Sexual Reproductive Health and Rights Repository (Aga Khan University)
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Impact of the menstrual cycle phases on the movement patterns of sub-elite women soccer players during competitive matches
Full text linkThe purpose of this study was to evaluate the influence of the menstrual cycle phases on the movement patterns of sub-elite women soccer players during competitive matches over three consecutive seasons. Individual movement data were analyzed and compared in eight players from the second French League at the early follicular (EF), late follicular (LF) and mid-luteal (ML) phases of their menstrual cycle, determined by the calendar method. The movement patterns, expressed as meters per minute, were recorded during competitive matches using devices placed on the player’s ankle. Our results showed significantly lower distances covered at moderate and high velocity in the EF phase than in the LF and ML phases (Cohen’s d effect size = 1.03 and 0.79, respectively). The total distance covered during matches and the number of sprints also were reduced during EF compared with LF (d = 0.78 and 0.7, respectively). Overall, the total distance and distance covered at low velocity were significantly lower during the second half-time of the matches (d = 1.51), but no menstrual cycle phase × game period interaction was noted. In conclusion, our study suggests that EF may impact the movement pattern of sub-elite women soccer players during competitive matches, without any modulation of this effect by the playing time. Despite the low sample size, these results can be useful for coaches and support staff to modulate training loads and player rotation during soccer games
Menstruation and menopause in autistic adults: Periods of importance?
Full text linkAutism spectrum conditions were once seen as a predominantly male condition, but this has caused research to have little focus on women. Therefore, little is known about menstruation and menopause in autism spectrum conditions. Some smaller studies indicate that autistic individuals might suffer from increased difficulties surrounding these events. This study aimed to investigate whether autistic women experience more frequent premenstrual dysphoric disorder, causing extreme physical, emotional, and functional impairment. In a partly overlapping sample, we also examined whether women with autism spectrum condition experience increased complaints surrounding menopause. We did not find an increased prevalence of premenstrual dysphoric disorder in autism spectrum conditions (14.3%) compared with non-autistic women (9.5%). Those with autism spectrum conditions did experience increased menopausal complaints. These menopausal complaints were associated with higher levels of depression and autistic traits. In non-autistic women, menopausal complaints were associated with increased inattention, hyperactivity/impulsivity (i.e. attention deficit hyperactivity disorder traits), and depression. With this work, we show the important role that major reproductive milestones can have in an autistic woman's life
The effect of a probiotic on gastrointestinal symptoms due to menstruation in healthy adult women on oral contraceptives: randomized, double-blind, placebo-controlled trial protocol
Full text linkIntroduction: For many women, uncomfortable and stressful symptoms accompany the menstrual cycle each month, sometimes in a debilitating manner. Previous studies have reported that gastrointestinal symptoms in healthy women significantly differ by the day of the menstrual cycle, but few studies have assessed interventions intended to minimize these symptoms. Probiotics supplements have been shown to attenuate gastrointestinal symptom severity as well as self-reported feelings of stress in various populations. This study evaluates the effect of a probiotic on abdominal pain and gastrointestinal symptoms in healthy women who take an oral contraceptive, have regular menses, and typically experience these symptoms during menstruation with the primary aim being change in abdominal pain intensity related to the menstrual cycle with probiotic versus placebo supplementation.
Methods and analysis: In this randomized, double-blind, placebo-controlled parallel study, participants will receive either a probiotic or placebo supplement. Participants will begin answering questionnaires approximately 7 days before the start of menstruation (i.e., active bleeding), and 3 days later, they will begin consuming the study supplement for 8 weeks. The questionnaires administered will collect data about abdominal pain severity (primary outcome) and duration related to the menstrual cycle, digestive health, dietary intake, stress, and digestion-associated quality-of-life. A subgroup of women will provide weekly vaginal swabs and stool samples to examine the effect of the probiotic supplement on microbiota composition and diversity for exploratory purposes. Two-sided tests using a linear model and a type I error rate of α = 0.05 will be employed to test all hypotheses. Continuous variables will be presented as means with standard errors and categorical variables, as counts or proportions.
Ethics and dissemination: This study was reviewed and approved by the University of Florida Institutional Review Board 01. Written informed consent will be obtained from all participants prior to any study activities. Study findings will be disseminated at scientific conferences and publication in the trial registry or in a peer-reviewed journal. Any protocol amendments will be reported in the final manuscript of this study
Adverse childhood experiences and their relationship with poor sexual health outcomes: results from four cross-sectional surveys
Full text linkImproving understanding of risk factors for risky sexual behaviour is fundamental to achieve better population sexual health. Exposure to adverse childhood experiences (ACEs) can increase the risk of poor sexual health outcomes, but most research is US-based. This study explored associations between ACEs and poor sexual health outcomes in the UK. Data from four cross-sectional ACE surveys with adult general populations in different regions of the UK from 2013–2015 (n = 12,788) were analysed. Data included participants’ demographics, ACE exposure, and four sexual health outcomes: having early sex (<16 years), having an accidental teenage pregnancy, becoming a teenage parent, or having a lifetime diagnosis of a sexually transmitted infection. ACE count was a consistent and significant predictor of all four sexual health outcomes for both males and females, with odds of these outcomes between three and seven times higher for those with 4+ ACEs compared to those with no ACEs. Increased risks of some, but not all, sexual health outcomes were also found with higher residential deprivation, younger age, being of white ethnicity, and being born to a teenage mother. Findings highlight the need for effective interventions to prevent and ameliorate the lifelong effects of ACEs. Trauma-informed relationships and sex education, sexual health services, and antenatal/postnatal services, particularly for teenagers and young parents, could provide opportunities to prevent ACEs and support those affected. Ensuring that those living in deprived areas have access to services and that barriers to uptake are addressed is also key
A systematic review of eHealth modes in preventing sexually transmitted infections
Full text linkPrevention of sexually transmitted diseases (STDs) is critical. Despite developing treatment and prevention programs, sexually transmitted infections (STIs) are essential in developing acute and chronic diseases. Because “eHealth” (electronic-Health) has excellent potential for disseminating health information to the public regarding STDs, we aimed to identify and review all published articles focusing on preventing STIs. After constructing the design and answering population, intervention, comparison, and outcome questions, two authors conducted a systematic literature search in four online databases in January 2022. The screening process and data extraction were conducted by two authors independently, and then, a quality assessment was performed. After removing duplicates, and two rounds of shortlisting, 16 articles were included for data extraction out of 5113 entries. Included studies were of different designs and assessed six preventive outcomes categories, with condom use being the most frequent result among studies. We also extracted implementation outcomes and reviewed them. Included studies with 13,137 participants have provided reasonable evidence of the effectiveness of different types of eHealth in improving STI prevention interventions. Although this systematic review was not without limitations, it can no longer be ignored that eHealth modes offer many opportunities to prevent STDs, especially among the young population
Factors associated with cervical cancer screening among women living with HIV in the Kilimanjaro region, northern Tanzania: a cross-sectional study
Full text linkDespite cervical cancer being a highly preventable disease, it is the fourth most common cancer among women in both incidence and mortality. Cervical cancer screening is crucial in preventing the disease. Women living with HIV (WLHIV) are at higher risk of cervical cancer because of their immune-compromised state. We aimed to determine factors associated with cervical cancer screening among WLHIV in the Kilimanjaro region, northern Tanzania.
A cross-sectional study was conducted in the Kilimanjaro region among 297 WLHIV attending care and treatment centers (CTC) in northern Tanzania between August 21 and September 3, 2020; and interviewed using a questionnaire. Logistic regression model determined factors associated with cervical cancer screening at 5% significance level.
Half (50.2 %) of the 297 WLHIV had ever screened for cervical cancer. WLHIV with positive attitudes towards cervical cancer screening (AOR = 3.48, 95 % CI 1.86, 6.51) and those who received information on cervical cancer from Health Care Providers (HCP) (AOR = 17.31, 95 % CI 6.00, 50.22) had higher odds of ever being screened for cervical cancer. Lower odds of screening (AOR = 0.50, 95 % CI 0.27, 0.96) were among women diagnosed with HIV within the past three years.
WLHIV having a positive attitude towards screening and received cervical cancer screening information from HCP, were likely to have ever screened. Women newly diagnosed with HIV are less likely to have ever screened. HCPs at CTC are an important source of information about screening and for promoting cervical cancer screening among WLHIV. Special attention should be given to women newly diagnosed with HIV.
Abbreviations: AOR, Adjusted Odds Ratio; CTC, Care and Treatment Clinic; HCP, Health Care Providers; IPH, Institute of Public Health; IQR, Interquartile range; KCMU-CRERC, Kilimanjaro Christian Medical University College Research and Ethics Review Committee; WLHIV, Women Living with HI
Role of the Intersections of Gender, Race and Sexual Orientation in the Association between Substance Use Behaviors and Sexually Transmitted Infections in a National Sample of Adults with Recent Criminal Legal Involvement
Full text linkLimited research has focused on how substance use and sexual risk behaviors differ among individuals impacted by the criminal legal system based on social identities. Using the National Survey on Drug Use and Health, we estimated relative risk for reporting a sexually transmitted infection (STI) among intersectional social groups with criminal legal involvement using a modified Poisson regression. We then utilized multivariate logistic regression and marginal effects to measure associations between substance use behaviors and STIs and to estimate whether these varied among the intersectional social groups with elevated STI rates. Three groups had elevated risk of reporting an STI compared to white, heterosexual men: white, heterosexual women (1.53, 95% CI: 1.05–2.20); Black, heterosexual women (2.03, 95% CI: 1.18–3.49); and white, gay or bisexual men (5.65, 95% CI: 2.61–12.20). Considering the intersections of gender, race, and sexual orientation, elevated risks for STIs among white and Black heterosexual women were mitigated after adjusting for substance use alongside other confounders. Only those who identified as white, gay or bisexual, and male had increased STI risk after controlling for substance use. Interventions targeting Black and white heterosexual women’s sexual health following incarceration should focus on substance use and interventions targeting white, gay or bisexual men should focus on healthy sexual behaviors, HIV/STI screening, and care continuum efforts
Positivity and risk factors for trichomonas vaginalis among women attending a sexual health clinic in Melbourne, 2006 to 2019
Full text linkBackground:
Trichomonas vaginalis is not a notifiable disease in Australia in most states, resulting in limited Australian epidemiological studies. This study aimed to examine the positivity of T. vaginalis in women attending the Melbourne Sexual Health Centre (MSHC) and identify associated factors.
Methods:
All women 16 years or older who were tested for T. vaginalis at MSHC from 2006 to 2019 were included. The diagnostic method changed from culture to nucleic acid amplification test in August 2018. The annual positivity of T. vaginalis was calculated. Because of the data completeness, we performed a generalized estimating equations multivariable logistic regression using data from 2011 to 2019 to examine factors associated with T. vaginalis positivity.
Results:
From 2006 to 2019, 69,739 tests for T. vaginalis were conducted, and 294 tested positive (0.42%; 95% confidence interval [CI], 0.37%–0.47%). Approximately 60% of women tested reported symptoms. After adjusting for potential confounders including the change in diagnostic method, there was a 21% (95% CI, 12%–31%) annual increase in T. vaginalis positivity between 2011 and 2019. Women with concurrent syphilis had the highest odds of testing positive for T. vaginalis (adjusted odds ratio [aOR], 21.55; 95% CI, 6.96–66.78), followed by women who had injected drugs in the last 12 months (aOR, 6.99; 95% CI, 4.11–11.87), were 35 years or older (aOR, 3.47; 95% CI, 2.26–5.35), or had concurrent chlamydia (aOR, 1.77; 95% CI, 1.05–2.99).
Conclusions:
The rising positivity of T. vaginalis at MSHC irrespective of change in diagnostic method suggests a concurrent community-wide rise in Melbourne. Given the rising positivity, testing informed by risk factors should be considered
Fertility-sparing and less radical surgery for cervical cancer
Full text linkPurpose of Review:
Patients with early-stage cervical cancer who desire future fertility may be candidates for less radical surgery. We review the literature supporting this approach in early-stage disease.
Recent Findings:
Retrospective data have shown that in carefully selected patients, the risk of parametrial involvement is less than 1%. This has led to interest in moving away from radical surgery towards more conservative approaches. Data from the newly published ConCerv trial, a prospective study evaluating the feasibility of conservative surgery in women with early-stage, low-risk cervical carcinoma, suggest that conservative surgery is feasible and safe in this patient population. Furthermore, neoadjuvant chemotherapy is being assessed as an option to extend fertility-sparing treatment to a larger group of women.
Summary:
Less radical surgery may be appropriate for carefully selected women with early-stage, low-risk cervical cancer, including those desiring future fertility
Preventive practices toward sexually transmitted infections and their determinants among young people in Ethiopia: A protocol for systematic review and meta-analysis
Full text linkBackground:
Globally, the estimated annual number of new cases of curable sexually transmitted infections occurring among young people aged 15–24 years is approximately 178.5 million. There are fragmented and inconsistent findings on preventive practices for sexually transmitted infections. Thus, this systematic review and meta-analysis protocol aimed to estimate the pooled prevalence of preventive practices of sexually transmitted infections and identify its determinants among young people in Ethiopia.
Methods:
The Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) will be used to develop the review protocol. Online databases such as PubMed, CINAHL, Scopus, Google, and Google Scholar will be used to search published and unpublished studies. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument will be used to assess the quality of the study. Statistical heterogeneity will be checked using the Cochran Q test and I2 statistics. Subgroup analysis and meta-regression will be performed to identify the sources of heterogeneity. The statistical analysis will be performed using STATA version 14 software. A random-effects model will be performed to estimate the pooled prevalence and identify determinants of preventive practices of sexually transmitted infections.
Discussion:
Young people have a high unmet need for sexual and reproductive health services and poor preventive practices toward sexually transmitted infections. Although there are studies on preventive practices for sexually transmitted infections, there is no study finding on the pooled prevalence of preventive practices for sexually transmitted infections and its determinants among young people in Ethiopia. Thus, this systematic review and meta-analysis protocol will help to develop appropriate strategies