As Childbearing Is Delayed, a Pre-Pregnancy “Women’s Health Checklist” Is Essential ... October 10 Is Pregnant Women’s Day

[Financial News] As the age at which women give birth rises, so does the importance of managing women’s health before pregnancy. Conditions such as uterine fibroids and endometriosis, as well as menstrual irregularities and obesity, can affect the chances of becoming pregnant and the risk of complications during pregnancy, prompting calls for women to check their health in advance.
Professor Park Jeong-hyeon of the Department of Obstetrics and Gynecology at Seoul St. Mary’s Hospital said, “Uterine fibroids and endometriosis can affect pregnancy and childbirth, while menstrual irregularities may signal ovulatory dysfunction or a hormonal imbalance.” Park added, “Obesity also increases the risk of complications such as gestational diabetes and gestational hypertension, so it should be managed before pregnancy.”

Uterine fibroids are benign tumors that develop in the muscular layer of the uterus and are common among women of reproductive age. Having fibroids does not necessarily make it difficult to become pregnant, but their size, location and number can affect conception and the ability to maintain a pregnancy. Submucosal fibroids, which protrude into the uterine cavity, can affect the environment for implantation and may be associated with infertility or recurrent miscarriage. Fibroids in the muscular layer can also affect pregnancy if they are large or distort the uterine cavity.
During pregnancy, hormonal changes can cause fibroids to change in size or become painful. Some pregnant women may face higher risks of preterm birth, placental problems, abnormal fetal position or cesarean delivery. However, these complications do not occur in every pregnancy.
Professor Park said, “If you are planning a pregnancy, it is a good idea to have an ultrasound to check the size and location of the fibroids and consult a specialist about the chances of becoming pregnant and whether treatment is needed.” Park added, “Even if surgery is necessary, the pregnancy plan, the condition of the uterus and the location of the fibroids should all be considered.”

Endometriosis is a condition in which tissue similar to the uterine lining grows outside the uterus, causing inflammation and adhesions. It can cause severe menstrual cramps, pelvic pain and pain during sex. If an endometrioma develops in an ovary or adhesions form around the fallopian tubes and surrounding tissue, becoming pregnant may be difficult. This is because the condition can affect ovarian function, fallopian tube movement and the pelvic environment, reducing the chances of pregnancy. If a woman has an ovarian endometrioma or has undergone surgery, a possible decline in ovarian reserve should also be taken into account.
Endometriosis does not necessarily improve just because a woman becomes pregnant. Some studies have reported that women with endometriosis may face higher risks of early miscarriage, ectopic pregnancy, gestational hypertension and preterm birth. That does not mean they should avoid pregnancy.
Professor Park stressed, “It is important to have the severity of endometriosis, ovarian function, age and pregnancy plans assessed together.” Park added, “Some hormonal medications used for treatment cannot be taken during pregnancy, so anyone planning a pregnancy should make sure to review their medication plan with their medical team.”

If menstrual cycles are extremely irregular, menstrual flow suddenly increases or periods stop for an extended time, the cause should be investigated. Menstrual irregularities can result from various causes, including stress, sudden weight changes, excessive exercise, polycystic ovary syndrome, thyroid disease and hyperprolactinemia. If ovulation is irregular or absent, it may be difficult to become pregnant.
Conditions that cause ovulatory dysfunction, such as polycystic ovary syndrome, may also involve insulin resistance or obesity, so the risk of metabolic complications such as gestational diabetes should also be considered during pregnancy. Excessively heavy menstrual bleeding can cause iron-deficiency anemia. Anemia can affect not only fatigue and dizziness but also a woman’s health during pregnancy and childbirth.
Professor Park advised, “Treatment for menstrual irregularities varies depending on the cause, so it is a good idea to keep track of changes in cycle length and bleeding, and to see a gynecologist if the irregularities persist.”

Understanding the menopausal transition has also become important. Menopause is when ovarian function declines—usually in the late 40s to early 50s—and menstruation stops permanently. Ovulation ceases, making natural conception more difficult. However, during the transition before menopause, ovulation can still occur even when periods are irregular, so the possibility of pregnancy does not disappear entirely.
Around menopause, levels of the female hormone estrogen fall, potentially causing hot flashes, sleep problems, vaginal dryness and mood changes. Over the long term, this may be followed by reduced bone density and an increased risk of cardiovascular disease.
Professor Park said, “Irregular periods alone should not be taken as a sign that menopause has begun.” Park added, “The possibility of pregnancy should be assessed by considering age, ovarian function and whether ovulation is occurring, among other factors.”

Obesity can affect ovulation and the process of becoming pregnant. Increased body fat can lead to insulin resistance and hormonal imbalances, and women with polycystic ovary syndrome may experience more severe ovulatory dysfunction and infertility. Obesity during pregnancy increases the risks of gestational diabetes, gestational hypertension, preeclampsia, cesarean delivery and macrosomia. Managing weight, blood sugar and blood pressure before pregnancy can help reduce the risk of complications.
During pregnancy, however, women should focus on staying within an appropriate range of weight gain for their pre-pregnancy weight and stage of pregnancy rather than trying to lose weight rapidly. Restrictive dieting or excessive exercise can instead harm the health of the pregnant woman and fetus.
Professor Park said, “Women preparing for pregnancy should maintain a healthy weight through a balanced diet and regular exercise. If they have an underlying condition such as diabetes or high blood pressure, it is advisable to work out a management plan with their medical team before becoming pregnant.”
 

[email protected] Jeong Myeong-jin, Medical Correspondent Reporter