International Journal of Women’s Health and Reproduction Sciences
Volume:7 Issue: 1, Winter 2019

  Sexual life may change during pregnancy. Due to negative attitudes toward having sex, unpleasant feeling, and fear of several issues, women might avoid vaginal intercourse during pregnancy. Therefore, the present systematic review aimed to investigate the frequency of vaginal intercourse in pregnancy. Comprehensive literature review was conducted to find the relevant articles published (from December 1990 to April 2018) on the issue including observational studies (e.g., cross-sectional and cohort studies) that certainly determined the mean frequency of vaginal sex throughout pregnancy. In this regard, online international databases such as ISI, PubMed, Scopus, Cochrane, and Google Scholar were independently explored and checked by two authors. Duplicate articles were removed by the EndNote X7 Reference Manager. The results were analyzed using RevMan 5.3 software. The P < 0.05 was considered significant. Totally, after excluding the duplicate and irrelevant articles based on having the mean frequency of vaginal intercourse during pregnancy, 13 articles were obtained. The range of vaginal intercourse frequency varied from 6.01 to 21 times every month pre-pregnancy, 3.67-9.87 times monthly in the first trimester, 2.78-7.21 times monthly in the second trimester, and 1.35-5.9 times monthly in the third trimester. Five out of the 13 selected articles reporting the mean and standard deviation were entered the current meta-analysis. The frequency of vaginal intercourse was obtained 7.75 (7.13-8.38) times monthly prior to pregnancy, 4.16 (3.86-4.46) times in the first trimester, 6.37 (5.60-7.14) times monthly in the second trimester, and 1.81 (1.49-2.13) times monthly in the third trimester. Generally, the frequency of vaginal intercourse decreased in the first trimester while increasing in the second trimester. However, a sharp decline was observed between the second and third trimesters of pregnancy.

  The present study aimed to investigate the effect of squat exercises with weight shift on muscle strength and postural control during pregnancy. The squat group comprised 21 pregnant women in their 20s and 30s with no exercise habits while the control group consisted of 20 randomly selected pregnant women in their 20s and 30s with no exercise habits. The squat group was instructed to perform two sets of daily squat exercises with weight shift in the anterior, posterior, right, and left directions, with 10 repetitions counted as one set, for 10 weeks. The stabilometer was used to measure postural control ability in the second and third trimesters. Meanwhile, muscular strength was taken as the toe grip force and quadriceps muscle strength before and after the intervention. In the squat group, significant increases were observed in the index of postural stability and the stability area. Conversely, however, significant decreases were detected in the average rectangular area. In addition, in the intervention group, significant declines were observed in the rectangular area in the posterior, right, and left directions. However, a considerable increase in muscular strength was only seen after the intervention in toe grip force. Based on the results, it was concluded that everyday squat exercises which were performed during pregnancy improved postural control. The improvement of postural control during squat movements was thought to have a greater impact on plantar sensation than on muscle strength. These findings suggest that squat exercises with weight shift may promote fall prevention.

  The purpose of the current work is to evaluate D-dimer plasma level among both normal and complicated pregnancies such as gestational diabetes (GD) and hypertension (GH) among Saudi females. It is also focused on exhibiting any possible factors that could also play a role in rising D-dimer levels besides the age of the pregnant woman and the period of gestation. A semi-quantitative latex agglutination assay was performed in the blood sample of healthy non-pregnant, pregnant and pregnant females with GD and GH. The results exhibited that 92% of pregnancies with GH and 90% of multiple pregnancies had high D-dimer levels. The analysis of the effect of age of pregnant women on D-dimer concentrations presented that 100% of pregnant women with GD, GH or multiple pregnancies aged above 40, had high levels of D-dimer. The results of the relationship between gestational age of pregnancies and D-dimer showed that by reaching the third trimester, about 66.6% of women who had multiple pregnancies had D-dimer concentration above 2000 ng/mL. Interestingly, all the pregnant females with GH had D-dimer concentrations above 2000 ng/mL. This study postulated that the concentrations of D-dimer significantly increase during pregnancy associated with common complications such as GD and GH. It is the first study to demonstrate the possible risk factors during pregnancy, which include age, number of pregnancies, gestational age and pregnancies with GD and GH, especially among Saudi Arabian women.

  Vitamin D deficiency is a controversial issue in pregnant women. The 1,25 dihydroxyvitamin D3 level is higher in pregnant than non-pregnant women. This study aimed to investigate the 1,25 di-hydroxyvitamin D3 status in vitamin D deficient pregnant women at the first trimester. This study was conducted during December 2011 and April 2012 in 2 hospitals of Istanbul, Turkey. Pregnant women who attended for the regular examination on the 12th gestational week were randomly assigned. They were divided into 2 groups including vitamin D deficient (vitamin D <30 ng/mL) and vitamin D optimal (vitamin D ≥30 ng/mL). Serum 25 hydroxyvitamin D3, 1,25 dihydroxyvitamin D3, fibroblast growth factor 23, calcium, phosphate, urinary calcium, and urinary phosphorus levels were measured. After exclusion of fourteen pregnant women due to inconvenient serum samples, the mean serum 25 hydroxyvitamin D3 level of one hundred sixty outpatient pregnant women was 10.8 ± 16.2 ng/mL. Totally, 132 (85.0%) of these women were vitamin D deficient (25 hy-droxyvitamin D3 level less than 30 ng/mL). Serum 1,25 dihydroxyvitamin D3 and urinary calcium levels were higher in vitamin D deficient than vitamin D optimal group. Even under severe vitamin D deficiency, the 1,25 dihydroxyvitamin D3 level was high in pregnant women. Active vitamin D status was not compatible with the 25 hydroxyvitamin D3 level in vitamin D deficient pregnant women at the first trimester.

  This study aimed to analyze the determinants of hospitalization and death in an intensive care unit (ICU) between pregnant and postpartum women. This is a quantitative and retrospective documentary research performed at Dr. César Cals Hospital. Data was collected through the analysis of charts obtained from puerperal or pregnant women admitted to the ICU. Regarding the type of delivery, 41 (73.2%) women had a cesarean section (CS) and, considering the outcome, the majority of the patients (51%) were discharged from the hospi-tal. Comparing the admission diagnosis and the outcome, it was revealed that many patients presented more than one diagnosis at the admission, the highest rate of which was the hyper-tensive disorders of pregnancy (HDP) and complications comprising of 23 (38.3%) patients out of which 4 of them died. Sepsis was the second cause of hospitalization including 17 (28.3%) patients. In addition, 11 (18.3%) patients had hemorrhaged. Moreover, there were 2 death reports related to fulminant hepatitis. It is expected that the results of the present study contribute to the extension of the professionals’ knowledge on the subject, collaborating to prevent hospitalization and death of these patients.

This study aimed to observe the difference in the area of endometriosis lesions and the histopathology of inflammatory cells and granuloma masses in an endometriosis mouse model treated with endometrial cell implants, endometrioma capsules, and adenomyosis tissue. This is an experimental study with posttest-only research design which was conducted with the control group. Thirty-two mice (Mus musculus) were injected with 0.2 mL/mice cyclosporin A and then were divided into three groups which were injected with endometrial tissue from the uterine cavity (group A), endometriosis from endometrioma capsule (group B), and endometriosis from adenomyosis (group C). The injection was done slowly into the peritoneal cavity, 0.1 mL each, and followed by intramuscularly Ethinyl estradiol, 0.2 μG/mice. On the 15th days, mice were dissected to observe the peritoneal endometriosis implant and microscopic examination with hematoxylin-eosin (HE) staining to determine the inflammatory cell infiltration and mass granuloma presence. Data were analyzed using SPSS, version 19. The study obtained that the area of implanted endometriosis lesions in group C covered a larger area of endometriosis implants than other groups (P < 0.05). The peritoneal damage in group C was the most severe based on the Klopfleisch method (P < 0.05), with mass granuloma and massive infiltration of inflammatory cells and fibrous connective tissue formation occurring in muscle tissue. The implantation of adenomyosis cell tissue is the best method to develop mice model of endometriosis based on its inflammatory infiltration, the extent of lesion implant, and granuloma mass

  The present study aimed at finding the effect of menopausal transition, exercise, smoking, and obesity on menopausal transition. In addition, the impact of menopausal transition on women’s quality of life was investigated. This cross-sectional study was conducted at family medicine clinics of Jordan University Hospital (JUH). Totally, 359 women whose age varied from 45 to 65 years old were included, Variables including sociodemographic, smoking exercise and obesity, menopause status and its symptoms, and quality of life were assessed by self-administered and validated questionnaire. Data were analyzed using SPSS, version 16. The mean age at the menopause was 49.4 years. More than 38% of the participants practiced no or irregular exercise and slightly more than 92% had abnormal body mass index (BMI) of ≥25 kg/m2. Besides, women who practiced no or irregular exercise were significantly more likely to experience irritability, be mentally and physically exhausted, report sexual problems, and muscles and joint discomfort (P value of < 0.05). In addition, women with an abnormal waist to hip ratio were statistically at an increased risk of experiencing sexual problems. Based on the results, it can be concluded that normal body weight and regular and effective exercise were the key factors in alleviating menopausal symptoms during the menopausal transition, especially the psychological or mental symptoms and muscle and joint discomfort. Meanwhile, women in the midlife stage are recommended to be counseled about menopausal transition and its effect on mental and physical health. Moreover, they should be encouraged to maintain effective levels of exercise and to optimize their body weight whenever possible.

Polycystic ovary syndrome (PCOS) is considered as one of the causes of infertility. Anti-Mullerian hormone (AMH) is 2-3 times higher in patients with the PCOS compared to others. The present study aimed to survey the association between basal AMH levels and ovarian response in infertile PCOS patients. In this cross-sectional study, 70 infertile PCOS women were enrolled referring to Milad Infertility Center (Mashhad, Iran) from May 2011 to April 2012. The basal blood level of AMH was evaluated. The patients received 5 mg of letrozole from the fifth cycle day (for 5 days) and then received 150 units of gonal F in the form of the recombinant follicle-stimulating hormone (FSH) on the ninth day of the cycle. Five thousand units of human chorionic gonadotropin (hCG) were prescribed for the patients who had one follicle of ≥ 18mm. Then, they should have had intercourse 36 hours later. After ovulation induction (OI) on the 10th cycle day, the second serum sample of AMH was taken. Changes of AMH did not have a significant relationship with the ovarian response, namely, it was lower in patients with positive ovarian response compared to those without any ovarian response. In addition, the basal level of AMH in patients with a positive response (3.91 ± 2.14) had no significant difference with the secondary AMH (3.27 ± 2.39) after the OI (P = 0.19). Generally, the AMH was not a predictor of ovarian response in PCOS patients and the amount of AMH reduced after the treatment. This effect was maybe related to letrozole and gonadotropin.

  Evidence indicates that regular physical activity has positive effects on the mother’s health and outcomes of pregnancy. The measurement of physical activity during pregnancy is required for planning and developing health-related interventions. The aim of this study was to evaluate the psychometric properties of the Persian version of the pregnancy physical activity questionnaire. This cross-sectional methodological study was conducted with a sample of 200 pregnant women living in Tabriz. Women with low-risk singleton pregnancies in the age range of 20-40 years were included in the study. Sampling was carried out using a multistage sampling method in healthcare centers. Exploratory factor analysis (principal component analysis with varimax rotation), multivariate analysis of variance and Pearson correlation were used for data analysis. Reliability and internal consistency of the questionnaire were assessed using a test-retest method with a 2-week interval and Cronbach’s alpha coefficient, respectively. A five-factor model was developed: ‘vulnerable people’, ‘activities related to work’, ‘home’, ‘sports’ and ‘activities related to leisure time’. They accounted for 43.32% of the observed variance. The Cronbach’s alpha coefficients of the entire instrument and domains were 0.879 and 0.83-0.93, respectively. The Intra-class correlation coefficient (ICC) was equal to 0.857 (CI95% = 0.75-0.93) indicating proper stability of the questionnaire over time. The Persian version of the pregnancy physical activity questionnaire is a valid and reliable tool for examining the risk of physical activities among Iranian pregnant women.

Evidence suggests that oxidative stress (OS) plays a prominent role in the pathophysiology of pregnancy complications in women. The present study was conducted to determine the levels of OS markers in early pregnancy loss and to compare the results with those in healthy pregnant women. A total of 32 women with early pregnancy loss and 32 healthy women in the first trimester of pregnancy, with similar demographic characteristics entered this study as the cases and controls. Serum levels of malondialdehyde (MDA), total antioxidant capacity (TAC), uric acid, and bilirubin levels were determined in both groups. The data obtained were then analyzed and compared between the groups using the independent samples t test and Mann-Whitney U test. The 2 groups matched in terms of personal-demographic characteristics including mother’s age, father’s age, gravidity, and body mass index (BMI). MDA levels increased significantly in the women with spontaneous abortion compared to the healthy pregnant women (4.35±1.47 vs. 3.42±1.68 µM/L; P = 0.026) and TAC decreased significantly in the cases compared to the healthy controls (552.34±212.79 vs. 1003.23±1168.68 U/mL; P = 0.040). Uric acid and bilirubin levels did not differ between the groups. The results of this study provides further evidence on the effect of increased OS on the incidence of early spontaneous abortion in the first trimester of pregnancy. High serum MDA levels and low TAC during pregnancy were 2 risk factors for spontaneous abortion. The present findings support the hypothesis that OS plays a key role in the etiopathogenesis of spontaneous abortion. Further studies are required for assessing the preventive role of antioxidant therapy in this complication.

  Vitamin D is important for the muscular tone and bone metabolism. Due to the high prevalence of vitamin D deficiency in Iranian women, this study aimed to investigate the difference in vitamin D levels between patients with and without pelvic floor disorder (PFD) to assess the possible effect of vitamin D on PFD. The present case-control study examined 209 women referring to Ayatollah Rouhani hospital of Babol in 2017. Patients were explored for prolapse and those with at least one disorder or without PFD were categorized as the case (n = 104) or control (n = 105) groups, respectively. Then, the serum level of 25-hydroxy vitamin D was compared between the groups. The mean age and abdominal circumference of the patients were significantly higher in the case group (P < 0.001 & P = 0.046, respectively) as compared to the control group. Meanwhile, the total mean ± SD serum level of vitamin D was 20.03±17.88 ng/mL and significantly higher in the case group (24.58 ± 20.75 ng/mL) than that of the control group (15.53±13.11 ng/mL), especially in patients with stress and urgency urinary incontinence (SIU/UIU) (both with a significance level of P < 0.001). As a result of PFD, the group with UI, especially the one with SIU or UIU had the highest vitamin D level compared to the control and other groups. Nonetheless, the mean age and educational level were significantly higher and lower in this group, respectively. These results could be due to the multifactorial nature of vitamin D level, that is, it varies based on nutrition, place of residence, and other factors.

  Recent guidelines of the World Health Organization (WHO) indicated administering tranexamic acid (TXA) in order to treat postpartum hemorrhage (PPH). Therefore, finding low-cost and low-risk alternative methods to control obstetric hemorrhage is of great importance. The present study aimed to evaluate the prophylactic effect of TXA on hemorrhage during and after the cesarean section (CS). In addition, it was attempted to explore the impact of TXA as a safe and inexpensive method for decreasing bleeding during and after CS so that to decrease the hazard of blood transfusion or hysterectomy in these patients. This randomized double-blind control trial was performed on 60 women who underwent CS using spinal anesthesia. These women were randomly assigned to two groups. The experimental group received 1 g of TXA 15 minutes before the incision while the control group received dextrose 5% in water as a placebo. The amount of bleeding was measured during and after the surgery. Data were entered into SPSS software version 21 and reported by descriptive statistics and analyzed using chi-square, t test, Mann-Whitney U test, paired t test, and ANCOVA and Wilcoxon tests. Based on the results, no significant difference was found between the groups regarding the mean age, mean gestational age, and the prothrombin time (PT) and partial thromboplastin time (PTT) (P > 0.05). The mean of the total bleeding volume was 551.8 and 713.1 mL for experimental and control groups, respectively which means that a significant difference was observed between both groups in this respect (P = 0.006). However, no significant difference was noted between the groups regarding changes in hemoglobin (Hb) concentration, systolic and diastolic blood pressure (BP), and heart rate. Generally, administering 1 mg of TXA in CS significantly reduced the volume of PPH. However, it did not cause significant changes in hemodynamic state or Hb level. Therefore, it can be recommended as an appropriate treatment for these patients.

  Endometrial pathologies inside the cavity can occur simultaneously with gestational unpleasant consequences but are not always capable of being diagnosed by the hysterosalpingography (HSG). This study aimed to examine the value of performing diagnostic hysteroscopy beside diagnostic laparoscopy among infertile women with normal uterine cavities in HSG. A total of 103 infertile women with normal uterine cavities in the HSG and within the age range of 18-40 who referred to Imam Reza hospital for laparoscopy during 2016-2017 were included in this cross-sectional study. Hysteroscopy was performed simultaneously with diagnostic laparoscopy. Then, the existence of uterine pathologies like endometrial polyps, submucous myoma, and uterine endometrial adhesions and their relationship with the patient’s age, infertility type and duration, and cycle time were evaluated. A P value less than 0.05 was considered statistically significant. Overall, 64 patients (63.1 %) had a normal uterine cavity in the hysteroscopy while 39 of them had an abnormal uterine cavity, the HSG false negative cases of whom were reported 37.9%. The pathologies found in the hysteroscopy were endometrial polyp (16 cases), submucous myoma (1 case), uterine septum (6 cases), asherman syndrome (7 cases), bicornuate uterus (4 cases), polyp + asherman (3 cases), polyp + submucous myoma (1 case), and septum + submucous myoma (1 case). Patients’ age, type of infertility, and menstruation time during performing hysteroscopy made no particular difference in diagnosing pathologies of the uterine cavity in the hysteroscopy. Based on the findings, conducting hysteroscopy in infertile women who are candidates of laparoscopy and have normal uterine cavities in HSG can result in recognizing some cases of uterine pathologies which influence the outcomes of future pregnancies is not dependent upon the patient’s age, menstruation time, type and duration of infertility, and result of laparoscopy.

  This study aimed to measure the umbilical cord indices (UCIs) after birth and to determine its relationship with prenatal complications. The present analytical cross-sectional study was conducted on all the pregnant women admitted to AlZahra hospital of Rasht. After birth, the umbilical cord was measured in terms of the appearance, number of vascular coils, and umbilical cord length. In addition, the umbilical cord vascular coils index was calculated. Further, maternal and neonatal variables were evaluated. The mean number of umbilical cord coils, umbilical cord length, and the umbilical cord coiling index for 397 umbilical cords were obtained as 16.02 ± 4.48, 51.6 ± 12.0 and 0.31 ± 0.05 cm, respectively. In evaluating the state of the coil, 9.8% were found as hypocoil while the remaining were either hypercoil (10.3%) or normocoil (79.85%). Furthermore, a significant difference was observed between the umbilical cord coiling index, as well as gestational hypertension and abnormal fetal heart rate (HR) (P < 0.05). In the final logistic regression model, the umbilical cord length was recognized as a predictor variable for neonatal complications. Moreover, in multiple analyses regarding the effects of umbilical cord coiling index on neonatal complications by controlling the interferences, variables such as maternal age and parity in addition to the coil length were considered as predictors of neonatal
complications. Generally, the abnormal umbilical cord coiling index was associated with pregnancy blood pressure (BP) and abnormal fetus HR. Therefore, diagnosing antenatal umbilical cord coiling index can be helpful in recognition of embryos at risk through a faster treatment process.

  The present study aimed to compare the role of the hydroalcoholic extract of Apium graveolens and Cinnamon zeylanicum on metabolically change and ovarian oxidative injury in a rat model of polycystic ovary syndrome (PCOS). In this experimental research, 64 female Wistar rats with breeding were used including the following groups (G): (I) G1: healthy control; (II) G2: PCOS which received no therapy; (III) G3: PCOS + A. graveolens; (IV) G4: A. graveolens; (V) G5: PCOS + C. zeylanicum; (VI) G6: no PCOS + C. zeylanicum; (VII) G7: PCOS + C. zeylanicum and A. graveolens; and (VIII) G8: C. zeylanicum and A. graveolens. The PCOS was induced by a single dose of the intramuscularly injected estradiol valerate (16 mg/kg). After 14 days, the animals were anesthetized, then their plasma samples were used to check the blood sugar (BS), insulin, and lipid profile. The ovaries of the rats were removed and fixed for histopathological assessment. In addition, the oxidative stress marker in ovarian tissue was evaluated. The levels of BS, insulin, and lipid profile in plasma significantly enhanced in G2 (P < 0.05) while decreasing significantly in the therapy groups, (P < 0.05). Moreover, a significant decline was observed in the serum level of high-density lipoprotein (HDL) in G2 (P < 0.05) while it enhanced significantly in the therapeutic animals (P < 0.05). Furthermore, a negative change was found in the PCOS group on the ovarian tissue. Besides the oxidative stress enhanced in this tissue while in the treated groups this change was improved. Generally, it was revealed that the extract of A. graveolens and C. zeylanicum had a useful impact on regulating the serum levels of fast blood sugar (FBS), insulin, lipid profile, and oxidative stress markers in the palliation of the PCOS complications.

  Polycystic ovarian syndrome (PCOS) is a common hormonal disorder that can lead to hirsutism, menstrual disorders, obesity, acne, and sometimes abortion and infertility. Considering the effect of PCOS-induced obesity on quality of life, the present study was aimed to evaluate the quality of life specified for polycystic ovary syndrome and its relationship with nutritional attitude and behavior. This cross-sectional study was done on 150 PCOS cases through convenience sampling in educational hospitals of Tabriz, Iran, in 2015. The used tools included socio-demographic questionnaire, Polycystic Ovarian Syndrome Questionnaire (PCOSQ), Three-Factor Eating Questionnaire (TFEQ-R18: uncontrolled eating (UE), cognitive restraint (CR), and emotional eating (EE)), and a questionnaire of eating attitudes (Eat-26: including food preoccupation, dieting, and oral control). The relationship between the quality of life and nutritional attitudes and behaviors was evaluated by Pearson correlation and multivariate regression analysis. In this study, P < 0.05 was considered significant. A mean quality of life score of 16.58±4.18 was obtained out of 0-35. Nutritional behavior averaged 42.28±19.63 out of a min-max range of 18 to 72. Mean nutritional attitude score was 24.64±12.55 out of 0-78. A significantly inverse relationship was observed between the quality of life and nutritional attitude (P < 0.001, r=-0.317), as well as nutritional behavior (P = 0.015, r=-0.198) in participants. In other words, the quality of life scores increased when nutritional attitude and behavior (positive attitude and behavior) decreased. Multivariate regression analysis showed that EE, dieting, and history of pregnancy were predictive variables affected the quality of life. There was a relationship between nutritional attitude and behavior and quality of life specified for polycystic ovary syndrome. Therefore, it is necessary to pay attention to nutritional and other predictors through better health planning for these women.

  Attachment to the fetus is formed before the birth and stronger prenatal maternal-fetal attachment is related to more desirable prenatal and postpartum behaviors and cares as well as better acceptance of the parenting role. Therefore, this study aimed to determine maternal-fetal attachment and its socio-demographic determinants among women with an unplanned pregnancy. This descriptive-analytical and cross-sectional study was conducted on a convenience sample of 200 women with unplanned pregnancies attending the maternity clinic of Alavi hospital (Ardebil, Iran) during 2016-2017. To collect the data, a socio-demographic questionnaire and the maternal-fetal attachment scale (MFAS) were completed through the interviews. Data were analyzed using independent t tests, one-way ANOVA, and the general linear model. The mean (standard deviation) of maternal-fetal attachment score in women with an unplanned pregnancy was 79.2 (11.2) ranging from 23 to 115. The mean attachment score was significantly higher in women with a mistimed pregnancy [83.5 (9.0)] than in those with an unwanted pregnancy [72.9 (11.0)]. The highest and lowest mean scores were observed in the “interaction with the fetus” [14.2 (3.3)] and the “role-taking” [9.2 (3.0)] sub-domains, respectively. Based on the general linear model, only the type of unplanned pregnancy (mistimed or unwanted) indicated a significant relationship with maternal-fetal attachment (P < 0.001). Based on the results, the type of unplanned pregnancy had a significant association with maternal-fetal attachment. Moreover, mothers with unwanted pregnancies needed greater counseling and support compared to those with mistimed pregnancies.

  The violence and prostitution are examples of the stressors in the women with high-risk sexual behaviors and can create a psychological crisis in these women. The purpose of this study was to determine the relationship of mental health with social support in the women with high -risk sexual behaviors visiting drop-in centers (DICs) in Tabriz, Iran, in 2017. This cross-sectional study was conducted on 149 women with high-risk sexual behaviors, visiting three DICs in Tabriz, Iran. The sampling was purposive and non-random. Data were collected using socio-demographic characteristics, social support (PRQ-part 85), and mental health (GHQ-28) questionnaires. A test of multivariate linear regression was performed to identify a number of mental health determinants and explanation of variance. The mental health score was 50.7 (18.2), the score ranged from 0-84. The best status belonged to depression subscale [10.5 (7.1)] and the worst status belonged to social dysfunction subscale [14.6 (4.5)]. The mental health and its subscales had a significant relationship with social support (P < 0.001, R= -0.55 to -0.33). The variables of social support, drug use, and spousal violence were able to predict 35.4% of mental health variance in the women. According to the results, appropriate strategies are needed to promote social protection and mental health in the women with high-risk sexual behaviors in order to reduce the sexually transmitted diseases especially HIV/AIDS in the society.

  The antioxidative role of Galega officinalis extract has been reported in several studies. However, this experimental study was designed in order to investigate the impacts of G. officinalis extract against parameters, such as histological, hormonal, and oxidative stress parameters, which were induced by ovarian torsion/detorsion. Adult female Wistar rats (n = 28) were randomly divided into 4 groups including sham (G1), ovarian torsion for 3 hours then-after detorsion (G2 or TD), ovarian torsion-detorsion orally received 50 mg/kg extract of G. officinalis (G3 or TDGO), healthy rats orally received 50 mg/kg hydroalcoholic extract of G. officinalis (G4 or GO). Ten days after torsion-detorsion, rats were sacrificed and their ovaries, and their blood levels of hormones including estrogen and testosterone, as well as some oxidative stress
markers were assayed. The structure of ovaries in TD groups of the study showed a notable change compared to other groups. The serum levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH), and also estrogen significantly decreased in TD group, while treatment with G. officinalis could prevent from decreasing mentioned parameters. Furthermore, although torsion-detorsion led to increasing the serum level of malondialdehyde (MDA), it was decreased after administration of G. officinalis. Obtained results showed that G. officinalis could be useful in elevating the estrogen level, reducing the oxidative stress marker (i.e. MDA) and ovarian tissue damages induced by torsion-detorsion.

  An increase in life expectancy results in the aging population growth. This study was designed to evaluate the efficacy and adverse events of ginseng that could be used as a herbal medicine in women with sexual dysfunction. The authors of this study searched Cochrane Library, MEDLINE, Web of Science, Embase, Scopus, ProQuest, Google Scholar, and Persian databases without a time limitation until May 2018 and examined all the randomized clinical trials (RCTs) that compared the effect of different types of ginseng on sexual function of menopausal women as compared to the placebo controls. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. The heterogeneity was determined using the I2 index. In addition, standardized mean difference (SMD) was used instead of mean differences (MD) and a random effect was reported instead of fixed effect in meta-analysis. The eligibility criteria were found in five RCTs. All the included studies were placebo-controlled. Two trials had a parallel design while three studies used a crossover design. Although four trials indicated that ginseng significantly improved sexual function, they didn’t report any treatment effect compared to the placebo group. Based on the results of meta-analysis obtained from five studies including 531 women, there was no statistically significant effect of ginseng on female sexual dysfunction (FSD) compared to the placebo control group (SMD: 0.26; 95% CI: -0.26 to 0.76). Nonetheless, there was a considerable heterogeneity among the studies (I2 = 81%; P < 0.0001). Moreover, all the included studies assessed adverse events, but in three of the RCTs, there was no significant difference between the placebo and ginseng groups. The evidence regarding ginseng as a therapeutic agent for sexual dysfunction is unjustifiable. Rigorous studies seem warranted in this respect.

  The use of herbs which has been increasing worldwide, requires special considerations particularly in pregnant woman. The present study was conducted at Alzahra Teaching hospital (from March 2016 to August 2017) to explore the pattern of herbal use during pregnancy in Guilan province (North of Iran). Data were obtained from 836 eligible women, who were interviewed at postnatal ward, and were analyzed. The results of the study showed that 19.6% of the women consumed herbs during pregnancy. The most commonly used herbs included mint, flixweld, and cinnamon; in addition, the most prevalent indications resulted from these herbs consumption were gastrointestinal complications and cold. The rate of herbal consumption in pregnancy was related to education (P = 0.001) and resistance (P = 0.008); however, no relation was found regarding age (P = 0.203), employment (P = 0.255), or gravity (P = 0.935). Although the findings of this study were preferable to those of some other studies, due to the importance of the issue, it is vital that health care providers to be open to question the herbal use during pregnancy.