Alcohol use as predictor for infertility in a representative population of Danish women

BACKGROUND: Our aim was to examine the association between use of alcohol and subsequent incidence of primary infertility. METHODS: The study subjects were chosen from a population-based cohort of Danish women aged 20-29 years. Eligible women were nulliparous and not pregnant (n = 7760). Information on alcohol intake and potential confounders (age, education, marital status, diseases in the reproductive organs, and cigarette smoking) was assessed at enrollment. The incidence of fertility problems during follow-up was obtained by record linkage with the Danish Hospital Discharge Register and the Danish Infertility Cohort Register. Main outcome measures were hazard ratios of infertility according to alcohol intake at baseline estimated in a multivariate Cox proportional hazards model. RESULTS: During a mean follow-up of 4.9 years, 368 women had experienced infertility. Alcohol intake at baseline was unassociated with infertility among younger women, but was a significant predictor for infertility among women above age 30. In this age group, the adjusted hazard ratio for consuming seven or more drinks per week was 2.26 (95% confidence interval: 1.19-4.32) compared with women consuming less than one drink per week. CONCLUSIONS: These findings suggest that alcohol intake is a predictor for infertility problems among women in the later reproductive age group.     

Magnesium intake and status and pregnancy outcome in a Danish population

OBJECTIVE--To investigate the relation between pregnancy outcome and magnesium intake and status. DESIGN--A prospective observational study in which the estimate of nutrient intake and serum samples were obtained before the final outcome of pregnancy was known. A second part of the investigation was a cross-sectional comparison of magnesium status of normal pregnant women and women with certain pathological pregnancies. SETTING--Antenatal clinic associated to the University Clinic of Obstetrics and Gynaecology, University of Aarhus, Denmark. SUBJECTS--1203 consecutive women in the 30th week gestation were invited to participate in the study, 991 (82.4%) accepted and records for 965 (80.2%) were available for analysis. DATA--Food intake data were collected by a combination of a self administered questionnaire and a structured interview of a dietary history type. Serum samples were obtained from blood withdrawn in the 30th and 37th week gestation. Obstetric data were collected from the midwifery and hospital records. For a second part of the investigation, biopsies from the uterus and the abdominal rectus muscle were obtained from women delivered by caesarean section. RESULTS--In the women with normal pregnancies and in the three groups of pathological pregnancies (pre-eclampsia, SGA-infants and preterm labour) the average magnesium intake was within the range of 200 to 208 mg per 1000 kcal per day (SD 32) and there were no differences between the groups. Neither were differences in serum magnesium observed. Birthweight for gestational age was not influenced by magnesium intake. No differences in magnesium status as assessed by determination of magnesium content in muscle biopsies were found between the normal pregnancies and women with pre-eclampsia, SGA-infants or preterm labour. CONCLUSION--The intake of magnesium seemed adequate, and pre-eclampsia, SGA-infants, or preterm labour did not seem associated with a low dietary intake of magnesium or magnesium deficiency. Routine magnesium supplementation during pregnancy is not recommended for populations of relative good socio-economic status.     

The elevated risk for violence against cohabiting women: a comparison of three nationally representative surveys of Canada

This study examined cohabiting women's elevated risk for male partner violence. It was predicted that an increased rate of cohabitation would be accompanied by a reduction in the bias toward selection into cohabitation and that this would result in greater similarity between characteristics of cohabiting and marital relationships as well as in their respective rates of violence. The results were generally consistent with this prediction. Cohabitation increased in Canada between 1993 and 2004, which appeared to have been reflected in some reduction in differences in selection and relationship variables as well as in lower rates of violence for cohabiting relative to married women. Nevertheless, persons who cohabited remained a select group and several relationship differences persisted. These selection and relationship differences accounted for the persistence of cohabiting women's elevated odds of violence in each survey. Results suggested that rates of violence in cohabiting and marital unions should eventually converge.     

Sexual dysfunction after a first trimester induced abortion in a Chinese population

Objective

To evaluate the short-term effect of a first trimester induced abortion on sexuality in a Chinese population.

Study design

This is a cross-sectional study. One hundred and four women attending the post-abortion clinic 3–4 months after a first trimester induced abortion were recruited. They completed a self-administered questionnaire anonymously. The associations of various factors with sexual behavior after abortion were analyzed by the Chi-square test.

Results

More than 30% of the women reported a reduction in both frequency of vaginal intercourse and sexual desire. Their partners also had a reduction in sexual desire. The reduction of vaginal intercourse is more significant among young, unmarried women and those not having sterilization (P = 0.01). In addition, the prevalence of reduction in sexual desire and enjoyment among those women who had repeated abortion was significantly higher (P < 0.01).

Conclusion

The sexuality of both women and their partners are affected after abortion. It may be due to both psychological trauma and the worry of another unwanted pregnancy. Proper counseling may relieve their anxiety and improve sexual lives.     

The Female Genital Self-Image Scale (FGSIS): results from a nationally representative probability sample of women in the United States

IntroductionOver the past two decades, an expanding body of research has examined women's and men's genital self‐image. Support for the reliability and validity of the 7‐item Female Genital Self‐Image Scale (FGSIS) has been found in a convenience sample of women.AimsThe purpose of this study was to assess the reliability and validity of the FGSIS, its model of fit, and its association with women's scores on the Female Sexual Function Index (FSFI) in a nationally representative probability sample of women in the United States ages 18 to 60. A second purpose was to assess the temporal stability of the scale in a subset of this sample.MethodsA nationally representative sample of 3,800 women ages 18 to 60 were invited to participate in a cross‐sectional Internet‐based survey; 2,056 (54.1%) participated.Main Outcome MeasuresDemographic items (e.g., age, race/ethnicity, marital status, sexual orientation, geographic region), having had a gynecological examination in the past year, having performed a genital self‐examination in the past month, frequency of masturbation in the past month, vibrator use in the past month, the FGSIS, and the FSFI.ResultsAn abbreviated 4‐item version of the scale, the FGSIS‐4, was a better fit to the data than the original 7‐item scale. Women's scores on the FGSIS‐4 were significantly related to vibrator use, frequency of masturbation, having had a gynecological exam in the past year, having performed genital self examination in the past month, and all FSFI subscales.ConclusionMost of the participants felt generally positively about their genitals and female genital self‐image was significantly related to female sexual function, women's sexual behavior and their sexual and genital healthcare behaviors. In addition, the FGSIS‐4 has evidence of reliability, validity, and temporal stability in a nationally representative probability sample of women in the United States. Herbenick D, Schick V, Reece M, Sanders S, Dodge B, and Fortenberry JD. The female genital self‐image scale (FGSIS): Results from a nationally representative probability sample of women in the United States.     

HPV infection among women in a representative rural and suburban population of the USA

Objective

To study the prevalence of low-risk and high-risk HPV genotypes in a largely suburban, non-Hispanic, white female population of the USA, and to determine the positive predictive value of one-occasion HPV detection and genotyping using high-grade squamous intraepithelial lesion (HSIL) cytology as the endpoint for clinical evaluation.

Methods

HPV DNA present in liquid-based cytology specimens collected by gynecologists in private practice was amplified using nested polymerase chain reaction. HPV DNA was validated by signature DNA sequencing for accurate genotyping.

Results

Of 2633 specimens, 278 were positive for HPV DNA of any genotype. Among 255 single HPV infections, the most prevalent genotype was HPV-16 (n = 50; 19.6%), followed by HPV-52 (n = 24; 9.4%). Only 10 specimens, all positive for a high-risk HPV, were associated with an HSIL cytology result. Among them were 6 of the 50 specimens (12%) tested positive for HPV-16. One novel HPV-39 variant was detected in repeat testing in a patient with persistent HPV infection.

Conclusion

DNA sequencing is a useful method for increasing the specificity of HPV genotyping as an aid to follow persistent high-risk HPV infections to reduce excessive colposcopies in populations with low cancer prevalence.     

Relationship between complementary and alternative medicine use and incidence of adverse birth outcomes: An examination of a nationally representative sample of 1835 Australian women

Objectivethere is evidence of high use of complementary and alternative medicine (CAM) by pregnant women. Despite debate and controversy regarding CAM use in pregnancy there has been little research focus upon the impacts of CAM use on birth outcomes. This paper reports findings outlining the incidence of adverse birth outcomes among women accessing CAM during pregnancy.Designa survey-based cohort sub-study from the nationally-representative Australian Longitudinal Study on Women׳s Health (ALSWH) was undertaken in 2010.Participantswomen (aged 31–36 years) who identified in 2009 as pregnant or recently given birth (n=2445) from the younger cohort (n=8012) of ALSWH were recruited for the study.Measurements and findingsparticipants׳ responses were analysed to examine the relationship between use of CAM and adverse birth outcomes from their most recent pregnancy. Of the respondents (n=1835; 79.2%), there were variations in birth outcomes for the women who used different CAM. Notably, the outcome which was most commonly associated with CAM use was emotional distress. This was found to occur more commonly in women who practised meditation/yoga at home, used flower essences, or consulted with a chiropractor. In contrast, women who consulted with a chiropractor or consumed herbal teas were less likely to report a premature birth, whilst participation in yoga classes was associated with an increased incidence of post partum/intrapartum haemorrhage.Key conclusionsthe results emphasise the necessity for further research evaluating the safety and effectiveness of CAM for pregnant women, with a particular focus on birth outcomes.Implications for practicehealth professionals providing care need to be aware of the potential birth outcomes associated with CAM use during pregnancy to enable the provision of accurate information to women in their care, and to assist in safely supporting women accessing CAM to assist with pregnancy, labour and birth.     

Taiwanese version of the EQ-5D: validation in a representative sample of the Taiwanese population.

BACKGROUND/PURPOSE: We know of no validated Taiwanese-language instrument to measure a utility of the patient's health. Our aim was to evaluate the reliability and validity of a Taiwanese version of the EuroQol instrument (EQ-5D) in a Taiwanese population. METHODS: Questionnaires containing the Taiwanese versions of the EQ-5D and the Short-Form 12 Health Survey (SF-12) were sent to 12,923 people in Taiwan in December 2002. Concurrent validity of the EQ-5D was analyzed by assuming that subjects with problems in any EQ-5D dimensions had decreased SF-12 scores. Discriminant validity of the EQ-5D was analyzed by assuming that subjects with the following characteristics had lowered EQ-5D indexes and scores on the EQ-5D visual analog scale (VAS): more chronic diseases than others, serious illness, more hospitalizations in the past year than others, poor general health, and more outpatient visits than others. Test-retest reliability was analyzed in a subgroup of respondents who were evaluated twice within a month by using the intraclass correlation coefficient and the kappa method. RESULTS: The general survey response rate was 12.7% (1644 of 12,923). SF-12 scores were lower in subjects reporting problems on EQ-5D dimensions than in others without such problems (p < 0.01). Subjects with more health problems than others had lower EQ-5D indexes and VAS scores (p < 0.01). The physical dimension of the EQ-5D was more strongly correlated with the SF-12 Physical Component Summary than with the Mental Component Summary; this finding satisfied the a priori hypothesis. For test-retest reliability of items on the EQ-5D, kappa values ranged from 0.49 to 1 (p < 0.001). CONCLUSION: The Taiwanese EQ-5D instrument appears to be a moderately valid and reliable tool for measuring the health status of the general population in Taiwan.     

Sexual dysfunction in patients with chronic hand eczema in the Turkish population

IntroductionHand eczema can cause considerable psychosocial disorders, such as anxiety, depression, and difficulties at work, and it may also cause sexual dysfunction.AimThe aim of this study was to investigate sexual function in patients with hand eczema and to find out whether concomitant depression has an additional negative effect on sexual function in these patients.Main Outcome MeasuresSexual functions were evaluated in hand eczema patients.MethodsNinety-one female (43 patients vs. 48 controls) and 79 male (45 patients vs. 34 controls) subjects were enrolled in the study. Hand eczema severity index was used to determine severity of hand eczema. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were used to assess sexual function. Quality of life was assessed with the Dermatology Life Quality Index. Diagnosis of depression was made based on the Structured Clinical Interview for the DSM-IV, while the Hamilton Depression Rate Scale was used for grading depression.ResultsAmong 43 female subjects with hand eczema, 26 had depression (60.46%); of the 45 male patients, 11 had depression (24.44%). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with controls (20.84 ± 9.19 vs. 24.04 ± 3.40, P < 0.05). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with those without depression (20.84 ± 9.19 vs. 22.23 ± 5.82, P < 0.05). IIEF total score was also found to be significantly decreased in male patients with or without depression compared with controls (52.36 ± 14.83 vs. 59.88 ± 5.65 vs. 62.03 ± 11.04, P < 0.05).ConclusionsThe results of the study demonstrated that patients with hand eczema had sexual dysfunction, and concomitant depression had an additional negative effect on sexual dysfunction. Patients with hand eczema should be evaluated with regard to sexual function and depression to provide a better quality of life. Ergün M, Türel Ermertcan A, Öztürkcan S, Temeltaş G, Deveci A, and Dinç G. Sexual dysfunction in patients with chronic hand eczema in the Turkish population.     

Gepirone-ER treatment of low sexual desire associated with depression in women as measured by the DeRogatis Inventory of Sexual Function (DISF) fantasy/cognition (desire) domain--a post hoc analysis

IntroductionGepirone‐extended release (ER) is effective in treating hypoactive sexual desire disorder (HSDD), as measured by the percent of females with HSDD that no longer met criteria for HSDD treatment. Another approach is to determine treatment effect on sexual desire using a recognized rating scale for sexual function. Because gepirone‐ER has antidepressant and anxiolytic effects, investigation of these effects on sexual desire is appropriate.AimThe aim of this study was to determine whether gepirone‐ER has positive effects on sexual desire as measured by the DeRogatis Inventory of Sexual Function (DISF) in a post hoc analysis of 8‐ and 24‐week studies and if this gepirone effect is independent of its antidepressant or anxiolytic activity.Main Outcome MeasuresThe main outcome measures used for this study were the Hamilton Depression Rating Scale (HAMD‐25), change from baseline (CFB), and DISF CFB.Methods:Three hundred thirty‐four women selected for depressive symptoms, not sexual dysfunction, received gepirone‐ER (40–80 mg/day) in a controlled study of atypical depression using the HAMD‐25 to measure antidepressant efficacy and a DISF subscale (domain I) to measure sexual cognition/fantasy (desire). After treatment, a 50% reduction from baseline HAMD‐25 score identified antidepressant responders. Item 12 of HAMD scale (psychic anxiety) was used to define anxiolytic response scores of 0, 1 as responders, and scores of 2, 3, and 4 as nonresponders.Results:Gepirone‐ER had no significant antidepressant or an anxiolytic effect in study 134006; however, DISF results demonstrate that gepirone‐ER improves sexual desire in short term (P = 0.043) and long term (P = 0.006). Both gepirone‐ER antidepressant and anxiolytic responders have statistically significant improved sexual desire. Gepirone‐ER antidepressant and anxiolytic nonresponders also show statistically significant improvement.ConclusionsIn depressed women, gepirone‐ER has three mechanisms of action affecting sexual desire: an antidepressant effect, an anxiolytic effect, and a pro‐sexual effect. Gepirone‐ER improves sexual desire from the 24th to the 50th percentile according to population norms for the DISF. Fabre LF, Smith LC, and DeRogatis LR. Gepirone‐ER treatment of low sexual desire associated with depression in women as measured by the DeRogatis inventory of sexual function (DISF) fantasy/cognition (desire) domain—A post Hoc analysis. J Sex Med 2011;8:2569–2581.     

Content validity of the Female Sexual Function Index (FSFI) in pre- and postmenopausal women with hypoactive sexual desire disorder

IntroductionThe Female Sexual Function Index (FSFI) has consistently been shown to have discriminant validity, test–retest reliability, and internal consistency as a measure of female sexual function. However, the content validity (relevance, clarity, comprehensiveness) of the instrument in women with hypoactive sexual desire disorder (HSDD) must also be established.AimThe aim of this study were to assess the content validity of the FSFI, specifically the FSFI desire domain, in pre‐ and postmenopausal women with HSDD.MethodsTwo single‐visit content validation studies were conducted in the United States. Eligible premenopausal (both studies) and postmenopausal (second study only) women with HSDD completed the FSFI followed by one‐on‐one, face‐to‐face cognitive debriefing interviews including open‐ended questions to capture information on their perceptions of the instrument. Information on women's experiences of decreased sexual desire was also captured.Main Outcome MeasuresThe main outcome measures of this study were the women's ratings of the clarity, ease of understanding, comprehensiveness, and relevance of the 19 items of the FSFI.ResultsInterviews with 15 premenopausal women (first study), and 30 pre‐ and 31 postmenopausal women (second study), were analyzed. Across the whole sample, most women (80–100%) found every item of the FSFI clear and easy to understand. The majority (53–70%) felt that the FSFI captured all their feelings about decreased sexual desire and other sexual problems, and most (84–90%) indicated that additional questions were unnecessary. Most women in both studies (93–100%) reported that the two items comprising the FSFI desire domain were clear, easy to understand, and were relevant to them. The majority of women thought that a recall period of ≥7 days is most relevant for recall of their sexual desire.ConclusionsThese studies establish the content validity of the FSFI in pre‐ and postmenopausal women with HSDD, supporting the use of this instrument as a measure of sexual function in women with this condition. Revicki DA, Margolis MK, Bush EN, DeRogatis LR, and Hanes V. Content validity of the female sexual function index (fsfi) in pre‐ and postmenopausal women with hypoactive sexual desire disorder (HSDD). J Sex Med 2011;8:2237–2245.