Reproductive Well-being Research Articles

A cross-sectional study on attitudes toward gender equality, sexual behavior, positive sexual experiences, and communication about sex among sexually active and non-sexually active adolescents in Bolivia and Ecuador

BackgroundIt is widely agreed upon that gender is a key aspect of sexuality however, questions remain on how gender exactly influences adolescents’ sexual health.ObjectiveThe aim of this research was to study correlations between gender equality attitudes and sexual behavior, sexual experiences and communication about sex among sexually active and non-sexually active adolescents in 2 Latin American countries.DesignIn 2011, a cross-sectional study was carried out among 5,913 adolescents aged 14–18 in 20 secondary schools in Cochabamba (Bolivia) and 6 secondary schools in Cuenca (Ecuador). Models were built using logistic regressions to assess the predictive value of attitudes toward gender equality on adolescents’ sexual behavior, on experiences and on communication.ResultsThe analysis shows that sexually active adolescents who consider gender equality as important report higher current use of contraceptives within the couple. They are more likely to describe their last sexual intercourse as a positive experience and consider it easier to talk with their partner about sexuality than sexually experienced adolescents who are less positively inclined toward gender equality. These correlations remained consistent whether the respondent was a boy or a girl. Non-sexually active adolescents, who consider gender equality to be important, are more likely to think that sexual intercourse is a positive experience. They consider it less necessary to have sexual intercourse to maintain a relationship and find it easier to communicate with their girlfriend or boyfriend than sexually non-active adolescents who consider gender equality to be less important. Comparable results were found for boys and girls.ConclusionsOur results suggest that gender equality attitudes have a positive impact on adolescents’ sexual and reproductive health (SRH) and wellbeing. Further research is necessary to better understand the relationship between gender attitudes and specific SRH outcomes such as unwanted teenage pregnancies and sexual pleasure among adolescents worldwide.

Menstrual hygiene practices: Is it practically impractical?

Background: Menstruation is the physiological process, but its physiology and nature are very poorly understood among the female population due to many sociocultural factors which make them to adapt certain practices unknowingly whether it is correct or false. This study was done with the objectives of exploring the menstrual practices followed among urban and rural female population. Materials and Methods: This study was done as a community based - cross-sectional study at the outskirts of Chennai, among the randomly selected females in the reproductive age (15-44) group from both rural and urban field practice areas using questionnaire and interview method. The results were expressed in percentages, and appropriate test of significance was performed. Results: Approximately, a total of 212 from the rural area and 206 from urban slum were randomly selected for the study of which 9% (19) from rural and 5.3% (11) not aware of sanitary pads that can be used during menstruation. Among the study participants, 42.5% (90) of rural and 40.3% (83) of urban were unaware from which organ menstruation is from. The prevalence of better menstrual hygienic practices using the menstrual hygiene index was found to be 63.6% (131) in urban slum and 35% (75) in a rural area which was found to be statistically significant ( P Conclusion: Our study has revealed that most of the females are still unaware menstrual hygienic practices which suggest that appropriate health promotive measures to be implemented for their reproductive well-being.

The implications of oil pollution for the enjoyment of sexual and reproductive rights of women in Niger Delta area of Nigeria

Oil is a major source of income for Nigeria and it is the mainstay of the country's economy. Nigeria's intensive oil sector accounts for nearly 40% of its gross domestic product, but declined steadily to an average of 14.71% of the country's total export between 2006 and 20111; and contributed about 80% of budgetary revenues that all tiers of government heavily depend on.2 Oil spills and gas flaring are some of the effects of the unregulated exploratory activities of the oil multinational companies that have contributed immensely to the physical and mental illness of the local inhabitants of the Niger Delta region and violated most of their rights as guaranteed under international and regional human rights instruments and the Constitution of the Federal Republic of Nigeria 1999 (as amended) 1999. In view of the growing threats to human health and the environment (posed by human activities), the international community has agreed to a number of treaties to respond to the health and human rights challenges posed by environmental degradation. Although Nigeria is a party to most of these instruments,3 it has done little or nothing to regulate the conduct of the oil companies that negatively impact on the health of the Niger Delta people. While the impact of oil extraction affects both men and women, the article focuses on its implications for women's reproductive well-being. This is because women are a disadvantaged and marginalised group and have continued to experience discriminatory practices in many parts of the country, including the Niger Delta area. The article discusses the health challenges associated with oil exploitation in the Niger Delta, paying attention to the position of women. It then proffers suggestions on measures and steps that could be taken by the Nigerian government and other stakeholders in ensuring the adequate protection of the health rights of local inhabitants.

Predictors and Reproductive Health Implications of Knowledge of HIV/AIDS among Female Out-of-School Adolescents in Iwaya Community, Lagos State

Predictors and Reproductive Health Implications of Knowledge of HIV/AIDS among Female Out-of-School Adolescents in Iwaya Community, Lagos State Human Immunodeficiency Virus (HIV) remains a major threat to the reproductive wellbeing of millions of young people in sub-Saharan Africa. Yet, some of the intervention programmes aimed at increasing knowledge about HIV fail to reach out-of-school adolescents. This study sought answers to questions on the level of knowledge about modes of HIV transmission and misconceptions about HIV; predictors of knowledge of HIV; and the relationship between knowledge of HIV and sexual behaviour among out-of-school adolescents (ages 10 to 19), in a slum in the city of Lagos.

Intensive versus extensive management systems in commercial egg production.

Abstract Despite the degree of environmental protection and economic feasibility offered by traditional poultry production systems, the practice of housing laying hens in cages has been widely criticized worldwide because of the public perception that caged housing systems provide poor welfare for laying hens. As a result of increasing public interest in laying hen welfare, alternative management systems such as free-range environments have been resurrected and new legislation such as the California Proposition Two is expediting a shift back towards extensive practices. The transition from intensive back to extensive practices coupled with the advent and increasing popularity of novel alternative layer housing management methods in recent years necessitates an examination of the influence of environmental stressors associated with different housing methods on layer egg production, immunological response and reproductive well-being. In this review, the evolution of intensive and extensive management practices is comparatively examined based on how these different management practices impact layer hen well-being and productivity. Different welfare assessment techniques are also examined in an effort to provide insight into the progression of research concerning layer hen welfare in different management systems.

“I’ve Lost My Mojo, Baby”

Few studies have explored women’s subjective experiences with Depo-Provera, in particular its impact on their sexual selves and everyday lives. Thirty-four (34) women were interviewed about their experiences using Depo-Provera and other methods of contraception, with interviews analyzed using a thematic narrative analysis approach. A key theme emerging in interviews was decrease in libido (sexual desire) in taking Depo-Provera, which was linked with emotions, body image, and had social ramifications. Four participants’ stories serve as exemplars for exploring subjective complexity. "Lived" accounts of user experiences are essential for overcoming a reductive focus on contraceptive side effects, which elides connections and obscures user understanding. A narrative perspective provides an empirical basis for developing family planning programs and sexual health policies that acknowledge more experientially grounded conceptualizations of women's sexual and reproductive health and wellbeing.

Work and Family Stress is Associated with Menstrual Disorders but not with Fibrocystic Changes: Cross‐sectional Findings in Chinese Working Women

To explore the separate and combined effects of work and family stress on menstrual disorders and fibrocystic changes in Chinese working women. Data were obtained from a cross-sectional study of 1,642 female railway workers. The Effort-Reward Imbalance Questionnaire and Family Stress Scale were used to measure work stress and family stress, respectively; the menstrual and breast conditions were evaluated by gynecologic interview and a medical examination. Multivariate log-binomial regression was performed to analyze the associations. Menstrual disorders were found in 59.3% of female workers, and 54.8% had fibrocystic changes. The risk of menstrual disorders was significantly elevated with respect to work and family stress. The highest risk was found in the group with combined exposure to both work and family stress (RR with 95% CI 1.33 (1.18-1.49)). No significant association between stress and fibrocystic changes was observed. Menstrual disorders were associated with stress from work and family life, but not fibrocystic changes, in working women. Tailored intervention measures reducing the burden of stressful psychosocial work and family environment are needed to improve women's reproductive well-being.

Inhibitory effect of curcumin on uterine leiomyoma cell proliferation

Objective. Uterine leiomyomas are the most common gynaecological benign tumour and greatly affect reproductive health and wellbeing. They are the predominant indication for hysterectomy in premenopausal women. Curcumin, a well-known component of turmeric, has been reported to prevent various diseases such as cancer, diabetes and obesity. Previous study reported that curcumin represses the proliferation of several tumour cells. However, there has not been a precise characterisation of the curcumin-induced inhibition of uterine leiomyoma cells. In this study, we investigated the inhibitory effect of curcumin on leiomyoma cells proliferation.Study design. Eker rat-derived uterine leiomyoma cell lines (ELT-3 cells) were used. Cell proliferation was assessed by counting the number of cells and MTS assay. The activation of peroxisome proliferator-activated receptor-gamma (PPARγ) was evaluated by luciferase assay.Results. We found that curcumin significantly inhibited ELT-3 cell proliferation. PPARγ was expressed in ELT-3 cells and curcumin acted as a PPARγ ligand. This inhibitory effect of curcumin was attenuated by the treatment of cells with PPARγ antagonist.Conclusion. These experimental findings in vitro show that the inhibitory effect of curcumin on ELT-3 cell proliferation occurs through the activation of PPARγ. Curcumin may be useful as an alternative therapy for uterine leiomyoma.

Understanding gendered influences on women's reproductive health in Pakistan: Moving beyond the autonomy paradigm

Recent research and policy discourse commonly view the limited autonomy of women in developing countries as a key barrier to improvements in their reproductive health. Rarely, however, is the notion of women's autonomy interrogated for its conceptual adequacy or usefulness for understanding the determinants of women's reproductive health, effective policy formulation or program design. Using ethnographic data from 2001, including social mapping exercises, observation of daily life, interviews, case studies and focus group discussions, this paper draws attention to the incongruities between the concept of women's autonomy and the gendered social, cultural, economic and political realities of women's lives in rural Punjab, Pakistan. These inadequacies include: the concept's undue emphasis on women's independent, autonomous action; a lack of attention to men and masculinities; a disregard for the multi-sited constitution of gender relations and gender inequality; an erroneous assumption that uptake of reproductive health services is an indicator of autonomy; and a failure to explore the interplay of other axes of disadvantage such as caste, class or socio-economic position. This paper calls for alternative, more nuanced, theoretical approaches for conceptualizing gender inequalities in order to enhance our understanding of women's reproductive wellbeing in Pakistan. The extent to which our arguments may be relevant to the wider South Asian context, and women's lives in other parts of the world, is also discussed.

Repressive effect of the phytoestrogen genistein on estradiol-induced uterine leiomyoma cell proliferation

Objective. Uterine leiomyomas are the most common gynecological benign tumor and greatly affect reproductive health and well-being. They are the predominant indication for hysterectomy in premenopausal women. Current epidemiological study reported that soy products intake is inversely associated with diseases leading to hysterectomy. Genistein is a soy-derived phytoestrogen and its inhibitory effect on leiomyoma cell proliferation is reported. In this study, we investigated the siginificant inhibitory effect of genistein on estradiol (E2)-induced leiomyoma cells proliferation.Study design. The Eker rat-derived uterine leiomyoma cell line ELT-3 cells were used. Cell proliferation was assessed by counting the number of cells. The expression of estrogen receptors and peroxisome proliferator-activated receptor-γ (PPARγ) was evaluated by Western blot analysis.Results. PPARγ was expressed in ELT-3 cells and genistein acted as PPARγ ligand. This inhibitory effect of genistein was attenuated by the treatment of cells with PPARγ antagonist bisphenol A diglycidyl ether (BADGE) or GW9662.Conclusion. These experimental findings in vitro show that the repressive effect of genistein on E2-induced ELT-3 cell proliferation is through the activation of PPARγ. Genistein may be useful as an alternative therapy for leiomyoma.

Elevated level of plasma vascular endothelial growth factor after gonadotropin-releasing hormone agonist treatment for leiomyomata

Objective. Uterine leiomyomata are the most common gynecological benign tumor and greatly affect reproductive health and well-being. The pathophysiology and epidemiology of fibroids are poorly understood. Gonadotropin-releasing hormone agonist (GnRH-a) pretreatment is one of the unfavourable factors for leiomyomata treatment with uterine artery embolisation (UAE). In this study, we investigated the plasma level of vascular endothelial growth factor (VEGF) in uterine leiomyoma patients with or without GnRH-a pretreatment.Study design. Thirty-two women who underwent UAE for symptomatic uterine leiomyoma were analysed. The plasma level of VEGF was studied before UAE.Results. The level of plasma VEGF was significantly higher in the GnRH-a pretreated group compared with the non-treated group.Conclusion. A compensative reaction for vasculature after GnRH-a treatment is speculated. Higher level of VEGF in GnRH-a pretreatment group could be one of the unfavourable factors for the treatment of uterine leiomyomata by UAE.

Beyond denial—women's dilemmas and choices around HIV-testing, treatment and disclosure

abstract The experiences of a group of women from the Lower South Coast region of KwaZulu-Natal highlight the ways in which lack of information, fear and denial, gender inequality, stigma and discrimination together maintain a deadly grip on women's efforts to make choices about their reproductive and sexual well-being. Interviews conducted with four women, who are all living openly with HIV and are all involved in counselling or care work, reveal the blame and judgment that even relatively ‘empowered’ women face from partners, family and community members, and from predominantly female health workers. While the women relate their personal histories and discuss the challenges they have overcome as individuals, their stories draw attention to a range of issues that affect many women's sexual and reproductive health rights. Based on their experiences and their encounters with other women who face dilemmas about testing, disclosure and treatment, the interviewees offer insights into the changes that need to happen to secure women's rights to control and care for their bodies.

Developmental programming of reproduction and fertility: what is the evidence?

The concept of the foetal/developmental origins of adult disease has been around for ~20 years and from the original epidemiological studies in human populations much more evidence has accumulated from the many studies in animal models. The majority of these have focused upon the role of early dietary intake before conception, through gestation and/or lactation and subsequent interactions with the postnatal environment, e.g. dietary and physical activity exposures. Whilst a number of theoretical models have been proposed to place the experimental data into a biological context, the underlying phenomena remain the same; developmental deficits (of single (micro) nutrients) during critical or sensitive periods of tissue growth alter the developmental pathway to ultimately constrain later functional capacity when the individual is adult. Ageing, without exception, exacerbates any programmed sequelae. Thus, adult phenotypes that have been relatively easy to characterise (e.g. blood pressure, insulin sensitivity, body fat mass) have received most attention in the literature. To date, relatively few studies have considered the effect of differential early environmental exposures on reproductive function and fecundity in predominantly mono-ovular species such as the sheep, cow and human. The available evidence suggests that prenatal insults, undernutrition for example, have little effect on lifetime reproductive capacity despite subtle effects on the hypothalamic–pituitary–gonadal axis and gonadal progenitor cell complement. The postnatal environment is clearly important, however, since neonatal/adolescent growth acceleration (itself not independent from prenatal experience) has been shown to significantly influence fecundity in farm animals. The present paper will expand these interesting areas of investigation and review the available evidence regarding developmental programming of reproduction and fertility. However, it appears there is little strong evidence to indicate that offspring fertility and reproductive senescence in the human and in farm animal species are overtly affected by prenatal nutrient exposure. Nevertheless, it is clear that the developing gonad is sensitive to its immediate environment but more detailed investigation is required to specifically test the long-term consequences of nutritional perturbations during pregnancy on adult reproductive well-being.

Sociocultural meaning of reproductive processes and well-being in a rural community in Kenya

This paper considers the meanings attached to reproductive processes and outcomes and how these are linked to the Kamba notions of illness, health and well-being. It explores the cultural meanings of reproductive failures and successes, and the importance of childbearing for individuals, the family and the wider kin. Drawing on anthropological data produced over a period of ten months' field study, the paper uses specific cases to show the ways in which social, sexual and reproductive misfortunes are perceived, explained, and managed. These, the paper argues, are embedded in the Akamba concepts of disease / illness causation, health and well-being. Cet article fait l'analyse des significations et des consequences attribuees aux processus de reproduction. L'analyse montre comment ces notions sont liees a la maladie, a la sante et au bien-etre du peuple Akamba. Il explore les significations culturelles des problemes et des reussites de la reproduction ainsi que l'importance de la grossesse pour les individus, la famille et les parents. L'article, par le biais des donnees anthropologiques recueillies sur une periode d'etude de dix mois, utilise des cas specifiques pour montrer comment les malchances sociales et sexuelles liees a la reproduction sont percues, expliquees, et gerees. Selon l'article, ces problemes d'infertilite font partie integrante du concept de la maladie, de la sante et du bien-etre du peuple Akamba.

Gender Equity for the 21st Century: The Imperative for Women to Control Their Bodies

Have you heard the song Pussy Control? If not you might want to take a listen to it. Despite its shocking use of the taboo word pussy it is an incredibly empowering song. The illustrious if vulgar thought promulgates in a womans mind that she in fact and in deed is the owner of her destiny. Such ownership begins by understanding the weight and power she wields with a few small skin flaps south of her belly button. In large part she controls her life and the world when she truly owns her vagina and her sexual and reproductive health and well-being. Of course I reference she as every woman in every corner and curve of the world. At the XIV International AIDS Society Conference both Bill and Melinda Gates spoke passionately if not eloquently about the imperative of pussy control as it relates to HIV. Although neither used those words and they were in fact much more urbane in their presentations the idea is the same. Women of the world are ravaged by HIV infection. This is often because of the fact that they have no true ownership of their bodies of their health (reproductive physical mental or otherwise) or of their place in the world as competent dignified human members in a world community. They are deprived of a voice and socialized to be forgettable and thus do not receive legitimate consideration or respect of their needs concerns and power. Honest ownership by a woman of her body all of it and acknowledgement of such property rights is the beginning of the end of gender inequality and in some part of the spread of HIV. (excerpt)

Women's Perception of Partner Violence in a Rural Igbo Community

Partner violence is a serious public health problem affecting mostly women. This qualitative study assessed the perceptions of rural Igbo women of Nigeria of intimate partner violence. Information was elicited using in-depth interviews and focus group discussion. Women of childbearing age were selected from the various women age grades in Ozubulu, Anambra State, Nigeria. Findings revealed that the women generally condone and are complacent with intimate partner violence, perceiving it as cultural and religious norms. The women felt that reprimands, beating and forced sex affecting their physical, mental and reproductive wellbeing are normal in marriage. They did not support reporting such cases to the police or divorcing the man, they would rather prefer reporting to family members. They felt that exiting the marriage would not gain the support of family members. They also expressed fear for the uncertainty in re-marrying, means of livelihood after re-marriage, social stigmatisation, and concern for their children. Socio-cultural norms and structures favour partner violence in Anambra State of Nigeria. There is a need for advocacy and concerted action that will involve the educational, health, civil and religious sectors of the society to evolve sustainable structures that will empower women and provide support to enable victims to react appropriately to violence.

Review of <em>Realizing Rights: Transforming Approaches to Sexual & Reproductive Well-Being.</em> Andrea Cornwall and Alice Welbourn (Eds.) Reviewed by Carol Tully.

Review of <em>Realizing Rights: Transforming Approaches to Sexual & Reproductive Well-Being.</em> Andrea Cornwall and Alice Welbourn (Eds.) Reviewed by Carol Tully.

Realizing Rights: Transforming Approaches to Sexual and Reproductive Well-being

Realizing Rights: Transforming Approaches to Sexual and Reproductive Well-being

Realizing Rights Realizing Rights

Sexual and reproductive wellbeing are rights recognised in international law. This collection brings together initiatives from around the world that aim to translate these rights into reality. Interventions are diverse, including popular theatre in Nigeria, collaborative planning in Egypt, role playing in Cambodia and participatory research in England. All emphasise the importance of putting the lived experiences and concerns of women, men and young people at the centre of efforts to improve sexual and reproductive wellbeing.

Micronutrients and reproduction in farm animals

Reproductive well-being and performance of farm animals is largely dependent on their nutritional status, which is often less than optimum in developing tropical countries. More often than not, they are malnourished, particularly with regards to micronutrients. Evidence was presented to show that because these micronutrients are involved in such functions as intracellular detoxification of free radials, synthesis of reproductive steroids and other hormones, carbohydrate and protein and nucleic acid metabolism, their deficiencies and/or excesses may impair spermatogenesis and libido in the male, fertility, embryonic development and survival, post-partum recovery activities, milk production and offspring development and survival. A plea was made for intensified research efforts, farmer education and quality control of vitamin–mineral pre-mixes, in order to improve micronutrient nutrition, and, consequently, the reproductive performance and overall productivity of farm animals in developing tropical countries.