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Feature Story

Women's untold stories

Shedding light on “taboos”.

By Darleth Romana-Bantiles, M.D.

MARCH 2013

In this age of almost-unlimited information and advanced telecommunications, women in the Philippines still have difficulty talking about certain topics, whether with peers or with healthcare professionals. Up to this day, there are topics some ladies still consider delicate to discuss: body image, sexual and reproductive issues, or abuse and harassment. But covertness is no place for these issues. It’s time we tried to shed light on that secret world of women.

The secrets to beauty

Inez became self-conscious when she noticed white striated marks on her upper arms. She felt embarrassed to ask anyone she knew about it, and wondered why no one who had the same predicament dared talk about it. In the end, she coped by removing all sleeveless items of clothing from her wardrobe.

According to Althea Tiamzon, M.D., a clinician and Diplomate of the Philippine Dermatologic society, the striae are more commonly known as stretch marks. Clinically, they appear as red-to-violaceous elevated lines, gradually becoming fine, white, and wrinkled in appearance. At the moment, there’s no exact treatment for it—meaning no case control studies—but some improvement has been seen with topical tretinoin, dermaroller or microneedling techniques and laser treatment.

Common causes of striae are pregnancy and abrupt weight gain. If physical changes aren’t the cause, people with stretch marks should consult a healthcare provider to assist them in determining if there is a problem in collagen formation, or any systemic condition such as diabetes, Ehler-Danlos syndrome or Cushings. Prolonged cortisone exposure may also trigger striae formation.

Another concern for many women are acne scars. These small marks, left after moderate or severe acne, also affect one's present and future. Women often try different creams and over-the-counter solutions as remedies, before consulting a trained professional. The management of acne scars depends on their type and presents several modalities, ranging from application of topical steroids to surgical intervention. constitution

Other conditions that Dr. Tiamzon observed to be difficult to disclose by patients are hyperpigmenation in the axilla, inguinal or genital area, or hyperhidrosis in the genital area. It usually takes time before patients bring it up at her clinic. Dr. Tiamzon often assures the patient that her concern isn’t an isolated case, which helps build rapport.

What happens behind closed doors

Chanda, a call center agent, felt itchiness in her genital region, after long bouts of sitting. Mistakenly attributing it to her dusty office chair, the problem still persisted after she changed the chair for a new one. She didn’t have time to consult a doctor about it, and also decided not to ask anyone else in the office if they had a similar experience—fearing that they might think she was doing illicit sexual activities. Only after the discomfort interfered with her concentration at work did she decide to consult a doctor.

What she experienced turned out to be cystitis, or a form urinary tract infection (UTI)—an inflammation of the bladder, primarily caused by bacterial growth. The propagation of bacteria may be from urine retention, insufficient fluid intake, and excessive salt in the diet. Sitting on dusty chairs doesn’t cause UTI, but hypersensitivity to underwear material or feminine wash can trigger it. An antibiotic regimen relieves the symptoms in a few days, and lifestyle modification prevents its recurrence in the future. It’s important that women with UTI confer with a physician, to help them manage their condition. This helps avoid complications like the development of ascending infection in the kidneys. The signs one should watch out for in cystitis are: back or side pain, fever, chills, nausea and vomiting. Consult with a physician is necessary, especially when the pain after urination lasts for hours or there’s visible blood in the urine.

There may be instances also when inflammation of the bladder isn’t due to infection. Further tests must be done to rule out other causative factors, like: chemicals from baths, washes or sprays; certain medications, particularly chemotherapeutic drugs; complications of conditions like gynecologic cancers, pelvic inflammatory disorders, endometriosis, Crohn's disease, diverticulitis, lupus or tuberculosis.

Chanda’s concern about what her colleagues would think is valid, because infection may also be brought about by sexual relations. It is important to note this, especially in recurrent UTI cases, where treatment may involve the diagnosis and management of the concomitant infection of a partner. For repeated bladder infections, preventive self-care measures recommended by doctors are:

• Drink plenty of liquids, especially water.

• Urinate frequently.

• Wipe from front to back after a bowel movement.

• Take showers rather than tub baths.

• Gently wash the skin around the vagina and anus.

• Empty your bladder as soon as possible after intercourse.

• Avoid using deodorant sprays or feminine products in the genital area.

Aesthetics and physical health are two important aspects of the world of women. Learn more about a third one—gender equality—in the March issue of HealthToday, out now in newsstands and bookstores.

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