女性性功能障碍与不孕

女性性功能障碍(female sexual dysfunction,FSD)发病率较高,国内妇女达70%左右,国外妇女为20%～50%.90%FSD为心理因素引起[1].不孕症(infertility)近年来发病率也呈上升趋势,有10%～20%为不明原因的不孕症[2].在临床工作中,女性不孕因素以排卵障碍及输卵管因素为主,对女性性功能障碍很少提及.为揭示不明原因的不孕症是否与FSD有关,现就女性性功能障碍及其与不孕之间的相互关系综述、分析如下.     

登封市农村不孕症夫妇家庭暴力的现况研究

目的:了解河南省登封市农村不孕症家庭中家庭暴力发生的现状和影响因素,为制定反家庭暴力的策略提供科学依据。方法:于2004年4~6月采用整群抽样方法,对687对河南省登封市农村患不孕症夫妇进行横断面调查。结果:登封市农村不孕症夫妇中过去一年家庭暴力粗发生率为10.48%,其中40.28%是重型暴力,48.61%是躯体暴力。在遭受家庭暴力的妇女中,生殖道感染的发生频率高于没有遭受家庭暴力的妇女,而且有家庭暴力的家庭更倾向于不要小孩。家庭暴力的发生与低文化程度、抱养小孩、与公公婆婆住在一起有密切的关系。家庭暴力相关的知识水平在遭受家庭暴力的家庭中较低,态度更消极。结论:登封市农村家庭暴力发生率较高,重型暴力的构成比也很高,且对家庭暴力和不孕症的相关知识还存在一些误解和消极态度。家庭暴力的发生与文化程度较低、没有小孩(抱养小孩)、家庭关系及保守观念和态度有密切的关系。家庭暴力对女性的生殖健康有一定的影响。     

武汉市社区妇女家庭暴力与创伤后应激障碍的相关性研究

目的 了解武汉市社区妇女家庭暴力的流行特征，分析家庭暴力与创伤后应激障碍（PTSD）的关系，为提高女性心理健康水平提供依据。方法 采用横断面研究方法，以在武汉市某社区卫生服务中心进行妇科检查的女性作为研究对象，调查其一般特征、社会支持、伤害情况、家庭暴力及PTSD流行情况。采用 χ²检验、t检验、Cochran-Armitage趋势检验分析PTSD组与健康组间差异，logistic回归分析PTSD与家庭暴力的关系。结果 家庭暴力终身发生率为29.36%，心理暴力、身体暴力和性暴力的发生率分别为28.28%、6.60%和3.55%；PTSD的总患病率为4.73%。遭受家庭暴力的女性患PTSD的风险是未遭受暴力女性的2.11倍（OR=2.11，95%CI：1.04～4.29）；同时遭受身体与心理暴力的女性发生PTSD的风险是未受暴力女性的5.06倍（OR=5.06，95%CI：1.91～13.42）。结论 家庭暴力与PTSD存在较强的相关性，对遭受家庭暴力的妇女应进行心理疏导，降低PTSD的发生风险。     

丈夫态度及社会支持对乳腺癌患者性功能障碍的影响

目的了解乳腺癌患者性功能障碍的发生情况及其与丈夫态度和社会支持间的相关性。方法采用女性性功能指数(FSFI)对2016年8月-2017年2月就诊于唐山市人民医院的303例乳腺癌患者进行评定。结果 303例患者FSFI得分平均(15.69±11.77)分,存在性功能障碍者占77.23%,主要障碍类型及发生率是性欲低下(70.6%)、性唤起困难(71.9%)、阴道润滑度降低(82.5%)、性高潮困难(78.5%)、性满意度降低(68.6%)和性交痛(68.6%)。年龄、临床分期、社会支持度、婚姻满意度、丈夫的性态度及丈夫对疾病的认知程度是患者性功能障碍的影响因素(P0.05)。结论应通过改善丈夫态度和提高社会支持水平来改善乳腺癌患者性功能,使患者放下心理包袱,重获高质量生活。     

农村地区家庭暴力发生情况及影响因素分析

目的了解我国农村地区家庭暴力发生情况及其影响因素。方法2004年11月～2005年1月．在联合国人口基金生殖健康／计划生育第五周期3个项目县，采用多阶段容量比例抽样方法，随机抽取25个乡镇．3998名18岁及以上的已婚育龄妇女进行定量问卷调查。这3个项目县分别为吉林东辽县、安徽居巢区和重庆铜梁市。结果我国部分农村地区家庭暴力发生率为65．0％．精神暴力最为常见。其次是躯体暴力，性暴力发生率相对较低，分别为58．3％．29．8％，16．9％。生活中的暴力经历与家庭暴力的发生有非常显著的关联，妇女年幼时经历过或看到、听到过家庭暴力者，其遭受家庭暴力伤害的危险明显增高．但妇女的个人特征与家庭暴力发生之间没有明显关系。结论在我国家庭暴力普遍存在，尤其是精神暴力。生活中的暴力经历对家庭暴力发生有重要影响。应该加强宣传教育．提高对家庭暴力的普遍性的认识，以减少暴力发生。     

上海市流动人口已婚妇女对家庭暴力的态度及其影响因素

目的：了解上海市流动人口已婚妇女对家庭暴力的态度以及相关影响因素,为制定干预措施提供依据。方法：本研究为横断面调查,采用同性别调查员匿名面对面访谈形式进行问卷调查,共收回有效问卷958份。用SAS9.1软件对数据进行统计分析。结果：80.8%调查对象同意“任何情况下,丈夫都不应该打妻子”,15.7%妇女认为“丈夫发现妻子对他不忠时,可以打妻子”,11.1%妇女同意“妻子不孝敬公公婆婆时,可以打妻子”;17.1%的妇女不同意“妻子自己不想要时,可以拒绝与丈夫过性生活”。多因素分析结果显示,年龄越大,由父母亲戚介绍/相亲方式结婚的研究对象更容忍家庭暴力,而文化程度越高的对象越反对家庭暴力。结论：上海市流动人口已婚妇女对家庭暴力态度较积极,但仍有部分流动人口已婚妇女对家庭暴力仍存在错误认识,需要加强对其进行性别平等意识、家庭暴力意识及反家庭暴力意识的宣传教育,提高她们预防和制止家庭暴力的能力。     

妻子性冷淡,丈夫也有责

一些女性对性生活的态度不积极,与丈夫缺乏对妻子爱抚的自觉、耐心和知识有关。例如,有的丈夫只求自己满足,对妻子在性生活方面的感觉和心态从不关心,妻子得不到满足,久而久之,产生性压抑,从压抑发展到厌恶,甚至拒绝丈夫的性要求。有研究认为,常见女性性功能障碍有性欲低落、性交困难、性高潮障碍等。造成这些障碍的原因,除需要妇科检查和治疗的器质性的     

外来已婚育龄妇女对身体暴力的应对情况分析

目的:了解外来已婚育龄妇女对身体暴力的应对情况和需求。方法:2010年4~5月在上海市某中心城区采用以社区为基础的多阶段整群抽样方法对符合条件的流动人口已婚育龄妇女961人进行问卷调查,对遭受丈夫身体暴力的103名妇女进行分析。结果:遭受过轻度身体暴力和重度身体暴力的比例分别为66.6%和33.4%。41.9%的受暴对象在遭受身体暴力时没有对丈夫进行过任何反击,59.1%的受暴对象没有将自己遭受暴力的情况告诉过任何人,受暴妇女主动告知及希望获得帮助的对象主要是家人/亲戚/朋友,仅少数对象主动报警和(或)诉诸妇联/居委会等相关机构希望获得帮助。认为"家丑不可外扬"是她们不向外界寻求帮助的最主要原因。结论:遭受丈夫身体暴力的妇女进行反击和向外界寻求帮助的比例较低,应加强对外来已婚育龄妇女反对和制止家庭暴力的宣传,改变她们对家庭暴力的认识,提高她们的维权意识及自我保护能力。     

了解不孕不育症

妊娠是一个复杂的过程,即使是完全有生育能力的夫妇,在不避孕的规律的性生活期间,怀孕的机会也仅为一个月经周期的20～25%。调查数据显示:我国大约有10～15%的夫妇患有不孕症,即每六对夫妇中就有一对经历过不同程度的不孕以及所承受的精神压力和自卑感。引起不孕的原因。首先讲一下女性不孕因素:输卵管情况是绝对不能被忽略的环节,因为,输卵管有运送精子、捡拾卵子及将受精卵送回     

女性如何预防后天性生育障碍

正妇女不孕,主要是由输卵管、盆腔因素(包括炎症、结核、子宫内膜异位症)等内因,以及工作和生活不良习惯等外因,造成的生育障碍。据初步估计,在不孕症人群中,男性因素约占40%,女性因素约占40%,不明原因占20%。女性因自身发育导致不孕症的真凶是排卵障碍,如患有阴道炎、宫颈炎、盆腔炎、输卵管炎等,导致输卵管阻塞。此外,还有多囊卵巢综合征、子宫内膜异位症、宫颈疾病等排卵障碍等。从外部环境来看,落     

Do changes in spousal employment status lead to domestic violence? Insights from a prospective study in Bangalore,India

The prevalence of physical domestic violence – violence against women perpetrated by husbands – is staggeringly high across the Indian subcontinent. Although gender-based power dynamics are thought to underlie women's vulnerability, relatively little is known about risk and protective factors. This prospective study in southern India examined the association between key economic aspects of gender-based power, namely spousal employment status, and physical domestic violence. In 2005–2006, 744 married women, aged 16–25, residing in low-income communities in Bangalore, India were enrolled in the study. Data were collected at enrollment, 12 and 24 months. Multivariable logistic regression models were used to examine the prospective association between women's employment status, their perceptions of their husband's employment stability, and domestic violence. Women who were unemployed at one visit and began employment by the next visit had an 80% higher odds of violence, as compared to women who maintained their unemployed status. Similarly, women whose husbands had stable employment at one visit and newly had difficulty with employment had 1.7 times the odds of violence, as compared to women whose husbands maintained their stable employment. To our knowledge, this study is the first from a developing country to confirm that changes in spousal employment status are associated with subsequent changes in violence risk. It points to the complex challenges of violence prevention, including the need for interventions among men and gender-transformative approaches to promote gender-equitable attitudes, practices and norms among men and women.     

Sexual Violence Towards Married Women in Bangladesh

This article explored the magnitude and nature of within marriage sexual violence against women and factors associated with physically forced sex by husbands in urban and rural Bangladesh using population-based survey data from 2001 (n = 2,702). Results showed high prevalence of lifetime sexual violence: 37 % in urban and 50 % in rural areas. An overwhelming majority of the women reported being sexually abused by husbands more than once. Logistic regression analyses revealed that six out of ten independent variables included in the models were significant. The factors positively associated with physically forced sex by husbands during the last 12 months were: history of physical abuse of husband’s mother by his father; level of controlling behavior by husband; and forced or coerced first sex. Women’s age (20–24 compared to 15–19) and dowry demand at marriage increased the likelihood of this violence in the rural area. Urban women in the second and third income quartiles were more likely to be exposed to this violence compared to women in the first quartile. Results highlight the need for prevention programs targeting men, which would help at the same time to break the cycle of intergenerational exposure and thereby transmission of violence. Notions of gender equality; women’s sexual rights; and women’s right to consent and choice need to be widely promoted particularly among men.     

Domestic violence against 116 Turkish housewives: a field study

In order to clarify the factors associated with domestic violence against married women and to learn the attitude of women toward violence and toward the inquiry of health personnel about domestic violence, a cross-sectional survey was conducted on 116 married Turkish women. The prevalence of domestic physical violence was found to be 41.4%, emotional violence 25.9%, sexual violence 8.6%, and controlling behavior 77.6%. Physical violence experienced at any time in their life was 50.9%. Rate of physical violence was found related with lower formal education of both women and husbands and their place of birth. The opinion of "husbands must not beat their wives" was more common among women with formal education. Eighty-two percent of women indicated that they would be willing to answer questions regarding domestic violence by health personnel. In conclusion, cultural background and formal education of either woman or man influence the likelihood of imposing or tolerating violent behavior at home. Inquiry about violence may be a routine in women's health care practice, and it is welcome by most women.     

家庭暴力对流动人口已婚育龄妇女性与生殖健康的影响

目的：了解丈夫的身体暴力或性暴力对流动人口已婚育龄妇女性与生殖健康的影响。方法：在上海市某中心城区采用以社区为基础的多阶段整群抽样方法对符合条件的流动人口已婚育龄妇女进行问卷调查,共收回有效问卷958份。结果：曾经或最近1年遭受过身体暴力或性暴力的对象有不良妊娠结局、曾经或最近1年有生殖道感染症状、性生活不和谐、曾经感到缺乏性欲和最近1年感到缺乏性欲的比例显著高于同一时期从未遭受过任何暴力的对象。Logistic回归分析发现,遭受过身体暴力或性暴力的对象有不良妊娠结局、生殖道感染、妇科疾病、性生活不和谐和缺乏性欲的危险性是未遭受过任何暴力对象的2.05～4.79倍。结论：身体暴力或性暴力对流动人口已婚育龄妇女的性与生殖健康状况有显著影响。     

Domestic violence in rural Uganda: evidence from a community-based study

Although domestic violence is an increasing public health concern in developing countries, evidence from representative, community-based studies is limited. In a survey of 5109 women of reproductive age in the Rakai District of Uganda, 30% of women had experienced physical threats or physical abuse from their current partner--20% during the year before the survey. Three of five women who reported recent physical threats or abuse reported three or more specific acts of violence during the preceding year, and just under a half reported injuries as a result. Analysis of risk factors highlights the pivotal roles of the male partner's alcohol consumption and his perceived human immunodeficiency virus (HIV) risk in increasing the risk of male against female domestic violence. Most respondents--70% of men and 90% of women--viewed beating of the wife or female partner as justifiable in some circumstances, posing a central challenge to preventing violence in such settings.     

2016—2018年瑞安市孕产妇艾滋病哨点监测结果分析

目的 了解瑞安市2016—2018年孕产妇艾滋病知晓情况和相关性行为特征,为制定艾滋病防治策略和干预措施提供依据。 方法 对2016—2018年每年4—7月期间首次到瑞安市妇幼保健院进行孕产期保健的孕产妇进行问卷调查,并采血进行HIV抗体、梅毒抗体、HCV抗体血清学检查。 结果 2016—2018年共监测孕产妇1 200人,其艾滋病知识总体知晓率86.25%,各年度分别为82.00%、85.00%、91.75%,呈逐年上升趋势(χ²＝16.82,P＜0.001)。年龄大于25岁、文化程度越高、初次孕产及生育次数越少者知晓率越高。孕产妇本人和其丈夫去过外地打工经商的比例分别为16.08%、19.25%,吸毒的比例分别为0.25%、1.16%,丈夫患过艾滋病或性病的占0.08%。孕产妇HIV抗体、梅毒抗体和HCV抗体阳性检出率分别为0、0.17%和0.08%。 结论 瑞安市孕产妇艾滋病HIV感染率总体处于低流行水平,但部分孕产妇存在本人或丈夫吸毒、丈夫患性病等现象,存在感染艾滋病/性病的风险,应当进一步采取有效措施,控制艾滋病/性病在该人群中传播。     

农村地区受暴妇女对家庭暴力的处理情况研究

目的:了解我国农村地区已婚妇女遭受家庭暴力的情况及其对家庭暴力的处理情况。方法:2004年11月~2005年1月期间,在吉林、安徽和重庆的人口基金项目县,采用多阶段容量比例抽样方法选择了25个乡镇,对3 998名18岁及以上的已婚育龄妇女进行问卷调查。结果:我国家庭暴力发生非常普遍,约65%的调查妇女有过暴力经历,但受暴妇女对家庭暴力的处理多采用被动方式,即便获取他人帮助时,大多也是身边的人,对妇联、公、检、法司及医疗机构等政府部门在反家暴中的作用了解较少。医疗系统在反家暴中存在很多问题,缺乏对家庭暴力的敏感性和应对能力。结论:在我国家庭暴力非常普遍,受暴妇女对家庭暴力的处理方面存在一定的缺陷,需要加大宣传教育力度,增强受暴妇女及相关部门特别是医疗机构正确处理和应对家庭暴力的能力。     

Violence against women in Ghana: a look at women's perceptions and review of policy and social responses

This study examines violence against women in Ghana and how it affects and is perceived by them. It looks at violence as experienced by Ghanaian women of varying ages, socio-economic status and professional standing. It defines domestic violence as violence intentionally perpetrated by husbands or male partners--people known to be intimate associates. Domestic violence is approached from a multidimensional perspective by examining the multiple facets of violence against women: sexual, socio-economic, cultural, pseudo-religious and mental torture. Women's perceptions of their rights, responsibilities, duties and abuses or violations are evaluated using open-ended qualitative questions in two major cities in Ghana: Accra and Kumasi. Policy responses to domestic violence are then examined by first reviewing what provisions exist in the country's constitution to address the problem and then the specific steps the government itself has taken. Civil society's response in the form of activities by non-governmental organizations is also reviewed. Finally, the effects of domestic violence on women's health and well-being are examined and suggestions for addressing the problem are made.