Women's midlife health最新文献

Background: Some symptoms at midlife are associated with stress, such as hot flashes, trouble sleeping, headaches, or depressed mood. Hot flashes have been studied in relation to laboratory stressors, physiological biomarkers, and self-reported stress, but less is known about hot flashes in relation to the larger context of women's lives. This study examined the risk of symptoms in relation to neighborhood disorder, exposure to neighborhood violence, social cohesion and perceived discrimination. We hypothesized that women exposed to more negative neighborhood characteristics and discrimination would be more likely to report hot flashes and other midlife symptoms.

Methods: Participants were black and white women, aged 40 to 60, drawn from a cross-sectional investigation of race/ethnicity, socioeconomic status, and blood pressure in New York City (n = 139). Demographic information, medical history, menopausal status, and symptoms were measured by questionnaire. Likert scales were used to measure neighborhood characteristics, specifically, the Neighborhood Disorder Scale, the Exposure to Violence Scale, the Perceived Violence Subscale, the Neighborhood Social Cohesion and Trust Scale, and the Everyday Discrimination Scale. Ten symptoms were included in analyses: lack of energy, feeling blue/depressed, backaches, headaches, aches/stiffness in joints, shortness of breath, hot flashes, trouble sleeping, nervous tension, and pins/needles in hands/feet. Each scale with each symptom outcome was examined using logistic regression analyses adjusting for significant covariates.

Results: Black women reported higher scores on all negative neighborhood characteristics and discrimination, and a lower score on the positive Neighborhood Social Cohesion and Trust. Neighborhood Disorder was associated with feeling blue/depressed, aches/stiffness in joints, and hot flashes, and Perceived Violence was associated with aches/stiffness in joints, after controlling for model-specific covariates. There was a lower risk of backaches with increasing Neighborhood Social Cohesion and Trust score. The Everyday Discrimination Scale was associated with lack of energy. Lack of energy, feeling blue/depressed, aches/stiffness in joints, and hot flashes appeared to be most vulnerable to negative neighborhood context and discrimination.

Conclusions: This study adds to the literature linking neighborhood environments to health outcomes. The associations between negative neighborhood contexts and discrimination with diverse symptoms, and the association between social cohesion and back pain, point to the need to expand analyses of stress to multiple physiological systems.

Background: A modern contraceptive method is a product or medical procedure that interferes with reproduction following sexual intercourse; however, contraceptive services remain out of reach for many women of reproductive age worldwide, resulting in millions of unwanted pregnancies and unsafe abortions each year. In addition to limiting the number of children, family planning is essential to promoting the well-being and autonomy of women, their families, and their communities. Factors influencing modern contraceptive utilization are multifaceted and challenging, therefore; this study aimed to assess modern contraceptive utilization and associated factors among mid to late reproductive age, married women in Finote Selam town, northwest Ethiopia.

Methods: A community based cross-sectional study was conducted from June 30 to July 15, 2017 among married women aged 30-49. A cluster sampling technique was used to select 1146 eligible participants from three randomly selected kebeles. A face-to-face interviewer administered a structured and pretested questionnaire. Binary logistic regression models, in bivariate and multivariable analyses, were fitted to identify factors associated with the outcome variable. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) was calculated to determine the presence, direction, and strength of associations.

Results: A total of 1134 women aged 30-49 participated in this study representing a response rate of 98.9%.The overall modern contraceptive utilization was 37% (95% CI 35.43-40.21). An injectable contraceptive was the most commonly used method, followed by an implant contraceptive method. Factors independently associated with modern contraceptive use were: educational status -secondary school (AOR = 1.5,95%CI 1.01-2.2) and college and above (AOR = 1.5,95%CI 1.02-2) compared to no education, number of previous pregnancy: nulligravid (AOR = 4.6,95%CI 3.2-5.5),1-2 previous pregnancies (AOR = 3.2,95%CI 2.03-5.44), 3-4 previous pregnancies(AOR = 2.3,95% CI1.4-3.7) compared to > 4 pregnancies and postnatal care utilization (AOR = 1.5,95% CI 1.1-2.1)compared to no postnatal service utilized.

Conclusion: Our findings show that modern contraceptive utilization among women age 30-49 is low in Finote Selam town Northwest Ethiopia. Women's educational status, low number of previous pregnancies and postnatal care service utilization during the last birth were independently associated with modern contraceptive method used. Providing modern contraceptives targeting grand multiparous women and women having no formal education is important. Improving postnatal care utilization is one potential strategy to enhance modern contraceptive utilization.

In recent years public awareness of healthcare disparities experienced by transgender individuals throughout the world have garnered increasing attention within the media and from health advocates. Despite this increasing awareness, a paucity of research data and clinical protocols of care for clinicians continues to exist, especially in regard to the transgender individual's family planning needs. Clinicians should be on the forefront of promoting strategies that forge a meaningful and collaborative relationship with the transgender man, including as he transitions through to the menopause and his sexual and reproductive healthcare needs. Unfortunately, despite best efforts to address the health concerns of transgender men in midlife, including their contraceptive needs and pregnancy desires, there is currently a paucity of research. Although hormonal contraceptives are not an option for this group of individuals, especially those on masculinizing hormones, IUD's, both copper containing and progestin containing, should be considered for those with intact pelvic organs. For this group of transgender men with potential for pregnancy who have either completed their family or choose not to give birth, sterilization can be offered. Regardless of where they identify along the gender spectrum, these midlife individuals with potential reproductive potential should have equitable access to and up to date counseling on their contraceptive options. This commentary addresses the contraceptive challenges of the midlife transgender man. (Note: Pronouns used in this article are he/him for cis and transgender men and she/her for cis and transgender women).