Chapter Eleven: Psychology and Women S Health Issues

Chapter Eleven: Psychology and Women’s Health Issues

Gender and Health Worldwide, being born female is dangerous to your health In the US, males have a higher death rate than females Average life expectancy in US: Females: 80 years Males: 75 years

Leading causes of death Gender differences and similarities

Heart Disease Effects of estrogen on cholesterol Silent disease Women manifest heart disease 10 yrs later Heart attacks are more often fatal for women Different symptoms and signs Women misdiagnosed as having an anxiety attack Interventions Women are less likely to receive Gender bias in medical research

Discrimination and Health High blood pleasure Discrimination, stereotype threat may be chronic, repeated stressors for women

Women and the Health Care System Feminists have been critical of the treatment of women in the health care system The physician-patient relationship reflects the subordinate status of women in society The medical profession has actively discriminated against women as practitioners Medical care offered to women is often inadequate, irresponsible, or uncaring E.g., 70% of hysterectomies are unnecessary Medical research conducted on women is often irresponsible or simply missing

Health Needs of Poor and Minority Women Poor and ethnic minority women have higher rates of infant mortality than White women Chronic diseases are more prevalent among ethnic minority women than among White women Life expectancy of ethnic minority women is 5-7 years less than that of White women Ethnic minority women are overrepresented among the poor

Menstruation Menstrual Problems: Cramps Dysmenorrhea: painful menstruation, cramps Women vary in the experience of cramps Cramps are caused by Prostaglandins: hormone-like biochemicals that stimulate the muscles of the uterus to contract Treatment: antiprostaglandin drugs

Psychological Aspects of the Menstrual Cycle Do girls and women experience changes in personality or mood depending on the phase of the menstrual cycle? Retrospective reports of symptoms and moods Unreliable Prospective self-reports Small fluctuations in mood and symptoms Correlational studies cannot prove that hormone levels influence mood

Psychological Aspects of the Menstrual Cycle Paige’s (1971) study with oral contraceptives High levels of estrogen and progestin lead to steady mood

Premenstrual syndrome (PMS): a combination of severe physical and psychological symptoms (such as depression) occurring in some women for a few days before menstruation Vaguely defined PMS is far from universal among women Ruble (1977): women report more problems when they think they are in the premenstrual phase

Cultural influences on menstrual-cycle mood shifts Perspectives of different ethnic groups suggest new interpretations

Practical Implications Magnitude of mood shift depend on individual woman Regarding hiring decisions, performance is more important that mood Generally no fluctuations in performance across cycle 3-D spatial ability negatively correlated with estradiol Likely that monthly hormonal cycles exist in men

Other Menstrual-Cycle Fluctuations Sensitivity of the senses Pain sensitivity Substantial variability in menstrual cycle mood fluctuations

Contraception 1 out of 14 women between the ages of 15 and 19 become pregnant every year 59% of these pregnancies result in live births 27% of these pregnancies are terminated by abortion the remainder end in miscarriage Worldwide, family planning is an important issue for women’s physical and mental health When women are able to practice contraception and space pregnancies farther apart, infant mortality declines and women’s physical health and mental health benefit

Abortion 1.2 million abortions are performed in U.S. each year 1 in 3 women have an abortion by age 45

Medical abortion 16% of abortions in US Take a medication (e.g., mifepristone) in a pill, which causes the lining of the uterus to be sloughed off Can be done up to 9 weeks

Surgical abortion Most commonly, vacuum aspiration Done in 1st trimester Done on outpatient basis with local anesthetic Very safe

Severe problems following abortion are rare Worst stress occurs before abortion Risk for psychiatric disorder increases in year following childbirth, but not in year following abortion

Adolescents who choose abortion are more likely to graduate from high school than those who carry pregnancy to term

Political bias a problem in research Poor quality studies report poorer long-term mental health outcomes of abortion But high quality students report better outcomes

Long-term consequences of restricting abortion 220 children born to women denied abortion in Czechoslovakia Do poorly in school, more likely to drop out Poorer relationships with mothers Poorer adjustment in adulthood

Women and HIV AIDS: acquired immunodeficiency syndrome HIV: human immunodeficiency virus Spread through: Sexual intercourse Contaminated blood Contaminated hypodermic needles Passage from an infected pregnant woman to her baby during pregnancy or childbirth Ingestion of breastmilk from infected mother

Number of infected women in the US is rising 25% of new AIDS cases are women 80% of those women were infected through heterosexual intercourse

HIV/AIDS are important issues for women Because women are disproportionately in caregiving roles such as nursing, they bear a huge burden in the care of HIV-infected patients HIV-infected women are more likely than infected men to be unemployed or to be employed in situations in which they feel vulnerable to being fired if status is known HIV-infected women are more likely than infected men to have sole responsibility for their children

Race and ethnicity are also important African Americans make up 65% of AIDS cases among women The pattern of transmission of HIV tends to be different in minority populations from its pattern among Whites Inequalities in power between women and men are at the heart of women’s heterosexual infection with HIV Implications of social dominance theory

In Conclusion Key issues discussed: Do women experience menstrual cycle fluctuations in mood and are these shifts caused by fluctuating hormone levels? At menopause, psychological symptoms such as depression and irritability show no increases compared with other life stages Contraception is a major issue for women Ability to space pregnancies is crucial Abortion is generally not a traumatic experience AIDS affects women in growing numbers, either because they are infected or because they are the wives, mothers, sisters, or caretakers of infected men