What does reproductive health include?

According to the mainstream definition of the World Health Organization, reproductive health is far more than just "the reproductive system is not sick". It is a complete state covering the three dimensions of physiology, psychology and social adaptation. It runs through the entire life cycle from birth to aging and is closely related to everyone regardless of age or gender.

Many people's understanding of reproductive health is still at the stage of "you need to pay attention only when you are preparing for pregnancy". In fact, related needs have already appeared since adolescence. Last week, I met a little girl who was a sophomore in high school at the outpatient clinic. She was sent to the hospital by her parents after her period pain was so painful that she vomited. When I asked her, I found out that she had been suffering from pain for almost two years. She had always been embarrassed to say that she felt that menstruation was a "shady thing". Even when buying sanitary napkins, she had to hide it in her sleeves, let alone take the initiative to research how to relieve dysmenorrhea and learn about menstrual hygiene. This is actually a typical manifestation of a lack of knowledge about reproductive health: the most basic content of reproductive health includes the normal understanding of the development of one's own reproductive system, as well as timely intervention of related diseases - ranging from dysmenorrhea care, foreskin cleaning, and detection of abnormalities in children's reproductive parts, to the prevention and treatment of reproductive system tumors and sexually transmitted diseases, all are covered by this part.

In addition to physical health, reproductive health is easily overlooked as its rights attribute. A girl who had just started working came to have an abortion. She said that she had been living with her boyfriend for half a year and was too embarrassed to go to the community to get free condoms for fear of being judged by the staff. She usually relies on calculating the safe period for contraception. If she accidentally fell into it, she was afraid of being cheated by going to a private hospital. She struggled for almost a week before coming to the public maternal and child care hospital. In fact, reproductive health itself includes the meaning of "all people can independently and responsibly decide their own reproductive behavior and have the right to obtain safe and accessible related services." Of course, there are currently different public opinions on this point. Some relatively conservative views believe that reproductive health services should only be provided to married groups of childbearing age. However, from the perspective of public health prevention and control, domestic grassroots service points will still provide contraceptive consultation and sexually transmitted disease prevention and control related services to all groups in need to minimize the risk of unwanted pregnancy and disease transmission.

There are also many people who have a misunderstanding. They think that reproductive health is a matter for young people and that they don’t need to worry about it when they reach menopause or are in their fifties and sixties. In fact, this is not the case at all. A 62-year-old aunt came for pelvic floor rehabilitation before. She said that she had been leaking urine for almost 10 years. She did not dare to dance in the square or go out for long distances. She always felt that "it is like this when you are older, and it would be embarrassing to talk about it." In fact, this is caused by the decline of estrogen after menopause and the relaxation of pelvic floor muscles. It falls completely within the scope of reproductive health intervention. After 1 to 2 courses of rehabilitation, it can be significantly relieved. Similar problems include prostate hyperplasia in elderly men and the normal sexual needs of middle-aged and elderly people. In fact, they are all covered by reproductive health. Incidentally, the current mainstream definition also includes “non-coercive, consensual safe sexual experience” within the scope of reproductive health. This is also discussed in academic circles. Some scholars believe that sexual health should be divided independently. However, in current public health practice, sexual safety education and sexually transmitted disease prevention and control are still included in the reproductive health work module.

To put it bluntly, reproductive health is really not a topic that needs to be shamed. The essence is to allow everyone to face their own bodies freely, without being ashamed of normal physiological phenomena, and to find solutions to problems when they do encounter them.