Psychological disorders are commonly associated with gynecological conditions, but are frequently undetected and untreated, and may influence the presentation and treatment outcomes of the physical condition. Some of the gynecologic conditions such as menopause, premenstrual syndrome, premenstrual dysphoric disorder, chronic pelvic pain, polycystic ovarian syndrome etc can be associated with an increased risk of psychological symptoms and disorders.

Anxiety and depression are common psychiatric conditions and are associated with significant morbidity. Gynecological conditions, by their nature, are likely to be accompanied by impairments in social, occupational and personal functioning. Greater emphasis should be placed on the mental health aspects of gynecological conditions.

Women present to gynecological clinics with a wide variety of physical conditions, ranging from bothersome premenstrual and menopausal symptoms, to incontinence and pelvic pain. It is well established that depression and anxiety occur more commonly in those with physical illness compared with healthy populations. 

Moreover, many gynecological conditions, by their nature, affect personal and intimate relationships, as well as social and professional roles, thus giving rise to a range of psychological issues, which, may in turn influence the presentation and outcomes of coexisting physical conditions. These relationships are complex, and involve the interplay of hormonal, social, cultural and individual psychological factors.

The gynecological setting provides an important opportunity for the detection and treatment of psychological issues. These can range from transient concerns to more serious symptoms of depression and anxiety, and depressive and anxiety disorders that meet specific diagnostic criteria. Yet, the psychological aspects of conditions presenting in the gynecological setting are somewhat neglected, resulting in relatively few studies that have examined the consequent mental health care needs of women attending gynecological clinics.

Harmful cultural practices, such as child marriage and female genital mutilation (FGM), are discriminatory practices committed regularly over long periods of time that communities and societies begin to consider them acceptable.

Around the world, hundreds of millions of girls and boys have experienced some form of violence, exploitation or harmful practice, although girls are at much greater risk. Child marriage and FGM span continents and cultures, yet, in every society in which they are practiced, they reflect values that hold girls in low esteem.

FGM can lead to serious health complications – including prolonged bleeding, infection and infertility – or even death. Girls and women who have undergone FGM are at heightened risk of experiencing complications during childbirth.

In some societies, FGM goes hand in hand with child marriage. Girls married as children are more likely to drop out of school and become pregnant as teenagers when they face increased risks of dying during pregnancy or childbirth.

Culture is shared patterns of behaviour, interactions, cognitive contracts and understandings that are learned through socialisation. Culture can also be defined as a collection of learned and easily identified beliefs and practices shared by groups of people, which guides their decisions, thinking and actions in a patterned way.  

Culture is a set of customs, traditions and values of a society or community such as ethnic group or nation. Culture also includes religion, social habits, beliefs, music and the arts.

Common Cultural Practices that may play a role in sexual and reproductive behavior worldwide are indicated as follows:-

• Motherhood sexual abstinence: Culture recommends husbands not to have intercourse with their wives during pregnancy and breastfeeding where men end up having extramarital affairs.

• Virgin myth: a belief that sex with a young girl including children and babies cures HIV/AIDS

• Polygamy: This is still practiced in many countries which plays a role in the spread of STI and HIV.

• Practice of never looking at adults in the face or saying no to an adult: In many African countries this culture allows the male adults to molest young women because she’s unable to say no.

These and many other cultures that are still practised in different parts of the world play a major role on SRH and also put a negative impact on women.

A birth defect is something abnormal about your newborn baby’s body. 

It can be one of the following:

• Visibly obvious, like a missing arm or a birthmark.
• Internal (inside the body), like a kidney that hasn’t formed right or a ventricular septal defect (a hole between the lower chambers of your baby’s heart).
• A chemical imbalance, like phenylketonuria (a defect in a chemical reaction that results in developmental delay).

Your baby can be born with one birth defect such as a cleft lip (a gap in their upper lip) or multiple birth defects such as a cleft lip and cleft palate (a hole in the roof of their mouth) together, or even a cleft lip and cleft palate with defects of the brain, heart and kidneys.

Birth defects are common. Between 2% and 3% of infants have one or more defects at birth. That number increases to 5% by age one (not all defects are discovered directly after your child’s birth)

Experts don’t know the exact cause of most birth defects, but there are some identifiable causes:

• Genetic or hereditary factors.
• Infection during pregnancy.
• Drug exposure during pregnancy.

Environmental factors can increase the risk of miscarriage, birth defects, or they might have no effect on your baby at all, depending on at what point during the pregnancy the exposure occurs.

Diabetes and obesity can possibly increase your child’s risk of birth defects. Your healthcare provider may suggest that you do your best to manage these conditions before you get pregnant

Alcohol is the most commonly used drug that causes birth defects. Foetal alcohol syndrome is a term used to describe the typical birth defects caused by the mother’s alcohol use:

• Learning disabilities.
• Developmental delay.
• Hyperactivity.
• Poor coordination.
• Abnormalities of facial features

Can birth defects be prevented? How?

Most birth defects cannot be prevented. There are certain important steps to promote a healthy pregnancy, however. 

These tips include:

• See your healthcare provider consistently.
• If you are trying to conceive, or if you are sexually active and not using contraception, take a prenatal vitamin with 400 mcg of folic acid.
• Contact your healthcare provider immediately if you think you’re pregnant.
• Don’t drink alcohol.
• Don’t smoke.
• Talk to your healthcare provider about any medications and supplements you’re taking.
• Avoid marijuana and illegal drugs.