Have Sex Research Articles

Aqueous Seed Extract of Nigella Sativa Ameliorated Metronidazole-Induced Testicular Damage Via Up-Regulations of the Antioxidant System

Background: Infertility is a condition characterized by the failure to achieve a pregnancy after 12 months or more of regular, unprotected sexual intercourse. Objectives: To determine the effect of aqueous seed extract of Nigella sativa on testicular antioxidant levels in metronidazole-induced infertility in male Wistar rats. Methods: A total of thirty-five (35) male Wistar rats (aged 7-10 weeks old) were randomly distributed into five different groups (n = 7 each); Group A (Control group), Group B (Metronidazole only), Group C (Metronidazole + aqueous seed extract of Nigella sativa), Group D (Metronidazole Recovery), and Group E (Metronidazole + aqueous seed extract of Nigella sativa + Recovery). Experimental animals received 500 mg/kg of metronidazole and 300 mg/kg of aqueous seed extract of Nigella sativa orally. Results: Metronidazole treatment caused a significant (p<0.05) reduction in the level of testicular glutathione (Control group - 3.50±0.50; MTZ only - 2.00±0.30; MTZ+NS - 2.50±0.40; MTZ+ NS+ Recovery - 2.80±0.40). Similar reductions occurred in the activities of testicular superoxide dismutase (Control - 1.58±0.10; MTZ only - 0.23±0.06; MTZ+NS - 0.68±0.10; MTZ+ NS+ Recovery - 0.68±0.10) and catalase (Control - 2.70±0.35; MTZ only - 0.70±0.25; MTZ+NS - 1.23±0.20; MTZ+ NS+ Recovery: 1.25±0.30) which was followed by histo-architectural alterations in the testes of rats. Thereafter, aqueous seed extract of Nigella sativa treatment improved all the initial alterations caused by metronidazole treatment. Two - weeks recovery period was accompanied by a significant (p = 0.017) increase in antioxidant enzyme activities of group E when compared with group B and group D. Conclusions: The aqueous seed extract of Nigella sativa exerts its ameliorative effect by improving antioxidant enzyme activities in the testes which then protect the testes against oxidative damage, enhancing sperm quality, preventing apoptosis, supporting testicular function, and aiding tissue repair.

Sexual Satisfaction in a Sample of Italian Women during the COVID-19 Lockdown Period

This study explored the relationships among psychological, relational, and sexual factors and their impact on sexual satisfaction among Italian women during the COVID-19 lockdown. Data were collected via an online survey with 3803 participants. The survey assessed mental health, relationship quality, frequency of sexual intercourse, frequency of masturbation, body awareness, and sexual satisfaction. Correlation analyses revealed positive relationships among all the variables and negative relationships with low mental health. A network analysis showed that sexual satisfaction was the most central variable, strongly linked to relationship quality, frequency of sexual intercourse, and body awareness. An exploratory mediation model examined the indirect effects of mental health and frequency of masturbation on sexual satisfaction through the other variables as mediators. The results indicated that mental health negatively influenced sexual satisfaction both directly and indirectly through relationship quality and body awareness, while frequency of masturbation had a positive indirect effect through body awareness. These findings highlight the complex interplay among mental health, body awareness, relational factors, and sexual satisfaction, emphasizing the importance of holistic approaches in enhancing sexual well-being. Future research should focus on longitudinal studies to establish causality and explore interventions that promote positive body awareness and relationship quality.

О некоторых аспектах выявления и расследования преступлений, совершенных в отношении половой свободы и неприкосновенности несовершеннолетних

Introduction. The article is devoted to some problematic issues that arise in the practice of investigating crimes committed against sexual freedom and inviolability of minors (rape, sexual violence, lewd acts, sexual intercourse and other acts of sexual nature with a person under the age of sixteen). The criminalistic characteristics of crimes are given, special attention is paid to the characteristics of the offender and the victim, the methods of committing crimes, the mechanism of trace formation. Typical investigative situations that develop at the initial stage are revealed, the specifics of initiating a criminal case and organising an investigation are revealed, criminal and criminal procedure legislation is analysed. Methods. The methodological basis was the system of scientific research methods used, based on the universal dialectical method, the use of which determines the choice of systemic, activity-based, functional and interdisciplinary approaches in the study of the personality of the offender and the victim in cases of crimes against sexual freedom and inviolability of minors and the totality of its properties and qualities as an integral object. In addition, when studying the mechanism of crime and the investigator’s search and cognitive activity, historical, formal-logical, statistical, sociological, comparativelegal, and modeling methods were used. Results. The most problematic aspects of obtaining significant criminalistic information as a result of verbal investigative actions have been identified, recommendations have been developed to overcome possible opposition from suspected defendants, as well as legal representatives of the victim; the legal positions of judicial authorities and law enforcement practice have been analysed; algorithms for the investigator’s actions in identified problematic situations have been formed. The provisions are substantiated that a minor as a subject of criminal proceedings has a number of characteristics of a demographic, socio-role and moral-psychological nature, which determine the peculiarities of perception, memorisation, analysis and reproduction of significant criminalistic information about the act committed against them. The conclusion is reasoned that special attention should be paid to the tactics of interrogation of victims, which is limited by the current criminal procedural requirements and is characterised by short-termism, one-time nature, and the list of participants. The importance of the results of this investigative action is justified by the prevalence of the results of interrogations in the evidence base for this category of crimes, because due to the postponement of the crime from the beginning of the investigation, the search for other traces, as well as the production of experimental and search investigative actions is significantly complicated.

The Impact of the COVID-19 Pandemic on the Sex Ratio at Birth in Ireland.

The sex ratio at birth (SRB), calculated as male divided by total live births, is an important indicator of population health. Typically, male live births slightly outnumber female live births. Population events, including pandemics, can alter the SRB, with effects sometimes evident 9 months post-event, potentially due to changes in sexual behavior and/or stress levels. This study investigates the impact of the COVID-19 pandemic on the SRB in the Republic of Ireland. Publicly available monthly live birth data for Ireland were obtained from the Central Statistics Office for the period 2015 to 2021. Time series analysis predicted the SRB for 2020 using data from 2015 to 2019, with comparisons made between observed and predicted values. In December 2020, 9 months after the March 2020 COVID-19 declaration, the observed SRB sharply fell to 49.44% (97.80 males for every 100 females), below the 95% prediction interval of 50.31% to 52.15%, significantly deviating from the expected male predominance. December 2020 also recorded the lowest average daily number of births (n = 145) in the study period. The sharp decline in the SRB in December 2020, alongside the lowest birth count, suggests reduced sexual intercourse at the population level, particularly in March 2020, aligning with recommendations from Ireland's Health Service Executive (HSE). The HSE advocated precautionary measures such as limiting partnered sex in March 2020 to mitigate the spread of COVID-19. These findings highlight the pandemic's potential impact on population dynamics and stress the importance of SRB monitoring as a low-cost and readily available health indicator, especially during national crises.

AYURVEDIC MANAGEMENT IN MALE INFERTILITY W.S.R TO OLIGO ASTHENOSPERMIA: A CASE REPORT

Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse[WHO]3 . Infertility may occur due to male, female or unexplained factors[WHO].In the male reproductive system, infertility may be caused by abnormal sperm function and quality [WHO]. Oligoasthenospermia is a condition with a decrease in the concentration of the spermatozoa and the percentage of motile spermatozoa in a sperm sample. A 36-year-old male patient with no issues for six years of marital life diagnosed with oligoasthenospermia visited our OPD in July 2022. Initially advised with Nitya Virechana, followed by Chandraprabha Vati and Burundi kashaya given after that, Tablet chandraprabha vati, Tab Confido, Tab Tentex forte and Tab Rejuspermin have been provided for six months. Followup showed improvement in seminal parameters regarding sperm concentration and motility, resulting in pregnancy. The present case signifies the importance of Ayurvedic treatment in bringing successful outcomes in the field of male infertility.

Characteristics and Management Outcome of Vaginismus

Vaginismus, a common pelvic floor dysfunction characterized by involuntary vaginal muscle spasms, often impedes sexual intercourse and is exacerbated by cultural barriers in Indonesia, where sexual issues are taboo. Healthcare providers' lack of knowledge contributes to patient dissatisfaction with treatments. This study aimed to evaluate risk factors and management outcomes in 36 Indonesian women with vaginismus. Primary data, including demographic details, vaginismus history, severity, and FSFI-6 scores, were collected through interviews and medical records. Results showed that 94.4% of participants were under 40 years old, 66.7% had been married for over two years, and 94.5% were university graduates. Most had normal BMI and no significant illness history. Among them, 77.8% had no history of penetration, with the majority having no medical, social, or psychological risk factor yet reporting good sexual satisfaction. Self-dilation was the primary treatment, with a 29.41% success rate in achieving penetration. Younger age and higher education were notable characteristics among cases, suggesting a need for increased disease awareness. The study highlights that while traditional risk factors were not predominant, self-dilation therapy yielded moderate success, and patient satisfaction with sexual and interpersonal relationships remained high.

Role of doxycycline post exposure prophylaxis in the prevention of sexually transmitted infections: a narrative review

Sexually transmitted infections (STIs) spread through sexual intercourse. They are caused by pathogens like Neisseria gonorrhoeae, Treponema pallidum, Chlamydia trachomatis, and Mycoplasma genitalium, and can be transmitted through direct contact or contact with genital secretions. Doxycycline is a second-generation tetracycline antibiotic with a broad antimicrobial spectrum, acting on intracellular and extracellular organisms. This review aims to explore the efficacy of doxycycline post-exposure prophylaxis (PEP) in the prevention and treatment of STIs. Some of the areas of uncertainty with the use of doxycycline PEP for STIs include the concern for developing antimicrobial resistance (AMR), the effect on the normal microbiome of the body, public acceptability, drug formulation and dosage and compliance issues. Recent clinical and observational studies have looked at using doxycycline PEP to reduce the transmission of STIs. This review aims to explore these studies to provide a comprehensive account of the current state of doxycycline PEP and its future prospects. We also look at the limitations and areas of improvement in using doxycycline PEP, opening avenues for future research. High-quality studies have shown that using doxycycline PEP can effectively reduce the transmission of STIs in a number of clinical trials as well as systematic reviews., making it a potential standard treatment for high-risk groups such as immunocompromised patients, individuals living with HIV, sex workers, and men who have sex with men (MSM).

Poppers, the Politics of Exemption and the Characteristics of Poppers Users in the annual English Festival Study, 2014–23

Abstract This paper explores the relationship between socio-demographic characteristics, self-reported alkyl nitrite (‘poppers’) use and sexual behaviours against a backdrop of UK policy change and ambiguity surrounding legal status. In 2024, the Advisory Council on the Misuse of Drugs recommended a unique, government-initiated, legal exemption from the Psychoactive Substances Act 2016 for poppers, because of its use by gay and bisexual men to reduce the risk of injury during anal sexual intercourse. Data from the annual convenience sample English Festival Study 2014–23 (n = 11,566) were used for Bayesian regression analyses of self-reported poppers use in three-time frames: lifetime, past year and past month use. Gay men were significantly more likely to report poppers use and particularly those reporting past-year participation in anal sex. Providing a critical analysis of recent trends in UK drug policy, the authors highlight how differential discrimination occurs within drug control where targeted exemption meets the politics of protected characteristics in UK law. This paper argues that poppers, therefore, provide a unique example in UK drug policy of how an apparent liberalization of legislative control could bolster the overarching drug prohibition regime while maintaining the appearance of rationality and fairness.

"What Is Normal?": A Qualitative Exploration of Health Practitioners' Reports of Treating Patients Presenting with Unpleasant Sexual Experiences.

Sexual health, including sexual pleasure, is fundamental to holistic health and well-being, and is considered an area of priority health in Australia. Despite the importance of sexual functioning, women experience significant gaps in sexual well-being compared to men and often do not seek medical care or treatment. Health practitioners are central to the identification and treatment of sexual dysfunction, including fostering sexual well-being for patients. Despite this, minimal research has explored health practitioners' experiences in treating reports of unpleasant sex. This study aimed to explore health practitioners' experiences, responses, and confidence in treating patients presenting for unpleasant sexual experiences. An online, mixed-methods survey was completed by 96 participants. Thematic analysis identified 11 core themes. These themes included five patient centred themes (health risks, diverse sex acts, painful vaginal intercourse, relationship breakdown and violence, unwanted sex) and six health practitioner centred themes (communication and counselling, what is normal, ongoing care and follow up, emotional response, limited practical training, and highly prevalent). Participants described a complex sexual health landscape, with social contexts impacting women's sexual experiences and engagement in treatment. Additionally, health practitioners reported the need for a biopsychosocial approach to understanding and responding to unpleasant sexual experiences for patients, while simultaneously reporting limited education in this area. Findings reflect the need for health practitioners to be cognisant of matters related to sexual function, consent, coercion, client engagement, and treatment pathways, identifying a need for greater education and holistic approaches to sexual healthcare across medical settings.

The In Vivo Effect of Water-Based Lubricants on the Vaginal Microbiome of Women from Varying Age Groups: Exploratory Analysis of a Randomized Controlled Trial.

Vaginal mucosa undergoes physiological changes across the lifespan, such as increased pH and reduced natural lubrication which are known to impact vaginal commensal microorganisms, hence increasing the chances of vaginal infections. An improved understanding of vaginal microbiome composition in different age groups and the effect of social behaviors, such as the use of personal lubricants, could facilitate the development of new strategies to maintain good vaginal health. The objective of this study was to assess the effect of water-based lubricants on the human vaginal microbiome. Fifty females from three age groups (18-29, 30-44, and 45-65 years) with mild-to-moderate vaginal dryness were randomized to one of five lubricants (four of which were formulated to meet expert guidance on osmolality and pH). Subjects entered the study at tolerance or treatment phase (vaginal intercourse minimum once a week using assigned lubricant). Four vaginal swabs per participant were sampled during pre-("baseline"), post-first ("2 h", "24 h") and post-last ("4 weeks") lubricant application to assess bacterial and fungal diversity via amplicon sequencing. Vaginal pH and relative humidity were measured at baseline, 2 h, and 24 h post-lubricant application. Relative bacteriome abundance was statistically compared between timepoints for each lubricant group. Vaginal moisture, age, BMI, and pH were correlated with bacteriome relative abundance. Lactobacilli and Gardnerella sp. Were predominant across participants. Repeated lubricant application did not significantly alter the vaginal bacteriome during 4 weeks of product use (p > 0.05) when measured by relative abundance and alpha-diversity index. Bacteriome diversity and abundance differed significantly between age groups at baseline whereas lactobacilli relative abundance was negatively associated with age and vaginal pH.

Pelvic Floor Disorders Due to Anal Sexual Activity in Men and Women: A Narrative Review.

Recent evidence shows that consensual anal penetrative intercourse has become more prevalent, not only limited to gay, bisexual, and other men who have sex with men but also for women who are in a sexual relationship with men. The aim of this review was to study the influence of consensual anal intercourse on pelvic floor function and the role of pelvic floor physical therapy treatment in preventing or treating consensual anal intercourse-induced anodyspareunia and/or fecal incontinence. We reviewed 68 references that showed that anal penetrative intercourse is a risk factor for anodyspareunia and fecal incontinence in both men and women. This risk of anal intercourse may increase with emotional discomfort, an overactive pelvic floor, lack of lubrication, frequency of anal penetrative intercourse, and hard practice (BDSM: bondage and discipline, dominance and submission, sadism, and masochism). It seems that pelvic floor physical therapists play an essential role in preventing and treating pelvic floor dysfunctions due to anal intercourse, which can lead to anodyspareunia and fecal incontinence; the treatment includes education, pelvic floor training with and without biofeedback, electric stimulation, manual therapy, and dilatators. Further studies are warranted to enhance our understanding of the causes and treatment efficacy of pelvic floor dysfunctions due to anal penetrative intercourse.

The diverse but common definitions of sex for young people in Australia

ABSTRACT Relationships and sexuality education is a key strategy for promoting safe sex and respectful relationships during adolescence. Understanding the ways in which young people define sex is critical to ensuring a shared understanding between sexual health educators and students. Young people aged 14–18 years (N = 6,043) who participated in a large-scale cross-sectional Australian study were asked to indicate whether various sexual practices (e.g. vaginal, anal or oral sex, genital rubbing, mutual masturbation) were included in their definition of ‘sex’. Associations between demographic characteristics, sexual experiences, and definitions of sex were identified using multiple logistic regression. Content analysis further examined open-text responses from 63 participants who expanded on their definitions. Almost all participants (99.1%) included vaginal sex in their definition of sex, 83.7% included anal sex and 59.7% included oral sex. Young people also included a diverse range of sexual practices that did not consistently align with common definitions used in sexuality education and sexual health promotion campaigns. Definitions of sex differed by gender and sexuality suggesting that when discussing sex with young people, educators and health professionals need to consider sexuality and gender diversity and take care to check common understanding of terminology.

Prostaglandins suppress neutrophil function after sexual intercourse and may promote urinary tract infections

Sexually active women have an increased risk of urinary tract infections (UTIs), which may be influenced by components in seminal plasma. Prostaglandins in seminal plasma are key modulators of the immune system and maternal-fetal immunological tolerance, influencing cells like platelets and neutrophils. Specifically, prostaglandin I2 (PGI2) inhibits platelet aggregation, while prostaglandin E2 (PGE2) alters neutrophil activity, including the production of reactive oxygen species (ROS) and the formation of neutrophil extracellular traps (NETs). Given that the NET response is associated with UTIs, and PGI2 is known to modulate NETs, these interactions may contribute to the higher incidence of UTIs in sexual activity in women. This study aims to investigate whether UTIs following sexual activity are facilitated by an imbalance in NET formation mediated by prostaglandins. We employed four search strategies: Sex and UTI, NETs and UTIs, Prostaglandins and NETs, and Inflammasome and NETs, alongside a review of original research publications. By understanding this mechanism, we hope to reveal how prostaglandin-mediated immune modulation may increase susceptibility to UTIs after sexual activity.

Experiences of women with symptoms of vaginal laxity – a qualitative study

BackgroundVaginal laxity (VL) is rarely discussed among patients and their physicians possibly due to the lack of evidence-based treatments, embarrassment, and lack of knowledge in recognizing this condition. We aimed to understand the meanings that women attribute to the sensation of VL.MethodsThis is a qualitative study using in-depth interviews and thematic analysis. Sixteen participants were intentionally selected from February 2020 to December 2021. One researcher interviewed each participant in a private room guaranteeing that rapport was established. Two independent researchers performed a complete transcript of each interview immediately after its end. The sample size was achieved according to the Information Power analysis. We followed the thematic analysis proposed by Braun and Clarke.ResultsOf 16 patients, only one did not undergo delivery. Her complaint was not different from the rest of the group. Five major themes and subthemes were identified: the long and lonely pathway: from the identification of symptoms of VL to diagnosis (from the invisibility of VL to the perception of their symptoms; “everything will fall out!”:shame, guilt and stigma as diagnosis barriers and “but I had no idea of looking for a treatment.” Women’s strategies to begin a help-seeking process), “the label of vaginal laxity is a heavy burden to bear” meanings associated with VL complaints, effect of VL on sexual intercourse and “I know it changed everything!” relationship with the partner.ConclusionVL is a symptom that is still little understood by women, and little explored by health professionals, with repercussions on personal and marital life.

Vaginal drainage of semen in underwear: A forensic study

The UK and Ireland Association of Forensic Science Providers’ (AFSP) Body Fluid Forum (BFF) conducted this research to investigate the occurrence of seminal fluid draining from the vagina onto underwear worn after penile-vaginal sexual intercourse with internal ejaculation. This study shows the differing effects of the female being either supine or upright and active on possible patterns of seminal staining on underwear, and the effect of time since intercourse on the deposition of seminal fluid on underwear in a limited study. Here, we demonstrate that post vaginal intercourse different distributions of semen staining can be observed on underwear.

Knowledge, attitudes and beliefs regarding HIV among medical students in Zagreb, Croatia

BackgroundMedical students, as future health-care providers (HCPs) play a significant role in shaping attitudes towards people living with HIV/AIDS (PLWHA) and should possess adequate knowledge of this infection. The study aim was to assess knowledge about HIV among medical students of the University of Zagreb School of Medicine, and to determine the level of discriminatory attitudes towards PLWHA.MethodsWe assessed knowledge about epidemiology, treatment, and prevention of HIV by using closed-ended and multiple-choice questions. Likert-scale questions were employed to determine attitudes towards PLWHA. Bivariate and multivariate ordinal logistic regression was used to assess correlates of certain discriminatory attitudes.Results561 medical students participated, with 46.7% attending preclinical courses. Overall, 42.1% of students think they received sufficient information on HIV/AIDS during elementary and high school education. Among clinical students, 42.6%, 20.8% and 11.8% estimated accurately transmission risk after a needle injury, unprotected vaginal, and anal intercourse, respectively. 66.8% of clinical students were aware that treatment can prevent AIDS, while 58.7% and 69.8% were familiar with the rationale of using pre-exposure (PrEP) and post-exposure prophylaxis (PEP). In the multivariate analysis, individuals lacking infectology course attendance (aOR = 1.45; CI: 1.00–2.09) and those unaware of transmission routes (aOR = 1.49; CI: 1.06–2.09) showed higher odds of advocating HIV status disclosure compared to those who did not yet attend an infectology course. Students supporting extra protection for handling PLWHA bodily fluids were more likely to support refusal to treat PLWHA (aOR = 1.80; CI: 1.22–2.69) compared to those who did not support that opinion. Males were more inclined to state that they would refuse to treat PLWHA (aOR = 1.66; CI: 1.11–2.50) and disclose their HIV status (aOR = 1.62; CI: 1.17–2.27) than females. Overestimating needle injury transmission risk raised treatment refusal likelihood (aOR = 2.22; CI = 1.29–3.92) compared to those accurately informed of this risk.ConclusionResults indicate lack of knowledge of HIV transmission risks after specific exposures and about PrEP, PEP and treatment effectiveness. Gender and knowledge about HIV transmission risks influence students’ attitudes towards PLWHA. Medical education should be focused on fostering correct attitudes and addressing stigma, which undermines prevention and treatment outcomes of PLWHA.

Contraceptive risk events among family planning specialists: a cross sectional study

BackgroundProponents of abortion restriction cite advancements in contraceptive technology as a reason against the need for abortion care today, most recently through oral arguments in the Supreme Court of the United States case, Dobbs v. Jackson Women’s Health. However, consistent and correct use of contraception requires reproductive health literacy. Our objectives were to quantify contraceptive risk events and assess contraceptive history and preferences among a population well-equipped to evade contraceptive risks, family planning specialists following initiation of their medical training. “Risk events” are defined as reported episodes of contraceptive failure, emergency contraception use and/or unprotected or underprotected intercourse.MethodsThis was a cross-sectional study among current members of a professional organization of family planning specialists. Inclusion criteria included: status as a current or retired clinician, consensual penile-vaginal intercourse and personal or partner capacity to become pregnant since the start of medical training. Descriptive statistics were performed. This study was IRB exempt.ResultsAmong 229 respondents, 157 (69%) reported experiencing a contraceptive risk event since training. Twenty-nine (13%) respondents reported an occurrence within the last year. By category, 47% (108/229; 3 reported unknown) reported under- or unprotected intercourse, 35% (81/229) reported emergency contraception use, and 52% of participants (117/227; 2 unknown) reported known or suspected contraceptive failure. The mean number of contraceptive methods used was 3.7 (SD 1.7) out of the 13 methods listed. Almost all (97%) participants reported at least one method was not an acceptable option, with a mean of 5.6 (SD 2.7) of the 13 listed methods.ConclusionsThe majority of family planning specialists have experienced contraceptive risk events during times of active pregnancy prevention since their medical training. Contraceptive method change is common and most respondents were limited in the number of methods that were personally acceptable to them. Dialogue idealizing the role of contraception in minimizing or eliminating abortion need is simplistic and inaccurately represents the lived realities of pregnancy-capable individuals and their partners, including among those with exceptional contraceptive literacy and access.

Assessment of male creatinine levels and fecundity in couples planning pregnancy: a national cohort study in China.

Is there an association between male creatinine levels and time to pregnancy (TTP) in couples planning pregnancy? Low and high male creatinine concentrations were associated with reduced couple fecundity. Abundant evidence suggests male creatinine dysfunction is associated with infertility in males with kidney diseases. However, the association of preconception creatinine levels with reduced fecundity among general reproductive-aged couples lacks evidence from an in-depth population study. Based on the population-based cohort study from the National Free Preconception Check-up Projects, 4023204 couples were recruited and met the inclusion criteria from 1 January 2015 to 31 December 2017. They were planning pregnancy and were followed up every 3 months until achieving pregnancy as detected by gynaecological ultrasonography or were followed up for 1 year for the analysis of TTP. Cox regression models were used to estimate hazard ratios (HRs) and 95% CI for creatinine deciles. Restricted cubic spline regression was adopted for the dose-response relationship of creatinine with HRs. R statistical software was used for data analysis. Of the included participants, 2756538 (68.52%) couples successfully conceived. The median male serum creatinine was 81.50 μmol/l. Compared with the reference group (78.00-81.49 μmol/l) including the median creatinine, fecundity in the first (≤64.89 μmol/l), second (64.90-69.99 μmol/l), third (70.00-73.99 μmol/l), and tenth (≥101.00 μmol/l) deciles decreased by 8%, 5%, 2%, and 1%, respectively (Decile 1 Adjusted HR 0.92, 95% CI 0.91-0.92; Decile 2 Adjusted HR 0.95, 95% CI 0.95-0.96; Decile 3 Adjusted HR 0.98, 95% CI 0.97-0.99; Decile 10 Adjusted HR 0.99, 95% CI 0.98-0.99). An inverse-U-shaped association was consistently presented among males such that non-inferiority for fecundity was shown when creatinine was in the 81.66-104.90 μmol/l range (P for non-linearity < 0.001). For males over 40 years old, the risk of fecundity impairment was more obvious and the recommended range of creatinine levels for TTP was reduced and more narrow, compared with that for younger males. Not including the time couples spend preparing for pregnancy before enrolment would lead to an overestimation of fecundity; additionally some couples place pregnancy plans on hold due to special emergencies, which would not have been recognized. Due to the lack of information regarding semen quality, psychological factors, sexual intercourse frequencies, and hazardous environmental factors, we could not adjust for these factors. Some variates were self-reported and dichotomized, which were prone to bias. Direct variables reflecting muscle mass and impaired kidney function were lacking. Thus, extrapolation should be done with caution. Male creatinine is associated with couples' fecundity and the relationship varied by age. This study provides a better understanding of the potential implications and significance of different creatinine levels and their association with the clinical significance regarding couples' fecundity. This research has received funding from the National Natural Science Foundation of China (Grant No. 81872634), the Basic Research Funds of Central Public Welfare Research Institutes of China (Grant No. 2023GJZ03), the National Key Research and Development Program of China (Grant No. 2016YFC1000307), and the Project of National Research Institute for Family Planning (Grant No. 2018NRIFPJ03), People's Republic of China. The authors have no conflicts of interest to declare. N/A.

The dawn of a sexual assault relief center: A 12-year fact-finding survey of victims of sexual assault conducted since2010 by SACHICO, Japan's first rape crisis center.

In Japan, amidst insufficient legal provisions and governmental support, in 2010, the first rape crisis center, the Sexual Assault Crisis Healing Intervention Center Osaka (SACHICO) was established. We compared SACHICO visitor data from 2010 to 2021 with National Police Agency statistics to clarify the current situation of sexual assault victims in Japan and considered future issues for Japan to address. This study was a cross-sectional study that analyzed the data described below. All visitations to SACHICO between April 2010 and December 2021 were considered targets for data totaling. Data on crime statistics were gathered from the official governmental statistics portal site. A total of 12 036 visitations occurred, of which 3189 were first-time consultations; 3100 initial medical examinations were conducted, and no medical examination was conducted in the remaining 89 cases (2.7%). The number of initial medical examinations increased 3.7 times from 2010 to 2021. Victims under the age of 19 comprised 60% of the total number of initial medical examinations (1863/3100). The reporting rate for all 3100 initial medical examinations was only 31.3% (969/3100) of the cases. The proportion of forcible sexual intercourse versus forcible indecency were the converse of those observed among acknowledged cases nationwide and in Osaka Prefecture. For several years, the number of initial medical consultations at SACHICO has exceeded that of acknowledged cases in Osaka Prefecture. Support for victims of sexual assault in Japan is still insufficient. It is necessary to strengthen the system of rape crisis centers system to realize an unbroken chain of support for victims.

Associations of tobacco and alcohol use with sexual behaviors among adolescents in 59 countries: a population-based study

BackgroundSexual behaviors, particularly risky sexual behavior, has become a serious public health concern among adolescents worldwide, presenting a substantial obstacle to the prevention of sexually transmitted infections, including human immunodeficiency virus (HIV). However, there is limited research using consistent and standardized methodology to examine associations between tobacco and alcohol use frequency and both total and risky sexual behaviors among adolescents. We aimed to examine the association between tobacco and/or alcohol use with both total and risky sexual behaviors among adolescents worldwide.MethodsData were collected from the Global School-based Student Health Survey, which comprised 211,847 adolescents aged 12–17 years from 59 countries. The frequency of tobacco or alcohol use during the past 30 days was categorized as 0, 1–2, 3–5, 6–9, or ≥ 10 days. Tobacco and alcohol use were also categorized as non-use, tobacco use alone, alcohol use alone, and combined use. Multi-variable logistic regression analysis was used to examine both the independent and combined associations of tobacco and alcohol use with total and risky sexual behaviors.ResultsCompared with no tobacco use, the odds ratio of engaging in sexual intercourse increased with the frequency of tobacco use from 1 to 2 days to ≥ 10 days (total: 2.03 [95% confidence interval 1.47–2.81] to 3.98[2.63–6.03]; risky: 2.43[1.75–3.38] to 4.21[3.26–5.42]), as well as with the frequency of alcohol use. Overall, combined users had greater likelihood of both total and risky sexual behaviors than tobacco users alone, alcohol users alone, and non-users. Similarly, the association between risky sexual behaviors and tobacco use alone was more pronounced among adolescent girls (vs. adolescent boys), as were those of risky sexual behaviors with alcohol use alone among younger adolescents aged 12–14 years (vs. aged 15–17 years) and with tobacco and/or alcohol use among adolescents in the Western Pacific region (vs. Regions of Africa and Americas).ConclusionsOur findings suggest independent and combined associations between tobacco and/or alcohol use with sexual behaviors among adolescents, with variations across age, sex, and WHO region.