Women’s Health Bulletin
Volume:10 Issue: 1, Jan 2023

Vaginal microbiota are believed to profoundly impact the overall quality of life. Moreover, reduced levels of circulating estrogen are responsible for the majority of the changes in the genital tract in postmenopausal women. Accordingly, the present study aimed to investigate the effects of E. angustifolia (EA) on the genitourinary system in postmenopausal women. In this double-blinded, randomized, placebo-controlled trial, we randomly assigned 58 postmenopausal women to one of the two medicinal herb-receiving (15 g of whole EA fruit powder) and placebo-receiving (7.5 g of isomalt+7.5 g of cornstarch) groups. Initially and after 10 weeks of the treatment, urinalysis, vaginal microbial culture, and vaginal pH measurement were carried out. This study was registered in the Iranian Registry of Clinical Trials with the code of IRCT20170227032795N4. Additionally, qualitative and quantitative data were analyzed using the Chi-square and the ANCOVA tests, respectively. The findings revealed that a 10-week treatment with EA had no significant effects on urine pH (5.733±1.014; P=0.728), specific gravity (1.022±0.006; P=0.438), as well as the count of red blood cells (1.533±2.562; P=0.080), white blood cells (3.750±7.109; P=0.349), and epithelial cells (2.116±1.798; P=0.595), and the qualitative parameters, including protein (P=0.612), blood (P=0.261), nitrite (P=0.483), bacteria (P=0.179), and mucus (P=0.564). Oral consumption of EA did not significantly change the studied parameters. Thus, further studies with larger sample sizes, longer duration, subjects of different age groups, and other routes of administration could be suggested.

Menopause is accompanied with symptoms that could be bothersome to the point that quality of life can be affected. The present study aimed to assess the prevalence and severity of menopausal symptoms and quality of life among women in their peri- and post-menopausal phase. This quantitative cross-sectional study was conducted from February to August 2022 on 332 peri-menopausal (n=162) and post-menopausal (n=170) women aged 45-55 years. They were recruited from the women who visited primary health centers in the East Gaza governorate using convenience sampling. The menopausal rating scale and a validated Arabic World Health Organization Quality of life-BREF (WHOQOL-BREF) were used. Descriptive and inferential analysis were applied and P<0.05 was considered as the level of statistical significance. The mean (SD) of the Menopausal Rating Scale (MRS) score was 2.27±0.49 vs 1.90±0.55 in the post-menopausal and peri-menopausal women, respectively. The most prevalent symptom was joint and muscle problems in peri-menopause (45.7%) and post-menopause (67.6%). The mean score of Quality of Life (QoL) dimensions, namely physical, social, environmental, and psychological domains was lower among the post-menopausal women compared to that among the peri-menopausal ones (3.19±0.73 vs 3.44±0.80, 3.46±0.72 vs 3.62±0.71, 3.50±0.60 vs 3.52±0.62, and 3.59±0.75 vs 3.68±0.77, respectively). Quality of life as well as the associated physical and social aspects were found to be significantly associated with menopausal symptoms (P=0.003 and P=0.048, respectively). Age (51–55 years; P<0.001), marital status (widowed/divorced; P=0.044), income (<300USD; P<0.001), and post-menopausal status (P<0.001) were significantly associated with severity of menopausal symptoms. Menopausal symptoms are common in the post-menopausal status. Their severity was found to increase as menopause status progressed. Psychological symptoms were the most severe symptoms reflecting the need for proper psychological supporting efforts. Menopausal symptoms with severe manifestations impair the quality of life and are associated with socio-demographic and clinical variables.

Marital conflicts can exacerbate anxiety, depression, and stress in couples and adversely affect their psychological well-being. The present study aimed to investigate the effectiveness of psychodrama and cognitive-behavioral therapy on the psychological well-being of women with marital conflicts. This was a quasi-experimental, pretest-posttest, follow-up study with a control group. The statistical population included all the married women with marital conflicts referring to the counseling departments of cultural centers in Isfahan Municipality in 2021. Sixty women were selected as the sample by cluster sampling method and randomly assigned to two experimental groups (cognitive-behavioral therapy and psychodrama) and a control group (20 participants per group). The first experimental group underwent twelve 180-minute sessions of cognitive-behavioral therapy, while the second experimental group received twelve 180-minute sessions of psychodrama. To collect data, Psychological Well-Being Scale was used. Data analysis was performed through repeated measures ANOVA. According to the results, these two methods affected the psychological well-being components of the women with marital conflicts (P<0.001). The mean±SD of psychological well-being in the post-test and follow-up stages was respectively 61.05±8.35 and 60.10±8.95 in the cognitive-behavioral therapy, and 46.15±5.87 and 45.00±5.17 in the control group. Moreover, the mean±SD of psychological well-being in the post-test and follow-up stages was respectively 65.80±7.54 and 64.67±8.22 in the psychodrama group. The results also revealed that the components of psychological well-being in the women with marital conflicts in the two experimental groups in the post-test and follow-up stages had a significant increase compared to those in the pre-test stage (P<0.001). The two methods were significantly different only in terms of the effects on environmental mastery (P<0.001). Psychodrama was found to be more effective than cognitive-behavioral therapy. Psychodrama and cognitive-behavioral therapy can result in positive outcomes, such as improving psychological well-being in couples therapy and marital relationships. Therefore, the use of these two interventions could be recommended to psychotherapists for improving the psychological well-being of women with marital conflicts.

Population growth is considered a problem in Malawi, Africa and fertility is reportedly a key factor in the growth of this population. The subject of studies on fertility-related factors has been period fertility rather than lifetime fertility. However, period fertility is reported to be associated with a tempo effect and therefore may not represent lifetime fertility accurately. The present study; therefore, examined whether age at first marriage or birth has an effect on lifetime fertility in Malawi, as it is the case with period fertility. Secondary data from the Malawi Demographic and Health Survey were used for this study. The study was conducted from October 2015 to February 2016 and surveyed 24562 women of reproductive age (15-49 years). The research was limited to a subsample of 3583 women because the focus of this paper is on women aged 40-49 years. The number of children ever born was used to determine fertility. Analysis of variance and Poisson regression model were used as statistical tests. The multivariable association between the number of children ever born and the independent variables was predicted using the Poisson regression model, while the bivariate relationship was calculated using analysis of variance. The results of the bivariate analysis showed that age of first cohabitation (P=0.01) and age of first birth (P=0.01) were strongly associated with total number of births. Both unadjusted and adjusted Poisson regression models showed significant associations for multivariable outcomes. Accordingly, the number of children ever born was significantly associated with the following variables: an adjusted model with age of 26 years and older as the reference category, beginning cohabitation (AIRR=1.09, P=0.04) or first birth (AIRR=1.61, P=0.03) at age younger than 18 years; cohabitation (AIRR=1.09, P=0.04) or first birth (AIRR=1.48, P=0.03) at age of 18 to 21 years. Based on the findings of the study, the study recommends stakeholders to support household income-generating capacity, expand access to education for both boys and girls, and maintain the use of modern contraceptives.

Patients with Fibromyalgia, in addition to widespread pain, often complain of fatigue, sleep disorders, cognitive impairment, anxiety, and depression. The present study aimed to investigate the effectiveness of mindfulness-based stress reduction and intensive short-term dynamic psychotherapy on intolerance of uncertainty and depression in women with Fibromyalgia. This was a quasi-experimental study with a pretest-posttest control design and a three-month follow-up. The study population included all women with Fibromyalgia visiting the rheumatology clinic at Hazrat-e Rasool-e Akram Hospital, in Tehran, Iran, in 2021. A total of 36 patients were recruited using purposive sampling and assigned to three groups, two experimental groups and one control group (n=12 patients in each group). The experimental groups 1 and 2 received mindfulnessbased stress reduction therapy and intensive short-term dynamic psychotherapy, respectively, in eight 120-minute sessions (one session every week). Meanwhile, the control group did not receive psychotherapy intervention during this period. The Intolerance of Uncertainty Scale and the Beck Depression Inventory were used for data collection. The repeated measures ANOVA were used for analyzing the data in SPSS version 25. The significance level of the research was set at α=0.05. The results indicated that both mindfulness-based stress reduction therapy and intensive short-term dynamic psychotherapy effectively reduced intolerance of uncertainty and depression in Fibromyalgia patients (P<0.001). However, intensive short-term dynamic psychotherapy proved to be significantly more effective than mindfulness-based stress reduction therapy; this difference was observed through the follow-up period (P<0.001). Mindfulness-based stress reduction and intensive short-term dynamic psychotherapy were effective and practical methods for reducing intolerance of uncertainty and depression. It could be therefore recommended that psychotherapists and counselors employ these approaches in order to reduce depression and intolerance of uncertainty in women with Fibromyalgia.

Considered as a major health concern worldwide, breast cancer (BC) is the most prevalent cancer among women. The present study aimed to investigate the effects of gestalt group therapy and reality therapy on perceived self-efficacy in women with BC. This quasi-experimental research adopted a pretest and posttest with a control group and follow-up period. The statistical population included all the women with BC visiting the subspecialty clinic of cancer in Yasuj, Iran, in 2021. We selected 60 patients via convenience sampling method. Afterwards, using a random number table, we placed them in two experimental groups and a control group (n=20 women in each group). The first experimental group received gestalt therapy (10 sessions of 60 minutes; once a week) while the second experimental group received reality therapy (based on choice theory) (10 sessions of 60 minutes; once a week). The control group was placed on the waiting list. We used the general self-efficacy scale for data collection. The data were analyzed with repeated measures ANOVA in SPSS version 25. Mean and standard deviation of the perceived self-efficacy for gestalt therapy, reality therapy, and control groups in the posttest were 52.06±8.83, 55.93±8.66, and 39.33±7.56, respectively. The results indicated that the gestalt group therapy and the reality therapy affected the perceived self-efficacy of women with BC (P<0.001). Moreover, the findings depicted no significant differences between the gestalt group therapy and the reality theory. The effects persisted in the follow-up (P<0.001). According to the results, the gestalt group therapy and the reality therapy could improve the psychological capacity and adaptability of women with BC in different personal and social aspects. Hence, psychotherapists are advised to employ gestalt group therapy and reality therapy in counseling centers in order to enhance perceived self-efficacy in women with BC.

Vitamin D deficiency/insufficiency can be regarded as a crucial public health obstacle that affects about 50% of the world’s population. Pregnant women are at a relatively high risk of developing deficient concentrations of vitamin D, which can result in detrimental pregnancy outcomes. This survey was designed to evaluate the correlation between serum vitamin D concentrations and first-trimester spontaneous abortion. This was a case-control study conducted at the Asalian Referral Gynecological Hospital in Khorramabad, Iran, from April 2021 to March 2022. Forty-two women hospitalized due to spontaneous pregnancy loss in the first trimester were recruited as cases, and 100 individuals referred for routine pregnancy care constituted the control group. Demographic and clinical data were recorded for all subjects, and blood samples were taken from both groups to determine serum vitamin D levels. The data were recorded on a researcher-made checklist. The chi-squared test and logistic regression were used for analysis in SPSS version 22. The frequency of vitamin D deficiency/insufficiency was higher in the case group (n=10, 23.8%) than in the control group (n=21, 21%), although this difference was not significant (P=0.899). Logistic regression revealed a significant link between vitamin D deficiency/insufficiency and age (P<0.001), gestational age (P=0.005), and body mass index (P<0.001). The results suggested no significant association between vitamin D deficiency/insufficiency and miscarriage during the first trimester.

There is scarce information about the effects of SARS‐CoV‐2 infection in pregnant women. The present study aimed to evaluate pregnancy’s clinical characteristics and outcomes in women with COVID-19 and their babies.

We conducted a case series study, from April 15 to May 30, 2021, including 24 cases with COVID-19 infection and their babies with a 30-day follow-up after delivery. The patients’ mean (SD) age of was 31.50 (5.69) years, and all the deliveries were in the third trimester. Fever and myalgia were the most prevalent clinical symptoms in women. Positive RTPCR test results [in 20 pateints (83.33%)], and CT scan findings [in four patients (16.67%)] confirmed the diagnosis. Moreover, 66.66% of pregnant women with COVID-19 underwent Cesarean section. Performing a Cesarean section was mostly due to obstetric indications or the mother’s request. None of the babies were positive PCR. Out of eight preterm infants, seven were admitted to the intensive care unit (NICU) for reasons other than COVID-19.

The most common obstetric outcomes were high rates of premature delivery and Cesarean section. Additionally, the most prevalent neonatal consequences were prematurity and low birth weight. There was; however, no evidence of intrauterine vertical transmission.