Journal of women's health
-
Journal of women's health · Sep 2019
ReviewCharacterization and Treatment of Recurrent Bacterial Vaginosis.
Bacterial vaginosis (BV) is a common but treatable condition, with a number of effective available treatments, including oral and intravaginal metronidazole and clindamycin and oral tinidazole. However, as many as 50% of women with BV experience recurrence within 1 year of treatment for incident disease. Some reasons for recurrence include the persistence of residual infection, resistance, and possibly reinfection from either male or female partners. ⋯ Secnidazole may be an attractive new option due to one-time dosing. Initial studies on biofilm disruption, use of probiotics and prebiotics, and botanical treatments have shown some promise, but must be studied further before use in the clinic. Despite limitations, antimicrobial therapy will remain the mainstay of treatment for recurrent BV for the foreseeable future.
-
Journal of women's health · Sep 2019
Pregnant Women Become Sweeter: A Population-Based Study of Trends in Glucose Challenge Test Results Over a Decade.
Background: Glucose challenge tests (GCTs) are widely used to screen for gestational diabetes mellitus. Women with high normal GCT results may be at increased risk for immediate obstetric complications and future diabetes. We analyzed the ∼10-year trend in mean GCT results and incidence of high normal (125-140 mg/dL) and abnormal GCT results (>140 mg/dL) in a large cohort of women in Israel. Materials and Methods: Data on all GCTs performed between 2005 and 2016 were gathered from the computerized database of the Central District of Clalit Health Services, the largest Health Maintenance Organization in Israel. ⋯ Over the study period, mean maternal age increased from 28.7 ± 5.1 to 30.1 ± 5.1 years and mean GCT results from 101.7 to 114.6 mg/dL (p < 0.001, for both), whereas the incidence of women with abnormal GCT (>140 mg/dL) increased from 10.6% to 18.1% (p < 0.001) and of those with high normal GCT (>125 mg/dL) from 20.2% to 31.3% (p < 0.001). A multivariable logistic model revealed that later years were associated with an increased risk for abnormal GCT result, while adjusting for maternal age and BMI (adjusted odds ratio = 1.07; 95% confidence interval 1.07-1.08). Conclusions: Over ∼10 years, mean GCT results and high GCT incidence have significantly increased. These findings are in line with the worldwide diabetes epidemic and demonstrate the worsening in glucose metabolism also in relatively young women.
-
Journal of women's health · Sep 2019
Factors Affecting Pre-Exposure Prophylaxis Implementation for Women in the United States: A Systematic Review.
Oral HIV pre-exposure prophylaxis (PrEP) is a highly effective pill that HIV-negative individuals can take once daily to prevent HIV infection. Although PrEP is a private, user-controlled method that empowers women to protect themselves without relying on a partner's behavior, women's PrEP use has been extremely low. We systematically reviewed the literature to identify and summarize factors that may be affecting PrEP implementation for women in the United States. ⋯ However, women and providers generally have positive views when aware of PrEP, including a willingness to use or prescribe PrEP to women. Most of the implementation barriers highlighted in studies were social or structural factors (e.g., access). Additional studies are needed to address research gaps, including studies of PrEP adherence and discontinuation.
-
Journal of women's health · Sep 2019
Pornography and Heterosexual Women's Intimate Experiences with a Partner.
Background: Pornographic media characterized by discordant images of sexual pleasure and aggression are increasingly formulating young heterosexual women's sexual scripts. Yet there has been little work done on the downstream role of pornography consumption; how does pornography use relate to heterosexual women's thoughts and feelings during sexual experiences with a partner? Methods: We surveyed 706 heterosexual women (18-29 years of age) in the United States, associating consumption of pornography with sexual preferences, experiences, and concerns. Results: Although most heterosexual women have seen pornography (83%), a little less than half (43.5%) use it for masturbation, half of whom use it one time per month or less. Among female consumers who were sexually active, higher rates of consumption for masturbation were associated with increased mental activation of the pornographic script during sex-heightened recall of pornographic images during sex with a partner, heightened reliance on pornography for achieving and maintaining arousal, and a preference for pornography consumption over sex with a partner. Furthermore, higher activation of the pornographic script during sex, rather than simply viewing pornographic material, was also associated with higher rates of insecurities about their appearance and diminished enjoyment of intimate acts such as kissing or caressing during sex with a partner. Conclusion: These findings suggest that pornography consumption may relate to female consumers' sexual experiences indirectly and indicate that pornographic thoughts during dyadic sexual encounters may not improve heterosexual women's sexual experiences with a partner.