Spectrum of gynecological disorders in geriatric women: a tertiary care centre study

Abstract

INTRODUCTIONGeriatric gynaecology deals with gynaecological pathologies encountered in postmenopausal women aged 65 years and above. The Indian society which was pyramidal till 20th century is now on the verge of becoming a rectangular society-a society in which nearly all individual survive to advanced age and then succumb rather abruptly over a narrow age range centering around the age of 85.1 Our success in postponing death has increased the upper segment of demographic contour. The average life expectancy in India is 68 years. 2 The rate of increase in number of postmenopausal women is substantially faster in developing than developed world. The number of women aged 60 years has grown from 5.4% in 1951 to 7.8% in 2001.2 It is estimated to increase to 12.4% of population by the year 2026.3 The age-related geriatric problems have emerged significantly with enhanced longevity of life. These are attributed to the physiological changes seen in reproductive organs due to their altered hormonal mileu. The unique features of geriatric illnesses arechronicity and heterogeneity, greater severity and slow or sometimes no recovery. The various gynaecological disorders peculiar to ageing are pelvic organ prolapse, postmenopausal bleeding, gynaecological malignancies, urinary incontinence, genital tract infections, vulvovaginal disorders. The spectrum of gynecological disorders in India differ from those in developed world as there are no screening programmes for early detection ABSTRACT Background: Older women constitute the fastest growing segment of Indian population. Postmenopausal phase is important and primary care physicians should be aware of common gynaecologic concerns and the potential impact of these on the function and quality of life of older women. Methods: A Prospective cross-sectional study was conducted over a period of one year on 100 postmenopausal women aged 65 years or above, who attended OPD or were hospitalised between November 2015 and October 2016. Results: Literacy rate was 30%. Study population was drawn equally from rural and urban population. Genital tract malignancy was the major gynecological disorder (32%), the commonest being the carcinoma cervix. Next in order was carcinoma ovary and carcinoma endometrium. This was followed by pelvic organ prolapse (26%) and urogenital infections (17%). POP was grade 3 in 85% patients. Conclusions: Pelvic organ prolapse, genital tract malignancies and urogenital infections were the major gynecological problems faced by older women. Moreover, postmenopausal bleeding was a possible underlying cause of malignancy, of which carcinoma cervix tops the list, emphasizing the need for a screening programme in Indian women. There is urgent need to develop dedicated geriatric units and to encourage women to receive routine gynecological check-ups in the early post menopausal period that will enable early diagnosis and treatment.

Assessment of gynecological disorders among geriatric women

“…Parity 1 was seen in 55 and >2 in 65. Kaur et al [10] conducted a study on 100 postmenopausal women aged 65 years or above, who attended OPD or were hospitalised. Literacy rate was 30%.…”