Sexual dysfunction among women of reproductive age: A systematic review and meta-analysis

Background: Available statistics show a high prevalence of sexual dysfunction (SD) among women worldwide. Various factors affect SD among women of reproductive age. Objectives: To evaluate studies on the prevalence and determinants of SD in different parts of the world. Materials and Methods: MEDLINE, EMBASE, Web of Science, Scopus and ProQuest databases were systematically reviewed during 2000–2019. All original articles were reviewed. The STROBE checklist was used to evaluate the quality of the papers. I2 was calculated to determine heterogeneity. Fixed effects and/or random-effects models were applied to estimate the pooled prevalence. Meta-regression analysis was also performed to identify the sources of heterogeneity. Results: Based on the results of the meta-analysis (21 eligible studies), the pooled prevalence with 95% confidence interval of SD was estimated at 50.75% (41.73–59.78). The prevalence of pain and disorders in arousal, sexual desire, lubrication, orgasm, and sexual satisfaction were calculated (39.08%, 48.21%, 50.70%, 37.60%, 40.16%, and 35.02%, respectively). Also, age, depression, low education level, increased duration of the marriage, and the presence of chronic diseases were the highest risk factors for SD. Conclusion: The prevalence of SD in women of reproductive age varies in different countries. Considering the importance of female SD, further studies are needed to facilitate the development of relevant educational interventions. Key words: Sexual dysfunction, Women, Reproductive age

The Correlation of Sexual Dysfunction with Prenatal Stress and Quality of Life: A Path Analysis

Background: Women are exposed to different stressors in life. Physical, emotional, and economic stressors of pregnancy might negatively affect couples’ emotional and sexual intimacy. Objectives: The present study was designed to perform a path analysis of the correlation of sexual dysfunction with prenatal stress and quality of life. Methods: In this descriptive, correlational study, 300 pregnant Iranian women were recruited via convenience sampling, based on the inclusion criteria from 4 governmental referral hospitals in 2016. Data were collected using female sexual function index, 26-item world health organization quality of life questionnaire, prenatal anxiety questionnaire, and a demographic questionnaire. Results: The goodness of fit indices (GFI) in the model indicated the suitability and reasonability of relationships among variables (root mean square error of approximation, 0.023; GFI, 0.99). Quality of life and age directly affected sexual dysfunction, while prenatal anxiety and income were indirectly correlated with sexual dysfunction through quality of life (P < 0.01). Other variables did not show any significant correlations. Conclusions: Anxiety can decrease sexual function in women during pregnancy. Poor quality of life can also cause sexual dysfunction in pregnant women. Therefore, it is an undeniable necessity to take measures to reduce prenatal anxiety and promote sexual activity during pregnancy for ensuring marital satisfaction. In addition, through such measures, we can maintain/improve the general and sexual health of couples, increase the quality of life in pregnant women, and eventually strengthen family bonds

Domestic violence and its associated factors in Iran: according to World Health Organization model

Background and Aim: Domestic violence is a global problem that led to many maternal and neonatal complications. Among the factors associated with domestic violence, social determinants of health are the most controversial issues in health policy domain. According to the WHO conceptual framework of Commission on Social Determinants affecting on health this study has been designed to investigate the articles that have been published on its prevalence and related factors in Iran. Materials and Methods: This descriptive study reviews the Iranian articles published in four data bases (PubMed, SID, Iran Medex, Magiran) between 2000-2013, by searching violence, abuse, pregnancy in title, abstract and keywords of the articles. Results: Overall, 38 articles, 5 English and 33 Persian, were selected according to inclusion criteria and assess. 35 articles were descriptive (longitudinal and cross-sectional) and 3 were analytic (cohort and case-control). Prevalence of domestic violence in pregnancy was reported between 19.3% to 94.5%. Among domestic violence related factors, the most prevalent factors in structural determinant were maternal education and in intermediary determinant were material circumstance: housing, psychosocial circumstance: unwanted pregnancy, behavioral factors: partner substance abuse and health system: lack of prenatal care. ‍Conclusion: The prevalence of domestic violence during pregnancy in Iran is a matter of concern and can be reduced by identifying high risk groups. Since many social determinants may affect domestic violence, performing etiological investigations is recommended

Correlation of spirituality and psychological well-being with pregnancy-specific stress

For downloading the full-text of this article please click hereBackground and Objectives: Pregnancy is a natural function for women, it is nonetheless a stressful experience, associated with extensive psychological and physical changes that make women psychologically vulnerable. One of the components of a healthy life is attending to spiritual needs, which can enhance quality of life and gradually reduce harmful behaviors. The present study, titled "Correlation of spirituality and psychological well-being with pregnancy-specific stress in women visiting health centers in Dehdasht township in 2015", was conducted considering the available data.Materials and Methods: The present descriptive-correlational study recruited 450 pregnant women visiting health centers in Dehdasht township. The data were collected using personal-social, pregnancy-specific stress, and spirituality and psychological well-being questionnaires, and were analyzed in SPSS-20.Results: The present study results showed correlations between spirituality and pregnancy stress(r=0.156) and also between psychological well-being and pregnancy stress(r=0.294). The results relating to the contribution of spirituality components in pregnancy stress showed that religious and spiritual health are able to affect pregnancy stress, and the results relating to the contribution of subscales of psychological well-being showed that purposeful life well-being and independent well-being can affect pregnancy stress(P=0.01).Conclusion: The results showed that spirituality and psychological well-being are associated with stress during pregnancy. It is recommended due to the impact of variable both spiritual and psychological well-being in developing coping skills, stress reduction program.Keywords: Stress, Spirituality, Psychological Well-being, PregnancyFor downloading the full-text of this article please click her

The Effects of Transdermal Estrogen Delivery on Bone Mineral Density in Postmenopausal Women: A Meta-analysis

Abstract Due to its minimal systematic adverse effects, transdermal estrogen is widely used for the prevention of osteoporosis in postmenopausal women. The present meta-analysis aimed to clarify the effects of transdermal estrogen on bone mineral density (BMD) of postmenopausal women. Studies were identified by searching electronic databases including Cochrane Library, MEDLINE, Embase , and CINAHL databases, and also the Sciences Citation Index. Systematic review of articles was published between January 1989 to February 2016.Reference lists of the included articles were also evaluated and consultations were made with relevant experts. While 132 studies included the desired keywords, only nine clinical trials met the inclusion criteria and were finally reviewed. The pooled percent change in BMD was statistically significant in favor of transdermal estrogen. According to resulting pooled estimate, lumbar spine BMD one and two years after transdermal estrogen therapy was respectively 3.4% (95% CI: 1.7-5.1) and 3.7% (95% CI: 1.7-5.7) higher than the baseline values. The test for heterogeneity was not statistically significant based on the I 2 heterogeneity index. One-two years of transdermal estrogen delivery can effectively increase BMD and protect the bone structure in postmenopausal women

The Correlation between Islamic Lifestyle and Pregnancy-Specific Stress: A Cross-Sectional, Correlational Study

BACKGROUND: Pregnancy is associated with great psychological, emotional and physical stress. In addition to undergoing hormonal changes, pregnant women experience a change in their attitude toward life and learn to re-assess their skills and lifestyle. Lifestyle, in general, and Islamic lifestyle, in particular, is concerned with the different psychological, social and physical aspects of the individual’s life.AIM: This study was conducted to evaluate the correlation between Islamic lifestyle and pregnancy-specific stress in pregnant women.MATERIAL AND METHODS: This cross-sectional, correlational study was conducted on 300 pregnant women presenting to prenatal care clinics. Data were collected using a demographic, the Islamic lifestyle and the pregnancy-related stress questionnaires.RESULTS: The results showed a statistically significant negative correlation (r = -0.284) between Islamic lifestyle and pregnancy-specific stress (P &lt; 0.01). The stepwise regression showed that the mean score obtained in the pregnancy-related stress questionnaire decreased by 0.75 per year of marriage and by 0.14 per point in the Islamic lifestyle questionnaire.CONCLUSION: There was a significant negative correlation between Islamic lifestyle and pregnancy-specific stress. Training mothers, raising their awareness and encouraging them to adopt an Islamic lifestyle may play a significant role in controlling pregnancy-specific stress

Correlation between self-esteem and perceived stress in pregnancy and ways to coping with stress

Background and Aim: Stress during pregnancy can have long-term negative consequences on both mother and fetus. Therefore, recognizing the factors that contribute to controlling stress can have a major role in pregnant women’s mental health. The current research was designed to determine the role of self-esteem on the level of stress during pregnancy and the ways to cope with it. Materials and Methods: In this regard, a cross-sectional study was conducted. The city of Tehran was divided into 4 geographic districts including north, south, east and west. A state hospital was elected for each district, and 450 pregnant women (24-32 of gestational week) were randomly chosen from the hospitals. After explaining the purpose of the study and obtaining an informed consent from the qualified pregnant women, they filled out the perceived stress, Rosenberg Self-Esteem and Coping Inventory for Stressful Situations (CISS) questionnaires. Data were analyzed using SPSS software version 19. The level of significance was considered p<0.05. Results: The age of the 450 participating pregnant women was 28.55 years, 78.9 percent had high school or lower education, and 90 percent were housewives. In this study, self-esteem was 21.918.33 and the perceived stress was 20.094.5, respectively. There was a significant inverse correlation between self-esteem and perceived stress. A significant difference was observed between individuals with different levels of self-esteem and the coping styles. ‍Conclusion: It appears that the level of self-esteem of pregnant women is effective on their level of stress and their coping style. By teaching techniques, which increase self-esteem, the level of stress can be decreased in pregnant women

Effects of Sex Hormones in Combined oral Contraceptives and Cyclofem on Female Sexual Dysfunction Score: A Study on Iranian Females

AbstractIntroduction: Unwanted pregnancy can endanger reproductive health, and its complications could adversely affect quality of life in females, families, and the community. A large number of unwanted pregnancies are terminated with abortion or stillbirth. Sex is an important aspect of quality of life. According to reproductive rights, females have the right to experience a safe and enjoyable sexual relationship. This study aimed at comparing sexual function scores between females taking combined oral contraceptives and Cyclofem at health centers affiliated to Shahid Beheshti University of Medical Sciences of Tehran, Iran, During Year 2013.Methods: This descriptive-comparative study was carried -out on 240 females (each group 120) in Tehran, Iran, by multistage sampling. Data collection tools had 3 parts; General Health Questionnaire (GHQ), demographic variables, and Female Sexual Function Index (FSFI) that were completed by interviews. Descriptive statistics, independent t, Mann-Whitney test, chi-square, and SPPS16 were used for analysis of data. P-values less than 0.05 were considered statistically significant.Results: The difference in sexual function between combined oral contraceptives and cyclofem was insignificant. Scores of desire and arousal dimensions were better in combined oral contraceptive consumers than cyclofem users.Conclusions: It is important for females to choose hormonal contraception methods, which are the most effective, yet, cause the least sexual dysfunction

Urogenital chlamydia trachomatis treatment failure with azithromycin: A meta-analysis

Background: Chlamydia Trachomatis is one of the most common pathogens transmitted through the genital tract in humans that leads to urogenital infection. Objective: Given the high prevalence of chlamydia infection and its adverse effects on the health of women and men, the present meta-analysis was conducted to determine the rate of treatment failure with azithromycin. Materials and Methods: Databases including MEDLINE, ISI - Web of Science, PubMed, EMBASE, Scopus, ProQuest, and Science Direct were searched for articles published between 1991 and 2018. The quality of the selected articles was assessed using the Cochrane risk of bias assessment tool. Heterogeneity was determined using the I2 and Cochrane Q-Test. Subgroup analysis and meta-regression were used to compare the prevalence rates on different levels of the variables. Results: A total of 21 articles that met the inclusion criteria were ultimately assessed. The pooled estimate of azithromycin failure rate was 11.23% (CI 95%: 8.23%-14.24%). Also, the azithromycin failure rate was 15.87% (CI 95%: 10.20%-21.54%) for the treatment of urethritis, 7.41% (CI 95%: 0.60%-14.22%) for cervicitis, and 7.14% (CI 95%: 10.90%-3.39%) for genital chlamydia. The pooled estimate of failure rate difference was 2.37% (CI 95%: 0.68%-4.06%), which shows that azithromycin has a higher failure rate in the treatment of chlamydia compared to doxycycline and other examined medications. The meta-regression results showed that the patient’s age contributes significantly to the heterogeneity for azithromycin treatment failure rate (β = 0.826; p = 0.017). Conclusion: Azithromycin has a higher failure rate than doxycycline and other studied medications in treating urogenital chlamydia infections. Key words: Azithromycin, Chlamydia trachomatis, Urogenital, Treatment failure, Meta-analysis

A Communicative Model of Mothers’ Lifestyles During Pregnancy with Low Birth Weight Based on Social Determinants of Health: A Path Analysis

Objectives: Low birth weight (LBW) is one of the major health problems worldwide. It is important to identify the factors that play a role in the incidence of this adverse pregnancy outcome. This study aimed to develop a tool to measure mothers’ lifestyles during pregnancy with a view to the effects of social determinants on health and develop a correlation model of mothers’ lifestyles with LBW. Methods: This study was conducted using methodological and case-control designs in four stages by selecting 750 mothers with infants weighing less than 4000 g using multistage sampling. The questionnaire contained 160 items. Face, content, criterion, and construct validity were used to study the psychometrics of the instrument. Results: After psychometrics, 132 items were approved in six domains. Test results indicated the utility and the high fitness of the model and reasonable relationships adjusted for variables based on conceptual models. Based on the correlation model of lifestyle, occupation (-0.263) and social relationships (0.248) had the greatest overall effect on birth weight. Conclusions: The review of lifestyle dimensions showed that all of the dimensions directly, indirectly, or both affected birth weight. Thus, given the importance and the role of lifestyle as a determinant affecting birth weight, attention, and training interventions are important to promote healthy lifestyles