Have Sex Research Articles

Vedic astrological factors for human immunodeficiency virus transmission within male individuals with sexual orientation as homosexual

Background: For almost more than 70 years, the modern science had labeled homosexuality as a mental disorder and was part of DSM (Diagnostic and Statistical Manual of Mental Disorders) until the fifth edition was released in the year 2013 and homosexuality was removed from the mental disorder list. Despite of the removal of homosexuality along with all kind of sexual orientation from mental disorder, it is still being considered taboo in the society. From Sanatana Dharma perspective, homosexuality is very well mentioned in multiple scriptures. In Vedic Astrology as well, this homosexuality along with diseases due to sexual intercourse is being described. In this modern era, one of the most common disease due to sexual intercourse is HIV. Although, HIV is considered relatively new transmission due to its first scientific mention in the late twentieth century, the symptoms and overall nature of this disease is clearly described in Vedic Astrology. Finding: This research paper is an extension of the existing research paper in the field of Vedic Astrology especially in the field of Vedic Astrology focusing on HIV transmission. A total of 314 HIV positive samples was collected from 18 countries selected from Asia, Europe, North America, South America, Africa as well as Australia in order to have a coverage of all the continents. All these HIV positive people belong to LGBT community, to be very specific Gay (homosexuals) and have been identified as HIV transmission due to anal intercourse with another Gay partner. The Astrological Natal Chart were analyzed for all these 314 samples against the KIRAN sutra (5 thumb rules) to find the possibility of HIV based on the sutras i.e. rules. Out of 314 samples, 310 charts fit the criteria (KIRA sutra) mentioned in the KIRAN sutra for HIV transmission. 4 samples were not checked against the criteria (N) due to insufficient Nakshatra-Pada i.e. Constellation-Phase coverage along with the complex nature of the Nakshatra sutra i.e. N sutra of KIRAN sutra. The result indicates that the KIRAN sutra is very effective sutra even to identify the HIV transmission from male-to-male partner with an accuracy of 98.73% (310 cases out of 314 cases) using only 4 sutras i.e. KIRA. Conclusion: The research is an effort to raise awareness and to help males with homosexual orientation to identify whether they are highly prone to HIV or not using their Vedic Astrological Natal Chart so that they can take preventive action. A new yoga i.e. Samalaingika Yauna Sankramaṇa Yoga is being introduced in the field of Medical Astrology focusing on males with sexual orientation as homosexual, commonly known as Gay in LGBT community in order to support Gays living a HIV free life without judging their sexual orientation. Novelty/Originality of this article: This study introduces the application of the KIRAN sutra from Vedic Astrology as a predictive method for assessing HIV transmission risk in homosexual men, achieving an accuracy rate of 98.73%, along with the introduction of a new configuration, Samalaingika Yauna Sankramaṇa Yoga.

Genital Attacks in Hereditary Angioedema and Their Effects on Sexual Life

Background and Objectives: Hereditary angioedema (HAE) is characterized by unpredictable skin and mucosal angioedema attacks. We aimed to find the frequency of sexual-activity-triggered attacks (STAs) and understand how the sexual life of HAE with C1-inhibitor deficiency (HAE-C1INH) patients is affected. Materials and Methods: Adult HAE-C1INH patients were included in this cross-sectional study, which started in March 2020. Demographic information, marriage properties, gender-specific sexual life characteristics, and the HAE-specific histories of the patients were collected. The Hospital Anxiety and Depression Scale (HADS) and the Turkish version of the New Sexual Satisfaction Scale (NSSS) were applied to all participants. Results: Among 42 symptomatic HAE patients, 33 (78.57%) had genital attacks and 17 (42.5%) had STAs. Ten (58.8%) had genital pain, tenderness, or swelling, and five (29.4%) had isolated abdominal and groin pain. Eight (47.1%) patients with STAs experienced a HAE attack during their first time engaging in sexual intercourse. Anxiety/depression scales, NSSS scores, and distribution of other HAE attack localizations were similar in patients with and without STAs, and no gender differences were observed. Compared to the patients without STAs, the ratio of patients who stated that their sexual lives were negatively affected and that they lost their sexual desire was higher in patients with STAs. Conclusions: Genital or abdominal attacks triggered by sexual activity may be more common than thought. Sexual activity should also be questioned for evaluating attack triggers. There is a possibility of triggering an attack with the first and ongoing sexual intercourse, and patients should be informed to keep their attack treatment medications ready in advance.

"I Don’t has the Desire to has Sex”: Quality of Life and Sexual Concerns of Women with Secondary Infertility in the Tamale Metropolis

Background Infertility adversely affects the general quality of life and sexual satisfaction among women. This study explored the quality of life and sexual concerns among women with secondary infertility in the Tamale metropolis. Methods A qualitative exploratory descriptive design was used. Individual in-depth interviews were conducted using a semi-structured interview guide. Ethical approval was received from the Ghana Health Services ethics review committee. Fourteen (14) participants with secondary infertility receiving treatment at the Tamale Teaching Hospital were purposively selected and interviewed for the study, each lasting about 30 minutes to one hour. The interviews were audiotaped with permission from the participants, transcribed verbatim and content analyzed. Conclusion The findings from this study revealed that happiness, well-being and value in life were compromised among these women. Concerning sexual satisfaction, the majority of the participants experienced low sexual drive and physical pain during sexual intercourse which led to poor sexual satisfaction. There is a need for more exploration into the sexual health of women with infertility

EMPIRICAL INDICATORS FOR CONSTRUCTING SOFTWARE FOR IMPLEMENTING THE SYSTEMATIZATION OF NURSING CARE IN ASSISTED REPRODUCTION

Infertility is defined as the inability to develop a successful pregnancy through sexual intercourse or artificial insemination within a period of 12 months or more. Nursing is involved in the implementation of assisted reproduction treatments. In this sense, the use of software provides support in the documentation of the actions that govern care, in addition to assisting in the elaboration of clinical judgment, which can result in better quality care. Thus, the objective was to identify the empirical indicators of women undergoing assisted reproduction techniques in order to structure a support software for the Systematization of Nursing Care for these women. This is a methodological research through the identification of empirical indicators related to women undergoing Assisted Reproduction techniques. As a result, a sample of 40 articles was obtained, from which 166 indicators were extracted. A total of 166 empirical indicators were obtained, of which 74 represented psychobiological needs, 88 psychosocial needs and 4 IES psychospiritual needs. Therefore, from the identification of altered empirical indicators of women undergoing assisted reproduction techniques in light of the theory of Basic Human Needs, it will be possible to develop valid software for Systematization of Nursing Care for women undergoing assisted reproduction techniques.

Sexual health in menopausal women with symptoms of pelvic floor disorders.

Sexual dysfunction in women is usually associated with the menopausal transition and menopause; however, there are factors that can also influence the sexual function of women in menopause. The aim of this study is to determine the association between pelvic floor disorders and sexual dysfunction in women in menopause. A cross-sectional study was carried out in Spain with menopausal women recruited by convenience sampling. Data were collected on background and health status. To evaluate the presence of pelvic floor problems, the Pelvic Floor Distress Inventory (PFDI-20) was used. Regarding the evaluation of female sexual function, the validated Sexual Function of Women (FSM-2) tool was used. Crude (OR) and adjusted odds ratios (AOR) were obtained using the SPSS 28.0 statistical program. A total of 197 women participated. The mean age was 57.7 years (SD=8.4), 51.3% (101 women) reported experiencing some form of sexual dysfunction. Despite this, the majority (79.5%; 155 women) indicated that they were satisfied with their sexual health. However, 25.5% (50 women) mentioned they faced difficulties when trying to initiate sexual intercourse. Additionally, 22.9% (45 women) reported having moderate to severe issues achieving orgasm. Furthermore, 29% (57 women) stated that they had never or only occasionally felt arousal in the past month. Women who experienced urinary incontinence and pelvic pain had a higher frequency of sexual dysfunction. The main associated factor observed was the risk of pelvic floor dysfunction through the PFDI-20 scale. For each point of this instrument, there was a small but increased risk of sexual dysfunction (OR=1.01; p<0.001). Type of birth or maternal disorders, such mental illness or gastrointestinal disorder, did not show any statistical association with sexual dysfunction. Pelvic floor dysfunctions symptoms in menopausal women are associated with their sexual health. Pelvic floor dysfunctions that influence sexual function are colorectal, urinary, and prolapse. Pelvic floor disorders such as urinary incontinence and pelvic pain are those that most influence sexual function.

Scoping Review of Pre-Exposure Prophylaxis and Post-Exposure Prophylaxis in HIV Prevention in Türkiye

Abstract Background Pre-Exposure Prophylaxis (PrEP) is a medical -antiretroviral- prevention method that reduces the risk of HIV transmission during sexual intercourse or injection drug use. Post-exposure prophylaxis (PEP) refers to taking medicine after risky exposure. The European Centre for Disease Prevention and Control (ECDC) has recommended the integration of PrEP into the existing HIV prevention packages since 2015. In Türkiye, first PrEP Guideline was published in 2022. The aim of this study is to evaluate the literature gap on the PrEP and PEP for HIV prevention research in Türkiye. Methods This study was conducted in October 2023. Searches were performed using the keywords ‘HIV, AIDS’ and ‘Pre-exposure prophylaxis, PrEP, Post-exposure prophylaxis, PEP’ in PubMed, Web of Science, Scopus, TRDizin, and Dergipark for all years. ‘Türkiye, Turkey, Turkish’ were added into the keywords in international indexes, without using country filters. Inclusion criteria were research on PrEP or PEP for HIV, research conducted in or using data from Türkiye, publications in English/Turkish. Exclusion criteria were non-HIV topics, non-Turkish data, non-English/Turkish publications. Lists were merged, duplicates were removed. Inclusion-exclusion criteria were conducted at title and abstract level. Full texts of the included articles examined for bibliometric characteristics, study types, and key results. Results 1014 publications yielded, 993 evaluated, and 17 fully reviewed. Four discussed Türkiye’s PrEP practices (2018-2023); three analyzed PEP regimens; three were reviews on PrEP/PEP in Türkiye (2016-2022). Two original research articles explored PrEP awareness among Türkiye’s men having sex with men (2022) and infectious disease physicians’ attitudes toward PrEP (2020). Studies showed gaps in PrEP information and service access. Conclusions There are limited studies published on PrEP and PEP in HIV prevention in Türkiye. This study highlights the need for local research on the topic. Key messages • Evaluation of Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) publications highlights gaps in HIV prevention research. • Limited literature on PrEP and PEP in HIV prevention emphasizing the need for further studies and improved access to PrEP information.

Utilization of modern contraceptives and associated factors among women of homeless reproductive age in Adama town, Oromia, Ethiopia

BackgroundFamily planning refers to a conscious effort by a couple to limit or space the number of children they have through the use of contraceptive methods. Contraceptive utilization is a practice that helps individuals or couples avoid unwanted pregnancy. A lack of family planning puts homeless individuals at a higher risk of unwanted pregnancies and sexually transmitted infections. However, there is little data about modern contraceptive utilization among homeless women in the study area.ObjectivesIt has aimed to assess the utilization of modern contraceptives and associated factors among homeless reproductive-age women in Adama town, 2023.MethodsA community-based cross-sectional study was conducted in Adama town among 286 homeless women. A convenience sampling technique was used. The data were collected through face-to-face interviews using a pretested structured questionnaire. The collected data were cleaned, coded, and entered into Epi Info, and the data were exported to the Statistical Package for Social Sciences (SPSS) version 22. Descriptive statistics were used to characterize the study population. The associations between dependent and independent variables were modeled using binary logistic regression. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to estimate associations, and a P value < 0.05 was considered to indicate statistical significance.ResultsOut of the planned 289 respondents, 286 (98.9%) were participated. The prevalence of modern contraceptive utilization was 56.6% [95% CI: (50.7, 62.2)]. Among the utilizers, implants (52.5%), injectables (42%), and pills (5.5%) were used. Homeless women aged 25–34 years [AOR = 4.22, 95% CI: (1.77, 10.05)], a formal education [AOR = 3.04, 95% CI: (1.21, 7.60)], a slept off-street [AOR = 2.81, 95% CI: (1.25, 6.34)], a monthly income greater than or equal to 2400 Ethiopian birr [AOR = 4.18, 95% CI: (2.11, 8.29)], a sexual intercourse AOR = 3.14, 95% CI: (1.17, 8.40)], and a history of pregnancy after joining the street life [AOR = 9.21, 95% CI: (3.67, 23.12)] were factors significantly associated with the utilization of modern contraceptives.ConclusionThe prevalence of modern contraceptive utilization among homeless women was relatively higher than in previous studies. The associated factors for contraceptive utilization included age, education, place for sleeping, income, sexual intercourse and history of pregnancy after joining the street life. The Regional and Adama town Health Bureau and facilities should develop targeted interventions (considering age, educational, and other disparities) to reduce the unmet need for modern contraception and halt unnecessary health outcomes among homeless women, their children, and families.

Alcohol consumption and risky sexual behaviours: consistent patterns in France and South Korea

Abstract Background Despite the concurrent increase in harmful alcohol use and risky sexual behaviours associated with STIs and HIV/AIDS among young adults, their relationship remains inconsistent due to the inherent influence of sociodemographic and cultural factors on drinking and sexual practices. This study aims to examine the relationship between alcohol consumption and risky sexual behaviours and cross-validate this relationship in France and South Korea. Methods We conducted a cross-sectional survey among young adults aged 18 to 30 in France and in South Korea in 2023-2024 (n = 998; 489 in France, 509 in Korea). A spearman partial correlation and a z-test on Fisher-transformed correlation coefficients were used to determine the relationship between alcohol use and risky sexual behaviours, as well as the consistency of this relationship across both samples. Results After controlling for age, gender, occupation, education, and perceived socioeconomic status, a positive correlation was found between the age of alcohol initiation and the age at first sexual intercourse in both samples (r=.17 in France, r=.28 in Korea; p &amp;lt; 0.001). Alcohol Use Disorder Identification Test (AUDIT) score and the frequency of drunkenness showed positive correlations with the number of sexual partners (r=.19, r=.26 in France; r=.19, r=.23 in Korea; p &amp;lt; 0.001). These two alcohol use indicators were also correlated with the frequency of inconsistent condom use (r=.15, r=.12 in France; r=.06, r=.14 in Korea; p &amp;lt; 0.001). The Z test confirmed that there is no significant difference in all correlation coefficients between the French and Korean samples. (p &amp;gt; 0.05, 95% CI). Conclusions An integrated health intervention aimed at simultaneously addressing harmful alcohol use and risky sexual behaviours is warranted to prevent high prevalence of sexually transmitted infections among young adults. Key messages • Recent data support that alcohol use is associated with risky sexual behaviours among young adults. • This relationship is consistent regardless of different sociodemographic and cultural settings.

Early exposure to (hetero)sexism in medical settings: young patients’ experiences with gynaecology

Abstract Background Gynaecology is a highly gendered specialty where gender norms are particularly susceptible to shape patient-provider interactions. Consultations about contraceptive practices, reproductive choices, and sexual activity are fertile settings for the potential confrontation of different sets of gender-related expectations, and the expression of gender-based discrimination, i.e. sexism and heterosexism. We therefore investigated young patients’ first experiences with gynaecological care in Germany with a focus on their experiences of (hetero)sexism. Methods We conducted 15 qualitative interviews with a gender-inclusive sample of patients aged 16-25 who narrated their first consultations and experiences of gynaecological care. We analysed the data thematically. Results Cis-gender heterosexual women composed the majority of the sample; a trans man and two persons who reported being at some point in same-sex relationships were also included. The main reasons for a first consultation were painful periods and contraception. Participants narrated examples of gender-based discrimination, with providers making what was perceived as gender-insensitive, demeaning, or plainly homophobic remarks. Those were particularly present in relation to conversations about the contraceptive pill, with either providers refusing to prescribe it on the account that the patient didn’t have sex or “real sex” (i.e. heterosexual intercourse) or with providers pushing for use of the pill “just in case”, even when patients didn’t need nor want it. Additionally, sexist, unrequited arguments about how the pill could enhance a patient’s breast or skin occurred in several conversations. Conclusions Our study shows clear occurrences of (hetero)sexism on the part of gynaecologists, from demeaning comments to more subtle reminders of sexist gender norms. It highlights the need to implement more patient-centred, gender-sensitive gynaecological practise to support the promotion of respectful care. Key messages • Young patients are exposed to various forms of gender-based discrimination in gynaecological care in Germany, highlighting how entrenched traditional, (hetero)sexist gender norms are among providers. • Promoting more gender-sensitive, respectful care could start with a reflection on consultations around the contraceptive pill, as they often crystallise the manifestation of damaging gender norms.

HIV-1 transmission clusters and drug resistance in men who have sex with men in Portugal

Abstract Introduction In 2022, 45.8% of diagnoses in the EU/EEA with known route of transmission were in Men who have Sex with Men (MSM). We aim to characterise HIV transmission clusters and transmission of drug resistance (TDR), as well as its determinants, using integrated sociodemographic, behavioural, clinical, and viral genomic data of MSMs newly diagnosed in Portugal between 2014 and 2019. Methods This study included data from 340 MSM who were diagnosed with HIV-1 infection. These individuals were newly diagnosed at 17 hospitals in Portugal between September 2014 and December 2019. Phylogenies were constructed and transmission clusters were identified with branch support ≥ 90% and 1.5% genetic distance. Logistic regression models were computed to examine the factors associated with clusters of transmission and with the presence of TDR. Results We identified 38 transmission clusters with 104 MSM, which included 26.6% of the total 305 MSM from our database used for cluster analysis. The overall prevalence of TDR was 8.2%. Only subtype C was significantly associated with TDR. 10.5% of the clusters had at least 1 drug resistance mutation (K103N, L90M or N88S). There was no significant difference in the prevalence of TDR between MSM inside and outside clusters. 50% of the clusters were composed of portuguese native MSM only, whereas 16% had exclusively migrant MSMs. No significant difference was found in the proportion of portuguese and migrant MSM inside and outside clusters. Factors associated with HIV-1 transmission clusters were age at diagnosis, district of residence, unprotected anal or vaginal sex with a woman, HIV testing frequency, presenter status and subtype. 87% of men engaged in sexual activity only with other men, while 13% with both men and women. Conclusions Specific subgroups of MSM are contributing to HIV dissemination in Portugal. Direct and precise prevention measures based on molecular epidemiology should be developed. Key messages • Specific subgroups of MSM are contributing to HIV dissemination in Portugal. • Direct and precise prevention measures based on molecular epidemiology should be developed.

AS COMPLICAÇÕES FUTURAS DO USO INDISCRIMINADO DO LEVONORGESTREL

Introduction: The indiscriminate use of levonorgestrel, an emergency contraceptive, can entail significant risks. Although it is effective in preventing pregnancy after unprotected sexual intercourse. Objective: To highlight the risks of frequent use and the side effects of emergency contraception. Methodology: This is a descriptive research, the method used aims to systematically summarize the results achieved in studies on a specific subject or issue. Through a bibliographic survey, based on the consultation and analysis of digital sources: Google Academy, Revista Ibero-Americana de Humanidades, Ciências e Educação, Brazilian Journal of Development and Scientific Electronic Library Online (SCIELO). Justification: The emergency contraceptive “levonorgestrel” can result in unplanned pregnancy, as well as does not protect against sexually transmitted diseases (STDs), where guidance from a health professional is crucial to select the most appropriate contraceptive method and ensure effective and safe family planning.

EHealth Communication Intervention to Promote Human Papillomavirus Vaccination Among Middle-School Girls: Development and Usability Study.

As the age of initiating sexual intercourse has gradually decreased among South Korean adolescents, earlier vaccination of adolescents for human papillomavirus (HPV) is necessary before their exposure to HPV. Health communication includes "cues to action" that lead to preventive health behaviors, and recently, social networking services, which operate with fewer time and space constraints, have been used in various studies as a form of eHealth communication. This study aims to investigate the feasibility and usability of an eHealth communication intervention for HPV vaccination in middle-school girls aimed at the girls and their mothers. The eHealth communication intervention for HPV vaccination was developed using a 6-step intervention mapping process: needs assessments, setting program outcomes, selection of a theory-based method and practical strategies, development of the intervention, implementation plan, and testing the validity of the intervention. A review of 10 studies identified effective health communication messages, delivery methods, and theories for HPV vaccination among adolescents. Barriers including low knowledge, perceived threat, and the inconvenience of taking 2 doses of the vaccine were identified through focus groups, suggesting a need for youth-friendly and easy-to-understand information for adolescents delivered via mobile phones. The expected outcomes and the performance objectives are specifically tailored to reflect the vaccination intention. Behavior change techniques were applied using trusted sources and a health belief model. Health messages delivered through a KakaoTalk chatbot improved awareness and self-efficacy. Quality control was ensured with the use of a log system. The experts' chatbot usability average score was 80.13 (SD 8.15) and the average score of girls was 84.06 (SD 7.61). Future studies need to verify the effectiveness of health communication strategies in promoting HPV vaccination and the effectiveness of scientific intervention using a chatbot as a delivery method for the intervention.

Female Phalangium opilio use fellatio to compensate sexual avoidance

Sexual conflict arises from differences in reproductive interests between the sexes. We allowed the female harvestman Phalangium opilio to sequentially mate with two different males to examine female sexual receptivity in this species. Virgin females were more sexually receptive than non-virgins. Males exhibited a high interest in repeated copulations with the same female, often engaging in aggressive behaviours such as biting and reversed sexual cannibalism. Fellatio, a behaviour in which females lick the male’s penis, was observed in 44% of trials and was associated with female unwillingness to mate and shorter copulation duration. Fellatio was repeatable, suggesting that it is influenced by individual characteristics or underlying physiological factors. Female lifespan was negatively correlated with the total number of eggs produced, suggesting a trade-off between reproduction and longevity. These findings provide evidence of the appearance of fellatio, a female mating strategy that evolved as compensation of avoiding unwanted sexual intercourse.

Factors associated with risky sexual behaviors among undergraduate students in Thailand

BackgroundRisky sexual behaviors refer to actions or practices that increase the likelihood engaging in sexual intercourse. Such behavior can lead to HIV infection/AIDS, sexually transmitted diseases, and unintended pregnancy. The impact of risky sexual behaviors is a growing public health concern. These issues pose significant challenges to public health, particularly among university students and younger age groups who may be more vulnerable to various factors. Thus, this research aimed to examine the factors and sexual health literacy associated with risky sexual behaviors among undergraduate students in the four major regions of Thailand.MethodA cross-sectional study was conducted among 916 undergraduate students in their final semester of the 2023 academic year, from March to May 2024, at public, autonomous, and private universities across four regions: northern, central, southern, and northeastern of Thailand. The study employed multistage random sampling method. A self-administered structured questionnaire was used to assess risky sexual behaviors and the data were analyzed using multiple logistic regression.ResultsA total of 916 students participated in the study. The prevalence of risky sexual behavior was 46.84% (95% CI:43.56% to 50.12%) students engaged in risky sexual behaviors. Risky sexual behavior was significantly associated with grade point averages (GPA) between 2.00–3.00 could protective risky sexual behaviors was 42% as compared to GPA > 3.00 (AOR = 0.58, 95%CI:0.42 to 0.79), ex-substance use (AOR = 3.48, 95%CI:1.46 to 8.26), Current smoker (AOR = 2.90, 95%CI:1.90 to 4.43), negative attitudes toward risky sexual behaviors (AOR = 2.32, 95%CI:1.32 to 4.06), access to places of ill repute and access to sexual arousal stimuli (sometime) (AOR = 2.23, 95%CI:1.41 to 3.52), social influences (high level) (AOR = 0.29, 95%CI:0.15 to 0.55), and sufficient to excellent level of the application of information about sexual health (AOR = 0.48, 95%CI:0.26 to 0.87) of statistical significance at P < 0.05, which was significantly associated with risky sexual behavior.ConclusionThe findings of this study offer important insights for preventing risky sexual behaviors among undergraduate students across four regions. By promoting healthy sexual practices and encouraging behavior modification, negative consequences can be reduced. Public health care providers, policymakers, and stakeholders should implement tailored strategies, such as comprehensive sexual education and accessible health services, to address the specific needs of these students. These targeted interventions can significantly reduce the prevalence of risky sexual behaviors.

Legislating Virginity: The Law and Ethics of Hymenoplasty and Virginity Testing

According to Merriam Webster, the definition of a ‘virgin’ is someone who has never participated in sexual intercourse. This definition revolves around heterosexual relationships and the assumption that the intercourse will involve a person with a penis and another with a vagina. However, what one considers sexual intercourse can vary from person to person (for example, whether oral sex is included) and the definition incurs greater difficulty when linked to anatomy, specifically the hymen. The hymen is a thin membrane of skin near the opening of the vagina, which consists of leftover fragments of tissue formed during foetal development, found only in female mammals. The presence of the hymen still holds significant importance in most religions as it is believed to determine a woman’s ‘purity’ and ability to marry, an essential factor for their position within their community, due to the commodification of female virginity. Consequently, women often face violence when they are accused of not being a virgin, or are found to have a hymen which is not intact. Due to the gender binary being imposed by the concept of virginity, this essay assumes that most people with hymens identify as women, whilst still acknowledging that trans*, non-binary and intersex people can also share this anatomical feature. This essay will discuss the cultural practices that encourage virginity testing and hymenoplasty, followed by an analysis of potential harm-reduction solutions with reference to the historical and religious background which places virginity as a gendered concept. Whether the measures put in place by the Health and Care Act 2022 are sufficient in preventing the violence against women which stems from practices surrounding virginity will be discussed in the context of the practical realities of virginity testing. This idea will be explored within the framework of the UK’s legal system with reference to other European jurisdictions for context.

Does a Tuberculosis Peritonitis Imitate an Advanced Ovarian Cancer?: A Case Report at Iringa Regional Referral Hospital in Tanzania

Tuberculosis (TB) Peritonitis is unexpected tuberculosis that happens in less than 2% of the patients worldwide. The incident rates are higher in the developing countries as a result of the inadequate diagnostic equipment. The mimicking of the tuberculosis peritonitis with an advanced ovarian cancer affects the decision of the gynecologist even after coming up with the confirmatory investigation of image findings. A 34-year-old female presented with progressive abdominal distension for 2 months, discomfort, abnormal vaginal discharge, which was foul smell and yellowish in color, painful sex intercourse, and denied history of diarrhea or constipation. Furthermore, present the history of passing black stool, but she denied history of vomiting blood or epigastric pain. A pelvic scan revealed the adnexal masses and ascites, with a conclusion of advanced ovarian cancer. A laparotomy was done; total abdominal hysterectomy and bilateral salpingoophorectomy were done. A specimen sent for histopathology, which revealed tuberculosis peritonitis and not ovarian cancer. A patient was administered anti-tuberculosis drugs, and on follow-up, the patient showed an improvement. Therefore, in this case, the gynecologist should think of tuberculosis peritonitis as a differential diagnosis of advanced ovarian cancer, and this can be confirmed by the laparoscope and histopathology of the specimen hence preventing unnecessary total abdominal hysterectomy.  Implication for policy makers: The diagnostic tools in the health care facilities should be readily accessible and available for such rare cases hence more on job training to equip the gynecologists with updated knowledge and skills.  Implication for public: The public health should be emphasized in the community by offering health promotion, encouraging screening, and prevention of diseases so as to prevent the consequences which affects the life of an individual.

Age at first sex and other determinants of multiple sexual partnerships among sexually active adolescent girls in Ghana: a regression analysis of the 2022 Ghana demographic and health survey

BackgroundEarly sexual debut is a widely recognized public health issue due to its influence on lifetime multiple sexual partners which can lead to complications such as teenage pregnancy, abortion, HIV/AIDS and other sexually transmitted infections. However, there is paucity of research evidence on sexual behaviour such as age at first sexual intercourse and the number of sexual partnerships among adolescent girls in Ghana. This study aims to examine the influence of age at first sexual intercourse and other determinants on multiple sexual partnerships among adolescent girls aged 15–19 years in Ghana.MethodsData for this study were obtained from the 2022 Ghana Demographic and Health Survey (GDHS) conducted between October 17, 2022 and January 14, 2023. A total weighted sample of 719 sexually active adolescent girls who reported having sexual partners was extracted from the women’s data file. Data were analyzed with SPSS version 27, employing multilevel logistics regression modelling. Statistical significance was set at p < 0.05.ResultsThe average age at sexual debut for adolescent girls aged 15–19 years in Ghana is 15.5 years. A little over half (51.6%) of adolescent girls reported having two or more lifetime sexual partners. Adolescent girls who initiated sex before reaching age 15 were more likely (aOR = 2.00; C.I 1.39–2.87) to have multiple partners compared to those who had their first sex before attaining age 20. After controlling for other factors, girls who had their sexual debut before age 15 had higher odds (aOR = 1.85; C.I:1.30–3.31) of engaging in multiple sexual partnerships. Girls living female headed households (aOR = 2.25; C.I:1.18–4.29] and consuming alcohol (aOR = 2.38; C.I 2.38–1.09–5.17) had higher odds of having multiple sexual partners.ConclusionThe study findings show that early sexual debut, living in female headed household, and consuming alcohol are strong predictors of multiple sexual partnerships among adolescent girls in Ghana. It suggests the need for policies promoting delayed sexual debut and empowering adolescents to make informed decisions to improve sexual health outcomes.

What is new on peri- and postmenopause?

Menopause is an increasingly discussed topic in recent years. More women are demanding consultancy and help from their doctors via different channels, be it online or in menopause centers.The term genitourinary syndrome of menopause (GSM) comprises vaginal and urological symptoms such as mucosal dryness, itching and burning, dysuria or bleeding and pain during sexual intercourse. GSM can strongly affect quality of life, is common if estrogen deficiency has lasted for 3 months and can be treated locally with very low doses of the weak estrogen estriol."Not feeling like myself anymore" - symptomatic perimenopause may present with sleep disturbances, mastalgia, mood swings, palpitations, panic attacks, but also entail joint pain, vertigo, headache, and brain fog - even years before menopause and in the presence of still adequate estrogen levels. In an online study, 20% of women in the menopausal transition reported symptoms which they could not explain, and which may cause fears of serious illness. This can lead to extensive medical work-ups if the possibility of perimenopause as the cause is disregarded.(Peri-)menopausal complaints last much longer than previously thought: The Study of women's health across the nation (SWAN) reported longer duration of vasomotor symptoms (median: 11,8 years) in women who were already affected in early perimenopause, while those in whom VMS started only after menopause experienced a shorter duration of symptoms (median: 3,4 years).Female hormones protect women from fatty streaks and hypertension, but menopausal hormone therapy (MHT) has positive effects only if started in the first decade after menopause. The interaction with stress, aging and lifestyle factors is complex.For the treatment of VMS, German and international guidelines list both drug and non-drug or non-prescription options, although there is no clear data on their effectiveness.Fezolinetant, a Neurokinin-3 receptor antagonist, is now available in Germany for the treatment of vasomotor symptoms in postmenopausal women with contraindications or aversion against steroid hormones. It modulates the thermoregulation center in the hypothalamus by blocking the KNDy-neurons. Studies on Elinzanetant, another representative of this class of drugs, are still ongoing.

Prospective Multicenter Comprehensive Survey on Male Sexual Dysfunction following Laparoscopic, Robotic, and Transanal Approaches for Rectal Cancer (the LANDMARC Study).

To investigate the incidence of male sexual dysfunction (SD) including erectile dysfunction (ErD) and ejaculatory dysfunction (EjD) after minimally invasive rectal cancer surgery. Male SD significantly affects post-rectal cancer surgery quality of life (QOL). Current assessments using the International Index of Erectile Function-5 are unsuitable for patients with reduced postoperative sexual activity, because it assumes sexual intercourse. This study addresses this gap using the Erection Hardness Score (EHS) and custom ejaculatory questionnaires. This prospective multicenter open-label phase II trial enrolled 399 patients who underwent laparoscopic (Lap), robotic (Ro), or transanal (Ta) rectal cancer surgery. EHS and custom ejaculatory questionnaires assessed ErD, EjD, and potency impairment at 3, 6, and 12 months postoperatively. The rates were assessed in the full analysis set and compared between the Lap and Ro groups after propensity score matching. At 12 months, the overall incidences of ErD and EjD were 34.7% and 29.8%, respectively. The Ro group showed a significantly lower EjD rate (25.0%) than the Lap group (40.9%), with no significant difference in ErD. Potency impairment was lower in the Ro group at 6 months (32.7% vs. 22.3%) and 12 months (29.0% vs. 17.8%) postoperatively. The Ta group showed relatively high ErD and EjD at 3 months, with some recovery at 12 months. Minimally invasive rectal cancer surgery commonly results in ErD, EjD, and potency impairment. Robotic surgery provides lower EjD rates and less potency impairment. Comprehensive sexual function assessments are essential to inform patients and improve QOL outcomes.

Issue of recreational use of sildenafil

Introduction and purposeErectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. Sildenafil is one of the most popular medications used to treat ED, but in recent years, there has been a growing trend of recreational use of this drug, particularly among younger individuals, which can lead to numerous negative health consequences. The aim of this article is to provide an overview of the recreational use of sildenafil, especially among younger individuals.State of knowledgeSildenafil primarily affects the smooth muscle of the blood vessels in the corpora cavernosa, facilitating the achievement and maintenance of an erection. The most common side effects of sildenafil include headaches, dizziness, facial flushing, nausea, muscle pain, and nasal congestion. A relatively rare but potentially severe side effect of sildenafil is priapism. It is noted that those using sildenafil recreationally often have multiple sexual partners, as the drug helps them prolong sexual encounters. Studies show that sildenafil is used by groups that should have no problem achieving sexual satisfaction. The use of the drug in combination with alcohol and other substances is noticeable.ConclusionsRecreational use of sildenafil appears to be an increasingly common behavior among young men who do not have difficulties achieving or maintaining an erection. There are no studies yet that specifically examine the recreational use of sildenafil among women. It is necessary to conduct further research to better understand the prevalence of this phenomenon and to identify the factors that predispose individuals to engage in recreational use of sildenafil.