Gynecological Illness Research Articles

Sexual Assault in the Military and Its Impact on Sexual Satisfaction in Women Veterans: A Proposed Model

Sexual assault in the military (SAIM) is associated with decreased sexual satisfaction. However, mediators of this association have not been fully described. Using a retrospective analysis of cross-sectional data collected for the national Veterans Affairs (VA) Women's Health Survey, we propose a mediator model to explain the association between SAIM and decreased sexual satisfaction among women veterans. Four mediators of the association between SAIM and decreased sexual satisfaction are tested: (1) emotional health-related quality of life, (2) physical health-related quality of life, (3) lack of a close partner, and (4) gynecological illness. These mediators were chosen to encompass independent domains potentially relevant to sexual satisfaction, including emotional, physical, and relational. Of 3161 women (87%) who answered the sexual satisfaction question, the mean age was 45 (SD 15) years; 85% were white. Twenty-four percent reported a history of SAIM, and 39% reported sexual dissatisfaction. In age-adjusted logistic regression analyses, both SAIM and sexual dissatisfaction were strongly associated with each of the proposed mediators. However, of the four mediators, emotional health-related quality of life most strongly attenuated the association between SAIM and sexual dissatisfaction. After including all mediators, the association between SAIM and decreased sexual satisfaction was markedly attenuated. SAIM's negative impact on sexual satisfaction in women veterans operates both directly and through its physical and mental health sequelae. Of the proposed mediators in this association, the most prominent is mental health-related quality of life; the other proposed mediators were minimally related.

Antiinflammatory and antiulcer properties of tannins from Myracrodruon urundeuva Allemão (Anacardiaceae) in Rodents

Myracrodruon urundeuva Allemão is a plant utilized in Northeast Brazil as an antiinflammatory, wound healing and in gynecological illnesses. The objectives of the present study were to evaluate the antiinflammatory and antiulcer properties of the tannin-enriched fraction (TEF) isolated from the stem bark of M. urundeuva, in the formalin test, in mice, and in carrageenan-induced paw edema and gastric ulcer models, in rats. The results showed that TEF dose-dependently inhibited both phases of the formalin test. However, the effect was predominant in the 2nd phase of the response where inhibitions of 47%, 76% and 85% were observed, with doses of 5, 10 and 50 mg/kg, i.p. In the carrageenan-induced paw edema, significant inhibitions were observed at 3 h (44%) and 4 h (28%), with a dose of 10 mg/kg, i.p. TEF also significantly decreased by 37%, 43% and 57% gastric ulceration induced by indomethacin, at doses of 10, 20 and 50 mg/kg p.o. In the ethanol-induced gastric ulcer model, TEF was less effective, and significant inhibitions (42% to 46%) were observed only with doses of 100 and 200 mg/kg, p.o., respectively. In conclusion, it was shown that TEF presents antiinflammatory and antiulcer effects, partly due to its antioxidant action, known to be present in polyphenols, including tannins.

Posttraumatische Belastungsstörung und gynäkologische Symptome in einer Frauenarztpraxis

Purpose: The aim of the study was to investigate the prevalence of traumatic events and of post traumatic stress disorder (PTSD) in primary care gynecological practice. Material and Methods: Study participants were women who presented to a primary care gynecologic practice in Germany between September and December 2002. The main instruments used for measurement were SCL-90-R and Posttraumatic Diagnostic Scale (PDS-d-1). Patients with trauma who fulfilled DSM IV criteria and who agreed to further participation received the Brief Symptom Inventory BSI of Derogatis, the Impact-of-Event-Scale (IES-R) and the questionnaire of dissociative symtoms (FDS). Results: Out of 500 questionnaires 498 (99.6%) were completed. The women reported the following traumatic events: severe accident (19.9%), nature disaster (3.2%), violent attack by a family member (6.2%) or by a foreign person (5.8%), sexual attack by a family member (2.8%) or a foreign person (3.6%), sexual contact when aged younger than 18 years with a person 5 years and more older (12.2%); 14.5% reported a severe disease, 12% pregnancy, 12.4% birth, 11 % post partum period and 6.6% a gynecologic illness or operation and 11 % a professional traumatic event as a severe traumatic event. Overall, 46 (9.3%) women met the criteria of PTSD. Gynecologic symptoms significantly associated with PTSD were mastodynia (p = 0.000), symptoms of premenstrual tension (p = 0.001), urinary incontinence (p = 0.007) and dysmenorrhea (p = 0.024). Conclusion: Trauma was common in this population. Attention by primary care gynecologists to a history of trauma could improve the detection of this disabling disorder.

Erinnern Sie Ihre Patientinnen an die Krebsvorsorge

The general practitioner called upon to provide medical care to the older woman for diseases other than gynecological or obstetric illness, should not neglect to recommend gynecological cancer screening, which is of particular importance in this group. In many differential diagnoses, the general practitioner must also give consideration to gynecological-obstetric aspects. Thus, for example, when a patient presents with lower abdominal pain, gynecological pathology must always be taken into account. Numerous preparations with differing actions and applications used in contraception or hormone therapy in the post-menopausal woman, require individual counseling by the gynecologist.

Complementary and Alternative Medicine. Part II: Clinical Studies in Gynecology

This review describes randomized and nonrandomized clinical studies in which complementary and alternative interventions were used to treat gynecologic illness and disease. The articles were identified through the use of The National Library of Medicine’s electronic database. Statistically significant clinical benefit could not be identified for most practices. However, additional scientific investigation with appropriate research methods would help clarify a number of provocative insights and suggestions of potential clinical effectiveness.

A follow-up study of adolescent girls with early sexual debut in combination with gynecological problems

This research examined the extent to which women's reproductive experiences during adolescence have repercussions in adult life with regard to sexuality, self-image and state of gynecological health. The investigated group comprised 30 female (study group), with a sexual debut at the age of 15 years or younger and documented gynecological ill-health during adolescence. A comparison was made with 30 matched females from the same school classes (control group) without documented gynecological ill-health. At the age of 25–30 a semi-structured interview was conducted with both investigated and control participants. The majority of the women from the study group experienced their adolescent sexual experiences as generally negative. In early adulthood these women had more recurrent and varied gynecological illnesses than their control group counterparts. The study group women more often referred to their appearance as an indicator of their femininity than did the control women (who defined femininity in terms of 'to be in a relationship'). The study group women had a more negative attitude towards their own body than did the control women. Study group women's early sexual experience was also linked to an increase in norm-breaking behavior, lower educational attainment and a younger age of adult responsibilities compared with the control women

Complementary and alternative medicine. Part II: Clinical studies in gynecology.

This review describes randomized and nonrandomized clinical studies in which complementary and alternative interventions were used to treat gynecologic illness and disease. The articles were identified through the use of The National Library of Medicine's electronic database. Statistically significant clinical benefit could not be identified for most practices. However, additional scientific investigation with appropriate research methods would help clarify a number of provocative insights and suggestions of potential clinical effectiveness.

Urbanisation, household composition and the reproductive health of women in a South African city

Post-apartheid South Africa is faced with the effects of a distorted urbanisation process. A coherent response to urbanisation includes the mitigation of the adverse health effects of urbanisation. Women, by virtue of the stringent control of their movements to urban areas under apartheid, have migrated to the urban areas at an increasing rate recently. One consequence has been the transformation of traditional household structures consonant with changing patterns of fertility and infertility in the urban areas. This paper describes the composition of households in Khayelitsha, South Africa, a suburb that has seen an explosive increase in population over a 5-year period, from 5000 to an estimated 250,000 people. A survey of 659 households revealed that woman-headed households increased from 11% in those women who had been in the urban areas for fewer than 5 years, to 35% in those who had been in the urban areas for more than 20 years. This was not a function of widowhood or divorce, but appears to be an adaptive strategy adopted by women in the face of gender oppression in a harsh urban environment. The study also revealed the phenomenon of “alliance” household formation, in which atypical households made up of a variety of non-descript combinations of people provide support for women from remote rural areas, another adaptive strategy. Fertility was related to age, income, education and urbanisation. Women who had been in the urban areas for longer than 10 years had a total fertility rate (TFR) of 2.5, while those who had been in the urban areas for less than 10 years had a TFR of 5.8. Reported infertility was related to marital status, education, gynaecological illness and urbanisation, with recently urbanised women reporting more infertility. This probably reflects the different expectations of rural women and changes the mix of attitudes to fertility in the urban areas substantially. These findings have major implications for population policies in South Africa and an eclectic mix of approaches, including small area-specific approaches, to family spacing is recommended.

Imaging of the Nontraumatic Acute Abdomen

Plain-film radiography of the abdomen is often the first-line imaging modality used for the patient in the ED. It is capable of demonstrating abnormal locations of gas, abnormal viscera, calcifications and foreign material, and skeletal and lower lung pathology. PFR findings may aid in the decision to proceed to other modalities. Contrast studies have a limited role in the ED but may be necessary to diagnose disease inadequately visualized by PFR, as in the case of perforated duodenal ulcer, missed on PFR in approximately 15 per cent of cases. Ultrasound is most useful in the ED for obstetric and gynecologic illness, as well as disorders of the hepatobiliary system. Nuclear medicine studies can be very useful for GI bleeding and inflammatory conditions but may not always be as available or convenient as other modalities. CT has very broad usefulness. Angiography is very useful for locating bleeding sites, especially in the large bowel, and for determination of mesenteric arterial patency in suspected mesenteric ischemia. Finally, MRI, which has enormous potential, is not funded by many third-party payment plans for use in emergencies, and must overcome certain obstacles before it assumes common usage in the ED.

Psychaesthenic syndrome related to leukorrhoea in Indian women

The belief that passage of ‘whitish discharge’ is associated with bodily complaints of weakness, tiredness, exhaustion, chronic pain is supposed to be widely prevalent among certain groups of women. The present study examines this aspect systematically in women in the reproductive age-group presenting with multiple psychosomatic complaints. Seventy consecutive female patients in the age-group 15–45 years, who reported with presenting complaints of more than 2 psychosomatic symptoms, were included in the study. Patients who had identifiable major physical illnesses, menstrual irregularities or gynaecological illness were excluded. Sociodemographic data were collected on a semi-structured proforma. Diagnosis was ascribed according to DSM-III, axis I. Twenty-eight (40%) patients reported passing white discharge on enquiry. Nine of these cases (32%) attributed their psychosomatic problems to ‘white discharge’. Major depression was significantly more often (P < 0.05) diagnosed in patients who reported white di...

Psychiatric Status After Hysterectomy

Forty-four randomly selected women who received noncancer hysterectomy were evaluated preoperatively and at one-year follow-up. The findings did not support the hypothesis that the hysterectomy procedure is followed by an excess of psychiatric symptoms. The group, in fact, was less symptomatic at follow-up than presurgically. On the whole, women manifesting psychiatric symptoms during the follow-up had had similar problems before surgery. Many of the symptoms were associated with a presurgical diagnosis of hysteria (Briquet's somatization syndrome), found at a striking excess in the sample (27% vs the 1% or 2% expected). The authors suggest that when hysteria is diagnosed, therapeutic decisions regarding hysterectomy should be based on objective findings rather than on complaints, in that women with hysteria may be placed at risk of hysterectomy on the basis of psychiatric rather than gynecologic illness.

Individual reaction to stress with former concentration camp immates (author's transl)

The individual disposition to react to different stressors to play an important role in an extreme stress situation, i.e. the incarceration in concentration camps. Ten to fourteen years after their liberation, 219 former concentration camp inmates now living in Bavaria, New York and Israel were given semi-structured interviews. Since no statistically significant correlations between psychic and somatic complaints and incarceration could be found, we computed a factor analysis on illness dimensions. We found high correlations between these and the stress induced by concentration camp incarceration. An important answer to the above mentioned questions was the fact that there was no homogeneous reaction syndrome, such as it has always been described in the literature on concentration camp syndromes. We found four patterns of delayed reaction to stress. According to the contribution of somatic and psychic complaints, the factors were named as follows: 1. psycho-physical syndrome, 2. internal disease, 3. gynaecological illness, 4. psychic (social) syndrome. Personality factors played an important role in the development of these syndromes, because they modified the degree of stress endured. Personality factors were shown to be dependent on life history. The importance of these results for mastering stressors is being discussed.

Gynaecological state of health of 2 654 women in Nurmes 1970-71. A clinical outpatient study.

The present report describes a gynaecological open care study intended to determine the incidence of gynaecological diseases in the 15–60 year old population of Nurmes and shed light on the effects on gynaecological morbidity of age, parity, certain habits in sexual behavior, socioeconomic situation and previous care. The series comprised 2 654 women who agreed to undergo an examination, i.e. 72.8% of the women 15–60 years of age listed in the census and 80.9% of those in the locality during the study period. The research methods used were: a written anamnesis, personal interview, gynaecological Pap test, clinical gynaecological examination, laboratory tests, histological tests and, when necessary, tests in a central hospital. The final result of the study on gynaecological state of health was the division of the subjects into the following four groups: (1) gynaecologically healthy, (2) subjectively gynaecologically ailing, (3) gynaecologically ill, and (4) asymptomatic persons suffering from gynaecological diseases. Gynaecological morbidity was also measured by the number of those in need of gynaecological treatment. These figures were compared with the number of those who, at some time in their life, had suffered from a gynaecological illness. Of the population studied, 21% were found gynaecologically healthy, 13% were subjectively gynaecologically ailing, 48% were ill and 18% were asymptomatic persons suffering from gynaecological diseases. Of the factors studied, those with the most profound effect on gynaecological morbidity were age and parity. In the younger age groups, up to 25, there were significantly more gynaecologically healthy than gynaecologically ill, after which age the number of those suffering from diseases exceeded the number of healthy subjects. Parous subjects had significantly more gynaecological diseases than nulliparous subjects. The number of births was not related to the total number of gynaecological diseases. Sexual relations increased gynaecological morbidity, though to a lesser degree than parity. Gynaecological morbidity in the different social classes was uniform. Those in the highest income classes accounted, relatively, for the largest number of cured gynaecological diseases.

Points from Letters: Gynaecological Illness after Sterilization

Points from Letters: Gynaecological Illness after Sterilization

Gynaecological illness after sterilization.

Gynaecological illness after sterilization.

Gynaecological Illness after Sterilization

Gynaecological Illness after Sterilization

Gynaecological illness after sterilization.

Gynaecological illness after sterilization.

Gynaecological Illness after Sterilization

Gynaecological Illness after Sterilization

Gynaecological illness after sterilization.

A total of 374 patients were followed up for at least 10 years after tubal ligation, and 43% required further gynaecological treatment. Major gynaecological surgery was needed by 25%. There seems a good case for the selective use of hysterectomy as a method of sterilization.