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Biomedical subjects

D Llewellyn-Jones

Publications and source records attributed to D Llewellyn-Jones.

At least 19 recordsLinked to original sources

Australian women's perceptions of hormone replacement therapy over 10 years.

The knowledge, beliefs and experience of 60 women with HRT was studied when the women were premenopausal, and 10 years later when they were postmenopausal. Thirty-eight women had taken HRT by 1993. In 1993 women no longer considered clinics and self help groups to be the most useful sources of information about the menopause. They were more likely to think that doctors' knowledge of HRT was not adequate and to favour the use of HRT. Their reservations about all postmenopausal women receiving HRT continued. The women's understanding of long-term use of HRT varied. The women continued to maintain a desire not to experience withdrawal bleeding with HRT. More than 60% of women considered that HRT helped hot flushes, non-specific emotional changes and vaginal dryness. Women in 1993 were more likely to consider that HRT would help the menopausal symptoms of osteoporosis, insomnia and loss of muscle tone while fewer considered anxiety and depression would be relieved by HRT. Only one third believed HRT would reduce the incidence of heart disease. Women were more likely to take or have taken HRT if they were working and had achieved a higher work status (professional), considered reading material as the most useful source of information about menopause, had experienced menopause symptoms as distressing, considered menopause made relationships with husband and children more difficult and supported the universal use of HRT for all women.

Attitude↗

The inter-relationship of premenstrual symptoms.

The prospective symptom reports of women seeking treatment for premenstrual symptoms and control subjects was investigated. In order to compare symptom reports from premenstrual symptom sufferers and control subjects a method of combining and analysing prospectively collected menstrual cycle symptom data is required. A technique that uses the time of onset of menses and the time of ovulation (as measured by urinary luteinizing hormone excretion) to standardize each cycle into 14 time points was developed. Summary factors were then empirically derived from data collected prospectively from 30 premenstrual symptom sufferers and 19 control subjects. Twenty-two mood symptoms were summarized into a single factor and the 29 most frequently occurring physical symptoms were summarized into two factors. Factor scores were calculated on the basis of these factors and the effect of time during the menstrual cycle on these scores examined. Both physical symptom factor scores increased significantly in the luteal phase for both the premenstrual symptom sufferer group and the control group. The single mood factor score increased significantly in the luteal phase for the premenstrual sufferer group but not for the control group, suggesting that the only qualitative difference between the groups was the presence of cyclic mood symptoms in the premenstrual symptom sufferer group. The premenstrual symptom sufferer group recorded significantly higher scores on each of the three factors than the control group. The correlation between the scores on each of the factors over three cycles was high both in the follicular and luteal phase suggesting that these factor scores provide a reproducible measure of menstrual cycle symptomatology.

Adult↗

Changes in Australian women's perception of the menopause and menopausal symptoms before and after the climacteric.

The symptoms and perceptions of menopause of 60 Australian women were studied, by questionnaire, when they were premenopausal and 10 years later when they were postmenopausal. Menopausal symptoms expected and experienced by the women were compared, fewer women experiencing hot flushes, headache, depression and nervousness and more experiencing insomnia, increase in appetite, abdominal fullness, numbness and muscular problems. The symptoms women thought were due to hormonal changes at menopause were compared. In 1993 more women cited osteoporosis, insomnia, loss of libido, obesity and loss of muscle tone as due to hormone change while fewer cited depression. The premenstrual symptoms and their severity experienced by a woman when she was premenopausal significantly predicts the type and severity of the menopausal symptoms experienced by the woman. The expected menopausal symptoms and their severity cited by a woman also significantly predicts the type of severity of the menopausal symptoms experienced. More premenstrual symptoms predict the menopausal symptoms than those menopausal symptoms the women expected. The expectation menopause will be 'a relief' or 'a nuisance' significantly predicted the overall menopause experience described by the women. Their negative attitudes about doctors' understanding and information available about menopause remained unchanged but they forget menstrual cycle problems over the 10 years. The results suggest a possible physiological basis for premenstrual and menopausal symptoms. Assistance for women with their premenstrual and menstrual cycle symptoms may improve their quality of life at menopause.

Adult↗

Attitudes to body weight, weight gain and eating behavior in pregnancy.

The eating behavior and attitudes to body weight of 100 healthy women were studied 3 days after the birth of their first child. During pregnancy women 'watch their weight' and use a range of methods of weight control which include cigarette smoking and inducing vomiting. During pregnancy 41 women reported weight control problems and 20 women considered their weight and eating problems to be greater than at any previous time. Picking was the most common unwanted behavior. Binge eating was experienced by 44 women, nine of whom reported it to be a 'severe' problem. Although women were ambivalent about being weighed at each antenatal visit, 81 recommended weighing once each month. The women held differing opinions on the effects of breastfeeding on body weight and on the need for nutritional supplements during pregnancy. Women reporting 'disordered eating' were more likely to have antenatal complications and give birth to low birthweight babies. The results suggest good obstetric care should include a history of the woman's eating behavior and body weight.

Adolescent↗

Psychological and sexual changes after the cessation of breast-feeding.

OBJECTIVE: To characterize the effect of breast-feeding cessation on the mood and sexuality of women after the birth of their first child. METHODS: Women in good physical and psychological health, who had been breast-feeding for 6-23 months and had responded to a request for subjects in a parents' magazine, collected data daily for 2 months before and 2 months after weaning. They were asked to rate 14 measures of psychological, physical, and sexual variables at the same time each day on 3- or 5-point scales. RESULTS: Nineteen women completed the study. Five of these subjects became pregnant before weaning and ceased breast-feeding when pregnancy was confirmed; their last menstrual period was 6 weeks before weaning. The non-pregnant women weaned their babies just before or during menstruation. After weaning, the nonpregnant women reported a significant decrease in fatigue, improvement in mood, and an increase in sexual activity, sexual feelings, and frequency of coitus. Significant changes in fatigue and mood occurred during the second week after weaning; in fatigue, sexual activity, and sexual intercourse during the third week; and in the frequency of sexual intercourse in the fourth week. THe results were not caused by the subjects' expectations about breast-feeding and sexuality or perineal comfort. The women who conceived did not show these changes; a gradual increase in fatigue and decline in sexuality was observed. CONCLUSION: In women who are not pregnant, the cessation of breast-feeding is associated with an improvement in mood, fatigue, and sexuality.

Adult↗

Should ovulation be induced in women recovering from an eating disorder or who are compulsive exercisers?

The eating and exercise history of women with secondary amenorrhea and failure of ovulation using CC was studied in 14 consecutive women on a GnRH-a program. All had a history of an eating or exercise disorder. At the time of the interview, 7 women continued to have an eating or exercise disorder. There were 15 pregnancies (12 women) with 12 live births, of which 4 weighed less than 2,500 g. Infertility specialists should inquire routinely about a woman's body weight and eating and exercise behaviors, and consider treatment for these before prescribing drugs to induce ovulation.

Adult↗

Menstruation, menstrual protection and menstrual cycle problems. The knowledge, attitudes and practices of young Australian women.

The results of a survey of 1377 young Australian women aged 14 to 19 years, conducted to determine their attitudes, state of knowledge and practices with regard to menstruation, are presented. The young women, as a group, lacked sufficient information about menstruation, about the time of ovulation, about menstrual discharge, and about the use of tampons. A high proportion (80%) considered menstruation to be inconvenient or embarrassing. Certain measures aimed at remedial action are suggested.

Adolescent↗

The psychosexual histories of young women with bulimia.

While it is known that anorexia nervosa patients show a wide range of sexual knowledge, attitudes and practices, the psychosexual histories of bulimia patients have not been studied. In this paper the psychosexual histories of 20 bulimic patients and 20 matched control subjects are presented. Bulimic patients were more likely to experience orgasm with masturbation, were more likely to have experimented with anal intercourse, and were more likely to describe their libido as 'above average.' Control subjects were more likely to experience orgasm during sexual intercourse. Bulimic patients associated high body weights with unattractiveness, and tended to withdraw from social and sexual activity at high weights. In other aspects of their sexual behaviour, and in their attitudes to sexual matters, the two groups were similar.

Adolescent↗

Changes in sodium and uric acid concentrations in plasma during the menstrual cycle.

Hormonal changes during the menstrual cycle are well documented, but many other biochemical variables have not been studied. We find that in the luteal phase of the menstrual cycle the concentrations of sodium and uric acid are significantly lower. The changes may be of significance for the determination of the normal reference interval.

Adult↗

Eating behaviours among young women.

Disordered eating and weight-control behaviour is becoming increasingly common among adolescent girls. We studied four groups of young women aged between 15 and 27 years (106 school and university students, 50 ballet school students, 22 patients suffering from anorexia nervosa and 44 patients with bulimia). Our results suggest that most young women diet at some time and lose more than three kg in weight; that they may experience episodes of binge eating and "picking" behaviour; and that they wish to be thinner irrespective of their current body weight. Twenty per cent of young women may fulfil the criteria for an eating disorder (bulimia or anorexia nervosa) at some stage, however briefly, and about 7% abuse laxatives or diuretics in order to achieve a fashionably slim figure. We suggest that most young women may pass through a phase of what is currently called disordered eating, and that this is part of normal development and may not necessarily require treatment. The incidence of disordered eating is greater in those young women who are under pressure to maintain a low body weight.

Adolescent↗

External breast prostheses. A survey of their use by women after mastectomy.

Women who have had a mastectomy for breast cancer have to cope with two major problems: first, that they have cancer, and second, that they have lost their physical appearance. The provision of an appropriate prosthesis can reduce the sense of disfigurement. If women were to obtain the full psychological benefit of wearing a breast prosthesis, they need to be informed about the available breast forms, have an opportunity to choose between them, and to be satisfied with their choice. In this study of 49 women, only 44% had had the opportunity to choose a prosthesis, 28% were dissatisfied with their prostheses, and 17% were still using temporary prostheses.

Aged↗