Sexual and gynecological health in women with a history of sexual violence: the role of the gynecologist

Objectives: Sexual violence is defined as any sexual act, attempt to commit a sexual act or unwanted sexual comment or action which, by means of force or coercion, is directed against a person's sexuality, regardless of the relationship with the victim. The global prevalence of sexual violence all over the world is 35.6%; 30% partner-related and 7.2% non-partner sexual violence, being the prevalence of sufferers from both types of sexual violence 1.6%. Sexual violence against girls and women is a global public health problem of epidemic proportions. As a violence free life constitutes a basic human right, actions to prevent sexual violence and to treat and follow-up its victims have to be undertaken. Mechanism: A multidisciplinary approach on these cases should be mandatory to help women in all the potential short-, mid- and long-term consequences, which need to be evaluated. Finding in brief: Consequences after sexual violence can be both physical and psychological, including a potential impact on gynecological, reproductive, obstetric and sexual issues of the individual. For this reason, gynecologists should play an important role in the follow-up of girls and women who have suffered sexual violence. Conclusions: Gynecologists have to participate in both the immediate attention and the follow-up of patients who have suffered sexual violence. Gynecologists have the gold opportunity to introduce sexual health care in their clinical practice and their visits should be the place where the discussion of sexual concerns is permitted and also where the identification, support and treatment of women with sexual violence is provided

Sexual health in women with female genital mutilation

Objective: Female genital mutilation or cutting (FGM/C) includes all the procedures which involve the partial or total removal of the external female genitalia for non-medical reasons. FGM/C exposes women to short and long-term health risks, such as sexual health impairment. For this reason, we have designed this review with the aim to investigate the impact of FGM/C on female sexual health. Methods: We searched Embase, Medline, and the Cochrane library to identify potentially relevant English publications on the effect of FGM/C on women's sexual health. Results: FGM/C constitutes a violation of sexual rights, including the principle of autonomy, integrity and sexual security of the body, as well as the right to sexual equality. A large proportion of women with FGM/C have female sexual dysfunction. Sexual therapy aims to empower these women to identify their own pleasure, raise their awareness about sensorial perceptions and sensuality, improve their genital image and self-esteem and also the proprioception of their genital area. Reconstructive surgery represents one of the therapeutic alternatives for women with FGM/C. Conclusions: Sexuality in women with FGM/C needs to be evaluated by a multidisciplinary team in order to offer an appropriate and personalized treatment, considering the physical and psychological dimensions of the individua

Genitourinary Syndrome of Menopause Assessment Tools

New therapeutic options are being considered to treat genitourinary syndrome of menopause (GSM), such as vaginal laser, ospemifene, or prasterone, but there is no explicit agreement in the scientific community for its use. Some concerns have arisen on how to evaluate the improvement of GSM symptoms. In 2003, the FDA suggested possible end points for this purpose: change in severity of symptoms, change in vaginal pH, and change in vaginal maturation index (VMI). Contrarily, the most common assessment tools used to quantify severity and improvement of GSM nowadays are the visual analog scale of GSM symptoms, the vaginal health index, and the female sexual function index. In our opinion, subjective and objective variables to evaluate GSM can be differentiated, and not many of the considered objective outcomes are used in the recent literature assessing GSM. There is the possibility that some therapies present only subjective improvement, giving place to a possible placebo effect that is not being evaluated. To conclude, there is a demand to evaluate whether vaginal pH and VMI are enough to assess objectively GSM changes or new objective approaches should be audited

First application of IFCB high-frequency imaging-in-flow cytometry to investigate bloom-forming filamentous cyanobacteria in the Baltic Sea

Cyanobacteria are an important part of phytoplankton communities, however, they are also known for forming massive blooms with potentially deleterious effects on recreational use, human and animal health, and ecosystem functioning. Emerging high-frequency imaging flow cytometry applications, such as Imaging FlowCytobot (IFCB), are crucial in furthering our understanding of the factors driving bloom dynamics, since these applications provide community composition information at frequencies impossible to attain using conventional monitoring methods. However, the proof of applicability of automated imaging applications for studying dynamics of filamentous cyanobacteria is still scarce. In this study we present the first results of IFCB applied to a Baltic Sea cyanobacterial bloom community using a continuous flow-through setup. Our main aim was to demonstrate the pros and cons of the IFCB in identifying filamentous cyanobacterial taxa and in estimating their biomass. Selected environmental parameters (water temperature, wind speed and salinity) were included, in order to demonstrate the dynamics of the system the cyanobacteria occur in and the possibilities for analyzing high-frequency phytoplankton observations against changes in the environment. In order to compare the IFCB results with conventional monitoring methods, filamentous cyanobacteria were enumerated from water samples using light microscopical analysis. Two common bloom forming filamentous cyanobacteria in the Baltic Sea, Aphanizomenon flosaquae and Dolichospermum spp. dominated the bloom, followed by an increase in Oscillatoriales abundance. The IFCB results compared well with the results of the light microscopical analysis, especially in the case of Dolichospermum. Aphanizomenon biomass varied slightly between the methods and the Oscillatoriales results deviated the most. Bloom formation was initiated as water temperature increased to over 15°C and terminated as the wind speed increased, dispersing the bloom. Community shifts were closely related to movements of the water mass. We demonstrate how using a high-frequency imaging flow cytometry application can help understand the development of cyanobacteria summer blooms

Impact of Urinary Incontinence on Women's Sexuality

Objective: Globally, the prevalence of urinary incontinence (UI) in women is estimated to be in the range of 25% to 45%. Different types of UI exist, being the most frequent ones stress UI, urgency UI and mixed UI. Being affected by UI is associated with a higher risk of sexual inactivity, regardless of its type. Mechanism: It is estimated that 5-38% patients with UI are sexually inactive due to UI, whereas 25-38% sexually active women would restrict their sexual activity due to UI. The prevalence of sexual dysfunction within sexually active women with UI is 23-56%. Findings in Brief: In patients with UI, the most frequent sexual dysfunctions are dyspareunia (44%),female sexual interest/arousal disorder (34%) and orgasmic disorder (11%). Therefore, UI has a negative impact on the sexual function of sexually active women with UI. Coital incontinence is defined as the complaint of involuntary loss of urine during or after intercourse. UI with penetration represents any complaint of involuntary loss of urine with vaginal stimulation (either with a sexual toy, manually or with penetration). Orgasmic UI refers to any complaint of involuntary loss of urine occurring at orgasm, regardless of the sexual behaviour that has triggered it. Due to the high prevalence of coital UI (50-60%) in the female population and its strongly negative impact on women's sexuality, patients should be specifically asked for coital UI in the gynecologic visits. Conclusions: UI affects between one in four and one in two women and had a negative impact on quality of life. Not only UI has an impact on female sexuality, but also different treatments which are offered to treat it can play a role. The reduction of sexual problems with pelvic floor muscle training in women with stress UI has been proved, being the rate of sexual activity doubled. A significant improvement of the overactive bladder associated to urgency UI and female sexual function has been described after the pharmacological treatment or botulinum toxin. Finally, significant improvement of the sexual function has also been found after midurethral slings for stress UI, as well as for coital U

Data from: Advection by ocean currents modifies phytoplankton size structure

Advection by ocean currents modifies phytoplankton size structure at small scales (1–10 cm) by aggregating cells in different regions of the flow depending on their size. This effect is caused by the inertia of the cells relative to the displaced fluid. It is considered that, at larger scales (greater than or equal to 1 km), biological processes regulate the heterogeneity in size structure. Here, we provide observational evidence of heterogeneity in phytoplankton size structure driven by ocean currents at relatively large scales (1–10 km). Our results reveal changes in the phytoplankton size distribution associated with the coastal circulation patterns. A numerical model that incorporates the inertial properties of phytoplankton confirms the role of advection on the distribution of phytoplankton according to their size except in areas with enhanced nutrient inputs where phytoplankton dynamics is ruled by other processes. The observed preferential concentration mechanism has important ecological consequences that range from the phytoplankton level to the whole ecosystem

Data: Advection by ocean currents modifies phytoplankton size structure

Contains data of currents, nutrients, chlorophyll and data of concentrations of small and large particles for June and September