Happiness

starts with good health”

Written By Ingrid Harm-Ernandes

May is Women’s Health Care Month/ Women’s Health Month For 2023 the theme is “Happiness starts with good health” Interestingly, May’s awareness topics also include National Osteoporosis Awareness and Prevention Month, National Women’s Health Week, National Women’s Check-Up Day, Fibromyalgia Awareness Day, and Preeclampsia Awareness Month Education is key to understanding and promoting health and happiness Understanding what the conditions are and how to recognize them, how frequently they occur, and how to get treatment can help live a healthier happier life

Diabetes is a chronic condition that affects how your body turns food into energy It can affect many of your body's systems over time, causing other illnesses A total of 37 4 million or 11 3 % of the US population have diabetes and 96 million people aged 18 years or older have prediabetes 1 in every 9 women has diabetes How does diabetes impact women differently from men? Diabetes significantly increases a woman’s risk of heart disease It increases the risk four times for women and about 2 times for men Diabetes can increase a woman’s risk of vaginal yeast infections and urinary tract infections A menstrual period may impact cravings and make it harder to avoid sugary or other foods that may raise your blood sugar, Diabetes can also cause or increase vaginal dryness making sex or tampon insertion painful. Education about good diet and exercise can improve symptoms of diabetes and diabetes itself.

Osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds worldwide. Osteoporosis incidence increases from 1 out of 10 at age 60 to 2 out of 3 by age 90. A significantly larger percentage of women have fractures (particularly forearm, upper arm, hip, and spine fractures. It is important to follow a bone-healthy diet that includes vitamin D. In addition, eliminating smoking, limiting alcohol (preferably under 2 drinks per day), and performing moderate daily exercise that includes impact activities (walking, jumping, etc.) all help reduce the risk of developing osteoporosis. Medication may be needed and a doctor should be consulted for proper type and dosage

Heart disease is a large category of conditions that impact the heart

Coronary artery disease is when plaque develops in the walls of arteries that travel to your heart and throughout your body Women are at higher risk of developing coronary heart disease during menopause

Arrhythmias are when the heart beats too slow, too fast, or irregularly

Heart Failure is when the heart is too weak to function well Over 60 million women in the US are living with some form of heart disease In fact, it is the leading cause of death for women Approximately 1 in 3 deaths for women is due to heart disease

Breast Cancer can occur in different parts of the breast and is defined as a disease where cells in the breast grow out of control US women’s lifetime risk of breast cancer is about 13% (1 in 8) Seer cancer gov The chance a woman will die from breast cancer is 2 6% (1 in 39) Breast cancer survivorship has improved over the years but not necessarily the quality of life

Now that patients’ survival rate has improved, the focus on quality of life has improved. Treatments, chemotherapy, radiation therapy, and hormone therapies can all cause dryness and irritation of the vaginal and vulvar tissues. As a result, intercourse can become extremely painful.

These patients do not have to live with this. Proper treatment by a pelvic physical therapist can significantly reduce and even eliminate the pain that occurs with intercourse In addition, a pelvic physical therapist can help with lymphedema (swelling that can occur in the arm), upper body, and abdominal function as well as pelvic floor function All of this can help the patient restore their quality of life

Pregnancy and the fourth trimester are often thought to have symptoms and issues that are “just part of being pregnant or during the post-partum time period” This is now being challenged and rightly so The body goes through significant changes during and after pregnancy The time period of recovering from pregnancy is not just 6 weeks after giving birth Instead, it can last for months and even years after birth If we address issues as they arise during and after pregnancy, we can eliminate the symptoms and prevent future issues. What is some of the issues that can definitely be addressed and effectively treated are neck, mid-back, and low back pain, headaches, hip pain, abdominal pain, pelvic floor pain, pain with sex, urinary incontinence, fecal incontinence, prolapse, and more. How often are women told that they just need to deal with or live with these symptoms? This narrative needs to change. In the fourth trimester not only is the mom dealing with these symptoms They are also learning their role as a mother, and dealing with reduced sleep and changed food intake This time period is critical for the mother to receive the care she needs If she is better cared for, she can then care for others

Irritable bowel syndrome (IBS) is defined by the NIDDK as a group of symptoms that occur together that include pain in the abdomen, changes in bowel movements (diarrhea and/or constipation or both), which can occur without any visible signs of disease to the digestive tract It is now considered a disorder of gutbrain interaction that can make your bowels more sensitive and cause increased awareness of pain and bloating In addition, individuals with IBS often have pelvic floor dyssynergia https://www.linkedin.com/in/ingrid-harm-ernandes-5057773b/ https://www.facebook.com/ingrid.harmernandes.71/

Pelvic floor dyssynergia is when pelvic muscles become uncoordinated and often have difficulty relaxing during rectal pushing/bowel movements. Psychological stress can contribute to the development of IBS as well. IBS occurs in approximately 11.2 % of the global population. Non-pharmacological (drug) treatments are now getting more attention. Treatments for IBS are improving over time. IBS needs to be addressed by an interdisciplinary team. Gastroenterologists, cognitive behavioral practitioners, nutritionists, acupuncturists, endocrinologists, and pelvic physical therapists are all part of this team.

Pelvic health is a common link with so many conditions that women experience over their lifetime. They are so often the caretakers of others but have difficulty taking the time to take care of themselves. Issues such as Urinary incontinence, fecal incontinence, pregnancy, fourth-trimester issues, and prolapse are all pelvic-centered issues. They are, unfortunately, often ignored and people do not want to discuss them.

How do we change the narrative and move pelvic conditions into the forefront? Education and advocacy are the keys to starting this conversation and working toward improved care. Both practitioners and patients alike gain strength and power with knowledge. My book “The Musculoskeletal Mystery: How to solve your pelvic floor symptoms” answers so many questions, demystifies the musculoskeletal system, and encourages people to advocate for themselves and their loved ones.

Ms. Harm-Ernandes is a pelvic physical therapist. She was the Co-Director and a mentor for the Duke Women’s Health Physical Therapy Residency Program, a mentor for new pelvic PTs, and participated in PFDN research projects. She is board certified in Women’s Health (WCS) and Pelvic Bloor Biofeedback and served on committees for both the APTA and AUGS. She enjoys presenting the importance of recognizing and assessing the pelvic musculoskeletal system. She published “Assessment of the Pelvic Floor and Associated Musculoskeletal System”, in the FPMRS journal in December 2021. In 2021 she published her book, “The Musculoskeletal Mystery: How to solve your pelvic floor symptoms”. She has been a guest on national and international podcasts and webinars and is “The Pelvic Detective on YouTube. Her goal is to provide individuals with the knowledge they need to get proper pelvic care and for everyone to realize that pelvic conditions are common but not normal.