1. The menstrual cycle is an indicator of a woman’s overall health, so pay attention to any abnormalities
A regular, stable menstrual cycle is an indicator of a woman’s health, says Dr. Miklós Sipos, Director of the Assisted Reproduction Center at Semmelweis University. Women of childbearing age usually have regular periods, which last about the same length each month, and there is always about the same interval between the periods. Periods typically last two to seven days, though five days are common. During a menstrual period, the average amount of blood lost is around 30-50 ml, equivalent to a few tablespoons. A menstrual disorder occurs when there is a change in the length of the cycle or the duration or intensity of the bleeding, that is, if you experience unusually heavy bleeding for more than 24 hours, or if your cycle is shorter than 21 days or longer than 35 days. Strong menstrual cramps that interfere with everyday activities are also a warning sign because, contrary to old beliefs, severe pain is not a natural part of menses. Dr. Miklós Sipos warns that if there are changes or irregularities in the menstrual cycle that last longer than two to three months, it is advisable to consult a specialist. These disorders can indicate certain gynecological or hormonal diseases, such as endometriosis and adenomyosis, as well as uterine fibroids and PCOS (polycystic ovary syndrome), which may be the underlying causes. In addition to producing unpleasant symptoms that can deteriorate the quality of life, these diseases can also lead to infertility, making it essential to recognize and treat them early on.
Symptoms of an under- or overactive hormonal system may include irregular menstruation or other menstrual disorders, cystic ovaries, failure to conceive, increased hair growth, balding, or male-pattern obesity. In such cases, consultation with an endocrinologist, reproductive medicine specialist, or gynecologist is recommended.
2. Be mindful of your age when planning to have children
Although the concept of reproductive health is linked to reproductive rights, including the freedom and responsibility of partners to decide on the timing and number of their children, it is important to take age-specific factors into account. The number of artificial inseminations is growing worldwide as couples are having their first child increasingly later, points out Dr. Miklós Sipos. Experts advise that all planned babies should ideally be born to women between the ages of 25 and 35, as live births outside this age range are less likely and entail higher health risks. The decline in women’s fertility begins slightly after the age of 30 and accelerates after the age of 35. Over 40, the natural ability to conceive decreases significantly, and the chances of achieving a healthy live birth through assisted reproductive treatments are extremely low, he warns. A woman who starts IVF treatment at the age of 35 has a 30-40 percent chance of getting pregnant, while the rate drops to 10 percent over the age of 40 and to less than 5 percent over the age of 42. Therefore, awareness-raising campaigns for teenagers should emphasize the significance of considering this aspect when planning a family, adds Dr. Miklós Sipos.
3. Don’t be afraid to see a gynecologist if you have unpleasant intimate symptoms. Choose personalized contraception
Women usually go to the doctor with infections and inflammations, such as vaginitis and fungal infections. It is not advisable to procrastinate the visit as recurring, prolonged, and untreated inflammation can lead to more serious long-term conditions and ultimately to difficulty with conceiving. For example, chlamydia and other sexually transmitted diseases can cause ascending infections that block the fallopian tubes, leading to infertility, inability to implant, and early miscarriages, says Dr. Miklós Sipos. He also emphasizes that patients with unpleasant symptoms such as heavy vaginal discharge, itching, or painful sexual intercourse should consult a gynecologist as soon as possible for professional and targeted treatment. It is also not worth experimenting with over-the-counter creams and suppositories at home, so check with your doctor first. The expert recommends that the method of contraception should also be chosen via personalized consultation, taking into account, for example, the frequency of sexual intercourse, the number of partners, the fate of any possible pregnancies (keeping or terminating), and the religious denomination or ethical orientation of the couple or individual.
4. Lifestyle and optimal weight affect not only your health but also your fertility
Achieving and maintaining an optimal lifestyle and body mass index (BMI) through regular exercise and eating the right amount and quality of food is primary to women’s health, emphasizes Dr. Miklós Sipos. Excessive calorie intake, saturated fats, and frequent alcohol consumption also pose a risk. Excess weight impacts metabolism, causing disruptions and increasing the risk of cardiovascular diseases and certain types of tumors, including breast and colon cancer.
The expert points out that reproductive potential is also reduced in overweight and underweight individuals. A BMI ranging between 18.5 and 24.9 may indicate optimal weight; a BMI lower than 18.5 may indicate underweight, whereas a BMI of 25 or more may indicate overweight.
Dr. Miklós Sipos adds that patients with a BMI over 30, for example, have twice the risk of spontaneous miscarriage, while those with a BMI between 35 and 40 have only one-third the chance of successful artificial insemination compared to couples in the normal weight range.
5. Screening and prevention start at 25
Condom use protects against sexually transmitted gynecological diseases, and vaccination against HPV is an important tool for preventing cervical cancer. In Hungary, the voluntary HPV vaccination, introduced in 2014, is available as part of a primary school campaign for seventh-grade girls aged 12 and over.
Gynecological screening consists of a cervical smear for cytological examination, which is nowadays complemented by HPV screening, and gynecological palpation to detect abnormalities of the pelvic organs. It is also recommended to have a vaginal ultrasound scan, which gives a detailed picture of the pelvic organs. Breast palpation is also part of the comprehensive gynecological cancer screening. Testing is recommended between the ages of 25 and 65, or earlier if you have had an active sex life.
It is advisable to regularly self-examine the breasts and armpits at home, preferably in the days after menstruation, and to have a check-up once a year. Ultrasound scanning is sufficient under the age of 40, and mammography and ultrasound are used together over 40. In Hungary, an organized mammographic breast screening program for women aged 45-65 has been running since 2002.
Cardiovascular disease accounts for the deaths of more women than men, and even among those under 65, more than twice as many women die from cardiovascular disease than from breast cancer. Cardiovascular screening is therefore crucial for women, especially at the onset of menopause, as the drop in estrogen levels increases the risk of heart disease, high blood pressure, and stroke. Regular check-ups help detect problems early on, allowing preventive measures such as lifestyle changes and medical interventions to be taken to maintain cardiovascular health.
It is recommended that post-menopausal women have bone density tests every two years to prevent and slow down osteoporosis, and ladies over 50 should also undergo a colorectal cancer screening at least every five years. In addition, once a year, it is advisable to have a comprehensive blood test (including TSH levels for thyroid function) and a urine test. Annual mole screening is also recommended for all ages, along with a yearly lung screening.
Cancer survivors also have a chance of getting pregnant
It is now possible for cancer patients in Hungary to undergo so-called onco-fertility treatment, highlights Dr. Miklós Sipos. This means that for women under 40, before an anti-cancer treatment that is likely to cause significant and irreversible damage to the ovarian reserve, a pre-treatment stimulation is applied, followed by the retrieval and freezing of eggs, which can later be used for artificial insemination once the cancer treatment has been completed. In certain cases, embryo freezing is also possible. The treatment for fertility preservation is initiated by the oncologist or onco-team and is available free of charge at the Assisted Reproduction Center.
Eszter Keresztes
Translation: Judit Szabados-Dőtsch
Photos by Bálint Barta, Attila Kovács – Semmelweis University; iStock
