Oral contraceptives and breast cancer among African-american women and white women

The higher incidence of breast cancer among African-American women younger than 50 as compared to white women points to the need to examine exposures that are common among younger women, including exposure to oral contraceptives (OC). We examined patterns of OC use and their associations with breast cancer in a population-based, case-control study conducted in North Carolina between 1993 and 1996. The study population was comprised of 858 cases and 789 controls, of whom 40% were African-American women. There was little evidence that breast cancer was associated with OC use among older women (age >50) of either race, most of whom discontinued use in the distant past. Among younger women, there was a modest, but nonsignificant, increase in risk associated with ever use of OCs for both African-American and white women. There was a trend of increasing risks with more recent use among African-American women, whereas no such trend was apparent for white women. Overall, we found more substantial age differences than race differences in patterns of OC use and the risk of breast cancer associated with their use. The similarity of the associations between African-American and white women suggest that racial differences in breast cancer incidence are not likely to be attributable to OC use.     

White women and HIV

Most HIV prevention programs that target women tend to focus on black and Latina women, the two groups of females hardest hit by HIV. However, significant numbers of white women are infected, and fewer outreach programs are available to them. Women overall represent 32 percent of all adult cases of AIDS, and 23 percent of those women are white. Patterns of risk and infection rates among this group are discussed. A number of HIV-positive women are interviewed, and they present their personal experiences of living with HIV, including how they were infected, difficulties they have faced in relationships with healthcare providers, and the lack of support they have felt. Prevention and outreach ideas are presented, and a list of service organizations for women is included.     

Intoxication and violent women

Alcohol and drugs have been linked to severe violent offending among women as well as men. The purpose of this study was to make a contribution to the limited knowledge of characteristics related to the state of intoxication in violent female offenders. The putative differences in the characteristics of female offenders and their violent offenses in relation to the state of intoxication at the time of the violent offending were examined. Of a nation-wide sample of 109 female offenders found guilty of homicide and other violent crimes and incarcerated in 1999–2000 in Finland, 60 offenders participated in the study. Of these offenders 49 (81.7%) had been intoxicated at the time the of index offenses. These were compared with 11 (18.3%) non-intoxicated offenders using a structured interview, the Structured Clinical Interview II for DSM-IV (SCID-II) and the Hare Psychopathy Checklist-Revised (PCL-R). The prevalence of substance abuse or dependence (73.3% and 0%), personality disorder (89.6% and 36.4%), particularly antisocial personality disorder (66.7% and 0%), as well as a history of criminality (69.4% and 0%) were significantly higher among the intoxicated women than among the non-intoxicated. The PCL-R scores were also significantly higher among the intoxicated offenders than among non-intoxicated offenders. The victims of the intoxicated women (23.9%) were less often emotionally close to the perpetrator than were the victims of the non-intoxicated women (66.6%). No differences emerged between the groups in experiences of childhood and adulthood abuse or stressful life events prior to the index crime. The findings indicate that intoxicated violent female offenders exhibit more of the characteristics previously found in violent men, than do the non-intoxicated female offenders. Moreover, the non-intoxicated group comprises both psychotic non-responsible and non-psychotic, fairly well-adjusted women, who are educated, working or studying at the time of the offense and has no history of criminality. Substance misuse constitutes an obvious risk factor for violent behavior in women, and therefore the prevention should include substance abuse treatment.     

Comparison of fundamental voice frequency between menopausal women and women at menacme

OBJECTIVE: To analyze comparatively the speaking fundamental frequency (F0) between women at menacme and women in the climacterium taking or not hormonal replacement therapy. METHODS: A controlled transverse study was conducted on 45 women divided into three groups of 15 women each: Group A (women aged 20-40 years with regular menstrual cycles taking no hormonal contraceptives), Group B (women aged 45-60 years with a duration of menopause of at least 2 years taking 1mg estradiol valerate +90 microg norgestimate per day in a continuous treatment scheme lasting at least 6 months), and Group C (women aged 45-60 years with a duration of menopause of at least 2 years taking no HRT for at least 6 months). The mean age for Groups A, B and C was 30.3, 54.5 and 56.5 years, respectively. The groups were analyzed comparatively regarding F0 values for the sustained vowels /e/ and /i/. RESULTS: Mean F0 for the sustained vowels /e/ and /i/ were 215.97 and 229.89 Hz, 206.21 and 221.79 Hz, 200.71 and 212.79 Hz for Groups A, B and C, respectively, with no significant differences between groups. CONCLUSIONS: Although there is evidence of a probable modulating effect of sex steroids on the larynx, in the present study no significant differences in speaking voice were observed regarding menopause or the use of HRT. The absence of such differences observed in F0 does not necessarily mean that there is no difference in vocal quality between these groups since F0 represents only a vocal parameter.     

HIV-positive women and their care

The medical care of HIV-positive women needs to be considered. After initial evaluation, HIV-positive women need to have a genealogical evaluation to determine if any conditions are present which may be difficult to treat or may have a more accelerated course. Pap smears should be done again after 6 months and then yearly. If CD4 counts fall below 250, pap smears should be done biannually. An abnormal pap smear could be a sign of a genital tract infection, which can cause cervical inflammation. Vaginal candidiasis, a yeast infection in the genital tract, occurs more frequently in women with lower CD4 counts. Some women may need chronic suppressive pill therapy for candidiasis. Human papillomavirus (HPV) also occurs more frequently in HIV-positive women. HPV infection can cause cervical dysplasia, which can only be diagnosed with a pap smear. Left untreated, certain kinds of HPV infections can lead to cervical cancer. Radical surgery and radiation therapy are the two treatments for cervical cancer. HIV-associated wasting may be related to the menstrual problems connected to HIV (i.e., irregular cycles and no menstruation), but this has not been proven. The treatment for female-specific conditions is not differentiated between HIV-positive and HIV-negative women. There are two large-scale national studies following the course of sexually transmitted diseases in HIV-positive and HIV-negative women.     

Self-regulation and women with asthma

PURPOSE OF REVIEW: Recent research related to sex and gender role influences on asthma in women is summarized. Implications for enhancing women's self-regulation and ability to manage asthma effectively are discussed. RECENT FINDINGS: Studies in the past year have indicated that asthma is a significant burden on women and emphasized the importance of control, especially during pregnancy. The significance of hormonal variation in symptoms and severity has been noted. An association between weight and asthma has been observed. Evidence suggests that hormonal changes contribute to the asthma prevalence shift from men to women in adolescence. One study showed positive results of focusing on sex-related and gender-related factors in self-regulation education for women. Recent findings imply that enhancing self-regulation and effective management of asthma in women requires attention to sex and gender role influences in clinical counseling and intervention research. SUMMARY: Clinicians may help female patients with asthma by incorporating sex and gender role related considerations into their clinical consultations. Evidence-based asthma education interventions to assist women with their particular asthma management challenges are needed.     

Nutrition and reproduction in women

Malnutrition is a major problem in developing countries, andobesity and eating disorders are increasingly common in developingas well as developed countries. The reproductive axis is closelylinked to nutritional status, especially undernutrition in thefemale, and inhibitory pathways involving detectors in the hindbrain suppress ovulation in subjects with weight loss. Recoverymay occur after minimal reacquisition of weight because energybalance is more important than body fat mass. Anorexia nervosaand bulimia nervosa affect up to 5% of women of reproductiveage causing amenorrhoea, infertility and, in those who do conceive,an increased likelihood of miscarriage. Obesity can affect reproductionthrough fat cell metabolism, steroids and secretion of proteinssuch as leptin and adiponectin and through changes induced atthe level of important homeostatic factors such as pancreaticsecretion of insulin, androgen synthesis by the ovary and sexhormone-binding globulin (SHBG) production by the liver. WHOestimates that 9 to 25% of women in developed countries areseverely obese, and obese mothers are much more likely to haveobese children, especially if they have gestational diabetes.Obesity-associated anovulation may lead to infertility and toa higher risk of miscarriage. Management of anovulation withobesity involves diet and exercise as well as standard approachesto ovulation induction. Many obese women conceive without assistance,but pregnancies in obese women have increased rates of pregnancy-associatedhypertension, gestational diabetes, large babies, Cesarean sectionand perinatal mortality and morbidity. Among contraceptors,the fear of weight gain affects uptake and continuation of hormonalcontraceptives, although existing trials indicate that any sucheffects are small. For all methods of hormonal contraception,weight above 70 kg is associated with increased failure rates.     

Personality and depression in women

Personality disorders and traits should be assessed in studies concerned with the etiology and treatment of depression in women. There has been a considerable amount of research concerned with the effect of personality functioning on the etiology and treatment of depression, and much of this research has concerned personality traits and disorders for which significant gender differences and issues apply. The importance of personality functioning, and the particular relevance to women and gender-related issues, is illustrated in this paper with regard to dependent personality disorder and dependent personality traits. Implications for future research on the etiology and treatment of depression in women are provided.     

Periodicity and self-actualization in women

Studied the relationship between menstrual cycle phase and self-actualization as measured by the Personal Orientaion Inventory (POI). In classroom testing sessions, 160 high school students completed the POI and personal data sheets, which gave information about their menstrual cycle phase. Premenstrual, menstrual, and midcycle groups of 20 Ss each were formed from those girls cligible for inclusion in each condition. Three one-by-three analyses of variance were run using the TC, I, and TC + I scores of the POI, which were selected as the best overall measures of self-actualization. A significant (p < 0.05) difforence on TC + I was found; subsequent t- tests revealed that the menstrual group's TC + I score was significantly (p < 0.02) higher than that of the midcycle group. The difference between menstrual and premenstrual Ss on TC + I, though not significant, lay in the same direction and was of the same order of magnitude. Possible explanations for the results and implications for future testing that involves females are presented briefly.     

Epidemiology of women and depression

BACKGROUND: Depression is the leading cause of disease-related disability among women in the world today. Depression is much more common among women than men, with female/male risk ratios roughly 2:1. AIMS: Recent epidemiological research is reviewed. Implications are suggested for needed future research. RESULTS: The higher prevalence of depression among women than men is due to higher risk of first onset, not to differential persistence or recurrence. Although the gender difference first emerges in puberty, other experiences related to changes in sex hormones (pregnancy, menopause, use of oral contraceptives, and use of hormone replacement therapy) do not significantly influence major depression. These observations suggest that the key to understanding the higher rates of depression among women than men lies in an investigation of the joint effects of biological vulnerabilities and environmental provoking experiences. CONCLUSIONS: Advancing understanding of female depression will require future epidemiologic research to focus on first onsets and to follow incident cohorts of young people through the pubertal transition into young adulthood with fine-grained measures of both sex hormones and gender-related environmental experiences. Experimental interventions aimed at primary prevention by jointly manipulating putative biological and environmental risk factors will likely be needed to adjudicate between contending causal hypotheses regarding the separate and joint effects of interrelated risk factors.     

Tropical parasitic diseases and women

Tropical parasitic diseases constitute the greatest threat to the health and socio-economic status of women as a gender and social group. There are some gender specific ways in which parasitic diseases affect women in contrast to men due to differences in exposure, occupational risk, sociocultural behavior, gender roles and practices. These parasitic diseases confer some social stigma, which affects the health seeking behavior of women. Women are therefore important in the control of these parasitic diseases and they are key agents of change, if they are included in community control programs. Women need more attention in endemic areas as a group that had been neglected. This deprived and excluded group have got vital role to play, as discussed in this review.     

Dominance and testosterone in women

Fifty-two young women completed the Simple Adjective Test (a questionnaire designed to measure dominance) and at the same time provided 5 ml blood for testosterone assay. Higher dominance scores were associated with higher serum testosterone levels (t-test P<0.008).     

The childhood and family background of women with clinical eating disorders: a comparison with women with major depression and women without psychiatric disorder

BACKGROUND: Childhood antecedents are often put forward as being of possible aetiological significance for both anorexia nervosa and bulimia nervosa. METHOD: Comparisons were made of groups of women with eating disorders with groups of women with major depression or without current psychiatric disorder, using the Childhood Experience of Care and Abuse interview (CECA). RESULTS: Women with bulimia nervosa (or mixed bulimia and anorexia nervosa) tended to report more troubled childhood experiences than did women from the non-morbid comparison group. In this respect, they resembled those with major depression. In contrast, those with anorexia nervosa resembled the non-morbid women rather than the other psychiatric groups. CONCLUSIONS: Adversity in childhood as measured by the CECA may play a part in the causation of bulimia nervosa but not of anorexia nervosa. It remains possible that more specific or subtle family influences may be relevant.     

The climacteric among South-American women,who immigrated to Sweden and age-matched Swedish women

Forty-nine immigrated South-American (SA) and 48 Swedish women, aged 42–67 years, were studied in a comparative semi-structured interview survey, concerning the climacteric and its treatment. The mean age at natural menopause was 47 for the South-American women and 50 for the Swedish women. The prevalence of moderate to severe vasomotor symptoms at the time of the survey did not differ significantly between the non-treated, non-operated, postmenopausal South-American and Swedish women (36% and 21%; N.S.). One reason for the trend towards a higher prevalence among South-American women could be that a greater number of Swedish women used hormone replacement treatment compared to South-American women (11 vs. 4). The general attitude to hormone replacement therapy was more positive among South-American women, although they did not use hormone therapy, as could be expected from their symptoms. These results are probably an illustration of the difficulties in getting access to treatment for the immigrated SA women.     

Menstrual and circadian variations in time perception in healthy women and women with premenstrual syndrome.

A time production test was performed in seven normal females and seven females with premenstrual syndrome (PMS). We used a time production test for six time intervals (6, 12, 24, 36, 48, 60 s). Time production tests were performed at 08:00, 14:00 and 20:00 h in the follicular, early luteal and late luteal phases (LLP), respectively. The results are as follows. (1) Normal females showed diurnal variations in time production only in the follicular phase (FP). In this phase, they overproduced time at 08:00 h suggesting that the interval clock in normal females was slowest in the morning. (2) Normal females showed menstrual variations in time production only at 20:00 h. They overproduced time in the LLP suggesting that the interval clock in normal females was slowest in the LLP. (3) Neither diurnal nor menstrual variation was found in PMS subjects at any menstrual stage or at any time of the day. These results suggest that the interval timing system in normal females is under the control of ovarian steroid hormones and the circadian clock, but the control of ovarian steroid hormone or the circadian clock does not operate in PMS subjects.     

Prevalence of hydrogen peroxide-producing Lactobacillus species in normal women and women with bacterial vaginosis

A predominance of Lactobacillus species in the vaginal flora is considered normal. In women with bacterial vaginosis, the prevalence and concentrations of intravaginal Gardnerella vaginalis and anaerobes are increased, whereas the prevalence of intravaginal Lactobacillus species is decreased. Because some lactobacilli are known to produce hydrogen peroxide (H2O2), which can be toxic to organisms that produce little or no H2O2-scavenging enzymes (e.g., catalase), we postulated that an absence of H2O2-producing Lactobacillus species could allow an overgrowth of catalase-negative organisms, such as those found among women with bacterial vaginosis. In this study, H2O2-producing facultative Lactobacillus species were found in the vaginas of 27 (96%) of 28 normal women and 4 (6%) of 67 women with bacterial vaginosis (P less than 0.001). Anaerobic Lactobacillus species (which do not produce hydrogen peroxide) were isolated from 24 (36%) of 67 women with bacterial vaginosis and 1 (4%) of 28 normal women (P less than 0.001). The production of H2O2 by Lactobacillus species may represent a nonspecific antimicrobial defense mechanism of the normal vaginal ecosystem.