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Ju I, Elhindi J, Hook M, Melov SJ, Sawleshwarkar S, Yapa HM, Zablotska I, Pasupathy D. Sexually transmitted infections: Prevalence and clinical outcomes among pregnant women in Western Sydney. Int J Gynaecol Obstet 2024; 166:107-114. [PMID: 38654697 DOI: 10.1002/ijgo.15548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/18/2024] [Accepted: 04/05/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE We report the prevalence, characteristics and clinical outcomes of women with sexually transmitted infections (STIs) in pregnancy in the Western Sydney Local Health District (WSLHD) serving a large culturally and socio-economically diverse community in New South Wales (NSW), Australia, over the last 10 years. METHODS A retrospective cohort study of all pregnant women booked for antenatal care at three hospitals in WSLHD between September 2012 and August 2022 inclusive. Characteristics and birth outcomes associated with STIs diagnosed in pregnancy (chlamydia, gonorrhea, and syphilis) are reported using multivariable logistic regression adjusting for relevant confounders. RESULTS During 2012-2022, there were 102 905 births and 451 women (0.44%) with an STI diagnosis during pregnancy. The number of women with a history of chlamydia prior to their current pregnancy has increased over the last 10 years (P < 0.001). STIs in pregnancy were more common in younger women aged <20 years (adjusted odds ratio [aOR] 7.30, 95% confidence interval [CI] 5.04-10.57), 20-24 years (aOR 3.12, 95% CI 2.46-3.96), and >40 years (adj OR 1.67, 95% CI 1.07-2.59), in women with body mass index >30 (aOR 1.73, 95%CI 1.37-2.19), and those who smoked (aOR 2.24, 95% CI 1.71-2.94) and consumed alcohol (aOR 3.14, 95% CI 1.88-5.23) and illicit drugs (aOR 2.10, 95% CI 1.31-3.36). STIs in pregnancy were borderline associated with stillbirth (aOR 2.19 95% CI 0.90-5.36) but did not have a significant impact on preterm birth (aOR 1.21, 95% CI 0.87-1.68), admission to neonatal intensive care unit (NICU) (aOR 1.02, 95% CI 0.77-1.34), or having a small-for-gestational-age (SGA) baby (aOR 0.97, 95% CI 0.74-1.27). CONCLUSIONS Sociodemographic factors such as age, weight, smoking, and alcohol and drug use, were associated with the STI incidence in pregnancy. While the latter did not have an impact on preterm birth, NICU admission, and SGA in our cohort, there was a borderline association with stillbirth. Future research should identify barriers and facilitators to testing in a multicultural population and understanding the drivers of higher rates of STIs in certain population groups.
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Affiliation(s)
- I Ju
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Obstetrics and Gynaecology, Westmead Hospital, Sydney, New South Wales, Australia
| | - J Elhindi
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - M Hook
- Department of Obstetrics and Gynaecology, Westmead Hospital, Sydney, New South Wales, Australia
| | - S J Melov
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Westmead Institute of Maternal Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia
| | - S Sawleshwarkar
- Western Sydney Sexual Health Centre, Sydney, New South Wales, Australia
| | - H M Yapa
- Sydney Infectious Diseases Institute, Faculty of Medicine & Health, University of Sydney, Sydney, New South Wales, Australia
| | - I Zablotska
- Western Sydney Sexual Health Centre, Sydney, New South Wales, Australia
| | - D Pasupathy
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Westmead Institute of Maternal Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia
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Saadedine M, Faubion SS, Grach SL, Nordhues HC, Kapoor E. Association between obesity and female sexual dysfunction: a review. Sex Med Rev 2024; 12:154-163. [PMID: 38112599 DOI: 10.1093/sxmrev/qead047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Obesity is a global health crisis that has been growing over the past few decades. The economic burden associated with obesity is substantial as it is associated with multiple disabling chronic diseases, such as cardiovascular disease, certain cancers, osteoarthritis, chronic pain, and mental illness. Obesity is known to be a risk factor for sexual dysfunction in men, but this association is less well understood in women. AIMS To provide a narrative review of the available literature on the relationship between overweight/obesity and female sexual dysfunction, elaborate on the possible mechanisms explaining this association, and discuss the effects of weight loss on sexual function in those with obesity. METHODS A search of the medical literature was carried out in PubMed and Medline, focusing on original research and systematic reviews of original research on obesity and sexual function in women. RESULTS The relationship between obesity and female sexual function is not consistent across studies. While women with obesity are more likely to have worse sexual function and avoid sexual activity, many studies have failed to identify these associations. Lifestyle changes resulting in weight loss lead to better sexual function, and bariatric surgery has been shown to improve sexual function in the first couple of years following the procedure; yet, the long-term effects of weight loss and bariatric surgery are still uncertain. CONCLUSIONS The evidence on the relationship between obesity and female sexual function is mixed. Nevertheless, weight loss has been shown to improve sexual function in women with obesity. The impact of weight loss medications and the long-term effect of bariatric surgery on female sexual function require further study.
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Affiliation(s)
- Mariam Saadedine
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, United States
- Center for Women's Health, Mayo Clinic, Rochester, MN 55905, United States
| | - Stephanie S Faubion
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, United States
- Center for Women's Health, Mayo Clinic, Rochester, MN 55905, United States
| | - Stephanie L Grach
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Hannah C Nordhues
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Ekta Kapoor
- Center for Women's Health, Mayo Clinic, Rochester, MN 55905, United States
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN 55905, United States
- Women's Health Research Center, Rochester, MN 55905, United States
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Mundhra R, Bahadur A, Khoiwal K, Kumar M, Chhetri SS, Chaturvedi J. Female sexuality across the menopausal age group: A cross sectional study. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100287. [PMID: 38419651 PMCID: PMC10900532 DOI: 10.1016/j.eurox.2024.100287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/28/2023] [Accepted: 02/08/2024] [Indexed: 03/02/2024] Open
Abstract
Background Female sexual dysfunction (FSD) is an important health issue and its relationship with menopausal symptoms needs special attention. Objective To identify the frequency of FSD in middle aged women and assess its relationship with obesity and menopausal symptoms. Methods This was a cross sectional study performed at a tertiary care centre in North India over a period of one year from June 2022 to May 2023. Sexually active women aged 40-55 years were included in the study sample. Exclusion criteria included those not willing to participate, having pregnancy, malignancy, mental illness or history of pelvic surgery. Baseline demographic and anthropometric details were noted. Sexual function and menopausal symptoms were assessed using Menopause Rating Scale (MRS) and Female Sexual Function Index Scale (FSFI) questionnaire respectively. Results Among one hundred and forty three sexually active middle aged women, 43 women had FSD (30.06%). FSD was observed in 9.09%, 22.73% and 45.45% in- 40-45 years, 46-50 years and 51-55 years respectively. No significant difference was seen in desire (p value=0.281), arousal (p value=0.424), lubrication (p value=0.143), orgasm (p value=0.637), satisfaction (p value=0.675), pain (p value=0.833), total score (p value=0.601) between body mass index (kg/m²). A significant strong negative correlation of somatic, urogenital, psychological and total MRS scores with female sexuality domains was observed excepting non-significant mild negative correlation between somatic with pain and psychological with orgasm and pain. Conclusion Female sexual dysfunction are quite common and has negative correlation with menopausal symptoms. Health care providers need to focus on this issue as part of their routine assessment for better quality of life.
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Affiliation(s)
- Rajlaxmi Mundhra
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Anupama Bahadur
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Kavita Khoiwal
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Mukesh Kumar
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Shivani Singh Chhetri
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Jaya Chaturvedi
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
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Babarinsa IA, Bashir M, AbdelRahman Ahmed H, Ahmed B, Konje JC. Bariatric surgery and reproduction-implications for gynecology and obstetrics. Best Pract Res Clin Obstet Gynaecol 2023; 90:102382. [PMID: 37506498 DOI: 10.1016/j.bpobgyn.2023.102382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
As the rates of obesity continue to rise across the world, there has been an increasing resort to bariatric surgery amongst the options for treatment. Through the reproductive lifespan, between menarche and menopause, women might benefit from this surgical intervention, which may have a bearing on other aspects of their health. The consequences of bariatric surgery have been reported and evaluated from various perspectives in obstetrics and gynecology. Fertility and sexuality are enhanced, but not all gynecological diseases are ameliorated. There are also psychological and behavioral sequelae to be cognizant of. With multi-disciplinary and responsive care, most post-bariatric pregnancies have satisfactory outcomes. The effects of bariatric surgery on the babies conceived thereafter remains a subject of interest, whereas the possible effect on the climacteric is speculative.
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Affiliation(s)
- Isaac A Babarinsa
- Women's Wellness and Research Centre, Hamad Medical Corporation, Doha.
| | | | | | - Badreldeen Ahmed
- Feto Maternal Centre, Al Markhiya, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar; Qatar University, Qatar
| | - Justin C Konje
- Feto Maternal Centre, Al Markhiya, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar; Department of Health Sciences University of Leicester, UK
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Mernone L, Fiacco S, Ehlert U. Positive body perception and its link to sexual satisfaction in aging women - findings from the Women 40+ Healthy Aging Study. J Women Aging 2023; 35:152-167. [PMID: 34882510 DOI: 10.1080/08952841.2021.2002647] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Research on the relation between physical appearance and sexual satisfaction in aging women is scarce. This study uniquely links attractiveness, body perception, and sexual satisfaction in 124 healthy aging women. Two-thirds reported being highly sexually satisfied. BMI and fat mass correlated significantly with sexual satisfaction. Weight and shape concerns moderated this relationship, affecting sexual satisfaction beyond the effect of body size and composition. Given the "unattractive stereotype" of older women related to the enduring social beauty ideal of a youthful and thin body, positive body perceptions in light of age-associated bodily changes should be promoted.
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Affiliation(s)
- Laura Mernone
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Serena Fiacco
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
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Chung MH, Chao JK, Ma MC, Lin RW. Sexuality and Quality of Life in Eastern Taiwan People With Schizophrenia. Psychiatry Investig 2023; 20:1-8. [PMID: 36721880 PMCID: PMC9890041 DOI: 10.30773/pi.2022.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/05/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Patients with schizophrenia are living at the border of society and their sexuality is often neglected. The aim of the study is to explore the association among The Brief Psychiatric Rating Scale (BPRS), quality of life (QoL), Taiwanese Depression Questionnaire, and Sexual Desire Inventory in people with schizophrenia (PwS). METHODS This study used a cross-sectional design with 277 psychiatric inpatients. A descriptive analysis, difference analysis, and logistic regression model were presented to identify relevant variables that may affect the probability of good QoL. RESULTS The study showed that male PwS had higher scores of standard deviation (SD) than females in PwS. The study also showed that smoking, early illness onset age, and shorter illness duration demonstrated a significantly higher SD. The logistic regression analysis showed that BPRS, depression, and SD significantly affected the probability of QoL. By structural equation model, SD would be positively correlated with mental status and SD would indirectly influence QoL. CONCLUSION Our results showed psychological and sociological factors interactions may contribute to the QoL and SD for PwS. This study also demonstrated a close relationship between SD, depression, and BPRS. These factors may predict the probability of good life quality for the PwS.
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Affiliation(s)
- Mei Hua Chung
- Graduate Institute of Bioresources, National Pingtung University of Science & Technology, Pingtung, Taiwan
| | - Jian-Kang Chao
- Department of Psychiatry, Yuli Branch, Taipei Veterans General Hospital, Hualien, Taiwan.,Graduate School of Human Sexuality, Shu-Te University, Kaohsiung, Taiwan
| | - Mi Chia Ma
- Department of Statistics, National Cheng Kung University, Tainan, Taiwan
| | - Ru Wei Lin
- Department of Plant Industry, National Pingtung University of Science & Technology, Pingtung, Taiwan
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Wang Z, Lu J, Weng W, Zhang L, Zhang J. Women's reproductive traits and ischemic stroke: a two-sample Mendelian randomization study. Ann Clin Transl Neurol 2022; 10:70-83. [PMID: 36398399 PMCID: PMC9852390 DOI: 10.1002/acn3.51702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We conducted a Mendelian randomization (MR) study to disentangle causal associations between women's reproductive behaviors and ischemic stroke (IS) and investigate the roles of two modifiable risk factors (body mass index (BMI) and educational attainment (EA)) in these associations. METHODS Using summary-level data from large-scale genome-wide association studies, we performed univariable MR to examine whether there is genetic evidence that women's reproductive traits are causally associated with IS and its subtypes. Multivariable MR and MR mediation analysis were used to investigate whether BMI and EA are common mechanisms or mediators for these associations. A set of sensitivity analyses were conducted to test valid MR assumptions. RESULTS We observed consistent and statistically significant associations across female and sex-combined analyses for earlier age at first birth (AFB) and age at first sexual intercourse (AFS) with a higher risk of IS and large-artery atherosclerotic stroke (LAS) risk in the primary analysis. The odds ratios of IS per 1 SD increase in genetically predicted early AFB and AFS were 0.93 (95% CI, 0.86-0.99; p = 0.046) and 0.83 (95% CI, 0.70-0.97, p = 0.020), respectively. Further analyses indicated that BMI played a shared role in AFS and IS/LAS while EA played a shared role in AFS/AFB and IS/LAS as well as a mediator in the path from AFS to IS/LAS. INTERPRETATION These findings may inform prevention strategies and interventions directed toward relative women's reproductive behaviors and IS. Future studies are warranted to explore other factors related to EA which are responsible for these causalities.
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Affiliation(s)
- Zhenqian Wang
- School of Public Health (Shenzhen)Sun Yat‐sen UniversityShenzhenGuangdong518107China
| | - Jiawen Lu
- School of Public Health (Shenzhen)Sun Yat‐sen UniversityShenzhenGuangdong518107China
| | - Weipin Weng
- Department of Neurology, The Second Xiangya HospitalCentral South UniversityChangshaHunan410011China
| | - Li Zhang
- School of Public HealthFudan UniversityShanghai200032China
| | - Jie Zhang
- Department of Neurology, The Second Xiangya HospitalCentral South UniversityChangshaHunan410011China
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McNamee K, Edelman A, Li RHW, Kaur S, Bateson D. Best Practice Contraception Care for Women with Obesity: A Review of Current Evidence. Semin Reprod Med 2022; 40:246-257. [PMID: 36746158 DOI: 10.1055/s-0042-1760214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The prevalence of obesity among females of reproductive age is increasing globally. Access to the complete range of appropriate contraceptive options is essential for upholding the reproductive rights of this population group. People with obesity can experience stigma and discrimination when seeking healthcare, and despite limited evidence for provider bias in the context of contraception, awareness for its potential at an individual provider and health systems level is essential. While use of some hormonal contraceptives may be restricted due to increased health risks in people with obesity, some methods provide noncontraceptive benefits including a reduced risk of endometrial cancer and a reduction in heavy menstrual bleeding which are more prevalent among individuals with obesity. In addition to examining systems-based approaches which facilitate the provision of inclusive contraceptive care, including long-acting reversible contraceptives which require procedural considerations, this article reviews current evidence on method-specific advantages and disadvantages for people with obesity to guide practice and policy.
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Affiliation(s)
| | - Alison Edelman
- Department of Obstetrics and Gynecology, School of Medicine, Oregon Health and Science University, Portland, Oregon
| | - Raymond Hang Wun Li
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Simranvir Kaur
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Palo Alto, California
| | - Deborah Bateson
- Faculty of Medicine and Health, Daffodil Centre, University of Sydney, Sydney, Australia
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Martin FZ, Madley‐Dowd P, Ahlqvist VH, Jónsson‐Bachmann E, Fraser A, Forbes H. Mode of delivery and maternal sexual wellbeing: A longitudinal study. BJOG 2022; 129:2010-2018. [PMID: 35856885 PMCID: PMC9804306 DOI: 10.1111/1471-0528.17262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To investigate the association between mode of delivery and subsequent maternal sexual wellbeing. DESIGN Prospective birth cohort study. SETTING Avon (in Bristol area), UK. POPULATION Participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). METHODS Mode of delivery was abstracted from obstetric records and sexual wellbeing measures were collected via a self-report questionnaire. Missing data were imputed using multiple imputation, and ordinal logistic regression models for ordered categorical outcomes were adjusted for the covariates maternal age at delivery, pre-pregnancy body mass index, diabetes during pregnancy, socio-economic position, parity, depression and anxiety. MAIN OUTCOME MEASURES Sexual enjoyment and frequency at four time points postpartum (between 33 months and 18 years) and two types of sex-related pain (pain in the vagina during sex and elsewhere after sex) at 11 years postpartum. RESULTS We found no association between mode of delivery and sexual enjoyment (e.g. adjusted odds ratio [OR] 1.11, 95% confidence interval [95% CI] 0.97-1.27 at 33 months) or sexual frequency (OR 0.99, 95% CI 0.88-1.12 at 33 months). Caesarean section was associated with an increased odds of pain in the vagina during sex at 11 years postpartum as compared with vaginal delivery in the adjusted model (OR 1.74, 95% CI 1.46-2.08). CONCLUSIONS These findings provide no evidence supporting associations between caesarean section and sexual enjoyment or frequency. However, mode of delivery was shown to be associated with dyspareunia, which may not be limited to abdominal scarring.
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Affiliation(s)
- Florence Z. Martin
- MRC Integrative Epidemiology UnitPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Paul Madley‐Dowd
- Centre for Academic Mental HealthPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | | | | | - Abigail Fraser
- MRC Integrative Epidemiology UnitPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Harriet Forbes
- Centre for Academic Mental HealthPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
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Feutry L, Barbe C, Marquet-Dupont A, Fèvre A, Lukas-Croisier C, Vitellius G, Delemer B, Barraud S. Contraception use and knowledge related to pregnancy in diabetic women. ANNALES D'ENDOCRINOLOGIE 2022; 83:88-94. [PMID: 35143750 DOI: 10.1016/j.ando.2022.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/02/2022] [Accepted: 01/20/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Diabetes mellitus prevalence is increasing among women of child-bearing age. Diabetic pregnancy is associated with major maternal and fetal risks, and these can be reduced by preconception care. Pregnancy can be planned using appropriate effective contraception. The objective of this study was to assess diabetic patients' knowledge about pregnancy and to describe their contraceptive use. STUDY DESIGN An observational study was conducted from February to July 2020 at Reims University Hospital, France. Inclusion criteria were: women aged 18 to 40years, with type 1 (T1D) or type 2 diabetes (T2D). Patients filled out a survey about contraceptive use and knowledge regarding diabetic pregnancy and data were completed from medical records. RESULTS Eighty-nine T1D and 33 T2D patients were included, with mean ages of 27.9±6.3 and 32.6±4.6years, respectively. Seventy-five percent reported that they had been informed about pregnancy-related risks and 67% about the need to plan pregnancy. The preconception HbA1c target was known by 33% of patients. Appropriate knowledge about pregnancy was greater in T1D patients (65.9%, versus 36.4% in T2D patients; P=0.003). The rate of patients using an effective contraceptive method was 66.4%. Fifteen percent patients for whom contraception was recommended reported having no contraceptive method; 12.5% of contraception users were using a contraindicated method. CONCLUSION A large majority of diabetic women were aware of pregnancy-related risks and the importance of pregnancy planning, but there are still gaps, especially in T2D patients. We need to improve our practices by providing more information and better access to appropriate effective contraception. CLINICALTRIALS GOV NUMBER NCT04350879.
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Affiliation(s)
- Louise Feutry
- CHU de Reims, Hôpital Robert-Debré, Service d'Endocrinologie - Diabète - Nutrition, avenue du Général-Koenig, 51092 Reims cedex, France.
| | - Coralie Barbe
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne UFR Médecine, 51, rue Cognacq-Jay, 51100 Reims, France.
| | - Aurélie Marquet-Dupont
- Polyclinique Reims-Bezannes, Service de Gynécologie-Obstétrique, 109, rue Louis-Victor-de-Broglie, 51430 Bezannes, France.
| | - Anne Fèvre
- CHU de Reims, Hôpital Robert-Debré, Service d'Endocrinologie - Diabète - Nutrition, avenue du Général-Koenig, 51092 Reims cedex, France.
| | - Céline Lukas-Croisier
- CHU de Reims, Hôpital Robert-Debré, Service d'Endocrinologie - Diabète - Nutrition, avenue du Général-Koenig, 51092 Reims cedex, France.
| | - Géraldine Vitellius
- CHU de Reims, Hôpital Robert-Debré, Service d'Endocrinologie - Diabète - Nutrition, avenue du Général-Koenig, 51092 Reims cedex, France.
| | - Brigitte Delemer
- CHU de Reims, Hôpital Robert-Debré, Service d'Endocrinologie - Diabète - Nutrition, avenue du Général-Koenig, 51092 Reims cedex, France; CRESTIC EA 3804, Université de Reims Champagne-Ardenne, UFR Sciences Exactes et Naturelles, Moulin de la Housse, BP 1039, 51687 Reims cedex 2, France.
| | - Sara Barraud
- CHU de Reims, Hôpital Robert-Debré, Service d'Endocrinologie - Diabète - Nutrition, avenue du Général-Koenig, 51092 Reims cedex, France; CRESTIC EA 3804, Université de Reims Champagne-Ardenne, UFR Sciences Exactes et Naturelles, Moulin de la Housse, BP 1039, 51687 Reims cedex 2, France.
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Wilson LF, Dobson AJ, Doust J, Mishra GD. Socioeconomic, behavioural and health factors associated with chlamydia testing in sexually active young women: an Australian observational cohort study. Sex Health 2022; 19:112-121. [PMID: 35478079 DOI: 10.1071/sh21230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/10/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Chlamydia trachomatis is the most frequently notified sexually transmitted infection in Australia. Untreated infections in women can cause health problems. Professional guidelines encourage opportunistic testing of young people. To increase understanding of who is being tested, we investigated factors associated with testing in a population of young women. METHODS In total, 14002 sexually active women, aged 18-23 years at baseline (2013), from the Australian Longitudinal Study on Women's Health, were included. We used random intercepts, mixed-effects binary logistic regression with robust standard errors to assess associations between socioeconomic, health and behavioural factors and chlamydia testing. RESULTS Associations between chlamydia testing and partner status varied by a woman's body mass index (BMI). Compared to women with a stable partner/BMI <25kg/m2 , women with a stable partner/BMI ≥25kg/m2 were less likely to be tested (adjusted odds ratios [AOR]=0.79, 95% CI: 0.71-0.88). In contrast, although women without a partner were more likely to be tested irrespective of BMI, the odds were higher for those with a BMI <25kg/m2 (AOR=2.68, 95% CI: 2.44-2.94) than a BMI ≥25kg/m2 (AOR=1.65, 95% CI: 1.48-1.84). Women who reported a prior chlamydia infection were also more likely to be tested (AOR=2.01, 95% CI: 1.83-2.20), as were women engaging in any combination of cannabis use and/or heavy episodic drinking compared to doing neither of these activities. CONCLUSIONS Women without a partner, women with a prior chlamydia infection and those engaging in risk-taking behaviours are more likely to have chlamydia testing. Additional research is needed to understand whether there are deficits in testing among overweight/obese women.
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Affiliation(s)
- Louise Forsyth Wilson
- The University of Queensland, NHMRC Centre for Research Excellence on Women and Non-communicable Diseases (CREWaND), School of Public Health, Herston Road, Herston, Qld, Australia
| | - Annette Jane Dobson
- The University of Queensland, NHMRC Centre for Research Excellence on Women and Non-communicable Diseases (CREWaND), School of Public Health, Herston Road, Herston, Qld, Australia
| | - Jenny Doust
- The University of Queensland, NHMRC Centre for Research Excellence on Women and Non-communicable Diseases (CREWaND), School of Public Health, Herston Road, Herston, Qld, Australia
| | - Gita Devi Mishra
- The University of Queensland, NHMRC Centre for Research Excellence on Women and Non-communicable Diseases (CREWaND), School of Public Health, Herston Road, Herston, Qld, Australia
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12
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Angulo J, Hannan JL. Cardiometabolic Diseases and Female Sexual Dysfunction: Animal Studies. J Sex Med 2022; 19:408-420. [DOI: 10.1016/j.jsxm.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 01/21/2023]
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Davis AC, Arnocky S. An Evolutionary Perspective on Appearance Enhancement Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3-37. [PMID: 33025291 DOI: 10.1007/s10508-020-01745-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 05/15/2023]
Abstract
Researchers have highlighted numerous sociocultural factors that have been shown to underpin human appearance enhancement practices, including the influence of peers, family, the media, and sexual objectification. Fewer scholars have approached appearance enhancement from an evolutionary perspective or considered how sociocultural factors interact with evolved psychology to produce appearance enhancement behavior. Following others, we argue that evidence from the field of evolutionary psychology can complement existing sociocultural models by yielding unique insight into the historical and cross-cultural ubiquity of competition over aspects of physical appearance to embody what is desired by potential mates. An evolutionary lens can help to make sense of reliable sex and individual differences that impact appearance enhancement, as well as the context-dependent nature of putative adaptations that function to increase physical attractiveness. In the current review, appearance enhancement is described as a self-promotion strategy used to enhance reproductive success by rendering oneself more attractive than rivals to mates, thereby increasing one's mate value. The varied ways in which humans enhance their appearance are described, as well as the divergent tactics used by women and men to augment their appearance, which correspond to the preferences of opposite-sex mates in a heterosexual context. Evolutionarily relevant individual differences and contextual factors that vary predictably with appearance enhancement behavior are also discussed. The complementarity of sociocultural and evolutionary perspectives is emphasized and recommended avenues for future interdisciplinary research are provided for scholars interested in studying appearance enhancement behavior.
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Affiliation(s)
- Adam C Davis
- Faculty of Education, University of Ottawa, Ottawa, ON, Canada
| | - Steven Arnocky
- Department of Psychology, Nipissing University, North Bay, ON, P1B 8L7, Canada.
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Tang R, Fan Y, Luo M, Zhang D, Xie Z, Huang F, Wang Y, Liu G, Wang Y, Lin S, Chen R. General and Central Obesity Are Associated With Increased Severity of the VMS and Sexual Symptoms of Menopause Among Chinese Women: A Longitudinal Study. Front Endocrinol (Lausanne) 2022; 13:814872. [PMID: 35557846 PMCID: PMC9086713 DOI: 10.3389/fendo.2022.814872] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/24/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Strong evidence has linked overweight and obesity to increased risks of cardiovascular disease and all-cause mortality in Chinese populations. Menopause is considered associated with increased obesity and central body fat distribution. However, the correlation between obesity and menopausal symptoms has not been well studied. OBJECTIVE To examine the associations between obesity or abdominal obesity and menopausal symptoms as women progressed from premenopausal to postmenopausal status. DESIGN This study included 430 midlife Chinese women who had experienced natural menopause and were followed up for 10 years. Physical examinations and questionnaires should be completed annually. The questionnaires include the Menopause-Specific Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, and other physical and behavioral factors. RESULTS Among women who were not obese (n=345) or not abdominal obese (n=372) at baseline, 5.8% and 31.7% became obese or abdominal obese at the recent follow-up visit, respectively. Women at the recent follow-up visit had an increased body mass index (BMI) by 0.14%, and the waist-to-hip ratio (WHR) increased by 5.2% compared with the data at baseline. In multivariate analysis, more frequent hot flashes, moderate/severe bothered vasomotor symptoms (VMS), mild bothered sexual functioning, and less anxiety symptoms were significantly associated with obesity. Increasing age, moderate/severe bothered VMS, and less anxiety symptoms were independently associated with abdominal obesity. Multivariable analysis also showed that less education level is independently associated with both obesity and abdominal obesity. CONCLUSION Our findings suggest that the proportion of obesity and abdominal obesity increased gradually during menopause. The increase of abdominal obesity is more rapidly than obesity in middle-aged women. Both obesity and abdominal obesity are related with severe or frequent VMS and anxiety symptoms in Chinese women. Although the proportion of obese women in China is lower than in western countries, the problem of abdominal obesity and related complications cannot be ignored.
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Affiliation(s)
- Ruiyi Tang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Yubo Fan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Min Luo
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Duoduo Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Zhuolin Xie
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Feiling Huang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Yuchen Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Gaifen Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yaping Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Shouqing Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Rong Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
- *Correspondence: Rong Chen,
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Chen G, Sun L, Jiang S, Chen X, Zhu J, Zhao X, Yu S, Dong Z, Chen Y, Zhang W, Yang W, Wang C. Effects of bariatric surgery on testosterone level and sexual function in men with obesity: A retrospective study. Front Endocrinol (Lausanne) 2022; 13:1036243. [PMID: 36760810 PMCID: PMC9902700 DOI: 10.3389/fendo.2022.1036243] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/28/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Bariatric surgeries induce well-documented weight loss and resolve obesity comorbidities. Sexual function is one of the aspects of life quality and may benefit from surgery. Few studies have revealed the impact of bariatric surgeries on sexual function in Chinese men with obesity. METHODS This is a retrospective cohort study of patients undergoing bariatric surgery [laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB)]. Data were collected between September 2017 and February 2022. The International Index of Erectile Function (IIEF) questionnaire was used to evaluate erectile function, intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction. Sex hormones and other blood tests were evaluated before and at least 1 year after the surgery. RESULTS Fifty-nine Chinese male patients completed the IIEF questionnaire. The multivariate logistic regression analysis revealed that body mass index (BMI) was the single independent risk factor of the severity of erectile dysfunction (ED). Preoperative testosterone levels had negative correlations with BMI and waist circumference. Thirty-seven patients completed the postoperative questionnaire with a mean follow-up of 23.2 months. CONCLUSION BMI and waist circumference were negatively correlated with testosterone levels. BMI was an independent risk factor for the severity of ED. LSG and LRYGB led to positive and sustained improvement in sexual function of men with obesity. The two procedures had a comparable effect, more subjects being needed. Sex hormone levels also could be reversible. However, more weight loss did not predict a positive change in sexual function. A greater BMI loss might predict a greater increase in testosterone.
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Affiliation(s)
- Guoji Chen
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
- Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China
- Department of Gastrointestinal Surgery, The First People's Hospital of Zhaoqing, Zhaoqing, China
| | - Luping Sun
- Department of urinary Surgery, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shuwen Jiang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
- Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Xiaomei Chen
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
| | - Jie Zhu
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
- Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Xin Zhao
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
- Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Shuqing Yu
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
| | - Zhiyong Dong
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
- Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Yuan Chen
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
- Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Wen Zhang
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
- Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
- Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China
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16
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Ciangura C, Bachelot A. [Contraception in women with obesity]. Med Sci (Paris) 2021; 37:882-887. [PMID: 34647876 DOI: 10.1051/medsci/2021147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Obese women are at high risk of unintended pregnancy. In addition, obesity is an important risk factor for venous thromboembolism events and arterial thrombosis. All of these data are to be considered in choosing a contraceptive method for obese women. The metabolic changes and the increased body mass of these women may be the cause of a reduction in the effectiveness of hormonal contraception. The progestin-only contraceptives (progestin only pills and etonogestrel subdermal implant) and the intra-uterine devices are the preferred contraceptive methods in women with obesity. The combined estrogen-progestin contraceptives may be proposed in young obese women without other cardiovascular risk factor. Obesity per se does not seem to increase the risk of failure of most contraceptive methods. Bariatric surgery is a complex situation. Contraception is needed for at least 12 months after surgery. Some bariatric surgery such as bypass can induce gastrointestinal malabsorption. In this situation, all oral contraceptives are not recommended because of a higher risk of failure.
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Affiliation(s)
- Cécile Ciangura
- Service de nutrition, ICAN (Institut de cardiométabolisme et nutrition), Hôpital Pitié Salpêtrière, Sorbonne Université, 47-83 boulevard de l'hôpital, 75013 Paris, France
| | - Anne Bachelot
- Endocrinologie et médecine de la reproduction, Centre de référence des maladies endocriniennes rares de la croissance et du développement, Centre de référence des pathologies gynécologiques rares, Hôpital universitaire Pitié Salpêtrière, 47-83 boulevard de l'hôpital, 75013 Paris, France
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Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021; 18:1532-1544. [PMID: 37057431 DOI: 10.1016/j.jsxm.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/01/2021] [Accepted: 06/24/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Appearance dissatisfaction is a sensitive issue and has been tied to depression, dissatisfaction in romantic relationships, and reduced sexual satisfaction. AIM This study sought to examine associations between appearance satisfaction and specific sexual problems and related distress, testing also the moderating role of relationship satisfaction. METHODS A large web-sample of Norwegians in romantic relationships (N = 2,903) completed a one-time survey. OUTCOMES Participants reported on their experience of five different sexual problems and associated level of distress. RESULTS We found that appearance satisfaction was associated with reporting fewer sexual problems, and specifically, with a smaller likelihood of experiencing problems with lack of enjoyment, lack of excitement, and lack of climax. Furthermore, appearance satisfaction was unrelated to overall sexual problem-related distress, but was associated with feeling less distress about lack of excitement and lack of climax. Relationship satisfaction did not serve as a moderator of the associations. CLINICAL TRANSLATION These findings suggest the importance of attending to appearance satisfaction when working with clients with multiple sexual problems, particularly those related to excitement and enjoyment. STRENGTHS AND LIMITATIONS Strengths of the study include a large sample of partnered adults and assessment of specific sexual problems and associated distress. A limitation is that outcomes were assessed using single items, rather than multi-item scales. CONCLUSION The study highlights the importance of examining the presence of sexual problems and associated distress separately, and to consider appearance satisfaction as a predictor of sexual functioning. Øverup CS, Strizzi JM, Cipric A, et al. Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021;XX:XXX-XXX.
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18
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Change in Birth Rate Before and After Bariatric Surgery in France. Obes Surg 2021; 31:4657-4661. [PMID: 34254260 DOI: 10.1007/s11695-021-05561-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/31/2021] [Accepted: 06/09/2021] [Indexed: 10/20/2022]
Abstract
IMPORTANCE Bariatric surgery worldwide has grown significantly over the past years and is performed, in a vast majority, in women of childbearing age. The impact of these procedures on birth rates remains largely unknown. OBJECTIVE The main objective was to study the evolution of the birth rates in these women, before and after bariatric surgery and in comparison with women from the general population. The secondary objectives were to compare the birth rates before and after surgery according to the Body Mass Index (BMI) (BMI 40-50 versus >50 kg/m2). METHOD Our analyses are based on a national medico-administrative database. All women of childbearing age and who had bariatric surgery between 2012 and 2016 were included, and we included all deliveries between 2012 and 2018 in this population. We compared the birth rates before and after bariatric surgery. National statistics (INSEE, Institut National de la Statistique et des Etudes Economiques) were used for comparison with women from the general population. FINDINGS A total of 69,932 women were included between 2012 and 2016, with a median age at surgery of 33 years [27; 39]. Among them, 9391 (13%) had a BMI over 50 kg/m2 before surgery, 46,818 (67%) benefited from a sleeve gastrectomy (SG), and 23,376 (33%) from a gastric bypass (GBP). Birth rates tend to be smaller after surgery compared to before surgery for women under 27 years (OR: 0.92, CI95% [0.88; 0.96]), while being not different after 27 in both groups (OR: 1.00, CI95% [0.97; 1.03]). Birth rates of obese women who have benefited or will benefit from the bariatric surgery were higher than the general population, with a peak at a younger age, and then decline earlier than the general population. Trends were different according to BMI class. Birth rates were higher for women with BMI between 40 and 50 kg/m2 compared to women with BMI greater than 50 kg/m2 (OR=1.28, CI95% [1.21; 1.36]) before surgery while slightly lower after surgery (OR=0.95, CI95% [0.91; 0.99]). CONCLUSIONS AND RELEVANCE We showed that birth rates after bariatric surgery were not different before and after bariatric surgery except for women under 27 years old who had a smaller birth rate. Interestingly, we observed an improvement of birth rates after surgery for women with a BMI of 50 kg/m2 or more.
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Boyce TM, Neiterman E. Women in larger bodies' experiences with contraception: a scoping review. Reprod Health 2021; 18:89. [PMID: 33926501 PMCID: PMC8082612 DOI: 10.1186/s12978-021-01139-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/12/2021] [Indexed: 01/29/2023] Open
Abstract
Background As the prevalence of obesity increases and the age of onset decreases, more women of reproductive age will be living in larger bodies. Research on weight-related efficacy and safety has informed clinical guidelines for routine and emergency contraceptive use by women with a higher body mass index; however, patient perspectives are needed to understand women in larger bodies’ experiences with contraception and contraceptive care. This scoping review summarizes the literature on women in larger bodies’ experiences with contraception with the goal of gaining a better understanding of the nature of these experiences and identifying gaps in the existing research. Methods Following Arksey and O’Malley’s framework, a scoping review of the literature was conducted. Four databases (PubMed, PsycINFO, SCOPUS, and CINAHL) were searched for peer-reviewed, empirical articles published in English between 2010 and 2020, with a focus on North America, Europe, Australia, and New Zealand. Data were summarized by identifying key themes in the reviewed literature. Results Twenty-nine articles meeting the eligibility criteria were reviewed. The literature was predominantly quantitative (n = 27), with only one qualitative study and one systematic review, respectively. Five themes were identified, including (1) use of contraception among women in larger bodies; (2) knowledge, attitudes towards and beliefs about contraception; (3) contraceptive (dis)satisfaction among women in larger bodies; (4) contraceptive counseling; and (5) barriers to contraception. The findings revealed that women in larger bodies may have unmet contraceptive care needs. Despite many articles addressing the need to improve contraceptive counseling for women in larger bodies (n = 26), few explored how women felt about their care (n = 2). Finally, only two articles focused on emergency contraception, indicating a need for further research. Conclusion This scoping review emphasizes the pressing need for qualitative research to explore women in larger bodies’ experiences with routine and emergency contraception, as well as receiving contraceptive counseling and care. Future research exploring the lived experiences of women in larger bodies is necessary to better characterize their contraceptive needs and identify avenues to improve patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01139-2. As obesity becomes more prevalent, more women of reproductive age will be living in larger bodies. This review highlights what is known about women in larger bodies’ experiences with contraception and suggests where future research is needed. We searched four databases for papers published in English from 2010 to 2020. Our review included 29 articles. Nearly all of the studies were quantitative, with one qualitative study and one review. Most articles talked about contraceptive use, but few of them included emergency contraception. Some papers highlighted women’s knowledge and opinions about contraception, whereas others talked about their contraceptive (dis)satisfaction. Many articles discussed contraceptive counseling. Finally, some papers considered potential barriers to contraception. Our findings suggest that women in larger bodies have unmet contraceptive needs. Notably, this review aimed to focus on patient experiences but women’s voices were rarely represented. Future qualitative research on women’s lived experiences will provide a better understanding of women in larger bodies’ contraceptive needs and suggest how care can be improved.
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Affiliation(s)
- Tierney M Boyce
- School of Public Health and Health Systems, Faculty of Health, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Elena Neiterman
- School of Public Health and Health Systems, Faculty of Health, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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Prevalence of Sexual Dysfunction in Women with Obesity and Associated Factors. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-020-09672-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Têtu C, Gaubil-Kaladjian I, Barbe C, Diaz Cives A, Barrois M, Bertin E, Delemer B, Fèvre A. [Contraception after bariatric surgery: Importance of a specific gynecologic course]. ACTA ACUST UNITED AC 2021; 49:709-715. [PMID: 33766790 DOI: 10.1016/j.gofs.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Indexed: 11/27/2022]
Affiliation(s)
- C Têtu
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France.
| | - I Gaubil-Kaladjian
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France; Centre spécialisé de l'obésité de Champagne Ardenne (CSO CA), CHU Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - C Barbe
- CHU de Reims, Unité d'aide méthodologique, Pôle recherche et santé publique, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - A Diaz Cives
- Centre spécialisé de l'obésité de Champagne Ardenne (CSO CA), CHU Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France; Service de chirurgie générale digestive et endocrinienne, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - M Barrois
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France; Centre spécialisé de l'obésité de Champagne Ardenne (CSO CA), CHU Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - E Bertin
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France; Centre spécialisé de l'obésité de Champagne Ardenne (CSO CA), CHU Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - B Delemer
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - A Fèvre
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
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Changes of androgens levels in menopausal women. MENOPAUSE REVIEW 2021; 19:151-154. [PMID: 33488324 PMCID: PMC7812536 DOI: 10.5114/pm.2020.101941] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/11/2020] [Indexed: 12/13/2022]
Abstract
Androgens play an important role in women’s health. They are responsible for the sexual well-being and for maintaining proper structure and function of genitourinary woman’s tract. In menopausal period a relative increase in androgens level is observed as a result of dramatic demise of estrogens and increase of sex hormone-binding globulin (SHBG). However, the response of target tissue depends on its ability to control androgens availability. In menopausal women the symptoms of both hyperandrogenemia and of androgens deficiency may be observed. Hyperandrogenemia may result in discrete symptoms, such as slight terminal facial hair grow, or worsening of scalp hair loss. Those symptoms should not be belittled in any of the cases, especially when their severity increases one should seek possible causes of postmenopausal hyperandrogenemia. Ovarian and adrenal aging, leading to a progressive decline in androgen levels, may exert detrimental effects on the quality of life. During menopause, changes in activation of particular brain spheres are connected with low sex hormone concentration and correlate with loss of sexual arousability. Hypoactive sexual desire dysfunction (HSDD) may be the direct result of androgens deficiency in menopausal women. It is the only evidence-based indication for the use of testosterone in women. However, before treatment, other diseases must be excluded that might alternatively be the cause of HSDD.
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Köhler H, Markov V, Watschke A, Gruner-Labitzke K, Böker C, Mall J, Kröger C. Psychosocial Predictors of Work Ability in Morbidly Obese Patients: Results of a Cross-Sectional Study in the Context of Bariatric Surgery. Obes Facts 2021; 14:56-63. [PMID: 33352562 PMCID: PMC7983534 DOI: 10.1159/000511735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 09/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Obesity is associated with a higher risk of work disability and premature early retirement. OBJECTIVE The aim of this study was to examine psychosocial predictors for work ability prior to surgery. METHODS Based on a sample of 197 surgery-seeking obese patients (preoperative body mass index [BMI] above 35 kg/m2) from a German bariatric surgery unit, the present cross-sectional study examined based on standardized self-rating measures whether depressive symptoms, dysfunctional eating behaviors, relationship satisfaction, and life satisfaction have a predictive value for work ability. RESULTS Considerable impairment of work ability was found in 51.8% of morbidly obese participants (n = 102). Multiple regression analyses revealed that older age, greater depressive symptoms, and lower life satisfaction were significant predictors of preoperative work ability. BMI, gender, relationship satisfaction, and dysfunctional eating behaviors did not predict work ability. CONCLUSIONS Our findings might indicate the use of further psychosocial measures following bariatric surgery to increase work ability.
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Affiliation(s)
- Hinrich Köhler
- Department of General, Visceral, and Bariatric Surgery, Herzogin Elisabeth Hospital, Braunschweig, Germany,
| | - Valentin Markov
- Department of Psychology, University of Hildesheim, Hildesheim, Germany
| | - Anna Watschke
- Department of Psychology, University of Braunschweig, Braunschweig, Germany
| | - Kerstin Gruner-Labitzke
- Department of General, Visceral, and Bariatric Surgery, Herzogin Elisabeth Hospital, Braunschweig, Germany
| | - Clara Böker
- Department of General, Visceral, Vascular, and Bariatric Surgery, Klinikum Nordstadt, Hanover, Germany
| | - Julian Mall
- Department of General, Visceral, Vascular, and Bariatric Surgery, Klinikum Nordstadt, Hanover, Germany
| | - Christoph Kröger
- Department of Psychology, University of Hildesheim, Hildesheim, Germany
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The relation between sexuality and obesity: the role of psychological factors in a sample of obese men undergoing bariatric surgery. Int J Impot Res 2020; 34:203-214. [PMID: 33328607 DOI: 10.1038/s41443-020-00388-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/10/2020] [Accepted: 11/24/2020] [Indexed: 01/04/2023]
Abstract
Obesity produces a significant deterioration in general and sexual health. The aim of this cross-sectional study was to investigate the impact of obesity on sexuality, illustrating the psychological constructs that may play a significant role in determining sexual functioning and satisfaction. During the psychological assessment for bariatric surgery eligibility, 171 obese men filled out a socio-demographic questionnaire, the International Index of Erectile Function (IIEF), the 20 Item-Toronto Alexithymia Scale, the Symptom Checklist-90-Revised, the Body Uneasiness Test, and the Obesity-related Disability test. A series of hierarchical multiple regression analyses highlighted how obese men sexual desire (F(11,159) = 10.128, p < 0.001), erectile function (F(10,160) = 63.578, p < 0.001), orgasmic function (F(10,160) = 33.967, p < 0.001), intercourse satisfaction (F(7,163) = 159.752, p < 0.001), and general satisfaction (F(10,160) = 18.707, p < 0.001) were significantly associated with other IIEF sexual domains, difficulties in identifying feelings, psychopathological symptoms (such as depression and paranoid ideation), body image, and quality of life. Findings are useful for deepening understanding of obese male sexual response, and more generally, for analyzing the complex and multivariate relation between obesity and sexuality, supporting the need of a multidisciplinary approach to obesity care that includes professionals with specific training in sexology.
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Nilsson-Condori E, Järvholm S, Thurin-Kjellberg A, Hedenbro J, Friberg B. A New Beginning: Young Women's Experiences and Sexual Function 18 Months After Bariatric Surgery. Sex Med 2020; 8:730-739. [PMID: 32980296 PMCID: PMC7691881 DOI: 10.1016/j.esxm.2020.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction Female patients expect improved quality of life, including sexual health and regain of fertility after bariatric surgery. Little has been published on to the extent to which patients’ expectations are met by the weight loss after surgery. Aim To explore how women perceive the effects of bariatric surgery on quality of life, focusing on sexual health and fertility. Methods A qualitative study based on thematic analysis, supported by questionnaire data. Interviews following a semistructured guide were conducted with childless women (n = 11) aged 25–34 years recruited from a university-affiliated Swedish bariatric center. The interviews took place 18 months after surgery in the participants’ homes or at the hospital and were recorded and transcribed verbatim. Data were analyzed with a thematic approach. Questionnaires were filled in at the time of the interviews and compared with preoperative data using a Wilcoxon test for paired data. Main outcome measures Participants described experiences related to female sexual health after bariatric surgery. The Hospital Anxiety and Depression Scale and the Female Sexual Function Index questionnaires were administered preoperatively and postoperatively. Results “A new beginning” was identified as the master theme, with 3 underlying subthemes: “Being worthy of love,” “Exploring sexuality,” and “Considering parenthood.” The participants described a transformation into being more comfortable with themselves that affected all areas of life, including sexual life. These findings were supported by lower scores for depression, 6.5 vs 2, and improved total Female Sexual Function Index scores, median 23.3 preoperatively and 29.1 postoperatively, P = .012. Conclusions Improved body image and enhanced self-esteem play important roles in improved sexual functioning in women after bariatric surgery. Nilsson-Condori E, Järvholm S, Thurin-Kjellberg A, et al. A New Beginning: Young Women’s Experiences and Sexual Function 18 Months After Bariatric Surgery. Sex Med 2020;8:730–739.
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Affiliation(s)
- Emma Nilsson-Condori
- Division of Reproductive Medicine, Department of Translational Medicine, Lund University, Lund, Sweden.
| | - Stina Järvholm
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Division of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ann Thurin-Kjellberg
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Division of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jan Hedenbro
- Department of Surgery, Clinical Sciences, Lund University, Lund, Sweden
| | - Britt Friberg
- Division of Reproductive Medicine, Department of Translational Medicine, Lund University, Lund, Sweden
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Terzera L, Rimoldi SML, Barbiano di Belgiojoso E. Sexual satisfaction among italian university students. GENUS 2020. [DOI: 10.1186/s41118-020-00096-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractThis paper examines the determinants of sexual satisfaction among Italian young men and women at the beginning of their adulthood, taking into account the different stages of sentimental and sexual transitions. We based the analyses on the data collected in 2017 by the SELFY Survey on a sample of 7842 university students in Italy. Results of the logistic regression models highlight that, above all, sexual satisfaction is positively associated with the frequency of intercourse within a stable and exclusive relationship. Furthermore, results highlight the essential role of all transitions, sexual and sentimental, in enhancing sexual satisfaction, both in a positive and negative direction. Religion has a positive effect too, but only among students who have not yet had intercourse, expressing a protective effect of the adherence to beliefs. Significant differences between young men and women emerged mainly concerning performance, other conditions being equal.
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Ayton A, Ibrahim A. The Western diet: a blind spot of eating disorder research?-a narrative review and recommendations for treatment and research. Nutr Rev 2020; 78:579-596. [PMID: 31846028 PMCID: PMC7682725 DOI: 10.1093/nutrit/nuz089] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Over the last 50 years, in parallel with the obesity epidemic, the prevalence of eating disorders has increased and presentations have changed. In this narrative review, we consider recent research exploring the implications of changing patterns of food consumption on metabolic and neurobiological pathways, a hitherto neglected area in eating disorder research. One of the major changes over this time has been the introduction of ultra-processed (NOVA-4) foods, which are gradually replacing unprocessed and minimally processed foods. This has resulted in the increased intake of various sugars and food additives worldwide, which has important metabolic consequences: triggering insulin and glucose response, stimulating appetite, and affecting multiple endocrine and neurobiological pathways, as well as the microbiome. A paradigm shift is needed in the conceptual framework by which the vulnerability to, and maintenance of, different eating disorders may be understood, by integrating recent knowledge of the individual metabolic responses to modern highly processed foods into existing psychological models. This could stimulate research and improve treatment outcomes.
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Affiliation(s)
- Agnes Ayton
- University of Oxford, Oxford, United Kingdom
| | - Ali Ibrahim
- South London and Maudsley NHS Foundation Trust, Snowsfields Adolescent Unit, Mapother House, Maudsley Hospital, London
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Maya ET, Boamah MO, Agyabeng K, Srofenyoh E, Mumuni K, Samba A. Prevalence of sexual dysfunction among prenatal women attending the Greater Accra Regional Hospital, Ghana. Int J Gynaecol Obstet 2020; 151:49-56. [PMID: 32682333 DOI: 10.1002/ijgo.13314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 05/24/2020] [Accepted: 07/15/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To estimate the prevalence and types of sexual dysfunction in pregnancy. METHODS A cross-sectional facility-based descriptive study among pregnant women attending the prenatal clinic of the Greater Accra Regional Hospital, a large tertiary health facility in Accra, Ghana, from May to June 2018. The inclusion criteria were 18 years or older, singleton pregnancy of 8 gestational weeks or more, and residing with their partner for at least 4 weeks before the study. Face-to-face interviews were conducted among consecutively enrolled women by using the Female Sexual Function Index (FSFI) tool. RESULTS Overall, 425 women were enrolled. The mean age was 30.8 ± 4.8 years. The mean gestational age was 32.3 ± 7.1weeks (range 9.7-42.0 weeks). The prevalence of sexual dysfunction in pregnancy was 64.9% (95% confidence interval [CI], 60.3%-69.4%) but only 32 (7.5%) women self-reported sexual problems. The predominant types of sexual disorder were desire disorder (377 [88.7%; 95% CI, 85.3%-91.4%] women) and arousal disorder (320 [75.3%; 95% CI, 71.0%-79.2%]). CONCLUSION Sexual dysfunction in pregnancy was found to be common, but most pregnant women were not aware that they had it.
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Affiliation(s)
- Ernest T Maya
- School of Public Health, University of Ghana, Accra, Ghana
| | - Martin O Boamah
- Department of Obstetrics and Gynecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Kofi Agyabeng
- School of Public Health, University of Ghana, Accra, Ghana
| | - Emmanuel Srofenyoh
- Department of Obstetrics and Gynecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Kareem Mumuni
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
| | - Ali Samba
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
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Faubion SS, Fairbanks F, Kuhle CL, Sood R, Kling JM, Vencill JA, Mara KC, Kapoor E. Association Between Body Mass Index and Female Sexual Dysfunction: A Cross-sectional Study from the Data Registry on Experiences of Aging, Menopause, and Sexuality. J Sex Med 2020; 17:1971-1980. [PMID: 32771351 DOI: 10.1016/j.jsxm.2020.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/24/2020] [Accepted: 07/02/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Obesity and female sexual dysfunction (FSD) are prevalent conditions, and both are associated with significant adverse effects on health and well-being. AIM To investigate the association between body mass index and FSD, as well as potential moderators. METHODS This cross-sectional study was performed by analyzing medical records of 6,688 women seeking consultation for menopause-related or sexual health-related concerns at women's health clinics at Mayo Clinic Rochester, MN, and Scottsdale, AZ, between May 1, 2015, and September 15, 2019. OUTCOMES Female sexual function was assessed by the Female Sexual Function Index, and sexual distress was assessed by the Female Sexual Distress Scale-Revised. RESULTS Being overweight or obese was associated with a lack of sexual activity. Among sexually active women, those who were overweight or obese had lower Female Sexual Function Index total scores and sexual function domain scores (indicating worse sexual function), including sexual arousal, lubrication, satisfaction, orgasm, and pain, and higher levels of sexual distress than those with normal weight. However, on multivariable analysis, these associations were found to be mediated by other factors, including age, level of education, reproductive stage, medication use, and mood disturbances, which are known to impact body weight and sexual function in women. CLINICAL IMPLICATIONS Overweight and obesity were associated with sexual inactivity and greater odds of having FSD, which should prompt proactive assessment of sexual function. STRENGTHS AND LIMITATIONS The strengths of this study include the large cohort size and assessment of sexual problems in addition to sexual distress, a key component of the definition of sexual dysfunction. This study also took into account multiple potential moderating factors. Limitations include the cross-sectional design, which precludes determination of causality as well as lack of diversity in the cohort, potentially limiting generalizability of results. In addition, sexual function was not assessed in women reporting no recent sexual activity, which may confound results. CONCLUSION Overweight/obesity and FSD are highly prevalent conditions, which appear to be indirectly associated. These results highlight the need to identify and address FSD in all overweight and obese women, with particular attention to potential contributing factors. Faubion SS, Fairbanks F, Kuhle CL, et al. Association Between Body Mass Index and Female Sexual Dysfunction: A Cross-sectional Study from the Data Registry on Experiences of Aging, Menopause, and Sexuality. J Sex Med 2020;17:1971-1980.
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Affiliation(s)
- Stephanie S Faubion
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA.
| | - Flavia Fairbanks
- Department of Obstetrics and Gynecology and PROSEX, University of Sāo Paulo School of Medicine, Sao Paulo, Brazil
| | - Carol L Kuhle
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Richa Sood
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Jennifer A Vencill
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA
| | - Kristin C Mara
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Ekta Kapoor
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA
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Urbute A, Thomsen LT, Belmonte F, Kesmodel US, Frederiksen K, Kjaer SK. The role of body mass index in incidence and persistence of cervical human papillomavirus infection. Ann Epidemiol 2020; 49:36-41. [PMID: 32711054 DOI: 10.1016/j.annepidem.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to assess the association between body mass index and incident or persistent cervical high-risk human papillomavirus (hrHPV) infection. METHODS This cohort study included 6809 women from the general Danish population who participated in two clinical visits (in 1991-1993 and in 1993-1995). Height and weight were measured by nurses, lifestyle data were obtained by structured interviews, and cervical cytology samples were obtained for hrHPV DNA testing. We conducted log-binomial regression to estimate risk ratios (RRs) with 95% confidence intervals (CIs) of incident and type-specific persistent hrHPV infection according to body mass index, adjusting for age, education, smoking, and the number of sexual partners in the past year. RESULTS We found no increased risk of incident hrHPV infection in women who were underweight (RRadjusted, 0.97; 95% CI, 0.64-1.48), overweight (RRadjusted, 0.98, 95% CI, 0.82-1.17), or obese (RRadjusted, 0.93; 95% CI, 0.63-1.36) compared with women of normal weight. The risk of hrHPV persistence was similar in overweight (RRadjusted, 0.98; 95% CI, 0.71-1.34) and obese (RRadjusted, 1.00; 95% CI, 0.56-1.79) women compared with women of normal weight, whereas underweight women had a lower risk (RRadjusted, 0.32; 95% CI, 0.11-0.95). CONCLUSIONS Overweight and obesity were not associated with HPV incidence or persistence when adjusting for sexual behavior.
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Affiliation(s)
- Aivara Urbute
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Federica Belmonte
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ulrik Schiøler Kesmodel
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Kirsten Frederiksen
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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Kvalem IL, Graham CA, Hald GM, Carvalheira AA, Janssen E, Štulhofer A. The role of body image in sexual satisfaction among partnered older adults: a population-based study in four European countries. Eur J Ageing 2020; 17:163-173. [PMID: 32549871 PMCID: PMC7292835 DOI: 10.1007/s10433-019-00542-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Body image issues can affect all domains of sexual functioning. The aim of this study was to examine how, in a sociocultural context where physical and sexual attractiveness is equated with young and slim body ideals, appearance dissatisfaction and importance are related to sexual satisfaction in older adults in four European countries. A cross-sectional survey with probability samples of the population aged 60-75 years was used. Only respondents with a partner were included in this paper, and the countries included Norway (n = 957), Denmark (n = 846), Belgium (n = 612), and Portugal (n = 367). Sexual satisfaction, appearance dissatisfaction, and importance were assessed, and frequency of intercourse/kissing and cuddling, relationship satisfaction, age, and body mass index were all used as control variables. Belgian men scored significantly lower on sexual satisfaction, while there was no difference in sexual satisfaction in women. Appearance dissatisfaction was lower in Scandinavian women and men, and in Belgian men, and appearance salience was lower in Norwegian men and women, and in Portuguese women. Linear regression analysis revealed that, adjusting for confounders, appearance dissatisfaction was significantly related to sexual satisfaction in Scandinavian women and men, as well as in Belgian men. Compared to research on younger adults, appearance evaluation appeared to play an equally important role in sexual satisfaction in older adults in our study. The variation in appearance dissatisfaction in older adults across European countries is a novel finding that needs to be examined further.
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Bag S, Akbas F. The Impact of Obesity on Sexual Functions and Dyadic Consensus in Patients with Obesity. Metab Syndr Relat Disord 2020; 18:308-312. [PMID: 32392432 DOI: 10.1089/met.2020.0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: Obesity is a chronic disease with several co-morbidities that increase morbidity and mortality and decrease quality of life. Psychopathologies are an important group of co-morbidities. In this study, it was aimed to search for the presence of depression and sexual dysfunction in patients with obesity, examine impact of obesity on marital adjustment, and highlight those important problems that are usually overlooked. Methods: Fifty patients who were seen in the obesity outpatient clinic in a random month as case group and gender-matched 50 healthy individuals as control group were included in the study. The inclusion criteria were body mass index (BMI) ≥30 kg/m2 and having a sexual partner. The exclusion criteria were having psychiatric/mental or any other chronic illness, using medication that would affect sexual functions, and alcohol/substance abuse. After recording the sociodemographic data, patients were asked to take three internationally validated questionnaires: The Arizona Sexual Experience Scale (ASEX), Dyadic Adjustment Scale (DAS), and Beck Depression Inventory (BDI). Results were analyzed using SPSS. Results: Fifty patients with obesity as case group and 50 normal weight healthy persons as control group were included in the study. BMI and BDI score were significantly higher in the case group than in the control group. DAS score was lower in the case group for consensus and affectional expression than the control group but there was no difference for satisfaction, cohesion, or total score between the groups. ASEX score was higher in the case group than in the control group. Conclusion: Patients with obesity have dyadic consensus problems with their partners. Their excessive weight causes distress and difficulty in expressing their feelings and usually results in marital problems and depression. Evaluation of the patient with a multidisciplinary approach in obesity centers will allow patients to be analyzed in every aspect of obesity including these issues and contribute to the success of the treatment.
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Affiliation(s)
- Sevda Bag
- Department of Psychiatry Clinic and University of Health Sciences, Istanbul Training and Research Hospital, İstanbul, Turkey
| | - Feray Akbas
- Department of Internal Medicine Clinic, University of Health Sciences, Istanbul Training and Research Hospital, İstanbul, Turkey
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Berkemeier S, Cheney K, Farber R, Sim KA, Black KI. The influence of maternal obesity on pregnancy intention: A cross-sectional analysis. Aust N Z J Obstet Gynaecol 2020; 60:474-478. [PMID: 32227338 DOI: 10.1111/ajo.13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 02/21/2020] [Indexed: 11/30/2022]
Abstract
This prospective cross-sectional study of 1498 pregnant women in early pregnancy sought to investigate the prevalence of pregnancy intention between women of differing body mass index (BMI) categories. There was no difference in the risk of unintended pregnancy between women who were in the healthy weight, overweight or obesity BMI categories. The study identifies and highlights the potential missed opportunities for all women to engage in healthy reproductive life planning behaviours to support health in pregnancy and beyond.
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Affiliation(s)
- Sophia Berkemeier
- Discipline of Obstetrics Gynaecology and Neonatology, The University of Sydney, Sydney, New South Wales, Australia
| | - Kate Cheney
- Discipline of Obstetrics Gynaecology and Neonatology, The University of Sydney, Sydney, New South Wales, Australia.,RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Rachel Farber
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kyra A Sim
- Charles Perkins Centre, Boden Collaboration, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Local Health District, Sydney, New South Wales, Australia
| | - Kirsten I Black
- Discipline of Obstetrics Gynaecology and Neonatology, The University of Sydney, Sydney, New South Wales, Australia.,RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Detection and quantification of the anti-obesity drug celastrol in murine liver and brain. Neurochem Int 2020; 136:104713. [PMID: 32151623 DOI: 10.1016/j.neuint.2020.104713] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 12/25/2022]
Abstract
Celastrol is a natural pentacyclic triterpene extracted from the roots of Tripterygium wilfordi (thunder god vine). Celastrol was reported as a powerful anti-obesity drug with leptin sensitizing properties that decreases food consumption and mediates body weight loss when administered to diet-induced obese mice at 100 μg/kg body weight. The weight lowering properties of celastrol are likely mediated by the CNS, in particular, by the hypothalamus, but the final proof for the accumulation of celastrol in the brain and hypothalamus remains to be established. Here, we aimed to demonstrate that intraperitoneal celastrol administration at 100 μg/kg can rapidly reach the brain and, in particular, the hypothalamus of mice. We developed and validated a sensitive liquid chromatography mass spectrometry method for the quantitative determination of celastrol in murine tissues, namely liver, brain and hypothalamus. Chow-fed lean mice were randomly assigned to the vehicle vs. celastrol groups, injected with saline or 100 μg/kg body weight of celastrol, and sacrificed 30 min or 120 min post injection. Celastrol was extracted from homogenized tissue using ethyl acetate as organic solvent, and quantified using a matrix-matched calibration curve with glycyrrhetinic acid as internal standard. Liver celastrol concentrations were 32.60 ± 8.21 pg/mg and 40.52 ± 15.6 pg/mg, 30 and 120 min after injection, respectively. We found 4.70 ± 0.31 pg/mg celastrol after 30 min, and 16.22 ± 3.33 pg/mg after 120 min in whole brain lysates, and detectable amounts in the hypothalamus. These results corroborate the validity of our methodology, demonstrate the accumulation of celastrol in the brain of mice injected intraperitoneally with a dose of 100 μg/kg, and confirm the CNS as possible site of action for the weight lowering properties of celastrol.
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Mollaioli D, Ciocca G, Limoncin E, Di Sante S, Gravina GL, Carosa E, Lenzi A, Jannini EAF. Lifestyles and sexuality in men and women: the gender perspective in sexual medicine. Reprod Biol Endocrinol 2020; 18:10. [PMID: 32066450 PMCID: PMC7025405 DOI: 10.1186/s12958-019-0557-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 10/17/2018] [Indexed: 01/13/2023] Open
Abstract
Sexual health is strictly related with general health in both genders. In presence of a sexual dysfunction, the expert in sexual medicine aims to discover the specific weight of the physical and psychological factors can cause or con-cause the sexual problem. At the same time, a sexual dysfunction can represent a marker of the future development of a Non-communicable diseases (NCDss) as cardiovascular or metabolic diseases.In the evaluation phase, the sexual health specialist must focus on these aspects, focusing especially on the risk and protective factors that could impact on both male and female sexuality.This article presents a review of researches concerning healthy and unhealthy lifestyles and their contribute in the development of sexual quality of life in a gender-dependent manner.Among the unhealthy lifestyle, obesity contributes mostly to the development of sexual dysfunctions, due to its negative impact on cardiovascular and metabolic function. Tobacco smoking, alcohol - substance abuse and chronic stress lead to the development of sexual dysfunction in a med-long term.In order to guarantee a satisfying sexual quality of life, sexual health specialists have the responsibility to guide the patient through the adoption of healthy lifestyles, such as avoiding drugs, smoke and excessive alcohol, practicing a regular physical activity, following a balanced diet and use stress-management strategies, even before proposing both pharmaco- and/or psychotherapies.
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Affiliation(s)
- Daniele Mollaioli
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Giacomo Ciocca
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Erika Limoncin
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Stefania Di Sante
- grid.7841.aDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, Rome, 00161 Italy
| | - Giovanni Luca Gravina
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio (Coppito 2), L’Aquila, 67100 Italy
| | - Eleonora Carosa
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio (Coppito 2), L’Aquila, 67100 Italy
| | - Andrea Lenzi
- grid.7841.aDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, Rome, 00161 Italy
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Grabovac I, Cao C, Haider S, Stefanac S, Jackson SE, Swami V, McDermott DT, Smith L, Yang L. Associations Among Physical Activity, Sedentary Behavior, and Weight Status With Sexuality Outcomes: Analyses from National Health and Nutrition Examination Survey. J Sex Med 2020; 17:60-68. [DOI: 10.1016/j.jsxm.2019.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/16/2019] [Accepted: 10/12/2019] [Indexed: 12/20/2022]
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McNabney SM, Wiese GN, Rowland DL. From Table to Bedroom: Nutritional Status, Dietary Interventions, and Women’s Sexual Function. CURRENT SEXUAL HEALTH REPORTS 2019. [DOI: 10.1007/s11930-019-00224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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La anticoncepción en la mujer obesa. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2019. [DOI: 10.1016/j.gine.2019.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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FSRH Guideline (April 2019) Overweight, Obesity and Contraception. BMJ SEXUAL & REPRODUCTIVE HEALTH 2019; 45:1-69. [PMID: 31053605 DOI: 10.1136/bmjsrh-2019-ooc] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Bates JN, Pastuszak AW, Khera M. Effect of Body Weight on Sexual Function in Men and Women. CURRENT SEXUAL HEALTH REPORTS 2019; 11:52-59. [PMID: 31576197 PMCID: PMC6771291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE OF REVIEW Obesity is a growing problem worldwide. This review aims to summarize the literature on the effects of weight on sexual function in both men and women from the past 5 years. RECENT FINDINGS In recent population-based studies of men and women, no relationship between weight and sexual function was identified. However, in studies of special populations such as women with gestational diabetes, polycystic ovarian syndrome (PCOS), pelvic organ prolapse or urinary incontinence, weight affected some aspects of sexual function. In women, surgical, but not non-surgical, weight loss was associated with resolution of some aspects of sexual dysfunction. In contrast, in men, both surgical and non-surgical weight loss improved sexual function. SUMMARY Weight plays a role in sexual dysfunction in both men and women. Bariatric surgery is linked to improved sexual function in both genders. However, more work is needed to fully understand the relationship between weight and sexual function.
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Affiliation(s)
| | - Alexander W. Pastuszak
- Department of Surgery - Urology, University of Utah, Salt Lake City, UT
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX
| | - Mohit Khera
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX
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Harris JA, Garrett AA, Akers AY. Obesity and Disparities in Human Papillomavirus Vaccination for U.S. Adolescent Girls and Young Women. Womens Health Issues 2019; 29:31-37. [PMID: 30446328 PMCID: PMC6295283 DOI: 10.1016/j.whi.2018.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/10/2018] [Accepted: 09/25/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Obesity is recognized as a barrier to receiving women's preventive health services, including cervical and breast cancer screening. Little is known about whether obesity is associated with a lower incidence of human papillomavirus (HPV) vaccination, another important preventive care service for adolescent girls and young women. The objective of this study was to determine if adolescent girls and young women with obesity are less likely to receive HPV vaccination compared with individuals with normal weight. METHODS We examined whether HPV vaccination was associated with obesity status in women aged 9-30 years surveyed from 2009 to 2016 by the U.S. National Health and Nutrition Examination Survey. Results from logistic and linear regression models were adjusted for age, race, income, insurance status, self-reported health, and health care use, accounting for the weighted survey design. RESULTS The final cohort included 5,517 women. Overall, 32.9% of participants reported vaccination, with a mean age at vaccination of 15.8 years. Adolescent girls and young women with obesity were less likely to report vaccination; the adjusted odds ratio of vaccination was 0.79 (p = .01) compared with normal weight women. Among those vaccinated, the age at vaccination was significantly older for women with obesity, 16.3 years compared with 15.2 years (p = .002), but there was no difference in the completion of the vaccination series rate by obesity. CONCLUSIONS Adolescent girls and young women with obesity were less likely to report HPV vaccination and, if they were vaccinated, received the vaccination at a later age.
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Affiliation(s)
- John A Harris
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; Magee-Womens Research Institute and Foundation, Pittsburgh, Pennsylvania.
| | - Alison A Garrett
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania
| | - Aletha Y Akers
- The Craig Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Irandoost SF, Taghdisi MH, Dehdari T, Bayangani B, Azadi NA. Obesity consequences from the people's perspective living in Kurdish regions of Iran: A qualitative content analysis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:159. [PMID: 31544124 PMCID: PMC6745888 DOI: 10.4103/jehp.jehp_13_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 05/24/2019] [Indexed: 05/06/2023]
Abstract
BACKGROUND Overweight and obesity are one of the most public health problems in the world. Considering obesity prevalence and its widespread health, economic, psychological, and social consequences, this study aimed to explain the consequences of obesity among women and men in the Kurdish region of Mukryan. SUBJECTS AND METHODS The present qualitative study was conducted in the Mukryan Kurdish region in West Azerbaijan province in Iran from June 2017 to November 2017. Data were collected by deep interview, focus group and dialogue with 111 obese and thin men and women and various fields experts who were selected by purposive sampling, and analyzed by qualitative content analysis technique of conventional type and Graneheim and Lundman steps. RESULTS Data analysis results were classified into two categories and 12 subcategories: Favorable consequences of normal obesity (social acceptance, internalization of obesity, and reproduction of the family institution), unfavorable consequences of extreme obesity (decreasing agency, physical-psychological dysfunctionalities, family fragility, prevalence of passive leisure, clothing obligation, social objectivity, exogenous and endogenous social exclusion, imposing economic costs, and devaluation of life). CONCLUSION With due attention to unfavorable consequences of extreme obesity on health, illness, social issues and costs, simultaneously with the adoption of preventive approaches to obesity through targeted policies in education, health literacy, promotion of sport culture, development of sports context especially for women, improving recreational facilities, etc., appropriate planning and interventions should be designed and applied for changing the behavior, culture, and community beliefs in dealing with obesity phenomenon.
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Affiliation(s)
- Seyed Fahim Irandoost
- Department of Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Taghdisi
- Department of Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Address for correspondence: Prof. Mohammad Hosein Taghdisi, Department of Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran. E-mail:
| | - Tahereh Dehdari
- Department of Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Bahman Bayangani
- Department of Social Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Nammam Ali Azadi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Vigoureux S, Le Guen M. [Current knowledge on contraceptive knowledge in France: CNGOF Contraception Guidelines]. ACTA ACUST UNITED AC 2018; 46:777-785. [PMID: 30416022 DOI: 10.1016/j.gofs.2018.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To summarize current knowledge on contraceptive coverage in France and worldwide, describe the effectiveness of different types of contraceptives, describe the characteristics of women using contraception, contraceptive failure situations and describe the different medical risks associated with contraceptive methods. METHODS Consultation of the Medline database and of national or international reports on contraception. RESULTS Contraceptive coverage in France is high: 97% of women in 2013 use a contraceptive method (among fertile, sexually active women without a desire for pregnancy), with a majority using medical methods (72% using pills and other hormonal contraceptives, intrauterine devices and 25% using natural and traditional barrier methods). The 2013 pill scare called into question the use of estrogen-progestogenic contraception and the information provided by doctors, but the pill remains the first contraceptive method followed by the intrauterine device, condoms and the traditional and natural methods. Lifetime contraceptive coverage changes according to a defined standard in France: condoms for the teen-agers, pills before pregnancy and then intrauterine devices after childbirth. Sterilization is very rarely chosen and offered. Contraception in France remains a predominantly female domain. Women and couples should be informed about all contraceptive methods, allowing them to choose the method that best suits their health, living conditions and sexuality.
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Affiliation(s)
- S Vigoureux
- Service de gynécologie obstétrique, hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), 78, rue du Général-Leclerc, 94000 Le Kremlin-Bicêtre, France; Faculté de médecine Paris-Sud, université Paris-Sud, 94276 Le Kremlin-Bicêtre, France; Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Équipe « Genre, sexualité, santé », hôpital Paul-Brousse, 94807 Villejuif, France.
| | - M Le Guen
- Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Équipe « Genre, sexualité, santé », hôpital Paul-Brousse, 94807 Villejuif, France; Institut National d'Etudes Démographiques, 75020 Paris, France
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Chu DT, Minh Nguyet NT, Dinh TC, Thai Lien NV, Nguyen KH, Nhu Ngoc VT, Tao Y, Son LH, Le DH, Nga VB, Jurgoński A, Tran QH, Van Tu P, Pham VH. An update on physical health and economic consequences of overweight and obesity. Diabetes Metab Syndr 2018; 12:1095-1100. [PMID: 29799416 DOI: 10.1016/j.dsx.2018.05.004] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/04/2018] [Indexed: 12/21/2022]
Abstract
Overweight and obesity (OW and OB) have been on the increase globally and posed health risks to the world's population of all ages, including pre-born babies, children, adolescents, adults and elderly people, via their comorbid conditions. Excellent examples of comorbidities associated with obesity include cancer, cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM). In this article, we aimed to review and update scientific evidence regarding the relationships between obesity and its common physical health consequences, including CVD, T2DM, hypertension, ischemic stroke, cancer, dyslipidemia and reproductive disorders. In addition, the economic burden of OW and OB will be discussed. Abundant evidence is found to support the associations between obesity and other diseases. In general, the odd ratios, risk ratios or hazard ratios are often higher in OW and OB people than in the normal-weight ones. However, the molecular mechanism of how OW and OB induce the development of other diseases has not been fully understood. Figures also showed that obesity and its-related disorders exert enormous pressure on the economy which is projected to increase. This review highlights the fact that obesity can lead to numerous lethal health problems; therefore, it requires a lot of economic resources to fight against this epidemic.
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Affiliation(s)
- Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam; Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Vietnam.
| | - Nguyen Thi Minh Nguyet
- Center for Environment and Health Studies, Thai Binh Medical University, Thai Binh, Vietnam
| | - Thien Chu Dinh
- Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Vietnam
| | | | - Khanh-Hoang Nguyen
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | | | - Yang Tao
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing, 8 210095, China
| | - Le Hoang Son
- VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Duc-Hau Le
- VINMEC Research Institute of Stem Cell and Gene Technology, Hanoi, Vietnam
| | - Vu Bich Nga
- National Institute of Diabetes and Metabolic Disorders, Hanoi, Vietnam
| | - Adam Jurgoński
- Department of Biological Function of Food, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Tuwima 10 Str., 10-748, Olsztyn, Poland
| | - Quoc-Hung Tran
- University of Economics and Business, Vietnam National University, Hanoi, Vietnam
| | - Pham Van Tu
- Faculty of Social Work, Hanoi National University of Education, Hanoi, Vietnam
| | - Van-Huy Pham
- AI Lab, Faculty of Information Technology, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
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Roxo L, Virgolino A, Costa J, Alarcao V. Understanding the relationship between BMI and sexual dysfunction: Can DSM-5 shed light into this topic? Rev Int Androl 2018; 17:130-137. [PMID: 30195481 DOI: 10.1016/j.androl.2018.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/06/2018] [Accepted: 07/16/2018] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The links between body weight and sexuality, notably sexual dysfunction (SD), are intricate and not yet fully understood. A more individual-focused evaluation of sexual difficulties, as recently provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), contributes to improve precision in SD diagnosis and has the potential to advance our knowledge on the association between body weight and SD. OBJECTIVES To identify gender differences in sexual behaviors and SD among Portuguese men and women within different classes of body mass index (BMI); and to explore the association between BMI and SD by using the new DSM-5 criteria. MATERIAL AND METHODS Face-to-face interviews followed by self-completed questionnaires of primary healthcare users in Portugal (n=323). Data on sociodemographic variables, BMI, sexual behaviors and SD were collected. DSM-5 criteria were used to assess sexual dysfunction. The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) for men and women, respectively, were used for comparison purposes. RESULTS Overweight and obese women reported less sexual partners, less satisfaction with sexual frequency and rated sexual life as less important. These differences were not found among men. Normal weight men and women had a higher score of IIEF and FSFI, respectively, than those overweight and obese. No significant effects of BMI scale on SD following DMS-5 were detected. CONCLUSIONS Women's sexual function is more impacted by BMI than men's. Individual-orientated approaches, as proposed in DSM-5, may allow a better understanding on the relation between body size and sexuality in both genders.
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Affiliation(s)
- Luis Roxo
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT) Universidade Nova de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal.
| | - Ana Virgolino
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Joana Costa
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Violeta Alarcao
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Centro de Investigação e Estudos de Sociologia (CIES-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
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Kudesia R, Wu H, Hunter Cohn K, Tan L, Lee JA, Copperman AB, Yurttas Beim P. The effect of female body mass index on in vitro fertilization cycle outcomes: a multi-center analysis. J Assist Reprod Genet 2018; 35:2013-2023. [PMID: 30132171 DOI: 10.1007/s10815-018-1290-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/09/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The aim of this study is to examine the impact of female body mass index (BMI) on IVF cycle outcomes. METHODS This is a retrospective cohort study including 51,198 women who initiated their first autologous IVF cycle in 13 fertility centers in the USA between 2009 and 2015. The effect of underweight, overweight, and obese BMI on four different IVF cycle outcomes (cycle cancellation, oocyte and embryo counts, and ongoing clinical pregnancy [OCP]) was evaluated in logistic or Poisson regression analyses with confounders adjusted. RESULTS Women with an overweight or obese BMI experienced worse outcomes than those with a normal BMI. These differences included (1) greater odds of cycle cancellation (aOR [95%CI] 1.17 [1.08, 1.26] for overweight, 1.28 [1.15, 1.41] for class-I obesity, and 1.50 [1.33, 1.68] for class-II/III obesity, P < .001 for all); (2) fewer oocytes retrieved (aIRR [95%CI] 0.98 [0.98,0.99] for class-I obesity, 0.93 [0.92,0.94] for class-II/III obesity, P < .001 for both); (3) fewer usable embryos (aIRR [95%CI] 0.98 [0.97,0.99] for overweight, 0.97 [0.96,0.99] for class-I obesity, 0.95 [0.93,0.97] for class-II/III obesity, P < .01 for all); and (4) lower odds of OCP (aOR [95%CI] 0.89 [0.83,0.95] for class-I obesity, 0.86 [0.79,0.93] for class-II/III obesity, P < .001 for both). In a subgroup analysis based on primary infertility diagnosis, these trends persisted in those with male or uterine factor and were especially pronounced in women with ovulatory dysfunction or PCOS. CONCLUSIONS A BMI above the normal range was an independent negative prognostic factor for multiple outcomes, including cycle cancellation, oocyte and embryo counts, and OCP. These negative outcomes were most profound in women with class-II/III obesity, ovulatory dysfunction, or PCOS.
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Affiliation(s)
- Rashmi Kudesia
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th floor, New York, NY, 10022, USA.,Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, 1176 Fifth Avenue, New York, NY, 10029, USA
| | - Hongyu Wu
- Celmatix Inc., 14 Wall Street, Suite 16D, New York, NY, 10005, USA
| | | | - Lei Tan
- Celmatix Inc., 14 Wall Street, Suite 16D, New York, NY, 10005, USA
| | - Joseph A Lee
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th floor, New York, NY, 10022, USA
| | - Alan B Copperman
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th floor, New York, NY, 10022, USA.,Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, 1176 Fifth Avenue, New York, NY, 10029, USA
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Pre-pregnancy body mass index classification and gestational weight gain on neonatal outcomes in adolescent mothers: A follow-up study. PLoS One 2018; 13:e0200361. [PMID: 30001386 PMCID: PMC6053897 DOI: 10.1371/journal.pone.0200361] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/24/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction: Institute of Medicine gestational weight gain recommendations are
based on body mass index (BMI) status using adult cut-off points for women of
all ages, even though adolescents have specific criteria, like WHO and CDC, so
adolescents can receive inadequate weight gain recommendations. Objectives: To
estimate the proportion of classification disparity between the three criteria
(WHO, CDC and IOM) of pre-pregnancy BMI status; and to analyze neonatal outcomes
according to weight gain recommendation based on pre-pregnancy BMI using the
three criteria. Methods: Follow-up study in pregnant adolescents 12–19 years.
Sociodemographic, anthropometric and pregnancy data were obtained. Percentage of
pre-pregnancy BMI classification disparity was calculated between three
criteria. Gestational weight gain was categorized in adequate, low and high
according to IOM. Regression models were used to analyze negative neonatal
outcomes. Results: 601 pregnant adolescents were included, mean age was 16±1.4
years. For pre-pregnancy BMI classification, 28.5% had classification disparity
using IOM vs WHO, and 14% when comparing IOM vs CDC. Greater classification
disparity was observed as BMI increased. When using WHO categories, a high
weight gain was associated with increased risk of having a low birth weight baby
(OR: 1.91, CI95%: 1.03–3.53). For CDC criteria, a low weight gain was associated
with increased risk of having a preterm baby (OR: 2.65; CI95%: 1.16–6.08) and a
high weight gain was associated with low birth weight (OR: 2.10; CI95%:
1.10–4.01). For IOM criteria, a weight gain either low or high were associated
with increased risk of low birth weight and preterm birth. Conclusion: There is
pre-pregnancy BMI classification disparity using criteria for adolescents
compared to adult criteria. Nevertheless, with WHO and CDC only a high
gestational weight gain was a risk for negative neonatal outcome. It is
important to have a BMI classification system for adolescents that better
predicts neonatal outcomes.
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Cardiometabolic Risk and Female Sexuality-Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes. Sex Med Rev 2018; 6:508-524. [PMID: 29730315 DOI: 10.1016/j.sxmr.2018.02.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 02/19/2018] [Accepted: 02/20/2018] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Erectile dysfunction is recognized as an opportunity for preventing cardiovascular (CV) events, and assessing the impairment of penile vascular flow by Doppler ultrasound is an important tool to ascertain CV risk. Conversely, the role of genital vascular impairment in the pathophysiology of female sexual dysfunction (FSD) remains contentious. AIM To focus on the current scientific support for an association between CV risk factors and female sexual health in the 1st part of a 2-part review. METHODS A thorough literature search of peer-reviewed publications on the associations between CV risk factors and FSD and their underlying mechanisms was performed using the PubMed database. MAIN OUTCOME MEASURES We present a summary of the evidence from clinical studies and discuss the possible mechanisms providing the pathophysiologic bases of vasculogenic FSD syndromes. RESULTS The peripheral sexual response in women is a vascular-dependent event, and evidence suggests that cardiometabolic-related perturbations in endothelial function can determine vascular insufficiency in female genital tissues. Although epidemiologic and observational studies demonstrate that the prevalence of FSD is higher in women with diabetes mellitus, a cause-effect relation between these clinical conditions cannot be assumed. Evidence on the effect of obesity, metabolic syndrome, and polycystic ovary syndrome on sexual function in women is controversial. Data on the associations of dyslipidemia and hypertension with FSD are limited. CONCLUSION Common cardiometabolic alterations could affect vascular function in the female genital tract. Based on limited data, there is an association between CV risk factors and female sexual health in women; however, this association appears milder than in men. Maseroli E, Scavello I, Vignozzi L. Cardiometabolic Risk and Female Sexuality-Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes. Sex Med Rev 2018;6:508-524.
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Clayton AH, Goldstein I, Kim NN, Althof SE, Faubion SS, Faught BM, Parish SJ, Simon JA, Vignozzi L, Christiansen K, Davis SR, Freedman MA, Kingsberg SA, Kirana PS, Larkin L, McCabe M, Sadovsky R. The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women. Mayo Clin Proc 2018; 93:467-487. [PMID: 29545008 DOI: 10.1016/j.mayocp.2017.11.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 10/25/2017] [Accepted: 11/09/2017] [Indexed: 01/16/2023]
Abstract
The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed to provide evidence-based guidelines for diagnosis and treatment of HSDD in women by health care professionals. Affecting 10% of adult females, HSDD is associated with negative emotional and psychological states and medical conditions including depression. The algorithm was developed using a modified Delphi method to reach consensus among the 17 international panelists representing multiple disciplines. The POC starts with the health care professional asking about sexual concerns, focusing on issues related to low sexual desire/interest. Diagnosis includes distinguishing between generalized acquired HSDD and other forms of low sexual interest. Biopsychosocial assessment of potentially modifiable factors facilitates initiation of treatment with education, modification of potentially modifiable factors, and, if needed, additional therapeutic intervention: sex therapy, central nervous system agents, and hormonal therapy, guided in part by menopausal status. Sex therapy includes behavior therapy, cognitive behavior therapy, and mindfulness. The only central nervous system agent currently approved by the US Food and Drug Administration (FDA) for HSDD is flibanserin in premenopausal women; use of flibanserin in postmenopausal women with HSDD is supported by data but is not FDA approved. Hormonal therapy includes off-label use of testosterone in postmenopausal women with HSDD, which is supported by data but not FDA approved. The POC incorporates monitoring the progress of therapy. In conclusion, the International Society for the Study of Women's Sexual Health POC for the management of women with HSDD provides a rational, evidence-based guideline for health care professionals to manage patients with appropriate assessments and individualized treatments.
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Affiliation(s)
- Anita H Clayton
- Department of Psychiatry and Neurobehavioral Sciences and Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA
| | | | - Noel N Kim
- Institute for Sexual Medicine, San Diego, CA.
| | - Stanley E Althof
- Professor Emeritus, Case Western Reserve University School of Medicine, Cleveland, OH; Center for Marital and Sexual Health of South Florida, West Palm Beach, FL
| | - Stephanie S Faubion
- Women's Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | | | - Sharon J Parish
- Department of Psychiatry and Department of Medicine, Weill Cornell Medicine, New York, NY
| | - James A Simon
- Department of Obstetrics and Gynecology, George Washington University, Washington, DC
| | - Linda Vignozzi
- Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | | | - Susan R Davis
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Murray A Freedman
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, GA
| | - Sheryl A Kingsberg
- Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, OH; Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH
| | | | - Lisa Larkin
- Lisa Larkin, MD, and Associates, Mariemont, OH
| | - Marita McCabe
- Institute for Health & Ageing, Melbourne, Victoria, Australia
| | - Richard Sadovsky
- Department of Family Medicine, SUNY Downstate Medical Center, Brooklyn, NY
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