Women's health (London, England)最新文献

Background: Cold water swimming is growing in popularity, especially among women. We have previously reported that women felt that cold water swimming helps with their menstrual and menopause symptoms. But little is known about the habits of women who cold water swim.

Objectives: To determine the habits of women who cold water swim.

Design: This was a mixed-methods study.

Methods: An online survey asked women who cold water swim about their experience of swimming and how this affected their menstrual and menopause symptoms. The survey was advertised for 2 months on social media, with a focus on advertising in cold water swimming Facebook groups. In this article, only the questions on the women's swimming habits were analyzed.

Results: The analysis of 1114 women, mainly from the United Kingdom, revealed that most had been swimming for 1-5 years (79.5%). Most swim in the sea (64.4%), and only 15.5% swim alone. The majority (89.0%) swim all year around, swimming for mainly 30-60 min in the summer and 5-15 min in the winter. The women mostly swim wearing swimming costumes (skins) throughout the year. The majority of the free-text responses showed women found mental and physical benefits from cold water swimming.

Conclusion: It was not surprising to learn that women swim for longer in the summer than the winter, but hearing how they feel cold water swimming helps their physical and mental health is important. With the limitations on access and safety of many wild swimming sites in the United Kingdom, it is time to ensure that cold water swimming is safer and more supported.

Fertility preservation is a major concern for women with ulcerative colitis who require surgical treatment. Previous studies have shown that the risk of infertility after restorative proctocolectomy is approximately four times higher. However, this risk appears to be lower in patients who undergo minimally invasive approaches, such as laparoscopic surgery. The benefits of laparoscopy have led to a debate on whether robotic-assisted surgery could offer better results in terms of fertility. Surgical robotic platforms can provide improved visualization of the pelvis and more precise dissection of anatomical structures. In theory, this could reduce tissue damage and the inflammatory response, leading to lower adhesion formation and fallopian tube blockage, thereby preserving fertility.

Background: Estrogen deficiency during menopause, aging, reproductive history, and factors increasing intra-abdominal pressure may lead to structural and functional failure in the pelvic floor. Lifestyle choices, such as eating behavior, may contribute to pelvic floor disorders.

Objectives: The objective of the study was to investigate associations of eating behavior with symptoms of pelvic floor disorders, that is, stress urinary incontinence, urgency urinary incontinence, fecal incontinence, and constipation or defecation difficulties among middle-aged women.

Design: A cross-sectional, observational study was performed using a population sample of 1098 Finnish women aged 47-55 years.

Methods: Eating behavior, food consumption frequency, demographical, gynecological, and physical activity variables were assessed using self-report questionnaires. Logistic regression models were used to assess the associations of eating behavior, food frequency, and symptoms of pelvic floor disorders. Models were adjusted with demographical, gynecological, and physical activity variables.

Results: In adjusted models, middle-aged women with disordered eating style were more likely to experience the symptoms of stress urinary incontinence (odds ratio (OR) 1.5, p = 0.002), and constipation or defecation difficulties (OR 1.4, p = 0.041). Adding body mass index into the models abolished associations. Of the studied food items, more frequent consumption of ready-made, highly processed foods (OR 1.5, p = 0.001), and fast foods (OR 1.5, p = 0.005) were independently associated with symptoms of stress urinary incontinence regardless of eating style, whereas consuming ready-made foods (OR 1.4, p = 0.048) was associated with symptoms of urgency urinary incontinence. Daily consumption of fruits (OR 0.8, p = 0.034) was independently associated with symptoms of stress urinary incontinence. Furthermore, we observed that daily consumption of porridge was associated with symptoms of constipation or defecation difficulties (OR 1.7, p = 0.010) independently of eating style. Alcohol consumption (OR 0.9, p = 0.015) was inversely associated with constipation and defecation difficulties. Women with overall higher quality diet had lower odds for stress urinary incontinence (OR 0.9, p = 0.002).

Conclusion: This study provides proof-of-concept evidence to the hypothesis that eating behavior and consuming certain food items are associated with perceived pelvic floor disorders. As a preventive action, eating behavior of women with the risk of these symptoms should be assessed, and guidance toward healthy eating patterns should be provided.

Background: Mortality rate of female gynecologic cancer is higher among individuals without affordable health insurance.

Objectives: We determined the impact of Medicaid expansion on the number of female gynecologic-related cancer inpatient admissions in Virginia (VA) relative to North Carolina (NC), the latter of which did not expand Medicaid.

Design: This quasi-experimental study was restricted to women between 18 and 64 years old admitted to general, acute, and short-term hospitals with gynecologic cancer.

Methods: We used Poisson fixed-effect event study regression to examine differences in the predicted number of female gynecologic-related cancer admissions in the quarters before and after Medicaid expansion (implemented in January 2019) in VA, compared to the same period in NC.

Results: Even though not significant, the predicted number of female gynecologic cancer-related inpatient admissions in VA increased by 4.8%, 4.9%, and 5.5% in the second, third, and fourth quarter of 2019, respectively, compared to the first quarter of 2019.

Conclusion: Medicaid expansion in VA increased access to health services for Medicaid members, possibly due to initial pent-up demand among uninsured individuals.

Background: Stigma and lack of social support are barriers to HIV prevention, especially among cisgender Black women in the United States. While HIV pre-exposure prophylaxis (PrEP) can decrease HIV transmission, PrEP initiation and adherence remains low among Black women, especially in the U.S. South.

Objectives: The purpose of this study was to characterize experiences with stigma and social support among PrEP-naïve and PrEP-experienced Black cisgender women in Mississippi.

Design: Qualitative study in which semi-structured interviews and focus groups were conducted.

Methods: We purposively recruited PrEP-naïve cisgender Black women who met PrEP indications to participate in focus groups and all PrEP-experienced cisgender Black women at a sexual health clinic in Jackson, Mississippi to participate in one-on-one semi-structured interviews. Inductive thematic analysis was used to analyze focus group and interview transcripts.

Results: A total of 37 PrEP-naïve Black cisgender women participated across 6 focus groups and 8 PrEP-experienced cisgender Black women completed semi-structured interviews. Four themes were identified: (1) the intersection of gendered racism, discrimination, and HIV stigma, (2) enacted and anticipated PrEP stigma, (3) stigma mitigation strategies and PrEP adherence, and (4) social support's role in PrEP initiation and adherence. PrEP-naïve and -experienced Black women discussed the negative consequence that sexual stigmatization and gendered racism has on HIV testing. PrEP-naïve Black women discussed how HIV stigma decreases PrEP initiation. Conversely, PrEP-experienced Black women were able to identify strategies they utilized to mitigate stigma. PrEP-experienced Black women discussed how differing levels of social support impact their PrEP use.

Conclusion: Improving social support and stigma mitigation strategies could help improve PrEP initiation and adherence among cisgender Black women at-risk of acquiring HIV in the U.S. South. Educating communities on PrEP, and training providers on stigma-mitigating strategies when serving Black women in the U.S. South who are seeking HIV prevention is paramount.

Background: Schoolgirls in resource-limited settings encounter significant challenges in maintaining proper menstrual hygiene management practices. Studies on associated factors in menstrual hygiene management practices among schoolgirls in Bahir Dar City are limited.

Objectives: The study aimed to evaluate the menstrual hygiene practices of schoolgirls and identify factors that influence these practices in the limited settings of Bahir Dar City.

Design: This study was a school-based, analytical, cross-sectional study conducted among schoolgirls between the ages of 11 and 25.

Methods: A total of 701 schoolgirls, selected at random based on their consent, participated in this school-based, analytical, cross-sectional study. The data collection process was comprehensive, involving a self-administered questionnaire and 5 rounds of observations at 10 schools using the Joint Monitoring Program for Water, Sanitation, and Hygiene monitoring tool. The study used a binary logistics regression model to determine the strength of the association between predictor and outcome variables, ensuring a rigorous analysis with a p-value < 0.05.

Results: In this study, 375 (53.50%) participants were found to have good menstrual hygiene practices. Factors such as the mothers' education (diploma and above vs not read and write (AOR = 26.29, 95% CI: 11.69-59.12), fathers' education (diploma and above vs not read and write (AOR = 19.21, 95% CI: 8.51-43.32), having access to basic water service (AOR = 14.62, 95% CI: 5.12-41.73), having access to basic sanitation services (AOR = 21.02, 95% CI: 7.87-56.15), being older among the schoolgirls (AOR = 19.69, 95% CI: 10.18-38.07), having private work (AOR = 15.58, 95% CI: 6.99-34.73), having open discussions with sisters (AOR = 27.01, 95% CI: 11.45-63.73), having friendly discussions about menstrual hygiene with schoolgirl friends (AOR = 18.67, 95% CI: 8.45-41.24), and residing in urban areas (AOR = 6.43, 95% CI: 3.52-11.73)) were significantly associated with good menstrual hygiene practices.

Conclusion: The schoolgirls in the study area had good menstrual hygiene practices. However, uneducated parents, inadequate facilities, limited access to absorbent materials, and lack of support were challenges that affected proper menstrual hygiene management practice. To improve menstrual hygiene practices, it is crucial to address these identified modifiable factors and consider education programs, better facilities, community support, and policy changes that prioritize menstrual hygiene management in schools for schoolgirls to manage menstruation.

Background: Women's empowerment is essential for achieving sustainable development goals. It involves enabling women to take control of their lives by giving them the agency, resources, and opportunities they need to make their own choices and reach their full potential. If more women are empowered to use modern contraceptives, greater reductions in maternal mortality will follow. By understanding this association, we can identify key women empowerment dimensions that have an association with family planning utilization and consider ways forward to improve reproductive health outcomes for women.

Objective: This study aimed to investigate the association between women's empowerment and modern contraceptive utilization among married mothers in Ethiopia.

Design: A facility-based quantitative study was employed.

Methods: A facility-based quantitative cross-sectional study was employed among 305 mothers selected by systematic random sampling at Jimma Town Public Hospital from July 1 to August 31, 2022. The interviewer-administered questionnaire was used for data collection. The collected data were entered into EpiData Manager, version 4.6.0.6, and then exported to SPSS, version 26. Bivariate and multivariate logistic regression analyses were used to investigate the associations between the dependent and independent variables.

Results: Among a total of 305 study subjects, 301 were used in the analysis. Approximately 65% (95% CI = 59.8, 70.8) of the women utilized modern contraceptive methods. High general self-efficacy (AOR = 4.17; 95% CI = 2.11, 8.23), an internal locus of control (AOR = 3.92; 95% CI = 2.01, 7.65), labor work participation (AOR = 4.53; 95% CI = 1.99, 10.31), and enrollment in elementary education (AOR = 8.30; 95%; CI = 2.96, 23.27) have a statistically significant association with modern contraceptive utilization.

Conclusion: Numerous dimensions of women's empowerment are significantly associated with modern contraceptive utilization. The dimension of women's empowerment needs considerable focus from stakeholders to empower women and enable them to utilize contraceptives and other maternal healthcare services.

Background: Adolescents worldwide engage in sexual activity, with the proportion rising gradually from the middle to late stages of adolescence. The incidence of early sexual initiation among female youth in sub-Saharan Africa is reported to be 46%. The increasing number of teenage pregnancies in Rwanda indicates that adolescents do not correctly use sexual and reproductive health services. In 2019, the Eastern Province of Rwanda documented 36% of all teenage pregnancies. Despite the availability of these services to youth through adolescent sexual and reproductive health (ASRH) focal persons, nurses, or midwives leading youth corners at the Health Center level, why they are not used remains unknown.

Objectives: To explore teenage mothers' perspectives, knowledge, and attitudes toward pregnancy and the utilization of sexual and reproductive health services in the Eastern Province of Rwanda.

Design: Qualitative descriptive study.

Methods: A qualitative descriptive design combined with the theory of reasoned action was used to capture teenagers' unique perspectives on knowledge about teenage pregnancy and attitudes toward ASRH service utilization. An in-depth interview was used to collect data from 25 informants across 3 districts in the Eastern Province of Rwanda, followed by traditional content analysis.

Results: Three major themes emerged, including lack of knowledge about teenage pregnancy, unfavorable attitudes toward ASRH service utilization, and the perceived negative impact of teenage pregnancy, including disrupting education, limiting career opportunities, and posing health risks to both mothers and infants.

Conclusion: While all young mothers were under pressure from the multitude of impacts of teenage pregnancy, parenthood, and social responsibilities, they had limited knowledge and selective utilization of ASRH services, mimicking potential gaps in education and mobilization of youth on available ASRH services with special emphasis on preventive components. Exploring the perceived enablers and challenges facing ASRH service utilization among the study population is necessary.

Background: Women may receive suboptimal pain management compared with men, and this disparity might be related to gender stereotypes.

Objectives: To assess the influence of patient gender on the management of acute low back pain.

Design: We assessed pain management by 231 physicians using an online clinical vignette describing a consultation for acute low back pain in a female or male patient. The vignette was followed by a questionnaire that assessed physicians' management decisions and their gender stereotypes.

Methods: We created an online clinical vignette presenting a patient with acute low back pain and assessed the influence of a patient's gender on pain management. We investigated gender-related stereotyping regarding pain care by emergency physicians using the Gender Role Expectation of Pain questionnaire.

Results: Both male and female physicians tended to consider that a typical man was more sensitive to pain, had less pain endurance, and was more willing to report pain than a typical woman. These stereotypes did not translate into significant differences in pain management between men and women. However, women tended to be referred less often for imaging examinations than men and were also prescribed lower doses of ibuprofen and opioids. The physician's gender had a modest influence on management decisions, female physicians being more likely to prescribe ancillary examinations.

Conclusion: We observed gender stereotypes among physicians. Our findings support the hypothesis that social characteristics attributed to men and women influence pain management. Prospective clinical studies are needed to provide a deeper understanding of gender stereotypes and their impact on clinical management.

Background: Musculoskeletal changes occur during pregnancy; one-half of pregnant women experienced low back pain and/or pelvic pain during pregnancy. Prescription opioid use for Medicaid enrolled pregnant women has increased dramatically due to severe low back pain/pelvic pain.

Objectives: This study aimed to explore the prevalence of low back pain/pelvic pain and related risk factors among a broader population.

Design: This is a retrospective cohort study.

Methods: This study utilized de-identified Medicaid claims data provided by the South Carolina Revenue and Fiscal Affairs Office, including individuals who gave birth between 2016 and 2021 during pregnancy. Low back pain/pelvic pain and a group of musculoskeletal risk factors were identified with International Classification of Diseases v10. Comparisons were made for the prevalence of low back pain and pelvic pain between those with pregnancy-related musculoskeletal risk and those without.

Results: Among 167,396 pregnancies, 65.6% were affected by musculoskeletal risk factors. The overall prevalence of low back pain was 15.6%, and of pregnancy-related pelvic pain was 25.2%. The overall prevalence for either low back pain or pelvic pain was 33.3% (increased from 29.5% in 2016 to 35.3% in 2021), with 24.6% being pregnancy-induced. Pregnancies with musculoskeletal risk factors were more likely to be diagnosed with low back pain (20.7% versus 5.7%, p < 0.001) or pelvic pain (35.3% versus 6.0%, p < 0.001) than those without.

Conclusion: This study found a very high prevalence of musculoskeletal risk and a high prevalence of low back pain or pelvic pain, with an increasing trend, among South Carolina pregnancies enrolled in Medicaid during the period 2016-2021. Most of the diagnosed low back pain or pelvic pain were pregnancy induced. Musculoskeletal risk factors were associated with low back pain or pelvic pain.