When Joyce was in her twenties she started working in the field of fertility and she often had conversations with friends about their bodies and their fertility.  At this time she read ‘Ourbody, Ourselves’ and felt it was a book that every woman should read, but she also felt that it did not cover all the topics a woman might want to know about.
Joyce started writing a book about women’s health in 1987.  At that time she knew a lot about fertility but was not an expert in the other key women’s health topics.  The idea of the book has been bubbling in Joyce’s thoughts for the last thirty years.
But first Joyce developed Global Women Connected. Through the years of working on Global Women Connected, Joyce has come to realize the topics that women want to know about.  But she also realized the limitations of a web site and so in 2016, she decided that she should finally write the book she thought of 30 years ago.

What Every Woman Should Know includes:

1.How to be healthy – wellbeing and lifestyle choices

Every woman should understand the importance of having a healthy lifestyle. In this chapter I will explore the seven dimensions of wellness, what we should and should not eat and drink, the importance of our gut microbiome, smoking and the myth of detoxing. I will also explain the importance of exercise throughout our lives including looking after our heart rate and blood pressure. I will discuss the importance of sleep. And finally I will explain what happens when things go wrong with our health including eating disorders, stress, anxiety, depression and anger and ways to cope including relaxation, breathing, mindfulness and having a positive outlook on the world.

2. Pregnancy, puberty and menstruation – let’s make it easier

Too many women do not understand their anatomy, what happens during puberty and the menstrual cycle. The menstrual cycle will have a significant affect on every woman’s life from puberty to the menopause, both physically and mentally. In this chapter I will explain the basic structures of the female reproductive system, how our eggs develop when we are a foetus, what happens during puberty and how the menstrual cycle works. I will discuss the range of sanitary products, including the menstrual cup, which will help us get through the bleed. I will also talk about what can go wrong including premenstrual syndrome, period pain, heavy periods and lack of periods. I will discuss the modern ways to manage your menstrual cycle – there is an app! And I will finish by looking at the global issues women have with their menstrual cycles.

3.  Everything you should know about sex – let’s get talking

Globally sex is a taboo subject, but I strongly feel that we should be more open about how we do it, what precautions we need to take and what we can do if things go wrong. In this chapter I will explain how hormones involved with sex work, the importance of human touch, being a virgin and the basics of sex including orgasms, masturbation, sex toys, and other ways to have sex. I will discuss how our sex drive changes when we are pregnant and grow older. Included will be a guide to sex education to provide parents with support on how to tackle this subject. And finally I will discuss how sex can go wrong, including sexting, pornography, revenge porn, sex addiction, prostitution, human trafficking, rape, incest, paedophilia, female genital mutilation and labial surgery.

4.  Sexually transmitted infections (STI’s) – practice safe sex

Unfortunately, along with sex comes the risk of sexually transmitted infections. In this chapter I will discuss all STIs from diagnosis to treatment. We will talk about human papillomavirus (HPV), chlamydia, genital herpes, gonorrhoea, syphilis, pelvic inflammatory disease, viral hepatitis, and HIV/AIDS. Each section will describe the disease, including how you can catch it, the symptoms, how it is diagnosed, how it is treated and ways to prevent it. I will finish by discussing some general ways to avoid STIs.

5.  How not to get pregnant – the importance of contraception

Most women spend the majority of their lives trying not to get pregnant but are unsure of their fertile period. In this chapter I will explore when a woman has the most chance of getting pregnant and how to avoid it. The current forms of contraception and the advantages and disadvantages of each will be explained. Finally contraception for young and older people, and a male injection currently under development will be discussed.

6.  How to get pregnant – fertility to birth

The majority of women want to have children. In this chapter I will discuss all aspects of pregnancy from getting pregnant through to delivery. I will start with pre-conception care, how to optimize getting pregnant, and cover what happens during pregnancy. I will explain which tests are done during pregnancy, including new techniques such as non-invasive prenatal testing. I will describe birth and birth plans. I will also discus teenage pregnancy, ectopic pregnancy, miscarriage, termination of pregnancy, maternal mortality, and cancer during pregnancy. Globally, women are delaying their fertility as they take on other life choices, and I will present the current options for predicting and preserving fertility, including social egg freezing.

7.  Infertility diagnosis and treatment – what can and cannot be done

Unfortunately 1 in 6 couples experience infertility and this is an increasing problem as women are leaving it later to have children. In this chapter, I will discuss all aspects of infertility investigations and treatment. Female infertility can be caused by ovulation disorders, tubal blockage, uterine abnormalities, or may be unexplained. I will also outline male infertility. I will describe the tests and investigations that should be done if a couple cannot get pregnant, and move on to talk about all aspects of fertility treatment, from intrauterine insemination (IUI) through to surrogacy, including social egg freezing and genetic testing of embryos and the risks and benefits of these treatments. I will also discuss the use of alternative therapies to treat infertility and whether fertility treatment should be funded. And finally, I will talk about where the future will take us. Will everyone reproduce by in-vitro fertilization (IVF)?

8. The menopause – let’s be positive

The menopause is a major change that every woman experiences. It is the reverse of puberty; in puberty reproductive hormones start being produced and in the menopause they stop being produced. And just as with puberty, the menopause can lead to physical and psychological symptoms. In this chapter I will explain what happens during the menopause, lifestyle changes that women should adopt at this time in their life, short and long term menopause symptoms and how to deal with them. Short-term symptoms include menstrual cycle changes, hot flushes, night sweats, effects on mood, genital and urinary problems, sexual difficulties, joint and muscle pain and putting on weight. Long-term symptoms include osteoporosis, cardiovascular disease, urinary incontinence, pelvic organ prolapse, and dementia and Alzheimer’s. Treatments include HRT, other types of drugs, cognitive behavior therapy and complementary therapies. Finally, I will discuss contraception and premature menopause.

9. Diseases that affect women – from polycystic ovarian syndrome to dementia

It is important to understand the major diseases that can affect women throughout our lives. In this chapter I will discuss disorders that only affect females, including polycystic ovarian syndrome (PCOS), endometriosis, pelvic inflammatory disease, pelvic organ prolapse, fibroids, ovarian cysts and urinary incontinence. Many of these disorders can affect the female reproductive system and can be caused by infections, physical damage or hormone imbalances. Some disorders can lead to infertility. I will also discuss the three main killers of women globally; cancer (I will cover the six common female cancers including breast, cervical, ovarian, uterine, vulval and vaginal cancers, explaining each one including the symptoms, diagnosis and treatment), cardiovascular disease (CVD) and dementia.

10.  The later years – what we need to consider

One certainty is that we all age and eventually die. In this chapter I will discuss the physical changes as we age, what we can do about it, how we can stay young, sex in older age, where we would like to live when we are older, making a living will, what kills women, and assisted dying.

Joyce is currently discussing the publication of What Every Woman Should Know and aims to have the book published in 2018. Any inquiries should be directed to WEWSK@thewellbeings.london

In 2018 Joyce will be doing road shows to discuss issues from the book including fertility, the menopause and being healthy. If you would like Joyce to talk, please email joyce.harper@ucl.ac.uk.