive statistics and logistic regression were used to compare the prevalence of each morbidity between cut and uncut women adjusting for possible confounders. A total of 1157 women consented to gynaecological examination and 58% had signs of genital cutting. There was a high level of agreement between reported circumcision status and that found on examination (97% agreement). The majority of operations consisted of clitoridectomy and excision of the labia minora (WHO classification type II) and were performed between the ages of 4 and 7 years. The practice of genital cutting was highly associated with ethnic group for two of the three main ethnic groups, making the effects of ethnic group and cutting difficult to distinguish. Women who had undergone FGC had a significantly higher prevalence of bacterial vaginosis (BV) [adjusted odds ratio (OR)=1.66; 95% confidence interval (CI) 1.25-2.18] and a substantially higher prevalence of herpes simplex virus 2 (HSV2) [adjusted OR=4.71; 95% CI 3.46-6.42]. The higher prevalence of HSV2 suggests that cut women may be at increased risk of HIV infection. Commonly cited negative consequences of FGC such as damage to the perineum or anus, vulval tumours (such as Bartholin's cysts and excessive keloid formation), painful sex, infertility, prolapse and other reproductive tract infections (RTIs) were not significantly more common in cut women. The relationship between FGC and long-term reproductive morbidity remains unclear, especially in settings where type II cutting predominates. Efforts to eradicate the practice should incorporate a human rights approach rather than rely solely on the damaging health consequences.

Adolescent↗

Occupational risk factors and reproductive health of women.

BACKGROUND: This in-depth review summarizes and interprets the available recent epidemiologic evidence on the relationship between occupational exposures and negative reproductive outcome among women workers. METHODS: The studies examined by the review include those published in the international scientific literature since 1990, and were identified through the search of relevant data banks using selected keywords. RESULTS: From the examination of studies dealing with exposures of women to chemical agents, pesticides, physical agents, ergonomic factors and stress, it appears that at present the evidence is sufficient to warrant the maximum protection of pregnant women to several well-documented occupational risk factors. These include exposures to anaesthetic gases, antineoplastic drugs, heavy metals, solvents, heavy physical work and irregular work schedules. For other work risks, such as exposure to non-ionizing radiation and psychosocial work stress, the evidence is often suggestive but not conclusive. CONCLUSIONS: Policy makers and health professionals should advise women and employers to avoid exposure to the well-known occupational risk factors, while epidemiologic research should pursue methodological improvements and provide more insight into the magnitude of exposures responsible for detrimental effects.

Environmental Pollutants↗