Female sexual dysfunction in a population-based study in Iran: prevalence and associated risk factors

To explore the prevalence and risk factors of female sexual dysfunction (FSD) in Iran. A total of 2626 women aged 20-60 years old were interviewed by 41 female general practitioners and answered a self-administered questionnaire on several aspects of FSD including desire, arousal, pain and orgasmic disorders (OD). Criteria of sexual dysfunction followed classification by DSM-IV. The sexual function was evaluated by the Female Sexual Function Index (FSFI). The subjects were randomly identified from 28 counties of Iran. Data on medical history, toxic habits and current use of medication were also obtained. Of the women interviewed, 31.5% (759) reported FSD. The prevalence increased with age, from 26% in women aged 20-39 years to 39% in those >50 years (tested for trend P<0.001). Thirty-seven percent reported OD, 35% desire disorders (DD) and 30% arousal disorders (AD), all of which increased significantly with age. Pain disorders were reported by 26.7%, occurring most frequently in women aged 20-29 years. The educational level (P=0.01) and marriage age (<18 years) (P=0.04) were inversely correlated with the risk of DD, OD and AD. No significant differences were detected in smoking history (P=0.18), the presence of previous pelvic surgery (P=0.08) and contraception methods used (P=0.42). A history of psychological problems (P=0.04), married status (P=0.03), low physical activity (P=0.012), chronic disease (P<0.01), multiparity (P<0.05) menopause status (P相似文献   

Potential future options in the pharmacotherapy of female sexual dysfunction

Female sexual dysfunction (FSD) is considered a common medical problem estimated to affect millions of women in the westernized countries. FSD has been classified into four different categories including sexual arousal disorder (FSAD), sexual desire disorder (HSDD), orgasmic disorder and sexual pain disorder. The focus of this article is the potential role of pharmacological compounds currently under development, in the treatment of sexual arousal and orgasmic disorders in order to enhance the sexual response in adult females. While a number of potential therapeutic options are available to date, not one of the pharmacological treatment regimens has been yet considered the Gold standard in the management of symptoms of FSD. This article reviews the rationale and potential benefits of using distinct drug formulations in the treatment of FSD.     

Sexual dysfunction in women partners of men with erectile dysfunction

We evaluated 113 female partners of men with erectile dysfunction (ED) attending a sexual dysfunction clinic in order to define sexual dysfunction among these women. In all, 51 (45%) women denied having any sexual dysfunction. The other 62 (55%) responded to questions classifying their complaint(s) according to the international classification of female sexual dysfunction (FSD) in the following topics (40/62, 65%, reported having more than one problem): decreased sexual desire (n=35, 56%), sexual aversion (none), arousal (n=23, 37%) and orgasmic disorders (n=39, 63%), dyspareunia (n=19, 31%), vaginismus (n=3, 5%), and noncoital sexual pain (none). Many female partners of men with ED report having some form of sexual disorder, mostly orgasmic problems and decreased sexual desire. Therefore, for optimal outcome of ED treatment, evaluation and treatment of male and FSD should be addressed as one unit within the context of the couple, and be incorporated into one clinic of sexual medicine.     

Prevalence and degree of sexual dysfunction in a sample of women seeking bariatric surgery

BackgroundSexual functioning has been shown to be impaired in women who are obese, particularly those seeking bariatric surgery. However, most previous studies evaluating sexual function in these populations have not used validated measures. We used the validated Female Sexual Function Index (FSFI) to assess the prevalence of female sexual dysfunction (FSD) in a sample of >100 women evaluated for bariatric surgery.MethodsThe FSFI was administered to reportedly sexually active women during their preoperative evaluation. The scores for the individual FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) ranging from 0 (or 1.2) to 6 were summed to produce a FSFI total score (range 2–36). A FSFI total cutoff score of ≤26.55 was used to identify participants with FSD. The participants' FSFI total and domain scores were compared with previously published norms available for women diagnosed with female sexual arousal disorder and healthy controls.ResultsOf the 102 women, 61 (59.8%) had FSFI total scores of ≤26.55, indicative of FSD. Older age and menopause were associated with FSD. Compared with published norms, bariatric surgery candidates had FSFI domain scores that were lower than those of the control group (all P values < 0.0001) but greater than those of the female sexual arousal disorder group (all P values < 0.0001), except for desire, for which the scores were similar.ConclusionWomen seeking bariatric surgery are clearly a population with substantial sexual function impairment, with 60% of participants reporting FSD. These findings highlight the need to initiate routine assessment of sexual functioning in this population and examine whether the weight loss after bariatric surgery contributes to a reversal of FSD.     

Ten-year incident osteoporosis-related fractures in the population-based Canadian Multicentre Osteoporosis Study — Comparing site and age-specific risks in women and men

BackgroundPopulation-based incident fracture data aid fracture prevention and therapy decisions. Our purpose was to describe 10-year site-specific cumulative fracture incidence by sex, age at baseline, and degree of trauma with/without consideration of competing mortality in the Canadian Multicentre Osteoporosis Study adult cohort.MethodsIncident fractures and mortality were identified by annual postal questionnaires to the participant or proxy respondent. Date, site and circumstance of fracture were gathered from structured interviews and medical records. Fracture analyses were stratified by sex and age at baseline and used both Kaplan–Meier and competing mortality methods.ResultsThe baseline (1995–97) cohort included 6314 women and 2789 men (aged 25–84 years; mean ± SD 62 ± 12 and 59 ± 14, respectively), with 4322 (68%) women and 1732 (62%) men followed to year-10. At least one incident fracture occurred for 930 women (14%) and 247 men (9%). Competing mortality exceeded fracture risk for men aged 65 + years at baseline. Age was a strong predictor of incident fractures especially fragility fractures, with higher age gradients for women vs. men. Major osteoporotic fracture (MOF) (hip, clinical spine, forearm, humerus) accounted for 41–74% of fracture risk by sex/age strata; in women all MOF sites showed age-related increases but in men only hip was clearly age-related. The most common fractures were the forearm for women and the ribs for men. Hip fracture incidence was the highest for the 75–84 year baseline age-group with no significant difference between women 7.0% (95% CI 5.3, 8.9) and men 7.0% (95% CI 4.4, 10.3).InterpretationThere are sex differences in the predominant sites and age-gradients of fracture. In older men, competing mortality exceeds cumulative fracture risk.     

Age-related reference intervals for bone turnover markers from an Australian reference population

BackgroundThis study was performed to establish age-related serum reference intervals for procollagen type I N-propeptide (P1NP) and type I collagen C-telopeptide (CTx) in the Australian population.MethodsFasting sera from 1143 males (mean age 60 years; range 20–97 years) and 1246 females (mean age 53 years; range 20–93 years) who participated in the Geelong Osteoporosis Study were analysed for CTx and P1NP using the automated Roche Modular Analytics E170 analyser.ResultsOptimal age-related reference intervals were based on the central 90% of the distribution. The male CTx reference interval was divided into three age groups. For men aged 25 to 40 years, the interval was 170–600 ng/L; 40 to 60 years, the interval was 130–600 ng/L; and for men aged greater 60 years the interval was 100–600 ng/L.For P1NP the male reference interval was 15–80 μg/L for men aged between 25 to 70 years. In men greater than 70 years of age values were higher possibly due to increased bone turnover.High values are frequently seen for both CTx and P1NP in males aged younger than 25 years. This is probably due to bone growth that is not completely finalised.The female CTx reference interval was divided into four age groups. For women aged less than 30 years, the interval was 150–800 ng/L; 30–39 years, the interval was 100–700 ng/L; 40–49 years, the interval was 100–600 ng/L; and for women aged 50 years or more the interval was 100–700 ng/L.The female P1NP reference interval was divided into four age groups. For women aged less than 30 years, the interval was 25–90 μg/L; 30–39 years, the interval was 15–80 μg/L; 40–49 years, the interval was 15–60 μg/L; and for women aged 50–69 years the interval was 15–75 μg/L. In women greater than 70 years of age values were higher possibly due to increased bone turnover.ConclusionValues obtained from this large study provide sound age-related reference intervals for serum P1NP and CTx values in the Australian population.     

Ten-year risk of second hip fracture. A NOREPOS study

BackgroundSecond hip fracture risk is elevated after the first, however whether risk differs with age, by sex or over time is not well known.ObjectiveTo examine the risk of second hip fracture by sex, age and time after first hip fracture.DesignData on all hip fractures in subjects 50 years and older and treated in Norwegian hospitals during 1999–2008 were retrieved. Surgical procedure codes and additional diagnosis codes were used to define incident fractures. Survival analyses with and without adjustment for competing risk of death were used to estimate the risk of second hip fracture.ResultsAmong the 81,867 persons who sustained a first hip fracture, 6161 women and 1782 men suffered a second hip fracture during follow-up. The overall age-adjusted hazard ratio (HR) of a second hip fracture did not differ between the sexes (women versus men, HR = 1.03; 95% confidence interval (CI): 0.98–1.09). Taking competing risk of death into account, the corresponding age-adjusted HR of a second hip fracture was 1.40 (95% CI: 1.33–1.47) in women compared to men. The greater risk in women was due to a higher mortality in men. Based on competing risk analyses, we estimate that 15% of women and 11% of men will have suffered a second hip fracture within 10 years after the first hip fracture. The ten-year cumulative incidence was above 10% in all age-groups, except in men 90 years and older.ConclusionFracture preventive strategies have a large potential in both women and men who suffer their first hip fracture due to the high risk of another hip fracture.     

Fracture-related mortality in southern Sweden: A multiple cause of death analysis, 1998–2014

PurposeTo assess fracture-related mortality among adults (aged ≥20 years) in southern Sweden using multiple causes of death approach.MethodsAll death certificates (n = 201 488) in adults recorded in the region of Skåne from 1998 to 2014 were examined. We identified fracture-related deaths and computed mortality rates by sex, age group, and fracture site. Temporal trends were evaluated using joinpoint regression and associated causes were identified by age- and sex-adjusted observed/expected ratios.ResultsFractures were mentioned on 6 226 (3.1%) death certificates, with majority of these occurred among women (60%) and those aged ≥ 80 years (77%). While hip was the most common site overall (61% of all fracture-related deaths), skull was the most common site in people <60 years (60% of all fracture-related deaths). Proportion of death certificates mentioning fracture was stable in women but increased by 0.4% (95% CI: 0.1 to 0.6) in men between 1998–2002 and 2010–2014. The mean age at death was higher in death certificates mentioning fracture than those without and this gap widened over time. The mean age-standardized fracture-related mortality rate was 18.8 (14.0) per 100 000 person-year in men (women) and declined by 1.5% (1.3%) per year during 1998–2014. Injuries (84.6%) and cardiovascular disorders (64.6%) were the most common comorbidities on death certificates mentioning fracture.ConclusionsFracture is a contributing cause of death in more than 3% of all deaths in southern Sweden with hip in lead among older and skull fracture among younger people. There was a slight increase in proportion of deaths associated with fracture in men but not women during the study period.     

Risk of second hip fracture persists for years after initial trauma

BackgroundSecondary prevention often targets women who suffer from higher rates of second hip fracture than men, especially in the early years after first fracture. Yet, the occurrence of second hip fracture by certain times also depends on the death rate, which is higher in men than women. We compared the risk of sustaining second hip fracture by a certain time between women and men remaining alive at that time.MethodsWe retrieved 38,383 hospitalization records of patients aged 60 years or older, who were discharged alive after admission for hip fracture surgery between 1990 and 2005 in British Columbia, Canada. The outcome variable was the time to a subsequent hip fracture.ResultsDuring ten years of follow-up, 2,902 (8%) patients sustained a second hip fracture, and 21,428 (56%) died before sustaining a second hip fracture. The risk of second hip fracture in the surviving post-fracture patients was higher in women than in men: 2% vs 2%, 5% vs 4%, 9% vs 7%, 15% vs 13%, and 35% vs 30% at 1, 2, 3, 5, and 10 years after initial trauma, respectively, crude OR = 1.25 (95% CI: 1.13–1.39). However, the risk did not differ between women and men after adjustment, OR = 1.09 (95% CI: 0.98–1.21).ConclusionsThe risk of second hip fracture persists for at least ten years among hip fracture survivors, and therefore secondary prevention should continue beyond an early post-fracture period. Women and men have similar risks of second hip fracture and both should be considered for secondary prevention.     

Lifetime female hormonal exposure and risk of rheumatoid arthritis in postmenopausal women: Results from the French E3N cohort

ObjectiveTo assess the relationships between lifetime female hormonal exposures and the risk of incident RA in postmenopausal women.MethodsE3N is an ongoing French prospective cohort of 98,995 women since 1990 aged 40–65 years at enrolment. Data on reproductive/hormonal factors and treatments were regularly recorded. Exposures were defined as follows: – reproductive span (in years) = duration from menarche to menopause; – total ovulatory years = reproductive span?(number of full-term pregnancies × 0.75 + number of miscarriages × 0.25 + total duration of breast feeding + total duration of oral contraception); – lifetime duration of hormonal exposure (in years) = reproductive span + total duration of menopausal hormonal therapy; – composite estrogen score (CES, range = 0–6): 1 point for each item: early menarche, high parity, history of hysterectomy, use of oral contraception, use of menopausal hormonal therapy and late menopause. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of incident RA were estimated using Cox proportional hazards regression models with age as the time scale.ResultsAmong the 78,391 postmenopausal cohort women, 637 validated incident RA cases occurred. Lifetime durations of hormonal exposures were not associated with incident RA in postmenopausal women. High (CES = 4–6) versus low (CES = 0–1) estrogen exposure was inversely associated with the risk of RA: HR 0.37; 95% CI 0.2–0.8.ConclusionIn the E3N cohort, high lifetime estrogen exposure, that summarizes cumulative endogenous and exogenous exposures, was associated with a decreased risk of RA in postmenopausal women.     

Vertebral fracture risk factors in postmenopausal women over 50 in Valencia,Spain. A population-based cross-sectional study

PurposeThis study aims to estimate the prevalence of risk factors for osteoporotic vertebral fracture and analyze the possible associations between these factors and the presence of densitometric osteoporosis and prevalent morphometric vertebral fracture.MethodsData from a population-based cross-sectional sample of 804 postmenopausal women over the age of 50 years old living in the city of Valencia (Spain) were used. The women were interviewed to identify the prevalence of osteoporotic fracture risk factors and underwent a densitometry and a dorsolumbar spine X-ray.ResultsThe most prevalent risk factors were densitometric osteoporosis (31.7%), history of parental hip fracture (19.4%), hypoestrogenism (19%), and body mass index (BMI) ≥ 30 kg/m² (35.2%). After adjusting for all covariables, densitometric osteoporosis was associated with increased age [odds ratio (OR)_{65–69 years}: 2.84, 95% confidence interval (CI): 1.75–4.61; OR_{70–74 years}: 4.01, 95% CI: 2.47–6.52; OR_75 + years: 5.96, 95% CI: 3.27–10.87] and inversely associated with high BMI (OR_25.0–29.9: 0.51, 95% CI: 0.34–0.76; OR_≥ 30: 0.30, 95% CI: 0.19–0.46). Morphometric vertebral fracture was associated with age (OR_{65–69 years}: 2.04, 95% CI: 1.03–4.05; OR_{70–74 years}: 4.05, 95% CI: 2.11–7.77; OR_75 + years: 8.43, 95% CI: 3.97–17.93), poor educational level (OR: 1.70, 95% CI: 1.06–2.72) and with densitometric osteoporosis and BMI ≥ 30 kg/m² (OR: 3.35, 95% CI: 1.85–6.07).ConclusionsThe most prevalent osteoporotic fracture risk factors were having a high BMI and the presence of densitometric osteoporosis. A higher risk of morphometric vertebral fracture in women with both low bone mineral density and high BMI was found. This association, if confirmed, has important implications for clinical practice and fracture risk tools. We also found a higher risk in women with a poor educational level. More attention should be addressed to these populations in order to control modifiable risk factors.     

Proportion of osteoporotic women remaining at risk for fracture despite adherence to oral bisphosphonates

BackgroundAdherence to oral bisphosphonates is often low, but even adherent patients may remain at elevated fracture risk. The goal of this study was to estimate the proportion of bisphosphonate-adherent women remaining at high risk of fracture.MethodsA retrospective cohort of women aged 50 years and older, adherent to oral bisphosphonates for at least two years was identified, and data were extracted from a multi-system health information exchange. Adherence was defined as having a dispensed medication possession ratio ≥ 0.8. The primary outcome was clinical occurrence of: low trauma fracture (months 7–36), persistent T-score ≤ − 2.5 (months 13–36), decrease in bone mineral density (BMD) at any skeletal site ≥ 5%, or the composite of any one of these outcomes.ResultsOf 7435 adherent women, 3110 had either pre- or post-adherent DXA data. In the full cohort, 7% had an incident osteoporotic fracture. In 601 women having both pre- and post-adherent DXA to evaluate BMD change, 6% had fractures, 22% had a post-treatment T-score ≤ − 2.5, and 16% had BMD decrease by ≥ 5%. The composite outcomes occurred in 35%. Incident fracture was predicted by age, previous fracture, and a variety of co-morbidities, but not by race, glucocorticoid treatment or type of bisphosphonate.ConclusionDespite bisphosphonate adherence, 7% had incident osteoporotic fractures and 35% had either fracture, decreases in BMD, or persistent osteoporotic BMD, representing a substantial proportion of treated patients in clinical practices remaining at risk for future fractures. Further studies are required to determine the best achievable goals for osteoporosis therapy, and which patients would benefit from alternate therapies.     

Prevalence and risk factors of osteoporosis in Korea: A community-based cohort study with lumbar spine and hip bone mineral density

PurposeTo investigate bone mineral density (BMD) profiles, osteoporosis prevalence and risk factors in a community-based cohort in Korea.MethodsThe present study is a cross-sectional study. The study population consisted of 1,547 men and 1991 women aged 40 years and older with BMD measurements using central dual energy X-ray absorptiometry from a prospective community-based cohort. The data were compared with other ethnic groups. Risk factors related to osteoporosis were analyzed.ResultsCrude prevalence of osteoporosis in the whole subjects (40–79 years old) was 13.1% for men and 24.3% for women by WHO criteria, at any site among lumbar spine, femoral neck or total hip. Standardized prevalence of osteoporosis between age of 50 and 79 at lumbar spine, femoral neck and total hip was 12.9%, 1.3% and 0.7% in men and 24.0%, 5.7% and 5.6% in women, respectively. The mean BMD of studied female subjects after age of 50 was not significantly different from that of Chinese but significantly lower than that of Japanese, non-Hispanic whites, non-Hispanic blacks and Mexican Americans. Risk of osteoporosis was significantly associated with the presence of past fracture history (OR, 1.45; 95% CI, 1.08–1.94), smoking ≥ 1 pack/day (OR, 1.63; 95% CI, 1.01–2.62), menarche after age of 16 (OR, 1.46; 95% CI, 1.14–1.87), last delivery after age of 30 (OR, 1.58; 95% CI, 1.20–2.09), more than three offspring (OR, 1.42; 95% CI, 1.07–1.89), post-menopause status (OR, 7.32; 95% CI, 3.05–17.6), more than 17 years since menopause (OR, 1.53; 95% CI, 1.10–2.14), regular exercise of two to three times per week (OR, 0.40; 95% CI, 0.18–0.89), monthly income above 500,000 won per household (OR, 0.64; 95% CI, 0.45–0.92), college graduate (OR, 0.29; 95% CI, 0.13–0.63) and calcium intake ≥ 627.5 mg/day (OR, 0.65; 95% CI, 0.43–0.98) after adjusting for age and BMI.ConclusionThe BMD and osteoporosis prevalence of Koreans are presented. Risk of osteoporosis was significantly associated with fracture history, smoking, reproductive history, regular exercise, income level, education background and calcium intake.     

Low calcaneal bone mineral density and the risk of distal forearm fracture in women and men: A population-based case-control study

ObjectiveWe used dual X-ray absorptiometry (DXA) to measure calcaneal bone mineral density (BMD) and estimate the prevalence of osteoporosis in a population with distal forearm fracture and a normative cohort.MethodsPatients 20 to 80 years of age with distal forearm fracture treated at one emergency hospital during two consecutive years were invited to calcaneal BMD measurement; 270 women (81%) and 64 men (73%) participated. A DXA heel scanner estimated BMD (g/cm²) and T-scores. Osteoporosis was defined as T-score ≤? 2.5 SD. Of the fracture cohort, 254 women aged 40–80 years and 27 men aged 60–80 years were compared with population-based control cohorts comprising 171 women in the age groups 50, 60, 70 and 80 years and 75 men in the age groups 60, 70, and 80 years.ResultsIn the fracture population no woman below 40 years or man below 60 years of age had osteoporosis. In women aged 40–80 years the prevalence of osteoporosis in the distal forearm fracture cohort was 34% and in the population-based controls was 25%; the age-adjusted prevalence ratio (PR) was 1.32 (95% CI 1.00–1.76). In the subgroup of women aged 60–80 years the age-adjusted prevalence ratio of osteoporosis was 1.28 (95% CI 0.95–1.71). In men aged 60–80 years the prevalence of osteoporosis in the fracture cohort was 44% and in the population-based controls was 8% (PR 6.31, 95% CI 2.78–14.4). The age-adjusted odds ratio for fracture associated with a 1-SD reduction in calcaneal BMD was in women aged 40–80 years 1.4 (95% CI 1.1–1.8), in the subgroup of women aged 60–80 years 1.2 (95% CI 0.95–1.6), and in men aged 60–80 years 2.6 (95% CI 1.7–4.1). Among those aged 60–80 years the area under the ROC curve was in women 0.56 (95% CI 0.49–0.63) and in men 0.80 (95% CI 0.70–0.80).ConclusionsThe age-adjusted prevalence of osteoporosis based on calcaneal BMD is higher in individuals with distal forearm fracture than in population-based controls. BMD impairment is associated with increased odds ratio for forearm fracture in both women and men but the differences between cases and controls are more pronounced in men than in women, which may have implications in fracture prevention.     

Vitamin D deficiency in northern Vietnam: Prevalence,risk factors and associations with bone mineral density

PurposeVitamin D deficiency has been linked to osteoporosis and also to the risk of cancer, autoimmune disorders and cardiovascular diseases. This study sought to determine the prevalence of, and risk factors for, vitamin D deficiency and its relationship with bone mineral density (BMD) in a Vietnamese population.MethodsThis cross-sectional study involved 269 women and 222 men aged 13–83 years, who were randomly selected from urban and rural areas in northern Vietnam. Serum concentrations of 25-hydroxy-vitamin D [25(OH)D] and parathyroid hormone (PTH) were measured by electrochemiluminescence immunoassay. Vitamin D deficiency was defined as serum 25(OH)D levels below 20 ng/mL. BMD was measured by dual X-ray absorptiometry.ResultsThe prevalence of vitamin D deficiency in women was 30%, almost two-fold higher than in men (16%). Significant predictors of vitamin D deficiency in women were urban residency (p < 0.01) and age less than 30 years (p < 0.01), whereas use of contraceptive pills was protective (p < 0.01). In men, winter season was the only significant predictor of vitamin D deficiency (p < 0.01). In multiple linear regression analysis, serum levels of 25(OH)D were positively associated with BMD in both women (p < 0.001) and men (p < 0.001).ConclusionsThese data suggest that the prevalence of vitamin D deficiency is high in the Vietnamese population, and that part of this prevalence could be explained by low exposure to sunlight (urban residency and winter season). The high prevalence of vitamin D deficiency should raise the awareness of potentially important health issues such as osteoporosis within the Vietnamese society.     

Unintentional cutting or piercing injuries at home amongst young and middle-aged New Zealanders resulting in hospital admission: Context and characteristics

AimThis study investigated the characteristics and contexts of unintentional cutting or piercing injuries at home amongst young and middle-aged adults.MethodsWe conducted a population-based study of individuals aged 20–64 years who were admitted to hospital in the Auckland, Waikato and Otago regions of New Zealand following an unintentional cutting or piercing injury sustained at home. Participants were interviewed using a structured questionnaire covering a range of factors including demographic information, circumstances of the injury, and personal factors such as medication, alcohol and recreational drug use.ResultsOf 340 eligible cases, 267(78.5%) were interviewed. The overall age-specific hospitalisation rate for cutting or piercing injuries was 30.7 per 100,000 (95% CI 27.4–33.9). The highest hospitalisation rates occurred amongst males aged 20–24 and 60–64 years. Common mechanisms of injury were: contact with sharp glass (30.0%), contact with a powered hand tool or household machinery (29.7%), contact with knife (10.8%), and contact with non-powered hand tool (10.8%). The mechanism of injury varied significantly by gender, age, and ethnicity.ConclusionPrevention strategies aimed at reducing the burden of cutting or piercing injuries occurring at home should focus on those most at risk including males aged 20–24 years, from injury by sharp glass, and those aged 40–64 years, from powered lawnmower, hand tool or household machinery-related injuries.     

Sexual problems among married Nigerian women

We interviewed and examined 293 married women, 15-49 years of age, seeking primary care at a teaching hospital in central Nigeria. One or more sexual problems were identified in 71% of women. The proportion of specific sexual problems was 39% for a desire problem, 40% for an arousal problem, 31% for a sex pain problem and 55% for an orgasmic problem. Poor marital communication, lack of foreplay, Islamic religion and advancing age were independently associated with a desire problem. Absence of foreplay was independently associated with an arousal problem. Lack of foreplay, lower abdominal pain, gynaecological conditions, working outside the home and younger age were independently associated with a sex pain problem. The absence of foreplay, poor marital communication and being a housewife were independently associated with an orgasmic problem. Sexual problems are common among married Nigerian women seeking outpatient care.     

Vitamin D deficiency in northern Vietnam: Prevalence,risk factors and associations with bone mineral density

PurposeVitamin D deficiency has been linked to osteoporosis and also to the risk of cancer, autoimmune disorders and cardiovascular diseases. This study sought to determine the prevalence of, and risk factors for, vitamin D deficiency and its relationship with bone mineral density (BMD) in a Vietnamese population.MethodsThis cross-sectional study involved 269 women and 222 men aged 13–83 years, who were randomly selected from urban and rural areas in northern Vietnam. Serum concentrations of 25-hydroxy-vitamin D [25(OH)D] and parathyroid hormone (PTH) were measured by electrochemiluminescence immunoassay. Vitamin D deficiency was defined as serum 25(OH)D levels below 20 ng/mL. BMD was measured by dual X-ray absorptiometry.ResultsThe prevalence of vitamin D deficiency in women was 30%, almost two-fold higher than in men (16%). Significant predictors of vitamin D deficiency in women were urban residency (p < 0.01) and age less than 30 years (p < 0.01), whereas use of contraceptive pills was protective (p < 0.01). In men, winter season was the only significant predictor of vitamin D deficiency (p < 0.01). In multiple linear regression analysis, serum levels of 25(OH)D were positively associated with BMD in both women (p < 0.001) and men (p < 0.001).ConclusionsThese data suggest that the prevalence of vitamin D deficiency is high in the Vietnamese population, and that part of this prevalence could be explained by low exposure to sunlight (urban residency and winter season). The high prevalence of vitamin D deficiency should raise the awareness of potentially important health issues such as osteoporosis within the Vietnamese society.