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PubMed1994

Reproductive health, use of estrogen and experience of symptoms in perimenopausal women: a population-based study.

OBJECTIVE: The aim of the study was to examine reproductive health, use of estrogen, lifestyle, experience of menopausal symptoms and work-role related issues in a population-based sample of perimenopausal women. METHODS: All women aged 48 years and residing in the catchment area of the Karolinska Hospital were recruited through the Swedish population register. They received a questionnaire covering sociodemographic background, reproductive health and gynaecological characteristics, social and work role related issues as well as a symptom rating scale. RESULTS: Seventy percent of the women returned the questionnaire. Of these, 73% were premenopausal, 21% were postmenopausal and 6% were perimenopausal. Hormone replacement therapy was used by 7.5% of the respondents and the rate of hysterectomy was 8.6%. Regular exercise was reported by 44.4%. Factor analysis of the symptom ratings yielded four independent dimensions: Negative Moods, Vasomotor symptoms, Decreased Sexual Desire and Well-being. Multiple regression analyses showed that only vasomotor symptoms were significantly related to menopausal status. Negative Mood and Reduced Sexual Interest were better explained by the presence of vasomotor symptoms and by reproductive health and lifestyle variables such as current or previous PMS, dysmenorrhea, smoking and lack of exercise. CONCLUSIONS: Only vasomotor symptoms were significantly related to menopausal status. Psychosocial and lifestyle variables as well as past or current reproductive health are more important determinants of women's psychological well-being during transition to menopause than menopausal status.

Attitude to Health↗
PubMedDate not supplied

Implementing reproductive health awareness: progress to date.

This paper describes the experience of various institutions in integrating a reproductive health awareness (RHA) approach into different health, school and community-based programs. RHA, an educational approach that evolved from the Institute's client empowerment approach to natural family planning and fertility awareness, is based on helping women and men to participate actively in their own family planning and reproductive health care by developing skills in self-observation, communication and self-advocacy. In addition to providing the Institute with an avenue for responding to the Cairo and Beijing mandates, RHA has also provided a means to introduce family planning, particularly natural methods of family planning, into programs and institutions. RHA has continued to evolve and strengthen during the process of field testing its contributions to existing reproductive health programs.

Awareness↗
PubMed2002

Use of technology in reproductive health information designed for communities in South Africa.

The need to change sexual behavior to reduce the spread of the HIV/AIDS epidemic has highlighted the critical need for dissemination of effective reproductive health information. A wide range of media, including visual technologies, is used to provide health information to communities in South Africa. However, little is known about the ability of the technology used in communicating intended messages or on the comprehension of messages by the target audience. The study determined the ability of the technology to convey intended messages and the level of understanding of the information disseminated among the community members. A survey of both rural and urban communities of Umtata district in the Eastern Cape province was conducted to examine the readability and understanding of reproductive health information. The study revealed that urban communities understood disseminated reproductive health information better than rural. The findings also indicated that visual communication is much more problematic for older people. Frequency and consistency of reproductive health information improved the level of comprehension.

Adolescent↗
PubMed2001

Where are we on teen sex?: Delivery of reproductive health services to adolescents by family physicians.

BACKGROUND AND OBJECTIVES: This study describes variation in reproductive health preventive services delivery to adolescents by family physicians in Upstate New York. METHODS: We surveyed a stratified random sample of 354 family physicians from three New York State metropolitan statistical areas about the proportion of their adolescent patients (ages 15-18) to whom they deliver preventive reproductive health interventions. Responses were averaged to create a preventive care practice score. RESULTS: Of 295 eligible respondents, 179 returned completed surveys (61%). Eighty-one percent were male. Respondents did not vary by geographical area. However, female family physicians were less likely to respond than males, and olderfamily physicians were less likely to respond than more-recent graduates. On average, family physicians reported asking 79% of their adolescent patients about contraceptive use, 73% about condom use, 72% about sexual relationships, and 61% about sexual behaviors. Only 36% reported asking teens when they thought sex was appropriate, and 30% had discussed sexual orientation. Seventy-six percent of physicians discussed adolescents' risks of HIV with adolescent patients, 78% advised adolescent patients to use condoms, 21% gave handouts about HIV, and 9% gave condoms to adolescent patients. Factors associated with provision of more preventive reproductive services included regularly discussing confidentiality, more-recent medical school graduation, placing a high value on the American Academy of Family Physicians recommendations, having read Centers for Disease Control immunization guidelines, having read American Academy of Pediatrics guidelines, and female gender Overall, these factors explained 26% of the variance in provision of preventive reproductive services. CONCLUSIONS: Family physicians report providing most reproductive preventive services to more than half of their patients. Female physicians, older physicians, physicians who regularly discuss confidentiality, and physicians who have a more-positive attitude toward andfamiliarity with preventive care guidelines are more likely to provide reproductive health screening and counseling during adolescent visits.

Adolescent↗
PubMed2000

Future directions for violence against women and reproductive health: science, prevention, and action.

Despite the recognition that violence may be associated with serious consequences for women's reproductive health, the understanding of the relationship between the two remains limited, as does our understanding of the most effective role for reproductive health care providers and services. This paper briefly summarizes the history of the nexus of public health, health care, and violence against women in the United States. In addition, we present some considerations for future directions for research, health care practice, and policy that will advance the understanding of the complex relationship between violence and reproductive health.

Adolescent↗
PubMed2006

Gender disadvantage and reproductive health risk factors for common mental disorders in women: a community survey in India.

BACKGROUND: Gender disadvantage and reproductive health are major determinants of women's health in developing countries. OBJECTIVE: To determine the association of factors indicative of gender disadvantage and reproductive health with the risk of common mental disorders (CMDs) in women. DESIGN: Cross-sectional survey from November 1, 2001, to June 15, 2003. PARTICIPANTS: A total of 3000 women randomly selected from a sampling frame of women aged 18 to 45 years in Goa; 2494 women participated. MAIN OUTCOME MEASURES: The primary outcome was the presence of a CMD, as defined by the Revised Clinical Interview Schedule. An interview and blood and vaginal/urine specimens were collected to ascertain risk factors. RESULTS: The prevalence of CMD was 6.6% (95% confidence interval [CI], 5.7%-7.6%). Mixed anxiety-depressive disorder was the most common diagnosis (64.8%). Factors independently associated with the risk for CMD were factors indicative of gender disadvantage, particularly sexual violence by the husband (odds ratio [OR], 2.3; 95% CI, 1.1-4.6), being widowed or separated (OR, 5.4; 95% CI, 1.0-30.0), having low autonomy in decision making (OR, 1.98; 95% CI, 1.2-3.2), and having low levels of support from one's family (OR, 2.2; 95% CI, 1.4-3.3); reproductive health factors, particularly gynecological complaints such as vaginal discharge (OR, 3.2; 95% CI, 2.2-4.8) and dyspareunia (OR, 2.5; 95% CI, 1.4-4.6); and factors indicative of severe economic difficulties, such as hunger (OR, 2.7; 95% CI, 1.6-4.6). There was no association between biological indicators (anemia and reproductive tract infections) and CMD. CONCLUSIONS: The clinical assessment of CMD in women must include exploration of violence and gender disadvantage. Gynecological symptoms may be somatic equivalents of CMD in women in Asian cultures.

Adolescent↗
PubMedDate not supplied

Reproductive health and AIDS-related services for women: how well are they integrated?

To explore the relationship between human immunodeficiency virus (HIV) and AIDS services and reproductive health services, a survey was undertaken in 1994 of 30 health care facilities that are grantees under Title IIIb of the Ryan White Comprehensive AIDS Resource Emergency Act, 19 family planning clinics that offer at least some HIV services, and two family planning agencies that are also grantees under Title IIIb. The Title IIIb providers and the family planning agencies offer similar sets of services, but they tend to view reproductive health and HIV and STD services as distinctly different categories. Eliminating the perceptual distinctions between these services and viewing reproductive health services as key components of HIV and AIDS prevention could result in a more integrated system of helping women with HIV infection or AIDS as well as those at risk of HIV infection.

Comprehensive Health Care↗
PubMedDate not supplied

Its perspective of adolescent reproductive health behaviour in a suburban town in Nigeria.

BACKGROUND: Parent/Adult Child communication has been shown to influence adolescent reproductive health behaviour Adults need to pass correct information across to youths to help them make proper decisions that will promote their health. The objective of this study was to assess the attitude of parents to adolescent reproductive health behaviour in a suburban Nigerian town. METHODS: This cross-sectional descriptive study was carried out in Ikenne, Ogun State. A Semi-structured questionnaire was used to gather information from 370 adults who were chosen by multi-staged sampling method. RESULT: About two-thirds of the adults surveyed (62.2%) were against premarital sex among adolescents. Although 46.8% said it was permissible for adolescents to use contraceptives, 87.1% will react negatively if they found contraceptives with their children. The condom was the most commonly approved contraceptive method for adolescents by 60.7% of those who approved of adolescents use of contraception, consisting of 14.6% of all the parents in the study. The major reasons against contraceptive use by adolescent were the promotion of promiscuity (41.5%) and infertility in the future (24.9%). Although gender difference was not statistically significant, the females expressed a more conservative attitude to adolescent sexuality and contraception than males; they were less likely to approve of sexual activity among young people (17.8% versus 23.6%) or contraceptive use by them (44.6% versus 49.2%). Eighty seven percent (87%) of those that had children/ward above 12 years had discussed sexuality issues with them. The major form of advice was sexual abstinence and the possibility of unplanned pregnancy. Only 8.5% had advised them about contraception. While 74.1% had approved of sex education in schools, only 31.9% approved of teaching about condom in schools. CONCLUSION: Adults are interested in the reproductive health of their children. Programmes that seek to involve parents in promoting the sexual health of youths will make significant progress if they specifically target parents (especially women) with information about the context of adolescent sexuality and address their misgivings.

Adolescent↗
PubMed1999

The close connection between classical rights and the right to health, with special reference to the right to sexual and reproductive health.

Although several international and regional human rights instruments, including the Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights, give explicit recognition to a broad right to health, this right, at present, offers little real protection to interests in individual and community health, including reproductive and sexual health. This is so, the author argues, because the mechanisms now in place for supervision and enforcement of this and other "social human rights" are extremely weak. In these circumstances, better protection is available indirectly, through enforcement of certain "classical human rights," such as the right to life, the right to be free from inhuman and degrading treatment, and the right to found a family, that contribute to--and depend upon--realisation of a right to health.

Family Planning Services↗
PubMed1999

[Medical and ecologic aspects of problems associated with protection of workers' reproductive health in Russia].

The article deals with various aspects of workers' reproductive health care during economic crisis in Russia. Deterioration of health state in children and adults threatens deeper negative demographic trends. The authors discuss basic principles of "Reproductive health as a problem in occupational medicine". Concept and suggest measures aimed to preserve and improve health of Russian population.

Adolescent↗
PubMed1999

Reproductive health needs: comparing women at high, drug-related risk of HIV with a national sample.

Women who inject drugs or have injection drug-using sex partners are at high risk of acquiring human immunodeficiency virus (HIV) infection and of transmitting HIV perinatally. Many of these women need standard reproductive health care services, specialized HIV care, pre- and postnatal care, and drug treatment, but the extent of the unmet need for such health services is unknown. Large-scale national surveys that estimate drug use do not include reproductive health topics and vice versa. In addition, such surveys typically employ a household sampling method that tends not to include drug-using women. This paper presents evidence from three convenience samples that a high-risk population of women who use drugs has limited access to reproductive health services, and that this population is not represented in the National Survey of Family Growth (NSFG), the national survey that informs public policy regarding reproductive health care in the United States. Policy makers would be well served by regular surveillance of the multiple service needs of women with HIV-risk-related behaviors.

Adolescent↗
PubMed2001

Support for school-based reproductive health services among South Carolina voters.

In 1997 a statewide random digit-dialed telephone survey of 534 South Carolina registered voters was conducted to determine level of support for school-based reproductive health services. Results indicated most voters supported services in secondary schools that would provide students with information and counseling about contraceptive methods and refer students to community-based agencies for abstinence education and counseling. Voters were less supportive of reproductive health services that would diagnose or treat sexually transmitted diseases, test for pregnancy, refer students to community-based agencies for contraceptives, or make contraceptives available to students at school. Significant associations in support for school-based reproductive health services were reported based on income, personal beliefs, intentions, and outcome expectations regarding sexuality education and contraceptive availability. These data reinforce the need for school-aged youth in South Carolina to have access to reproductive health services within their communities, outside of the school setting.

Adolescent↗
PubMed2002

The reproductive health of daughters of pregestational diabetic women: Medical Birth Registry of Norway.

Maternal diabetes may have an impact upon a daughter's reproductive health through genetic influences, an altered fetal metabolic environment or both. We examined the reproductive health of daughters of diabetic women using linked generation data from the Medical Birth Registry of Norway. Among all female births between 1967 and 1982 (n = 459182), 739 had a mother with registered pregestational diabetes, a rate of 1.6 per 1000 deliveries. A total of 142904 daughters delivered at least one child by 1998. After taking into account differences in survival, we observed no differences in the percentage of childbearing and in the average number of children born by 1998 between daughters with and without a diabetic mother in age-stratified analyses. In analyses limited to singleton deliveries and stratified by mothers' and daughters' diabetic status, we found a threefold excess stillbirth delivery rate among women who had either a mother with pregestational diabetes (2.6%) or pregestational diabetes themselves (2.6%) compared with the stillbirth delivery rate observed in non-diabetic women with no maternal history of diabetes (0.8%). These findings were unaltered in multivariable analyses adjusting for daughters' maternal age and registered obstetric risk factors. Our results indicate that pregestational diabetes remains a health care challenge in Norway and that further evaluation of the reproductive health of daughters of diabetic pregnancies is warranted.

Adult↗
PubMedDate not supplied

[Prophylactics in the formation and correction of reproductive health].

In this article, an analysis of data from the published literature is given together with findings from the author's investigations designed to study disorders of reproductive health. The paper focuses on the key items of reproductive health and on risk factors as well. A system of measures is substantiated designed to prevent disorders and to correct the reproductive health of the population.

Health Status Indicators↗
PubMed2000

Women's reproductive health: monotheistic religious perspectives.

It is important to those who practice reproduction techniques to learn about the different religious attitudes related to reproductive health problems. Religion exerts an influence on civil authorities in the field of reproduction such as prevention or procreation and in issues such as abortion and infertility therapy. The Jewish attitude towards reproduction can be learned from the fact that the first commandment of God to Adam was be fruitful and multiply. Judaism allows the practice of all techniques of assisted reproduction when the oocyte and sperm originate from the wife and husband, respectively. All Rabbinical rulings permit the use of contraception for medical indications. Economic difficulties and inconveniences of raising children are not indications for birth control practice. According to Judaism abortion on demand is forbidden but it may be performed if the mother's life is in danger. The attitude toward reproductive practice is different among the different divisions of Christianity. The practice of assisted reproduction is not accepted by the Vatican, however, it may be practiced by Protestant, Anglican and other Denomination's. According to the Roman Catholic doctrine the primary purpose of marriage is procreation. The contraceptive act destroys the potential of producing new life by sexual intercourse and violates the purpose of marriage and, therefore, is a sin against nature. The Christian tradition views the embryo as a human being since conception and, therefore, abortion is strictly forbidden. According to Islam, the procedure of IVF and ET is acceptable, however, it can be preformed only if it involves the husband and the wife. It allows contraception practice only under some circumstances and only in some special cases abortion can be preformed. Religion, being concerned with affairs that are regarded as extraordinary and as having unique importance in life, is an intrinsic aspect of the culture of all societies, religious groups, however, still exert influence on the civil authorities in issues of reproduction such as contraception, procreation, abortion, and infertility therapy. They have been active in pressing their bioethical positions on the public arena in pluralistic societies. Developments in science and technology in reproduction raise new religious questions that do not always have clear answers. The role of theology in bioethics is foremost to clarify for the different religious communities the perceived attitudes toward these developments. Therefore, it is important to those who practice reproduction techniques to learn about the different religious attitudes related to reproductive health problems.

Abortion, Induced↗
PubMed2005

Preventing transmission: plant-derived microbicides and mucosal vaccines for reproductive health.

Exclusion of infectious agents from mucosal surfaces of the reproductive tract is a key objective of microbicides and mucosal vaccines. With mucosal antibodies as a common mechanism of exclusion, parallel development of passive and active immunization strategies is an opportunity to determine and achieve protective antibody concentrations in the female reproductive tract. Recognizing that access to sexual and reproductive health products will require low-cost and high-capacity production technologies, the emerging tools of plant biotechnology for complex biopharmaceutical production are crucial. Unfortunately, few preclinical or clinical studies have been completed to date with plant-derived agents intended for reproductive health.

Animals↗