A review of the psychosocial factors that contribute to sexuality, female sexual dysfunction, and sexual pain among Muslim women

INTRODUCTION

Sexual pain disorders are complex conditions experienced by women around the world. Muslim women experience sexuality and sexual dysfunction in a distinct manner that is influenced by religious and cultural standards. Muslim women experiencing sexual pain are a unique patient population whose cultural background should be understood by health care professionals to provide culturally competent care.

OBJECTIVES

To identify the psychosocial factors that influence Muslim women's experience of sexual pain.

METHODS

A comprehensive review of the literature through PubMed and Google Scholar was conducted to compile information related to sexual dysfunction, sexual pain, and treatment options in the Muslim women population in the United States and internationally.

RESULTS

Painful sex among Muslim women has been associated with female genital cutting, cultural taboos, lack of sex education, absence of language to discuss sex, negative cognitions about sex, expectations to bear the male partner's inconsiderate sexual performance, and familial interference. Typical treatments for sexual pain in Islamic countries were explored, with new treatments that have recently been tested.

CONCLUSION

Understanding sexual pain among Muslim women, including the religious and cultural factors that are potentially associated with this pain, is important for health care professionals to care for their Muslim patients in a culturally competent manner and reduce the implicit bias that may affect quality of care. It appears that providing sexual education, with treatment modalities such as psychotherapy and physical therapy, is useful in treating female sexual pain. We suggest that sexual education, as well as a cultural shift that embraces women's sexual agency, is needed to reduce and prevent sexual pain.

Consumers' perceptions about risk of and access to nonprescription medications

OBJECTIVES

To examine how consumers balance the principles of safety with regulatory access to pharmaceuticals and to identify respondent characteristics, including prior misuse of nonprescription medications, that are associated with a preference for nonprescription status.

DESIGN

Cross-sectional survey within-subject attitudinal analysis.

SETTING

Large midwestern metropolitan region of the United States.

PARTICIPANTS

Convenience sample of 553 members of the general public.

INTERVENTIONS

Anonymous self-administered surveys with hypothetical vignettes in which a heartburn or antihypertensive drug could be available without a prescription but in doing so would entail an increased risk (1/100,000, 1/10,000, or 1/1,000 chance of heart attack) to the user that would not be present with the medical care afforded by prescription drug status.

MAIN OUTCOME MEASURE

Proportion of respondents preferring nonprescription availability.

RESULTS

Overall, 33%, 19%, and 11% of respondents preferred nonprescription availability when the additional risks of a heart attack with nonprescription availability were 1/100,000, 1/10,000, and 1/1,000, respectively. Risk tolerance did not differ between the heartburn and antihypertensive vignettes. Although preference for nonprescription status was significantly greater among respondents who were men (42% versus 28%) and white (42% versus 32%), and a statistical trend was evident among respondents with higher self-reported health (37% versus 27%) and a college education (36% versus 28%), most of these differences did not persist on multivariate analysis.

CONCLUSION

A substantial minority of the public appears willing to accept considerable risk to gain greater access to pharmaceuticals. Heterogeneity among the general public with regard to how safety and access to nonprescription medications should be balanced challenges policy makers working to design responsive yet appropriate regulatory policies.