Gynaecology or gynecology

[1]
is the medical practice dealing with the health of the female
reproductive system (uterus, vagina, and ovaries). Literally, outside medicine, it means "the
science of women". Almost all modern gynaecologists are also obstetricians (see obstetrics
and gynaecology). It is the counterpart to andrology, which deals with medical issues specific
to men. The Kahun Gynaecological Papyrus is the oldest known medical text, (dated to about
1800 BCE) dealing with women's complaintsgynaecological diseases, fertility, pregnancy,
contraception, etc. The text is divided into thirty-four sections, each section dealing with a
specific problem and containing diagnosis and treatment, no prognosis is suggested.
Treatments are non surgical, comprising applying medicines to the affected body part or
swallowing them. The womb is at times seen as the source of complaints manifesting
themselves in other body parts.
[2]

According to the Suda, the ancient Greek physician Soranus of Ephesus practiced in
Alexandria and subsequently Rome. He was the chief representative of the school of
physicians known as the "Methodists." His treatise Gynaikeia is extant (together with a 6th-
century Latin paraphrase by Muscio, a physician of the same school).
In the United States, J. Marion Sims is considered the father of American gynaecology.
Contents
[hide]
1 Examination
2 Diseases
3 Therapies
4 See also
5 References
6 External links
[edit] Examination

This section does not cite any references or sources.
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challenged and removed. (September 2009)
Gynaecology is typically considered a consultant specialty. In some countries, women must
first see a general practitioner (GP; also known as a family practitioner (FP)) prior to seeing a
gynaecologist. If their condition requires training, knowledge, surgical technique, or
equipment unavailable to the GP, the patient is then referred to a gynaecologist. In the United
States, however, law and many health insurance plans allow/force gynaecologists to provide
primary care in addition to aspects of their own specialty. With this option available, some
women opt to see a gynaecological surgeon without another physician's referral.
As in all of medicine, the main tools of diagnosis are clinical history and examination.
Gynaecological examination is quite intimate, more so than a routine physical exam. It also
requires unique instrumentation such as the speculum. The speculum consists of two hinged
blades of concave metal or plastic which are used to retract the tissues of the vagina and
permit examination of the cervix, the lower part of the uterus located within the upper portion
of the vagina. Gynaecologists typically do a bimanual examination (one hand on the abdomen
and one or two fingers in the vagina) to palpate the cervix, uterus, ovaries and bony pelvis. It
is not uncommon to do a rectovaginal examination for complete evaluation of the pelvis,
particularly if any suspicious masses are appreciated. Male gynaecologists often have a
female chaperone (nurse or medical student) for their examination. An abdominal and/or
vaginal ultrasound can be used to confirm any abnormalities appreciated with the bimanual
examination or when indicated by the patient's history.
[edit] Diseases
The main conditions dealt with by a gynaecologist are:
1. Cancer and pre-cancerous diseases of the reproductive organs including ovaries,
fallopian tubes, uterus, vagina, and vulva
2. Incontinence of urine.
3. Amenorrhea (absent menstrual periods)
4. Dysmenorrhoea (painful menstrual periods)
5. Infertility
6. Menorrhagia (heavy menstrual periods). This is a common indication for
hysterectomy.
7. Prolapse of pelvic organs
8. Infections (including fungal, bacterial, viral, and protozoal)
There is some crossover in these areas. For example, a doctor who deals with women with it
may be referred to a urologist.
[edit] Therapies

This section does not cite any references or sources.
Please help improve this article by adding citations to reliable sources. Unsourced material may be
challenged and removed. (September 2009)
As with all surgical specialties, gynaecologists may employ medical or surgical therapies (or
many times, both), depending on the exact nature of the problem that they are treating. Pre-
and post-operative medical management will often employ many "standard" drug therapies,
such as antibiotics, diuretics, antihypertensives, and antiemetics. Additionally, gynaecologists
make frequent use of "specialized" hormone-modulating therapies (such as Clomifene citrate
and hormonal contraception) to treat disorders of the female genital tract that are responsive
to pituitary and/or gonadal signals.
Surgery, however, is the mainstay of gynaecological therapy. For historical and political
reasons, gynaecologists were previously not considered "surgeons", although this point has
always been the source of some controversy. Modern advancements in both general surgery
and gynaecology, however, have blurred many of the once rigid lines of distinction. The rise
of sub-specialties within gynaecology which are primarily surgical in nature (for example
urogynaecology and gynaecological oncology) have strengthened the reputations of
gynaecologists as surgical practitioners, and many surgeons and surgical societies have come
to view gynaecologists as comrades of sorts. As proof of this changing attitude,
gynaecologists are now eligible for fellowship in both the American College of Surgeons and
Royal Colleges of Surgeons, and many newer surgical textbooks include chapters on (at least
basic) gynaecological surgery.
Some of the more common operations that gynaecologists perform include:
1. Dilation and curettage (removal of the uterine contents for various reasons, including
partial miscarriage and dysfunctional uterine bleeding refractive to medical therapy)
2. Hysterectomy (removal of the uterus)
3. Oophorectomy (removal of the ovaries)
4. Tubal ligation
5. Hysteroscopy
6. Diagnostic laparoscopy - used to diagnose and treat sources of pelvic and abdominal
pain; perhaps most famously used to provide definitive diagnosis of endometriosis.
7. Exploratory laparotomy - may be used to investigate the level of progression of benign
or malignant disease, or to assess and repair damage to the pelvic organs.
8. Various surgical treatments for urinary incontinence, including cystoscopy and sub-
urethral slings.
9. Surgical treatment of pelvic organ prolapse, including correction of cystocele and
rectocele.
10. Appendectomy - often performed to remove site of painful endometriosis implantation
and/or prophylactically (against future acute appendicitis) at the time of hysterectomy
or Cesarean section. May also be performed as part of a staging operation for ovarian
cancer.
11. Cervical Excision Procedures (including cryosurgery) - removal of the surface of the
cervix containing pre-cancerous cells which have been previously identified on [Pap
smear]].



Abstract
Infertility is a central issue in the lives of many couples who suffer from it. In resource-poor countries the
problem of childlessness is even more pronounced compared with Western societies owing to different
sociocultural circumstances. It often leads to severe psychological, social, and economic suffering, and
access to infertility treatment is often limited to certain procedures and certain costumers. The issue of
infertility in resource-poor countries is underestimated and neglected, not only by local governments but
also by the international nonprofit organizations. Simplification of the diagnostic and therapeutic procedures,
minimizing the complication rate, and incorporating fertility centers into existing reproductive healthcare
programs are essential measures to take in resource-poor countries if infertility treatment is to be accessible
for a large part of the population. For reasons of social justice, a search for strategies to implement
simplified methods of infertility diagnosis and treatment in resource-poor countries is urgently warranted.








Access to sexual and reproductive health for young people: Bridging the
disconnect between rights and reality
Abstract
Of the 1.5 billion young people globally, 78% live in Asia and Africa, the poorest regions of the world. The
majority of young people infected with HIV are female and adolescent girls have a significant increased risk
for maternal mortality and morbidity, such as fistula. Trends to delay marriage do not decrease the age of
onset of sexual activity, but highlight the need for access to sexual and reproductive information, and skills
and services to learn healthy sexuality and prevent unwanted pregnancy and sexually transmitted
infections. Youth-friendly services require confidentiality, privacy, and non-judgmental attitudes, and rights
of adolescents include the consideration of their evolving capacities to consent to services. Denial of young
people's sexuality and rights by conservative and traditional forces has lethal consequences, especially for
women and girls. Countries have committed to these rights through numerous international instruments and
many are making progress, but challenges at the community level are significant.
2.3. Rights to sexual and reproductive health services
While most are familiar with societal debate surrounding access to information and services for
contraception and abortion for young people, the appearance of HIV has added greater weight to the
discussion in support of the rights due to adolescents and youth. The right of young people to freely
express their views and opinions and have them considered speaks to the need to develop an
approach that allows meaningful participation opportunities at the policy level that respect young
people's interests and needs in programming for HIV and reproductive health services.
The health of mothers and their children is of critical importance, both as a reflection of the current health
status of a large segment of the world's population and as a predictor of the health of the next generation. A
range of indicators of maternal and neonatal health existthose primarily affecting pregnant and
postpartum women, and those affecting the health and survival of infants. Pregnancy outcome may be
affected by toxicant exposure, maternal habits, occupational hazards, psychosocial factors, socioeconomic
status, racial disparity, chronic stress, and infections. An increase in obstetric pathologies related to
lifestyle, environment, aging, and diet has been seen in Western countries. Large segments of the
population are obese and this factor is associated with a great number of adverse reproductive health
outcomes. In other countries, the most important objective is to reduce the incidence of infectious diseases
and their transmission from mother to fetus. AIDS remains the leading cause of death of children worldwide.
2.5. Universal access to youth-friendly sexual and reproductive health care
Equitable access to and utilization of health care has been articulated as a basic human right.
Reproductive health services have a special role in attaining MDG 5 for the improvement of maternal
health, including maternal and newborn health, family planning, prevention of unsafe abortion, control
of sexually transmitted infections, and promotion of sexual health. HIV control and gender are
crosscutting issues to be addressed, also captured in the MDGs. Strengthening sexual and
reproductive health services for adolescents and young people should involve them in determining
their needs as these vary between countries and regions. In particular, most family planning and
reproductive health programs designed to serve young people have neglected the special needs of
married adolescents, a particularly disadvantaged group.
Lack of availability of services is commonly noted as the most important barrier, but lack of access to
reproductive health knowledge was also associated with lack of self-confidence among adolescents to
discuss such issues. In Sri Lanka, focus group sessions found that the most common problems for
1719 year-olds were psychological distresses, masturbation, and menstrual cycle problems [21].
Young people rated expected factors as most important in youth-friendly services: confidentiality,
privacy, short waiting time, low cost, and friendliness to both young men and young women [22], [23],
[24]. Least important characteristics included youth-only service, youth involvement, and young staff.
Studies of the attitudes of health professionals to adolescent SRH problems concerning provision of
services in Kenya, Zambia [25], Swaziland [26], and Uganda [24] confirmed reported experiences of
young people. There was disapproval of adolescent sexual activity, including masturbation,
contraception, and abortion, although those with more education had more youth-friendly attitudes.
Studies from the USA and UK have found similar needs to improve youth services and male-
friendliness as well as integration of HIV services, learning from lessons integrating services for family
planning and sexually transmitted diseases [27].
Health Sector reform in Mongolia has resulted in innovative youth-friendly services engaging urban
youth. They reduced maternal mortality and increased contraceptive use, but sexually transmitted
infections and rising rates of adolescent pregnancy remain a challenge [28]. Many countries are taking
steps such as removing legal obstacles so that young people can access needed services, for
example, under South African law, anyone 14 years or older has the right to receive contraception [1].
Cultural taboos present challenges to policy even when governments are progressive, for example in
Nepal the practice, not the policy, is that government family planning services are provided to married
couples only. The consequent reality is that almost 25% of girls become pregnant before 19 years,
two-thirds of new cases of HIV occur among adolescents, and over half of all abortions carried out
occur among women aged under 25 years [29].
Some taboos have been successfully addressed, such as improving traditional youth education to
avoid pregnancy and prevent HIV/AIDS in Ghana. Work by the Planned Parenthood Association
supported by the Department for International Development (DFID), reached almost 30 000 young
people and the number of young people using contraception increased from 27% to 80%. In Zambia,
DFID support to the AIDS Alliance has helped support sexual and reproductive health sessions with
80 000 young people; a community member said, More boys and girls recognize their rights to refuse
sex, enjoy their feelings without intercourse or insist on using a condom [29].
Reaching special vulnerable groups of young people, including sex workers and street children in
urban areas, may require innovative pilot studies in service delivery formats, such as unconventional,
non-clinical settings, and escorts or referrals using coupons or vouchers. In addition, studies should be
undertaken to determine under which local epidemiological and health service conditions they would
be cost-effective [5]. Integrating sexually transmitted infection (STI) prevention with reproductive
health services instead of separate STI services can also help to ensure privacy and reduce stigma
[19].
During the Pre-Congress Workshop at the 2006 FIGO Congress, the International Planned
Parenthood Federation (IPPF), FIGO, and young people explored access issues for youth-friendly
services. They noted that service providers needed greater understanding of the changing needs and
evolving capacities of young people and that preservice curriculum was the optimal time to improve
attitudes through education. Recommended comprehensive services for adolescents included
emergency contraception, safe abortion, and care for survivors of sexual violence [30]. In follow-up,
FIGO is beginning an initiative, with UNFPA support, to advance young people's SRH and rights
through partnerships at global, regional, and national levels. The project will include dialogue between
young people and health professionals in SRH, leading to the development and dissemination of a
training curriculum and guidelines.
3. Conclusion
There is significant unmet need for information, education, and services for sexual and reproductive
health for married and unmarried young people. It is essential to create an environment conducive to
keeping girls in school through the secondary level and to address gender inequalities for successful
development of nations. The ideological resistance to comprehensive sexuality education programs
and youth-friendly reproductive health services for males and females is not evidence based, leaves
young people vulnerable, and perpetuates gender inequalities. Attitudes of health professionals often
pose a barrier to access and must be addressed through leadership from health professionals using
the evidence, to encourage broader social discussion of the issues, improve access to SRH services
by young people, and access to male-friendly providers.
No single program is likely to be able to serve the needs of all young people; what is required is that
the particular reproductive health needs of adolescents are addressed and youth-friendly services
provided are based on their input, broadly and in their communities in these decisions that affect their
lives, their health, their future, and the future of their countries. This will require working with local
political and religious leaders to increase public awareness of the reproductive and sexual health
issues affecting adolescents and young people. It is unethical and a violation of multiple human rights
agreed to by most member states of the United Nations to continue denying access to information and
services that will prevent untimely deaths of young people, especially young women, from HIV/AIDS
and complications of pregnancy. The target of universal access to reproductive health in the
Millennium Development Goals can only be achieved if policy makers and legislators focus their
attention on young people, especially those in poverty, while continuing the progress on education.

Women's groups and professional organizations in advocacy for sexual and
reproductive health and rights
yes platform+medline author author
Adrienne Germaina, Jerker Liljestrandb
published online 19 June 2009.
Abstract
After the International Conference on Population and Development (ICPD) in 1994 and the Fourth World
Conference on Women in 1995, sexual and reproductive health and rights (SRHR) have improved in many
countries, and been supported by awareness raised by women's health advocates, increasingly by youth
groups, and also by organizations of health professionals. In the HIV/AIDS area, involvement of
organizations of people living with HIV/AIDS is crucial to improve prevention and care. However, after
victories during the 1990s, combating opposition by social and political conservatives has taken up much
energy in recent years. Continuous advocacy to broaden acceptance of the fundamental importance of
SRHR, their role in meeting the Millennium Development Goals, and the imperative to increase funding, is
essential.
Keywords: Advocacy, Professional organizations, Sexual and reproductive health and rights, Women's groups
Article Outline
Abstract
1. Introduction
2. Establishing and protecting sexual and reproductive health and rights in global agreements
3. Turning global agreements into reality, with professional organizations
4. What remains to be done
5. The emergence of new challenges
6. Looking ahead
References
Copyright
1. Introduction

This paper reviews the work of two major constituencies for sexual and reproductive health and rights
(SRHR) from the mid 1990s to date, joined at the turn of the 21st century by increasingly organized
youth groups. It focuses on advocacy for SRHR policies and programs concerned with low- and
middle-income countries in Africa, Asia, and Latin America, but also encompassing the Middle East,
the former Soviet Union and Eastern Europe, and Central Asia.
In the limited space available, the paper highlights initiatives by women's health and rights advocates
to establish sexual and reproductive health and rights in intergovernmental agreements in the 1990s;
assesses the extent to which women's groups, joined by youth groups, have protected the agreements
in intergovernmental negotiations from 2001 to date; reflects on the roles of both women's groups and
professional organizations in implementation of the agreements; and analyzes the challenges ahead.
2. Establishing and protecting sexual and reproductive health and rights in
global agreements

Simultaneously, but unknown to each other, a leading obstetrician/gynecologist, Professor Mahmoud
Fathalla, and women's health advocates published definitions of reproductive health and rights in the
late 1980s [1] that reflected nearly two decades of advocacy by local, regional, and international
women's health and rights organizations and movements [2]. That movement decided to use the
opportunity of the 1994 United Nations (UN) Conference on Population and Development (ICPD) to
institutionalize the reproductive health concept and transform population policy, working with and
perforce converting, governments, donors, the UN, and family planning and other professional groups
long committed to population control [3].
The ICPD was path-breaking in its commitment to individuals' sexual and reproductive health and
rights including contraception, abortion where legal, pregnancy and delivery care, and diagnosis and
treatment of sexually transmitted infections, including HIV/AIDS. Agreements on women's
empowerment and on the health and human rights of adolescents, including comprehensive sex
education, were equally remarkable. But advocates lost the negotiation to use the term sexual rights,
which was construed by conservative governments to promote promiscuity and homosexuality. The
following year, at the UN Fourth World Conference on Women (FWCW), therefore, the women's
movement again pursued the issue, recognizing that protection of human rights in the realm of
sexuality is a fundamental requirement not only for women's empowerment and health, but for social
justice [4]. The result was Paragraph 96 in the Platform for Action, to this day the strongest language
in the UN on sexual rights [5]: The human rights of women include their right to have control over and
decide freely and responsibly on matters related to their sexuality, including sexual and reproductive
health, free of coercion, discrimination and violence. Key aspects of sexual rights were included in the
definition, although the term itself was rejected.
In the ensuing years, women's health advocates, increasingly joined by young people, worked, not
only in the 5- and 10-year reviews of these two conferences, but also in various other UN fora
(Commission on Population and Development; Commission on the Status of Women; High Level
meetings on HIV/AIDS), to strengthen, extend, and protect these agreements. Until 2001, progress
was made. Since 2001, however, advocates and like-minded governments have primarily had to
protect the agreements against severe conservative opposition, often led by the United States
government, which had been a stalwart ally and leader in the 1990s.
3. Turning global agreements into reality, with professional organizations

At the country level, at least from the 1980s, strong examples exist of dialogue and collaboration
between health professionals, especially obstetricians/gynecologists, and women's health advocates
(e.g. Indonesia, Nigeria, Brazil), even though they did not agree on everything [6] and some in each
constituency refused to work with the other. At both national and international level, collaboration
between the two groups has been pivotal for implementing the sexual and reproductive rights and
health agreements of the 1990s.
An example, following the ICPD-Plus-Five decision [7] that, where abortion is legal, it should be safe
and fully available according to the law of the respective country, advocates persuaded the World
Health Organization (WHO) that they should produce guidelines for countries, and then worked
intensively for 3 years with health professionals, primarily obstetricians/gynecologists, to draft them,
gain approval, and then help WHO introduce them [8]. Similar examples of collaboration can be found
in the arenas of maternal and neonatal mortality [9], promotion of work on sexually transmitted
infections, and continuing work to improve the quality of care in family planning services.
At the country level, an exceptional example of collaboration among women's health advocates, health
professionals, government and donors, is the development and initial implementation of a new
national health and population program in Bangladesh following the ICPD. Using the ICPD definitions,
this program centered on an essential package of services which, in 5 years, reduced maternal
mortality by 26%, increased use of prenatal services, sustained contraceptive prevalence, reduced
infant mortality, initiated an HIV/AIDS program, and began work with young couples. Almost this entire
program was unprecedented [10].
A different, but vitally important example, is joint work by women's health advocates and courageous
obstetricians/gynecologists across Latin America, and in a few countries of Sub-Saharan Africa
(Ethiopia, Mozambique, Nigeria, South Africa), and Asia (Indonesia, Nepal) to foster access to safe
abortion through advocacy to liberalize restrictive laws, education of health professionals and women
on what current laws allow, and creation of public awareness [11].
Professional organizations by themselves or in collaboration with women's organizations also show an
increasing range of activities aimed at improving SRHR. See Table 1 for such examples, largely driven
by national societies of obstetrics and gynecology. Women-led SRHR advocacy in Africa, especially in
support of adolescents' health and sexual and reproductive rights, provides another critically important
example of the strongest work to implement the ICPD and FWCW commitments. In Nigeria, several
NGOs that had created comprehensive sexuality education programs in their highly diverse states,
joined to assist the federal government to create a national curriculum. These same groups are now
assisting state governments to adopt and implement the curriculum. A similar effort is underway in
Cameroon and other examples are emerging.
4. What remains to be done

The UN agencies, most donor governments, and most national governments have adopted the ICPD
SRHR framework for policy and programming and, as the examples above indicate, many ideas and
experiences provide a strong foundation for full ICPD implementation. Nonetheless, implementation
will require more robust and consistent financing, both by governments and by donors, as well as
investment in strengthening basic health systems, and the legal policy environment including
protection of human rights and promotion of gender equity and equality.
5. The emergence of new challenges

Even as countries have repeatedly reaffirmed their commitments to SRHR, two important challenges
to implementation emerged from 2001 onward. First was the increasing mobilization of conservative
opposition legitimized by the United States government, particularly the policy positions of the Bush
administration and supporters in both houses of Congress. This dramatic change of US policy has had
considerable negative, global impact. It has required that UN advocates spend most of their effort in
recent years protecting existing agreements rather than moving them forward. Interestingly, in this
time, the women's health advocates have been joined at both global and country/regional level by
increasingly vocal and effective youth SRHR networks, especially from Latin America.
The second challenge is in the area of HIV/AIDS. Since the pandemic became known in the early
1980s, people living with HIV/AIDS have played a crucial role in heightening awareness about
HIV/AIDS, and lobbying for increased efforts and funding for HIV/AIDS. An unprecedented political
movement has evolved, fuelled by people living with HIV. The goal has been to ensure universal
access to HIV treatment, through strong financial commitment by donors and national governments to
HIV/AIDS treatment and, to a lesser extent, prevention. While these commitments might reasonably
have been expected to foster sexual and reproductive rights and health, it is only recently that
HIV/AIDS has begun to be understood as an SRHR issue, especially for girls and women [12].
In 2005, an international group of women from 7 diverse constituencies (HIV/AIDS groups, women's
rights and human rights organizations, youth groups, faith-based organizations, SRHR organizations,
and women living with HIV/AIDS) initiated With Women Worldwide: A Compact To End HIV/AIDS
(www.withwomenworldwide.org). Its focused action agenda calls for investment of HIV/AIDS-
earmarked funds in sexual and reproductive health services, comprehensive sexuality education, and
protective methods that women can initiate such as the female condom. The Compact has over 300
signatories from over 50 countries, including leaders of the 7 constituencies. In 20072008, thanks in
part to advocacy by these constituencies, both UNAIDS and the Global Fund to fight AIDS,
Tuberculosis, and Malaria have taken major decisions to encourage countries to address the factors
that make women and young people so vulnerable to HIV/AIDS. These should help move the SRHR
agenda forward substantially.
6. Looking ahead

Entry of women's health and rights advocates into the ICPD negotiations was a significant initial step
toward broadening what had been a fairly narrow base of support for family planning [13]. The further
broadening of that base enabled by the SRHR agenda described aboveincluding its increasing
implementation and support by professional societies will, in the end, protect against contemporary
conservative forces as we work toward securing SRHR for all. It will also enable quick, strong action
when more progressive political leadership comes into power, as it inevitably must.
Introduction

Political will and leadership are fundamental to improving women's access to sexual and reproductive
health services.
Parliamentarians are well placed to promote gender sensitive health and, in particular, sexual and
reproductive health and rights (SRHR) policies through legislative mandates, acting as public role
models or spokespersons for gender equality and public openness about SRHR.
Efforts to increase women's access to health services have, however, fallen short in many countries
because of underlying economic, political, social, and cultural constraints and/or ideological-driven
campaigns.
2. All Party Parliamentary Groups on Population, Development and
Reproductive Health

All Party Parliamentary Groups on Population, Development, and Reproductive Health (APPGs on
PD&RH) have now been established in almost 100 countries to promote the full implementation of the
International Conference on Population and Development Programme of Action (ICPD PoA) and
acknowledge the ICPD PoA as an essential element for the successful implementation of the
Millennium Development Goals (MDGs).
Four regional parliamentary umbrella networks also exist to coordinate regional and international
parliamentary activities.
In the UK, the All Party Parliamentary Group on PD&RH was established in 1979, and I am proud to
have been the chair since 1997. Through its 75 members and with the assistance of a full-time policy
adviser and a part-time assistant, the Group provides a discussion forum for MPs and Peers, on
population, development, and sexual and reproductive health.
The Group raises parliamentary awareness on population, development, and reproductive health,
facilitating negotiations between key stakeholders and parliamentarians, and encouraging initiatives
that increase access to and improve reproductive and sexual health programs worldwide. Activities
include:

regular public meetings in Parliament with guest speakers from the sexual and reproductive health
sector in the UK and abroad;

coordinating written and oral parliamentary questions and debates on population, development, and
reproductive health issues;

organizing public and private meetings between group members and government ministers and
officials;

holding parliamentary hearings on SRHR subjects;

facilitating study tours to low-income countries to improve understanding of sexual and reproductive
health needs and services;

encouraging the establishment of and maintaining contact with similar Parliamentary Groups
worldwide;

enabling consultations and briefings with population, reproductive health, and development NGOs
and the Departments for International Development (DFID) and Health.

Parliamentarians promote, review, and adapt legislation, including budget appropriations. They also
approve policies, formulated by the executive branch of governments, and endorse resolutions and
statements on important SRHR topics that further the ICPD PoA.
The ICPD PoA was a groundbreaking event, placing the individual at the core of population policies
and development. SRHR issues that used to be taboo are today on the international agenda, including
adolescent sexuality, gender-based violence, and harmful traditional practices, such as female genital
mutilation.
3. UK parliamentary advocacy

In the UK, the APPG on PD&RH, has been instrumental in furthering the ICPD PoA and defending its
principles, via parliamentary bills, questions and debates, and via meetings and conferences.
For example, in 20012002, the UK Overseas Development bill was debated, with the purpose of
legislating, for UK Overseas Development Aid (ODA), including humanitarian aid, as well as other
activities such as conflict reduction and peace building.
Amendments were tabled and debated, indicating that some SRHR organizations, including UNFPA
and IPPF, supported coercive family planning, sterilization, and abortion in countries such as China
and should therefore be excluded from UK ODA. Under my chairmanship, the Group was central to
the defeat of these amendments and ensuring that SRHR organizations, including UNFPA and IPPF,
were not excluded from receiving UK ODA.
In 2003, the Group was instrumental in helping introduce and enacting the new Female Genital
Mutilation (FGM) Act, which ensures the:

Prosecution upon entry to the UK, of a person who has aided, abetted, counseled, procured, excised,
infibulated a girl/woman abroad, despite FGM being legal in the country where it was performed.

Conviction of indictment to be lengthened to 410 years.

Change of female circumcision to read FGM.

The new Act sends a strong message to FGM practicing communities in the UK, that FGM is not
acceptable and against human rights.
Over the past few years the antichoice lobby has become more vocal and several bills have been
tabled in Parliament with a view to amending the 1967 UK Abortion Act.
Last year, antichoice amendments were tabled to the Human Fertilisation and Embryology bill, which I
am pleased to say, were overwhelmingly defeated. Through Parliamentary Hearings, the UK APPG on
PD&RH has also been instrumental in formulating and progressing national policies.
Hearings have been held on young people, FGM, linking SRHR and HIV/AIDS, population, and the
MDGs, and we have just launched into an inquiry into maternal morbidity.
In response to the FGM hearings, the Department of Health Strategy on sexual health and HIV 2002
has a section on FGM.
DFID's 2004 HIV/AIDS strategy and the review in 2007 both make strong reference to the importance
of linking SRHR and HIV/AIDS services to combat HIV/AIDSin part a response to the Group's
hearings on linking SRHR and HIV/AIDS. The 2007 strategy now includes actions to halve unmet
demand for family planning by 2010; to achieve universal access to family planning by 2015; and to
spend 6 billion on health systems and services by 2015 to help maximize progress on AIDS through
closer integration of AIDS, tuberculosis, malaria, and SRHR, including maternal and child health
services.
DFID's Health StrategyWorking Together for Better Health 2007 and the Annual Report 2007
make strong reference to population and the need for SRHR services. Furthermore, the profile of
population and its links to climate change, migration, and poverty eradication have risen on the
political agenda, partly owing to the Group's hearings on population growth and the MDGs.
APPG on PD&RH hearing reports are launched internationally at the biennial International
Parliamentary Conferences on the Implementation (IPCI) of the ICPD PoA. The 2009 IPCI ICPD PoA
will be held in Cairo, Egypt, and our current hearings on maternal morbidity will be launched at that
conference.
Parliamentarians and ministers representing all regions of the world attend the IPCI conferences to
focus on creating an enabling legislative and policy environment for SRHR, and mobilizing national
and international resources for SRHR.
Launching hearing reports at relevant international parliamentary conferences helps disseminate and
promote good practice and policies.
4. Council of Europe parliamentary advocacy

In the Council of Europe (CoE), I was recently elected chair of the Social Health and Family (SHF)
Committee and was appointed the rapporteur for opinion on the CoE Abortion Report.
After a 4-hour debate and decisions on 72 amendments, the Report was finally adopted by the
Parliamentary Assembly in April, with a majority of 33.
The CoE report calls for member states to:

decriminalize abortion, within reasonable gestational limits, if they have not already done so;

guarantee women's effective exercise of their right to abortion;

allow women freedom of choice and offer the conditions of a free and enlightened choice;

ensure that women and men have access to contraception at a reasonable cost, of a suitable nature
for them, and chosen by them.

The Report is a great achievement for the women of Europe.
In 2003/04 and 2006/07, as a member of the SHF Committee, I was successful in bringing forward two
motions on resolutions, one on SRHR and one on HIV/AIDS. In 2004 the European Strategy for the
promotion of SRHR was adopted and in 2007 the European HIV/AIDS strategy was adopted.
5. International parliamentary advocacy

Parliamentarians are central to the promotion of SRHR as above examples illustrate.
The UNFPA report, Cairo to 2015: The Road to Success [1], summarizes other successful
international Parliamentary SRHR advocacy.
The survey read: With regard to ICPD issues, parliamentarians were personally involved in enacting
250 laws in 77 countries: proposing 157 bills in 63 countries; and approving 67 policies in 35
countries. This is from a sample of 322 parliamentarians from 104 countries and institutions: 269
parliamentarians from 85 developing countries, and 53 parliamentarians form 18 donor countries and
of the European Parliament.
Of particular interest, the survey noted that: parliamentarians shared many of the same interests, with
gender equality and women's empowerment, HIV/AIDS and Reproductive Health and Rights topping
their list.
Only a few parliamentarians took a more proactive role in advancing sensitive aspects of the ICPD
agenda, including sexual rights including abortion rights and overturning the US restrictions on family
planning funding. Gender-based violence was highest in Latin America and Eastern Europe.
Women parliamentarians were more likely than men to point to gender equality and gender-based
violence. Men were more likely than women to mention development issues and demographic
concerns among priority issues.
6. Antichoice campaigns

The biggest obstacle to promoting SRHR in parliaments remains the resurgence of misinformation and
ideologically-driven campaigns, in part from conservative religious groups. The US Global Gag rule
and the previous administration's general opposition to SRHR have been key challenges.
Parliamentarians spend more and more time correcting misinformation and opposing ill-judged
legislation at the expense of developing innovative ideas that further the ICPD PoA agenda for the
benefit of women, men, girls, and boys around the world.
At International United Nations conferences, the US and their ideological allies have repeatedly
undermined the ICPD PoA; examples can be found at the World Summit on Sustainable
Development, 2002, where the US delegation objected to wording around women's rights in the
outcome document, and at the UNGASS, 2006, the US objected to any reference to intravenous drug
users and linkages between SRHR and HIV/AIDS.
I am delighted that one of President Obama's first decisions has been to rescind the Global Gag Rule,
which will save many women's lives. I also welcome the reinstatement of funding to UNFPA, which
means that the US joins 180 other donor nations working collaboratively to reduce poverty, increase
the health of women and children, prevent HIV/AIDS, and provide family planning assistance to
women in 154 countries.
Politicians must be brave and speak out against misinformation or ill-informed and ideologically-driven
campaigns that mitigate the promotion of women's health and rights.
7. New MDG 5 target on reproductive health

The new MDG target under MDG 5 to ensure universal access to reproductive health services by
2015, is a direct result of 8 years of successful political campaigning and is crucial to the achievement
of the ICPD agenda.
Parliamentarians prepared numerous international statements in support of the new target and
hundreds, if not thousands, of lobby letters were sent to Presidents, Prime Ministers, and relevant
Ministers. Parliamentarians and Ministers, of every party and from all countries, must now use and
promote the new UN target, at every opportunity.
Next year's ICPD +15 is an opportune moment to put SRHR high on the political agenda, particularly
maternal health, which Sarah Brown, our Prime Minister's wife, is championing as the patron of the
White Ribbon Alliance.
8. Conclusion

In conclusion, Parliamentarians are fundamental to the promotion and full implementation of the ICPD
PoA and they must act as spokespersons for gender equality and SRHR for all.
ICPD +15 must be the launch pad to galvanize support for the new MDG 5 target, giving all women
the access to their SRHR and, in doing so, save lives.
Loss of sexual desire hits postmenopausal womens quality of life
hard
January 22nd, 2009 - 12:32 pm ICT by ANI -
Washington, Jan 22 (ANI): Postmenopausal women with low levels of sexual desire are likely
to be depressed and to suffer physical symptoms such as back pain and memory problems,
says a new study.
The study by researchers at the University of North Carolina at Chapel Hill and Procter &
Gamble Pharmaceuticals found that females with low levels of sexual desire, often as a result
of menopause, are more likely to be sad and have a bad health than women who report higher
levels of desire.
The study has been published in Value in Health, the official journal of the International
Society of Pharmacoeconomics and Outcomes Research.
According to researchers, women with hypoactive sexual desire disorder (HSDD) reported
poorer health status and worse health-related quality of life than women without the disorder.
Hypoactive sexual desire disorder is defined as the persistent lack of sexual desire causing
marked stress or interpersonal difficulties.
The study shows that women with the disorder have a degree of physical and mental
impairment comparable to chronic conditions such as hypertension, diabetes, osteoarthritis
and asthma, researchers say.
Our research shows that HSDD is a significant and clinically relevant problem, and not a
normal or inevitable part of the aging process, said Andrea K. Biddle, Ph.D., associate
professor of health policy and management at the UNC Gillings School of Global Public
Health.
Women with the disorder experience health burdens similar to individuals with serious
chronic conditions, the expert added.
The study was based on telephone interviews with 1,189 postmenopausal women. Using
quality of life surveys, researchers asked women about their levels of sexual desire and
feelings of physical and emotional well-being or distress.
Results showed that women with the disorder were more likely to be depressed and to express
dissatisfaction with their home lives and their sexual partners. Surgically menopausal women
(women who underwent menopause by having their ovaries removed) were slightly more
likely to have the disorder than women who underwent menopause naturally. (ANI)




Sydney, Sep 30 (IANS) Sexually satisfied women scored higher on psychological well-being
and the vitality index compared to their sexually dissatisfied counterparts, a new study has
revealed.
The study was based on 295 women who were sexually active more than twice a month.
To assess whether sexual satisfaction and well-being were linked, the team from Monash
University in Australia recruited women aged 20-65 who self-identified as being satisfied or
dissatisfied with their sexual function.
We wanted to explore the links between sexual satisfaction and well-being in women from
the community and to see if there was any difference between pre-and postmenopausal
women, said Sonia Davison of the Womens Health Programme at Monash University who
led the study.
The most commonly reported sexual problems in women relate to sexual desire and interest,
pleasure and satisfaction. For most women these are part of the overall sexual experience and
are inextricably related.
Women were also found to be frequently sexually active despite a high level of sexual
dissatisfaction.
We found that women who were sexually dissatisfied had lower well-being and lower
vitality. This finding highlights the importance of addressing these areas as an essential part
of womens health care because women may be uncomfortable discussing these issues with
their doctor, said Davison.
These findings were published in The Journal of Sexual Medicine.
Women's Health Issues A - Z
By Tracee Cornforth, About.com Guide to Women's Health
Womens health diseases, conditions, and issues arranged alphabetically to help you quickly find
the womens health information you need. This page covers womens health issues from puberty to
menstruation, menopause and beyond, as well as general health, fitness, and wellness information
for girls and women.
A
Women's health issues beginning with the letter A.
Abnormal Pap Smears
Abnormal Uterine Bleeding
Acne
AIDS
Anal Cancer
B
Women's health articles beginning with the letter B.
Bacterial Vaginosis
Before You Get Married Know This
Bleeding Between Periods
About.com's Breast Cancer Guide
About.com's Breastfeeding Guide
C
More women's health issues beginning with the letter C.
Calcium and Women
About.com's Cervical Cancer Guide
Cancer - What Is Colon Cancer?
Cancer - What Is Endometrial Cancer?
Cancer - What Is Ovarian Cancer?
Cancer - What Is Skin Cancer?
Cancer - What Is Uterine Cancer?
Cervix - What Is The Cervix?
Cervical Erosion - What Is Cervical Erosion?
Cervix - Cyrosurgery Of The Cervix
Chlamydia - What Is Chlamydia?
Colonoscopy
Colposcopy
About.com's Contraception Guide
Contraceptives - Non-Contraceptive Benefits Of The Pill
D
Information about women's health beginning with the letter D.
D&C For Early Miscarriage
The Date Rape Drug - Facts About Rohypnol and Dating Violence
Deep Vein Thrombosis
Depression and Women
Dermatology and Rashes During Pregnancy
E- F- G
Women's health articles beginning with the letters E, F, and G.
Easy Steps To Health For Women
Eating Disorders and Women
Endometriosis
Environmental Toxins and Reproductive Health
Epilepsy and Women
Exercise and Weight Loss For Women
About.com's Fertility Guide
Fibrocystic Breast Disease Basics
Gallbladder Disease Basics
Genital Herpes Basics
Going To The Gynecologist
Gonorrhea Basics
H
Women's health information starting with the letter H.
Hairloss In Women
Headaches
Heart Disease
Hemochromatosis - Iron Overload
High Blood Presure and Women
Hormone Therapy During Perimenopause
Hot Flashes
Hysterectomy
Hysteroscopy
I- J- K- L
Information about women's health issues beginning with the letters I, J, K, and L.
Infertility
Laparoscopy - Overview Of Pelvic Laparoscopy
LEEP Procedure
Lupron Depot
M
More women's health articles beginning with the letter M.
Mammography
Medical Tests and Screenings For Women
Menopause 101
Menstrual Cramps
About.com's Menstrual Disorders Guide
Menstruation Basics
About.com's Miscarriage Guide
Mittelschmerz - The Pain Between Periods
Marriage - Health Checks For Brides
N- O
Women's health issues beginning with the letters N and O.
Nutrition - Women's Nutrition Calculator
Osteoporosis
Ovarian Cysts
Ovaries
P
Women's health information beginning with the letter P.
Patient Empowerment Basics
About.com's PCOS Guide
Pelvic Inflammatory Disease - PID
Pelvic Pain
About.com's Preemies Guide
Perimenopause
Plastic Surgery
PMS
About.com's Pregnancy Guide
Q- R- S
More women's health articles beginning with the letters Q, R, and S.
Rape - What to Do If You've Been Raped
Rape - What Is A Rape Kit?
Rashes During Pregnancy
Sabaceous Cysts
Sex - Bleeding During Sex
STDs
Smoking and Reproductive Health
Stress and Your Health
Surgery - Do You Really Need Surgery?
Syphilis Overview
T
Information about women's health issues beginning with the letter T.
Tampons - Are Tampons Safe?
Tanning Booth Risks
Thyroid Disease - Undiagnosed Thyroid Disease
Tubal Ligation
Tubal Ligation Reversal
U- V
More women's health articles beginning with the letters U and V.
Urinary Tract Infections
Vaginal Douches - Should You Use Them?
Vaginal Itching and Burning After Sex
Vaginal Itching During Pregnancy
Vaginal pH Testing At Home
Vaginal Infections - Trichomoniasis, Chlamydia, and Viral Vaginitis
Vulvitis
Vulvodynia
W- X- Y- Z
Information about women's health issues beginning with the letters W, X, Y, and Z.
Weight Loss - Is Dieting Right For You?
Yeast Infections