Iranian Women Of Reproductive Age Research Articles

Evaluation of Body Composition Assessment Methods in Reproductive-Aged Iranian Women: A Cross-Sectional Study Between Body Mass Index (BMI) and Bioelectrical Impedance Analysis (BIA)

Background: Despite the introduction of modern scales for assessing physical health, "body mass index" (BMI) remains a foundational metric in many health assessments. Objectives: This community-based cross-sectional study aims to compare BMI with bioelectrical impedance analysis (BIA) in evaluating the physical health of Iranian women of reproductive age. Methods: A descriptive cross-sectional study was conducted on 182 Iranian women aged 30 - 45 years, selected through random sampling from the population served by selected urban health centers. The Omron BF511 bioelectrical impedance analysis device was used to measure BMI, skeletal muscle mass, total body fat, and visceral fat. A structured questionnaire was also administered to collect sociodemographic data. Results: The average BMI of the participants was 27.47 kg/m², with skeletal muscle mass comprising 24.98%, visceral fat averaging 6.93%, and total body fat at 40.04%. When comparing BMI with total body fat, 52% of cases were misclassified; with visceral fat percentage, 68% were misclassified; and with skeletal muscle mass percentage, 73% were misclassified. Misclassification was most pronounced among individuals with a normal BMI who were overweight or obese according to body fat percentage. Conclusions: This study highlights the critical need to reassess the use of BMI as an accurate health indicator for women of reproductive age. The researchers argue that reliance on BMI as a sole health metric is outdated, emphasizing the need for a comprehensive reevaluation of health assessment criteria for women in this demographic.

The association between dietary phytochemical index and bacterial vaginosis risk: secondary analysis of case-control study

IntroductionBy studying the dietary habits of patients with bacterial vaginosis (BV) and the controls, we aim to find out whether the dietary intakes of phytochemicals could reduce the odds of BV. To the best of our knowledge, no study has ever examined the matter before. Therefore, we decided to conduct this secondary analysis of case-control study to examine the association between dietary phytochemicals and BV.MethodThis case-control study was conducted at the gynecological clinic of Imam Hossein Hospital using a convenience sampling method from November 2020 to June 2021. To diagnose BV, all participants underwent examination by a gynecologist, assessing the presence of 3 or 4 criteria from the Amsel criteria. A validated semi-quantitative food frequency questionnaire was used. The phytochemical index was determined using McCarty’s method. To assess the association between dietary phytochemical intake and the odds of BV, binary logistic regression was utilized.ResultsAfter adjusting for potential confounders, the association between phytochemical index and BV remained significant (odds ratio (OR) = 0.349, 95% confidence interval (CI): 0.176–0.695, p-value = 0.003). Furthermore, each unit increase in fat intake was associated with higher odds of BV (OR = 1.008, 95% CI: 1.002–1.014, p-value = 0.006), and a positive family history of BV continued to show significantly increased odds of BV (OR = 3.442, 95% CI: 2.068–5.728, p-value < 0.001).ConclusionIn summary, the findings of this study indicate that increased consumption of dietary phytochemicals is associated with a reduced risk of BV among Iranian women of reproductive age. Additional research, especially longitudinal dietary studies, is required to explore the potential impact of dietary modifications on BV.

Psychometric analysis and linguistic adaptation of the Persian version of Contraceptive Self-Efficacy Scale (CSES-P)

BackgroundThis study was aimed to test adaptability of the Contraceptive Self-Efficacy Scale (CSES) for use on Persian-speaking women of reproductive age.MethodA preliminary draft of the Contraceptive Self Efficacy Scale (CSES) was prepared according to the standard translation/back translation procedures and an expert panel appraised its content and face validities. The approved draft was tested on 400 randomly selected women of reproductive age (15–49 years) at the 29th Bahman Hospital of in Tabriz, the capital city of East Azerbaijan province, North West of Iran from May to August 2018. The exploratory and confirmatory factor analysis (EFA, CFA) was carried out to verify the implicit factor structure of the CSES for use on Persian-speaking women of fertile age. The Cronbach’s α and Interclass Correlation coefficients were estimated for internal consistency and accuracy assessment of the instrument.ResultsThis translated scale indicated good internal consistency (0.9) and reliability (0.9). A four-factor solution best fitted the study data and the estimated fit indices were in the acceptable range (chi square/ degree of freedom = 2.956, the Root Mean Square Error of Approximation = 0.070, Confirmatory Fit Index = 0.667, The Tucker-Lewis Index = 0.599).ConclusionThe CSES-P can be considered as a potentially valid and reliable tool to assess contraceptive self-efficacy among Persian-speaking women. The CSES-P is a general instrument to measure overall contraceptive self-efficacy of the Iranian reproductive age women and it would also be fascinating to work on method specific self-efficacy tools in future.

Psychometric evaluation and cross-cultural adaptation of the Australian Pelvic Floor Questionnaire (APFQ-IR) in Iranian reproductive age women

Pelvic floor disorders (PFDs), as a silent alert, is one of the pervasive debilitating health concerns among women all over the world, such that in developed countries, one in four women, suffers from PFDs. Validity and reliability of the Australian Pelvic Floor Questionnaire (APFQ) has not been determined in Iran, so to determine APFQ’s psychometric characteristics, we decided to conduct this study on women of reproductive age in Tabriz city, Iran. This methodological cross-sectional study was intended to determine the psychometric properties of the Persian version of the APFQ-IR in 5 steps including “translation process, content validity, face validity, construct validity (exploratory and confirmatory factor analyses and examination of ceiling and floor effects) and reliability” on 400 reproductive age women referring to health centers in Tabriz city, Iran, with cluster random sampling method in the period between May 2022 to September 2022. The translation process was done based on two approaches, Dual panel, and Beaton et al.’s five steps. Then, in order to evaluate content validity, face validity, and construct validity, 10 instrument and PFDs experts, 10 women from the target group investigated the instrument's items, and 400 eligible women completed the instrument. Finally, to determine the reliability, two internal consistency methods, (Cronbach's alpha and McDonald's omega) and test–retest method (ICC) were used. In the present study, content validity assessment of APFQ-IR, showed a good level of validity (CVR = 0.96, CVI = 0.94). To assess construct validity, exploratory factor analysis results on 36 items, led to the identification of 4 factors including bladder function, bowel function, prolapse symptom and sexual function, which explained 45.53% of the cumulative variance and indicated the sufficiency of the sample size (Kaiser–Meyer–Olkin = 0.750). Implementing confirmatory factor analysis, (RMSEA = 0.08, SRMR = 0.08, TLI = 0.90, CFI = 0.93, χ2/df = 3.52) confirmed the model fit indices. Finally the internal consistency and reliability was high for the entire instrument (Cronbach’s alpha = 0.85; McDonald's omega (95% CI) = 0.85 (0.83–0.87) and Intraclass Correlation Coefficient (95% CI) = 0.88 (0.74–0.94)). The Persian version of the APFQ-IR, has a good validity and reliability and has acceptable psychometric properties, thus can be used both for research purposes and for clinical evaluation of pelvic floor disorders symptoms in health centers.

The impact of migration and settlement context on Iranian Women's agency in accessing and using reproductive healthcare services in Australia: A qualitative study.

This qualitative study aimed to understand how immigration and settlement context shape Iranian immigrants' agency in accessing and using reproductive healthcare services (RHCS). Twenty-one Iranian women of reproductive age (18-49 years) living in Australia were recruited in 2022 through social media platforms. The findings highlighted that although Iranian women's utilisation of RHCS in Australia is highly constrained by established sociocultural beliefs and values of their origin country, they become agents of making changes over their reproductive choices, reformulating beliefs and values, and taking control of reproductive health because of Australian sociocultural norms and context. This suggests a tension between the impacts of sociocultural contexts in their origin country and becoming agents of change after migrating to Australia. These findings need to be included in healthcare policy and practice to support greater consideration of cultural sensitivities and specific needs of immigrant women when accessing Australian RHCS.

Translation and measurement properties of the pelvic floor distress inventory-short form (PFDI-20) in Iranian reproductive age women

BackgroundEvery year, millions of women worldwide suffer in silence from pelvic floor disorders (PFDs) as an annoying health problem. Despite the high prevalence rate and negative effects of PFDs on the quality of life, the validity and reliability of pelvic floor distress inventory-short form (PFDI-20) has not been confirmed for Iranian women of reproductive age. Hence, this study aimed to determine measurement properties of PFDI-20 among women of reproductive age in Tabriz, Iran.MethodsThe current study was cross-sectional research that selected 400 women of reproductive age referring to health centers in Tabriz City, by using cluster random sampling from May 2022 to September 2022. Measurement properties of the Persian version of PFDI-20 were determined and evaluated through five steps, including content and face validity within two quantitative and qualitative parts, structural validity by using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and reliability testing through internal consistency, test-retest reliability, and measurement error. Moreover, ceiling and floor effects were investigated.ResultsIn this research, CVI (content validity index) and CVR (content validity ratio) of PFDI-20 equaled 0.94 and 0.97, respectively. In addition, the EFA process was applied to 20 items and derived the structure of three factors, which explained 58.15% of the total variance. In CFA phase, values of fit indicators (RMSEA = 0.07, SRMR = 0.07, TLI = 0.97, CFI = 0.99, x2/df = 3.19) confirmed the model validity. To determine reliability, Cronbach’s alpha = 0.84; McDonald’s omega (95% CI) = 0.84 (0.82 to 0.87) and Intraclass Correlation Coefficient (95% CI) = 0.98 (0.97 to 0.99) were obtained. Also, the SEM was 2.64, and the SDC indicating the smallest individual change was 8.91. Regarding the inventory feasibility, the ceiling effect was not observed in total value and subscales, while the floor effect in the total score of PFDI-20 equaled 24.0. The latter rate equaled 45.8, 38.3, and 50.8 for subscales POPDI-6, CRADI-8, and UDI-6, respectively.ConclusionsPersian version of PFDI-20 is a valid and reliable scale used to evaluate PFDs in Iranian women of reproductive age. Healthcare professionals can use this scale to screen PFDs, and researchers can consider it a reliable tool for their studies.

Pelvic floor disorder and relevant factors in Iranian women of reproductive age: a cross-sectional study

BackgroundWith high severity and prevalence, pelvic floor disorder is a health issue that women face worldwide. Different demographic-obstetric factors are involved in the emergence of this dysfunction that can have many adverse effects on a woman’s quality of life. Hence, this study aimed to determine the prevalence of pelvic floor disorder and its related socio-demographic and obstetric factors among Iranian women of reproductive age.MethodsThe statistical population of this cross-sectional study included 400 woman of reproductive age (15–49 years) covered by the health centers of Tabriz, Iran in 2022. The cluster sampling method was employed to select the participants. The data collection tools were a socio-demographic and obstetric characteristics questionnaire and the PDFI-20 (Pelvic Floor Distress Inventory-20). The chi-squared test was conducted to determine the association between socio-demographic and obstetric characteristics and prevalence of pelvic floor disorder in a bivariate analysis, whereas the multivariate logistic regression test was used in a multivariate analysis.ResultsThe general prevalence of pelvic floor disorder was 76%. The prevalence rates of pelvic organ prolapse distress 6 (POPDI-6), colorectal-anal distress 8 (CRAD-8), and urinary distress (UDI-6) were 54.3%, 61.8%, and 49.3%, respectively. The results of the multivariate logistic regression test indicated that constipation (odds ratio = 5.62; 95% CI 1.97 to 16.03; P = 0.001) increased the risk of pelvic floor disorder.ConclusionsAccording to the findings, the prevalence of pelvic floor disorder is high among Iranian women of reproductive age. This condition is correlated with constipation. Therefore, screening is recommended through valid tools in addition to offering preventive measures such as preventing and curing constipation to reduce the risk of pelvic floor disorder.

A population-based survey on sociodemographic risk factors of cigarette smoking among Iranian women of reproductive age

&#x0D; The trend of smoking among women is rising in some developing countries. The objective of this population-based cross-sectional study was to determine the sociodemographic risk factors of cigarette smoking among Iranian women of reproductive age. A total of 1359 women were randomly selected for the study. Multivariable logistic regression analysis was used to estimate the adjusted association between sociodemographic variables and cigarette smoking. The odds of cigarette smoking were higher among divorced women (OR [odds ratio]: 14.0; 95% CI [confidence interval]: 4.1–47.3) and women with a university education (OR: 2.6; 95% CI: 1.3–5.0). This study highlights an association between marital status and education with cigarette smoking among Iranian women.&#x0D;

The Prevalence of Polycystic Ovary Syndrome, Its Phenotypes and Cardio-Metabolic Features in a Community Sample of Iranian Population: Tehran Lipid and Glucose Study.

ObjectivesThe aim of the present study was to evaluate the prevalence of polycystic ovary syndrome (PCOS), its phenotypical and cardio-metabolic features in a community sample of the Iranian population in comparison to healthy eumenorrheic, non-hirsute women without polycystic ovaries. The second aim was to assess the cardio-metabolic characteristics of women who suffered from one criteria of PCOS compared to those healthy eumenorrheic, non-hirsute women.MethodsIn this cross-sectional population-based study, a total of 1,960 eligible women, aged (18–45 years) were recruited from the Tehran-Lipid and Glucose-Study participants and were classified as the three groups of (i) women with PCOS by the Rotterdam criteria, (ii) non-PCOS women with one criteria of PCOS and (iii) healthy eumenorrheic, non-hirsute women without polycystic ovaries morphology (PCOM) as the control group. Further PCOS women were extended to four phenotypes of hyperandrogenism, oligo-anovulation, polycystic ovaries (phenotype A), hyperandrogenism, oligo/anovulation (phenotype B), hyperandrogenism, polycystic ovaries (phenotype C) and oligo-anovulation, polycystic ovaries (phenotype D). Cardio-metabolic profiles and the prevalence of comorbidities of metabolic syndrome (MetS) and lipid abnormalities were compared among these groups linear, and the median regression models adjusted for age and body mass index.ResultsThe prevalence of PCOS according to the diagnostic criteria of the NIH, Rotterdam and AE-PCOS Society were 13.6, 19.4, and 17.8, respectively. Among those who met the Rotterdam criteria, 23.9, 46.3, 21.6, and 8.2% had phenotypes A, B, C, and D, respectively. Among the remaining 1,580 women who did not fulfil the PCOS criteria, 108 (6.8%) suffered from only oligo/anovulation, 332 (21%) only hyperandrogenism/hyperandrogenemia, 159 (16.2%) only PCOM in ultrasound and 981 (62%) were healthy eumenorrheic, non-hirsute women without PCOM. The study revealed that some adiposity indices and lipid abnormalities in PCOS phenotypes with hyperandrogenism (A, B, and C) were worse than in healthy women. By contrast, women with phenotype D did not differ from the healthy ones in terms of adiposity and lipid abnormalities. However, the respective values for other cardio-metabolic profiles and MetS rates in different phenotypes of PCOS were similar to the healthy women. Only the prevalence of MetS in phenotype A was significantly higher than in the healthy women. There were no statistically significant differences between participants with one criteria of PCOS and healthy counterparts in terms of most adiposity indexes, cardio-metabolic factors, and comorbidity of MetS and its components. However, women with hyperandrogenism had a significantly higher level of the waist to height ratio (WHtR) and hypertriglyceridemia than their healthy counterparts.ConclusionPCOS, mainly classical phenotypes A and B, are common among Iranian women of reproductive age. Women with PCOS who had androgen excess exhibited the worst lipid profile, and those who had full three criteria of the syndrome exhibited the higher rate of MetS. However, women with only ovulatory dysfunction and only PCOM had similar cardio-metabolic characteristics, compared to healthy subjects. These data suggest that routine screening for metabolic disturbances may be needed in the prevention of cardio-metabolic disorders in patients with more serious phenotypes of PCOS.

Comparison of Laparoscopic Myomectomy Outcomes Based on Myoma Weight: A Cross-sectional Study

Objectives: Myomas are the most common non-malignant pelvic neoplasm in women’s reproductive life. The aim of present study was to compare the outcome of large myoma Laparoscopy in Iranian reproductive-age women. Materials and Methods: This cross-sectional study was conducted on 86 women with symptomatic uterine myoma who underwent laparoscopic myomectomy between December 2013 and October 2018. Participants were divided into two groups based on the myoma weight (&lt;80 (n=15) and ≥80 g (n=71)). Finally, age, body mass index, number of myomas removed, duration of surgery, postoperative hospitalization, amount of blood transfusion, and hemoglobin reduction were compared between the two groups. Data were analyzed by SPSS software version 22. Results: The mean age of participants were similar in both groups (P=0.48). There were no significant differences between the two groups regarding body mass index (P=0.56) and indications for laparoscopic myomectomy (P=0.46). The mean weight of myoma and duration of surgery were significantly different between the two groups (P&lt;0.001 and P&lt;0.007, respectively). Changes in hemoglobin and days of hospitalization after surgery were not significantly different between the two groups. Conclusions: The length of hospital stay and blood loss in laparoscopic myomectomy did not differ significantly based on myoma weight. So, laparoscopic myomectomy could be considered a minimally invasive alternative for managing symptomatic large myoma.

Socio-demographic determinants of low sexual desire and hypoactive sexual desire disorder: a population-based study in Iran

BackgroundVarious socio-demographic factors have been introduced as the determinants of Low Sexual Desire (LSD), but whether these variables can also contribute to the Hypoactive Sexual Desire Disorder (HSDD), remains uncertain. In this study, we sought to identify the socio-demographic determinants of LSD and HSDD in Iranian women of reproductive age.MethodsThis was a population-based, cross-sectional study of 1000 married Iranian women of reproductive age (16–49 years) who met the inclusion criteria. The participants were chosen using the systematic random sampling method from all the healthcare centres in the city of Sari, Iran. LSD was defined as a score no higher than 33 on the Sexual Interest and Desire Inventory-Female (SIDI-F). The sexually-related personal distress was considered as a score of at least 11.0 on the Female Sexual Distress Scale-Revised (FSDS-R), and HSDD was determined based on the sum of those scores. Descriptive statistics were used to describe the socio-demographic characteristics and a chi-square test was run for data analysis using grouping variables. Multivariate logistic regression test was also employed to adjust the effect of confounding variables.ResultsThe mean score of sexual interest/desire among women was 30.6 ± 10.5. After adjusting the effect of confounding variables, logistic regression showed that socio-demographic variables including age at first intercourse, length of marriage and the level of satisfaction with income were significantly associated with both LSD and HSDD (P < 0.01). While advancing age (P < 0.001) and body mass index (P < 0.01) were just predictors of LSD.ConclusionSome socio-demographic factors could predict LSD in women, while they were not associated with HSDD. In other words, some factors associated with LSD do not instigate sexually-related personal distress, which is one of the criteria necessary for the diagnosis of HSDD.

Food Insecurity and Cardiovascular Risk Factors among Iranian Women

ABSTRACT We evaluated whether food insecurity is associated with clinical evidence of diet-sensitive cardiovascular diseases (CVD) risk factors, including obesity, hypertension, dyslipidemia, and diabetes. In this population-based cross-sectional study, 630 women aged 18–50 years under cover of health centers in Iran randomly selected and interviewed face-to-face. Food insecurity was evaluated using a household food insecurity access scale (HFIAS) questionnaire, which its validity and reliability was determined in the Iranian population. Logistic regression was used to assess the associations between food insecurity and having CVD risk factors including general and abdominal obesity, hypertension, hypercholesterolemia, high low-density lipoprotein cholesterol (LDL), low high-density lipoprotein cholesterol (HDL), hypertriglyceridemia, and diabetes. The probability of having hypertriglyceridemia (Adjusted OR = 2.04, P = .031), general obesity (Adjusted OR = 2.43, P = .029), abdominal obesity (Adjusted OR = 2.09, P = .024), and hypertension (Adjusted OR = 2.04, P = .038) increased with exacerbation of women’s food insecurity condition. The odds ratio of having CVD risk factors became stronger after adjusting for confounders. Food insecurity was associated with increased risk of CVD risk factors among Iranian reproductive-age women. Efforts to improve food security conditions among women might be associated with reductions in the incidence of CVD-related metabolic risks.

Pregnancy and Motherhood Concerns Surrounding Women with Multiple Sclerosis: A Qualitative Content Analysis.

ABSTRACTBackground: There is a high prevalence of multiple sclerosis (MS) among Iranian women of reproductive age. However, very few studies have been conducted in Iran to assess the experiences with and concerns about pregnancy and motherhood of such patients. The present study was conducted to better understand the experiences and concerns of women with MS about pregnancy and motherhoodMethods: The present qualitative study was conducted from August 2016 to January 2017 among Iranian women with MS visiting the Iran MS Society in Tehran, Iran. The purposive sampling method was used to recruit the participants and the sampling was continued until data saturation. Based on the inclusion criteria, a total of 25 women with MS were recruited in the study. The data were collected by in-depth semi-structured face-to-face interviews and analyzed using the MAXQDA 10 softwareResults: The analysis of the interview data resulted in four main categories, namely “Pregnancy concerns”, “Fear of failing as a parent”, “Feeling of threatened fertility”, and “Lack of social support”. The results showed that Iranian women with MS avoided pregnancy due to the negative effects of the disease on their physical abilities and on life in general. They were also concerned about possible infertility, the effect of MS medications on their menstrual cycle, and the limitations of infertility treatments due to the presence of MS. These concerns led them to postpone pregnancy and lose time or opt for voluntary childlessness and consequently miss out on the experience of motherhoodConclusion: MS poses a serious challenge to women who consider getting pregnant and wish to experience motherhood. Health care professionals should support such patients to overcome their concerns and indecisiveness by providing appropriate information and counseling

Understanding Interpersonal Influences on the Use of Formal Health Services among a Population of Iranian Women in Reproductive Age: A Qualitative Study.

BACKGROUND:One of the most important factors contributing to using formal health care services by women is people who are involved in the social network around them.AIM:This study aimed to understand the interpersonal influences on the use of formal health services among Iranian women of reproductive age.METHODS:This study is a deductive content analysis approach based on the Health Promotion Model. Twenty-two semi-structured interviews were done with women of reproductive age and health care staffs in Qom, Iran. Transcripts were analysed by a deductive content analysis approach based on the Health Promotion Model (HPM).RESULTS:Three main categories and eight subcategories were drawn consisting of (1) social support with 4 subcategories including “Family support and influence”, “support of religious people”, “support of health care providers” and “negative social support”; (2) social pressure and expectations with 2 subcategories including “feeling pressure due to role-playing” and “society’s expectations regarding women’s health”, and (3) healthy role models with 2 subcategories including “family role models” and “modeling friends and peers in taking action for treatment”.CONCLUSION:A positive interpersonal influence in women acts as a strong incentive to seek health care when they are suffering from a disease, and prevents the chronicity of the disease by timely treatment.

Women's reproductive health needs assessment questionnaire: development and validation.

Assessment of reproductive health (RH) needs is necessary for describing the status of women's RH and identification of the actions needed. This study aimed to develop and validate a questionnaire for the assessment of the women's RH needs. A sequential exploratory mixed method study (qualitative and quantitative) was conducted with Iranian women of reproductive age (age 15-49 years) living in Rasht. The qualitative exploratory phase was used to explain the concept and dimensions of RH needs. The qualitative exploratory phase was used to develop and validate a questionnaire. The results of the qualitative section, RH needs consists of two themes "Reproductive Health Education Needs" and "Reproductive Health Services Features". A Women's Reproductive Health Needs Assessment Questionnaire (WRHNAQ) was designed with 19 items. The content validity ratio (CVR) and content validity index (CVI) of the questionnaire were 0.89 and 0.93, respectively. The instrument's internal consistency was confirmed by an alpha coefficient of 0.881. The results of this study showed that the WRHNAQ is a culturally sensitive, valid and reliable scale for assessing the RH needs. The WRHNAQ will be helpful for identifying needs and need-based intervention.

Prevalence of Sexual Dysfunction among Reproductive-age Women in Iran: A Systematic Review and Meta-analysis

Background & aim: Sexual dysfunction is one of the most common problems in women which negatively affect their quality of life, self-esteem, and interpersonal relationships. The prevalence of this problem varies in different studies. Regarding this, this review was conducted to provide a clear picture of the prevalence of sexual dysfunction among reproductive-age women in Iran using a systematic review and meta-analysis. Methods: The relevant articles published up to April 9, 2017 were searched both in the international including Google Scholar, PubMed, Scopus and national electronic databases such as SID, IranMedex, Magiran, and Irandoc. The searching process was accomplished using a set of standard keywords. The data were analyzed using RevMan software, version 5.3. Results: Thedatabase search resulted in the retrieval of 1,024 articles, 9 cases of which were selected for systematic review. Out of the selected studies, seven articles were eligible to be included in the meta-analysis. According to the results of the reviewed studies, the pooled prevalence rate of sexual dysfunction among the reproductive-age women was estimated as 52% (95% CI: 39-66%). Furthermore, the pooled prevalence of sexual dysfunction in the domains of sexual desire, sexual arousal, lubrication, sexual pain, and orgasm was estimated as 39% (95% CI: 35-42%), 34% (95% CI: 21-46%), 32% (95% CI: 21-43%), 38% (95% CI: 24-51%), and 30% (95% CI: 22-38%), respectively. Conclusion: The results of the retrieved studies demonstrated that sexual dysfunction is a common health problem among the Iranian women of reproductive age. However, more high-quality research is needed in this area.

Testing Psychometrics of Healthcare Empowerment Questionnaires (HCEQ) among Iranian Reproductive Age Women: Persian Version.

Producing high quality data needs an accurate measurement in any fields of study. This study aimed to test psychometrics of the Persian version Healthcare Empowerment Questionnaire (HCEQ) in relation to personal care among Iranian reproductive age women and to validate the instrument for future use. A cross-sectional study was conducted on 549 reproductive age women in a health centers affiliated to Tehran University of Medical Sciences producing a response rate of 100%. Content validity was established using translation and backtranslation procedures, pilot testing, and getting views of expert panel. Construct validity was measured using explanatory factor analysis. Cronbach's alpha was used to measure internal consistency, and intra-class correlation coefficients were used to confirm stability. The results indicated that explanatory factor analysis of 10 items in three dimensions explained 63.2% of the total variance. Validity and reliability of the 10-items of HCEQ with two response scales (perception of control and motivation of being empowered) assessed for internal quality showed the reliability of internal consistency (α=0.70; range=0.62-0.76). The correlation between convert (10 items) and apparent (3 factors) variables was 0.5 times higher than the revealed convergent validity. The findings of this study supported the reliability and validity of the Persian version of HCEQ to assess the degree of individual empowerment in relation to personal healthcare and services among reproductive age women. Therefore, the HCEQ-Persian version could be a useful, comprehensive, and culturally sensitive scale for assessing healthcare empowerment among reproductive age women.

Women's Perceptions and Feelings about Loss of Their Sexual Desire: A Qualitative Study in Iran.

Reduced sexual desire leaves serious impacts on women's life. The current study aims to investigate the perceptions and concerns of Iranian women of reproductive age with female sexual interest and arousal disorder (FSIAD). This qualitative research was conducted using content analysis approach. Data were collected through seventeen in-depth interviews from October 2015 to June 2016. Purposive sampling was carried out from among reproductive-aged women suffering from FSIAD who responded to female sexual function index (FSFI) with mean scores of ≤3.3 and ≤3.4 in desire and arousal domains, respectively and went through validation by a psychologist. Data analysis was performed using Granheim and Lundman's approach. MAXQDA 10.0 software was used for data organization. The three main themes that emerged in this study included: 1) "Spoiled feminine identity" with two categories of "deteriorated sexual self-esteem" and "deteriorated feminine position", 2) "Struggle in sexual issues" with two categories of concern about losing the relationship and spouse, and surrendering to sexual relationship, and 3) "Deterioration of the couple's relationship" with two categories of deteriorated marital interaction and sexual disharmony between the couple. Feeling inability to play gender role as a woman and fear of losing the spouse are the most important concerns of women with lack of interest in sex. Training communication skills for sexual talks with the spouse and expression of feelings are the first steps to help such women.

Do Sleeping Disorders Impair Sexual Function in Married Iranian Women of Reproductive Age? Results from a Cross-Sectional Study.

Purpose This study aimed to evaluate the relationship between sleep quality and sexual function among Iranian women. Methods This study was conducted on 277 married women of reproductive age. The inclusion criteria were as follows: married women aged 18–45 years, with at least basic literacy, and women married monogamously for at least one year. The following tools were used for gathering data: a demographic questionnaire; Pittsburgh Sleep Quality Index (PSQI); Insomnia Severity Index (ISI); Epworth Sleepiness Scale (ESS); and Female Sexual Function Index (FSFI). Pearson correlation coefficients, independent t-tests, chi-square tests, and linear regression analyses were used to analyze the data. Results There was a significant inverse relation between poor sleep quality (r = −0.13, P = 0.02), daytime sleepiness (r = −0.39, P < 0.001), insomnia (r = −0.35, P < 0.001), and sexual function. Sexual desire was significantly related to sleep quality and insomnia (P < 0.001). Sexual arousal (r = −0.18, r = −0.29, P < 0.001), lubrication (r = −0.21, r = −0.3, −0.12, P < 0.001), orgasms (r = 0.17, r = −0.15, P < 0.001), and sexual satisfaction (r = −0.02, −r = 0.3, r = −0.15, P < 0.001) were significantly related to all types of sleep disorders (poor sleep quality, insomnia, and sleepiness). Pain during intercourse was significantly associated with poor sleep quality and insomnia. With each unit decrease in sleep quality, sexual function decreased by 0.49 (P < 0.001), and with each unit increase in the delay of sleep onset, sexual function decreased by 1.58 (P = 0.04). Conclusion Results of this study showed that there was a significant relationship between sleep quality and sexual function in Iranian women of reproductive age. The quality of sleep among reproductive-aged women merits the attention of health care providers and policy makers.

Exploring the feelings of Iranian women of reproductive age about health care seeking behavior: a qualitative study.

Background: Despite the important role of feelings in health care seeking behavior (HCSB), this subject has not yet been adequately investigated. HCSB-related feelings begin with the onset of disease symptoms and persist in different forms after treatment. The aim of current study was to explore the feelings that women of reproductive age experience when they seek health care.Methods: In this deductive, qualitative content analysis, participants were selected by purposeful sampling. Semi-structured, in-depth interviews with 17 women of reproductive age and 5 health care staffs in Qom, Iran were carried out until data saturation was achieved. Qualitative data were concurrently analyzed by deductive content analysis, using the Health Promotion Model (HPM). The MAXQDA10 software was used to manage qualitative data analysis.Results: Three main categories were drawn from data to explain the HCSB-related feelings of participants consisting of (1) feeling of inner satisfaction with the treatment with 2 subcategories including "peace of mind" and "feeling alive", (2) multiple roles of fear with 5 subcategories including "fear about the consequences of delay", "fear of having hidden diseases", "fear of unknown experiences", "fear of hearing bad news" and "fear of medical errors" and (3)uncomfortable feelings with 3 subcategories including "feeling uneasy when attending health facility", "feeling embarrassed" and "feeling worthless due to dealing the doctor".Conclusion: This study revealed that the inner feelings of women varied widely, ranging from positive or motivating feelings to negative or inhibitory ones, given their experiences with the formal health care system and the current situation of medical and health services. Highlighting patients’ perceived inner satisfaction and reducing fear and uncomfortable feelings by adopting culture-based practical strategies can enhance women’s HCSB.