~ Fading Fast: Women And Chronic Fatigue: Over the last five years, the number of women coming into my office complaining of being drained or exhausted most of the time has dramatically increased. Few statistics have been compiled on the incidence of this important problem, but I would estimate that between 20 to 40 percent of women suffer from chronic fatigue.

~ How Much Stress Are You Under?: Dr. Hans Selye, a leading Canadian expert on stress once said, "Complete freedom from stress is death." But in the 1990's women are being bombarded by stress.

~ How To Cut Down On Stress: Managing stress requires that you not only recognize and respect the stresses in your life but also that you take steps to reduce stress and achieve some control over it.

~ The Sexes Aren't Equal When It Comes To Booze: All alcoholics are not the same. In fact, although they have usually been lumped together, the reasons women drink, the way they drink, the way it affects their bodies, and the way they recover is completely different than for men.

~ Are Computers Hurting Your Health?: Within ten years every clerical worker in the U.S. and Canada will likely be working in front of a computer. Women now hold the majority of jobs that involve full-time computer use. At least half of these women are of child-bearing age.

~ Grief Is Hard Work: Anthropologist Margaret Mead once said, "When a person is born we celebrate, when they marry, we jubilate, but when they die, we act as if nothing has happened."

~ No Magic Pill: SPECIAL NOTE: Much of the information contained in this article is taken almost verbatim from the Canadian Federal Government's 1985 Report on Oral Contraceptives. However, most of the research on which the report was based was done on birth control pills that contained a much higher dose of both estrogen and progesterone than are contained in the pills commonly used today.

~ Cervical Cap Makes A Comeback: Years ago, the ancient Sumatrans of Indonesia knew about barrier methods of birth control. They fashioned caps made of opium to fit around their cervixes. Women in the Orient moulded oiled silk paper over their cervixes. And in Hungary, women used beeswax to make their caps. The modern world has been slow to catch up.

~ Permanent Birth Control: The Facts: When a woman or a couple becomes certain they want no more children, or no children at all, they may want to consider the option of permanent birth control or sterilization.

~ Know Your Body's Cycles - To Get Pregnant Or To Avoid Pregnancy: The true mark of a modern woman is to be in control of her own fertility. Getting to know your body's monthly rhythms is the first step to taking charge of your body. This information can be used both if you are trying to get pregnant or to avoid pregnancy.

~ The Yeast Among Us: In 1973, on my first day of work as a medical doctor, a woman walked into my office having suffered from vaginal itching for 20 years. She turned out to have a chronic yeast infection, which eventually she was able to overcome.

~ Bladder Blues: So many women suffer from repeated episodes of bladder problems that until recently it was considered part of the fate of women. The female urethra (the tube that connects the bladder to the outside) was thought to be too short and close to the rectum, thus making it susceptible to repeated infections.

~ Chlamydia - The Greatest Threat To Reproductive Health: Do you have a new lover in your life? Getting vague low abdominal pains and your doctor doesn't know why? Does it hurt when you urinate but your urine cultures always come back negative? Do you have a pelvic infection that doesn't clear up with the usual antibiotics?

~ Favourite Childbirth Books: Pregnancy, birth and the beginning of motherhood represent one of the major life transitions you will experience as a woman. In fact, childbirth offers you an unparalleled opportunity for personal growth and change.

~ The Amazing World Of The Unborn Child: Over ten years ago, the first world conference on pre and perinatal psychology was held in Toronto with leading experts from all over the world. This new science brought forth evidence of the startling mental, physical, and emotional capacities of the unborn child.

~ Should Every Pregnant Woman Have An Ultrasound?: From the crude type of ultrasound available in the 1950's, ultrasound (US) has developed into a highly sophisticated diagnostic tool for use during pregnancy. Ultrasound use has grown rapidly to the point where most pregnant women now receive one or more ultrasound exams during their pregnancies. According to 1987 update report on ultrasound by Health and Welfare Canada, up to 80 percent of all newborns are exposed to ultrasound.

~ Testing The Waters - All About Amniocentesis: Over the last decade, amniocentesis has proved a valuable tool for monitoring the progress of women whose pregnancies involve a high degree of risk to their babies. In addition, it is used to detect inherited defects in babies ahead of time, thus giving women the opportunity to abort these fetuses if desired. Thus amniocentesis has ushered in a whole new era of reproductive choice, and brought with it many unanswered questions about the ethics of that choice.

~ The Challenge Of Pregnancy Over Thirty Five: If you are 35 or over and considering pregnancy for the first time, you are joining an ever-growing group of contented older mothers who are rising to the different challenges that motherhood at that age requires. With advances in prenatal care, as well as the increased health awareness of older mothers, pregnancy after 35 is no longer any riskier than pregnancy at an earlier age.

~ Keeping Fit While Pregnant Is Good For You And Your Baby: Pregnancy creates a special need for exercise. In fact, pregnancy is a major stress on your body. Fortunately your body is well equipped to handle this stress if you pay attention to its needs and look after it well.

~ Dealing With The Discomforts Of Pregnancy: During pregnancy a woman's body, mind, and emotions go through an amazing transformative process. In the process of this great change, a woman may experience any number of a wide variety of new physical sensations.

~ How Painful is Childbirth?: For most women in the Western world, childbirth is painful. Most women feel pain during childbirth ranging from mild discomfort to honest-to-goodness pain. Only a few women say they had no pain at all. One mother giving birth to her third child actually laughed throughout her whole labour. But this is uncommon.

~ The Unkindest Cut: Are Episiotomies Really Necessary: Episiotomy is the most common operation performed on women in Canada and the U.S. without their formal consent. In fact, it is performed in between 40 and 80 percent of all births. An episiotomy is a surgical incision into the area between the vagina and the rectum (the perineum) to enlarge the opening through which the baby will come. After the baby is born, the edges of the cut are approximated, frozen, and sewn back together.

~ Once A C-Section, Always?: For years doctors have told women who have had Cesarean sections that they would have to deliver all future babies the same way. They based this on a rule postulated in 1916 which said, "Once a Cesarean, always a Cesarean." This policy has caused the C-section rate in the U.S. and Canada to soar dramatically over the last ten years. In Canada, there are about 66,000 Cesareans per year; and almost 970,000 in the U.S. each year. Of these, an estimated 25 percent to 50 percent were clearly unnecessary.

~ Miscarriage: The Need For Support: Approximately one in five women suffer a miscarriage after becoming pregnant. To family, friends, physician, and even to the woman herself, miscarriage may seem like a minor event of no real significance.

~ The Thyroid Gland Acts Up After Pregnancy: Four months after the birth of her first baby, Trudi felt more tired than she ever remembered feeling before. She often felt depressed and anxious. However, she didn't pay much attention and attributed her symptoms to a combination of the demands of a new baby, postpartum blues and chronic lack of sleep. After another four months, she finally felt like her old self again.

~ PMS - Strength Or Weakness?: Premenstrual syndrome is a real medical condition that affects about 40 percent of all women in their reproductive years. While the media has made women more aware of the cyclical changes they experience monthly, it has also passed on a lot of negative misinformation.

~ New Hope For Lumpy Painful Breasts: As Dr. William Ghent, former Professor Emeritus of Surgery at Queen's University in Kingston, Ontario, used to say, "premenstrual breast pain and tenderness is not normal. If it's painful, premenstrually, it's sick. I am sure that males would not accept sore testicles for seven to ten days of each month as normal." Dr. Ghent also pointed out that fibrocystic breast disease did not necessarily disappear with menopause, particularly if estrogens were used. Twenty years of research in the field led him to

~ Pelvic Inflammatory Disease: Jill Weiss is the co-ordinator of the Canadian PID Society and has done extensive research in the area. She wrote this chapter to make sure women were informed about this important health issue.

~ Endometriosis - A Disease Of The 90's: This first chapter about endometriosis (endo) discusses what is currently taught in medical schools about endo, and what most doctors still believe. A new section of this chapter has been added to cover the newest drugs used for treatment. Finally, the most recent addition to the first chapter is the latest information on the link between endometriosis and environmental contaminants. Four years ago, I became aware of the intriguing new ideas of Dr. David Redwine which are presented in the second chapter on endo. Out of necessity another section has also been added that outlines a natural approach to treatment.

~ A New View Of Endometriosis: Endometriosis (endo) affects an estimated half million women in Canada and five to ten million in the U.S.

~ The Major Milestone Of Menopause: Menopause is a process of change and transition as a woman's body sheds its child-bearing potential and adjusts to lower levels of hormones. Menopause usually starts around the late forties, when periods start to get more irregular and finally stop altogether. The average age at which periods stop is around fifty, but it can occur earlier, particularly in black and non-European women.

~ Preventing And Treating Bone Loss: Bone is a living tissue which is always changing. New bone is constantly being made and old bone is constantly being taken up or reabsorbed. These two processes are coupled together and normally balance each other out so that there is no net bone loss.

~ How To Save Your Uterus: Hysterectomy is the most common major surgery performed in North America today. In both Canada and the U.S. you have a 30 to 50 percent chance of having your uterus surgically removed by the time you are 65 years old. In contrast, if you live in Sweden or any of six other European countries, your chance of having a hysterectomy is only ten percent by that age.

~ The Great Debate Over Breast Cancer Screening: Fear of breast cancer strikes terror into the heart of many women. One in nine or ten women will develop breast cancer in the course of her life time. According to recent estimates, 70 to 75 percent of these women will survive five years after diagnosis. Ten years later, only 60 to 63 percent will be alive. This is an improvement of only two to three percent over 1950 survival rates.

~ Life Can Be A Drag Without Enough Iron: Kathy, a 31-year-old mother of two preschool children, felt tired all the time. She wondered if something was wrong with her. She started swimming three times a week, but only felt worse. At first, her doctor told her that her fatigue was inevitable with two young kids. At her insistence, her doctor finally did blood tests, and found her to be anemic due to low iron levels in her blood. She began to pay special attention to the sources of iron in her diet, and took iron supplements for six months. Within three weeks, she felt much better, and within six weeks her energy level had returned to what it had been before the two pregnancies. She was astonished at the

~ Exploring The Inside Of Your Uterus: D-and-C is an abbreviation for one of the most common operations performed on women of all ages. The initials stand for dilatation and curettage, and refer to a short surgical operation usually done under general anesthesia, although it can be done under local anesthesia too. During this operation, the mouth of your womb, or cervix, is opened up or dilated to about the size of your thumb, and the lining of your womb is then scooped out with a spoon-like instrument called the curette. The D-and-C is usually used as a diagnostic tool. But it can also be used as a treatment.

~ Those Annoying Varicose Veins: Most doctors find the whole topic of varicose veins boring. In fact, many doctors do not know a lot about them. The whole topic has been neglected because it is just another one of those annoying problems that mainly affects women. Approximately 40 percent of women have varicose veins, and the amount of suffering and disability from aching, swollen and painful veins is considerable.

~ Beauty With Conscience: The new ecological awareness of the 1990's has made women increasingly aware of their power and responsibility as consumers. Today, consumers, the majority of them women, spend well over two billion dollars on beauty and cosmetic products every year in Canada and 200 billion in the U.S.

~ The Good News About Gallstones And Women: Fifteen to 20 percent of all North Americans have gallstones, and gallbladder surgery is the most commonly performed abdominal surgery in both Canada and the United States. More than 50,000 gallbladders are removed annually in Canada and about 500,000 in the U.S. The good news is that gallstones is probably another health problem related to the excesses of the Western diet, and there is much that a woman can do to prevent their occurrence.

~ Lesbian Health Care: No book on women's health would be complete without addressing the health concerns of lesbians. Dr. Ruth Simkin has moved to British Columbia from Calgary, Alberta where she was Associate Professor In Family Practice at the University of Calgary. For many years, she has written and taught about lesbian health care issues, and has graciously agreed to contribute this chapter.