Reproductive Health Concerns Research Articles

0098 Prenatal Maternal Sleep Quality Predicts Neonatal White Matter Microstructure and Infant Negative Emotionality

Abstract Introduction Poor prenatal sleep health is a pervasive reproductive health concern that informs the health of the mother and fetal development. Despite the almost ubiquitous nature of sleep disturbances across pregnancy, sleep health within pregnant populations, and its effects on the next generation, remain poorly studied. We recently showed that prenatal maternal sleep quality predicts newborn hippocampal volume. However, the relation between prenatal sleep quality and neonatal neural circuit development remains unknown. Changes in neonatal white matter microstructure presage compromised socioemotional and cognitive health, including the development of psychopathology and neurocognitive disorders, making it a plausible neurobiological pathway linking prenatal maternal sleep and offspring socioemotional health. This study first examined the relations between trajectories of prenatal maternal sleep quality and subsequent neonatal white matter integrity. We next evaluated whether neonatal white matter integrity partially mediates associations between prenatal sleep and infant negative emotionality. Methods Pregnant participants (n = 116) provided prospective and longitudinal data of prenatal maternal sleep quality at 16, 29, and 35 gestational weeks using the Pittsburgh Sleep Quality Index. Neonatal (53% female) white matter integrity was assessed via diffusion weighed images using magnetic resonance imaging (MRI). Infant negative emotionality was collected at 6 postpartum months using the Infant Behavior Questionnaire. Results Trajectories of prenatal maternal sleep quality predicted higher bilateral neonatal fractional anisotropy (FA) in the uncinate fasciculus (e.g., right: b = 0.15, p = .023). Further, higher uncinate FA predicted more infant negative emotionality (e.g., right: b = 0.25, p = .011) and uncinate FA partially mediated the association between prenatal maternal sleep and infant negative emotionality (right: indirect effect = 0.014, CI = [.0001, .0323], p < .05). Associations remained after covarying for infant postconceptional age at MRI, motion in MRI scan, sex, and income-to-needs ratio. Conclusion These findings highlight prenatal maternal sleep health as a prenatal signal with intergenerational connections to offspring neurobiology and negative emotionality, both of which have been previously implicated in the development of psychopathology. Pregnancy is a sensitive period in which interventions may inform the health of two generations. Support (if any) NIMH R01MH109662, NHLBI R01HL155744, and diversity training supplement for 1st author; F32MH125572 for 2nd author.

Menstrual Hygiene Practices and its Predictors Among Young Women in India: Findings from the National Family Health Survey-5 (2019–2021)

Introduction India is moving towards menstrual hygienic practices. However, using unhygienic menstrual absorbents is still a reproductive health concern among women in India. Objective This study investigates the prevalence of menstrual hygiene practices by geographical location and socio-economic factors among women in India. Materials and Methods National Family Health Survey-5 (NFHS-5) (2019–2021) data were utilized to fulfill the study objectives. The study participant included 241,180 young women aged 15–24 years. A bivariate chi-square test was applied to present the percentage distribution of menstrual hygienic practices. Multivariate logistic regression analyses were used to examine the predictors linked with hygienic practices related to menstruation. Results About 77% of the women used hygienic absorbents to protect menstrual bloodstains in India. The menstrual hygienic practices are significantly lower in the improvised states of central and eastern India. Multivariable analysis reveals that higher educated women (adjusted odds ratio (AOR): 5.36; 95% confidence interval (CI): 4.18–6.87) residing in the richest quintile households (AOR: 6.17; 95% CI: 4.61–8.26) have a higher probability of hygienic practices related to menstruation. Besides, higher autonomy and mass media exposure are positively associated with hygiene practices. Conclusion The study findings recommend opportunities for reproductive education among women, offering financial incentives, and improving women’s empowerment may increase menstrual hygienic practices. Additionally, interventions should focus on socioeconomically poor women to increase the use of sanitary napkin. Interventions should also focus on marginalized women to increase the use of sanitary napkin.

The Sexual and Reproductive Health Concerns, Needs and Priorities of University Students in Nairobi County, Kenya

Despite the efforts universities are putting in place to address the sexual and reproductive health (SRH) concerns and needs of their students, the rate at which students are engaging in casual unprotected sex is reportedly high. This has resulted in increased rates of unsafe abortions and unintended pregnancies among the student population. It is against this background that this thesis sought to establish the SRH concerns, needs and priorities of university students in Nairobi County in Kenya. The Social Economic Model guided the study in understanding the problem while the Andersen and Newman Framework of Health Services Utilization guided the study in identifying possible solutions to the challenges identified. The targeted population was students studying in universities with main campuses in Nairobi County. Stratified random sampling was used to select the four public and private universities (Kenyatta University, Multimedia University of Kenya, United States International University - Africa and KCA University) which were part of the study. The study was guided by cross-sectional and exploratory research designs. The target population was 192,193 students. Stratified random sampling was used to select the three hundred and seventy (370) students who completed the study questionnaires. Sixteen key informants were purposefully selected to participate in-depth interviews while four focus group discussions (FGDs) of either gender were carried out. The study established that university students are most concerned about getting infected with HIV/AIDS followed by getting pregnant or impregnating someone. The study revealed that what the students need the most is access to condoms, pills and contraceptives for pregnancy prevention and youth friendly services. The study also revealed that university students prioritize confidentiality, the cost of SRH services and being attended by friendly healthcare providers in this order.

Role of the Q36R polymorphism in the KISS1 gene in female infertility

BackgroundInfertility has evolved into a worldwide reproductive health concern that is distinctively constituted within various socio-cultural contexts. Female infertility is a global health concern ailment in couples who have been unable to conceive for a year. Kisspeptin (KISS1) is a peptide hormone that is important in women's health difficulties such as infertility. Based on previous studies, single nucleotide polymorphisms (SNPs) in KISS1 gene can be a cause for infertility. The objective of this study is to explore into the Q36R SNP in the KISS1 gene in Saudi infertile women. MethodsIn this case-control study, 96 cases of female infertile and 96 control women was selected. Deoxyribonucleic acid (DNA) was extracted to perform polymerase chain reaction and followed by restriction fragment length polymorphism analysis. All DNA products were run on 2% agarose and obtained data was imported into excel to perform the statistical analysis using SPSS software between cases and controls. ResultsThe anthropometric analysis (p > 0.05), genotype (OR-3.60; 95 %CI:0.96–13.55; p = 0.04), allele (OR-2.49; 95 %CI: 0.86–7.21; p = 0.08) and different genetic models (AG + GG vs AA; OR-1.00; 95 %CI: 0.01–7.02; p = 0.005) showed negative association and fertility histories showed significant association (p < 0.0001). Anova analysis showed the positive association with weight (p = 0.01) and BMI (p = 0.003). ConclusionThis study found no connection between the Q36R SNP in the KISS1 gene and female infertility in Saudi Arabia.

PENDAMPINGAN SISWA OLEH KADER “GEMPI KESPRO” GENERASI MUDA PEDULI KESEHATAN REPRODUKSI DI SMPIT BINA INSANI KOTA KEDIRI

Reproductive health issues are always an interesting topic of discussion among youth groups, including junior high school students. This community service activities aims to realize SMPIT Bina Insani Kediri as a school with a "gempi kespro" perspective, namely a school that has concern for reproductive health. Activities have started in 2021 with the formation of the Gempi Kespro Cadre and continued with training involving 35 students. This year (2022) is the 2nd year of implementing community service activities with the target of student mentoring activities by the Gempi Kespro Cadre to provide information and education on adolescent reproductive health issues under the supervision of the Gempi Kespro Advisor. Each cadre is given the opportunity to accompany 1 student by using the module, pocket book and Gempi Kespro comic, as a medium of information and education. From the activities carried out, it can be seen that there was an increase in participants' knowledge about adolescent reproductive health, including: reproductive organ anatomy, physiology, puberty and adolescent reproductive health problems. From the evaluation results, it was also found that 91.43% of cadres and 85.71% of participants stated that they were satisfied and benefited from participating in this activity. The majority of participants stated that the benefits obtained were in the form of: information about reproductive health (92.86%), the ability to communicate with friends (97.14%), having an interest in the world of health (74.29%). This activity is expected to be continued in the 3rd year with the target of strengthening school infrastructure with the concept of Gempi Kespro.Keywords: students, cadres, mentoring, reproductive health

Associations of Reproductive Health Concerns, Health-Related Quality of Life, and Stress Among Adolescents and Young Adults with Chronic Illness.

Adolescents and young adults (AYA) living with chronic illness are as sexually active and interested in having children as healthy peers. Few studies have examined the intersection of managing chronic illness and concerns about realizing reproductive goals, including fertility, pregnancy, childbirth, and parenting. Even less is understood regarding how these concerns might be associated with psychological distress. This study examines associations between the reproductive health concerns (RHC) and health-related stress of AYA patients living with chronic conditions including rheumatologic, cardiac, pulmonology, gastrointestinal disorders, and solid organ transplant. A total of 140 patients aged 15 to 20 years (68% female; 81% Hispanic/Latinx) recruited from a transition program located at a safety-net pediatric institution completed surveys examining multiple dimensions of RHC and health-related quality of life (life satisfaction, illness burden, and illness-related anxiety) and condition-related stress. Exploratory factor analyses of RHC variables yielded 3 factors used in regression analyses to identify convergent validity of RHC factors with health-related mental health measures. Three RHC factor loadings emerged: concern about availability to raise children (timing/future), impact of condition/medication on fertility and childbearing (pregnancy/fertility), and impact of condition on motivation to have children (motivation/decision-making). Positive associations were found between all RHC factors and illness-related anxiety; condition-related stress was associated with motivation/decision-making. RHC, health-related anxiety, and stress can impede healthy sexual and reproductive health and development of AYA living with chronic conditions. Providers' proactive exploration of patients' concerns about their reproductive future can offer critical support as they navigate the unique existential challenges of early adulthood.

Perfluorooctanoic acid (PFOA) promotes follicular growth and alters expression of genes that regulate the cell cycle and the Hippo pathway in cultured neonatal mouse ovaries

Perfluorooctanoic acid (PFOA) is a synthetic chemical resistant to biodegradation and is environmentally persistent. PFOA is found in many consumer products and is a major source of water contamination. While PFOA has been identified as a contaminant of concern for reproductive health, little is known about the effects of PFOA on ovarian follicular development and growth. Recent evidence indicates that the Hippo pathway is an important regulator of ovarian physiology. Here, we investigated the effects of PFOA on ovarian folliculogenesis during the neonatal period of development and potential impacts on the Hippo signaling pathway. Post-natal day 4 (PND4) neonatal ovaries from CD-1 mice were cultured with control medium (DMSO <0.01% final concentration) or PFOA (50 μM or 100 μM). After 96 h, ovaries were collected for histological analysis of folliculogenesis, gene and protein expression, and immunostaining. Results revealed that PFOA (50 μM) increased the number of secondary follicles, which was accompanied by increases in mRNA transcripts and protein of marker of proliferation marker Ki67 with no impacts on apoptosis markers Bax, Bcl2, or cleaved caspase-3. PFOA treatment (50 μM and 100 μM) stimulated an upregulation of transcripts for cell cycle regulators Ccna2, Ccnb2, Ccne1, Ccnd1, Ccnd2, and Ccnd3. PFOA also increased abundance of transcripts of Hippo pathway components Mst1/2, Lats1, Mob1b, Yap1, and Taz, as well as downstream Hippo pathway targets Areg, Amotl2, and Cyr61, although it decreased transcripts for anti-apoptotic Birc5. Inhibition of the Hippo pathway effector YAP1 with Verteporfin resulted in the attenuation of PFOA-induced follicular growth and proliferation. Together, these findings suggest that occupationally relevant levels of PFOA (50 μM) can stimulate follicular activation in neonatal ovaries potentially through activation of the Hippo pathway.

Biotherapy using Sperm Cell-oriented Transportation of Therapeutics in Female Reproductive Tract Cancer.

Female reproductive tract cancers like ovarian, cervical, vaginal, etc. have led to a serious concern for reproductive health as well as an increase in physical and psychological stresses amongst women. Various conventional techniques like surgery, radiation and chemotherapy are employed but possess limitations such as organ toxicity, infection, nausea, vomiting, etc. Also, several nanotechnology-based synthetic vehicle delivery systems like liposomes, nanoparticles, etc. are used but they lack targeting efficiency that results in poor propulsion and control. Therefore, there is a need for naturally-driven drug carriers to overcome such limitations. Sperm-based drug delivery is the new area for targeted delivery that offers self-propulsion to tumor sites, higher biocompatibility, longer lifespan and increased tissue penetration with enhanced localization. Drug-loaded sperm cells are harnessed with micro/nanomotor that will guide them to the intended target site. The critical analysis of the sperm-based drug delivery system was executed and summarized along with the current challenges. This article deals with the art of delivering the anticancer drug to female reproductive cancer sites with proof-of-concept-based research data and critical discussion on challenges in formulating the sperm-based delivery with a future perspective.

Characterization of primary female infertility in a Nigerian tertiary hospital: A case-control study.

Primary female infertility is a serious reproductive health concern amongst many women in Nigeria with associated psychosocial impact. There is a need for early prediction of this disorder for increased chances of fertility in Nigerian women. This study reported the anthropometric, sociodemographic, and clinical baseline characteristics of primary infertility females and studied their viability as predictors of primary infertility. This is a case-control study of primarily infertile (54) and fertile (50) Nigerian females aged 20-44 years recruited by random selection of patients who visited University College Hospital between August and November 2020. A clinical proforma was utilized to assess sociodemographic data, fertility history and clinical diagnosis of study participants. The body mass index (BMI) of both fertile and infertile females was in the overweight category (27.98±0.87 and 28.18±0.59, respectively). Both fertile and primary infertile females present a normal menarcheal age (13.68±0.27 and 13.91 ± 0.32 years, respectively), and there was no significant difference between the menarcheal age (p = 0.411) in both study groups. Ovarian disorder was the most contributing clinical diagnosis (67%) of primary infertility. There is a significant strong association between menarcheal age, ovarian factor infertility (χ2 = 13.839, φc = 0.458, p = 0.008) and tubal factor infertility (χ2 = 11.111; φc = 0.527, p=0.025). Females with primary infertility may present with overweight in no significantly different way than fertile females and BMI may not be useful in predicting primary infertility. However, menarcheal age may be a valuable tool to predict the ovarian and tubal factors in primary infertility.

Comparative in vitro antimicrobial study of Panchavalkal and modified Panchavalkal in three different extract solvents: a study protocol

Background: Charak, Sharangdhar, Kashyap, BhavaPrakasha described Panchavalkala, is a combination of five astringent barks viz., Vata (Ficus bengaenesis Linn.), Udumbara (Ficus glomerata Roxb.), Ashvattha (Ficus religiosa Linn.), Parisha (Thespesia populanea Soland excorrea) and Plaksha (Ficus slacor Buch-Ham.). In Ayurveda sometimes substitute plants are described to work better for a particular medical condition. Such type of alternative drug suggested by BhavaMishra and Kaiyadeva Nighantu for classical Panchavalkala is Shirish (Albezzia lebbeck Linn.) in place of Parisha. Such type of altered Panchavalkal is called as modified Panchavalkal. Both Panchavalkals are essentially important in acute, chronic ulcers, wound healing and reproductive health concern women’s diseases like leucorrhea, irregular or heavy bleeding etc. So, these Panchavalkals at three different extract solvents i.e., water extract, alcoholic extract and hydro alcoholic extract in comparison to standard anti-microbial drugs will be studied.Methods: Panchavalkal and modified Panchavalkal in water, alcohol and hydro alcoholic extract will be subjected to a test antimicrobial property by agar well diffusion method. Results will be assessed on the basis of minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and the zone of inhibition (ZOI) of plant extracts against the microorganism that will be measured.Conclusions: Conclusion will be drawn on the basis of results obtained about anti-microbial activity of Pachavalkal and modified Panchavalkal in three different extracts.Trial registration: It is taken, Ref. No. MGACHRC/IEC/February-2021/193-A

Sexual and Reproductive Health Concerns in Adults with Cloacal Anomalies: A Qualitative Study

Background: The repair of a cloacal anomaly involves complex decisions with the goal to achieve sexual, menstrual, and obstetric function, and urinary and bowel control. Little research exists regarding long-term gynecologic outcomes. This qualitative study was conducted to assess the perceived sexual and reproductive health challenges of patients born with cloacal anomalies and to characterize the experiences of these patients as adults.

Abstract 9551: Presence of Disabilities is Associated With Reproductive Health Counseling, Concerns, and Experiences and Marital History Among Women With Congenital Heart Defects, 2016-2019

Most females with congenital heart defects (CHD) will reach reproductive age. Our objective was to examine whether presence of disabilities is associated with reproductive health counseling, concerns, and experiences among women with CHD. Methods: We used 2016-2019 population-based data from the Congenital Heart Survey To Recognize Outcomes, Needs, and well-beinG (CH STRONG) among women ages 19 to 38 years with CHD born in Arkansas, Arizona, and Atlanta, Georgia. We examined contraceptive and pregnancy counseling, pregnancy concerns and experiences, and marital history by disability status. Disability was based on six validated questions on vision, hearing, mobility, cognition, self-care, and independent living. Multivariable Poisson regression was used to examine adjusted prevalence ratios (aPR) between reporting ≥ 1 disability and each outcome, adjusted for CHD severity, age, race/ethnicity, place of birth, and insurance type. Results: Of 783 survey respondents with complete data (88% of all respondents), 41.9% were 25-30 years of age, 66.8% were non-Hispanic White, and 41.5% reported ≥1 disability. Women with CHD and disabilities were more likely than women without disabilities to receive clinician counseling on safe contraceptive methods (aPR=1.3) and on avoiding pregnancy because of their CHD (aPR=2.3). They were also more likely to report concern about their ability to have children (aPR=1.2) and having delayed or avoided pregnancy because of their CHD (aPR=2.2). They were less likely to have ever been pregnant (aPR=0.8) or married (aPR=0.7). Associations held across specific disability types and after excluding 71 women with known chromosomal anomalies. Conclusions: Among women with CHD, those with disabilities may be more likely to receive clinician advice to avoid pregnancy and less likely to ever have been pregnant. Evidence-based information may improve services and help women with CHD and disabilities meet their reproductive health goals.

An Exploration of the Reproductive Health Concerns in Women with Systemic Lupus Erythematosus

An Exploration of the Reproductive Health Concerns in Women with Systemic Lupus Erythematosus

In silico and in vitro assessment of androgen receptor antagonists

There is a growing concern for male reproductive health as studies suggest that there is a sharp increase in prostate cancer and other fertility related problems. Apart from lifestyle, pollutants are also known to negatively affect the reproductive system. In addition to many other compounds that have been shown to alter androgen signaling, several environmental pollutants are known to disrupt androgen signaling via binding to androgen receptor (AR) or indirectly affecting the androgen synthesis. We analyzed here the molecular mechanism of the interaction between the human AR Ligand Binding Domain (hAR-LBD) and two environmental pollutants, linuron (a herbicide) and procymidone (a pesticide), and compared with the steroid agonist dihydrotestosterone (DHT) and well-known hAR antagonists bicalutamide and enzalutamide. Using molecular docking and dynamics simulations, we showed that the co-activator interaction site of the hAR-LBD is disrupted in different ways by different ligands. Binding free energies of the ligands were also ordered in increasing order as follows: linuron, procymidone, DHT, bicalutamide, and enzalutamide. These data were confirmed by in vitro assays. Reporter assay with MDA-kb2 cells showed that linuron, procymidone, bicalutamide and enzalutamide can inhibit androgen mediated activation of luciferase activity. Gene expression analysis further showed that these compounds can inhibit the expression of prostate specific antigen (PSA) and microseminoprotein beta (MSMB) in prostate cell line LNCaP. Comparative analysis showed that procymidone is more potent than linuron in inhibiting AR activity. Furthermore, procymidone at 10 μM dose showed equivalent and higher activity to AR inhibitor enzalutamide and bicalutamide respectively.

Reproductive Health Concerns of Women With High Risk Sexual Behaviors.

IntroductionExpansion of reproductive health services and addressing its different aspects in national and international levels is an important step towards ensuring family and public health. Female sex workers are a vulnerable population that are exposed to high risk sexual behaviors and increased incidence of co-morbid health problems. This study aims to identify the concerns of women with high risk sexual behaviors. Clarifying different aspects of reproductive health and its problems in female sex workers can assist relevant authorities to plan and intervene on reproductive health and to provide more effective solutions on this issue.MethodsA qualitative study was conducted using a conventional content analysis approach. Snowball sampling was performed in 20 volunteer women with high risk sexual behaviors through in-depth semi-structured interviews conducted in drop-in centers, triangle centers, etc. The data were analyzed through conventional content analysis using the MAXQDA software.ResultsFive main categories and 13 subcategories emerged during the interviews. The main categories included violence, fear, and lack of knowledge, stigma, and psychological problems. Women with high risk sexual behaviors have several reproductive health concerns, including unwanted pregnancy, abortion, STIs (Sexually transmitted infections), HIV, etc. In addition, different types of violence and threats against women, intimidation, objectification, stigma, unresponsiveness of counselling centers, patriarchal culture, gender inequality, etc. were observed in these women.ConclusionThe study revealed that women in this study experienced deep problems of reproductive health and little attention is paid to them by authorities. Proper planning and appropriate solutions should be provided to solve the problems of these women and the society.

Factors associated with modern contraceptive use: a comparative analysis between younger and older women in Umlazi Township, KwaZulu-Natal, South Africa.

Introduction:Unplanned pregnancy continues to be a global reproductive and public health concern among women. This study aimed to investigate whether factors associated with modern contraceptive use differ by age-group among young and older women of reproductive age.Methods:This was a cross-sectional study conducted among 433 women of reproductive age, with the median age of 25 years (interquartile range: 21–28), and aged between 18 and 49. Data were collected from 10 public health care clinics in Umlazi Township, KwaZulu-Natal, using a structured questionnaire. Data were coded, entered into Epi Data Manager and exported to Stata for analysis. A Pearson’s chi-square test and logistic regression models were employed to assess the level of the association between the predictor and outcome variables, and the p-value of 0.05 or lower was considered statistically significant.Results:Most women in the sample (n = 351, 81%) had obtained a secondary level of education, while 53% (n = 230) were unemployed and 89% (n = 387) were single. We found that women with secondary level of education (AOR: 2.89, 95% CI: 0.99–5.38) or a tertiary level of education (AOR 3.80, 95% CI: 1.07–3.53) were more likely to use contraceptive methods compared to women with lower education. Women who experienced unplanned pregnancy (AOR 0.51, 95% CI: 0.22–3.79) were more likely to use contraceptives. Women aged 25–49 years who experienced pregnancy, whether planned (AOR 3.87, 95% CI: 1.08–3.89) or unplanned (AOR 3.60, 95% CI: 2.15–4.19), were more likely to use a contraceptive method. Results showed that the level of education (p = 0.942) and whether one experienced unplanned pregnancy (p = 0.913) were not significant predictors of contraceptive use among women aged 18–24 years.Conclusion:Concerted educational efforts to addressing existing barriers deterring women from accessing contraception among young women are necessary. Different groups of women should be targeted with family planning interventions specific to their needs.

Healthcare providers' knowledge and perceptions regarding the use of modern contraceptives among adolescent girls in Umlazi Township, KwaZulu-Natal province, South Africa.

Introductionthe phenomenon of unintended adolescent pregnancy continues to be a reproductive and public health concern in sub-Saharan Africa. Healthcare providers play an important role in influencing the use of contraceptives among adolescent girls. This study assessed knowledge and perceptions of healthcare providers regarding the use of modern contraceptives among adolescent girls in Umlazi township, KwaZulu-Natal province, South Africa.Methodsthis was a descriptive study involving 35 healthcare providers covering all 10 primary healthcare clinics in Umlazi township. Data collected through a structured questionnaire were coded, entered into Epi data manager (version 4.6) and exported to STATA (version 15.0) for analysis.Resultsof the thirty-five healthcare providers that participated in this study, professional nurses (54.3%) and enrolled nurses (17.1%) constituted the majority. The mean age of the participants was 42.11 years, with 88.6% being females. More than a third (37.1%) of healthcare providers did not know whether or not modern contraceptives make users promiscuous, while more than half (57%) had negative attitudes towards adolescents exploring contraceptive methods. Healthcare providers viewed health systems challenges, such as poor working conditions, long queues, and contraceptives stock-outs, as deterrents towards the provision of quality sexual behaviour counselling and modern contraceptive education to users.Conclusionpoor health systems and negative behaviours by healthcare providers influences the delivery of family planning services in primary healthcare clinics and serve as barriers to quality family planning services provided to younger women.

The Reproductive Health Priorities, Concerns, and Needs of Women in Midlife: A Feminist Poststructuralist Qualitative Analysis.

Reproductive health research rarely involves the inclusion of women over 40, creating a large knowledge gap regarding women in midlife. Women continue to have reproductive health needs, concerns, and priorities up to the point of menopause that should be examined to improve reproductive health outcomes and provide individualized care. In-depth, individual, semi-structured interviews were conducted with 20 women between the ages of 40 and 55 who had not reached menopause and did not have a permanent method of sterilization. Using the feminist poststructuralist tenets, three major themes were identified: (a) knowledge acquisition during the perimenopause, (b) subjectivity regarding family planning, and (c) the agency of aging. Participants spoke to a need for reproductive health that listens to their lived experience, addresses menopause clinically and positively, and encourages autonomously driven health priorities. Further research on effective nonhormonal contraception, education on perimenopausal symptoms, and healthy aging is necessary.

Patient-Centered Communication to Address Young Adult Breast Cancer Survivors’ Reproductive and Sexual Health Concerns

ABSTRACT Women faced with a diagnosis of breast cancer as young adults commonly experience negative effects of cancer and cancer treatment on their reproductive and sexual health (RSH) that are inadequately addressed by their healthcare providers (HCPs). The objectives of this study were to 1) identify approaches to improving RSH communication from YA breast cancer survivors’ perspectives, 2) identify facilitators and barriers to the approaches identified, and 3) identify specific strategies to improve patient-centered RSH communication. We conducted individual telephone interviews with 29 women who were diagnosed with breast cancer under age 40 years. We used a grounded theory approach to identify themes, and explored how the themes related to the PCC framework to elucidate specific strategies for improving communication. Three main themes emerged: 1) Normalizing and integrating assessment of RSH concerns; 2) HCP conveying genuine caring and investment; and 3) Improving accessibility of comprehensive RSH services after cancer. Results revealed concrete strategies for improving patient-centered RSH communication at the patient-provider and health system levels. These included reminding patients that RSH concerns are common, routinely asking about RSH, using active listening, and connecting patients to HCP who can address their RSH concerns.

Factors Influencing the Knowledge and Practice of Emergency Contraception among Nigerian Male Undergraduates

Background: Unwanted pregnancies among young women is a growing reproductive health concern. Correct and consistent use of contraception will stop this ugly trend while emergency contraception (EC) can also be viewed as a 'second chance method' in preventing unwanted pregnancies and unsafe abortions. The aim of this study is to assess the knowledge and practice of emergency contraception among Nigerian male undergraduates as they are known to have risky sexual behaviours.Methodology: This was a cross sectional study involving three hundred and thirty male undergraduates from three Tertiary institutions in Ibadan. A Multi-staged random sampling technique was used to recruit participants.Results: Knowledge about EC was poor among majority (74.5%) of male undergraduates. About 55.2% of the participants were sexually active and out of which 33.9% are currently using EC. The commonly (67.5%) used EC by their partners was levonorgestrel only pill (Postinor). Participants with higher levels of education, awareness of EC, previous use or having a partner who had previouslyused EC, participants who had sex within the past 6 months and those who were willing to recommend EC to others had a better knowledge of EC, which were all statistically significant.Conclusion: Providing accurate information to improve knowledge of EC among young men could lead to an increase in the uptake of EC.