Women specific health problems in Nepal and its preventive measures.

1. Women Specific Health Problems
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2. 1. Obstetric fistula
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• Obstetric fistula (OF) is a condition in which there
is an abnormal opening between a woman’s
vagina and bladder or rectum caused by
prolonged obstructed labor.
• OF occurred in the course of pregnancy and
results in chronic incontinence of uncontrolled
passage of urine, faeces into the vagina.
• In Nepal, 4362 live with obstetric fistula.
• UNFPA and WOREC estimates that there are 200
to 400 new cases of obstetric fistula in Nepal each
year.

3. Signs and Symptoms
• Flatulence.
• Pain during sexual activity.
• Foul-smelling vaginal discharge..
• Repeated vaginal or urinary tract infections.
• Irritation or pain in the vagina or surrounding areas..
• Urinary incontinence or Fecal incontinence which may
be continual or only happen at night..
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4. Risk Factors
• Poverty.
• Pelvic Fracture
• Malnutrition.
• Obstructed labor.
• Lack of education.
• Teenage pregnancy.
• Sexual violence, Rape, Trauma.
• Inflammatory bowel disease. (IBD)
• Lack of quality access to maternal and health care.
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5. 2. Breast cancer
• Brest Cancer
Breast cancer is the most frequent cancer among women and the
second most common cancer overall impacting 2.1 million
women each year.There were over 2 million new cases in 2018 it
is estimated that 627,000 women died from breast cancer .(
approx. 15% of all cancer deaths among women )
Breast cancer is the second most common malignancy among
Nepalese women after the cancer of cervix.
• According to WHO 2014, breast cancer death in Nepal reached
865 or 0.55% of the total death.
• The highest incident rate of it in the age 45-49 followed by the
55-59
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6. Signs of breast cancer:
I. Lumps in the breast.
II. Change in breast shape.
III. Nipple discharge.
IV. Dimpling skin.
V. Changes in the skin texture.
VI. Redness.
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7. Risk factors:
Modifiable risk factors Non-modifiable risk factor
Radiation exposure
Reproduction
Breastfeeding
Oral contraceptives
Body weight
Physical activity
Alcohol use
Tobacco smoke
Gender
Age
Family history
Personal history
Breast density
Early menstruation ( before
age 12 )
Late menopause (after age 55)
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8. 3. Uterine Prolapse
Uterine prolapse refers to the prolapse or drooping of uterus, which occurs when
pelvic floor muscles and ligaments stretch and weaken and no longer provide
enough support for the uterus.
The global prevalence of uterine prolapse is 2-20%; the hospital admission for
uterine prolapse is 20.4%, surgery for prolapse is 16.2%.
In 2073/74 more than 14,600 women were screened for the reproductive morbidity,
23 percent of women (3374 women) were diagnosed of having POP.

9.  Sensation of heaviness or pulling in your pelvis
 Tissue protruding from your vagina
 Urinary problems, such as urine leakage
(incontinence) or urine retention
 Trouble having a bowel movement
 Feeling as if you're sitting on a small ball or as if
something is falling out of your vagina
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10.  Inaccessibility to quality maternal health care
 Poverty and gender discrimination related to
health
 Nutrition
 Workload during postnatal period
 Domestic violence
 One or more pregnancies including vaginal
births and difficult labor
 Giving birth to a large baby
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11.  Tightening of stomach using “patuka” after
delivery
 Chronic cough and Increasing age
 Obesity
 Prior pelvic surgery
 Chronic constipation or frequent straining during
bowel movements
 Family history of weakness in connective tissue
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12.  Pelvic inflammatory disease (PID) is an
infection of the female reproductive organs.
 PID is an infection and inflammation of the
uterus, ovaries, and other female
reproductive organs.
 The CDC has estimated that more than 1
million women experience an episode of PID
every year.
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13.  The signs and symptoms of pelvic inflammatory disease
might be mild and difficult to recognize. Some women
don't have any signs or symptoms. When signs and
symptoms of PID are present, they most often include:
 Pain — ranging from mild to severe — in your lower
abdomen and pelvis
 Abnormal or heavy vaginal discharge that may have an
unpleasant odor
 Abnormal uterine bleeding, especially during or after
intercourse, or between menstrual cycles
 Pain during intercourse
 Fever, sometimes with chills
 Painful, frequent or difficult urination

14.  Cervical cancer is the commonest
malignancy among women in Nepal.
Every year 2,332 women are diagnosed
with cervical cancer and 1,367 women die
from the disease. Cervical cancer ranks
as the first most frequent cancer among
women in Nepal and the first most
frequent cancer among women between
15 and 44 years of age.
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15.  You might be at higher risk of cervical cancer if
you:
 Started having sex before age 16 or within a
year of starting your period
 Have multiple sexual partners
 Take birth control pills, especially for longer than
5 years
 Smoke cigarettes
 Have a weakened immune system
 Have a sexually transmitted disease (STD)
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16.  Cervical Cancer Symptoms
 You might not notice symptoms of cervical cancer until it’s far along.
They may include:
 Pain when you have sex
 Unusual vaginal bleeding, such as after sex, between periods, after
menopause, or after a pelvic exam
 Unusual vaginal discharge
 After it has spread, the cancer can cause:
 Pelvic pain
 Trouble peeing
 Swollen legs
 Kidney failure
 Bone pain
 Weight loss and lack of appetite
 Fatigue
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