Reproduction after man's own kind is an acknowledged means of ensuring continuity of life. Reproductive health is, therefore, crucial to our continual existence on earth. Unfortunately, the events of reproduction put so many burdens on us, especially females. We, as humans, need to harness all the resources available to us in order to meet these challenges, else we fall mentally ill when we succumb adversely to these reproductive events. Reproductive events that can progress to overt mental disorders include menarche, the first menstrual period, the menstrual cycle itself, for example, pre-menstrual syndrome, and coitarche, the first time sexual intercourse takes place. It is not unusual to hear young ladies admit that their first sexual contact was without their consent. Depending on when and how it happened, women may develop hatred for sex and even for men. This may cause some women to avoid marriage, or when they do marry, not enjoy sex in marriage. Other reproductive events in female adults likely to affect their mental health are infertility and the stress of its management, pregnancy and its related diseases, labour with its accompanying risk of death and care of the new-born, especially in the first few weeks. Onset of mental disorders is common in weeks following a delivery. The most common type of mental disorders during this period is disorder of emotion, such as depression and bipolar disorder - a condition in which the person gets a sustained elated or irritable mood with other symptoms. They are referred to as post-partum depression and post-partum psychosis because of their onset in the period following a delivery. These disorders can also be brought on by abortion, whether criminal or safe. Abortion in Ghana is the termination of pregnancy earlier than 28 weeks of pregnancy. The female reproductive organs deteriorate in function as a woman ages. For instance, the regular menstrual cycling ceases as a result of reduced female hormone production. Women, during this time, lose their abilities to make any more babies and if they never had one in their lifetime or had secured a new relationship with the hope of cementing it with a baby, they get disappointed. Some cultures in Ghana sometimes maltreat the women because they are perceived as not being of much use again. These social challenges at a period when the woman biologically gets unpredictable mood changes from menopause can only worsen the plight of women and make them more susceptible to mental disorders. Advancing age in women may also come with some increased likelihood of developing cancers of the reproductive organs. Cancers are quite stressful and their (mis)management can be more stressful. Sometimes cancers, especially when diagnosed late, may require life-threatening treatment regimes or therapies that result in the disfiguring of their bodies, such as the removal of the breasts. This may cause anxiety disorders and depression. The functioning of the female reproductive system places women at a higher risk of developing mental disorders than their male counterparts. There are a lot of clinics and NGOs in the country that specialise in the health care of women, sometimes neglecting their mental health. Gynaecological and obstetric health care in Ghana needs to incorporate mental health services, at least the service of a clinical psychologist, if holistic care of our women is cherished. Credit: Dr Eugene Dordoye/Daily Graphic Dr Eugene Dordoye is a psychiatrist and member of the Health Education and Advocacy Unit of the Ghana Medical Association.

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