Marjan Khajehei

A Comparison of Sexual Outcomes in Primiparous Women Experiencing Vaginal and Caesarean Births

Background and Objective: We conducted this study to evaluate and compare postpartum sexual functioning after vaginal and caesarean births. Materials and Methods: This was a cross-sectional study that was carried out in postnatal health care in a hospital. A total of 50 primiprous women who had given birth 6-12 months ago and came to the hospital for postnatal care were asked to join the study. Forty of the women completed the entire questionnaire. Among these women, 20 delivered spontaneously with mediolateral episiotomy and 20 had elective caesarean section. Sexual function was evaluated by a validated, self-created questionnaire. A statistical evaluation was carried out by SPSS v.11. A two-part self-created validated questionnaire for data collection was administered regarding sexual function prior to pregnancy and 6-12 months postpartum. Results: The median time to restart intercourse in the normal vaginal delivery with episiotomy (NVD/epi) group was 40 days and in the caesarean section (C/S) group was 10 days postpartum. The most common problems in the NVD/epi group was decreased libido (80%), sexual dissatisfaction (65%), and vaginal looseness (55%). In the C/S group, the most common problems were vaginal dryness (85%), sexual dissatisfaction (60%), and decreased libido (35%). There were clinically significant differences between the two groups regarding sexual outcomes, but these differences were not statically significant. Conclusion: Postnatal sexual problems were very common after both NVD/epi and C/S. Because sexual problems are so prevalent during the postpartum period, clinicians should draw more attention to the womens sexual life and try to improve their quality of life after delivery.

Effect of treatment with dydrogesterone or calcium plus vitamin D on the severity of premenstrual syndrome.

To compare the effects of dydrogesterone and calcium plus vitamin D in women with severe premenstrual syndrome (PMS).

Effect of St John's wort on severity, frequency, and duration of hot flashes in premenopausal, perimenopausal and postmenopausal women: a randomized, double-blind, placebo-controlled study

Objective: Because of a decline in estradiol levels, premenopausal, perimenopausal, and postmenopausal women experience symptoms related to vasomotor instability. Certain plants have been found to have molecular components that are identical in structure and function to human hormones. We conducted this study to compare the efficacy of St Johns wort with that of placebo in women with hot flashes. Methods: A total of 100 women participated in a clinical trial conducted in an academic medical center in Shiraz-Iran. Women were treated with St Johns wort extract or placebo for 8 weeks. Climacteric complaints were evaluated by using the Blatt-Kupperman Index at two follow-up visits. Statistical analysis was carried out by using descriptive statistics and multivariate analysis. Results: The mean age of the participants was 50.4 years. Both groups responded to the interventions, and the within-group differences in frequency, duration, and severity of hot flashes were statistically significant (P < 0.05). The difference in duration of hot flashes between groups was not significant on the 4th week of intervention (P = 0.27); however, it was statistically significant between the two groups on the 8th week of treatment (P < 0.001). The fall-off in frequency of hot flashes on the 4th and 8th weeks of intervention was more evident in women receiving St Johns wort, and the differences between groups were statistically significant (P = 0.005 and P < 0.001, respectively). Furthermore, comparing both study groups, we showed that the decrease in the severity of flashes in women who received St Johns wort was more evident on the 4th and 8th weeks (P = 0.004 and P < 0.001, respectively). Conclusions: St Johns wort can be used as an effective treatment for the vasomotor symptoms of perimenopausal or postmenopausal women.

Effect of acupressure at the Sanyinjiao point on primary dysmenorrhea: a randomized controlled trial.

OBJECTIVE We conducted this study to assess the effect of acupressure at the Sanyinjiao point on primary dysmenorrhea. METHODS Eighty-six students participated in the study. All participants met the inclusion criteria. The study group received acupressure at Sanyinjiao point, while the control received sham acupressure. The severity of dysmenorrhea was assessed at the following time periods: prior to the intervention, 30 min, 1, 2 and 3h following the intervention. Data were analyzed using SPSS. RESULTS The acupressure caused decline in the severity of dysmenorrhea immediately after intervention in both groups during their first menstrual cycle, although, there difference was not significant (p>0.05). In addition, during the same cycle, the severity of the dysmenorrhea decreased more in study group rather than control group at 30 min, 1, 2 and 3h after intervention (p<0.05). During the second menstrual cycle, acupressure made dysmenorrhea reduced in both study and control groups; however, the decline was more salient among participants of the study group at all stages after the intervention (p<0.05). CONCLUSIONS Acupressure at Sanyinjiao point can be an effective, feasible, cost-effective intervention for improving primary dysmenorrhea.

Prevalence and Risk Factors of Sexual Dysfunction in Postpartum Australian Women

INTRODUCTION Female sexual dysfunction is highly prevalent and reportedly has adverse impacts on quality of life. Although it is prevalent after childbirth, women rarely seek advice or treatment from health care professionals. AIM The aim of this study was to assess the sexual functioning of Australian women during the first year after childbirth. METHODS Postpartum women who had given birth during the previous 12 months were invited to participate in this cross-sectional study. A multidimensional online questionnaire was designed for this study. This questionnaire included a background section, the Female Sexual Function Index, the Patient Health Questionnaire (PHQ-8), and the Relationship Assessment Scale. Responses from 325 women were analyzed. RESULTS Almost two-thirds of women (64.3%) reported that they had experienced sexual dysfunction during the first year after childbirth, and almost three-quarters reported they experienced sexual dissatisfaction (70.5 %). The most prevalent types of sexual dysfunction reported by the affected women were sexual desire disorder (81.2%), orgasmic problems (53.5%), and sexual arousal disorder (52.3%). The following were significant risk factors for sexual dysfunction: fortnightly or less frequent sexual activity, not being the initiator of sexual activity with a partner, late resumption of postnatal sexual activity (at 9 or more weeks), the first 5 months after childbirth, primiparity, depression, and relationship dissatisfaction. CONCLUSION Sexual satisfaction is important for maintaining quality of life for postpartum women. Health care providers and postpartum women need to be encouraged to include sexual problems in their discussions.

The effect of education and awareness on the quality-of-life in postmenopausal women.

Objectives: Women are one of the most important parts of the family and society, and community health is dependent on provision of the needs of this group. Menopause is one of the most critical stages of life among women. One of the aims of health services for all of the people in the 21st century is improvement of the quality-of-life. In menopausal women, the term quality-of-life incorporates its physical symptoms such as hot flushes, night sweats and vaginal mucosa dryness. We set out this study in order to evaluate the effect of education on the quality-of-life and the improvement of health standards in menopausal women. Materials and Methods: Sixty-two women aged 44–55 referring to and academic outpatient clinic in Shiraz were selected by simple random sampling, and allocated in two groups. Data was collected using a modified Hildich questionnaire on quality-of-life in menopause stage. Quality-of-life of the subjects (vasomotor, psychosocial, physical and sexual aspects) were evaluated prior to and 3 months after educational intervention. Results: Mean quality-of-life score in study and control groups, prior to education, was 81.7 and 74.8; changing to 75.3 and 75.8, respectively three months after intervention. The study group showed a significant improvement in their quality-of-life (P = 0.001). A significant difference was seen between groups in terms of changing quality-of-life after intervention (P = 0.001). Conclusions: Appropriate training to menopausal women improves their quality-of-life and promotes their health.

An update on sexual function and dysfunction in women

Sexual function of women can be affected by many factors resulting in female sexual dysfunction (FSD). Sexual dysfunction is a common problem among women of all ages and has negative effects not only on their quality of lives but also on the sexual function and quality of life of their partners. It can also affect mental health of the entire family and society. Regarding the multidimensional nature of female sexual dysfunction and considering its consequences, this condition needs to be recognised in its early stages in order to prevent future consequences and impacts. This article discusses biopsychosocial aspect of female sexual function, classifications and risk factors of female sexual dysfunction and investigates current approaches to identify and treat this problem.

Comparison of the Effect of Ginger and Zinc Sulfate on Primary Dysmenorrhea: A Placebo-Controlled Randomized Trial

Primary dysmenorrhea is common among young women and results in their incapacitation; it can be accompanied by various symptoms that can disrupt their lives. The aim of this randomized trial was to compare the effect of ginger, zinc sulfate, and placebo on the severity of primary dysmenorrhea in young women. One hundred and fifty high school students were recruited. The participants were divided into three groups. The first group received ginger capsules, the second group received zinc sulfate capsules, and the third group received placebo capsules. All participants took the medications for four days, from the day before the commencement of menstruation to the third day of their menstrual bleeding. The severity of dysmenorrhea was assessed every 24 hours by the pain visual analog scale. The severity of pain was significantly different between, before, and after the intervention in both the ginger and the zinc sulfate groups (p < .001). Compared with the placebo receiving group, participants receiving ginger and zinc sulfate reported more alleviation of pain during the intervention (p < .05). Ginger and zinc sulfate had similar positive effects on the improvement of primary dysmenorrheal pain in young women.

Effect of Ginger (Zingiber officinale) on Heavy Menstrual Bleeding: A Placebo‐Controlled, Randomized Clinical Trial

Objective: A wide range of herbal plants have been reported to treat various gynecological problems of women. This study was set out to investigate the effect of ginger (Zingiber officinale) on heavy menstrual bleeding (HMB) in high school girls. Methods: Ninety‐two young women who experienced HMB and met the inclusion criteria were recruited in this study. Participants were evaluated for six consecutive menstrual cycles. During 3 assessment cycles, their HMB was confirmed by Pictorial Blood Assessment Chart. They were then randomly allocated to two study groups to receive either ginger or placebo capsules. The participants filled in the same chart during three intervention cycles. Results: The level of menstrual blood loss dramatically declined during the three intervention cycles in ginger‐receiving group. The decrease of blood loss in ginger‐receiving group was significantly more remarkable than that of participants receiving placebo (p < 0.001). Minimum number of participants reported adverse effects. Conclusion: HMB is highly prevalent among young women. Considering the significance of appropriate and timely treatment and also the importance of prevention of unwanted consequences, ginger may be considered as an effective therapeutic option for HMB. Copyright

The Efficacy of Acupressure at the Sanyinjiao Point in the Improvement of Women's General Health

OBJECTIVES This studys objective was to examine the effectiveness of Sanyinjiao point (SP6) acupressure on womens general health. DESIGN This was a randomized, single-blind clinical trial. SETTING The setting for this trial was at Medical University, Bojnoord University of Medical Science, Bojnoord, Iran. MATERIALS AND METHODS Eighty-six (86) university students were recruited for this study. Their demographic characteristics were gathered before the intervention commenced. Participants completed General Health Questionnaires (GHQ) prior to participation. Next, they were randomly assigned to either the acupressure-receiving group or the sham-pressure-receiving group. The study group received acupressure at the Sanyinjiao point, while the control group received sham pressure. OUTCOME MEASURES Both groups completed GHQ after both the first and second months of intervention. Data analysis was carried out using SPSS version 13.5 for Windows. RESULTS The mean age of those who completed the study was 20.84±1.64 years. Mean scores of GHQs were similar between groups before intervention (p>0.05). The general health of participants in both groups improved after intervention, and the amelioration in four domains was significant in the groups (p<0.05 within group). It was found that acupressure was more effective than sham pressure. In addition, there was a statistically significant difference between the two groups in the four domains of their general heath after the first month of the intervention (p<0.0001). Furthermore, the general health status of the participants changed much more after the second month in both the acupressure intervention and the sham pressure groups; nevertheless, acupressure was more effective than sham pressure (p<0.05). CONCLUSIONS Both acupressure and sham pressure were effective in promoting womens general health; nevertheless, the efficacy of acupressure was more than that of sham pressure. SP6 acupressure could be regarded as a self-manageable approach to improve womens general health.