Mental Health

The cervix is located at the opening of uterus. It has a transformation zone, which is an area where two epithelial cell layers meet, the squamous cell layer coming from the vagina from below and the columnar epithelium coming from the uterus. This transformation zone is the most common site of origin of cervical cancer. Cervical cancer is the fourth leading cause of death in women worldwide. It occurs when there is abnormal growth of cells involving the cervix. The most common cause of cervical cancer is human papillomavirus (HPV) which is a common sexually transmitted infection. There are many strains of this virus, but the cancer-causing strains are HPV 16 and 18.  This cancer is of two types, squamous cell carcinoma and adenocarcinoma. The prior has more incidence. Image Source: Freepik.com Cervical cancer usually involves young women. Human papilloma virus- HPV HPV has the highest incidence of causing cervical cancer. There are around 150 strains of this virus, but the high-risk strains are 16 and 18. This is a sexually transmitted disease and has greater incidence in sexually active women with multiple partners. The virus is present on the genital surface and hence spreads during vaginal, anal and oral intercourse. There are vaccines available to prevent disease from HPV. These vaccines are highly effective and are available in quadrivalent (Gardasil), bivalent (Cervarix) and nonvalent forms. Another effective way to prevent this disease is protected sex using condoms, especially for women who have multiple partners or a partner who has a positive history of this infection.  Human immunodeficiency virus- HIV Infection with HIV predisposes a person to all kinds of infections. This virus weakens the immune system and impairs its ability to fight off infections. Along with increasing the susceptibility to various infections, HIV impairs the body’s defense to slow cancer cell growth and hence the local disease becomes malignant faster. Smoking Smoking has multiple negative effects on our health. It is a carcinogen that enters bloodstream and imposes injurious effects on our organs. These harmful compounds increase the chances of developing cancer and slow down the immune system. Cervical mucus of smokers contains cigarette components proving the effect of cigarette constituents on organs and its role in disease causation. Oral contraceptives  The use of oral contraceptives has been noted to be associated with an increased risk of cancer. This may be because women on ocps don’t use barrier contraceptives like condoms which is very important in preventing all sorts of sexually transmitted diseases. Inflammatory disease When there are inflammatory diseases affecting the body, the production of inflammatory cytokines predisposes the body to develop disease and infections. Inflammatory diseases like rheumatoid arthritis and systemic lupus erythematosus (SLE) increase the risk of developing cervical dysplasia and cervical cancer up to 1.5 times. This may be due to the use of immunosuppressive drugs in these women. Multiple pregnancies Women with multiple full-term pregnancies are more likely to get cervical cancer. This can be due to increased sexual activity or the fact that pregnancy can be an immunocompromised condition. Diethylstilbesterol Diethylstilbesterol is a drug that was used to induce abortion before 1971. This drug was reported with the incidence of vaginal and cervical cancer in women whose mothers had taken this drug. The type of cervical cancer associated with this drug is clear cell adenocarcinoma of the vagina and cervix. According to a study the risk of developing cancer in women with DES exposure is 30% more than in unexposed women. Image Source: Freepik.com Signs and symptoms Cervical cancer may present in many ways. Some of the most common signs and symptoms are: Bleeding Bleeding per vagina is a very common complaint of females with cervical cancer. The bleeding may be post-coital, intermenstrual or post-menopausal. Post coital bleeding can be due to many causes like cervical ectropion, polyp or cervical erosion. Whatever the reason may be, the cause must be investigated and treated. (9) Intermenstrual bleeding also has multiple causes specially in young women. These causes can be infection, fibroids, contraception, cancer, endometritis etc. Post menopausal bleeding is seen in women of old age. It can be due to vaginal atrophy, cervical or endometrial polyps and cancer. Dyspareunia This refers to pain during sexual intercourse. Cervical cancer can cause discomfort and pain during sex. There can be many causes for this hence it should be promptly addressed. Vaginal discharge Vaginal discharge can also be a symptom of cervical cancer. Although this is usually a symptom of an infection, this abnormal discharge can also denote cervical cancer. Pelvic pain Pelvic pain may occur when the disease disseminates to surrounding organs and pelvic lymph nodes. Image Source: Freepik.com Diagnosis Diagnosis of cervical cancer is facilitated by screening by pap smear. Pap smear This is a highly convenient technique used to diagnose abnormality in the cervical cells. Pap smear is now done routinely in women of reproductive age. Routine testing with pap smear has greatly reduced the incidence of cervical cancer. Not does this facilitate early diagnosis but also favors prompt diagnosis. This test is available in hospitals and clinics. In this, a sample of cells is taken on a swab from the transformation zone of the cervix in a circular motion. This sample is then studied under a microscope for any noticeable abnormalities. Colposcopy This procedure is done to visualize the cervix in detail. During this procedure a speculum is placed to open the vagina and to expose the cervix. The cervix is then visualized by a microscope from the outside. This procedure is usually followed by abnormal pap test results that show abnormality in cervical cells. This test can rule out many cervical abnormalities like cervical polyps, cervical cancers, cervical ectropion etc. A biopsy can also be taken during this procedure for further investigations. Large loop excision of transformation zone (LLETZ) or cone biopsy This is an invasive procedure done in patients with cervical abnormalities like cervical cancer. This is usually followed by a pap test and colposcopy. This is an intervention done

Breast cancer is a global health concern affecting millions of women each year. In Pakistan, this issue takes on a unique dimension due to cultural factors that often discourage women from seeking medical attention for breast-related concerns. In this article, we will explore the critical importance of breast cancer awareness in Pakistan, shed light on the tendency within desi families to downplay women’s health issues, and emphasize why ignoring the signs of breast cancer can have devastating consequences. Image Source: humsari.com In Pakistan, like in many other South Asian countries, societal norms and cultural expectations often place women’s health on the back burner. Desi families may tend to downplay or dismiss women’s medical concerns, especially when it comes to sensitive issues such as breast health. This cultural reluctance to discuss women’s health openly can lead to delayed diagnosis and treatment, ultimately jeopardizing lives. Ignoring the Signs One of the primary reasons why breast cancer awareness is vital in Pakistan is the tendency to ignore or misinterpret the signs and symptoms of this disease. Early detection of breast cancer significantly improves the chances of successful treatment and survival. However, in many cases, women dismiss breast lumps, pain, or changes in breast size as normal or unrelated to cancer. This ignorance can have dire consequences, as breast cancer is a leading cause of cancer-related deaths among Pakistani women. Cultural Stigma Breast cancer awareness in Pakistan is further hindered by the stigma associated with discussing women’s health openly. Many women fear that speaking out about breast-related issues will bring shame upon their families or themselves. This fear of stigma can discourage women from seeking timely medical care and can result in breast cancer diagnoses at advanced stages, making treatment more challenging and less effective. Lack of Education Another significant factor contributing to the lack of breast cancer awareness in Pakistan is the lack of education and awareness campaigns. While organizations like Pink Ribbon Pakistan have been working tirelessly to educate and screen women for breast cancer, there is still a long way to go. Many women in rural areas may not even be aware of breast cancer or its symptoms, further exacerbating the problem. Changing the Narrative To combat the issue of breast cancer ignorance in Pakistan, it is essential to change the narrative around women’s health. Families and communities must be encouraged to prioritize the well-being of their women, including discussing breast health openly. Medical professionals, community leaders, and educators should collaborate to develop culturally sensitive awareness campaigns that reach even the most remote areas. Image Source: Freepik.com Self-Examination and Regular Check-ups Empowering women with knowledge is a critical aspect of breast cancer awareness. Pakistani women should be educated about the importance of self-breast examinations and the need for regular clinical check-ups. Self-examinations can help women identify changes in their breasts early, while regular clinical check-ups can detect abnormalities that may not be apparent through self-examination alone. Breast cancer awareness in Pakistan is a matter of life and death for countless women. Cultural factors, stigma, and ignorance have contributed to a climate where breast cancer is often diagnosed at advanced stages, reducing the chances of successful treatment. It is vital to break the silence surrounding women’s health issues and promote open dialogue within desi families and communities. With education, early detection, and the removal of stigma, we can make progress in the fight against breast cancer in Pakistan, ultimately saving lives and ensuring a healthier future for all women.

In Pakistan, like many other parts of the world, the issue of gender bias in healthcare is a pressing concern that often goes unnoticed. One significant facet of this problem is the tendency of healthcare professionals, including doctors, to not take women’s health concerns seriously, thereby downplaying or dismissing their complaints. This pervasive issue leads to delayed diagnoses and treatment, exacerbating health problems, and undermining women’s well-being. This article delves into the problem of gender-based medical gaslighting in Pakistan, emphasizing the urgent need for change and reform. Image Source: brecorder.com The Reality of Gender Bias in Healthcare Women in Pakistan face numerous challenges in accessing healthcare. Societal norms, cultural barriers, and financial constraints often limit their ability to seek medical attention promptly. However, when they do overcome these hurdles and consult healthcare providers, they frequently encounter another barrier: medical gaslighting. Medical gaslighting is a phenomenon in which healthcare professionals minimize, trivialize, or dismiss a patient’s concerns or symptoms, leading them to doubt their own experiences and perceptions. In the context of women’s health, this problem becomes particularly pronounced. Women are often told that their pain or discomfort is “all in their head” or attributed to psychological factors, hormonal changes, or stress. Why Does Medical Gaslighting Persist? Several factors contribute to the persistence of medical gaslighting in Pakistan. One crucial factor is the deeply ingrained gender bias within the medical field itself. Many healthcare professionals hold implicit biases that can lead them to perceive women’s health concerns as less serious than those of men. These biases affect not only the diagnosis but also the treatment provided to female patients. Additionally, cultural and societal norms play a significant role. Pakistani society often downplays women’s autonomy and independence, which can seep into healthcare settings. Women are expected to endure pain quietly and are discouraged from challenging medical professionals. This makes it easier for healthcare providers to dismiss their complaints. The Consequences of Dismissing Women’s Health Concerns The consequences of medical gaslighting are dire. Women whose health concerns are brushed aside may not receive timely diagnoses or treatment, leading to the progression of illnesses that could have been treated effectively if detected earlier. This results in unnecessary suffering, complications, and sometimes even fatalities. Furthermore, the emotional toll on women is substantial. They may experience anxiety, depression, and a deep sense of frustration due to the lack of validation and empathy from healthcare providers. This emotional distress can further exacerbate their physical health problems. Image Source: brecorder.com Addressing the issue of medical gaslighting in Pakistan requires a multi-faceted approach. Here are some key steps that can help tackle this problem: Education and Sensitization: Medical institutions and professionals should undergo training to recognize and combat implicit biases. They must be made aware of the importance of taking women’s health concerns seriously. Empowerment of Women: Women should be encouraged to advocate for their own health and seek second opinions if they feel their concerns are being dismissed. Education and awareness campaigns can help empower women to assert their rights in healthcare settings. Legal Framework: Legislation should be in place to protect patients from medical negligence and malpractice, including cases of medical gaslighting. Laws that hold healthcare professionals accountable for their actions are essential. Cultural Change: Shifting societal norms to value women’s health and autonomy is crucial. This requires a broader cultural change that recognizes and respects women’s agency and rights. The issue of medical gaslighting in Pakistan is a deeply ingrained problem that affects the well-being of countless women. It is a manifestation of the broader gender bias present in society and the healthcare system. To address this issue effectively, a concerted effort from healthcare professionals, policymakers, and society as a whole is needed. Only by acknowledging and rectifying these biases can we ensure that women’s health concerns are taken seriously and that they receive the medical care and attention they deserve. The health and lives of Pakistani women depend on it.