Dysmenorrhea in a multiethnic population of adolescent Asian girls

Objective

To determine the prevalence of dysmenorrhea, its impact, and the treatment-seeking behavior of adolescent Asian girls.

Method

A cross-sectional study with 1092 girls from 15 public secondary schools and 3 ethnic groups in the Federal Territory of Kuala Lumpur, Malaysia.

Results

Overall, 74.5% of the girls who had reached menarche had dysmenorrhea; 51.7% of these girls reported that it affected their concentration in class; 50.2% that it restricted their social activities; 21.5% that it caused them to miss school; and 12.0% that it caused poor school performance. Ethnicity and form at school were significantly associated with the poor concentration, absenteeism, and restriction of social and recreational activities attributed to dysmenorrhea. Only 12.0% had consulted a physician, and 53.3% did nothing about their conditions. There were ethnic differences in the prevalence, impact, and management of dysmenorrhea.

Conclusion

There is a need for culture-specific education regarding menstruation-related conditions in the school curriculum.     

Network analysis of knowledge and practices regarding sexual and reproductive health: a study among adolescent street girls in Kinshasa (DRC)

Objectives: The aim of the study was to ascertain the influence of knowledge and interventions in sexual and reproductive health and contraception practices among adolescent street girls from Kinshasa, Democratic Republic of the Congo.

Methods: A cross-sectional study was carried out among street girls between 12 and 21 years of age. A standardised questionnaire was used, encompassing socio-demographic data and knowledge and practices regarding sexual and reproductive health. A network analysis was carried out.

Results: The study comprised 293 street girls. The mean age was 17.1 years (range 12–21 years) and the mean time spent living on the streets was 3.9 years (range 0–15 years). Commercial sex was reported by 78.5% (95% confidence interval [CI] 73.3%, 83.2%) as the main source of their income. During their last sexual intercourse, 44.0% (95%CI 38.1%, 50.4%) had not used a condom; 29.3% (95%CI 23.3%, 35.9%) had used hormonal contraception. Previous pregnancy was reported by 62.5% (95%CI 56.7%, 68.3%) and current pregnancy by 12.3% (95%CI 8.8%, 17.2%); 24.5% of previous pregnancies ended in voluntary termination, with a higher rate among the youngest street girls (12–15 years, 50.0%; p?=?0.01). Time spent living on the streets was independently associated with pregnancy (odds ratio 1.2; 95%CI 1.1, 1.4). Practices and outcomes (previous or current pregnancy) were poorly correlated with knowledge about sexual and reproductive health. The network analysis confirmed the poor influence of exposure to intervention activities on sexual and reproductive health practices and outcomes, but did confirm a centrality effect of knowledge about HIV/AIDS.

Conclusion: Street girls in Kinshasa are extremely vulnerable with regard to their sexual and reproductive health, especially the youngest street girls. Behavioural and biomedical interventions have had limited influence. Structural and societal changes are necessary to positively impact street girls’ sexual and reproductive health. Knowledge about HIV/AIDS than about risk of pregnancy had a greater influence on sexual and reproductive health practices.     

Psychosexual Correlates of Unwanted Sexual Experiences in Women Consulting for Female Sexual Dysfunction According to Their Timing Across the Life Span

Background

Comparative data on the psychopathologic and sexual correlates of unwanted sexual experiences (USEs) occurring during childhood, adolescence, or adult life are lacking.

Influences of social norms and context on sexual decision making among adolescent women

Introduction: The aim of this study was to explore women's decisions to initiate and continue sexual activity in late adolescence. Methods: Narrative inquiry was the qualitative methodology used to research the perceptions of factors that influence the sexual decision making of women in late adolescence. Single interviews were conducted with 10 late-adolescence women between the ages of 18 and 22. Both purposive and snowball sampling were used, and recruitment ended when data saturation was achieved. Results: The main findings that emerged as the story contained 3 distinct and influential components: the influence of social context provided the introduction to the story, perceptions of the expected social norm for sex and relationships formed the plot, and the narratives concluded with a discussion of how these adolescents' decision-making processes evolved in the years since coital debut. Discussion: The results of this study provide evidence that adolescent sexual decision making is a multifaceted process with many layers of influence that reflect the complex world adolescents must navigate as they make decisions about their sexual behaviors. Detailed assessment of adolescent sexual activity and anticipatory guidance by health care providers will lay the foundation for risk reduction behavior and safer sexual encounters.     

Role of gender in sexual behaviours and response to education in sexually transmitted infections in 17-year-old adolescents

Objective

to investigate gender differences in high school students with respect to sexual risk behaviours, and their perceptions of the effect of an educational programme on sexually transmitted infections (STIs). In addition, this study aimed to investigate differences between students in programmes preparing for university compared with vocational programmes.

Participants, setting and design

second-year high school adolescents from two communities in south-west Sweden were invited to participate in the study, and completed a questionnaire on sexual experience, sexual risk behaviours and the impact of the educational programme on STIs.

Findings

males took less responsibility for STI prevention than females. Furthermore, males perceived themselves to be less influenced by the STI education than females. Females had more experience of same-sex sexuality than males.

Conclusions and implications for practice

males take less responsibility for STI prevention than females. When planning STI education, it is important to consider gender, traditions and various learning styles. If STI education fails to reach males, the prevalence of these infections will continue to increase.     

Reproductive and sexual health problems of adolescent girls in Kenya: A challenge to the church

Young women growing up in a poor country like Kenya face multiple discrimination on the basis of sex, age and economic status. Although pre-marital sex is condemned in nearly all societies, and young, unmarried people, especially young women, are not expected to be sexually active, the gap between expected and actual behaviour is enormous. In sub-Saharan Africa, the majority of young girls are sexually active, sometimes with multiple partners. Studies in sub-Saharan Africa indicate that youth are initiated into sexual activity as early as age 12 for girls and 13 for boys.¹ It is also estimated that 62 per cent ofall mothers in sub-Saharan Africa are within the 15–19 age cohort.² This results in reproductive health problems, including pregnancy, abortion, HIV infection and other sexually transmitted diseases and stress, which are of both policy and theological significance. The Church could take a lead in putting the reality of youth sexuality into the public consciousness and onto the political agenda. As the moral conscience of Kenyan society, the Church should condemn discrimination against adolescent girls and take positive action by initiating a youth pastoral ministry through which the reproductive health needs of adolescents might be addressed.     

Promotion of adolescent sexual health in primary care: survey in Finnish health centres

Objectives To describe adolescent sexual health services in primary care in Finland, focusing on services for contraceptive counselling, sexually transmitted infections and abortion.

Methods Service provision, accessibility and practices were surveyed in all 63 health centre organizations (HCOs) in a hospital district in Western Finland via separate e-mailed questionnaires to chief physicians (n = 49, response rate 78%), directors of nursing (58, 92%), doctors (49, 78%) and nurses (62, 98%).

Results Dedicated youth clinics existed in only three HCOs. In others, services were provided in family planning, maternity or outpatient clinics. The average wait for contraceptive consultation was 4.8 days to a nurse and 12.5 days to a doctor. In 15 HCOs doctors stipulated a minimum age for combined hormonal contraception. Free supply of contraceptives was often limited to initiation. On-site instructions for chlamydia screening existed in 11 HCOs. Nurses could test for chlamydia without doctor's involvement in 46 HCOs. School nurses participated actively in sexuality education in secondary schools.

Conclusions Adolescent sexual health services were generally adequately available in the HCOs studied. However, services tailored for adolescents were rare. Some medical barriers to access to contraception were found. To improve the system, further involvement of nurses in service provision is recommended.     

The perspectives of Australian midwifery academics on barriers and enablers for simulation in midwifery education in Australia: a focus group study

Objective

to describe Australian midwifery academics' perceptions of the current barriers and enablers for simulation in midwifery education in Australia and the potential and resources required for simulation to be increased.

Design

a series of 11 focus groups/interviews were held in all states and territories of Australia with 46 participating academics nominated by their heads of discipline from universities across the country.

Findings

three themes were identified relating to barriers to the extension of the use of simulated learning environments (SLEs) (‘there are things that you can't simulate’; ‘not having the appropriate resources’; and professional accreditation requirements) and three themes were identified to facilitate SLE use (‘for the bits that you're not likely to see very often in clinical’; [‘for students] to figure something out before [they] get to go out there and do it on the real person’; and good resources and support).

Key conclusion

although barriers exist to the adoption and spread of simulated learning in midwifery, there is a long history of simulation and a great willingness to enhance its use among midwifery academics in Australia.

Implications for practice

while some aspects of midwifery practice may be impossible to simulate, more collaboration and sharing in the development and use of simulation scenarios, equipment, space and other physical and personnel resources would make the uptake of simulation in midwifery education more widespread. Students would therefore be exposed to the best available preparation for clinical practice contributing to the safety and quality of midwifery care.     

Exploring the Effect of a Promotion and Prevention Regulatory Focus on Subjective Responses to Vaginal Sensations in a Laboratory Research Design

BackgroundSelf-regulation is an important process to explain sexual, emotional, and pain-related responses in the context of genital pain. Although highly relevant, self-regulatory focus theory is not well integrated into the literature on genital pain.AimThis study explored the impact of a promotion and prevention regulatory focus on genital pain responding. Sex would typically endorse a promotion focus, whereas pain during sex is likely to provoke a prevention focus oriented toward harm avoidance and safety.MethodWe induced gradually increasing vaginal pressure in a sample of 56 women using an intra-vaginal balloon that simulated potentially painful vaginal sensations. Women were first primed with a promotion vs prevention focus by making them list their ideals vs responsibilities as a sexual partner. We measured trait regulatory focus, pleasant and painful vaginal pressure sensations, sexual arousal, expectations, and approach-avoidance motivational tendencies.Main outcomeThe effect of trait and state promotion and prevention regulatory focuses on the appraisal of vaginal pressure and sexual arousal.ResultsWhen primed with a prevention compared with a promotion focus, women with a predominant prevention orientation reported less sexual arousal, less pleasant vaginal pressure appraisals, and lower approach tendencies regarding sexual stimuli. Women who experienced a match between their state and trait promotion focus appraised the vaginal pressure as less painful. No significant effects of regulatory focus were found on the expectancy measures.Strengths and LimitationsWe provided first evidence on self-regulatory motivation in the context of genital pain responses using an experimentally controlled laboratory design. Our sample was small and consisted of young students without (a clinical diagnosis of) genital pain, which limits our conclusions on the effect of promotion vs prevention regulation on genital pain responses.Clinical ImplicationsFuture research is needed to examine the clinical value of self-regulation and regulatory fit and to identify possible ways to target self-regulatory motivation in clinical interventions of genital pain.ConclusionSelf-regulatory focus theory has clear potential to explain the sexual and motivational correlates of genital pain.Dewitte M and Kindermans H. Exploring the Effect of a Promotion and Prevention Regulatory Focus on Subjective Responses to Vaginal Sensations in a Laboratory Research Design. J Sex Med 2021;18:303–314.     

Audit on the management of complainants of sexual assault at an emergency department

Objective

Proper medical management should be offered to rape complainants, including systematic investigation for sexual transmitted diseases, prophylactic antibiotics, a pregnancy test, emergency contraception, and psychological and medical follow up. We conducted an audit on the medical management of complainants of sexual assault in a public university hospital with a high referral of rape complainants.

Study design

Retrospective study of rape complainants, based on medical records (n = 356) including women admitted at the emergency department between January 1, 2002 and December 31, 2007.

Results

Most complainants were Caucasian (median age: 25 years, range: 15-79 years). About 82% of the assaults were committed by one assailant only, and almost two-thirds of the rapes were characterized by vaginal penetration. In 8% of the patients, no blood sample to screen for sexually transmitted disease had been taken and in 38% of the patients, no cervical smear for C. trachomatis had been done. Prophylactic antibiotics were provided to 40% of the patients. Eighty percent of the complainants who were not using contraception received an emergency contraceptive treatment. Respectively, 10%, 16% and 11% of the complainants were seen at a gynecological, infectious diseases or psychological support follow-up visit.

Conclusion

Only about 20% of the complainants received optimal care. Different steps were taken to improve the medical management, including a specific computerized checklist and involvement of a social nurse for the follow up. These steps aim at reducing psycho-affective and medical morbidity of rape complainants.     

Age at sexual initiation and number of sexual partners in the female Spanish population Results from the AFRODITA survey

Objectives

The AFRODITA study was designed to describe patterns relating to the number of lifetime sexual partners (SP) and age at first sexual intercourse (AFSI) by geographic region in a representative sample of Spanish women.

Study design

A representative sample of the female Spanish population was obtained using the Access Panel Technique. Postal questionnaires were sent to 11,086 women aged 18–70 years. Data were collected on AFSI, number of sexual partners, contraceptive methods, cervical cancer screening and socio-demographic characteristics.

Results

The average AFSI was 20.9 years. AFSI below the age of 19 years was reported by 30.8% of the women. Among sexually active women, 70.6% reported being monogamous and 6.4% reported ≥5 lifetime sexual partners. Younger age at interview was strongly related to earlier AFSI and to higher number of lifetime sexual partners. Women younger than 25 were 39 times more likely to have an AFSI before age 18 than women over age 55. The percentage of women aged less than 25 reporting two or more sexual partners was four times higher than that of women 56 and older. In the multivariate analysis, having two or more sexual partners was independently associated with young age, early AFSI, having ever used oral contraceptives, living in an urban area, having had a screening Pap test in the last 3 years, having a sexually transmitted infection and nuliparity.

Conclusions

This study confirms important changes in the sexual behaviour of Spanish women. Younger cohorts show a younger age at sexual initiation and higher number of sexual partners. These are key factors that may induce changes in the human papillomavirus (HPV) prevalence and the cervical cancer incidence in Spain.     

The influences of the COVID-19 pandemic on medical service behaviors

The outbreak of the novel coronavirus (COVID-19) has greatly impacted medical services worldwide. In addition to changing the processes used by hospital medical services, it has also changed the behaviors of medical staff, resulting in a completely different appearance. Fear of being infected with COVID-19 makes patients fear entering hospitals, and hospitals must repeatedly screen patients prior to entry in order to confirm that they are not infected. Patients are then separated according to their symptoms and travel, occupation, contact and cluster histories (TOCC), which seriously affects them. In addition, hospitals have invested a lot of money into the whole visiting process and into the equipment required to prevent the spread or lessen the impact of COVID-19.     

Impact of the RHANI Wives intervention on marital conflict and sexual coercion

Objective

To assess the effects of the RHANI (Reducing HIV among Non-Infected) Wives intervention on marital conflict and intimate partner violence (IPV) in urban India.

Methods

A 2-armed cluster-randomized controlled trial (7 intervention, 6 control clusters) of the RHANI Wives intervention was conducted with 220 women contending with a history of IPV and/or husband’s drunken behavior. Participants were surveyed at baseline and 4.5-month follow-up. Outcome measures included marital conflict (arguments with husband in past 3 months), marital IPV (physical or sexual violence from husband in past 3 months), and marital sexual coercion (husband forcing sex at last sex). Intention-to-treat logistic generalized linear mixed models were used to determine intervention impact.

Results

One-third (35.0%) of participants reported physical or sexual abuse from their husband in the past 3 months, and 58.6% reported that their husband was drunk in the past 30 days. Intention-to-treat analyses indicated time × treatment reductions in marital conflict (risk ratio [RR] 0.4; 90% confidence interval [CI], 0.1–0.9; P = 0.06) and marital sexual coercion (RR 0.2; 90% CI, 0.05–0.9; P = 0.08), but not IPV.

Conclusion

The findings suggest the potential utility of this intervention in reducing marital conflict and sexual coercion among women in urban India.ClinicalTrials.gov: NCT01592994.     

Assessment of sexual dysfunction and determination of its risk factors in the Republic of Korea

Objective

To assess sexual function among women via self-evaluation of female sexual dysfunction (FSD) and to determine risk factors for FSD among Korean women.

Methods

A preliminary questionnaire-based study in Ansan, Korea, enrolled 935 women between January and December 2010. Participants completed the Female Sexual Function Index and a self-administered survey. Participants were divided into 2 groups: in the recognized group (RG), women were aware of their sexual problems; in the unrecognized group (URG), women were not.

Results

The prevalence of FSD was 46.1% (n = 431). The prevalence of recognized FSD was 21.5% (n = 201), whereas that of unrecognized FSD was 24.6% (n = 230) Younger women showed a significantly more positive attitude toward sex compared with older individuals (P < 0.001). Sexual desire, sexual arousal, dyspareunia, lubrication, and sexual satisfaction were factors of sexual dysfunction in the RG. In the URG, sexual arousal, sexual desire, orgasm, dyspareunia, and sexual satisfaction were identified as significant factors.

Conclusion

Women in the RG had positive attitudes toward sex, whereas those in the URG had negative attitudes. Women who were unsatisfied with their sexual life did not express a need for treatment. The sociocultural background of Korean women should be considered in the diagnosis and treatment of FSD.     

Evaluation of the role of pudendal nerve integrity in female sexual function using noninvasive techniques

OBJECTIVE: Using quantitative sensory testing and a validated questionnaire, we investigated the role of pudendal nerve integrity in sexual function among women. STUDY DESIGN: Participants completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). Vibratory and pressure thresholds were measured at the S2 dermatome reflecting pudendal nerve distribution. RESULTS: A total of 56 women enrolled; 29 (51.8%) were asymptomatic and 27 (48.2%) had 1 or more forms of female sexual dysfunction (total sexual dysfunction) including: desire disorder 16.1%, arousal disorder 26.8%, orgasmic disorder 25%, and pain disorder 12.5%. Age, parity, menopausal status, and body mass index were similar between groups. PISQ scores were lower in symptomatic subjects compared with controls (P < .001). Decreased tactile sensation was found at the clitoris for women with total sexual dysfunction, desire disorder, and arousal disorder. Women with arousal disorder also had decreased tactile sensation at the perineum. CONCLUSION: Pudendal nerve integrity may play a role in female sexual dysfunction.     

The long-term effects of superovulation on fertility and sexual behavior of male offspring in mice

Purpose

To evaluate the long-term effects of superovulation on fertility and sexual behavior of male offspring in mice.

Method

The mice were superovaluted, and the fertility of male offspring (F1 generation and F2 generation) were evaluated in terms of the percentage of plugs and pregnancies, serum testosterone concentrations, and sperm motility. Furthermore, the sexual behavior of male offspring and sex ratio (F1 generation and F2 generation) were measured.

Results

There were no significant differences in the percentage of plug and pregnancies, serum testosterone concentrations, sperm motilities and sex ratio between the offspring in naturally conceived group and superovulation groups (both F1 generation and F2 generation). The sperm hyperactivity at 90 min after incubation of F1 generation in naturally conceived group were higher than that of F1 generation in superovulation group, but the differences did not reach statistical significance. The offspring produced by superovaluted oocytes (both F1 generation and F2 generation) did not exhibit significant alterations in sexual behavior.

Conclusions

No significant alterations were found in fertility and sexual behavior of male offspring in mice produced by superovaluted oocytes compared with those of naturally conceived offspring.