Fertility and fertility preservation: knowledge,awareness and attitudes of female graduate students

Purpose: To evaluate the general knowledge of female graduate students on reproductive aging and fertility preservation options, as well as to investigate the perceptions, personal beliefs, and desires regarding fertility and preservation modalities.

Materials and methods: A cross-sectional online survey study of female graduate students and medical trainees from academic institutions in Ohio was performed. Women were excluded if the online survey was incomplete or if they were?>45 years.

Results: Analysis of 590 surveys was performed (response rate of 26.3%). Ninety-four percent (557/590) of subjects were between 20 and 35 years. Our respondents tended to be nulliparous (87%), married or in a relationship (51%) and interested in future fertility (77%). The reasons cited for delaying childbearing were multi-factorial, with career building noted most commonly (69%). Nearly 60% of women reported they would consider fertility preservation in the future; however, the majority (87%) cited two or more barriers. When asked about their desire for information on fertility preservation, 28% desired to receive education on their choices and 36% wanted their Ob/Gyn to discuss fertility preservation options. Women?>30 years were significantly more likely to desire future fertility, want more fertility preservation education and consider pursuing fertility preservation in the future.

Conclusions: Graduate-level women often delay childbearing for professional pursuits. This study demonstrates a need for increased fertility preservation awareness and education, especially by Ob/Gyn providers.     

Oral contraceptive practices among female medical students of the University of Warsaw

DESIGN: Apparently no researches have been conducted regarding oral contraceptive usage among female medical students in Poland. In the last ten years, all over the world, only five publications have dealt with this topic. OBJECTIVES: The purpose of the research reported in this article was to establish the types, choices and frequency of usage of oral contraceptive pills among female medical students of the University of Warsaw. MATERIAL AND METHODS: 634 female students responded to a specially designed questionnaire. RESULTS: Data collected indicated that, 52.2% of the students have been involved in sexual intercourse. 167 of them used Oral Contraceptive Pills (OCP). Two third survey participants used OCP following a doctors recommendations. CONCLUSIONS: 1.30.5% of the sexually active students used OCP. 2.31.9% of this group of students believed the use of OCP was the most effective of all the contraceptive methods. 3.65.0% of the respondents used OCP following a doctors recommendations. 22.7% of the survey participants used OCP in order to regulate their menstrual cycles. 4. The respondents who reported customary use of OCP cited the most frequently used OCP as: Cilest-28.0%, Mercilon-19.2% and Minulet-13.2%.     

Oral contraceptives and liver hemangioma: a case-control study

OBJECTIVE: To study whether there is an epidemiological association between liver hemangiomas and oral contraception use, as may be suggested by clinical observations of liver hemangioma growth during pregnancy and under estrogen administration. METHODS: A case-control study of 40 women with liver hemangiomas, as diagnosed by imaging studies [ultrasonography (US) or computed tomography (CT) and nuclear scan], and 109 age-matched control with normal studies. The women were interviewed with respect to their menstrual, reproductive and oral contraception use history. RESULTS: The liver hemangioma and control groups did not differ significantly with regard to their menstrual or reproductive history. Ever oral contraception use was reported by 30% of the cases and 27% of controls. The odds ratio (OR) was 1.1 [95% confidence interval (CI) 0.52-2.60] for ever use, 1.64 (95% CI 0.37-7.13) for initiation before the age of 20, and 0.62 (95% CI 0.16-2.42) for use duration of less than 1 year. On the multivariate analysis only the women's age emerged as a predictor for liver hemangiomas (OR 3.1; 95% CI 1.16-8.96). CONCLUSIONS: In this study liver hemangiomas were not associated with menstrual, reproductive and oral contraception use history.     

Oral contraceptives and bone mineral density: A population-based study

OBJECTIVE: We sought to test the hypothesis that exposure to oral contraceptives protects the skeleton. STUDY DESIGN: Multiple regression techniques were used to analyze data for a random sample of 710 Australian women (age range, 20-69 years). Bone mineral density was measured at the lumbar spine, proximal femur, whole body, and distal forearm. Oral contraceptive exposure was assessed by a questionnaire. RESULTS: Women exposed to oral contraceptives had a 3.3% greater mean bone mineral density adjusted for body mass index and age at the lumbar spine (partial r (2) = 0.009; P =.014). Adjusted mean vertebral bone mineral density was 3.3% greater for premenopausal women (partial r (2) = 0.008; P <.05), but the effect did not reach significance among postmenopausal women. Higher bone mineral density was associated with increased duration of exposure, with a mean increase of 3.2% associated with the first 5 years and a further 0.2% with >/=5 years of exposure. No association was detected at other sites. CONCLUSION: Exposure to oral contraceptives may be associated with higher lumbar spine bone mineral density.     

Oral contraceptives and benign breast disease: a case-control study

The relationship between benign breast disease and use of oral contraceptives was analyzed in a case-control study conducted in Milan with 288 cases of clinically relevant and histologically confirmed benign breast disease and 285 age-matched controls with a spectrum of acute conditions apparently unrelated to use of oral contraceptives. Compared to the risk for women who had never used oral contraceptives, the relative risk for users was 1.0 (95% confidence interval: 0.6 to 1.5). There was no significant association with duration of use; however, a significantly lower relative risk was found in women using oral contraceptives during the year before breast biopsy (relative risk: 0.4; 95% confidence interval: 0.2 to 0.8). The protection in current users increased with increasing duration of use. In spite of this finding, the overall results of the present study do not support the hypothesis that oral contraceptive use protects against development of histologically confirmed and clinically relevant benign breast disease.     

Obstetrician-gynecologists' knowledge of and attitudes toward medical abortion in Guatemala

ObjectiveTo characterize the legal and clinical knowledge of Guatemalan obstetrician–gynecologists (OB/GYNs) regarding medical abortion and to determine factors associated with approval of its use for specific indications.MethodsA trained interviewer administered a multiple-choice survey to 172 private-practice OB/GYNs across Guatemala. Univariate, bivariate, and multivariate analyses characterized medical abortion opinion and knowledge, and logistic regression identified influential factors.Results73% of OB/GYNs knew that abortion is legally permitted when the woman's life is at risk. Although 92% knew that misoprostol can be used to induce abortion, only 35% knew the WHO-recommended dosage. Only 25% knew of mifepristone. Compared with older OB/GYNs, those under 40 years of age were 7 times more likely, and 40–49 year olds were twice as likely to approve of medical abortion for fetal death and severe eclampsia with fetal death, respectively.ConclusionCurrent indications for abortion under Guatemalan law, as well as OB/GYN practices and beliefs regarding medical abortion, are hindering women's access to safe medical abortion and, therefore, potential reductions in maternal morbidity and mortality. Future research should aim to identify whether and why Guatemalan OB/GYNs are unfamiliar with these drugs, prefer to use other methods, or are completely against abortion.     

Emergency contraception: knowledge and attitudes of Turkish nursing and midwifery students.

OBJECTIVES: To assess the knowledge and attitudes of emergency contraception (EC) among nursing and midwifery students of a university in the Eastern-Mediterranean region of Turkey. METHODS: The survey was conducted among 210 nursing and midwifery students. RESULTS: One hundred and twenty-five participants (59.5%) knew at least one method of EC. One hundred and fourteen participants (54.3%) had heard about emergency contraceptive pills (ECPs), but only 17 (8.1%) knew what they contained. Rates of hearing about ECPs were statistically higher in third and fourth classes than first and second classes, and in midwifery students than in nursing students (P < 0.001). In spite of their very unsatisfactory level of knowledge, 166 students (79.0%) thought that ECPs should be sold in pharmacies. CONCLUSION: The nursing and midwifery students we assessed have a very insufficient knowledge of EC. Probably therefore, many are prejudiced against it. They should be much better acquainted with this modality of contraception since, after graduation, they will play an important role in the dissemination of information about EC in the population.     

Sexual attitudes and behaviors among medical students in Dokuz Eylul university, Turkey.

Gaining a healthy sexual attitude and behavior and being able to show appropriate approaches to patients in terms of sexual issues are important acquisitions for medical students. The aim of the present study was to determine, compare, and evaluate the sexual attitudes and behaviors of Dokuz Eylul University Faculty of Medicine students. An anonymous questionnaire was filled in by first- and sixth-year students in order to determine their sexual attitudes and behaviors. While information sources in the adolescence period for both genders were friends in the first place, these sources were mostly mothers, books, newspapers--magazines for females, and newspapers--magazines and television for males. The opinion of males about having sexual intercourse before marriage for males was positive, and females were more tolerant about males having this experience before marriage as compared to females having sexual experience before marriage. Rates of expression of having sexual intercourse and masturbation were found to be higher for male students. The first sexual experience with a sex worker or sentimentally insignificant partner was high among males. In general, the rate of condom use was lower, and the rate of coitus interruptus was found to be higher than in foreign studies. All the students declared 'my own will and values' as the most frequent factor affecting their sexual attitudes and behaviors, and high rates for 'social factors', 'religious requirements', 'the expectations of families', and 'protection from sexually transmitted diseases' were observed. The findings lead to the conclusions that gender differences exist in the sexual attitudes and behaviors of medical students; the enhancing effect of the traditional structure on gender discrimination is still continuing; students are not provided with sufficient scientific approach or training prior to the university education; and beyond biomedical training, they should receive more support in those fields during their medical education.     

Oral contraceptives and mortality from circulatory system diseases: an epidemiologic study in Taiwan

An epidemiological study on the association between oral contraceptive (OC) use and circulatory system disease (CSD) mortality undertaken in Taiwan by proxy interview of closest family members of 306 deceased cases, 305 deceased controls, and 611 healthy neighborhood controls indicated that the relative risk between the cases and health controls was 0.98 (0.62-1.54) and that between cases and health controls was 0.82 (0.56-1.21). Use of OC by Taiwanese women has not produced any overwhelming adverse effects on CSD mortality.     

Closing the gap in education: Raising medical professionals' knowledge and attitudes in transgender health

Transgender and gender diverse (TGD) health is a rapidly evolving, underserviced, and underresearched healthcare field. This chapter will provide a brief review of the research in TGD health and medical education and offer further areas of research and curriculum design.     

Use and knowledge of contraceptive methods in female students of children education

An inquire about contraception use and knowledge was applied to 292 female students. (Average of age = 21.3 years) An 88.4% of the woman with sexual activity had used contraceptive methods at least once. Principal reason for not going on using them, was not having sexual intercourse. In single women, the use of contraceptive methods was related with age, while the type selected was related with sexual intercourse's frequency. The most used contraceptive methods were rhythm and pill, which were not the best known ones.     

Perceptions of motherhood: The effect of experience and knowledge on midwifery students

Objective

to explore the factors that influence student midwives’ constructs of childbearing, before and during their undergraduate midwifery programme.

Design

a naturalistic, qualitative study.

Setting

a university in the East Midlands, UK.

Participants

58 women registered on a 3-year midwifery education programme.

Measurements

focus groups were conducted at programme commencement and at 9–12 monthly intervals with two cohorts of midwifery students who were separated into groups of mothers and non-mothers (32 focus groups in total). This paper draws on data from the nine focus groups held at the start of the students’ programme.

Findings

the main themes that emerged from the data were in relation to image during pregnancy, expectations/experiences of childbirth and parenting. In particular, students believed that pregnancy and childbirth should be special. They suggested that a lack of knowledge about sexuality and choice options affected women's ability to be in control. Although normality was the students’ expectation of childbirth, they also assumed that hospital birth was the norm. They were unsure whether the baby's father was the best birth partner. Their mothers were suggested as likely to be more supportive, but there was lack of agreement regarding whether they were the best parenting role models. Students also said that there was a lack of positive images of breast feeding. The overall motivation to become midwives was ‘to make a difference’.

Conclusions

students need to be facilitated early in their programme to explore their belief systems and constructs of childbearing critically so that they are equipped to support parents to have a positive experience, whether childbirth is normal or complex, and so that they can cope with any dissonance between their own expectations and the uncertainties and realities of practice.     

Complementary medicine: knowledge, use and attitudes of doctors

The recent growth in interest in the use of complementary medicine by the general public has been well reported. Health professionals, particularly nurses and midwives, are incorporating the use of complementary therapies into their practice. The medical profession is involved in the political processes affecting legislation governing complementary medicine and it is therefore important to determine the views of doctors when considering the use of complementary therapies by nurses within the health-care system. A critical review of published research studies which consider the knowledge, use and attitudes of doctors to complementary medicine is presented. These studies suggest doctors' interest in complementary medicine but they also raise a number of concerns including lack of evidence to demonstrate effectiveness, possible harmful effects, inadequate knowledge of doctors and lack of statutory regulation for most therapies. Recommendations of recent reports are outlined which attempt to address these and other issues.