Couples are increasingly opting not to have children for many reasons; however, due to this, the woman is at higher risk of some medical conditions. — 123rf
Children are a blessing.
In a world full of chaos, coming back to your home and children is one thing most of us look forward to.
Children bring immense joy to us and can give our lives significant meaning and purpose.
While some naturally progress to having kids after marriage, there are a growing number of couples who are choosing to live a child-free lifestyle.
This type of lifestyle isn’t new; in Western countries, it has been around since the 1960s, but was a rarity.
With the emergence of social media platforms, a child-free culture has gained great popularity, especially among millennials and Gen Zers.
This lifestyle is also catching on in Malaysia, with quite a few newly-married couples leaning towards being child-free by choice.
Couples who both earn an income and are voluntarily childless are often referred to as “double income, no kids (DINK)”.
Among the reasons people choose this lifestyle are career goals, financial considerations, personal freedom, environmental concerns, relationship focus, lifestyle flexibility, and physical and mental well-being.
Some are also worried about the many challenges that come with raising children, especially the burden of parenting correctly and responsibly.
Increased breast cancer risk
Another aspect that women who opt to be child-free should consider is their increased risk for certain medical conditions due to this choice.
Studies have shown that women who have never given birth to a live baby are at greater risk for some diseases.
This group of women are known as the nulliparous, a term derived from the Latin root “null”, meaning “not”, and the verb “parere”, meaning “to bring forth”.
Nulliparity puts a woman at risk for cancers in the reproductive organs, like breast, ovarian and endometrial cancer.
Women exposed to the hormones oestrogen and progesterone produced by the ovaries over long periods are at higher risk of breast cancer.
This hormone exposure is reduced with each pregnancy.
Nulliparous women have a 20-40% higher risk of postmenopausal breast cancer than parous women who first gave birth before the age of 25.
Mothers with five full-term pregnancies are about 50% less likely than nulliparous women to develop breast cancer.
In a case-control study by British physiologist Dr Janet Lane-Claypon, published May 1926 in Ministry of Health. Reports on Public Health and Medical Subjects No 32, it was found that lack of breastfeeding was associated with higher breast cancer risk.
Women who breastfed for at least a year were shown to have lower breast cancer risk, as most women do not experience ovulation when breastfeeding, thus reducing their exposure to oestrogen and progesterone.
Breastfeeding might also change breast cells in a way that may make them less likely to develop malignancies.
Nonetheless, all women, including nulliparous ones, can reduce their overall risk of breast cancer or detect any changes early by doing these simple steps:
Conduct a BSE on the fifth or seventh day after your period.
Do choose one specific day or date, so that you can remember to do it consistently.
This examination should only take 10 minutes.
You can do your BSE before taking your shower in the bathroom.
Do it in front of a mirror so that you can see any differences between your left and right breasts.
It is suggested for women aged 20 to 40 years old to have clinical breast examination performed by a doctor.
The doctor may also suggest doing an ultrasound to see if there are any signs of cysts or fluid-filled sacs in the breasts.
For women aged 40 years old and above, it is recommended to do a mammogram once every two years to detect any breast tumours before they are large enough to feel.
This will help to reduce the risk of potential breast cancer, or if detected, enable treatment to be started at an early stage.
Other medical conditions
An analysis from the Ovarian Cancer Cohort Consortium found that the risk of ovarian cancer increases with an increase in the lifetime number of ovulatory cycles.
Again, pregnancy reduces the lifetime number of ovulatory cycles, and thus, the risk of ovarian cancer.
For those who are particularly at risk for ovarian cancer – such as women with a family history of ovarian cancer or who are BRCA1 gene carriers – a risk-reducing prophylactic surgery to remove both their ovaries and fallopian tubes can be done.
Meanwhile, endometrial cancer is the sixth most common cancer in women worldwide.
It also carries the highest co-morbid (associated) disease burden of any cancer.
Multiparous women (women who’ve had multiple pregnancies) are known to have a lower risk of developing endometrial cancer than nulliparous women.
The lack of ovulation and the shifting of the balance of sex hormones with decreased oestrogen levels and increased progesterone levels during pregnancy, has traditionally been thought to be the major contributors to this decreased risk.
Osteoporosis and cardiovascular (heart) health impacts are also among the other risks of nulliparity.
Regrets have been expressed by some who have led a child-free lifestyle – a change of mind that happens more often than not at a later age when conceiving is more difficult.
Some women are also childless not by choice, but because of health issues or fertility challenges.
For such cases, it is worth a visit to a fertility specialist for a thorough consultation, as advancement in medical technology provides many opportunities for conception.
Procedures such as in vitro fertilisation (IVF) have been fruitful to many desiring to build a family.
Dr Deepashni Thulasiraman is a medical officer pursuing her speciality in obstetrics and gynaecology. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
