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Biomedical subjects

E W Freeman

Publications and source records attributed to E W Freeman.

66 records · Page 4Linked to original sources
PubMed1982

Never-pregnant adolescents and family planning programs: contraception, continuation, and pregnancy risk.

Four hundred urban Black teenagers enrolling in a family planning program before pregnancies occurred were followed for one year to assess factors influencing continuation of contraceptive use. Over half the follow-up respondents claimed to always use contraception. Program discontinuers were less likely to use contraception, but nearly half had no sex activity when contacted at follow-up. Sex frequency reported in the sample was low. Background factors of age, grade, and household were associated with contraceptive use and with pregnancy. Girls who had pregnancies were significantly more likely to live in a single-parent household, to have sex more frequently, and to have stated at enrollment that they wanted their first child before age 20. A majority of the sample, nearly all of whom obtained oral contraception, did not know at the one year follow-up how to use any alternative methods for preventing conception, hence many would again be at risk of pregnancy when sex activity resumed.

Adolescent↗
PubMed1980

Adolescent contraceptive use: comparisons of male and female attitudes and information.

Information and attitudes about contraception and pregnancy were assessed with a self-administered questionnaire in a sample of urban Black teenagers. Data were obtained from 607 male and female students in high school health classes and a demographically similar group of 123 never-pregnant teenage women in a family planning clinic who had not attended these classes. Males were less likely to recognize the risk of pregnancy, had less information about contraceptives, and fewer attitudes that supported contraceptive use than females who participated in the same shool health classes. More males than females indicated that school classes had been the main source of contraceptive information. Teenage women in the family planning clinic did not differ from the high school females in attitudes about contraceptives, but the school group had somewhat more contraceptive information. The female school group was more likely to have discussed contraception with parents, obtained more contraception information from their mothers, and discussed contraception more with male friends than the teenagers who requested contraceptives at the family planning clinic.

Adolescent↗
PubMed1980

Emotional distress patterns among women having first or repeat abortions.

Thirty-five percent of a sample of 413 women undergoing first-trimester abortions were repeating abortions. All patients rated their emotional symptoms on an SCL-90 scale and completed a brief demographic questionnaire. Preabortion and postabortion emotional distress factors and associated demographic characteristics were compared for women having first and those undergoing repeat abortions. Elevated distress levels were similar in both groups prior to abortion procedures, particularly depression, anxiety, and somatization. After abortion, repeat aborters continued to have significantly higher emotional distress scores in dimensions relating to interpersonal relationships. The variables that discriminated most between first and repeat abortion groups were number of living children, race, and phobic anxiety.

Abortion, Induced↗
PubMed1977

Influence of personality attributes on abortion experiences.

Questionnaire responses of women who underwent legal abortions reveal a range of complex emotional reactions. This study suggests that both the resolution of negative feelings post-abortion and the motivation to use contraception are related to individual personality characteristics. Implications are offered for therapeutic intervention and for contraceptive counseling with young, unmarried women.

Abortion, Legal↗
PubMedDate not supplied

Evaluation of a unique oral contraceptive in the treatment of premenstrual dysphoric disorder.

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). This is the first trial of a unique oral contraceptive containing a combination of drospirenone (DRSP, 3 mg) and ethinyl estradiol (EE, 30 microg) for the treatment of PMDD. DRSP is a spironolactone-like progestin with antiandrogenic and antimineralocorticoid activity. Spironolactone has been shown to be beneficial in PMS, whereas oral contraceptives have shown conflicting results. In this double-blind, placebo-controlled trial, 82 women with PMDD (Diagnostic and Statistical Manual of Mental Disorders, 4th ed. [DSM IV]) were randomized to receive DRSP/EE or placebo for three treatment cycles. The primary end point was change from baseline in luteal phase symptom scores as assessed on the Calendar of Premenstrual Experiences (COPE) scale. Patients treated with DRSP/EE showed a numerically greater change from baseline compared with those treated with placebo on each of the 22 COPE items and each of the 4 symptom factors. Between-group differences in symptom improvement reached statistical significance in factor 3 only (appetite, acne, and food cravings, p = 0.027). The secondary end points, Beck Depression Inventory (BDI) and Profile of Mood States (PMS), were consistent with the primary end point in that patients treated with the oral contraceptive showed a numerically greater improvement from baseline compared with those treated with placebo. The results of this study show a consistent trend in the reduction of symptoms that suggested a beneficial effect of DRSP/EE for the treatment of PMDD, despite limitations of the study design.

Adaptation, Psychological↗
PubMedDate not supplied

Hot flashes in the late reproductive years: risk factors for Africa American and Caucasian women.

Hot flashes are a primary reason that midlife women seek medical care, but there is little information about the onset or the predictors of hot flashes in the years before the menopause. This study examines women's experience of hot flashes in the late reproductive years, comparing African American and Caucasian women, and identifies hormonal, behavioral, and environmental risk factors for hot flashes associated with ovarian aging. Data are from a population-based prospective cohort study of ovarian aging in women who were ages 35--47, in general good health, and had regular menstrual cycles at study enrollment. Hot flashes were assessed by subject report in a structured interview at the first follow-up period and correlated highly with previous prospective daily ratings of hot flashes (p = 0.0001). Blood samples were obtained in the first 6 days of the menstrual cycle in two consecutive cycles at enrollment and two consecutive cycles at follow-up. Predictor variables include hormone measures, structured interview, and standard questionnaire data. Thirty-one percent of the sample (n = 375) reported hot flashes (mean age 41 years). In bivariate analysis, more African American than Caucasian women reported hot flashes (38% vs. 25%, p = 0.01). Significant predictors of hot flashes in the final multivariable logistic regression model were higher follicle-stimulating hormone (FSH) levels (odds ratio [OR] 3.19), anxiety (OR 1.06), baseline menopausal symptoms (OR 4.91), alcohol use (OR 1.09), body mass index (BMI) (OR 1.04), and parity (OR 1.20). Race did not predict hot flashes after adjusting for these variables. Hot flashes commonly occur before observable menstrual irregularities in the perimenopause and are associated with both hormonal and behavioral factors. The association of hot flashes with increased body mass (BMI) challenges the current "thin" hypothesis and raises important questions about the role of BMI in hormone dynamics in the late reproductive years.

Adult↗
PubMedDate not supplied

Personality factors in women with premenstrual syndrome.

The recently developed Tridimensional Personality Questionnaire (TPQ) was used to examine personality correlates in women diagnosed with premenstrual syndrome (PMS). The hypotheses were that the TPQ scores, specifically harm avoidance (HA), would be higher in PMS subjects than in the general population but lower than in depressed populations because major mood disorder is an exclusion from the PMS diagnosis; harm avoidance would have the strongest association with PMS, but other TPQ factors might characterize nondysphoric subgroups in the PMS population. The sample included 157 women who sought medical treatment and met clearly defined criteria for PMS. Two comparison groups of age-matched women with major depression (MDD, N = 20) and premenstrual exacerbation of major depression (MDD + PMS, N = 24) were also evaluated. TPQ scores were significantly higher for PMS subjects on all three dimensions compared with external normative TPQ data. The TPQ dimensions of HA and novelty seeking (NS) were modestly correlated with the premenstrual symptom scores. The HA dimension correlated with premenstrual depression and physical aches; high NS scores correlated with premenstrual food cravings, headache, and mood swings. As hypothesized, the HA scores were significantly higher in the comparison groups diagnosed with major depression; the NS and reward dependence (RD) dimensions did not differ between the PMS and MDD groups. PMS was associated with only modest nonnormative personality correlates, as assessed by the TPQ. Elevations of the HA and NS dimensions were associated with a tendency for the PMS to present with specific symptom patterns: depressive symptoms for the HA factor and food cravings and mood swings for the NS factor. Further research employing other assessment methods is needed to confirm these findings.

Adolescent↗
PubMedDate not supplied

Symptom reports from a cohort of African American and white women in the late reproductive years.

OBJECTIVE: To identify symptoms experienced in a cohort of healthy women in the late reproductive years; to compare symptom reports between African American and Caucasian women; and to determine the extent to which other factors in reproductive health, mood and behavior, lifestyle, and demographic background are associated with the reported symptoms. DESIGN: A cohort of women aged 35 to 47 years (mean age, 41 years) was identified through random digit dialing. This study is a cross-sectional analysis of data collected at enrollment from a subset of 308 women who completed daily symptom reports (DSR) for one menstrual cycle. Data were obtained in structured interviews and self-administered standard questionnaires. The associations of the study variables with symptoms as assessed by the DSR were examined using analysis of variance and general linear models. RESULTS: The African American women were significantly more likely to report in interview that they experienced menopausal symptoms (46% vs. 30%; p < 0.001) and had significantly higher ratings on the physiological symptom factor of the DSR, which included hot flashes, dizziness, poor coordination/clumsiness, urine leaks, and vaginal dryness. The DSR yielded two other factors of psychological and somatic symptoms. Race was associated only with the physiological symptom factor in the multivariable analyses. Neither race nor age were associated with psychological symptoms, which were predicted by current or past mood problems. CONCLUSIONS: Symptoms commonly associated with the menopause are experienced in the late reproductive years before observable changes in menstrual cycles. African American women reported more physiological symptoms than white women. These data provide an essential baseline for longitudinal study of symptoms associated with the ovarian decline in the perimenopausal years.

Adult↗
PubMedDate not supplied

Abortion: subjective attitudes and feelings.

The decision to terminate a pregnancy is neither casual nor easy. Most women see abortion as a difficult but necessary alternative to an unintended birth. Their ambivalence is no reason to counsel against the abortion. Most resolve their problems soon after the procedure. Lack of support by partners can be a major source of distress.

Abortion Applicants↗